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Assessment and Treatment of Adolescents with Intellectual Disabilities Who Exhibit Sexual Problems or Offending Behaviors

EXECUTIVE SUMMARY

The assessment, treatment, supervision, and case management of adolescents who have sexual problems or offending behaviors (SPOB) are recognized as both complex and different from services provided to adults. This can be particularly challenging when these adolescents also have intellectual disabilities (ID). Sexual problems or offending behaviors are defined in this context as sexual behaviors that are offensive and/or harmful to others, that place the adolescent at odds with society’s rules, and that may lead to legal sanctions. The prevalence of adolescents with intellectual disabilities who have SPOB varies from study to study, but the general view is that adolescents with intellectual disabilities are overrepresented in the juvenile justice system. As a result, practitioners providing assessment, treatment, and case management services to adolescents who have SPOB are likely to encounter adolescents with ID.

Adolescents with intellectual disabilities who also have SPOB are an important subpopulation of offenders requiring specialized attention. Where possible, each section of this paper reviews the literature and covers relevant elements that point to treatment and case management adaptations needed to accommodate the individual’s cognitive abilities. Similarly, each section discusses limitations within the research literature and in the use of contemporary tools and approaches designed for mainstream adolescents who have offended sexually. The paper is divided into the following sections:

  • The Role of Intellectual Disability in Juvenile Criminal Behavior
  • Sexual Development in Adolescents with ID
  • Sexual Problems or Offending Behaviors by Adolescents with ID
  • Effects of Developmental Disabilities on Parents
  • Collaboration Between Parents and Involved Systems of Care
  • Overarching Approaches to Intervention with Adolescents with ID
  • Assessment of Adolescents with ID
  • The Neurodevelopmental Impact of Trauma: Implications for Assessing and Treating Adolescents with Intellectual Disabilities
  • Treatment for Adolescents with ID
  • Residential Treatment Considerations for Adolescents with ID

This information packet summarizes much of what is known, yet much more is unknown. Problems have been noted where assessment measures originally designed for adolescents who are not intellectually disabled are used with those who have ID. This paper provides suggestions regarding appropriate assessment strategies—including structured risk assessment instruments—and emphasizes the need to properly consider the intellectual disability status.

Adolescents with ID most often receive community support services through local disability service agencies; however, many professionals working with individuals who have ID do not possess knowledge or expertise related to SPOB. Appropriate supervision and case management require cooperation and collaboration between families, the justice system, and disability service agencies. As definitive standards of care cannot be prescribed, this document offers what is considered evidence-based and promising practices.

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