Social risk factors, executive neuropsychological functioning, and emotional numbing were examined as potential risk factors for violent sexual assaults by an adolescent male. The subject had been exposed to at least four previously identified social risk factors, including neglect, early separation from both parents, sexual abuse, and low socio-economic status. At the time of assessment, executive neuropsychological functioning was intact. While impaired emotional responsiveness was an important factor in the assaults, the construct of emotional numbing is too broad to identify the specific neuropsychological impairment involved in the subject's assault behavior. The authors suggest that failures in sensory-emotional integration contributed to the likelihood of violent behavior. Implications for further research and clinical practice are discussed.