Children with Sexual Behavior Problems: Identification of Five Distinct Child Types and Related Treatment Considerations

Abstract

This research was conducted to define empirically derived and clinically relevant types of children with sexual behavior problems. A theory-driven hierarchical cluster analysis was performed using Ward's method. Five distinct types of children with sexual behavior problems emerged. Significant differences were found among the five child types on a large number of historical, diagnostic, behavioral, and demographic variables, including number of victims, degree of aggression employed during sexual acting out, sexual penetration, psychiatric diagnosis, internalizing, and externalizing. Clinical relevance of the child types was examined by analyzing change scores on an objective measure of sexualized behaviors in children who had earlier been assigned randomly to one of two treatment conditions. The analysis of treatment efficacy revealed a significant main effect of child type and a significant child type by treatment type interaction. After a short time in treatment, the highly traumatized child type derived significantly more benefit from a cognitive behavioral intervention than from an expressive therapy. This study demonstrates that distinct types of children with sexual behavior problems exist, that they can be distinguished on a wide range of clinically relevant variables, and that identification of child type may be relevant to choice of treatment modalities and outcome.