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An Overview of Violence Against Children with Disabilities

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Title: An Overview of Violence Against Children with Disabilities


1
(No Transcript)
2
An Overview of Violence Against Children with
Disabilities
  • Presented by Nora J. Baladerian, Ph.D., CST,
    BCFEDisability, Abuse Personal Rights Project
  • CAN DO! Project of Arc RiversideChild Abuse
    Neglect Disability Outreachfor the
  • BEST PRACTICE II CONFERENCE 2004
  • On Child Abuse Neglect
  • Mobile Birmingham, Alabama

3
Prevalence of Violence Against Children with
Disabilities
  • How many are there?
  • People with Disabilities are said to constitute
    approximately 20 of the population, with 10
    having severe disabilities (DOL)
  • There are current increases in certain types of
    disability due to
  • Violence - Longer life spans
  • Accidents - Improved medical care

4
Who are Children with Disabilities?
  • Children born with disabilities
  • Children who acquired disabilities as children
    through accident or illness
  • Children who acquired disabilities as a result of
    criminal behavior by others
  • Children who acquired a disability by other means

5
What kinds of disabilities are included?
  • Sensory
  • The 5 senses hearing, vision, touch, taste,
    smell (NOTE The 6th sense does not seem to be
    impacted by the disability!! Interesting, eh?)
  • Communication
  • Mobility Impairment
  • Intellectual
  • Social (Characterological or Autism Spectrum)
  • Psychiatric (Bio-Medical, thought disorders)
  • Medical including Neurological, Endocrine, etc.
  • Orthopedic
  • Respiratory

6
Hey, What about Developmental Disabilities?
  • Developmental Disability is a legal term that
    exists at both the federal and state levels.
  • The theme is to identify people whose normal
    developmental progress is changed due to a
    disability that causes a need for specialized
    interventions and services.
  • In most states, people with mental retardation
    have constituted the highest percentage of those
    with developmental disabilities, although with
    the increase of about 600 in the incidence of
    autism over the past 10 years, the balance has
    changed.

7
Data on Prevalence of Abuse shows that
  • Children with Disabilities are
  • 3.4 times more likely to be abused than others
    (Sullivan, 2001)
  • 1.7 times more likely to be abused than others
    (Westat, 1991)
  • 4-10 times more likely to be abused than others
    (Garbarino, 1989)
  • Adults with Disabilities are
  • Equally as likely to be abuse victims as the
    generic population (Nosek, 1999) BUT
  • The extent of the abuse is much worse for women
    with disabilities.
  • Have equal vulnerability as children with
    disabilities (Baladerian,, 2001 anecdotal) (Why
    would it be different, since vulnerability
    transcends age categories)

8
Other studies show
  • Increased rates of abuse by both men and women
    with disabilities from 31-83
  • For women with mental retardation other
    intellectual impairments rates from 40-90
  • Approximately 5 million vulnerable adults
    annually become crime victims. (NAS, Petersilia,
    2001)
  • Approximately 2 million elders per year have
    substantiated abuse cases.

9
Children (0-18 years of age)
  • Approximately 1 million children (generic) per
    year have substantiated abuse cases.
  • Estimates 1 in 4 girls, 1 in 7 boys
  • How does that work for kids with Disabilities?
  • 12 of those would have Disabilities BUT
    increased rates of abuse change that...what is
    1in 4 x 3.4?
  • 1 in 4 25 x 3.4 85
  • 1 in 7 14 x 3.4 47.6
  • 1 in 4 25 of girls of whom 12 likely have a
    disability, .12 x 25 3 x 3.4 10.2

10
Overview of Abuse People with
DisabilitiesChildren with disabilities are
abused more than generic kids by a factor of
  • 1.7 DHHS/NCCAN, 1991,Westat
  • 3.4 Boystown Research Hospital, 2000, Sullivan
  • 7 Compilation of smaller studies from 1982 to
    date

11
Boystown Research Population Sample1.
Hospital based study to identify prevalence of
disabilities among maltreated versus
nonmaltreated children, researchers merged
gt39,000 hospital records from 1982 to 1992 with
the social service central registry, the foster
care review board and police records for both
intra and extra familial maltreatment. Merger
resulted in 6,000 matches, an overall
maltreatment prevalence rate of 15 percent.
12
Among the 15 maltreated, 64 had a
disability,Of the nonmaltreated 32 had a
disability.
13
Boystown Study continued...Identified
disabilities of the hospital based study
includedBehavior disorders 38Speech/language
disorders 9Mental retardation 6Hearing
impairment 6Learning disability 6Other
disabilities 4Health impairments 2ADD (w/o
behavior disorder) 2
14
Boystown Study 2School based Study Public
Parochial SchoolsThe study merged almost 50,000
records from Omaha public and parochial children
matriculated during the1994-95 school year with
the Nebraska central registry of abuse neglect
cases, foster care review board and Omaha police
records of child maltreatment.From the merger,
4,954 children were identified as maltreated, 11
in the public schools, 5 in parochial schools.
15
Boystown Study 2 Contd31 of the children
with an identified disability had records of
maltreatment in either social services or police
agencies.The relative risk for maltreatment
among children with disabilities was found to be
three times that of other children.There was a
strong association between disabilities
neglect, with children with disabilities being
four times more likely to be victims than other
children.Children with behavior disorders and
mental disabilities were significantly more
likely to be neglected.
16
Abuse Neglect - OverviewApproximately 25 of
children with disabilities acquired the
disability as a result of abuse.52 of
neglected children acquire a permanent
disability.
17
Hey, how does abuse effect kids in later life???
  • Why is this important when we are think about
    long term effect? Research shows that adults
    abused as children
  • Have ongoing sequella that impact physical,
    psychological and social functioning
  • Are more likely than others to become abuse
    victims
  • Are less likely to have resources to report and
    recover.

