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Aspects of young sex abusers Abstract and summary: This article concerns itself with the serious problem of juvenile sexual abuse in our society, which appears to be increasing worldwide. It will also consider the incidents, the patterns of offending and comparison studies, followed by the causes and associated features of mainly juvenile sexual abusers. The assessment and diagnosis of sex abuse offenders, the risk assessment of sex abusers and prevention and treatment approaches are followed by specific aspects of female sex offenders and the ethical and legal issues. The literature reviewed has been in the fields of psychological and psychiatric studies rather than legal studies, and the time frame selected has been chosen to highlight the growing problem and the lack of methods being found to combat such a problem. 1. Introduction It is becoming increasingly important to identify adolescents who may sexually abuse children. The purpose of identifying potential and real sex abusers is in order to protect potential victims and to improve the ongoing life chances of alleged perpetrators (Fyson et al, 2003). Research over the past twenty years indicates that adolescent sex offenders account for a significant number of child sex abuse perpetrators. Studies indicate that this group has a variety of severe family problems, including neglect and physical and sexual abuse suffered by themselves. They also have educational and behaviour problems, various psychopathologies, feelings of social isolation and hence a tendency towards sex offending (Veneziano & Veneziano, 2002). LeBlanc & Lapointe (1999) suggest that the social and psychological difficulties of the perpetrators and victims of sexual aggression are much more serious than those young offenders and adolescents covered by the Youth Protection Act. Many sex abusers have themselves been victims of sex abuse in the past. A number of investigators have pointed out the incidents, which will be discussed later, of sexual abuse, this being perpetuated by adolescents and also later as they become adults (Sheerin, 1998). Sexual abuse by adolescents of children constitutes severe damage to victims and the urgent need to treat such juveniles, whether they are victims or perpetrators ( Eckert, 1998). Lowenstein (1998) in his book ‘Paedophilia (the sexual abuse of children, its occurrence, diagnosis and treatment') considers young sex abusers of children should be particularly important target for diagnosis and treatment for the purpose of preventing them becoming adult sex abusers. Parents' reactions to sexual abuse was studied by Briones (2000). The reactions of parents of adolescents who sexually abuse is a combination of shock, denial, the realisation of anger and the need for treatment as well as feelings of guilt, depression etc. 2. Incidents of adolescent sexual abuse Research over the past 20 years indicated that adolescent sex offenders account for a significant number of child sexual abuse perpetrators. A number of researchers have noted the incidents of sexually aggressive adolescents including Burton (2000). More than 46 % of the aggressive adolescents began their deviant behaviour before the age of 12. Studies in America and England by Campbell (2000) found that one third of sexual offences in England and 50% of the same offences in the United States were committed by adolescents. Sexual aggression has been found to be a widespread problem among adolescents in Germany also (Krahe et al, 1999). Similar findings in the USA , were obtained by Pithers and Gray, 1998. They noted that nearly 40% of all child sexual abuse is performed by youths less than 20 years old, with 6-12 year old children being the source of 13-18% of all substantiated child sexual maltreatment. Another US study by Bennett & Fineran (1998) in a sample of 463 high school students, found that 43% reported being the victim of either sexual violence or severe physical violence by peers in the past year. Perpetrators were more likely to be known rather than unknown to the victim. 70% of those who experienced violence by peers were girls. Two comprehensive American studies by Ryan et al (1996) and (1998) studying 1,660 juveniles who were referred to a specialised evaluation found that 22% had themselves suffered from sexual abuse and that the perpetrators of this abuse were females. A later section dealing with female sex abusers will be considered in detail. Pithers & Gray (1998) found that child abuse had reached epidemic proportions in America despite efforts to control this behaviour. Failure to treat adolescents who commit such offences is likely to lead to them sexually assaulting adults (Sheerin 1998). 3. Patterns of offending and comparison studies The characteristics of the perpetrators of childhood abuse have been studied and have indicated that juvenile sex offenders are a heterogeneous population with diverse characteristics and treatment needs. A number of typologies have been developed to classify various types of offenders. One study has indicated that homelessness and runaway type adolescents were more likely to be perpetrators of childhood abuse, (Tyler & Causce 2002). 