Moore Center Sex Abuse Symposium: Part Two: Effective Public Health Prevention And Juvenile Sex Offender Registration

In case you missed the other parts for this series, please see part one, three, four, or five.

As a refresher...

So, What Is This Symposium?

The Moore Center Symposium is a "meeting of the minds" on the prevention of child sexual abuse. It offers professionals (and advocates) an opportunity to learn more about the issue of child sexual abuse and how it can be prevented. The Moore Center for the Prevention of Child Sexual Abuse is a subset of Johns Hopkins' Bloomberg School of Public Health, which is a major educational institution in Maryland that is well-known for its work in the public health sector (as its name should indicate). The Moore Center is currently being directed by Dr. Elizabeth Letourneau, who used to be the president of The Association for the Treatment of Sexual Abusers (ATSA), and is a researcher that studies a myriad of topics within the realm of sexual abuse prevention. I am watching these admittedly dry and boring speeches to pull the essential parts out and communicate them to you. If you want to view them yourself, by all means, just be forewarned that they are dry and can be triggering.

Beginning Introductions

The symposium starts with an introduction by Johns Hopkins' President, Ronald Daniels, regarding some of the reasons for the symposium and the keynote speaker at the symposium, Patrick McCarthy, who is the president and CEO of the Annie E. Casey Foundation, an organization that focuses on improving the lives of children in a variety of ways.  Other speakers at the symposium were Dr. Elizabeth Letourneau, Dr. Bruce Taylor (an expert in criminology), and Jill Levenson (expert in sociology and social work), followed by a showing of the film Untouchable, which I have talked about on this blog before. Following the film, there is a panel discussion about the film and closing remarks by Stephen and Julia Moore, the founding donors of the Moore Center.

Copyright note: The images of this post are copyrighted to Johns Hopkins University, which I have emailed approval for.


Elizabeth Letourneau's Speech

Dr. Letourneau's speech starts with acknowledgements and a brief discussion of prior symposiums. The topic of her speech, as with Patrick's, was to focus on policy's impact on prevention. Her speech focuses on juvenile sex offender registration and notification policies. She starts by looking at how someone would ordinarily solve a problem using a public health approach. First, you would do "surveillance" to determine what the problem is, then you would do "risk factor identification" to determine the cause of the problem, then "intervention evaluation" of what works to solve the problem, and finally, you would "implement" or take action to solve the problem. In that order, of course.

She points out that many issues have been resolved using this model, such as violence, environmental issues, infectious diseases, etc... yet child sexual abuse does not use this model. Instead, policy reactions to child sexual abuse are focused around the idea that abusers are sexually and morally deviant and at high risk to abuse the rest of their lives. She counters this notion with an incomplete list of causes for harmful sexual behavior in juveniles:

1. Traumatized children reacting to their own abuse
2. Persistently delinquent teenagers
3. Otherwise normal adolescents acting experimentally but irresponsibly
4. Generally aggressive and violent youth
5. Immature and impulsive youth
6. Adolescents engaging in normal but illegal consenting sex
7. Youth who take what they want because they are indifferent to others
8. Youth imitating what they see in the media
9. Youth misinterpreting what they thought was mutual interest
10. Youth ignorant of the legality of their actions or the possible ramifications
11. Youth imitating what is normal in their family background
12. Youth who get a thrill out of violating the rules
13. Socially isolated youth who use younger children as substitutes for peers
14. Seriously mentally ill youth
15. Youth responding to peer pressure
16. Youth preoccupied with sex
17. Youth using drugs or alcohol
18. Youth who get swept away by a moment of sexual pleasure
19. Youth with sexual deviance problems

She also points out that sexual crimes committed by juveniles have less duration and severity than adult offenses, and that juveniles are highly responsive to evidence-based treatment. She points out the findings of a study done in 2016 (Quantifying the Decline in Juvenile Sexual Recidivism Rates, Michael F Caldwell, full text available). That study looked at 106 studies and 11,000 cases and found that the general recidivism rate for juvenile sex offenders from 1980-1995 was 34.47% and the sexual recidivism rate for that period was 10.3%. Contrasted to the period of 2000-2010, which found a 30% general recidivism rate and a 2.75% sexual recidivism rate, Dr. Letourneau highlights that recidivism rates have declined, and that 97% of juvenile sex offenders will not reoffend with a new sexual offense.

