Making the invisible, VISIBLE

By Joan Tabachnick, Kieran McCartan, and David Prescott

For 30 years, each of us has struggled with this essential question: How can we make the invisible visible? How can we create good research and emerging practice in the most effective way? This is especially true when our working lives sit at the intersection of research, policy, and practice, each of which often has different ways, means, and justifications to enable making the invisible visible.

In the world of sexual violence prevention, the question is how to prove that something didn’t happen because of an essential intervention, education program, or other factors that protected against harm. Disentangling evidence from practice and “proving” the effectiveness of an intervention is difficult in any field and especially so in an emerging field like sexual violence prevention. In the last 30 years we have seen incredible change – most importantly in the general acceptance of strategies to prevent the perpetration of sexual violence from members of the public to frontline professionals, to national policy makers and transnational organizations. In the wake of ATSA’s name change, with new funding for prevention, more acceptance of this perspective from the victim advocacy community, and new research emphasizing the importance of primary prevention on preventing the perpetration of sexual abuse, we were all feeling optimistic.  

Unfortunately, in the USA at this moment, we are now heading in the totally opposite direction and diametrically opposed to international trends, especially those in other anglophone, westernized countries (i.e., UK, Australia, New Zealand, and Norway, to name a few). 

Last week, this question of how we make things visible became even more important, Ironically, April is sexual violence awareness month, and yet in early April the US Center s for Disease Control’s Office of Violence Prevention was gutted, leaving research funding, national organizations, and local sexual violence prevention programs adrift (NPR, 2025).  More than two-thirds of the staff lost their jobs, jeopardizing essential programs to prevent child abuse, child sexual abuse, sexual assault, and gun violence. 

Except for one or two articles and a few organizational statements (including one from ATSA), the world has been silent.  In fact, it seems that the public has not become aware of these changes and their impact.  Much of this is due to the onslaught of political and social change and commentary going on in the USA and its reverberations around the world. Yet the impact of these cuts and layoffs will be felt by countless numbers of people for many years to come. 

Again, how do we make the invisible, visible?  How can we help people feel these changes today, this week, this month. How do we highlight the importance of prevention, its messaging and investment to communities and individuals, when the people that sexual violence prevention activities support do not often bring attention to themselves, and the topic is uncomfortable and challenging for society.

The people who benefit the most from our prevention efforts may never know anything about our efforts  because we have been successful and they have never experienced harm. More than ever, we need to shine a light on this.

What exactly are we losing?  For decades, the CDC has offered research about the risk and protective factors for those who have been sexually abused or those who have perpetrated sexual abuse.  They have also offered critical surveillance data, strategies for preventing sexual abuse, and the funding and guidance to evaluate the results.  And for decades they offered funding for research and for programs specifically through Rape Prevention and Education (RPE) funding that has been essential for the victim advocacy movement.  Again, removing this funding and these staff will not be immediately felt in the next days or weeks ahead. However, it all signals a shift in societal (or at least governmental) perspectives on the importance of sex and relationship education as well as sexual violence prevention. It will doubtless take years to re-focus communities’ attention on the scope of these issues.

While we don’t have that key strategic advice about what is the one thing that would make a huge difference.  We do know it is important to do something and look for hope in what others are doing. We need to look to our international colleagues, as well as those in related fields, for help, support, and direction.

We find hope in the courage and tenacity of our colleagues.  ATSA did not just issue a statement, they issued a call to all ATSA members in the US to contact their elected officials to emphasize the importance of research-informed policymaking in the effort to eliminate sexual violence.  If you have not done this yet, please make those calls. 

We find hope in movies and stories that take the risk to expand the narrow narrative of sexual violence, perpetrated by monsters lurking in the shadows.  Look for a new thoughtful documentary film called “Predator” that is really an expose on the salacious TV show called “To Catch a Predator”.  According to the film’s director, this offers insights into the complex experiences of those whose thoughts and desires do not match who they are on the inside.