372 homeless and runaway adolescents aged 13 - 21 were interviewed. Approximately half of the sample reported being physically abused and almost one third experienced sexual abuse. The females experienced significantly higher rates of sexual abuse compared to males, and sexual minority youths experienced significantly higher rates of physical and sexual abuse when compared with heterosexual youths. Sexual abusers were rated as extremely violent by more than half of those who were abused. Biological parents were the majority of perpetrators for physical abuse whereas non family members were more likely to perpetrate sexual abuse. The average age of the perpetrator was late twenties to early thirties and the majority were male for both types of abuse. The pattern of exploitation and victimisation within the family was thought to have serious and cumulative developmental consequences for these youth as they enter the street environment. Early intervention programs were needed to break the cycle of exploitation and abuse. When the criminal records were reviewed on 126 male juveniles arrested for sexual offences against children or peers it was found that there appeared to be more offences against females who were strangers or acquaintances, more frequently they had committed their crimes in a public area. Peer/adult offenders were also more likely to commit sex crime in association with other criminal activity, and the evidence points to higher overall levels of aggression and violence. Generally, the aggression of child molesters tends to intimidate rather than physical force actually being used. A study by Kaufman et al (1998) found that adolescent offenders more frequently used a variety of modus operandi strategies to gain victim compliance in sexual activities and to maintain victim silence following the onset of abuse, including approaches designed to coerce or manipulate victims. The characteristics of young sexual abusers were also studied by Becker (1998). The study showed that little was known about female adolescent sexual offenders in comparison with male adolescent sexual offenders. A comparison of treatment outcomes was studied by Hagen & Cho to consider the outcomes between adolescent rapists and child sexual offenders. They assessed the differences between recidivism for 50 adolescent perpetrators for sexual assault against children versus 50 adolescent perpetrators (all subjects aged 12 - 19 years) of rape. With a 2 year minimum follow up no evidence was found for significant differences between success with either group of offenders. 4. Causes and associated features of young sexual abusers Perceptions of seriousness for sexual aggression and the influence of gender were studied by Hilton et al (2003). Sexual aggression was rated as more serious than non sexual physical aggression, especially when involving physical force. Girls gave higher seriousness ratings than did boys. Male to female aggression was rated as most serious and male to male aggression least serious. There is some evidence that causal relationships connect childhood abuse with adolescent and adult male perpetrators as was noted by Bailey (2001). Similar results were obtained by Veneziano et al (2000) who indicated that 92% of subjects had been sexually abused themselves before committing abuse. Furthermore, male sexual offenders who had been sexually victimised were more likely to select victims and commit sexual behaviours reflective of their own sexual victimisation. These findings suggest that sexual abuse of children by some adolescent offenders was maybe a re-enactment of their own sexual abuse. The profile of young sexual offenders was studied in South Africa by Wood et al (2000). Results showed that half of the sample who had committed sexual offences had a history of consenting sexual interactions and had committed a non sexual offence and had behavioural problems. Half reported a history of abuse. Typically these individuals had not received any sex education. They were often socially isolated as victims and socially anxious and had a number of friends who they had compared with themselves as having adequate social skills. The home environment was characterised by over-crowding, alcohol abuse and domestic violence. A male relative was likely to have committed a criminal offence. In the community there was regular violence and sexual activity. A British study by Manocha & Mezey (1998) confirmed the seriousness of the problem of sexual abuse posed by adolescents and reported a multi factorial aetiology, including environmental, familial, inter-personal and developmental elements. Of particular note was a prior history of abuse and victimisation and lacking of protective parenting. Other factors cited as contributing to the potential for being abused are physical abuse, parental separation, and school related educational and behavioural difficulties. These were more common in sexual abuse perpetrators as well as victims. Another British study of 100 sexually abuse male adolescents aged 11 - 18 indicated that the family and social environment contributed to both the abuser and the abused. Findings were no different from those described in North American literature. 