She points out that sexual recidivism among juvenile abusers almost never happens once a child has been caught. She also cites a study she and her colleagues did sampling all of the juvenile offenders in Maryland, Oregon, and South Carolina who were in the legal system and they have the same findings as the above study: 3% reoffend sexually. She highlights this as a single example for the plethora of other studies with similar findings on the subject.

She discusses the restrictions placed on juveniles, such as residential treatment programs, sex offender registration, public notification, residence restrictions, employment restrictions, and education restrictions. She states that 38 states subject children adjudicated as minors to sex offender registration, and all minors adjudicated as adults. She gives the example from a juvenile offender featured in a New York Times article. That offender, named Johnnie, was caught at age 11 receiving oral sex from his younger sister. From there, the mother contacted the police, and Johnnie was arrested, charged, and convicted, then sent to a residential treatment program for a year and four months. Then, he was required to register as a sex offender in Delaware and put on their public list: His first suicide attempt was 2 weeks after being publicly listed (just shy of age 13, if you did the math).

They list some of the requirements of sex offender registration to illustrate what it is like:

1. Verify registry information in person at a state or local police station
2. On the offender's birthday, register every 90 days (tier three offenders), 3 months (tier two offenders), or 6 months (tier one offenders).
3. Register in each jurisdiction where someone resides or works.
4. May be handcuffed or put into a cell while waiting for processing
5. A sign may indicate that the offender is at the "Sex Offender Registration Desk"
6. Adult offenders and juvenile offenders may be registered in the same place (children in the same room as adult sex offenders)
7.  Agents that process registration can be in any frame of mind: Angry, sad, happy, etc.
8. Provide 75 separate pieces of information, like SSN, internet identifiers, email address, vehicle registration/description, addresses for residence, work, or school.
9. Must report any change within 3 business days
10. Registration may be distributed online, or released to schools and other child-centered organizations, or law enforcement only, depending on risk level.

Note/Aside: Is this reminding anyone of Nazi, Germany? I never watched many Holocaust movies, and this seems eerily familiar...

She talks about this young man being just one example out of many hundreds, and references a Human Rights Watch report on the subject.

One Study On Juvenile Sex Offender Registration And Notification

Then she overviews a study that she did with the funding and collaboration of several other researchers and organizations, and begins discussing the recent follow-up study she did with the same collaborators to expand on it. The aims of their study were to examine the effects of registration and notification on six domains: Mental health, victimization, feeling of safety, feeling of social support, behavior, and association with peers. The demographics of the participants were discussed: Most were male, and the sample size was between 200 and 300 with an average age of 15.1 years old. Most were attending school, and most were heterosexual.

She discusses characteristics of the offenses, and compared those who were required to register with those who were not and did an analysis to control for any differences between the two groups. Registered offenders were more likely to be older, have a formal charge/adjudication, have a victim, and be caucasian.

The results of their analysis, without and with controlling for demographic differences found a variety of impacts on each of the six domains they were studying. They found that registered offenders were more likely to have mental health issues like suicide attempts/thoughts, depression, anxiety. They also found that registrants were more likely to have been victimized by someone sexually, were less likely to feel safe, and that non-registered offenders felt less social support than registered offenders.

Does Juvenile Sex Offender Registration Work?

She then asks the question, if even with all the collateral consequences of juvenile sex offender registration, does registration still work? Does registration make anyone safer? The research answers with a resounding no: There is no baby in the bathwater of juvenile sex offender registration, and every published study (yes, every one- if you want to challenge Dr. Letourneau's claim, by all means) has found no evidence of preventative or positive effects from juvenile sex offender registration. Many studies, by contrast, have found unintended and even harmful effects on juvenile offenders. She points out that registration has nothing to do with the causes of child sexual abuse and does not fit the realities of adolescence.

She talks about how rare it is in research to find such consistent findings across research literature on a particular policy. She agrees with the findings of Patrick McCarthy in his own mission, and states that juvenile registration is a failed policy that must end. She states three points to support this assertion: That few US policies have such wide research consensus regarding the effectiveness of a policy, that registration is like youth imprisonment where the message is that registered youth are dangerous, feared, and worthless with no real future, and that holding children accountable and providing them with evidence-based treatment can reduce the likelihood of future offending where sex offender registration cannot reduce that likelihood.