We find hope when people begin to talk about institutional courage rather than institutional betrayal.  This challenges us to think about what we can do when we hear stories of sexual abuse and what can do within our institutions whether they are campuses or youth serving organizations or faith-based communities or government agencies.  How we can come together as communities to argue for and establish the need for sexual abuse prevention and the impact that it has across society. When leaders choose to face the harms that have happened and take the time to listen, that alone can make a difference.  And when leaders choose to ask what can be done to repair the harm, that can be incredibly healing for everyone.  The Center for Institutional Courage is collecting the research and hopefully make these stories of courage more visible. 

The CDC and the Division of Violence Prevention are essential to our work.  We cannot remain silent.  We need to find ways to talk about the importance of their work, their research, and their funding to continue our efforts on behalf of society.  Please don’t give up; look for places of hope that can help sustain us in the weeks and months and possibly years ahead. 

The role of sudden insights in making difficult changes

By David S. Prescott, LCSW, LICSW

“I know it sounds funny, but I changed that night when I got arrested. Nobody would ever believe it, but when I was in the back of the cop car… That was it. I knew I would never hurt anyone again. That’s when I really changed.”  Many professionals will hear these words and assume that this individual was engaging in impression management, putting himself into the best light he could under the circumstances.

In fact, this person (whose progress in treatment I was asked to assess) went on to describe how everyone assumed that he needed treatment in order to change (meaning to manage risks and lead a better life). His perspective was that although he had already changed, he needed treatment to help make those changes solid and durable. He also appreciated the opportunity to reflect on his life with therapists and group members.

It was an interesting way to look at the treatment process, one that our field rarely discusses. From the perspective of treatment planning, he sought to demonstrate in his actions who he had become in his identity. It was certainly a different pathway to completing treatment, although the end game was the same: the development of a lifestyle incompatible with harming others. What helped this client move forward, however, was that by viewing himself as a different person he could more easily maintain a better outlook on his future.

Another client was asked to reflect on what made him get himself together and participate meaningfully in treatment. He had made a sudden turn for the better in every respect, surprising everyone in his multidisciplinary team. He resided in one of two treatment programs located on the same campus. One night, a client into his program became highly aggressive, to the point where he overcame a staff person. The other staff member shouted out for help, telling the client to run and get help from the program next door.  While many will recognize this as reflecting several problems with program staffing, the client did what he was told.

He later recalled, “When I saw the look on the staff’s face in the doorway as I told her they needed help next door, that’s when it all made sense. I did not want to spend the rest of my life in places where all this could happen. I knew I had to do something different.” He did; he went on to make meaningful changes in his life and returned to living independently in the community. Arguably, his life changed quickly, with treatment being a means to become in his life who he now was in his heart. The clients in these cases went on to live successfully, all things considered.

How is it that these sudden insights so infrequently receive attention? We tend to structure treatment programs in a stepwise fashion to help clients change their lives slowly, and for good reason. Living one’s life differently is a lot of work. Often, our attempts to reduce risk don’t easily mesh with many clients’ progress, which can proceed in fits and starts. Nonetheless, whether we call them sudden insights, quantum changes, or epiphanies, they do happen and can be cause for celebration. They also illustrate how no one treatment plan or program is a perfect fit for every individual.

Perhaps one reason these sudden changes don’t garner more discussion is that professionals so often have a wait-and-see attitude. There was a conference presenter who observed with sarcasm that, “I’ve seen more people suddenly find God in the back seat of a police cruiser than in any chapel.” Many have seen some variation of this observations in their own practice. With that kind of attitude,  it is no surprise that professionals are very cautious. On the other hand, if we remain too skeptical, we may miss the opportunity to help clients consolidate their motivations to change and weather the storms of generalizing treatment insights into daily behaviors. As always, change can be messy and sporadic, and therapists need to work hard to make sure that they hear, understand, and respect their clients as fellow human beings. 

 

The use of TV drama ‘adolescence’ in schools: why simple solutions to complex problems don’t work

 By Kieran McCartan, PhD., & Sophie King-Hill, PhD.

Editor’s note: This blog follows up on Sophie King-Hill's last week’s blog on the Netflix show Adolescence. It was originally posted on the UWE Bristol research and enterprise blog. Kieran.

