The child who is sexually abusive needs treatment. A new report gives an overview of current thinking on the issue and makes recommendations for a national strategy.
Any school that has experienced working with a pupil who sexually abuses other children will understand the difficulties in trying to get help for them at the same time as trying to support children who have been hurt by them. Schools also face the difficult decision making about the needs of the individual and the needs of all the other children and, if this is not enough, schools may also need to manage complaints from the parents of children who have been sexually abused. Schools know also that simply getting rid of the child through permanent exclusion is not a real solution and may simply pass the problem on to another school. Clearly the child who is sexually abusive needs treatment; however, there seems to be very little treatment on offer across the country. CAHMS may offer a service but at the present time the provision of treatment specifically designed for this behaviour is not common to all CAHMS. In recognition of a growing acknowledgement of these issues the government has published The Needs and Effective Treatment of Young People who Sexually Abuse: Current Evidence, which we summarise below. This publication offers an overview of the current literature and thinking around these behaviours and treatments for them. It makes a series of recommendations relating to the establishment of common assessment processes and treatment models that the government intends taking forward as part of a national strategy.
Definition of sexual abuse
The report supplies the following definitionfrom Ryan and Lane (1997): ‘Any sexual interaction with person/s of any age that is perpetrated (1) against the will of the person, (2) without consent, (3) in an aggressive, exploitative or threatening manner.’
Typology of young person who sexually abuses
The report says that the research literature suggests that young people who sexually abuse are not a homogeneous group, but that three groups of characteristics have been identified.
Group one – Developmentally impaired – more of the sex offenders and some sexual assaulters. Higher levels of enuresis, encopresis, speech and language delay, learning difficulties, lower IQ, higher levels of victimisation through sexual abuse (intra and extra-familial), emotional abuse, bullying, high levels of sexually inappropriate behaviour at school and in the community, especially in children’s homes, higher level of social isolation and withdrawn behaviour.
Group two – Violent, physically abused group – no child molesters found in this group.
Some of the young people in this group had committed offences against peers and women, higher levels of violent non-sexual offending, higher levels of childhood physical abuse, higher levels of violence at school, failure to attend school and subsequent expulsion, no social isolation and no withdrawn behaviour at school, more foster care and residential care moves, more offending and convictions of any type, more likely to blame criminal behaviour on mental and emotional instability, more likely to have relationship problems with father or father figure, more evidence of hypermasculinity.
Group three – Socialised delinquent group – most well adjusted, higher number of sexual assaults on female peers and women, some child sex offenders, fewer with histories of emotional and behavioural problems, neglect and sexual abuse, physical abuse, SEN and peer relationships problems, lower number of foster placements and fewer placement moves, higher IQ, higher reading age, higher age at first recorded offence, less delinquency, fewer family problems and educational problems, lower self-reported psychological problems.
Hendriks and Bijleveld (2004), found that adolescents who abuse children showed higher levels of neuroticism and psychopathology, were more likely to have been bullied, have low self-esteem and have less contact with their peers. Significantly, more had abused boys and were more likely to be related. Peer abusers were more likely to have assaulted a stranger than a true peer. This group used significantly more violence and violence was more prevalent in previous offending behaviour.
Taylor (2003) studied the characteristics of 227 young people who had been subjects of strategy meetings due to allegations of sexually abusive behaviour over a six-year period. Taylor found that 70% had at least one reported school problem, the most prevalent being undisciplined behaviour (49%), followed by underachievement (48%), aggression/bullying (37%) and isolation (33%). Inappropriate sexual behaviour was reported in 28% of the cases and 13% had been bullied by other children. Thirty per cent of the young people were described as not having problems at school and some were said to be ‘model pupils’.
Most studies will underestimate figures as reporting rates to the police are still very low. Home Office statistics show that in 2003 approximately 25% of people convicted of sexual abuse crimes were aged 10 to 24 years old.