She then discusses some of the progress that is being made nationwide towards reforming juvenile sex offender registration: On a federal level, the Attorney General dropped juvenile notification requirements from federal policy and as of last year permits discretion in the registration of juvenile sex offenders; On a state level as of last year, Oregon and Delaware have replaced automatic juvenile registration with discretionary policies; The State Supreme Courts of Ohio and Pennsylvania have ruled against some components of juvenile sex offender registration.

She closes by stating that the time has come to abandon juvenile sex offender registration as a failed policy.

Moore Center Sex Abuse Symposium: Part Three: Adolescent Relationship Abuse/Teen Dating Violence

In case you missed the other parts for this series, please see part one, two, four, or five.

As a refresher...

So, What Is This Symposium?

The Moore Center Symposium is a "meeting of the minds" on the prevention of child sexual abuse. It  offers professionals (and advocates) an opportunity to learn more about the issue of child sexual abuse and how it can be prevented. The Moore Center for the Prevention of Child Sexual Abuse is a subset of Johns Hopkins' Bloomberg School of Public Health, which is a major educational institution in Maryland that is well-known for its work in the public health sector (as its name should indicate). The Moore Center is currently being directed by Dr. Elizabeth Letourneau, who used to be the president of The Association for the Treatment of Sexual Abusers (ATSA), and is a researcher that studies a myriad of topics within the realm of sexual abuse prevention. I am watching these admittedly dry and boring speeches to pull the essential parts out and communicate them to you. If you want to view them yourself, by all means, just be forewarned that they are dry and can be triggering to certain people. 

Beginning Introductions

The symposium starts with an introduction by Johns Hopkins' President, Ronald Daniels, regarding some of the reasons for the symposium and the keynote speaker at the symposium, Patrick McCarthy, who is the president and CEO of the Annie E. Casey Foundation, an organization that focuses on improving the lives of children in a variety of ways.  Other speakers at the symposium were Dr. Elizabeth Letourneau, Dr. Bruce Taylor (an expert in criminology), and Jill Levenson (expert in sociology and social work), followed by a showing of the film Untouchable, which I have talked about on this blog before. Following the film, there is a panel discussion about the film and closing remarks by Stephen and Julia Moore, the founding donors of the Moore Center.

Copyright note: The images in this post are copyright-protected. I waited on this post to get permission directly from Dr. Taylor to use them, so please ask Dr. Taylor if you would like to use them yourself.

Bruce Taylor's Speech

The third speaker, Dr. Taylor, discusses findings from a study he did on teen dating violence (funded by three grants from the United States Department of Justice), also known by researchers as adolescent relationship abuse, which Dr. Taylor uses interchangeably throughout his speech. I will refer to it as ARA. Much of his speech is about interventions into ARA, and the practicalities around what works in teaching children about boundaries and relationships to further primary prevention of this very serious problem. 

As many speakers do, he overviews his study:

As well as what he wants to talk about:

How Serious Is ARA?

He then focuses on how serious of an issue adolescent relationship abuse (ARA) is: According to a national study, 68% of youth between ages 10-18 report being victimized by it, and 62% report perpetrating it. The health consequences for adolescent relationship abuse are very similar to those for child sexual abuse. The full overview of what he discusses about the seriousness of ARA:

He then talks about what sort of classroom interventions he used for his studies. Varying approaches have been tried, but there are barriers to these approaches such as parental and school concerns about letting outside organizations like rape crisis centers into schools. In short, schools are reluctant to let people do any kind of mental health intervention. 

Two Main Approaches

The approaches are broken into two categories, interaction-based curriculum and law/justice curriculum:

Interaction-based curriculum focuses on setting and communicating boundaries, developing friendships and relationships and the continuum of the intimacy of relationships in general, as well as identifying wanted/unwanted behaviors and bystander intervention. Law/justice curriculum focuses on laws, definitions, and facts in general around what sort of consequences that inappropriate behavior can have.

Their findings in Cleveland in attempting both approaches and a control group showed that both approaches changed attitudes, but also increased violence and no change in sexual harassment, which he explained could be because of new awareness around inappropriate behaviors. 

Expanding The Approaches

Based on these findings, they expanded their study with more interventions and specialization to schools in New York City. There were a lot of specifics for how and why they expanded their interventions, and how they specialized their interventions for New York City compared to Cleveland that the average person would ignore. Interested parties can see the video for these specifics. Of note is that interventions cannot wait until a child is 10-13 years old, it must happen earlier because by age 10, children are already facing ARA.