Recently, there has been a lot of debate about the Netflix show Adolescence. It tells a fictional story of a 13-year-old boy who is rejected by a female classmate and because of the influence of incel counterculture goes on to stab and kill her. The narrative of the four-episode story is that children and young people are being influenced by harmful online social media, which is radicalising them into accepting extreme misogynistic beliefs, which they then unwittingly internalise and act on. The drama touches upon how exposure to unfiltered, problematic social media may change children and young people’s perceptions of, and engagement with each other.

The drama skirts many issues about misogyny that involve hate crime, violence against women and girls, gender-based violence and Incel culture, mental health, wellbeing, radicalisation, risk management, education, radicalisation, knife crime, counterculture, the collapse of parental engagement, issues with family systems, and growing societal disengagement.

This is where the drama falls short as an educational resource.  Four hours over the episodes is not enough time to unpack these issues in any meaningful way. The programme signals the need for an informed debate and conversations about all these issues yet does not cover these in any great depth. Adolescence is not the answer to the issues posed and it is dangerous to think of it as such, for it offers no solutions. The show has sparked a national debate in the UK, with the Prime Minister stepping in to say that adolescence should be screened in schools to educate, and raise awareness with children and young people about the realities of harmful online social media and misogynistic hate crime. This sensationalist, knee-jerk reaction to a range of complex and endemic problems and issues that are faced by children and young people in society is problematic. Although across the political spectrum in the UK there is not a considered evidence-based response to this with Kemi Badenoch, leader of the opposition, although not having seen Adolescence believes that removing phones from children and young people in schools is one of the most effective responses. It is important to remember that under the last Conversative government the issue of Relationships and Sex Education in schools was a challenging issue and unresolved debate.

The show, given its short run time and structure which includes an episode about a different aspect of the story - the arrest, the school based follow up, the risk assessment, and the consequence, delves into parts of this story but does not offer a rounded in-depth perspective. No understanding of how and why the young boy was “radicalised” into accepting Incel culture as is implied. The complex social interactions between the boy, his friends, his family, his community or the victim are not explored. This is problematic, especially if the show is to be used as a teaching and critical reflection tool in schools.

No points of intervention and what those interventions look like are offered, as this was not designed as an educational resource. What is implied is that there is a problematic online community that are out there influencing children and young people, but no explanation is given as to how or why. Additionally, the show indicates that online misogyny, Incel culture and violence against women and girls is omnipresent in the lives of children and young people and that children and young people are accepting of this. This approach takes away the autonomy and agency of children and young people. This is problematic and works against the prevention of sexual abuse and violent behaviour. A multi-level approach is needed to tackle social issues being targeted at individuals and the community and society in which they sit. In preventing radicalisation, how the individual is affected needs exploring, which cannot be done with ‘Adolescence’.

Wanting to introduce this into schools is naïve. Adolescence is a fictional story, designed for TV/streaming and therefore its content, although based in real world issues, is fictionalised. Its aim, although to raise awareness of social issues, is to increase viewership and ratings. It is important to state that teen murders are rare and that most online hate crimes and misogyny do not result in fatalities. TV shows are not always realistic and can often adapt knowledge and practice to fit the needs to the story. Which means that the evidence based, research informed and even practice consultation which may be part of the development and writing of the screenplay can get lost of the needs of the story as they can get in the get in the way of the drama.

The best example of this flaw in Adolescence is the admission in episode four that the main character is going to change their plea from not guilty to guilty. Which goes against the narrative of episode one and three, and there is no real discussion of change of heart in episode four. It seems out of place, but it wraps the story up nicely in the last episode. Which means that the psychological or behavioural change in the character is not seen and therefore learning cannot take place from their experience. The arc of the story and the story telling approach do not allow a nuanced debate about the reality of the offence committed, the thinking and motivation behind it or the best way to understand it.

‘Adolescence’ does not help understanding of Incel culture or online hate crime better. It does not help understanding knife crime and harmful behaviour between children and young people better. It sets out that children and young people are at risk but does not offer any solutions to the problem.