18
Vulnerability is mediated by
  • Opportunity and Intent of the Perpetrator
  • Over 90 of the perpetrators are in an
    authorized care providing position (parent,
    school personnel, work or home services)
  • Most frequently identified are male,
  • Family members, transporters, care providers
  • Abuses occur at home, day activity (school, work)
    and transportation
  • Lack of information preparation of the
    individual and their family about this issue
    what they can do to lessen vulnerability

19
Prevalence and Risk Factors (Physical,
Intellectual, Sensory Psychiatric Disabilities)
  • Less than 10 of abuse is ever reported
  • Children with Developmental Disabilities usually
    cannot report
  • Developmental Disabilities Services professionals
    infrequently receive training in identification
    reporting of abuse
  • They frequently state an unawareness that abuse
    effects their clients
  • Reporting disincentives impact the agency
  • Most adults with Disabilities report that if they
    had been asked about abuse when they were
    children they would have told someone
  • Many children with Disabilities do not know or
    believe that an abuse-free life is an option.
  • For adults neglect, including medical neglect is
    a frequent problem, followed by sexual abuse.

20
How to Identify Abuse in Children with
Disabilities
  • Depends upon the type of disability the child has
    and
  • Upon the type of abuse that occurred
  • ?

21
Physical Abuse
  • Signs of physical abuse in Children with and
    without disabilities are the same. HOWEVER
  • Sometimes the signs of ABUSE are attributed to
    the DISABILITY and ignored
  • Sometimes the disability causes conditions that
    mimic signs of ABUSE and are mistaken, causing
    care providers to erroneously by accused of
    abuse.
  • Physical neglect (failure to provide medicine,
    food, water, assistive devices, etc) may cause an
    exacerbation of the symptoms of the disability
    leading to temporary mental aberration, physical
    symptoms, coma and even death.
  • Often Children do not disclose the abuse for
    multiple fears and no apparent sign that help is
    available.

22
Sexual Abuse
  • Physical signs of sexual abuse are the same for
    both Children with and without disabilities.
    HOWEVER,
  • Children with disabilities may not disclose the
    assaultby the time they do, all physical signs
    are gone (except STDs and pregnancy of course)
  • Children with disabilities may not show obvious
    signs of distress that expose the abuse, but may
    have changes in mood conduct that signal
    something has happened.
  • Children whose care provider is the perpetrator
    may show signs that no one sees or notices, or is
    attributed by the observer to causes other than
    assault.
  • Children assaulted in medical facilities (acute
    care hospitals for example) rarely disclose the
    abuse due to threats of death or other
    retribution by those who know their address and
    threaten direct harm.

23
Signs of Emotional Abuse
  • These are essentially the same as for Children
    without disabilities, HOWEVER
  • Verbal assaults and withholding of attention are
    powerful tools of abuse that are used but are
    difficult to prove, thus disclosure is delayed
    as the victim feels she has no proof of what
    has occurred.
  • Depression, withdrawal, anxiety, fears and
    re-enactments may be observed or suspected.

24
How can you know for sure?
  • ASK!!!
  • Most adults who have disabilities state that
    although they have been abused many times in
    their life, NO ONE ever asked about this aspect
    of their lives
  • PLEASE be sure that you have something to offer
    if you decide to ask this question. Such as
  • Time to listen to their story
  • Suggestions for help such as a GOOD referral to
    therapy, groups, books, pamphlets, videos, peer
    groups
  • Dont just ASK then leave them in the memory of
    the tragedies they have survived.

25
What is the biggest enemy ?
  • Negative attitudes toward people with
    disabilities.
  • We are all products of our culture
  • Our culture is disability-negative
  • We all need to do personal work to discover then
    change any remaining negative attitudes sourced
    in myth and stereotype (sourced in fear and lack
    of contact)

26
Barriers to Overcome
  • Stereotypes blind us to seeing each persons
    individual needs while perceiving some imagined
    group characteristic. Stereotype People with
    Downs Syndrome are all so loving and kind.
  • Myths impair our ability to understand or
    believe what is apparent. Myth people with
    profound mental retardation are not
    sexual...therefore could not be sexual assault
    victims.

27
Attitudes, Stereotypes Myths...lead to Crazy
Thinking or Not thinking
  • Attitudes Living in a disability-negative
    society, negative attitudes towards individuals
    with Disabilities may underlie failures to
    address the needs of children adults with
    Disabilities that are usual fare for their
    generic peers. (For example, awareness that
    individuals with Disabilities are victimized
    through sexual assault and domestic violence.)
  • Crazy thinking occurs when a generic discussion
    is infused with the word disability, normal,
    rational thinking frequently goes awry...for
    example discussions of sexuality normal sexual
    development. Physician performing a vasectomy on
    a teenager to preclude same sex orientation (
    multidisciplinary team decision).

