Management of sexually inappropriate behaviours in men with learning disabilities

Abstract

Care professionals were interviewed regarding the extent, nature and victims of inappropriate sexual behaviour of 46 men with learning disabilities, and an adapted form of a version of the Structured Anchored Clinical Judgement risk assessment protocol (SACJ-Min: Hanson and Thornton, 2000) was completed for each. Risk judgements were unrelated to objective risk, as assessed by the SACJ-Min, to seriousness or frequency of sexual offending, to treatment outcome, or to a wide variety of other factors examined. The variables most strongly associated with risk judgements were the presence of a child victim and criminal convictions for inappropriate sexual behaviour, both of which, paradoxically, were perceived to decrease the risk of reoffending. Respondents were confident that existing management arrangements were effective in decreasing the risk of reoffending, and that the more intensely clients were supervised, the greater was the decrease in risk. However, level of supervision was unrelated to objective risk, as assessed by the SACJ-Min, to seriousness or frequency of sexual offending, to identity of the victims targeted, or to a wide variety of other factors examined. A few variables were found to be associated with supervision level, but in every case these differences are most plausibly understood as consequences of supervision, rather than causes. The results suggest that the management of sexually inappropriate behaviour in men with learning disabilities has little if any rational basis.