The UK government want to screen it in schools as a prevention and desistence tool to educate children and young people about the issues of radicalisation, online hate and synonym. Which is problematic, as this is not what it was designed to do and does not offer those insights. What does is say then? The main discussion piece from the show detracts from the main narrative, that understanding and engagement with young people is needed to better understand these issues. In episode four where the parents recognise that they could have done, and maybe should have done more, is where the real message is. The showing of adolescence in schools to GCSE and A-Level students (as its rated 15) will not help pre-teens and younger teenagers understanding and engage with these issues better and it will not help their parents understand the issues or how to engage with them better on it. In the UK it would be better to have a conversation about the reality of growing up online, the intersection between the online and offline worlds and how they impact the mental health and wellbeing og children and young people and how we as adults, and parents, can better support them in this transition. There are pockets of work being carried out that do this with young men and boys that are evidence based and well evaluated. Why is the upscaling of these not the focus.

The period of adolescence is a point of transition and liminality in the lives of children and young people how can we support them in becoming well rounded, thoughtful and critically engaged adults. By engaging with children and young people, talking and communicating directly and thoughtfully we can learn how to best fit their individual needs. This cannot be done by simply showing them a fictionalised TV show.

Has Anyone Asked Young People? The Risks of Sensationalising Adolescence in Schools

This blog was originally published on the University of Birmingham College of Social Sciences blog” - Kieran 

By Sophie King-Hill, PhD 

‘Adolescence’, a recent Netflix drama about a boy who stabs and murders a girl from school has been highlighted via many media channels for its powerful storytelling and also by the Prime Minister, who has backed a campaign to show the drama in schools. 

Whilst programmes like this can be useful, sensationalism and extreme examples can also be incredibly damaging. One of the first aspects of this series that is particularly striking is the title. As this is about extreme violence carried out by a boy against a girl it is useful to consider the implications of this. The title inextricably links ‘adolescence’ with extreme negative content.  

Whilst the writers may have been intending to highlight the complex landscapes young people have to negotiate, they may have also inadvertently have linked this period of a young person’s life to extreme negativity. Research indicates that it is important to listen to young people at this point in their lives as they are the experts in the online and offline worlds in which they live in today. Associating this with negativity and violence is only highlighting one part of this journey and risks compounding the perspectives within society that teenagers are inherently bad.  

Adolescents are not the problem; negative behaviours that may present within young people are a symptom of a much bigger cause within society and how young men and boys are viewed. 

If the storyline is then explored, it is extreme in both context and outcomes. Murders like this are rare, although not unheard of, such as the tragic story of 15-year-old Elianne Andam, who was murdered by a 17-year-old boy in 2023. This type of sensationalism in TV storylines may state that it is geared around raising awareness, however it may be doing more harm than good. This extreme act of violence, linked to online bullying, Incel grooming and the impact of the manosphere risks demonising boys as a gender to be feared.  

However, these issues form only part of a complex world that young men and boys are negotiating in society today. Programmes like this do highlight serious issues within society, that are not going away. This can be evidenced in the 2021 Ofsted report into sexual harassment in schools and the Everyone’s Invited website that has received over 50,000 testimonials of sexual harassment since its inception in 2020.  Figures show that harmful sexual behaviour among under-18s in the UK is increasing. It is evident this problem is not going away. Yet we have to question is this type of sensationalist, extreme story helpful? 

These programmes risk detracting from other issues that surround sexual harassment and harmful sexual behaviour carried out by boys against girls that do not appear as extreme. These issues need addressing in a safe environment where young people of all genders can explore the issues that surround them. One key factor that shuts down this vital and difficult conversation is blame. The issues of misogyny and violence against women and children carried out by men and boys are evident yet conversations and communication needs to happen – and a blame culture shuts this down. 

When considering Incel culture, society needs to take a step back and recognise that many of those that engage in this online discourse often talk about loneliness, depression, self-harm and suicide. There is an intersectionality of issues at play with many young men and boys being pushed down a rabbit hole by online algorithms when they are searching for support and answers.  

Whilst this programme has brought a vital discussion out into the open it also risks detracting from the support that young men and boys need – alongside that of other genders. Showing this in schools needs careful consideration. With adequate wrap around lessons, discussions and aftercare. This cannot just be shown to children and young people without this – to help them explore the issues that it raises. However, whilst work in schools around this may be useful to start important conversations it is not the solution to the complex and endemic issues that surround young men and boys. Another aspect to consider is that the cast are not incredibly ethnically diverse, and appear to be, in the main, heterosexual. This then begs the question whether showing this to all young people will have an impact if they cannot see themselves in the cast or relate to the issues on a personal level. 