5. Assessment and diagnosis of sexual abuse offenders Due to the diversity of the population of sex abuse offenders, careful assessment is needed before treatment plans are developed and implemented. Most treatment plans are modelled on those found to be effective with adult sex offenders, but some new programmes are aimed more specifically at juveniles. The main approaches currently being used in the assessment of alleged sex abusers who are adolescents is the interview method. This is open to considerable criticism. Interviews are noted for their lack of accuracy unless they are combined with other measures such as history taking and psychological testing. Unfortunately, at the present time there are as yet no highly reliable tests of a psychological nature which can identify with certainty adolescent sex abusers. Lowenstein (1998) attempted such testing by developing a test for alleged perpetrators, alleged victims of abuse and for accusers. Hershkowitz et al (2004) sought to introduce a structured interview protocol designed for investigative interviews of youthful alleged perpetrators of child sexual abuse. All interviews were conducted as part of the investigators regular work and followed the structured interview guide. Older and younger children were questioned similarly but there were fewer directive questions and option posing prompts to suspects who denied the allegation. The results noted that older and younger children appeared to respond similarly. More information was solicited from the perpetrators using invitations rather than suggested or option-posing prompts. A study by Curwen (2003) investigated the reliability and validity of three scales of the interpersonal reactivity index (iri), emphatic concern (ec), prospective taking (pt) and personal distress (pd) with a clinical sample. These scales were also used to examine the differences in empathy among groups of sex offenders. 123 male adolescent sex offenders aged 12 - 19 completed a battery of psychometric measures that included the (iri) during a sex offender specific assessment. Moderate internal consistency and convergent validity was established for (iri) scales. Victim empathy was not related to (iri) scales. Justification and acceptance of sexual and interpersonal violence were negatively correlated to (ec) and positively correlated to (pd). Those who committed violent offences reported more (ec) and (pt); However, a generally hostile temperament was negatively related to these scales. Researchers using the (iri) with male adolescent sex offenders should be cautious of the influence of age and socially desirable responding according to Curwen. A controversial but in some respects favoured approach to the assessment of alleged adolescent sex offenders is the use of phallometric testing, (Seto 2000). Participants were 40 adolescent sex offenders against children, 75 young adult sex offenders against children, and 39 young adult comparison participants. The responses of adolescents with female victims resembled those of comparison participants. Adolescents with any male victim had larger relative responses to child stimuli than comparison participants. Young adult offenders, regardless of victim sex had larger relative responses to child stimuli than a comparison participant. Using a cut score of (0) indicating equal or greater arousal to children than adults, sensitivity was 42% for adults with male victims, and specificity was 92% for the comparison participants. Results suggest that phallometric testing can identify paedophilic interests among these adolescent sex offenders. Another assessment procedure favoured by a number of practitioners is the Achenbach Child Behaviour Check List and the Family Assessment Measure. This test has been used with children who had been sexually victimised by juveniles, (Shaw et al 2000). The children were given the family assessment measure and trauma symptom checklist for children. The clinician completed a parental reaction to incest disclosure scale. No differences were found between the younger and older victims of sexual abuse, penetration or the use of force. Juvenile perpetrators were younger and more likely to be males who were abused in a school setting, home or relative's home by a sibling or non-related male. Those who were abused by adults tended to be sexually preoccupied and manifested border-line clinically significant symptomatology. The Abel assessment for interest in paraphilias (AAIP; G.G. Abel, 1995), was used by Smith & Fisher (1999) with juvenile sexual offenders. The mean age of these adolescent sexual offenders was 15.8 years and they were in seven residential and day treatment centres. The temporal stability, sensitivity and specificity of the able assessment interest paraphilias test as used by adolescents in residential and day treatment centres were not supported. The results indicated the need for further refinement of this tool. This was also confirmed by Bonner et al (1998, 2000) who considered it imperative that further tests which were more accurate were developed with adolescent sexual offenders to indicate risk of re-offending. Becker (1998) also indicated the need for a comprehensive assessment of juvenile sex offenders and their family. It was especially felt important to obtain reports from outside sources, taking a developmental, sexual, family, medical and psychiatric history, and assessing the family current attitude towards sexual offences. 