Most sex offenders appear to desist from sexual and other violent offending; however, research on this population has historically focused more on the characteristics of individuals who persist offending versus those who desist from offending. The present study examined change patterns of 563 child sexual abusers’ scores on the Sex Offender Treatment Intervention and Progress Scale, a dynamic risk measure, at three points of time over 2 years. Individuals who did versus did not commit a new serious offense, defined as a new sexual or other violent offense, at 5-year follow-up were contrasted. Desisters demonstrated most changes during their first year in treatment, whereas change among persisters more often occurred during their second year in treatment. All classes of offenders made gains in addressing dynamic risk related to sexually specific needs, whereas desisters made significantly greater gains in social stability needs. Findings are discussed in light of treatment dose allocation and community reentry needs.