To think this will solve issues, just by watching a programme, is at the very least naïve.   

One distinct voice that is missing from the current discussions about this programme is that of young people.  

How is it known that young people think that showing this in schools will be useful? What do they think about it?  

And what more can wider society do to support them in the complex online and offline worlds that they live in? 

It begs the question, has anybody thought to ask them? 

Five Years After the First Lockdown: Our Failure to Prevent Domestic Violence

By Kasia Uzieblo, PhD

Over the past few weeks, the media has reflected extensively on the first COVID-19 lockdown, five years ago this month. We have heard stories about the impact on healthcare, the economy, and the mental well-being of the population. What largely remained undiscussed, however, was the effect of the lockdown on domestic violence.

During the lockdowns society, policymakers, and support services were rightly concerned about the safety of children and adults in unsafe home environments. This was reflected in a significant increase in calls to helplines about child abuse and partner violence. The message was clear at the time: for many who were not safe at home, lockdown meant confinement in dangerous conditions.

The pandemic did not cause domestic violence, but the crisis did make this abuse more visible. For some families, lockdown situations even intensified or worsened the violence. The pressure of financial uncertainty, the loss of social oversight, and the lack of escape options allowed existing tensions to escalate. In that sense, the pandemic not only exposed existing vulnerabilities but also accelerated them.

Five years later, the question arises: where do we stand in the prevention of domestic violence? Notably, the number of calls to helplines about child abuse and partner violence has remained relatively stable since then. This is positive in the sense that victims and bystanders continue to find the helpline. However, it also means that domestic violence remains a persistent problem that is not going away. Are we doing enough to thoroughly address this issue?

Since the lockdowns, support services for domestic violence have certainly expanded. For example, helplines such as the Flemish Helpline 1712, have become more accessible, with increased availability and a stronger integration of the chat service, which is particularly crucial for minors. Additionally, the “Safe Homes” in Belgium (Veilig Huizen) have been strengthened in both capacity and functioning. These initiatives are commendable and essential, but the question we must dare to ask is whether we are sufficiently committed to actually preventing this type of violence. These initiatives mainly target situations in which violent behavior has already occurred and there are already victims. Prevention, however, is broader and should focus equally – if not more – on preventing violence altogether, by intervening before violence occurs and structurally addressing the circumstances that give rise to it.

Broader prevention requires addressing the structural risk factors that enable or facilitate such violence. This means investing in poverty reduction, accessible mental healthcare, reducing stress in families, supporting parenting skills, promoting gender equality, tackling excessive alcohol and drug use, and breaking cycles of violence that are passed down through generations. Teaching people to deal with their own frustrations, fears, and anger, as well as helping them develop constructive ways to solve everyday problems, are also essential to preventing violence. Prevention also implies being attentive to signs of potential violence, including subtle patterns of control, humiliation, or neglect. This list is far from exhaustive, but it illustrates both the complexity of preventing domestic violence and the need for an intersectoral approach.

However, many of these areas are under significant pressure in 2025. Families are struggling with increasing financial insecurity, waiting lists in mental health care remain painfully long, and concerns about alcohol use are often downplayed. Meanwhile, initiatives around sexual education, teaching social skills, and dealing with emotions in schools face limitations in time and resources, and even provoke protests. As a result, there is a growing tendency to place these responsibilities fully back on parents, which is understandable from both a policy and societal standpoint. But if those parents themselves are struggling with these topics or do not see their importance, a problem arises that continues to repeat itself across generations. Additionally, many professionals face daily challenges such as lack of time, staff shortages, and administrative overload, which means that in education, childcare, and social services, there is still too little room to focus on early detection, let alone preventive support. In such circumstances, prevention risks being reduced to a noble intention, when in reality it should be an absolute priority.

