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Abuse of Individuals with Disabilities

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Title: Abuse of Individuals with Disabilities Author: splummer Last modified by: Chien Huang Created Date: 10/31/2011 7:03:08 PM Document presentation format – PowerPoint PPT presentation

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Title: Abuse of Individuals with Disabilities


1
Abuse of Individuals with Disabilities
  • Dr. Sara Plummer
  • Rutgers University

2
Overview
  • History of abuse
  • Prevalence rate
  • Types of abuse
  • Risk factors
  • Screening

3
History
  • 660 BC Ancient Greece
  • The Spartans threw babies born with disabilities
    over a cliff
  • It was assumed they would not be able to
    adequately contribute to society
  • The Athenians placed unwanted infants in jars and
    then left them in temples for people to adopt

4
History
  • Euthanasia the intentional putting to death of
    a person with an incurable or painful disease
  • Nazi euthanasia program initially targeted people
    with severe mental and physical disabilities
    (more than 100,000 mental hospital patients and
    5,00 children with developmental disabilities
    were killed between 1939 and 1941)

5
American History
  • Eugenics the science that advocates for the
    improvement of genetic qualities (Sir Francis
    Galton Darwin)
  • More than 300,000 individuals in special
    education programs, residents in institutions
    with intellectual disabilities were sterilized

6
American History
  • 1800s restrictive marriage and reproduction
    laws that prohibited marriage and intercourse
    amongst individuals with developmental
    disabilities and epilepsy
  • Many states had laws that allowed and encouraged
    the use of eugenics. VA - 1924, passed the
    Eugenic Sterilization Act,
  • Act called for sterilizations based on the
    intent
  • 1. to promote an individual's health or
  • 2. to protect the welfare of society.

7
American History
  • By 1930s over half of the states had eugenic
    laws giving doctors the right to forcibly
    sterilize individuals deemed unfit to reproduce
  • VA test court case Buck vs. Bell (MD)
  • Carrie Buck - identified as having epilepsy and
    being feebleminded) was committed to the
    Lynchburg Colony for the Epileptic and
    Feebleminded (asylum or institution) after giving
    birth to a baby girl

8
American History
  • Described as promiscuous, sterilization was seen
    as logical fix to end generations of the
    feebleminded and an imbecile
  • Mother and child were deemed also to have
    intellectual disabilities

9
American History
  • Carrie and family fought sterilization and it
    went to Supreme Court Ruling 81 against Carrie
  • Judge who wrote decision, Oliver Wendell Holmes
    said "Three generations of imbeciles are
    enough. (Carries mother has similar diagnosis)
  • End note Carrie was raped by a family member
    and likely sent away to hide this fact, later she
    and her daughter were found to have no
    significant intellectual disabilities, her sister
    was also sterilized

10
American History
  • From 1927 1972 doctors at this hospital alone
    sterilized more than 8000 individuals including
    those with intellectual disabilities and those
    without disabilities

11
American history
  • 1941 Foster Kennedy, MD presented The Problem of
    Social Control of the Congenital Defective
    Education, Sterilization, Euthanasia to the
    American Psychiatric Association
  • He proposed the killing of hopelessly unfit
    children with developmental disabilities by age 5
  • "I believe when the defective child shall have
    reached the age of five years . . . that the case
    should be considered under law by a competent
    medical board." The board would be authorized "to
    relieve that defective . . . of the agony of
    living.
  • This was seen as purification through
    extermination and a natural step in evolution

12
Prevalence
  • Individuals with disabilities experience abuse at
    similar or increased rates
  • Life time rates of abuse 62 for both individuals
    with disabilities and general population (Young,
    et al. , 1997)
  • In a study of physical and sexual abuse, physical
    rates were equal and sexual abuse was 4 times
    higher for individuals with disabilities (Martin,
    et al, 2006)
  • In a study of over 1000 women in family practice
    clinics, those who reported experiencing abuse
    were 2 times more likely to report having a
    disabilities

13
Prevalence
  • Studies also suggest that women with disabilities
    experience abuse for longer periods of time and
    by more perpetrators
  • The research does not truly estimate the
    prevalence due to lack of
  • Screening
  • Outreach
  • Accessible services
  • No attempt to seek services since little to none
    are available

14
Types of abuse
  • Individuals with disabilities suffer from
    multiple forms of abuse
  • Physical, sexual, emotional, economic
  • Also experience disability related abuse
  • Denying access to mobility devices
  • Preventing them from accessing medical care
  • Neglecting personal care
  • Withholding medications

15
Examples of disability related abuse
  • Refusal to aid in toileting
  • Over or under-medication
  • Breaking communication and mobility devices
  • Wheelchair, TTY, pager, prosthetic limb
  • Moving furniture in a home of a visually impaired
    person
  • Taking away a prosthetic limb
  • Mistreating service animals

16
Examples of disability related abuse
  • Force the person to allow them to become the
    representative payee
  • Threatening to report them to DYFS
  • Historically courts have ruled against women with
    disabilities
  • Threatening to institutionalize them

17
Risk Factors
  • Some suggest having a disability in this world
    immediately places that person at risk
  • Research has suggested some specific risk factors

18
Isolation
  • Isolation creates a barrier to support and
    services
  • Individuals who are less mobile, and more
    socially isolated have a higher likelihood of
    experienced abuse (Nosek et al, 2006)
  • Isolation can be a result of
  • Lack of accessibility
  • Lack of mobility
  • Social isolation
  • Lack of transportation

19
Perpetrators
  • Individuals with disabilities are exposed to
    multiple potential abusers
  • This population is at risk by the sheer number of
    people they come into contact with
  • Intimate partners
  • Family members
  • Health care providers
  • PAS workers
  • Ambulance drivers