6. Risk assessment of sexually abusing adolescent offenders Sexual recidivism amongst those returning to the community is of great concern to all. When released from incarceration or removal from treatment is being considered it is vital to predict the likelihood of re-offending in adolescent sexual offenders. According to Murphy et al (2001) a number of variables significantly predicted sexual arousal and hence further offending. The most consistent predictors were gender of victim, race, the interaction of race and gender of victim and to some extent the interaction of offender abuse history and gender of the victim. Caucasian subjects tended to respond more than African American subjects did, and this had not been reported previously in the literature. An eight year comparative analysis of adolescent rapists and adolescent child molesters as well as other adolescent delinquents in the general population reveals some interesting results, (Hagan et al 2001). Of the 150 participants, 50 were adolescent rapists who had perpetrated a sexual assault against a same age or older peer, 50 were perpetrators of sexual assaults against children, and 50 were delinquents adjudicated for an offence other than sexual assault. The results showed that adolescent sexual offenders were significantly more likely to sexually re-offend in the eight-year period after their release from a juvenile correctional facility than were a control group of other adolescent delinquents from the same institution. Juvenile non sex offenders, child sexual offenders, and adolescent rapists were all found to be significantly more likely to be involved in sexual assaults than was the general male population in the United States . Sheridan et al (1998) conducted interviews with clinicians and twenty-two participants who had completed treatment with North Side Inter-Agency Project, (NIAP), a community based treatment program for adolescent sexual abusers. Clinicians reported that a majority of adolescents completed all steps of the program and the majority of families had been highly supportive of the adolescents' participation in treatment. Difficulties with the management of conflict, the regulation of negative emotions, and cognitive deficits were the principle areas in which clinicians judged these adolescents to have problems in addition to their sexually abusive behaviour patterns. Despite having these difficulties, two thirds of the cases were judged by therapists to be at low risk of re-offending following treatment. In just over half of the cases, adolescents reported entering into situations, following treatment, which placed them at risk of re-offending, but in an anonymous questionnaire, none reported sexually re-offending. Finally Kaufman et al (1996) examined the predictability of adolescent sexual offenders modus operandi based on differences in victim, perpetrator, and offence characteristics. Modus operandi denoted the pattern of behaviour which perpetrators displayed in the period prior to, during, and following illicit sexual contact. The study focussed primarily on the behaviour often labelled “grooming.” Results showed that a history of sexual abuse was related to the selection of male victims and younger victims. Furthermore, sub-groups of offenders differed significantly in the strategies they employed to build victims trust, gain compliance with illicit sexual activity, and to maintain victims silence following the onset of sexual abuse. In order to consider the risk of sexual re-offending it was necessary to investigate these aspects of potential future behaviour with perpetrators. 