28
Myths and Stereotypes about People with
Disabilities
  • Spread
  • Deviancy Evil
  • Contagion
  • Innocence
  • Wildness
  • Shame

29
  • Cannot distinguish the truth from a lie
  • Cannot understand the consequences for lying
  • Dont have a sufficient or correct vocabulary to
    describe the abuse...their communication style is
    suspect.
  • Alternative methods of communication cannot be
    used.
  • Are just plain not bright enough to be able to
    repeat their story
  • Are making up lies to get attention (hmm why?)
  • Are asexual and engaging in wishful thinking

30
Preferred LanguageorI dont know the right
words
  • Dont say Say
  • Wheelchair bound Uses a wheelchair
  • Deaf dumb Deaf non-verbal
  • Mentally Retarded Slow learner
  • The disabled People who have x
  • Crippled, lame Person with mobility
    impairment
  • Wacked, loosely wrapped Person with a mental
    illness
  • Label jars not people! (People First)
  • Susie HAS a cold.not Susie IS a cold aka
  • Susie HAS mental retardationnot IS retarded
  • Dont group folks as in the disabled

31
What makes abuse different with this population?
  • It is a bigger secret
  • It is more extensive
  • Agencies often deny services
  • Abuse response agencies (LEA, non-profits,
    protective services) are not trained and do not
    announce that their services are for all
  • Disability services agencies are not yet fully
    on board in conducting outreach, information
    referral or direct services

32
  • Children with disabilities are often completely
    left out of information processes that would
    give them a vocabulary to understand and describe
    the abuse and to know that they can get help.
  • Although the abuse is not significantly different
    than abuse and neglect with the generic
    population, aspects of the abuse only occur
    because of certain disabilities
  • Withholding assistive devices
  • Withholding medications
  • Complete physical control over the child
  • Threats by the abuser/PCA to leave threaten the
    life of the victim

33
What about the Nexus of Disability and Abuse?
  • Domestic Violence
  • Head Trauma ? Acquired Brain Injuries
  • Head Trauma ? Vision Impairment/Blindness
  • Head Trauma ? Hearing Impairment/Deafness
  • Head Trauma ? Speech impairments
  • Head Trauma ? Disfigurement
  • Other types of trauma can cause mobility
    impairments, injury to internal organs, etc.

34
What about the Nexus of Disability and Crime
Victimization?
  • Crimes committed by strangers (story of Sharon
    DEusanio)
  • Crimes committed by acquaintances
  • Crimes committed against marginalized women
    (homeless, prostitution) (Farley, Ackerman
    Banks)

35
Is there a Culture of Disability?
  • Deaf Culture
  • People with mental retardation
  • People with physical disabilities
  • How about separate
  • Languages?
  • Life Styles?
  • Being a member of an oppressed class?

36
OKAbuse is a BIG problem for Children with
Disabilities.What can we do?
  • Responding to Abuse
  • Getting Disclosures so we can provide supportive
    services
  • Preventing abuse
  • Becoming a raving advocate !!

37
Break for Part II
  • Wheres the cookies and milk?

38
Noras Nifty Nine Keys to Effective
SensitiveService Delivery to Survivors
  • Nothing About Us Without Us
  • In all Phases and Phrases
  • Full ADA-guided accessibility Spirit Letter of
    the Law
  • All staff receive disability sensitivity training
  • CREDO
  • Recognize when you dont know Ask when you
    dont know
  • Website Access
  • Monthly meetings with Disability service agencies
  • Utilize CAN DO other listservs for consultation
    guidance advice.
  • Then START implementing your plan !!!

39
1. Nothing About Us Without Us
  • Include people with disabilities in
  • All planning for physical site changes
  • All planning for service delivery procedures,
    protocols and policies
  • Your Board membership
  • Your Advisory Board membership
  • All training activities

40
2. In all Phases and Phrases
  • All phases of service delivery planning
  • All phrases of whom you serve
  • All phrases of whom you employ
  • All phrases of how you serve
  • All depictions of whom you serve
  • At all sites where you deliver service
    (headquarters, shelters, community trainings,
    Board meetings)

41
3. Full ADA-guided accessibility Spirit
Letter of the Law
  • Using your agencys requirement to be in
    compliance with the Americans with Disabilities
    Act
  • Both the letter and spirit of the law
  • Add serving people with disabilities into all
    your PSAs, brochures (for clients, public
    awareness and employment searches)
  • Assure comprehensive physical accessibility
    throughout your agency (and wherever you conduct
    business)
  • Assure comprehensive program accessibility
    throughout all services you provide
  • NOTE Help is available if you are not sure
    from qualified ADA compliance support agencies
    and consultants.
  • Begin an ongoing campaign to conduct outreach
    activities in your area when you are ready to
    serve effectively.