Broader trends, both online and offline, also raise major concerns. Young people increasingly appear to incite one another to violence against peers, film these attacks, and share them for “likes.” Some even become entangled in online circles that encourage them to create and distribute extremely violent videos, sometimes with family members as victims. On social media, misogyny runs rampant, and violence against women is trivialized or even glorified (as evidenced in the recent activities of Andrew Tate). Additionally, online communication is becoming increasingly polarized, with numerous demographics becoming targets of hate, exclusion, and violence. World and local leaders alike have too often reinforced these trends.

We need to problematize these developments: they normalize harmful ideologies and undermine years of progress in gender equality and violence prevention. António Guterres, the Secretary-General of the United Nations, also warns against these trends and emphatically states that the “poison of patriarchy” is back “with a vengeance.” When this was discussed on the Belgian program *De Afspraak* (March 17, 2025), several participants reflexively claimed that this is a distant issue and that things are not so bad here – a response that risks minimizing structural problems and blinding us to similar trends within our own country.

Five years after the pandemic, we must be honest: we have not found structural solutions for domestic violence, nor more broadly for violence in our society. We continue to mainly react to violence that has already occurred, while prevention is systematically pushed to the background. Worse still, we are not only failing to prevent domestic violence – we seem to be drifting ever further from the structural approach that is urgently needed. Some may see this as a bleak view of the world, but those who witness the impact of violence on people every day, and how long that impact endures, cannot help but feel frustrated. If we truly want children and adults to live safely and to realize their right to a healthy, violence-free existence, the clock is ticking. We have very little time left to change the course of this ship before the consequences of our failure become irreversible for future generations.

Roadmap to Talking about Perpetration Prevention

By, Jannine Hebert, Ryan Shields, Joan Tabachnick and Judith Zatkin

How we talk about our work has a huge impact on how our friends, family, community and society react. Recent shifts in our organization, such as the name change of ATSA to the Association for the Prevention and Treatment of Sexual Abuse, provide new opportunities to talk about our work. It is now more important than ever to navigate these conversations effectively and foster meaningful connections both within and outside of our field.     

To create guidance for how to answer the question, “What do you do for work” and to help navigate the opportunities offered by ATSA’s new name, ATSA’s Prevention Committee released a new “Roadmap to Talking about Perpetration Prevention.”    

The Roadmap argues that it is essential for ATSA members to lead with our values.  So when someone asks, “What do you do for work?” the best response is WHY you do your work.  Even if you work in a secured facility with adults who have committed serious sex offenses, your answer can be: “My work is about preventing sexual abuse.”  At this point you probably have their attention, and you can add, “I want to prevent any further victimization and help to create a safer community for everyone.” 

In a deeper conversation and if you feel they want to know more, you can add in HOW you do your work, as well.  In this case, it is so important to use person-first language and not be afraid to acknowledge how challenging your work can be.  For example, you can say: “I do the difficult job of working with the children, adolescents and/or adults who cause the harm.”  Be sure to share your stories of success. Let your audience know that people can learn to live safely again in their communities and that you have seen what it takes to make that happen. 

There has also been a shift in the public understanding of who engages in sexual violence.  Instead of the “dirty old man lurking at the edge of the playground” or “predators luring kids on social media apps”, for the first time parents are beginning to say, “This could be my son.”  This shift in public understanding is an opportunity for ATSA members to get involved in these conversations in new ways. 

By sharing your values, why you do your work, and by sharing stories of hope, you can avoid the chill in the room that can often follow a statement like, “I work with adult or juvenile sex offenders”. This Roadmap offers you a more detailed overview and examples about how to frame your work, such as:

1.      Talking about your work and sexual abuse with a wider circle of people you know

2.      Creating new partnerships or alliances – people in the victim advocacy world need your support more than ever

3.      Sharing your expertise in your communities

The Roadmap also explores how the change in our name to include both prevention AND treatment means that we are pulling our attention towards primary prevention – how to prevent sexual abuse BEFORE anyone is harmed.  To be clear, treatment is prevention and occurs AFTER someone is harmed. 