7. Prevention and treatment approaches in dealing with adolescent sexual abusers In recent times there has been an increasing amount of research in the area of addressing the therapeutic aspects of young sex offenders. There has been some uncertainty however as to the treatment effectiveness for adolescent sex offenders. Different treatment appeared to assert different effectiveness, (Letourneau 2004). There are however, some optimistic views expressed by Boswell & Wedge (2003) as to the effectiveness of treating young sex abusers usually in late adolescence. They undertook a pilot evaluation of a therapeutic community for adolescent male sex abusers. The re-conviction rates of both sexual and non-sexual offending was seen to be considerably reduced. The ex residents were almost unanimously positive about their time at one particular treatment centre, (Mc Gregor Hall) and the coping techniques which were developed for them. Bentovim (2002) considered the ways of preventing sexual abusing by young people and hence victimising younger groups into eventually also becoming sex abusers. Bentovim (2002) considers that sexually abused children often tend to live in violent surroundings, suffer physical abuse and are exposed to abuse of maternal figures. They also often suffer from disruption and poor quality of care and supervision. Green & Masson (2002) warn against the placement of sex abusing young people in centres with child victims of sexual abuse. Research suggests that the inadequate ways in which sexual behaviour in children's homes is perceived and managed, serves to compound the problems of both the sexually abusive and non-abusive adolescents placed there. A chapter in a book by Vizard et al in a book by Ray Bull ‘Children and the Law' (2001) discusses definitional issues regarding child and adolescent sex abuse perpetrators and reviews literature on abuser and offence characteristics, theories of aetiology, and outcome of treatment programs. Unfortunately many studies were noted to have a small number of subjects. They suggested that many factors had not been reported such as how many individuals needed a repeat of a program offered to them earlier because they failed to complete the program or for other reasons. Vizard et al sought to differentiate between those labelled as sexually aggressive or sexually abusive. A study of an Australian adolescent sex offender treatment program by Flanagan & Hayman (2000) addressed certain factors related to both victim and perpetrators such as a history of victimisation and self reported problem behaviour as assessed by the Achenbach Youth Self Report Form. A rather dark picture has been painted by Ryan (1999) in relation to the increase in sexually abusing youths despite current diagnostic and therapeutic procedures. This may be partly due to the greater chance of identification of sex abusers and their victims as well as better professional cooperation. Vizard & Wusikin (1999) concentrate on emphasising the role of early trauma in the genesis of abusive behaviour and emphasised the value of individual psychotherapy with young sex abusers. Such views are psycho analytic in nature an approach not currently in vogue with the emphasis being on cognitive behavioural approaches. A number of investigators emphasised the importance of multi-disciplinary approaches and seeing individuals both through individual therapy and in groups and with families, (Erooga & Masson 1999). They also emphasised the use of a program specifically for working with children under the age of ten and with female adolescent abusers. The importance of providing consistent and timely help for those who are perpetrators of sexual abuse due to compulsive tendencies was emphasised by Brown (1999), They also however indicated that any treatment should be carried out within the community wherein such children reside. One study from Pittsburgh attempted to evaluate the treatment of juveniles who sexually abused other children and youths. As yet there has not been any result of such an evaluation indicated. Difficulties may well be due to the fact that young sex abusers suffer from a multi determined aetiology and therefore require a multi-systemic therapy, (Swenson et al 1998). The importance of involving schools has been the view of Eckert (1998) in both the identification and treatment of violent sex offenders but thus far there have been little outcome data available concerning this approach. It is encouraging to note in one study where youngsters were sent to the North Side Inter-Agency project, that all the adolescent sex abusers completed the steps necessary for the program and that their families also cooperated well in the treatment of such youngsters, (Sheridan et al 1998). It was noted that many of these youngsters suffered from conflict in the regulation of their negative emotions and cognitive deficits. These appeared to be associated with sexually abusive behaviour patterns. Despite having these difficulties, two thirds of cases were judged by therapists to be at low risk of re-offending following treatment. Another study which confirms later research by O' Reilly (1998) shows that youngsters who sexually abused other children tend to have numerous school related problems and behavioural difficulties in addition to the sex abuse demeanour. The treatment of these conditions would undoubtedly be of value to prevent further sexual abuse. The goal therefore should be of early identification and hence treatment of children who are likely to or have already sexually abused other children, (Ryan 1998). Despite the importance of treatment following identification it was noted that social and educational problems play a large part in the victimisation of children by other children. Treatment often requires the perpetrators in some cases to be placed in special units and there such youngsters are to be treated preferably by cognitive behavioural and psycho-dynamic approaches, (Woods 1997). There consideration can also be given to the individual causes of sexually abusive behaviour when providing treatment, (Ryan 1997). There also can be combined both individual therapeutic work as well as group therapy, (Mc Garvey & Lenaghan 1996). It is important to regard adolescent sexual offenders as both victims and perpetrator when dealing with their problems. Again utilising cognitive behavioural and or psychodynamic methods, (Woods 1997). 