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Sexual Offending Behaviours: Urgent Need for ‘Autism Sensitive Risk Assessment Guide’

Clare Alley's latest blog entry

[Posted on 27 February, 2018 by Clare Allely]

It has long been suggested that there exists an association between autism spectrum disorder (ASD) and sexual deviance or sexual offending (Chesterman & Rutter, 1993). Behaviours can include inappropriate courtship scripts, exposing one’s genitals and/or masturbating in a public place, inappropriate touching, and downloading child pornography.

Is it true that individuals with ASD are more likely than other people to sexually offend?

First, it is important to emphasise that the association only suggests that individuals with ASD may be more at risk of engaging in particular forms of offending behaviour. In fact, studies indicate that sexually offending behaviour more generally in such individuals is rare, and some studies have found that they may in fact be less likely to offend. There have been no studies which have found that individuals with ASD are more likely to commit violent sexual offences (e.g., rape, sexual assault). However, there has been increasing attention on the association between ASD and sexually abusive behaviour.

While ASD does not increase the risk of offending behaviour overall, it is important to investigate the symptoms inherent in ASD which may contribute to the minority who commit sexually-related offenses. Research has found that inappropriate sexual behaviours may reflect common ASD symptoms such as repetitive patterns of behaviour, inappropriate use of speech, and preoccupations/fixations on people or objects (Allely & Creaby-Attwood, 2016). Researchers have also found evidence which suggests that due to limited or no experience of being in an intimate relationship, individuals with ASD may have difficulty expressing their sexuality within the context of an appropriate relationship which may contribute to offending behaviour (Murrie et al., 2002).

In their review, Mogavero and Mogavero (2016) identified a variety of studies suggesting that, rather than being due to any malice, a large portion of the deviant or sexual offending behaviour which is carried out by individuals with ASD is very often explained by their ASD symptoms. A case study which illustrates this is the case described by Chesterman and Rutter (1993) of a 22-year-old male with a diagnosis of ASD who had a history of stealing cotton lingerie and masturbating while holding women’s nightdresses. This case illustrates how an individual with ASD might engage in such offending behaviour as a result of their sexual preoccupations (Creaby-Attwood & Allely, 2017).

Repetitive or obsessive behaviour may also contribute to pornography-related offenses. Individual with ASD are likely to accumulate large amounts of pornography (due to their ritualistic nature) and do so without focusing on wider issues such as where and how they got the images/files, who else might be able to access them and what the implications may be for any minors in the images (Mesibov & Sreckovic, 2017). However, this does not imply that they are more at risk of sexually abusing children compared to individuals without an ASD diagnosis. Studies indicate that, compared to adults without ASD, adults with ASD are much less likely to engage in these offending behaviours. Murrie and colleagues (2002) described the case of an adult male with Asperger’s syndrome who obsessed with collecting pornography and filming and photographing minors. He was arrested for showing pornography to and filming his nine-year-old daughter and her friend.

Another important issue to consider here is that some individuals with ASD often view child pornography in order to understand sexuality within the comfort and privacy of their own home as opposed to it being a precursor to the sexual abuse of children (Mesibov & Sreckovic, 2017). This aspect (amongst others) is explained in more detail in the book The Autism Spectrum, Sexuality and the Law: What every parent and professional needs to know written by Tony Attwood, Isabelle Hénault and Nick Dubin published in 2014.

Urgent Need for an ‘ASD Sensitive Risk Assessment Guide’

In order to determine what strategies would be appropriate and effective for individual offender management (such as sentencing, release from custody, or community management), sex offender risk assessment is crucial. Sugrue (2017) recently raised a crucial limitation with current risk assessments for use with individuals with ASD. Specifically, these currently used risk assessments are normed for people who are not on the spectrum. They have also not been normed for someone who simply viewed images of child pornography. Another issue raised by Sugrue (2017) is the assumption that there is an association between risk of offending and number of images that the offender has in their possession or the nature of the content (for instance, if it is extremely sexually violent). This notion is not supported by findings from the research, even more so in cases of ASD, since it does not take into consideration the relationship between the quantity of collected pornography and the compulsivity characteristic inherent in ASD.

