Prescott, LICSW, and Jill Levenson, Ph.D.
The ATSA Forum, Spring 2007
Recent years have seen
a dramatic shift in how the public thinks about sexual violence and
youth who have sexually abused. Public policy and the legal system
have turned to increasingly harsh punishments for sexual abuse in
the form of tougher dispositions, community notification, and registration.
Waiving youth to adult courts has become commonplace, and efforts
to enforce lifetime registration for youthful sexual abusers are
occurring at the state and national level. Coffey (2006) observes
that the sealing of young peoples’ criminal records upon their entry
into adulthood is no longer a core philosophy of the legal system.
These changes have
accompanied dramatic shifts in public perspective. Where adults once
considered juvenile delinquents of all types to be in need of education
about accountability, public outcry increasingly demands that they
be held accountable. Ironically, this has occurred in tandem
with research demonstrating that base rates for sexual recidivism
are lower than once believed (e.g., Alexander, 1999; Epperson, Ralston,
Fowers, DeWitt, & Gore, 2006; Reitzel & Carbonell, 2006),
and that youthful criminality is often limited to adolescence (Moffitt,
1993). The policies accompanying increased media coverage and public
furor have in many cases proven the adage that “bad cases make bad
law.” Recently, Iowa reconsidered its law about residence restriction, and
Trivits and Repucci (2002) report that over half the states in the U.S. required
juveniles adjudicated for sex crimes to register despite the lack
of evidence of either enhanced public safety or any reduction in
This article contains
several cautions that those who make and enforce laws and public
policy should take into account when considering registration and
public notification of youth who have sexually abused.
There remains no empirically validated method for determining the
of a young person to abuse again. Although this simple fact can speak for itself, it is worthwhile
to note that even the most recent proposed tools for risk assessment
have yet to be validated. Their authors go to pains to describe their
limitations and warn against their misuse. Such instruments include
the JSOAP-II (Prentky & Righthand, 2003), the ERASOR (Worling & Curwen,
2000), and the JSORRAT – II (Epperson, Ralston, Fowers, Dewitt, & Gore,
Caution #2: Young
people change. In
our rush to classify individuals, it is easy to forget that adolescence
is a time of dramatic change, with or without treatment interventions.
In their introduction to their risk assessment tool, the JSOAP – II,
Prentky and Righthand (2003) observe that “No aspect of their
development, including their cognitive development, is fixed
or stable. In a very real sense, we are trying to assess the
risk of ‘moving targets’.” For this reason, they recommend that
youth be re-assessed every six months (p. i). Additionally, the
factors that contribute to their behavior are subject to change.
a recent review of the general recidivism literature regarding juveniles,
Quinsey, Skilling, Lalumiere, and Craig (2004) note that the best predictors of juvenile delinquency among general youth
change from ages 6 through 11 and ages 12 to 14. The authors go on
to describe three types of adolescent antisociality: “adolescence-limited
delinquents, … early-starting life-course-persistent antisocial individuals
whose behaviors are associated with neuropathology resulting from
prenatal, perinatal, and/or postnatal problems, sometimes in combination
with family and neighborhood adversity”, and “early-starting life-course-persistent
antisocial individuals” without neurodevelopmental pathology. They
note that this third category appears to comprise a distinct class
of individual, or taxon, different from other antisocial individuals” (p.
Caution #3: Registration
and notification laws create collateral consequences for sex offenders
that are likely to interfere with facilitating a successful transition
Research suggests that
sex offender registration and community notification can interfere
with community re-entry and adjustment for adult offenders (Levenson & Cotter, 2005a; 2005b; Levenson, D'Amora, & Hern,
2006; Sample & Streveler, 2003; Tewksbury, 2004; Tewksbury, 2005;
Tewksbury & Lees, 2006; Zevitz, Crim, & Farkas, 2000; Zevitz,
2006a). Many sex offenders report adverse consequences such
as job loss, relationship loss, being denied a place to live, threats,
harassment, or property damage as a result of public disclosure (Levenson & Cotter, 2005a; Tewksbury, 2004; Tewksbury,
2005; Zevitz et al., 2000). Many report negative emotions such as shame, embarrassment,
depression, or hopelessness and indicate that their families are
affected by registration and notification (Levenson & Cotter, 2005a; Tewksbury, 2004; Tewksbury,
2005). Though extreme vigilantism is rare, some offenders
report that they have been physically attacked, and cases of arson,
vandalism, and even murder of sex offenders have been documented (Sample & Streveler, 2003). Sex offender policies can lead to ostracization and
underemployment for sex offenders, and they are therefore likely
to live in socially disorganized, economically depressed neighborhoods
that have fewer resources for deterring crime and protecting residents (Mustaine, Tewksbury, & Stengel, 2006; Tewksbury & Mustaine,
2006; Zevitz, 2004;2006b). It is likely that all of these unintended consequences
are exacerbated for young adults who are less financially and developmentally
equipped to maintain financial independence and social stability.