8. Female sex abusers Findings suggest that the sexual abuse of children by some adolescent offenders may be a re-enactment of their own sexual abuse. Although numbers of female sex abusers are smaller than in the case of male sex abusing adolescents it was considered important to differentiate between male and female abusers. Relatively little is known about adolescent females who commit sexual offences, (Kubik et al 2002). In a two part exploratory study a sample of eleven adolescent females with sexual offence histories was described. It was noted that sexually offending females had significantly fewer anti-social behaviour problems, such as alcohol or drug problems or problems with fighting or difficulties in school. They began their offence behaviour at a younger age than their non sex offending delinquent peers. Few differences emerged with respect to attitudes about offence behaviour, such as levels of denial. In a second study females with sex offence histories were compared with a group of aged matched adolescent males with sex offence histories. The two sex offending groups were found to be remarkably similar. There were a few differences with respect to psychosocial and criminal histories, anti-social behaviour and variables related to clinical presentation and treatment. Likewise, the two groups were remarkably similar with respect to specific sex offence behaviours. The females, however, appeared to have experienced more severe and pervasive abuse compared to the males. Tardiff (2001) studied factors associated with sexual abuse among female adolescents and adults. The subjects studied were nine female adults with a mean age of 37.7 years and 15 female adolescents with a mean age of 14.7 years. They had been convicted of abuse in France . Data on age, marital status, family history of abuse, abuse characteristics, abuse victims, sexual problems, psychiatric symptoms, and maternal bonding were obtained by semi-structured interview. The results indicated multiple perturbations in family relationships associated with sexual abuse behaviour. This included parent abandonment and parent conflict as well as parent violence. Also more likely to be present were substance abuse, negligence and physical and sexual abuse as well as maternal and feminine sexual identity issues. A study by Miccio (2000) of 18 female sex offenders who were compared with 332 male sex offenders and with 215 females who were not sex offenders on various experiences in their personal histories. Female sex offenders who were the victims of sexual abuse were compared to female sex offenders who were not. The groups were analysed with regard to psychological, medical, gynaecological, urological, drug and law enforcement variables and homicidal and suicidal histories. Other variables included sexual difficulties and dysfunctions, sexual health and life stressors. Female and male sex offenders differed significantly on numerous psychological, life stressor and sexual variables. Female sex offenders differed significantly from females who were not sex offenders on the same set of variables, and they were significantly younger. Finally, Mathews et al (1997) found that female young sex offenders had extensive and pervasive childhood maltreatment experiences. Many of these young girls were exposed to the modelling of interpersonal aggression by females as well as males. The majority of these juvenile female sexual offenders demonstrated repetitive patterns of sexual offending with multiple victims, suggesting psycho social disturbances equivalent in severity to the comparison group of males. 9. Ethical and legal issues. Ethical and legal issues in the assessment and treatment of juvenile sex offenders was studied by Hunter & Lexier (1998). They noted that the evaluation and treatment of juvenile sex offenders represented an area of practice fraught with clinical, ethical, and legal complexity. Other approaches that may be viewed as controversial are the use of phallometric and polygraph assessments. The authors emphasise the importance of establishing ethically sound patterns of clinical practice. The use of other diagnostic instruments has also been viewed as controversial. Here are included personality tests, which seek to identify and differentiate sex abusers from non-sex abusers. At present, there are a dearth of assessment procedures that differentiate with some degree of certainty when sex abuse has not been admitted. More work needs to be