Douglas Hugh Russell

The management and treatment of harmful sexual behaviors (HSBs) in autistic adolescents is a complex area of research and clinical practice. Autistic adolescents face unique challenges in understanding social and sexual interactions, putting them at a higher risk of engaging in HSBs. Existing research on interventions for HSBs among autistic adults is growing, but evidence for adolescents is not well understood. Thus, understanding the effectiveness of interventions targeting HSBs in autistic adolescents is crucial. We conducted a rapid evidence assessment to review peer-reviewed research on the effectiveness of interventions for autistic adolescents at risk of or engaging in HSBs. In all, 12 studies met the criteria for review. Inclusion criteria required articles to be published in a peer-reviewed journal, be related to HSB prevention and intervention in adolescents aged 12 to 18 with autism spectrum disorder, be written in English, and include original data. Six databases were used, and we screened the titles and abstracts of 34 studies. The reviewed studies described cognitive-behavioral therapy, pharmacological interventions, family involvement, and multidisciplinary team approaches in addressing HSBs. However, the literature has significant limitations and we suggest that the literature is not robust enough to indicate a promising evidence-based approach for interventions for autistic adolescents who are at risk of or who display and engage in HSBs, and the findings are not transferable to practice. Additional research is required to better prepare healthcare professionals for addressing HSBs in autistic adolescents.

Child sexual abuse prevention strategies typically focus on teaching children ‘protective behaviours’, including telling a ‘trusted adult’. However, disclosure rates are low, and we know little about who they tell. We analysed data from over 3400 young people aged 10–18. After viewing hypothetical unsafe scenarios involving either an adult or peer, participants were asked whether – and whom – they would tell someone if such a situation occurred. Most (83.9 per cent) said they would tell someone about concerns involving an adult; fewer (79.3 per cent) would tell if they encountered an unsafe situation with a peer. Across adult and peer scenarios, participants were most likely to say they would approach their mother (about concerning behaviour of an adult, 68.7 per cent; or a peer, 63.1 per cent), a friend (64.4; 57.9 per cent) or their father (52.2; 48.9 per cent). Those most likely to tell a friend were girls and older children. Children in out‐of‐home care and community welfare organisations were less likely to tell someone about concerning behaviour from a peer/friend than in other organisational contexts. Although organisations must train staff in supporting young people who raise concerns or make disclosures, it is vital to consider the role of parents and other young people in hearing about concerns and building their capacity to respond appropriately.