42
4. All staff receive disability sensitivity
training
  1. Prior to employment or within 6 weeks, all staff
    shall have completed the Disability Sensitivity
    Information Training
  2. Monthly meetings with Disability service
    agencies Rotate your meetings with these
    agencies during the year
  3. CIL Center for Independent Living
  4. Services for people who are Deaf/Hard of Hearing
  5. Services for the Blind/Visually Impaired
    Deaf/Blind
  6. Services for adults with Developmental
    Disabilities
  7. Services for adults with mental illness
  8. Services for adults with mobility impairments
    (SCI)
  9. By rotating in this way, you will include most
    people with disabilities AND make good outreach
    by frequent contact.

43
5. CREDO
  • C - Compassion
  • R - Respect
  • E - Empathy
  • D - Dignity
  • O - Open to needs of the survivor
  • Demonstrated in your interactions by
  • Time/patience
  • Repetition
  • Understanding that their form of communication
    is just as valid as yours, only different. Not
    better, not worse. Theirs.

44
7. Website Access
  • Make sure your clients have access to computers
    at your site that are
  • Bobby Approved
  • Accessible for people with disabilities
  • Make sure your site is Bobby Approved!
  • Join listservs to stay up to date get help
  • Participate in on-line learning experiences,
    especially the Arc-Riverside First Professional
    Online Conference on Abuse and Disability.
  • And, participate in the Arc Riverside
    National/International Conference on Abuse
    Disability each year in March.

45
8. Monthly CAN DO meetings with Disability
service agencies
  • Collaborative meetings with all agencies in your
    area that provide services to crime victims on a
    regular basis will
  • Ensure a better response
  • Educate generic service providers
  • Continue to make others aware of crime victims
    with disabilities by mentioning it at each
    meeting.
  • Conduct cross trainings between CJS/DV and
    disability service providers
  • CAN DO is Arc Riversides Model Program for
    improving response to crime victims with
    disabilities These multiagency monthly meetings
    are modeled on the SCAN teams in child abuse.
  • CAN DO Collaborating on Abuse Neglect
    Disability Outreach. We can help you become a
    Certified CAN DO Community

46
9. Utilize CAN DO other listservs for
consultation guidance advice.
  • Stay connected with others to both give and get
    information support
  • Learn about new materials as soon as they are
    available videos, curricula, training programs,
    conferences, etc. Share materials youve found.
  • Learn about tried and true materials (Nora
    ad) for stuff Ive written, stuff Ive
    collected. (Blue/brown/green/pink)
  • Ask your questions, get immediate responses from
    others who share your experiences.

47
START
  • Begin work on the plan you have developed with
    your Board and Advisory Board.
  • Develop a time line. Reward yourself for all
    steps no matter how large or small.
  • If you dont start now, you wont.
  • No one ever achieved success through the
    practice of procrastination.
  • Develop a baseline from which you can measure
    your success and achievements.

48
Dos Donts
  • Use preferred language both in and out of earshot
    of individuals with disabilities, and in writing.
  • Talk to the survivor not about her with others in
    her presence
  • Dont touch!
  • Dont talk down or infantalize
  • Dont touch the wheelchair
  • Explain what you are about to do
  • Use Plain English!
  • Dont talk to the interpreter, talk to the
    survivor!

49
Quality Service
  • Make sure your staff is TRAINED to provide
    effective and sensitive services to clients with
    disabilities not any willing provider aka
    warm body will do.
  • Use certified staff where certifications are
    required
  • Conduct client evaluation surveys for
    self-assessment and service improvement guide.

50
Getting Disclosures so we can provide supportive
services
  • Using Abuse Screening Tools
  • What is the purpose of asking? Know this for
    your agency and for your self.
  • What supportive services can you immediately
    offer? Know your referrals, make the appointment
    for the client. This helps keep up with changing
    phone numbers agency availabilityas well as
    relieves the client of added burdens.
  • What linkages do you have with the community to
    assure access to supportive services
    (availability, transportation, confidentiality,
    accessibility, trained personnel)?
  • Issues of mandatory reporting
  • Care not to interview when that interview may
    ruin the case for legal prosecution.

51
Preventing abuse
  • Understanding public health concepts
  • Primary Educating everyone about a problem
  • Secondary Educating those likely to have the
    problem
  • Tertiary Providing intervention services to
    those who have experienced the problem

52
Responding Investigating
  • The DCFS or APS hotline receive reports of
    suspected abuse.
  • The police or sheriff in a locality may receive
    the initial report
  • They SHOULD/COULD ask if the individual has a
    disability...this would
  • Prepare the individual who will respond to the
    report to use disability-specific protocols
    call for assistance as needed, for example Sign
    Language interpreters.
  • Assist in the development of a data base of
    reported cases referred for first response
    screening

53
Interviewing, Intervention Prosecution
  • The first responder should interview the victim
    others present, determine next step for the
    case
  • Interview SHOULD follow normal legal protocols
    accommodations for the disability of the victim
  • Prosecutors SHOULD be trained in issues of
    disability to address concerns such as witness
    credibility
  • Intervention SHOULD involve a multidisciplinary
    team providing specialized information
    resources for both the victim/family the team.

