Abuse and Neglect of Children with Disabilities
Background - JoAnne, a Fourteen-Year-Old Girl, lives in a Skilled Nursing Facility. She has Profound Mental
Retardation and Multiple Disabilities, including Seizure Disorder and Cerebral Palsy.
She requires assistance for all her Daily Living Activities.
When she was discovered to be Eight Months Pregnant, Facility Staff Reported Suspected Child Abuse. The Perpetrator
was never identified.
Of the remaining Ninety-Eight Residents living in the same Facility, over 80% Tested Positive for a Variety of
Verereal Diseases.
Child Abuse and Neglect was identified as a "National Epidemic" in the 1991 Report of the U.S. Advisory Board
on Child Abuse and Neglect.
In 1993, the National Committee to Prevent Child Abuse (NCPCA) determined that approximately 219 Million Children
were identified and or Reported as Victims of Child Abuse and Neglect throughout the United States. Until recently, however,
the Number of Children with Disabilities who have been Abused and Neglect has not been well Documented.
In November, 1993, the National Center on Child Abuse and Neglect (NCCAN) released a Study regarding the Abuse
of Children with Disabilities.
This First National Effort to determine the Incidence of Abuse among this Population found that Children with
Disabilities are Abused at approximately twice the rate of Children without Disabilities (WESTAT, 1993)
Other Studies Document an Increased Risk of Abuse for Children with Disabilities between Four to Ten times that
of Generic Population (Baladerian, 1990).
All forms of Abuse, including Multiple Types of Abuse with the same Child, Multiple Perpetrators of Abuse and
Multiple Victims within a grouping of Children, are found within the Population of Children with Disabilities. The vast majority
of the Perpetrators are well known to the Abuse Victims. Perpetrators may include Family Members and Service Providers such
as Teachers, Doctors, Administrators, Direct Care Providers, Therapists, and Transportation Providers.
Abuse Can Cause Disabilities - Sammy, now Thirteen Years old, had Mild Mental Retardation and Cerebral
Palsy. In Counseling he revealed that he was thinking about his Future including Marriage and Parenthood. Afraid that his
Children would "be Retarded like me," he was asked the Cause of the Disability. "I was Born Normal.
My Dad used to come Home Drunk and get real mad. I remember he would throw me against the Wall. My Head hurt
a lot. This happened all the time, when I was little. Now I'm Retarded." Although Sammy understood the Origin of his Disability,
he did not understand Genetics or Heredity.
When told his Children would probably be Born just like he had been, he was happy. He said, "I would never hurt
my Kids like my Dad{dis} (sic)."
In addition to the fact that Children with Disabilities are at Increased Risk of Abuse is the fact that Child
Abuse can Cause Disabilities.
The exact number of Abuse-Caused Disabilities is unknown, but it is Estimated to represent 25% of all Developmental
Disabilities (Baladerian, 1992).
In addition, more than 50% of Child Abuse Related Fatalities were Children under One Years of Age, and 90% of
the Children were under Five Years of Age (April 1994 Carnegie Report). Head Trauma is the Leading Cause of Death for Children
who Die from Child Abuse (Michael Durfee, 1994). It is unknown how many more Children Suffer "Near Misses" and retain Serious
Permanent Disabilities due to Head and Neck Trauma. Specific Causes of Brain and other Central Nervous System Injuries may
result from the "Shaken Baby Syndrome," Blows to the Head (e.g., Slapping, Hitting, Child Tossing), as well as Asphyxiation
(due to Suffocation or Strangling).
Identification
The Signs of Abuse Characteristics of Children in the General Population are pertinent to Children with Disabilities.
These Signs include the following:
. Physical Injuries including Unexplained Bruises, Welts, Broken Bones, Burns
. Frequent Unexplained Injuries
. Aggressive or Withdrawn Behavior
. Unusual Fears
. Craving for Attention
. Wary of Physical Contact
. Afraid to go Home
. Destructive to Self and Others
. Poor Social Relations
. Fatigue
. Lack of Concentration
. Unusual Knowledge of Sex
Unfortunately, for Children with Severe Disabilities discovery of their Abuse is usually dependent upon the Emergence
of Incontrovertible Physical Signs (e.g., Death, Pregnancy, Venereal Disease, Physical Injury) and/or Obvious Behavioral Signs
(e.g., Sudden Changes in Behavior that re-enact the Abuse). Less obvious Behavioral Signs do not necessarily alert the Untrained
Caregivers to Possible Abuse. Even more Problematic is that Professionals providing Services to children with Disabilities
have too often attributed Clear Signs of Abuse to a Disability. This Oversight has left Children in Abusive Situations, in
some cases for several Years.
In addition many People have difficulty believing Children with Disabilities can be Victims of Abuse and Neglect.
This misperception creates an exaggerated level of Vulnerability, as Children with Disabilities, and their Families, are not
prepared Psychologically, Intellectually, or Physically to resist or respond to Abuse. One Woman, who has a Severe Disability,
recently stated that, "until as an Adult I was Sexually Abused, I never thought that Persons with Disabilities were Rape Victims.
I'd never heard of it. Of course I know about Sexual Abuse, but it never occurred to me that People with Disabilities
were Abused. I was so naive."
Prevention
Parents of Children with Disabilities often receive a lot of information about Disabilities, Child Care, Child
Development, and Community Resources, but are rarely prepared or Trained on the Subject of Physical of Sexual Abuse or Neglect.
While Abuse Prevention Programs exist in various forms throughout the Country, these are rarely offered to Children
with Disabilities and their Families. When Programs are offered, they are not always Age Appropriate, as when Programs Designed
for Younger Children are presented to Older Children with Disabilities.
Programs that are Designed with the "No-Go-Tell" Concept as their base are not, in general, useful for the Child
with a Disability. These Programs teach Children to tell the Potentially Abusive Adult, "No!" then go to someone they trust,
and tell them about the other Adult's Behavior. Telling an Adult, "No!" is difficult for any Child, Children with Disabilities,
however, may have even greater difficulty as they are usually taught to strongly respect the Authority of almost any Adult
or Person who is "in charge." In addition, most Persons who Abuse Children with Disabilities are in positions of Trust, Authority,
and Relationship with the Children (e.g., Parents, Professionals, Paraprofessionals, or other Family Friends).
Thus the ability to Socially resist an Abuse is diminished.
So, what does work? First, the Parents and Family Members of Children with Disabilities should be informed that
their Children; like other Children, are at Risk. Frequently, Parents, and the Children themselves, believe that due to the
Disability they cannot become Abuse Victims.
Second, Parents should talk directly to their Children about Abuse Awareness, and develop a Communication cue
that will alert the Parent that something has happened. Parents need to be empowered to take firm action to apprehend the
Identified Perpetrator.
Many Children with Disabilities can benefit from Self Defense Programs with Individually Tailored Defense and
Response Techniques, depending on the Child's Disability. Programs are in effect all across the Country, and in Europe, teaching
Self Defense Techniques to Children with Intellectual
