Sex-offending behavior continues to exist as a major public health concern. In recent years, studies of risk prediction and identification of both static and dynamic factors associated with the behavior of sexual perpetrators have added to a collective understanding of the problem. However, a limited amount of available information exists concerning how to translate relevant factors into effective clinical treatments or risk management strategies for this population. This is particularly true with regard to intellectually disabled offenders. This paper presents a model of sex offending that focuses on cognitive behavioral variables proposed as functional causal pathways to guide assessment and treatment of such individuals. Clinical case examples are provided to illustrate the linkage between assessment and treatment.