According to the Youth Justice Board 0.6% of sexual crimes were committed by young people aged 10 to 17 years old, peak age of the offenders was 15 years old and 97% were males.
A number of charitable organisations including the NSPCC report having worked with children under 10, who do not show in the figures because they are under the age of criminal responsibility.
Young people with learning difficulties are over-represented in the statistics but this may present a false view; such young people may be easier to catch because of their naivety when challenged and because of the tendency to repeatedly target the same victim or same place.
Retrospective research shows that many of the young people who sexually abuse others have been abused themselves; however, while all incidents of sexual abuse are serious, the majority of young people who have been abused do not go on to abuse others. Risk factors associated with sexually abusive behaviour include:
- the experience of previous abuse
- non sexually abusive antisocial behaviour
- impulsive behaviour
- abusive behaviour significantly associated with ADHD symptoms
- witnessing serious intra-familial violence
- rejection by the family
- discontinuity of care
- being abused by a female
- experience of physical abuse
- cruelty to animals
- experience of affectionless, controlling parenting.
The report describes a number of key principles to be observed in developing treatment strategies:
- If there is a conflict between the welfare needs of the offender and the victim, the victim’s needs must come first.
- Many abusers are in need of care and protection themselves; however, they must be held accountable for their own actions.
- Child protection procedures must be followed for both perpetrator and victim.
- Interagency, multi-professional approaches to treatment strategies are essential.
- Treatment for the offender must be offered as soon as possible.
- Where possible, family should be involved in the management of the case.
- Parents play a vital role in reducing risk and developing resistance.
The report calls for all professionals who work with children and young people to be offered training on this issue. Assessment that is specific to young people who sexually abuse is considered essential. There is a need to identify and clarify different needs between sub-groups of young people displaying sexually harmful behaviours; for example, between those who have abused young children and those who have abused peers, and those displaying neuropsychiatric problems, learning disabilities, Asperger’s syndrome and emotional instability. Multi-agency assessments are needed and where at all possible family members should be involved. The report cites the AIM project in Greater Manchester as having a good working model of assessment.
For example, young people arrested for, and admitting, their first sexual offences in Greater Manchester are bailed for 20 days to allow for an in-depth assessment to take place. The AIM Project assessment procedure involves the lead agency identifying the assessors, consultant and a date for the completion of the report, which should then assist in decisions regarding the identification of where to place services.
The process involves four domains of assessment (offence specific, developmental, family/carers and the environment), which inform concern and strength continuums. The AIM project stresses the importance of assessing a young person’s strengths as well as just looking at abusive behaviour.
The report ends with a comprehensive list of recommendations including:
- the increase of service provision and treatment opportunities
- a better understanding of the different subgroups of sexually abusive behaviours to ensure that young people are not labelled as paedophiles where their behaviours, while problematic, do not suggest that patterns of abuse against children are likely to develop
- all staff to have access to good training and supervision
- that good practice models should be documented and rolled out across the country to ensure consistency of approach.
This report is very full and comprehensive and will be of interest to education staff who are working closely and directly with young people who sexually abuse others and those staff who are responsible for the strategic development and or commissioning of services.
AIM (2001), Working with Children and Young People who SexuallyAbuse: Procedures and Assessment.
Hendriks, J, and Bijleveld, CCJH (2004), ‘Juvenile Sexual Delinquents: Contrasting Child Abusers with Peer Abusers’, Criminal Behaviour and Mental Health, 14:238-250.
Ryan, G, and Lane, S (eds) (1997), Juvenile Sexual Offending. Causes, Consequences and Corrections. Lexington, Massachusetts/Toronto: Lexington Books.
Taylor, J F (2003), ‘Children and Young People Accused of Child Sexual Abuse: A Study within the Community’, Journal of Sexual Aggression, 9(1):57-70.
To read the full report, go to: www.dh.gov.uk/assetRoot/04/14/02/69/04140269.pdf