• Youth Who have Sexually Abused: Registration, Recidivism, and Risk
 • Residence Restrictions and their Impact on Sex Offender Reintegration, Rehabilitation, and Recidivism
 • A Reflection for the Times
 • Interview with Ray Knight
 • An Important Message Regarding Clinical Membership
 • Call for Nominations
 • ATSA 26th Annual Research & Treatment Conference
 • Recognizing and Honoring Those Who Have Contributed to the Field
 • Education and Training Committee Report
 • Public Policy Committee
 • Ethics Violations
 • New Members
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Vol. XIX, No. 2
Spring 2007
Youth Who have Sexually Abused: Registration, Recidivism, and Risk

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 recidivism.


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.


Caution #1: There remains no empirically validated method for determining the likelihood 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, 2006).


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.


In 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. 94).


Caution #3: Registration and notification laws create collateral consequences for sex offenders that are likely to interfere with facilitating a successful transition to adulthood. 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, 1998;2001).


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.


Many 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. 56).


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.


Professionals entering 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 experience.


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 Executive Summary:


In accordance 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…


This 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.


Caution #10: 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.


Caution #11: 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 offenders.




Communities coming 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 abuse.




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