done in this area as attempted by Lowenstein (1998). Such new tools should be used always alongside other personality tests, structured and unstructured interviews and phallometric approaches. Guilt should never be assumed on the basis of allegations made by alleged victims or those who make allegations on behalf of victims. Treatment, particularly of juveniles should be considered paramount as opposed to incarceration. The complex history of the known perpetrator should be further studied and taken into account when treatment procedures are formulated and implemented with prevention from an early stage being the goal in order to best protect the general public. Conclusions• Most research indicates the importance of identifying young sex abusers and their victims as soon as possible for positive treatment and prevent further victimising and abusing. • Much research indicates that sexual abuse is carried out by a significant number of older children. • The background of both abusers, and in some cases victims, is neglect and physical and sexual abuse, suffered by both perpetrator and often victim from other sources. • Many have educational and behavioural as well as emotional problems. • There is considerable evidence that young sex abusers also become eventually adult sexual abusers or commit other sexual offences. • There is a need to treat the victims of sexual abuse as soon as possible. International studies including those from Germany , United States , Great Britain , Australia and many other countries indicate that this is a problem of significant proportions. • Studies have shown that child sexual abuse is performed by youth less than 20 years of age accounting for 40-50% of all abusing. • Young perpetrators of sexual abuse tend to be known by their victims. • Most of those who experience abuse and violence are girls. • Homosexual youths experience significantly higher rates of physical and sexual abuse when compared with heterosexual youths. • Much sexual abuse by young persons is committed through violence. • Young child sex abusers tend to intimidate rather than use physical force in the pursuit of their sexual offence. • Only a few studies have been conducted in the area of female adolescent sex offenders and hence little is known when compared with male adolescent sex offenders. • Young sex offenders who have been victimised themselves are likely to choose victims and use similar methods that were used when they themselves were abused. • Research indicates that those who commit sexual offences against children are likely to have also been in trouble in school and suffer from behaviour problems. • A multi-factorial aetiology is considered as likely to be the reason for sexual abusing adults. • A careful diagnosis is required before treatment commences. The present and most common method of approach is through interview. This includes history taking and psychological testing in some cases. • There is currently no diagnostic method using psychological tests which is foolproof. • The use of phallometric testing is still controversial, but the arousal to specific child victims is apparent and hence phallometric testing could identify paedophilic interests among adolescent sex offenders. • Children who have themselves been sexually abused have been submitted to the Achenbach Child Behaviour Checklist and the Family Assessment Measure. They have also been known to complete the Trauma Symptom Checklist. • Needless to say most juvenile perpetrators of sexual abuse are males. • Treatment reactions appear to favour Caucasian subjects over African-American subjects as far as success is concerned. • Re-offending even after having been placed in a juvenile correctional facility was likely to be greater for sex offenders than for other adolescent delinquents. • Those who receive treatment are less likely to offend subsequently. Two thirds of those treated are judged by therapists to be of low risk of re-offending. • Some research indicates that sexual abusers should not be placed in children's homes or therapeutic communities with victims of sexual abuse. • A number of investigators emphasise the importance of multi-disciplinary approaches to treatment with an emphasis on individual therapy as well as group therapy. • Treatment should include dealing with negative emotions in cognitive deficits found in many young sex abusers. Problems related to schools and poor school behaviour and achievement should also be considered for mediation. • The preferable treatment approach at present and indicated by recent research is Cognitive Behaviour Therapy and psychodynamic approaches. • Few differences emerge in respect to attitudes about offence behaviour in males as compared with female offenders. Both have a high level of denial. • In the case of young female sex abusers the background appears to be very much as in males with parent abandonment, parental conflict and parental violence being present. Such girls also suffer early from physical and sexual abuse.
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