Levenson and Hern (2006) found that young adult sex offenders
were significantly more likely than older offenders to have difficulty
securing affordable housing. This group of offenders was also more
likely to be unable to live with supportive family, presumably because
their parents lived in residential neighborhoods in which sex offenders
are prevented from residing. For young people, registration requirements
can create obstacles to completing their education as well as securing
employment. Social stability is important to successful re-entry
into the community by sexual and other criminal offenders, and lifestyle
instability is associated with increased risk for recidivism (Hanson & Harris,
Few empirical studies have evaluated the effectiveness of
registration and notification but most have found no reduction in
recidivism as a result of such laws (Adkins, Huff, & Stageberg,
2000; Matson & Lieb, 1996; Walker, Maddan, Vasquez, VanHouten, & Ervin-McLarty,
2005; Zevitz, 2006a). One exception
is a recent investigation by the Washington State Institute for Public
Policy. A decrease in sex offense recidivism (from 5% to 1%) was
found after 1997, and the authors suggested that community notification
may have played a role in this decline (Washington State
Institute for Public Policy, 2005).
In general, the benefit of these laws to public safety remains
unclear, but they are likely to interfere with sex offenders’ community
reintegration. Young people are particularly vulnerable to the obstacles
these laws create to facilitating productive and stable lives. Such
laws create difficulties for sex offenders to assume prosocial roles
in a variety of domains, including employment, educational attainment,
property ownership, parenting, and civic participation.
Caution #4: Sexually
abusive youth are at higher risk to cause other kinds of harm,
while treatment appears most effective at reducing risk. A review of the research into recidivism rates and related factors yields
surprising findings that are often counterintuitive to lay people.
These findings have direct implications as professionals attempt
to classify individuals according to their willingness to engage
in future harm.
authors, such as Serin and Brown (2000) and Monahan (1981/1995) have
emphasized the importance of taking rates of re-offense into account
in classifying dangerousness.
However, studies of adolescent sexual recidivism have not been prolific
and have yielded varying results across populations and jurisdictions
(Worling & Curwen, 2000). It appears that studies conducted outside North America find
higher base rates of re-offense (e.g. Nisbet, Wilson, & Smallbone,
2004; Langstrom & Grann, 2000). However, the available studies
in North America often
find lower re-offense rates than one might think. In one meta-analysis
including 1,025 juveniles, Alexander (1999) found recidivism rates
of 5.8% for rapists, 2.1% for child molesters, and 7.5% for “unspecified” adolescent
abusers. Of note, all had been “treated.” There could be any number
of reasons for these discrepancies (including the presence of “status
offenders” in North American samples), but none have been tested.
Further, Worling and
Curwen (2000) followed 148 Canadian youth for an average of six years.
They found that those who received “abuse specific” treatment had
a 72% reduction in sexual recidivism. The untreated youth recidivated
at 18% in the follow-up period, while the treated youth recidivated
at a rate of 5%. More recently, in a meta-analysis of nine studies,
Reitzel and Carbonell (2006) found that youth who had received abuse-specific
treatment recidivated at a rate of 7.37% while youth who received
no treatment recidivated at a rate of 18.93%. Taken together, these
results show a very encouraging effect of treatment on recidivism.
Other authors (e.g., Smith, Goggin, & Gendreau, 2002) have noted
that on their own, incarceration and intermediate sanctions have
no effect on recidivism.
