Developmentally Disabled Sex Offenders

The term developmental disability (DD) when applied to sex offenders is largely synonymous with the terms intellectual disability, mental retardation, and learning disability. These descriptors are used to refer to sex offenders who have IQ scores below 70 and who display concurrent deficits in adaptive behavior. There are particular challenges in the service delivery, assessment, and treatment of sex offenders with DD.

It wasn't too long ago that this group was labeled “feebleminded imbeciles” and thought to be unbeatable. As such, little attempt was made to provide them with even basic human rights, let alone understand their abilities, disabilities, or behavior. Through a change in professional and societal views, the knowledge base regarding sexual offenders with DD has grown extensively in the last 25 years. Clinical efforts initially worked on adapting the approaches used with mainstream offenders, often with limited success.

In the past 10 years, the clinical and research focus has moved to the development and evaluation of specific assessment and intervention approaches for individuals with DD. This approach has yielded a plethora of theoretical, clinical, and ethical advancements in the treatment of sex offenders with DD.

When working with individuals with DD it is important to identify their strengths and developmental [Page 185]challenges in order to provide successful assessment and intervention. Individuals with DD display a range of information-processing deficits. These may include difficulties with attention, memory, and language comprehension. Cognitive and language deficits should be comprehensively assessed and incorporated into individualized assessment and treatment strategies. This may limit the use of complex language and self-report questionnaires and increase the need for multimodal presentation of information (i.e., pictorial or visual presentation). In addition, a comprehensive assessment should include information regarding personal history, social history, psychiatric history, offending history, coping strategies, and cognitions.

A range of treatment approaches have been utilized with DD sexual offenders. There is very little research evidence for the efficacy of psychopharmacology approaches. Behavioral approaches have been used to teach self-control techniques, improve social/sexual skills, and decrease inappropriate arousal. Cognitive-behavioral approaches have received the most empirical validation. These approaches apply behavioral methods in conjunction with challenging cognitive distortions regarding the offense (e.g., minimization or denial). This work is tailored from the relapse prevention literature and has been developed specifically for DD offenders. There is some evidence that treatment programs of greater than 1 year duration are better at reducing recidivism than shorter programs.

A range of etiological models have been developed to help explain sexual offending in this population. They include impulsivity models, sexual abuse theories, deviant sexual interests and arousal patterns, lack of sexual knowledge, and poor social skills.