title: Practitioner review: The victims and juvenile perpetrators of child sexual abuse--assessment and intervention.
abstract: BACKGROUND
  The assessment of victims of child sexual abuse (CSA) is now a recognized aspect of clinical work for both CAMH and adult services. As juvenile perpetrators of CSA are responsible for a significant minority of the sexual assaults on other children, CAMH services are increasingly approached to assess these oversexualized younger children or sexually abusive adolescents. A developmental approach to assessment and treatment intervention is essential in all these cases.
  
  
  METHODS
  This review examines research on the characteristics of child victims and perpetrators of CSA. It describes evidence-based approaches to assessment and treatment of both groups of children. A selective review of MEDLINE, Psycinfo, Cochrane Library, and other databases was undertaken. Recommendations are made for clinical practice and future research.
  
  
  RESULTS
  The characteristics of CSA victims are well known and those of juvenile perpetrators of sexual abuse are becoming recognized. Assessment approaches for both groups of children should be delivered within a safeguarding context where risk to victims is minimized. Risk assessment instruments should be used only as adjuncts to a full clinical assessment. Given high levels of psychiatric comorbidity, assessment, treatment, and other interventions should be undertaken by mental health trained staff.
  
  
  CONCLUSIONS
  Victims and perpetrators of CSA present challenges and opportunities for professional intervention. Their complex presentations mean that their needs should be met by highly trained staff. However, their youth and developmental immaturity also give an opportunity to nip problem symptoms and behaviors in the bud. The key is in the earliest possible intervention with both groups. Future research should focus on long-term adult outcomes for both child victims and children who perpetrate CSA. Adult outcomes of treated children could identify problems and/or strengths in parenting the next generation and also the persistence and/or desistence of sexualized or abusive behavior.
authors: NSPCC National Clinical Assessment and Treatment Service and the Behavioural & Brain Sciences Unit, Institute of Child Health, University College London, London, UK. e.vizard@ucl.ac.uk
authors: Eileen
authors: E
authors: Vizard
mesh_terms: D000293:Adolescent; D002648:Child; D002650:Child Abuse, Sexual / Q000175:diagnosis* / Q000523:psychology / Q000534:rehabilitation* / Q000706:statistics & numerical data; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D019548:Crime Victims / Q000523:psychology* / Q000534:rehabilitation* / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D019317:Evidence-Based Medicine; D006801:Humans; D007604:Juvenile Delinquency / Q000523:psychology* / Q000534:rehabilitation / Q000706:statistics & numerical data; D020380:Needs Assessment; D010552:Personality Assessment / Q000706:statistics & numerical data*; D011594:Psychometrics; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D055502:Secondary Prevention; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation; D016896:Treatment Outcome; D006113:United Kingdom; D055815:Young Adult