MEGA: A New Paradigm in Protocol Assessing Sexually Abusive Children and Adolescents

Abstract

a comprehensively-structured risk assessment protocol for assessing sexually abusive behavior in all youth ages 19 years and under. This includes male and female adjudicated and non-adjudicated youth, children under 12, and developmentally delayed youth. MEGA (Miccio-Fonseca, 2006b) is composed of seven aggregates and four distinct risk scales: (a) risk, (b) protective risk, (c) estrangement, and (d) persistent sexual deviancy. Exemplary internal consistency reliability data (a > .80, p = .001) on a sample of N = 1,184 (979 males and 205 females) are presented; findings on the estrangement and persistent sexual deviancy scales are discussed in depth.

Trauma Outcome Process Assessment (TOPA) Model: An Ecological Paradigm for Treating Traumatized Sexually Abusive Youth

“…Empirical support for the ecological risk factors in the TOPA is found in the validation findings (N = 1,184) of the MEGA risk assessment tool (Miccio-Fonseca, 2009. A number of variables related to history of violence and abuse within the youth's family are assessed by one of MEGA 's ecological domains, the Family Lovemap Aggregate; it was strongly supported by MEGA 's validation (i.e., internal consistency reliability = .749; Miccio-Fonseca, 2009.…”

“…Almost three quarters (70%) had behavior problems in school, and 64.1% had a history of two or more disciplinary actions (e.g., detention, suspensions, expulsions). In the majority of cases, behavior problems led to trouble with the law; 60% had been arrested before the age of 16 (Miccio-Fonseca, 2009). …”

“…It presumes that individuals' responses to trauma are influenced by their own idiosyncratic, multifaceted combination of neuropsychological and ecological risk and protective factors. Risk factors influence trauma outcomes, contribute to a lack of self-awareness, and increase vulnerability for maladaptive responses to trauma (or triggers reminiscent of past traumas; see Figure 1), while protective factors ameliorate risk (Miccio-Fonseca, 2009) and lead to increased self-awareness, resiliency, and healthy adaptation in the face of traumatic experiences.…”

Dialogue on Risk Assessment on Youth and Accuracy of Terms: A Response to Worling's (2010) Letter to the Editor

“…However, these items are not specifically designated as neuropsychological risk factors, and it is likely that only seasoned clinicians would consider their relationship with neuropsychological functioning. We believe attention problems are distinct from self-regulation difficulties and that attention problems and cognitive impairments associated with such things as low intellectual functioning and learning disabilities are a salient feature of neuropsychological dynamics (Miccio-Fonseca, 2009;Miccio-Fonseca & Rasmussen, 2009a). The neuropsychological risk factors that we see in the ERASOR 2.0 are limited to self-regulation and do not address other neuropsychological aspects of attention problems and cognitive impairments nor make the connection to other neuropsychological variables.…”

“…Research on older youth is considered adolescent research, not adult (e.g., Gerhold, Brown, & Beckett, 2007). The tool is supported by research on the various age groups, as documented by the literature review in the MEGA Manual and Rating Booklet (Miccio-Fonseca, 2009;Miccio-Fonseca & Rasmussen, 2008). MEGA is designed to pick up on those risk factors that are particularly relevant to the various age groups from young children aged 4 up to 12, and children over 12.…”