Objectives: To obtain national estimates of youth involved in sexting in the past year (the transmission via cell phone, the Internet, and other electronic media of sexual images), as well as provide details of the youth involved and the nature of the sexual images. Methods: The study was based on a cross-sectional national telephone survey of 1560 youth Internet users, ages 10 through 17. Results: Estimates varied considerably depending on the nature of the images or videos and the role of the youth involved. Two and one-half percent of youth had appeared in or created nude or nearly nude pictures or videos. However, this percentage is reduced to 1.0% when the definition is restricted to only include images that were sexually explicit (ie, showed naked breasts, genitals, or bottoms). Of the youth who participated in the survey, 7.1% said they had received nude or nearly nude images of others; 5.9% of youth reported receiving sexually explicit images. Few youth distributed these images. Conclusions: Because policy debates on youth sexting behavior focus on concerns about the production and possession of illegal child pornography, it is important to have research that collects details about the nature of the sexual images rather than using ambiguous screening questions without follow-ups. The rate of youth exposure to sexting highlights a need to provide them with information about legal consequences of sexting and advice about what to do if they receive a sexting image. However, the data suggest that appearing in, creating, or receiving sexual images is far from being a normative behavior for youth.

Internet harassment can be a serious event for some youth. Because there has been a significant increase in the prevalence of Internet harassment from 2000 to 2005, adolescent health professionals should continue to be vigilant about such experiences in the lives of young people with whom they interact. Social problems and online aggressive behavior are each associated with elevated odds of being the target of harassment. Thus, prevention efforts may be best aimed at improving the interpersonal skills of young people who choose to communicate with others using these online tools. Adolescent health professionals should be especially aware of events that include aggressive offline contacts by adult harassers or asking the child or adolescent to send a picture of themselves, because each of these scenarios increase the odds of reporting distress by more than threefold. Findings further support the call for the inclusion of Internet-harassment prevention in conventional antibullying programs empowering schools to address Internet bullying situations that occur between students. This will not solve all situations, however. We also must encourage Internet service providers to partner with consumers to be proactive in serious harassment episodes that violate criminal laws and service-provider codes of conduct.

More research concerning the potential impact of Internet pornography on youth is warranted, given the high rate of exposure, the fact that much exposure is unwanted, and the fact that youth with certain vulnerabilities, such as depression, interpersonal victimization, and delinquent tendencies, have more exposure.

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Hampshire to conduct this second survey is vital to maintaining the consistency of research methods in order to get the most accurate interpretation of the results. Dr. Finkelhor has been a well-known national authority on child sexual abuse. The conclusions from YISS-1 have formed the basis for many educational initiatives. The work of Dr. Finkelhor and his colleagues represents a valuable addition to our knowledge and awareness of this difficult and complex problem. We thank staff members at NCMEC and the U.S. Department of Justice's Office of Juvenile Justice and Delinquency Prevention along with representatives of the Internet Crimes Against Children Task Forces for their work on this much-needed report and their leadership in helping to safeguard all youth. Our sincere appreciation is also extended to David Finkelhor, Kimberly Mitchell, and Janis Wolak. Their efforts will help legislators, families, and law-enforcement personnel better understand and address this threat to children in an effective, appropriate manner. The best way to preserve the positive uses of the Internet is to help ensure it is not a sanctuary for pedophiles, child pornographers, and others who prey on children. We are committed to assisting law-enforcement personnel fight these crimes and inform families about available resources to help them better protect children. By helping to ensure law-enforcement personnel and families have the necessary tools and knowledge to counter misuse, the Internet will continue to be a powerful source of education, entertainment, and communication. Together we must aggressively enforce a "zero tolerance" policy regarding online victimization of children. There is still much work to be done as we seek to learn more about what youth are encountering on the Internet today. This report provides a critical base of knowledge so we can act, doing far more to ensure we make the Internet the safest it can be for every child.

The publicity about online "predators" who prey on naive children using trickery and violence is largely inaccurate. Internet sex crimes involving adults and juveniles more often fit a model of statutory rape-adult offenders who meet, develop relationships with, and openly seduce underage teenagers-than a model of forcible sexual assault or pedophilic child molesting. This is a serious problem, but one that requires approaches different from those in current prevention messages emphasizing parental control and the dangers of divulging personal information. Developmentally appropriate prevention strategies that target youths directly and acknowledge normal adolescent interests in romance and sex are needed. These should provide younger adolescents with awareness and avoidance skills while educating older youths about the pitfalls of sexual relationships with adults and their criminal nature. Particular attention should be paid to higher risk youths, including those with histories of sexual abuse, sexual orientation concerns, and patterns of off-and online risk taking. Mental health practitioners need information about the dynamics of this problem and the characteristics of victims and offenders because they are likely to encounter related issues in a variety of contexts.

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We examined exposure to Internet pornography before the age of 18, as reported by college students (n = 563), via an online survey. Ninety-three percent of boys and 62% of girls were exposed to online pornography during adolescence. Exposure prior to age 13 was relatively uncommon. Boys were more likely to be exposed at an earlier age, to see more images, to see more extreme images (e.g., rape, child pornography), and to view pornography more often, while girls reported more involuntary exposure. If participants in this study are typical of young people, exposure to pornography on the Internet can be described as a normative experience, and more study of its impact is clearly warranted.