54
Next Steps AFTER 1st Response
  • Contacting the Victims Assistance Advocates
    office to facilitate first contact for the
    survivor, and advising them to assure that an
    interpreter or other needed accommodation will be
    readily available
  • Identify the needs the survivor wants to address
    first, provide for those needs
  • Where necessary, advocate for the survivors
    access to generic and specialized services.

55
Assuring Proper Treatment for Victims of Violence
with Disabilities
  • ADA Requires Accommodation to the (mental health
    )Patients disability
  • Mental health treatment for sexual assault
    victims with cognitive Disabilities or
    developmental Disabilities (autism, mental
    retardation) requires that the specialist
    providing (child) abuse or sexual assault
    treatment also be trained and skilled in working
    with people with Disabilities
  • The treatment may require many sessions over
    time, shorter sessions, adaptive equipment and
    Certified Interpreters unless the therapist is
    fluent in the signing or other communication
    method used by the patient
  • The treatment will require involvement with the
    family (as secondary victims) to reinforce the
    treatment
  • The team will need to collaborate with others in
    the community with whom the patient is or should
    be involved
  • Understanding that trauma will not express itself
    in the same way in people with some
    Disabilities...this does not mean no trauma has
    been felt.

56
Issues that have arisen
  • The myth of informed consent for sex, rather
    than intervention for non-consensual sex.
  • The withholding of sexual rights for people with
    Developmental Disabilities
  • A false belief that Sex education does not
    require formal teaching preparation
  • This is a BIG area of concern, which is why there
    are certification programs. One should be
    CERTIFIED to teach any subject, particularly one
    fraught with such controversy, misinformation,
    disinformation, and entwined in morality, ethics
    and law. One can become CERTIFIED as a sex
    educator, sex counselor or sex therapist.
    Allowing non-certified individuals to teach is
    yet another demonstration of the lack of value
    given to individuals with Disabilities
  • Sex Education is not the same as sexual assault
    awareness. Nor is sex education clinical
    psychotherapy OR sexual assault or trauma
    treatment.
  • Using abuse awareness programs that address
    stranger danger is a gross misuse of time and
    money since 99 of the problem is missed.

57
  • A frequent response to sexual assault is to
    provide sex education. Thus, Noras Maxim
  • Sex Education
  • Is to
  • Sexual Assault
  • As
  • Budgeting Training
  • Is to
  • Armed Robbery

58
Over time, perpetrators have offered a variety of
reasons for the sexual contact or denying the
sexual contact
  • She came on to ME!
  • It was consensual
  • I was teaching her/him about sex
  • I dont have a penis
  • Or their colleagues, in one case....
  • Shes a nympho AND he is a GREAT guy

59
How to find qualified consultants?
  • Contact the Disability, Abuse Personal Rights
    Project
  • Contact Arc Riverside
  • Visit the CAN DO website www.disability-abuse.com
    /cando
  • Contact the disability service agency in your
    area (ILC or the State or National ILC
    association)
  • Contact NADD for suggestions in your area
  • Contact the UAP/UCE in your area

60
9th National/2nd International Conference on
Abuse of Children Adults with
DisabilitiesMarch 2003
  • Conference Highlights DVD
  • 67 Minutes of the Best of the Best
  • Available from Arc Riverside
  • Just visit the Website for ordering information
  • Also view the entire program, order
  • Videotapes of selected presentations
  • Audiotapes of selected presentations
  • Purchase by contacting Arc Riverside
  • Phone 1 909 688 5141 FAX 909 688 7207
  • Nora_at_disability-abuse.com
  • www.disability-abuse.com/cando

61
First Online Professional Conference on Abuse
Disability
  • WHEN September 9-30, 2004
  • WHERE At your computer!!!
  • WHAT 22 seminars by top nationally recognized
    experts teaching
  • Identification Reporting - First Response -
    Investigation - Interviewing - Prosecuting -
    Judges Role - Victim Services - Psychotherapy
  • AND Communication - Legislation - Policy

62
From YOUR computer!!
  • HOW MUCH 150 full tuition, includes CEUs .
    No late registration fees. Limited
    Scholarships.
  • Advantages You can attend on your own schedule
    (time shifting)no travel, parking, child care,
    time off work. You can repeat viewing of all
    seminars. All faculty offer up to 9 hours post
    conference consultation with registered students.
  • REGISTER TODAY
  • WWW.DISABILITY-ABUSE.COM

63
The End!
  • Please stay in touch !!!
  • By visiting www.disability-abuse.com/cando
  • By email nora_at_disability-abuse.com
  • CAN Do! Project
  • 2100 Sawtelle Blvd. 303
  • Los Angeles, CA 90025
  • 310 473 6768 (Office)
  • 310 996 5585 (Fax)

64
OVC Video
  • The Time is Now
  • Meet us Where We Are
  • Available at no charge from the Office for
    Victims of Crime
  • OVC Resource Center 1 800 627 6872
  • TDD 1 877 712 9279
  • www.ncjrs.org

65
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66
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67
People with Developmental Disabilities
Abuse Crime Victimization - How to Help
68
  • Nora J. Baladerian, Ph.D., LMFTCST, ACFE, C.Hyp.
    EP
  • Abuse Disability Projects Director CAN DO
    Child Abuse Neglect Disability Outreach
    ProjectArc Riverside, California
  • Jim Stream, Executive Director Project Director

69
Purpose for the TrainingDescribe abuse
neglect. Present research on incidence Present
practices for risk reduction Describe the effect
of maltreatment upon individuals with
disabilities and their families.
70
Knowledge is Power !!Use the Pink Book as
your guide.
  • A Risk Reduction Guidebook on Abuse to Use for
    Children Adults with Developmental
    Disabilities
  • Defines Abuse
  • Lists signs and symptoms
  • Outlines what to do after options resources
  • Describes impact of abuse on the person the
    family
  • Describes how to plan for this contingency.

