This case study explores the response of Education Other Than at School (EOTAS) to providing a service to children who display sexually harmful behaviour. Through participating in EOTAS panel meetings it became apparent to the researcher that there was a cohort of children and young people referred to EOTAS who generated much more discussion and concern about placement than other referrals. This was the cohort of children and young people who had sexually inappropriate behaviour identified on their referral form. This cohort were proving to be more problematic to place in EOTAS provision than any other group of children and young people referred, some of whom had committed other acts of interpersonal violence such as physical violence towards teachers or support staff. This research was designed to explore this phenomenon. A case study using mixed methods was employed to answer six research questions and was conducted in five phases. Phase 1 generated data from 174 referral forms. Phase 2 used a Delphi survey to gain the views of panel members. Phase 3 investigated the services available locally to support children families and schools. Phase 4 employed group interviews to explore the views of teachers and support assistants. Phase 5 used individual interviews to gain the views of children and their families (service users). Data analysis was both quantitative and qualitative using thematic analysis. The research highlighted that working with children who display sexually harmful behaviour is professionally challenging and emotionally charged and this can undermine timely and effective decision-making. However, when structured research was undertaken, it became apparent that implementing the ideas and strategies identified could mitigate this. The research identified and prioritised areas for development. These included informed and effective decision making and providing a range of services from the informal and preventative to specialist assessment and treatment. Local services were able identify priorities for developing their services which paid attention to the rights of individuals and those around them. The priorities identified by teachers and support staff reflected the local and national debate about teaching and learning while service users identified fairness and transparency in service provision as a dominant theme. Finally, the role of the educational psychologist is discussed and how a Structured, ecological response to the issues raised in the research could generate awareness of the issues raised and how the EP could work with services identified in the research to develop and enhance the services they provide.