20
Perpetrators
  • Intimate partners are the most commonly
    identified perpetrators of domestic violence
    including husbands and live in partners
  • Perpetrators of sexual violence are most often
    people they come into daily contact with but not
    people they live with
  • Most often men are identified as the perpetrator

21
Perpetrators in Relationships
  • Certain predatory individuals may view a romantic
    relationship with a person with a disability as
    an opportunity for exploitation, mistreatment and
    abuse
  • An individual may specifically target individuals
    they believe to be vulnerable and intentionally
    seek out individuals they believe they can
    exploit, mistreat and abuse
  • The expectation may be that the woman will not be
    believed if she reports abuse
  • Which is often the case
  • Less likely to resist or fight back

22
Perpetrators family
  • Family members parents and siblings who have
    limited patience or regard for the individual may
    become abusive
  • Some parental relationships become strained due
    to the additional needs of a child with a
    disability the child is then blamed for the
    break down in the marriage and in turn abused or
    neglected
  • Siblings may become jealous due to the added
    attention the child receives as a result of the
    disability and may act out towards the child

23
Perpetrators Service Providers
  • PAS, Healthcare workers, group home worker
  • The nature of the relationship between individual
    and worker is viewed as a risk factor
  • Ongoing contact (many hours in the home, time
    spent in day treatment programs, etc)
  • Intimate nature of contact (bathing, toileting)
  • Blurring of boundaries (worker vs.
    friend/partner)
  • Perpetrators may enter the field in order to
    specifically target this population
  • Perceived vulnerabilities and opportunities

24
Dependency
  • Perpetrators may have the role of both partner
    and primary caregiver
  • Physical, emotional and financial dependency may
    increase the risk of abuse and limit ones
    ability to leave
  • This creates a dichotomous and confusing
    relationship of abuser and caregiver
  • An abused individual will be fearful of losing
    their source of daily care
  • As a result the abused individual may feel he or
    she needs to compromise or accept the abuse to
    continue to receive the benefits of the
    relationship (Hassouneth Phillips, 2005)

25
Learned Helplessness/Compliance
  • Children with disabilities may experience
  • Overprotection (no allowing child to experience
    various things)
  • Segregation (separation in schools)
  • Isolation (lack of social networks)
  • Limited autonomy (told to comply with doctors,
    nurses)
  • Creates lack of understanding of social cues and
    increases potential for learned compliance as
    adults
  • The attempt to protect a child or make less of a
    burden may inadvertently facilitate situations
    that are potentially abusive

26
Learned Helplessness/Compliance
  • Creates individuals who are overly agreeable, and
    accommodating
  • Individuals are taught to comply with others
    wishes early on in life
  • Creates a fear of rocking the boat and avoids
    stating ones needs
  • Compliance is then over generalized to other
    individuals and situations in life

27
Lack of Identification
  • Abuse against individuals with disabilities often
    goes unrecognized
  • Due to nature of abuse which often targets the
    persons disability
  • These behaviors are often not defined as abuse by
    state laws
  • The person often does not realize the behavior is
    abusive

28
Lack of identification
  • May not tell others for fear of disbelief
  • People dont want to believe this occurs so will
    dismiss it
  • The person accused is viewed as an upstanding
    citizen, may be a person of authority
  • People with disabilities are historically not
    seen as reliable sources of information
  • Lack of knowledge about victimization
  • Do not know who to contact
  • There are not many places to go for help

29
System and Cultural Barriers
  • Lack of accessible resources
  • Lack of accessibility
  • Limited physical access
  • No interpreters
  • Attitudinal barriers
  • Disability organizations in general have lack of
    information and resources on abuse
  • Lack of capacity to address issue (screening,
    resources, referral)
  • Historically attempts at seeking help has been
    met with insensitivity
  • Lack of coordinated response disability and DV
    or SA

30
System and Cultural Barriers
  • Oppression and devaluation of women with
    disabilities
  • Ableist and sexist view points
  • Negative valuations of individuals with
    disabilities
  • Seen as less than (not the ideal female form)

31
System and Cultural Barriers
  • Discrimination and oppression become internalized
  • Creates self devaluation and poor self esteem
  • Women with disabilities report overall high rates
    of low self esteem
  • This translates in a fear of being alone
  • Doubts another partner would want to be with them
  • Lack of worthiness around being in a relationship
  • May blame themselves for the abuse

32
Tips for serving survivors with disabilities
  • Screening
  • Always screen for abuse
  • There remains a lack of screening across
    disciplines

33
Screening
  • You can begin to screen all clients who you
    encounter
  • Has anyone ever hit, slapped, kicked, pushed,
    shoved, or otherwise physical hurt by someone?
  • Has anyone ever forced you to engage in sexual
    activities?
  • Has anyone ever threatened, intimidated, coerced
    or manipulated you to do things you did not wish
    to do, done or said anything to make you feel
    fearful, or humiliated, overly criticized, or
    bullied you?
  • it is important to ask about lifetime history
    and current history (i.e. within the last year or
    6 months)

34
Screening
  • Then ask disability related abuse questions
  • Has anyone prevented you from using a wheelchair,
    cane, respirator, or other assistive devices?
  • Has anyone you depend on refused to help you with
    an important personal need, such as taking your
    medicine, getting to the bathroom, getting out of
    bed, getting dressed, or getting food or drink?
  • Within the last year, did someone take your SSI
    or SSD check, a paycheck, or financial aid check
    without your permission, refuse to allow you to
    access your bank account, or restrict your use of
    money, a debit or credit card?
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