Problems with Sensory Information Processing in Sexual Offenders with an Autism Spectrum Disorder Who Are Treated in a Forensic Psychiatric Clinic. a Qualitative, Exploratory Study.

Background:

In recent years abnormalities in sensory functioning have been increasingly regarded as an important, even a central characteristic of autism spectrum disorder (ASD). Yet these abnormalities are still a neglected area in the forensic diagnosis and treatment of offenders with an ASD.

The current study was conducted in a (medium risk) forensic psychiatric clinic and out- patient clinic in the Netherlands, specialized in the treatment of (high functioning) sexual offenders with an ASD.

Research shows that the diagnosis ASD, on a group level, does not imply an increased risk for sexual offending. With regard to people with ASD who did commit sexual crimes, theorists have hypothesized that almost every characteristic of the autistic phenotype could potentially contribute to the likelihood of committing such an the offence. Abnormal sensory information processing however, is a neglected area in this respect.

Objectives:

The objective of this study was to explore the role of abnormal sensory information processing in the lives of forensic ASD patients who committed sexual offences. The research questions were:

- Do these patients in effect experience abnormalities in their processing of sensory stimuli?

- Do these abnormalities pose problems for them in their everyday lives and, if so, how do they cope with these difficulties?

- Do they perceive a relationship between these problems and their criminal sexual behaviour?

Methods:

Eight adult male patients participated after informed consent. Research design: ‘thematic analysis’, a qualitative method for identification and analysis of patterns in a qualitative dataset. Specialized software (Atlas.ti) was used to facilitate analysis. The data were acquired with a semi- structured interview. The interviews were taped and transcribed. A set of codes covering all aspects of the phenomena under investigation was carefully constructed. The interviews were subsequently coded and the analysis was conducted on the resulting data.

Results:

All respondents experienced several types of abnormal sensory information processing. Visual, tactile and auditory oversensitivity were the most prevalent. Five patients had problems with the filtering of multiple sensory stimuli or with the integration thereof. Seven out of the eight respondents experienced severe problems as a result of their abnormal sensory processing. Problems that affected their social relationships in a negative way were most mentioned. Coping strategies that patients used were overwhelmingly the avoidance of situations involving problematic sensory stimuli. In the majority of cases this resulted in social isolation. Four out of eight patients described a relation between these sensory problems and their sexual offences.

Conclusions:

Although this exploratory study has its limitations, the results indicate that abnormal sensory processing may pose real problems for many forensic patients with ASD who committed sexual offences and may be a risk factor for offending. Careful assessment of, and attendance to, these problems may improve treatment quality and contribute to the reduction of recidivism.