Clearly, all of these
results require cautious interpretation. First, ethical considerations
have prevented the highest-quality randomized treatment/no-treatment
comparisons. Even if these were possible, the specific “active ingredients” of
treatment have yet to be determined, although community-based multi-systemic
treatment (MST; Henggeler, Schoenwald, Borduin, Rowland, & Cunningham,
1998) appears particularly promising. Second, recidivism rates
are susceptible to adults’ ability to detect re-offense. One may
argue that these rates are gross underestimates given that victims
often do not report crimes. On the other hand, one might also argue
that because youthful sexual abusers often have high rates of recidivism
for nonsexual crimes, they are not particularly adept at evading
detection. One might further argue that upon arrest for sexually
abusive behavior, many youth have far less opportunities for re-offense
due to increased supervision. Finally, one might argue that the measurement
treatment effect is obscured by attrition.
Caution #5: Unaided
attempts to assess dangerousness have no empirical support. It is very tempting to believe in one’s ability to
tell how dangerous another individual is. Many busy professionals
are forced into quick decisions based on thin information, while
others are just plain wrong. Many people pride themselves on
their ability to observe and understand, but their ability to
assess risk has gone largely untested.
Hanson and Bussiere
(1998) found that typical clinical judgment yielded an average correlation
not much better than chance (r=.10), while having prior convictions
on their own correlated at .20. That is, convictions prior to whatever
charge brought the individual to the attention of authorities. In
a subsequent analysis, Hanson and Morton-Bourgon (2004) found that
actuarial scales were more accurate than unstructured clinical judgment
(d=.61 and d=.40 respectively). Further complicating matters, some
authors have observed that including too much information in the
decision-making process can result in reduced accuracy of assessments
(Monahan, 1981/1995, p. 88; Quinsey, 2000). Quinsey, Harris, Rice,
and Cormier (1998) observe that “More importantly, the amount of
information available to the clinician was unrelated to accuracy
but was highly related to the degree of confidence in the judgment,” and
that humans “are, in fact, most confident when making extreme judgments” (p.
These findings are
challenging. Accurate risk classification should be objective and
include only the critical information, while comprehensive assessments
will include information vital to guiding treatment but are not necessarily
predictive. There is evidence that risk assessments by treatment
providers can become less effective the longer a professional is
in contact with the subject (Williams, 1975; also see De Vogel & De
Ruiter, 2004). Many (e.g., Doren, 2005) argue against treatment providers
engaging in risk assessment.
Caution #6: Elements
that might seem important have no empirical basis. Put simply, much of what the field of sexual offender
assessment believed to be true in past decades has turned out
to be unsupported. Nowhere is this more apparent than in the
tenuous relationship between items that seem important but haven’t
been demonstrated in the literature.
Empathy is considered to be of fundamental importance in assessment
and treatment, and yet its role in re-offense is not well established.
However, its measurement and contribution to abusive behavior have
been the source of much discussion and debate (Fernandez, 2002).
In one study with adolescents (Curwen, 2000), the well-known Interpersonal
Reactivity Index (which appears in Salter, 1988) did not tap victim
empathy. Hanson (2003) has observed that some offenders genuinely
do not understand the harm they have caused while others do understand
but remain willing to abuse. Meanwhile, the human brain’s pre-frontal
cortex, where empathy is located, continues to develop well into
adulthood (Stien & Kendall, 2004, p. 23). While how much of a
youth’s capacity for empathy remains to be developed into adulthood
is open to speculation, this single element of adolescent development
will give assessors of risk reason for caution.
For many years, practitioners
working with sexual abusers assumed that denial was related
to sexual re-offense risk. However, recent meta-analyses (Hanson & Bussiere,
1998; Hanson & Morton-Bourgon, 2004) found no correlation between
denial and risk. There are many views on how this may be. It could
be that researchers are measuring denial differently than practitioners.
