Sexual offending and autism spectrum disorders
| DOI | https://doi.org/10.1108/JIDOB-09-2015-0029 |
| Date | 14 March 2016 |
| Pages | 35-51 |
| Published date | 14 March 2016 |
| Subject Matter | Health & social care,Learning & intellectual disabilities,Offending behaviour |
Sexual offending and autism spectrum
disorders
Clare Sarah Allely and Ann Creaby-Attwood
Clare Sarah Allely is based at
Department of Psychology,
School of Health Sciences,
University of Salford, Salford,
UK and Gillberg
Neuropsychiatry Centre,
Sahlgrenska Academy,
University of Gothenburg,
Gothenburg, Sweden.
Ann Creaby-Attwood is based
at Department of Law,
Northumbria University,
Newcastle upon Tyne, UK.
Abstract
Purpose –Studies have found innate vulnerabilities which potentially may increase the risk of an individual
with autism spectrum disorders (ASD) finding themselves involved with the criminal justice system as a result
of being charged with a sexual offence. The purpose of this paper is to evaluate the literature which has
explored sexual offending in individuals with ASD.
Design/methodology/approach –A systematic PRISMA review (PRISMA, Preferred Reporting Items for
Systematic Reviews and Meta-Analyses) was conducted using internet-based bibliographic databases
(PsycINFO, MEDLINE, Psychology and Behavioural Sciences Collection and PsycARTICLES) in order to
access studies which investigated to any degree the association between ASD and sexual offending.
Findings –Only a small number of case reports (n ¼7) on sexual offending in individuals with ASD and a
small number of prevalence studies (n ¼7) were identified.
Research limitations/implications –Research is urgently required to identify the specific requirements
and needs of sexual offenders with ASD in order to inform an appropriate treatment strategy for successful
outcomes.
Originality/value –Relatively few studies and reviews have investigated the area of ASD and sexual
offending specifically.
Keywords Sexual offending, Sexual offences, ASD, Autism spectrum disorder, Asperger, AS
Paper type Literature Review
1. Introduction
The Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V) now includes the
new name of Autism Spectrum Disorder (ASD) to encompass four previously separate disorders:
autistic disorder (autism), Asperger’s syndrome (AS) disorder, childhood disintegrative disorder
and pervasive developmental disorder not otherwise specified (PDD-NOS) (DSM-V, American
Psychiatric Association, 2013). ASDs are typically characterised by impairments in social
reciprocal interactions and communication and restricted, repetitive pattern of interests and
behaviour (American Psychiatric Association (APA), 2000, 2013). The “true”extent of ASD
prevalence is still unknown (Fernell et al., 2012). However, it is considered to be present in at least
1 per cent of the general population (Simonoff, 2012).
1.1. Background
Mawson et al. (1985) were the first to report a case where there was an association between
AS and violent crime. Only a few years later, Baron-Cohen (1988) reported the case
of a 21-year old man who had a history of recurrent violence towards his 71-year old
girlfriend. However, a review highlighted that individuals with AS are no more likely to
Received 9 September 2015
Revised 10 November 2015
Accepted 29 November 2015
Conflicts of Interest: the author(s)
have no conflicts of interest to
declare.
Funding: this project was not
funded.
DOI 10.1108/JIDOB-09-2015-0029 VOL. 7 NO. 1 2016, pp.35-51, © Emerald Group Publishing Limited, ISSN 2050-8824
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JOURNAL OF INTELLECTUAL DISABILITIES AND OFFENDING BEHAVIOUR
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PAGE35
commit violent crime compared to the general population (Ghaziuddin et al., 1991). That
individuals with ASD are not at increased risk of offending has been found by more recent studies
(Woodbury-Smith et al., 2006; Mouridsen, 2012). Individuals with ASD may actually be less likely
to commit violent crime (Mouridsen et al., 2008) and the large majority of individuals with ASD are
law-abiding (Murrie et al., 2002; Woodbury-Smith et al., 2006). In their systematic review on the
literature looking at ASD in the criminal justice system, King and Murphy (2014) concluded that
there is no evidence to support the theory that individuals with ASD are disproportionately over-
represented in the criminal justice system. The studies reviewed also revealed the variety of
crimes committed by individuals with ASD and, importantly, the predisposing factors involved.
They highlighted the sparse evidence in support of the frequently maintained over-representation
of individuals with ASD committing particular types of offending behaviour. King and Murphy
(2014) suggest that more research is carried out using population samples which are
representative of everyone with a diagnosis of ASD. The fact that many of the studies looking
at sexual offending and ASD involved case studies does emphasise the need for more empirical
research in this area.
A few papers have reported cases where an individual with ASD has engaged in a sexual
offence or inappropriate sexual behaviour. Inappropriate behaviours can include anything
from giving a stranger a kiss (Clements and Zarowska, 2000), intruding on the personal
space of an individual that they are infatuated with (Green et al., 2000; Howlin, 1997; Katz and
Zemishlany, 2006), to inappropriate acts of masturbating (e.g. masturbating in a public
place) (Haracopos and Pendersen, 1992; Ray et al., 2004). Some studies have also
reported cases of individuals with ASD who have become sexually violent (Fujikawa et al., 2002;
Kohn et al., 1998; Murrie et al., 2002). However, while some studies indicate that individuals
with ASDs are no more likely to commit violent crime compared to the general population, there
are some studies which have suggested that it is important to recognise that in individuals
with ASD impairments in the social domain coupled with a desire for attachment or sexual
relations may subsequently lead to sexual offending behaviour (Murrie et al., 2002). Increased
understanding of these ASD impairments are important for informing appropriate treatments.
Increased understanding of these issues faced by some individuals with ASD is also crucial if we
are to avoid unjust harsh sentencing (Freckelton, 2013) such as in the case of Jacob Fisher in
Nebraska who received a prison sentence (20-60 months) for stealing underwear from a
neighbour (WOWT News, 2011). The purpose of the present review is to evaluate the literature
which has explored sexua l offending in individua ls with ASD in order to invest igate
whether studies have found innate vulnerabilities which potentially may increase the risk of an
individual with ASD finding themselves involved with the criminal justice system as a result of
being charged with a sexual offence. Sexual offending or sexual offences covers a variety
of criminal offenses including rape, unlawful sexual intercourse indecent assault, indecent
exposure and gross indecency with a minor. This review will look at studies across this range
of sexual offending behaviours.
2. Method
Internet-based bibliographic databases (PsycINFO, MEDLINE, Psychology and Behavioural
Sciences Collection and PsycARTICLES) were searched in order to access studies which
investigated to any degree the association between ASD and sexual offending. The flowchart
below outlines the process of eliminating non-relevant papers (following PRISMA guidelines,
Liberati et al., 2009) (see Figure 1). The search included all publications dated between 2002 and
2015. Duplicates were excluded prior to the retrieval of references. Searches on all four
databases were originally conducted on 30 April 2015. The following search criteria were entered
into the four databases: [ASD OR autis* OR asperger*] AND [“sex* offend*”OR pornography OR
indecent assault OR rape OR voyeurism].
In addition to these database searches, numerous permutations of ASD and sexual offending
were entered into Google Scholar and thoroughly searched for articles which were not identified
through the database searches, for instance, (ASD AND sexual offence); (autism AND sex
offending); (ASD AND sexual assault). These searches only returned 13 additional potentially
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