Also of note is that one of the expansions was a building intervention, where children drew simple maps of their school with what areas of the building were safe, unsafe, and in between. They refer to this as "hot spots mapping", and those are used to add school personnel to unsafe areas. The results of this particular intervention were very promising.

Resistance To ARA Interventions

Despite nationwide studies being done by multiple groups (besides Dr. Taylor's) showing the effectiveness of these mental health interventions, there is high resistance to interventions around teen dating violence/ARA. This resistance seems to be in place despite offering incentives, such as free but copyrighted materials. They did not have any major guesses as to why there was resistance to implementing interventions. They wondered if state/national education mandates, time restrictions, and budget cuts might be a factor in the resistance to school-based research and interventions into ARA. 

Moore Center Sex Abuse Symposium: Part One: Juvenile Sex Offender Policies And Effectiveness

In case you missed the other parts for this series, please see part two, three, four, or five.
As a refresher...
So, What Is This Symposium?

The Moore Center Symposium is a "meeting of the minds" on the prevention of child sexual abuse. It offers professionals (and advocates) an opportunity to learn more about the issue of child sexual abuse and how it can be prevented. The Moore Center for the Prevention of Child Sexual Abuse is a subset of Johns Hopkins' Bloomberg School of Public Health, which is a major educational institution in Maryland that is well-known for its work in the public health sector (as its name should indicate). The Moore Center is currently being directed by Dr. Elizabeth Letourneau, who used to be the president of The Association for the Treatment of Sexual Abusers (ATSA), and is a researcher that studies a myriad of topics within the realm of sexual abuse prevention. I am watching these admittedly dry and boring speeches to pull the essential parts out and communicate them to you. If you want to view them yourself, by all means, just be forewarned that they are dry and can be triggering. 

Beginning Introductions

The symposium starts with an introduction by Johns Hopkins' President, Ronald Daniels, regarding some of the reasons for the symposium and the keynote speaker at the symposium, Patrick McCarthy, who is the president and CEO of the Annie E. Casey Foundation, an organization that focuses on improving the lives of children in a variety of ways.  Other speakers at the symposium were Dr. Elizabeth Letourneau, Dr. Bruce Taylor (an expert in criminology), and Jill Levenson (expert in sociology and social work), followed by a showing of the film Untouchable, which I have talked about on this blog before. Following the film, there is a panel discussion about the film and closing remarks by Stephen and Julia Moore, the founding donors of the Moore Center.

Patrick McCarthy's Speech

At the beginning of his speech, Dr. McCarthy observes that before he learned about the Moore Center, almost everything he knew about child sexual abuse was wrong. Yes, this is the guy with a master's and doctorate in social work, and the keynote speaker of a child sexual abuse prevention symposium. He says that there are only three things about child sexual abuse that he still believes, now knowing more of the facts:

• Everyone has been affected by child exual abuse- as a victim or as someone who knows a victim. 
• The pain of child sexual abuse is long-lasting and can be made less significant, but is still present years later.
• Whatever our own experiences, we all want to protect children from sexual abuse.

Policies Not Based In Fact And Ineffective

He suggests (as you have heard me say before) that many of the policies we have around sexual abuse seem to be based in common sense, but are completely wrongheaded and ineffective. The example he cites to support this idea the perception among the public that those who abuse children kidnap them off the street, rather than the factual idea that children are abused by people they know and trust, even adolescents. He says that half of child sexual abuse involves an adolescent with the average age of 14. He states that rather than addressing the facts, we teach stranger danger and fail to take the steps that would be effective in keeping children safe. He says again that the policies we have in place too often make children less safe.

Dehumanizing Abusers

He points out that we throw abusers under the bus, because we treat anyone who engages in any sort of inappropriate sexual behavior as a monster we want to protect our children from. We even treat teenagers and children, some as young as eleven years old, like monsters. He discusses that sex offender registration and community notification can isolate abusers away from support systems, and thus make them more likely to reoffend rather than less likely. 

Public Health Approach Vs. Criminal Justice Approach

One of the points made is that the criminal justice approach to stopping sexual abuse, while this approach must be a part of addressing sexual abuse, is failing because we are not integrating facts and research into these policies. He argues that if we treat sexual abuse as both a public health issue AND as a criminal justice issue, more children could be spared the pain of abuse. 

He suggest several ways in which criminal justice system is failing to protect children and are wrongheaded. The first example he uses is that public policy is based on the idea that offenders cannot change, so policies focus on removing offenders from the community through incarceration and community isolation. At the same time, we focus on changing the behavior of potential victims (attempting to increase reporting, in other words), which he says runs the risk of teaching victims and potential victims that they or their families were responsible for the abuse and are re-victimized by believing they could have stopped it. 