71
Defining Abuse and NeglectSexual Physical
Emotional/verbal Severe Neglect Financial
72
Identifying laws related to abuse and reporting
responsibilityChild abuse lawsDependent or
vulnerable adult
73
Major Issues in Disability1. The Biggest
Disabilityis negative attitudes towards people
with disabilities2. Myths Stereotypes3.
Language4. Crazy thinking
74
Principle Negative Attitudes
  • Devaluing
  • Demeaning
  • Distancing

75
Myths Stereotypes
  • These include beliefs that undermine the full
    personhood of someone due to their disability,
    such as credibility, or the validity of their
    disclosures.
  • This includes the difficulty aka denial that
    some experience believing that anyone would
    sexually assault someone with a disability.
  • Another myth is the belief that all persons with
    Down Syndrome are loving wonderful people, that
    they are all innocent (asexual).
  • Finally, fears that people with disabilities are
    either sex maniacs or asexual.

76
Language Concepts
  • Using language that enhances rather than language
    that hurts, demeans or dehumanizes requires
    listening to those who tell us the words
    phrases they like.
  • The People First proclaims label jars, not
    people, and encourages referring to the
    disability only when necessary to a conversation.
  • Do not use euphemisms such as the words
    (mentally) challenged,
  • Or words that group (THE disabled).
  • First refer to the PERSON, then the disability if
    necessary. Lets talk about Susan, the woman
    who has Down Syndrome.
  • Understand that people HAVE disabilities, not ARE
    disabilities. As in, Suzy HAS a cold, not
    Suzy IS a cold.

77
Some things to say.and to avoid
  • Deaf dumb ?person who is deaf non-verbal
  • Retarded gt has mental retardation or an
    intellectual impairment
  • Wheelchair bound person who uses a wheelchair
  • Autistic has autism
  • Visually challenged - blind
  • Cue STAY TUNED! Language preference change and
    grow. So does disability nomenclature
  • Out TBI Traumatic Brain Injury
  • In ABI Acquired Brain Injury (reason to
    include those who have acquired brain injuries
    through stroke other medical conditions but
    require identical treatment resources.
  • Out Challenged/Differently Abled
  • In Person who has x disability
  • Your desire to be respectful and treat others
    with dignity while we learn and change makes all
    the difference.
  • Take care with casual talk that is so
    retarded!look at that spazfrom teen talk
    such as Beavis Butthead.

78
Crazy ThinkingSanity leaves when you say...
disability.For example, some have erroneously
stated that
  • All people with Down Syndrome, in their young
    adulthood, begin to exhibit abnormal sexualized
    conduct, depression, irritability, anxiety
    PTSD. (misattribution of signs of abuse)
  • People with autism do not have feelings, thus
    cannot be injured psychologically. (De
    humanizing individuals with disabilities.)

79
Which leads to creating innovative responses to
normal work activities
  • Pointing to ones self to illustrate abuse or body
    parts
  • Investigators interview all in the home/family
    except the victim
  • Using baby talk with adults with cognitive
    impairments
  • Agree to place young man in an institution for
    normal affection with a child

80
Boystown Study And Other Significant
Contributions to the field can be found
atwww.nap.eduClick on Article on Crime Victims
with Disabilities
81
Abuse Neglect - Abusers It is estimated that
in 98 of cases of sexual abuse, the perpetrator
is well known to, trusted by, and in a care
providing position to the victim.Perpetrators
seek people with disabilities as they are less
likely to be caught or be convicted.
82
Abuse Neglect VictimsCascade of Barriers to
HelpingMost victims do not tell anyone about
the abuse.
83
  • Most are not asked about abuse
  • If they tell, there is rarely help given
  • If a report is taken, most likely it will not be
    effectively investigated (interview, external
    evidence).

84
gtIf a report is filed, prosecutor is less likely
to accept itgtIf case is tried, case is less
likely to result in a conviction
85
  • gtIf a conviction, a short or reduced sentence is
    most likely
  • gtRarely referred for psychotherapy regardless of
    legal case outcome and process.
  • gtIf referred for psychotherapy, most likely to
    receive treatment from a student untrained in
    working with folks with disabilities.