Most conventional formal risk assessments (e.g., The Historical Clinical Risk Management-20, Version 3, HCR 20) assess a variety of factors which would not be considered relevant for offenders with ASD. Some of these factors include, for example, the presence of delusions, hallucinations, compliance with medication and illicit drugs use. There is an urgent need for an ‘ASD sensitive risk assessment guide’ which includes the factors which may increase the vulnerability of individuals with ASD to engage in certain kinds of offending behaviour. Some of these vulnerability factors would include, for example, communication; impairments in cognitive and sensory domains; social awareness; vulnerability; sensitivities; preoccupations; unusual interests; anxiety provoking situations and obsessions or compulsions. Factors which possibly may be protective in individuals with ASD in relation to offending behaviour include an immediate environment which is structured and unambiguous (Murphy, 2010).

In summary, given the lack of validated instruments for evaluation of risk of offending in individuals with ASD, clinicians and forensic practitioners have to rely, predominantly, on the research which is based on neurotypical individuals and then extrapolate based on their knowledge of individuals with ASD (Sugrue, 2017).

Highly Recommended Texts:
Attwood, T., Hénault, I., & Dubin, N. (2014). The Autism Spectrum, Sexuality and the Law: What every parent and professional needs to know. Jessica Kingsley Publishers.

Allely, C. S., & Creaby-Attwood, A. (2016). Sexual Offending and autism Spectrum Disorders. Journal of Intellectual Disabilities and Offending Behavior, 7(1), 35-51.

Chesterman, P., & Rutter, S. C. (1993). Case report: Asperger’s syndrome and sexual offending. The Journal of Forensic Psychiatry, 4(3), 555-562.

Creaby-Attwood, A., & Allely, C. S. (2017). A psycho-legal perspective on sexual offending in individuals with Autism Spectrum Disorder. International Journal of Law and Psychiatry, 55, 72-80.

Mesibov, G., & Sreckovic, M. (2017). Chapter 2. Child and juvenile pornography and autism spectrum disorder. In Caught in the Web of the Criminal Justice System: Autism, Developmental Disabilities, and Sex Offenses. Edited by Lawrence A. Dubin, J.D. and Emily Horowitz, Ph.D. Foreword by Alan Gershel, J.D. Introduction by Mark Mahoney, J.D. Afterword by Tony Attwood. Jessica Kingsley Publishers.

Mogavero, M. C., & Mogavero, M. C. (2016). Autism, sexual offending, and the criminal justice system. Journal of Intellectual Disabilities and Offending Behaviour, 7(3), 116-126.

Murphy, D. (2010). Extreme violence in a man with an autistic spectrum disorder: assessment and treatment within high-security psychiatric care. The Journal of Forensic Psychiatry and Psychology, 21(3), 462-477.

Murrie, D. C., Warren, J. I., Kristiansson, M., & Dietz, P. E. (2002). Asperger’s syndrome in forensic settings. International Journal of Forensic Mental Health, 1(1), 59-70.

Sugrue, D. P. (2017). Chapter 4. Forensic assessment of individuals with autism spectrum charged with child pornography violations. In Caught in the Web of the Criminal Justice System: Autism, Developmental Disabilities, and Sex Offenses. Edited by Lawrence A. Dubin, J.D. and Emily Horowitz, Ph.D. Foreword by Alan Gershel, J.D. Introduction by Mark Mahoney, J.D. Afterword by Tony Attwood. Jessica Kingsley Publishers.

This is a blog. The purpose of the blog is to provide information and raise awareness concerning important issues. All views and opinions expressed are those of the writer and not necessarily shared by the GNC.