Cognitive-behavioural treatment of children with sexual behaviour problems can have long-term beneficial impact.(Sex Research Update)

There has been a growing focus in recent years by the juvenile justice, child welfare, and mental health systems on aggressive, victimizing, or very inappropriate sexual behaviour by preadolescent children which is usually directed at same age peers or younger children. Sexual behaviour problems (SBP) among children are increasingly perceived as a progressive behaviour pattern that leads to adolescent and adult sexual offences. Although retrospective studies have indicated that up to half of adult sex offenders report a childhood onset of sexually abusive behaviours, retrospective data do not accurately indicate the prospective risk that a child with SBP will progress to adolescent or adult sexual offending. In addition, no prior published research has followed children with SBP and measured their risk for future sexual offending. Nevertheless, as Carpentier, Silovsky, and Chaffin (2006) point out in the introduction to their ten-year follow-up study of children with SBP, social/legal policy increasingly assumes that childhood SBP are difficult to modify and that such children pose a disproportionately high risk for sexual offending in the future.

 
   Because preadolescent children as young as 
   9 years old or occasionally younger are 
   adjudicated as delinquent for sex crimes, 
   some states include these children on lifetime 
   public sex offender registries and Internet 
   sites, and federal legislation has been 
   proposed and passed in the U.S. House of 
   Representatives that would mandate 
   including all adjudicated children with SBP 
   on lifetime public Internet sex offender 
   registries (p. 482). 

Carpentier, Silovsky, and Chaffin (2006) conducted a randomized trial study in a southern U.S. state that tracked children with SBP prospectively for sexual abuse perpetration, other sexual offences, and nonsexual offences using child welfare, juvenile justice, and adult criminal justice surveillance systems. The study compared three different groups of children; two with SBP, one that received Cognitive Behavioural Treatment (CBT) specifically for SBP and another that received non-specific Play Therapy (PT), and an additional comparison group of children without SBP but who had attention deficit disorder, adjustment disorder, or oppositional defiant disorder. The sample consisted of 135 children aged 5 to 12 with SBP who were randomly selected to receive either the CBT or PT and 156 who served as the control group. Just over 60% of the children in the SBP groups were male. All participants were recruited into the study between 1992 and 1995 and post-baseline reports were drawn from the appropriate data bases in 2005. Children in the CBT group received a structured 12-session intervention that addressed topics including identifying inappropriate sexual behaviour, learning concrete sexual behaviour ...