Another example is that public policy is focused on predicting and controlling individual behavior, based in the erroneous principle that we can guess and who will and will not commit a crime. He blasts tools like plethysmographs, polygraphs, and risk assessments as not being based in science, and suggests that we instead view sexual abuse as something that is situational and context-specific, so employing community education techniques can help change how the public views sexual abuse as an issue.

His next example is that juvenile offenders who engage in abusive acts are seen as permanently pathological, or "damaged," requiring lifelong monitoring and "coercive treatment". He suggests that the research supports instead the idea that juvenile offenders are engaging in perfectly normal exploratory and experimental behaviors that have gone off-track. He calls these behaviors harmful but preventable. 

He observes the idea that anyone with a sexual attraction to children is a sociopath, someone with no empathy for the victims and families and no interest in controlling their behavior. By contrast, he suggests that the groundbreaking work being done by Dr. Letourneau in the Help Wanted study is challenging that idea, and showing that youth who have an attraction to children often face barriers to getting help with their attractions, and indeed, a desire to get that help. He illustrates that public policy pushes people away from that help, sometimes at risk of arrest and isolation.

His final example is that public policy is based on the idea of high recidivism among juvenile offenders: That idea, he states, is not supported by research, and indeed, fewer than 5% of juvenile offenders will reoffend, raising the question of whether their crime could have been prevented in the first place. 

Need For Public Policy Advocacy

He says the examples show how far we have to go until the evidence from research and practice informs the policies being made by policymakers. He suggests that there needs to be advocates who can inform policymakers on effective policies. 

A Disaster From 25 Years Ago

His next point regards the predictions of a few big names about 25 years ago about the idea that we would see a rise in super-predators, or those with horrifying behaviors that developed during the predator's youth. The policies that were formed in reaction to this prediction, such as zero-tolerance policies, mandatory minimum sentencing, and so forth have set the backdrop for where we are today with policies. The data we have today shows that the prediction was wrong: Recidivism is low, and violent crime rates are dropping, not skyrocketing. These policies that were formed in reaction to this prediction, he says, are harmful and wrongheaded. 

How Do We Change Policy?

He prefaces his suggestions on how we can change policy with the observation that he does not have a magic answer, but suggests that the specific steps to changing policy can depend on what an individual advocate or group wants to accomplish. He recommends two priorities: Reversing course from current public policy initiatives to target and punish sex offenders, and increasing public involvement in developing public policy that is more effective at reducing crime. 

He recommends in regard to the first priority, eliminating the need for juveniles to register as sex offenders, a goal he suggests is very feasible. He proposes eliminating the indiscriminate sentencing of child sex offenders and the "bad science" options of plethysmography, polygraphy, and indefinite monitoring. He suggests instead developing prevention methods that are systemic (schools and community groups) and address at-risk youth to prevent harm before it can happen. In that, he suggests intervention strategies that get help to at-risk youth, whether they are at-risk because of having a sexual attraction to children or for some other reason. 

With that in mind, he comes up with five things he has learned:

1. Rather than a broad campaign to change public opinion, individual outreach to policymakers and policy implementers (judges, youth-serving organizations, politicians, etc.), and outreach to those that influence these policies, or those that already have relationships with policymakers and policy implementers. 
2. Linking the data and research to personal experience and stories that are effective in changing perceptions.
3. Not investing huge amounts into standalone advocacy, but building on existing messaging and advocacy platforms. This means outreaching and partnering with victim advocates, field-leading organizations like ATSA, the National Conference of State Legislators, the National Governor's Association, the National Council of Juvenile and Family Court Judges, the National Juvenile Defenders Association, etc. This also means outreaching to organizations to libertarian, conservative, and other "unlikely allies" that can be more powerful in reaching other viewpoints.
4. Be strategic and opportunistic so that when unexpected opportunities come up through the contacts with other advocacy platforms.
5. Data, facts, and evidence matters, as is the stories that can display those facts to the general public. 

Public Investment Into Prevention Strategies

He points out the value of individuals and organizations that donate money to researching, developing, and supporting the infrastructure to make prevention a reality. However, he points out that we need policymakers to dedicate public funds to developing the prevention of child sexual abuse because of the great need for funding and research into creating more effective policies.