86
How can the number of maltreatment incidents be
reduced?We can focus our efforts upon the
victims to be responsible OR----------------gt
87
We can focus on care giving conduct that can
reduce the number of abuses against children
adults with disabilities that is thoughtfully
considered, based upon simple rational steps
efforts.
88
First, in studying the research we find that in
about 99 of cases, the perpetrator is well known
to the victim, either as a Family member or
close family friendFathers, grandfathers,
uncles, domestic partners, roommatesUsually
males (by report) who have a close family
relationshipOften the perpetrator lives with or
has careprovider responsibilities authority
89
Further, Often the perpetrator is well liked by
others the abuse is hard to believeAnd has an
authorized position with the child/adult
victimSpecial Education teachers or teacher
aides, or other professional roleWork
supervisors, counselors, staff
administrationAllied health professional such as
Physical Therapist, Occupational
TherapistSupportive staff such as transporters
(bus drivers, driver aides)Authorized respite
care or residential care provider or assistant
90
With this knowledge, we can, as the adults
(professional or parent), institute very
effective protections to reduce the incidence of
abuseIdeas would include1. Improved
employment practices including thorough
employment history verifications and background
checks PRIOR to beginning employment
91
2. Requiring training qualifications for the
position (no waivers) (approximately 60 of
current Special Education teachers in California
do not have a credential but are on waivers).3.
Requiring that Individual Education or Program
Plans be adhered to, particularly when potential
danger has been identified and a protection
established. Same for Individual Program Plans
and Individual Habilitation Plans.?
92
  • 4. Using teams of at least two persons to be
    present when a single child or adult is being
    treated, educated or assisted
  • 5. Using a system of rotation of individuals in
    charge of children and adults.

93
6. Increasing the pay and qualifications for
those entrusted with child care and adult
care7. Providing abuse recognition reporting
training at schools and other locations where
mandated reporters work8. Establishing
reporting supportive atmospheres in agencies,
schools, and other organizations where children
adults with disabilities are.
94
Noras personal
beliefIncreasing personal safety, and
accelerating reporting (as soon as possible after
the assault) is the responsibility of the adults
in the individuals life, not the individual with
a disability.There is no characteristic that a
person can develop that will guarantee freedom
from abuse, regardless of a disability.
95
Assertions skills, body language, or self defense
may not be effective when the perpetrator is
ones own family member, supervisor, coach or
transporter. This holds true for both children
and adults.
96
3 Critical Factors for an Effective Risk
Reduction Plan
  • It uses the strengths of the child/adult with a
    disability
  • It is wholeheartedly adopted by the individual
    and his/her family
  • It is practiced regularly within the family
    setting along with other safety plans
    (earthquake, etc.)

97
Effective vs. Non-Effective Risk Reduction Plans
Effective Non-Effective
Consistent with strengths beliefs of individual Violates Social Rules
Focus on persons real life factors (family, transportation, health, communication skills) General rules such as no, go, tell
Based on concrete instructions and tasks Based on abstract concepts
Wanted v not wanted is taught rather than good/bad touch Body Integrity is assumed.
Focus is on those with whom the person family is familiar. Focus is on strangers
98
How canThe impact upon the abuse victim be
ameliorated?PODER "Poder" means "Power" in
SpanishUsing the Individualized Response Plan
(IRP)
99
Power through information and awarenessInformatio
n about abuse should be
100
  • Family Based
  • Culturally relevant
  • Environmentally presented
  • in a non-threatening way
  • using clear statements
  • using concrete images and examples
  • in Plain English/French/Spanish

101
Overt responses to possible abuse taught that
make senseTechniques children adults can use
if abuse occurs should be reasonabledo-able En
vironmentally soundindividualized culturally
responsivepracticed
102
Determination of potential dangerIn order to
avoid, recognize and acknowledge possible abusive
situations, there needs to be a basis for
distinguishing abuse from accident, volition from
error, and a forum in which to talk about these
distinctions in which free flow discussion allows
the child to learn to form ideas and trust
her/his own judgment. Therefore it is best when
possibly abusive situations are examined that...
103
gtideas and questions are respected gtquestioning
is based in reason or intuitiongttogether with
friends or care providers who are
trustedgtthrough frank and everyday type family
discussions, andgtinclude the possibility of
identifying abuse that is past or current
104
Effective PreparednessSkills and knowledge that
are used frequently can be called upon almost
automatically when needed. The most powerful
reactions to emergencies are those that have been
practiced repeatedly and employ skills used
regularly. The following are those skills that
fit these criteria
105
trust of the sixth sense self knowledgeverbal
self defense physical self defenseassertion
106
gttrust of the sixth sensegtawareness of one's
surroundingsgtfamiliarity with persons in one's
immediate vicinitygtself-respect (demonstrated
from and to one's self)
107
Response to abuse is expected and effective and
isgtimmediategtcalminggtexactly what had been
explained and practicedgtreduces the emotional
impact of the abuse gtcalls upon a pre-identified
support systemgtresults in effective intervention
for primary and secondary victim
108
The Objective Is to Reduce the Incidence and
Impact of Abuse and Neglect of Children Adults
with Disabilities PODER presumes unequal
abilities among children and youth, a wide
variety of personalities, cultural and ethnic
heritages, a wide variety of community and
national cultural rules and boundaries. PODER
presumes that there are a variety of family or
living situations in which one might reside, and
a variety of family relationships for the child
or youth with a disability
109
LEARNING MODALITIES The most powerful learning
modalities are suggested. These are in
descending order example, experience and
explanation. The material to be taught
regarding abuse in general includes learning what
abuse is, learning how to recognize it, learning
how to react if abuse is attempted or
completed, and learning what to do when abuse
occurs.
110
LEARNING STYLESIn addition, each individual has
a preferred learning style, be it visual,
auditory or kinesthetic. The schools use a
"multi modal" approach, using all three to teach
their material. It is equally important to do
this when teaching this critical information on
self care. Using books or pamphlets with
drawings, doing drawings or using puppets or role
plays, as well as hearing and saying practiced
responses is very effective.
111
Through the use of PODER as an overlay to your
curriculum for reducing the risk of abuse or
reducing the emotional impact of abuse, you can
expect success. The individualized approach
combined with a realistic appraisal of the
individuals environment, abilities and cultural
aspects work together to assure success. The
program works when all concerned are in agreement
with the plan and continue to rehearse the
response to an assault regularly, so that if it
should be needed, the ability to use the planned
response is present.
112
Effects of Abuse
  • Fears such as social anxiety, generalized
    anxiety, phobias
  • Depression and sadness
  • Irritability, anger
  • Withdrawal
  • Trouble thinking, concentrating, remembering
  • Re-enactment somatization
  • Change in normal behavior personality
  • Self injury
  • Sleep disturbances

