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.
