Recommendations for research

The guideline committee has made the following recommendations for research.

1 Long-term outcomes for children and young people displaying harmful sexual behaviour

What are the long-term outcomes for children and young people displaying harmful sexual behaviour, when should practitioners intervene and what potentially modifiable factors have the most important impact?

Why this is important

Longitudinal evidence spanning the life-course of children and young people who display harmful sexual behaviour is needed to understand when to intervene. This is particularly true for children and young people whose sexual behaviour does not warrant an intervention from harmful sexual behaviour services or the criminal justice system.

There is a lack of evidence on thresholds for intervening, including evidence on modifiable risk and protective factors that prevent the behaviour escalating. We also need evidence on quality of life measures.

As a result we should be able to avoid mislabelling younger children as 'sexual offenders' and subjecting them to intrusive and stigmatising interventions.

2 Effective interventions for children and young people displaying harmful sexual behaviour

What interventions are effective with children and young people displaying harmful sexual behaviour?

Why this is important

Most of the evidence on interventions is inconclusive. It comes from small clinical populations of adolescent males convicted of sexual offences. More research is needed on the effectiveness of current interventions and to understand how to avoid children and young people who display sexualised behaviour being taken into the criminal justice system. This includes research on:

  • prepubescent children

  • young women

  • children and young people with neurodevelopmental and learning disabilities

  • minority ethnic and migrant communities

  • looked after children (including those in non-family based settings).

  • children and young people in the criminal justice system (community and custody).

Evidence on interventions for looked-after children needs to include those in non-family based settings and in unstable foster care. For this group, there is also a lack of evidence on interventions to promote placement stability and permanence, as well as on interventions specifically relating to harmful sexual behaviour. The former is needed because a stable home life may help reduce the risk of harmful sexual behaviour.

Evidence of effective interventions could help target resources more effectively and ensure programmes are tailored to meet children and young people's differing needs.

3 Effective interventions for the families and carers of children and young people displaying harmful sexual behaviour

What type of therapeutic interventions are effective when working with the family and carers of children and young people who display harmful sexual behaviour?

Why this is important

Evidence on effective interventions for families and carers of children and young people who display harmful sexual behaviour is equivocal. Evidence of effectiveness for the 2 most common approaches – cognitive behavioural therapy and multisystemic therapy – and other therapies is very limited. Further research is needed to help practitioners tailor interventions according to need.

4 Early interventions to prevent problems escalating

What interventions are effective in diverting children and young people away from further harmful sexual behaviour before a legal response is needed?

Why this is important

There is a need for more evidence on what is effective in diverting children and young people away from further harmful sexual behaviour at the earliest stages of its development. Research is needed on missed opportunities to intervene and what the trajectory has been for those children and young people who were missed. Such evidence could help ensure children and young people receive timely support to prevent an escalation of the behaviour.

5 Assessment models for different groups of children and young people

How effective are the models currently used for assessing the needs of, and level of risk for, children and young people from different population groups who display harmful sexual behaviour?

Why this is important

Assessment is at the heart of effective intervention planning and risk management. Without good assessment models, levels of risk may be misclassified. To date, risk assessment tools have mainly been used on small clinical populations of adolescent males who have sexually offended and there is a need for assessment tools for other groups of children and young people. Assessment results are also a basis for needs assessment and decisions about therapeutic interventions, treatment placements and care plans.

For those in the criminal justice system, an assessment provides a clear guide to sentencing and multiagency management (for example, multi-agency public protection arrangements).

Lack of evidence on current assessment models means that we know little about:

  • problems caused by mislabelling a child or young person

  • impact of the assessment process on the child and young person and their families and carers

  • treatment outcomes.

6 Electronic media

How does the use of electronic media affect harmful sexual behaviour?

Why this is important

The reasons behind the growth in online grooming, the viewing of online pornography, and the making and distributing of sexual images is poorly understood. There have been few studies into the links between aggressive behaviour, sexual offending and the use of electronic media.

Longitudinal studies are needed to understand the impact electronic media has on sexual behaviour and on the general values, attitudes, beliefs and behaviour of children and young people. Research is also needed on its long-term impact on children and young people's social and psychological development. Such research could provide evidence on how best to assess, intervene and manage the risks associated with the use of electronic media in this area.

  • National Institute for Health and Care Excellence (NICE)