113
Post Traumatic Stress Disorder New Disabilities
either psychiatric, physical, sensory, or
other.Family Impact Secondary Victims include
family members (including residential care
providers).
114
ResourcesSubscribe to newsletters and journals
that provide relevant informationJoin NADD,
AAMR, and other professional organizations
Attend conferences for people with
disabilitiesAnd.....
115
Acquire books, articles of relevance and interest
from Nora others1. Guidebook on Abuse
Individuals with Cognitive and/or Communication
Impairments (The Pink Book)2. Sexual
Assault Survivors Guidebook for People with
Developmental Disabilities (The Blue Book) 3.
Treatment Guidelines for Abuse Victims with
Disabilities (The Yellow Book) 4. FACTS
Forensic Assessment of Consent to Sex
5.
Counseling People with Developmental Disabilities
who have been Sexually Abused (NADD, Shiela
Mansell, PhD.)6. Treating Rape Victims with
Developmental Disabilities (NADD, Ruth Ryan, M.D.)
116
Join with Arc Riversides CAN DO Project
  • This project develops improvements in local and
    Statewide responses to abuse of children with
    disabilities through
  • Improvement of statewide data collection
    activities
  • Development of multidisciplinary team approaches
  • Provision of training programs for responders
  • Collection dissemination of resource
    information
  • On Line Consultation among the experts on CAN
    DO listserve cando_at_disability-abuse.com

117
You can help
  • Volunteer with the CAN DO Project
  • Work with the CAN DO Project to make your local
    community eligible to become a Certified CAN DO
    Community. Contact us for eligibility criteria
  • Becoming informed about these issues and
    conducting public awareness or technical training
    or consultation programs
  • Distribute information about the CAN DO Project
    at your associations and other membership
    organizations
  • Work with us on the next National Conference

118
March 2003 9th National - 2nd InternationalConfe
rence On Abuse ofChildren and Adults with
DisabilitiesTogether We CAN DO
it!!www.disability-abuse.com/cando/confEverythin
g from the Conference is still available to you
except being there! -gt
119
DVD with Conference Highlights
  • 67 minutes of information-packed presentations
  • Includes heart warming Keynote by Victor Rivers,
    NNEDV spokesperson
  • Can be utilized for in-service training
  • Can also be used for general trainings
  • Great to select speakers for your Conference!!!

120
First Online Professional Conference on Abuse
Disability
  • WHEN September 9-30, 2004
  • WHERE At your computer!!!
  • WHAT 22 seminars by top nationally recognized
    experts teaching
  • Identification Reporting - First Response -
    Investigation - Interviewing - Prosecuting -
    Judges Role - Victim Services - Psychotherapy
  • AND Communication - Legislation - Policy

121
Online Conference
  • HOW MUCH 150 full tuition, includes CEUs .
    No late registration fees.
  • Advantages You can attend on your own schedule
    (time shifting)no travel, parking, child care,
    time off work. You can repeat viewing of all
    seminars. All faculty offer up to 9 hours post
    conference consultation with registered students.
  • REGISTER TODAY WWW.DISABILITY-ABUSE.COM

122
Plan to attend our 10th National 3rd
International Conference at the Riverside
Convention CenterMarch 14-16, 2005by Arc
Riverside inRiverside, California (Near Palm
Springs)
123
Get more information...www.disability-abuse.comW
e say, www dot disability minus abuse dot com
!!!To help take abuse out of the lives of
those with disabilities!!
124
Where you can RegisterGet Call for Papers
Submit your proposalGet the Hotel Registration
informationGet more information as the
Conferences developGet information on how to
become a SponsorGet information on how to
volunteer to help...
125
JOIN OUR PROFESSIONAL NETWORK
  • Join with hundreds of others from around the
    world to share information, successes and
    failures (aka learning experiences !!) by
    becoming a member of our CAN DO Listserv.
  • Just go to our website, and click to join us. We
    need you!

126
The End! Thank you for coming!!
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