The State of Forensic Literature on Persons with Intellectual Disability Who Sexually Offend

Persons with intellectual disability charged with sexual crimes (PWID/SC) pose a unique challenge for the forensic psychiatrist. They represent a heterogeneous group whose motivations and pathology range from a simple lack of adaptive functioning to more complex comorbid paraphilic disorders. Although there is a growing body of literature on the risk assessment and treatment of PWID/SC, there is a relative lack of guidance and research on the evaluation of these individuals throughout the legal processes that follow being charged with a sexual crime. To address this deficit, this article reviews the literature germane to several key aspects of this process. We first review the current understanding of intellectual disability and sexual pathology. We identify landmark legal decisions that may relate to PWID/SC. We then review the literature related to PWID/SC and competency assessments, defenses involving mental disease or impairment, sexually violent predator evaluations and court-mandated pharmacotherapy. We aim to both bring attention to this unique forensic population and highlight areas for further research and exploration.