The purpose of this paper is to explore to what extent neuro-typical theories of sexual offending apply to clients with Levels 2 and 3 autism with a co-morbid intellectual disability (ID). The paper develops a model of harmful sexual behaviour (HSB) for this client group and makes suggestions for how these behaviours can be understood and reduced.,The revised Integrated Theory of Sexual Offending (ITSO) (Ward and Beech, 2016) is used as a starting framework to understand HSB in this client group. This attends to specific neuropsychological systems, brain development, motivation and emotional processing.,The revised ITSO has some utility in understanding HSB in this client group. This is improved when neuro-atypical specific state factors are identified. Practical ways of establishing these state factors are made which attend to the function of the behaviour in line with “Good Lives” model of rehabilitation.,Recommendations for ways in which the function of HSB in this client group can be identified are made as well as recommendations for how treatment can be tailored dependent on the function of behaviour in this client group.,The paper makes practical recommendations for how interventions for people with ID and autism in line with Ward, Clack and Haig’s (2016) Abductive Theory of Method which noted that interventions should be adopted to consider wider explanations for offending thus acknowledging that treatment could extend beyond cognitive behavioural therapy for clinical phenomena. Future treatments for clients with autism and LD are suggested which attend to sensory needs, teaching alternative communication strategies for seeking out “deep pressure” or attention in ways that do not involve sexual offending, using picture communication, information technology or Makaton to communicate needs or using social stories to explain the consequences of behaviour. In addition, neuro-atypical interventions which attend to the neuropsychological functioning of clients could also be included in treatment for neuro-typical clients, thus ensuring that interventions attend to every aspect of the ITSO and not purely clinical phenomena.,Enhancing treatment interventions for clients with ID and autism could both reduce risk and enhance quality of life for this client group.,Much of the work to date exploring HSB in clients with autism has attended to clients with Level 1 autism or those without an additional ID. This paper provides practitioners with a theory upon which to understand HSB in clients with a dual diagnosis of Levels 2/3 autism and an ID as well as practical recommendations for reducing HSB in this client group.

中文翻译：

---

自闭症和合并症智障人士有害性行为的多因素模型-理论和实践指南

本文的目的是探讨性犯罪的神经性典型理论在多大程度上适用于患有2级和3级自闭症并存智力障碍（ID）的患者。本文针对该客户群开发了有害性行为（HSB）模型，并就如何理解和减少这些行为提出了建议。使用修订后的性犯罪综合理论（ITSO）（Ward和Beech，2016）一个了解此客户群中HSB的入门框架。这涉及特定的神经心理学系统，大脑发育，动机和情绪处理。修订后的ITSO在理解此客户群中的HSB方面具有一定的作用。当确定神经非典型的特定状态因素时，这将得到改善。提出了建立这些状态因素的实用方法，这些行为与行为的功能相适应，符合“好生活”康复模式。提出了确定该客户群中HSB功能的方法的建议，以及关于如何根据此客户群中的行为功能来量身定制治疗的建议。，本文根据Ward，Clack和Haig（2016年）的归纳方法论提出了针对ID和自闭症患者如何进行干预的实用建议。应采取干预措施以考虑到更广泛的违法解释，从而承认治疗可能会超出针对临床现象的认知行为疗法。建议针对自闭症和LD的患者未来的治疗方法应满足感官需求，教授替代性的交流策略，以不涉及性犯罪的方式寻求“深层压力”或注意力，使用图片交流，信息技术或Makaton交流需求，或使用社交故事来解释行为的后果。此外，对于神经性典型客户而言，也可以将涉及非典型患者的神经心理干预的神经非典型干预措施纳入治疗，从而确保干预措施涉及ITSO的各个方面，而不仅仅是纯粹的临床现象。带有ID和自闭症的用户可以降低风险并提高该客户群的生活质量。迄今为止，探索自闭症患者中的HSB的许多工作都是针对具有1级自闭症或没有其他ID的患者。