It might also be that denial is more closely related to readiness
and motivation for treatment, or to the responsivity principle, so
that its connection to re-offense is not as direct and “washes out” of
research findings. It could also be as simple as denial indicating
that the person is not ready to admit what they have done.
the field of risk assessment are surprised to find that aspects of
the youth’s most recent offense (sometimes known as the “instant” or “index” offense)
have not proved to be predictive (Marczyk, Heilbrun, Lander, & DeMatteo,
2003; Hanson & Thornton, 1999). Rather, it is the past history
of sexual aggression that is. In other words, it is not the youth’s
willingness to abuse on one occasion that predicts, but rather the
youth’s persistence that can be predictive of future harm. Although
professionals should not discount that the youth has, at least on
one occasion, engaged in harmful behavior, there is no consensus
in the literature that the referral offense in itself is predictive.
Likewise, victim penetration has generally not proven to be associated
with risk for sexual recidivism among youth, although it has been
associated with elevated risk for violence (Langstrom & Grann,
2000). However, victim penetration has been associated with deviant
sexual arousal patterns in the case of same-sex child molestation
by adolescent males.
Caution #7: The uncertainty of sexual
arousal. There is little question that sexual arousal to children is a powerful
predictor of sexual recidivism among adult abusers (Hanson & Bussiere,
1998; Hanson & Morton-Bourgon, 2004). However, the clarity appears
to end there for risk classification purposes. Arousal to rape among
adults has not been shown to be predictive of subsequent sexual re-offense,
although this may be due in part to the methods employed (ibid.).
There is growing consensus, however, that sexual arousal in youth
is more dynamic than once believed, that its changing nature prevents
it from being an effective predictor, and that it is therefore less
of a treatment target for youthful sexual abusers than for their
adult counterparts (Johnson, 2005; Rich, 2003). Hunter (1999) observes:
A minority of sexually
abusive youth manifest paraphilic (deviant) sexual arousal and interest
patterns. These arousal and interest patterns are recurrent and intense,
and relate directly to the nature of the sexual behavior problem
(e.g., sexual arousal to young children). Deviant sexual arousal
is more clearly established as a motivator of adult sexual offending,
particularly as it relates to pedophilia. A small subset of juveniles
who sexually offend against children may represent cases of early
onset pedophilia. Research has demonstrated that the highest levels
of deviant sexual arousal are found in juveniles who exclusively
target young male children, specifically when penetration is involved.
In general, the sexual arousal patterns of sexually abusive youth
appear more changeable than those of adult sex offenders, and relate
less directly to their patterns of offending behavior. (p. 3)
The sexual arousal
patterns of youth have proven to be elusive targets for both assessment
and treatment. Given that adolescence is by definition a time of
accelerated development, it makes sense that sexual interest and
arousal is subject to change. However, adolescence is also a time
when antisocial behavior is common (Moffitt, 1993).
There is evidence that
youth are simply more willing to report behaviors that cause concern
in adults (Zolondek, Abel, Northey, & Jordan, 2001). In many instances, youth may be re-enacting
their own abuse or situations that they have witnessed (Schwartz,
Cavanaugh, Prentky, & Pimental, 2006) rather than demonstrating
a long-term proclivity towards sexual dangerousness. Given the histories of abuse, neglect, and
trauma among sexually abusive youth, it may well be that harmful
sexual behavior is not deviant within the context of their limited
Research suggests that
youthful sexual abusers do not manifest sexual disorders in the same
ways as adults. The evidence indicates that sexual arousal is fluid
and dynamic across adolescence (Hunter & Becker, 1994). Although
sexually abusive youth can engage in sexually deviant behavior, it
appears that the majority of them do not experience persistent and
entrenched sexual deviance.
