Children and adolescents treated for general delinquency problems and rated by caregivers as having sexual behavior problems (N = 696) were compared with youth from the same sample with no sexual behavior problems (N = 1185). Treatment outcome through 12-months post-treatment follow-up and criminal offense rates through an average 48-month post-treatment follow-up were compared for both groups. It was hypothesized that youth with any sexual behavior problems (SBP) would improve significantly over time but would continue to evidence greater psychopathology than youth with no sexual behavior problems (NSBP). These hypotheses were supported. Specifically, both groups evidenced significant improvement on parent-reported treatment outcomes, although the SBP group exhibited more behavior problems, relative to the NSBP group through follow-up. It was further hypothesized that youth with sexual behavior problems would not differ from youth with no sexual behavior problems in rates of future sexual or non-sexual offenses. These hypotheses were also supported. Specifically, SBP group membership was not a significant predictive factor in analyses modeling future offending in general or future person offenses. Few youth in either group had sexual offenses (1.5% and 1.9% for the SBP and NSBP groups, respectively). The importance of these findings for clinical and policy decision-making is discussed.The scientific literature on children with sexual behavior problems is limited, but of exceptionally high quality. There have, for example, been multiple randomized clinical treatment trials (Bonner, Walker & Berliner, 1993, 1999 Cohen & Mannarino, 1996, 1997Pithers & Gray, 1993;Pithers, Gray, Busconi, & Houchens, 1998) and, recently, a 10-year follow-up from one of those trials (Carpentier, Silovsky & Chaffin, 2006). The results of these and other treatment outcome studies collectively support short-term, sexual behaviorfocused cognitive-behavioral (CBT) interventions that substantively include children's caregivers (Carpentier et al., 2006; Cohen & Mannarino, 1996, 1997 Deblinger & Heflin, 1996;Silovsky, Niec, Bard, & Hecht, 2005). In a 10-year follow-up, Carpentier and colleagues reported that youth treated with CBT committed significantly fewer sexual offenses than youth treated with play therapy. Importantly, the rate of future sexual offending by the CBT condition was indistinguishable from a sample of children originally presenting with non-sexual psychiatric problems (Carpentier et al., 2006). Taken together, these results do much to dispel concerns that children with sexual behavior problems follow a developmental path that leads them through adolescent sexual offending and on to adult sexual predatory behaviors-a pathway suggested by retrospective studies linking adult (or adolescent) sexual offending to adolescent (or childhood) sexual misbehavior (Abel et al., 1987; Burton, 2000; Zolondek, Abel, Northye, & Jordan, 2001). Letourneau, & Silovsky, 2002, p. 208). To date, most research on SBP, including the rand...