ATSA members have a unique lens into primary prevention because to truly prevent sexual abuse, we need to prevent the perpetration of abuse.  ATSA members know more about what to look for in a person who may be at risk to sexually abuse.  Given your work, you know how to talk with someone about boundaries and consent.  You know how to encourage a strong role for families and friends, whether it is about confronting and naming behaviors in someone they love or simply being curious about how someone is acting with a child or adolescent or a vulnerable adult.  If this does not seem true to you, think about the last time you saw a movie or a TV show with sexual abuse and you probably saw that plot line coming before anyone else in your social circles.  You are just tuned into these stories so much more than the general public.  So, trust your expertise!  

Your stories of success and hope are needed more than ever.  We hope the Roadmap offers some assistance as you communicate about your important work.

 

Multi-systemic responses and understanding to the prevention and intervention of harmful sexual behaviour in autistic children and young people.

By David Russell, PGc, Kieran McCartan, PhD, & Sophie King-Hill, PhD  

The field of sexual abuse and harmful sexual behaviour is broad, with many different behaviours, offences, and types of individuals displaying these behaviours. Most of the research over the years has focused on neurotypical adult men, and to a lesser degree boys between the ages of 13-18. Very little has focused upon children and young people of all genders who are neurodiverse. Research and practice have focused on understanding the many psychological and personality motivators for why men and boys commit sexual harm; but this is quite limiting, as sexual harm is a complicated field and as such we need to move beyond just individual motivations. Sexual harm is a community and social issue committed by individuals against one another, therefore we need to understand the role of interpersonal dynamics, community relations and society norms as well as understanding individual motivations.

 

Over the last 20 years, an understanding has grown, with the introduction of public health as well as health and wellbeing approaches to understanding criminogenic behaviour (Epidemiological criminology – EpiCrim), but specifically to sexual abuse and harmful sexual behaviours in children and young people. The theory, policy, and practice literature on EpiCrim approaches is quite rich, although the data is limited and underdeveloped. Fortunately, this is starting to change with more regional, national, and global money being invested into public health approaches to understanding sexual abuse (Prevent to protect through support (2PS)).

 

A public health approach argues that society looks at sexual harm across different population levels (individual, interpersonal, community, and societal) and that in doing so we can look to prevent first time offending (primary and secondary prevention) or re-offending (tertiary and quaternary prevention) across these population. Taking a health-based approach means that you can work effectively with criminal justice populations in in a holistic, reflective, trauma informed and multi-disciplinary way. EpiCrim approaches to sexual abuse prevention are in their early days and really focused on certain populations (I.e., adult men and boys between 13-18) and certain areas (i.e. reducing reoffending, population education on sexual abuse, treatment/rehabilitation, community integration and risk management post release), but we need to expand the field to understand all forms of sexual abuse better. 

 

Over the last 20 years there has also been an increased focus on neurodiversity, with a growing recognition that people in the criminal justice system, of all ages and genders, are more neurodiverse that the general population or ADHD (Criminal Justice joint inspectorate); but again, this has focused on adults. Recent research highlights that much of the child sexual abuse is harmful sexual behaviour amongst children and young people, which means that we need to understand this population better (King-Hill & McCartan).

 

While there has been research into harmful sexual behaviour, neurotypicality, autism and sexual abuse it has focused mainly the individual and tertiary prevention, meaning that the full range of the EpiCrim framework is not being utilized and that we are focusing on individual motivations, risk management, and preventing reoffending. Research, policy and practice need to address all the levels of the socio-ecological model, especially the interpersonal, community and societal aspects to upskill people’s understanding of neurodiversity and the behaviours associated with it through the development of better primary prevention initiatives (i.e., school and community based messaging and educational programmes), so that secondary prevention initiatives can be developed and rolled out (i.e., working with autistic children and young people to prevent first time or low level sexual harm) and that more effective quaternary prevention initiatives can be strengthened (i.e., improved community integration and pro-social engagement post-conviction to reduce risk for future harm). 

 

The authors propose the model below that considers the four domains and relates these specifically to autistic children and young people and the considerations that are required when harmful sexual behaviour is being displayed in this cohort. 

 

 

 

With the work being done in the prevention of sexual abuse sphere, and the UK Labour government’s commitment to reducing violence against women and children as well as child sexual abuse, this is the perfect time for framing of the how we understand working with neuro-atypical children and young people, particularly those with autism, to prevent and reduce sexual harm.