Caution #8: Risk
assessment can reflect or contribute to poor public policy. There are many worthwhile reasons to consider the likelihood
of a young person to engage in further harm. These include community
safety, the establishment of treatment targets and plans, placement/reunification
decisions, consideration of making amends to victims, etc. In
many instances, however, risk assessment has been used to implement
policies of unknown and/or questionable impact on youth. In one
case, Poole, Leidecke,
and Marbibi (2001), investigated Static 99 (Hanson & Thornton,
1999), an adult actuarial scale for use with adolescents. At
that time, the Texas Youth Commission was interested in the use
of this scale for registration and community notification purposes
in accordance with Texas law SB 1650 and established a high-risk cutoff score
of 4 rather than the authors’ recommended score of 6. From the
with SB 1650, the Risk Assessment Review Committee chose the Static-99
as its assessment tool and altered the scoring procedure based on
their data. All Texas sex offenders 18 years and older are subject to assessment using the
Static-99. One concern of using the Static-99 was that all sex offenders,
18-21 years of age received a score of one in the following categories:
age at time of release and marriage status. In order to obtain a
high-risk level, an offender needs to score a four or more on the
Static-99. Therefore, everyone in this population was automatically
half way to being a high-risk sex offender. Research on juvenile
sex offenders suggests that other characteristics may apply to offenders
who were juvenile at the time their sex crime was committed…
study found that Static 99 did assign a high-risk level to all juvenile
offenders (four juveniles) who were arrested for another sex offense
within the four-year follow-up period. However, it also assigned to
the high-risk category, 17 juvenile offenders who did not recidivate
sexually. This raises questions about the rate of false positives observed
in this study and the sensitivity of the instrument with adults who
committed their sex crimes as juveniles… The high percentage of false
positives is most likely attributable to the Risk Assessment Committee’s
decision to change the scoring system, making four or higher the High-Risk
cutoff point. (pp.1-2)
The authors conclude
with a recommendation to change the scoring system. Whatever side
one comes down on with respect to policies such as notification and
registration of sexually abusive youth or of changing scoring protocols,
assessing risk in young people does not occur in a vacuum. Professionals
will need to consult their personal and professional ethics before
undertaking assessments of young people. If the purpose of an assessment
is to identify treatment and management strategies, it may be best
to forego the use of language such as “risk” and focus instead on
ideas such as “predisposition to”, “vulnerability towards”, etc.
in the context of a “sexual aggression assessment”, “needs assessment”,
etc. and include the time limitations described earlier.
Caution #9: An
exclusive focus on reducing risk through registration and notification
has the potential to steer attention and resources away from
assisting victims and preventing future abuse. As
communities look to promote community safety, it is possible
that the allocation of resources towards registration of young
people will divert funds and attention away from necessary entities
such as victim’s advocate offices, rape crisis centers, and shelters
for women and children seeking refuge from abusers. Given the
uncertainty around the effectiveness of registration of sexual
offenders generally, it is imperative that communities not lose
sight of the important safeguards they have and can develop.
Registration can have detrimental effects on the families of
young people, especially when the victim and abuser are from
the same family. Young people who have sexually abused frequently return
home to their families, whether as the result of good treatment
planning or not. In many instances, the victim of their sexual
abuse is there. There can be many reasons why it is entirely
appropriate for family members to live with each other after
abuse has occurred (Schladale, 2007; Thomas & Viar, 2006).
Communities using registration and notification have an obligation
to protect the well being of those affected by sexual abuse,
including victims and other family members.
Just as adolescents are different from adults, children 12 and
under are different from adolescents. Although
it can be tempting for lay people to believe that young children
who engage in sexually harmful behavior are at the beginning
of a lifetime of escalation, destruction, and havoc, there is
no research to support this. For example, Carpentier, Silovsky,
and Chaffin (2006) found that among 135 children receiving cognitive-behavioral
treatment in a prospective randomized trial with a ten-year follow-up,
two percent of those receiving treatment engaged in sexual offenses
in the follow-up period. Ten percent of the children receiving
group play therapy were known to have sexual offenses in the
follow-up period. Those that completed treatment did not differ
from the general clinic population, three percent of whom engaged
in subsequent sex offenses. The authors concluded that short-term,
focused cognitive-behavioral treatment are helpful and that the
findings dispute the commonly held belief that young people with
sexual behavior problems necessarily become adolescent or adult
to terms with youthful sexual aggression have many reasons to be
cautious in their understanding of youth and predictions of what
they might do. Adults have long considered young people fundamentally
unpredictable and the notion that we can reasonably predict and prevent
behaviors that thrive on secrecy is testimony to both our communities’ optimism
and desperation. However, those who make and implement policy will
want to exercise great caution in their attempts to implement registration
for juveniles. The emerging consensus in the research is that young
people are less likely to recidivate sexually than many might think,
but more likely to recidivate for non-violent crimes if they do come
into contact with the legal system. There remains no empirically
validated means for classifying young people according to sexual dangerousness, and registration
laws have the potential to divert resources and attention away from
necessary programs for assisting survivors and preventing sexual
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