Abuse of Children with Cognitive, Intellectual & Developmental Disabilities

By Leigh Ann Davis, M.S.S.W., M.P.A.
Assistant Director of Professional & Family Services

Why are children with disabilities more at risk of being abused?
Children with disabilities of any kind are not identified in crime statistic systems in the U.S., making it difficult to determine their risk for abuse (Sullivan, 2003). A number of weak and small-scale studies found that children with all types of disabilities are abused more often than children without disabilities. Studies show that rates of abuse among children with disabilities are variable, ranging from a low of 22 percent to a high of 70 percent (National Research Council, 2001). Although the studies found a wide range of abuse prevalence, when taken as a whole, they provide consistent evidence that there is a link between children with disabilities and abuse (Sobsey, 1994).

One in three children with an identified disability for which they receive special education services are victims of some type of maltreatment (i.e., either neglect, physical abuse, or sexual abuse) whereas one in 10 nondisabled children experience abuse. Children with any type of disability are 3.44 times more likely to be a victim of some type of abuse compared to children without disabilities. (Sullivan & Knutson, 2000).

Looking specifically at individuals with developmental disabilities, they are 4 to 10 more times as likely to be victims of crime than others without disabilities (Sobsey, et al., 1995). One study found that children with developmental disabilities were at twice the risk of physical and sexual abuse compared to children without disabilities (Crosse et. al., 1993).

Why are these children more likely to be abused?
According to researchers, disability can act to increase vulnerability to abuse (often indirectly as a function of society’s response to disability rather than the disability in itself being the cause of abuse). For example, adults may decide against making any formal reports of abuse because of the child’s disability status, making the abuse of those with disabilities easier for the abuser (Sullivan, 2003). Parents fear if they report abuse occurring in the group home, they may be forced to take their child out of the home with few options for other safe living arrangements. Often the abusers are parents or other close caregivers who keep the abuse secret and do not report out of fear of legal and other ramifications.

Children may not report abuse because they don’t understand what abuse is or what acts are abusive. Communication problems that are inherent in many disabilities also make it difficult for children to understand and or verbalize episodes of abuse (Knutson & Sullivan, 1993). Those with limited speaking abilities have had no way to talk about or report abuse. Only recently have pictures demonstrating acts of abuse and sexual anatomy been added to communication boards to help non-communicative children and adults (or those with limited communication) report acts of abuse.

Are children with different types of disabilities more at risk for being abused?
A number of studies have found that different types of disabilities have differing degrees of risk for exposure to violence. For example, Sullivan (2003) reported that those with behavior disorders face greater risk of physical abuse, whereas those with speech/language disorders are at risk for neglect.

Sullivan & Knutson (1998) also found that out of all the types of disability, children with behavior disorders and children with mental retardation were both at increased risk for all three forms of abuse (neglect, physical abuse and sexual abuse) compared to those children with other types of disabilities (speech/language disorders, hearing impairments, learning disabilities, health impairments and Attention Deficit Disorder).

There are no differences in which form of child maltreatment occurs the most often between disabled and nondisabled children. For both groups, neglect is the most prevalent, followed by physical abuse, sexual abuse and emotional abuse (Sullivan & Knutson, 2000).

How can I tell if a child with disabilities is being abused?
Children with and without disabilities share similar indicators of abuse. Along with physical signs (bruises, broken bones, head injuries, or other outward marks) two primary indicators are reports from the child that abuse has occurred and changes in the child’s behavior. Children with disabilities face greater risk of abuse going unnoticed if their behavior change can be attributed to their disability instead of the abuse. Also, children with developmental disabilities may be viewed as easily suggestible or untrustworthy, especially when the report involves abuse that seems improbable. Any time abuse is suspected, it is the adult’s responsibility to carefully monitor the child’s behavior, ask the child about his or her safety and follow through by reporting any suspected abuse. State laws vary regarding who is considered a mandated reporter, although usually professionals who have regular contact with children are included, such as teachers, physicians, dentists, speech pathologists, etc. (see “To report abuse” in the box on the back page for more information).

What are the consequences of being abused?
Consequences of abuse may be physical in nature, such as damage to the central nervous system, fractures, injury to internal organs of the abdomen, burns, malnutrition, and trauma to the head (such as in the case of Shaken Baby Syndrome). Other consequences reap havoc on the heart and in the mind of a child, with abuse resulting in long-term emotional trauma and behavioral problems.

Another possible consequence of being abused is to become disabled. Some children who had never had a disability before become disabled due to abuse. For example, a one-year study of children with firearm injuries identified an 11.7% mortality rate and a 10% permanent disability rate. (Dowd, et.al., 1994).

How can I help prevent abuse of children with cognitive, intellectual and developmental disabilities?
Encourage training and continuing education about violence against children with disabilities for those with disabilities themselves, their families, legal professionals, judges, prosecutors, victim advocacy agencies, Guardians ad Litem, public defenders and police officers. Children with disabilities need early education about the risks of abuse and how to avoid it in a way that they can understand.

Parents can get to know all persons working with their child and observe interactions closely for any signs of abuse. Parents and other caregivers may be the abusers, so other adults in the child’s life should also be able to identify possible abuse and know how to go about reporting the abuse.

Parents of children with disabilities and the organizations they are a part of (such as local chapters of The Arc or state Developmental Disability Councils) can form relationships with local victim assistance or child abuse agencies, share each other’s expertise and partner together in serving children with disabilities in their local communities.

Obtaining (or advocating for the funding of) family support programs, such as respite care, that have a direct impact on families with disabilities can help prevent abuse by giving families breaks from day-to-day caregiver responsibilities that can seem overwhelming.

What legislation exists to help children with disabilities?
Although there is no single public policy initiative that addresses abuse of children with disabilities, there have some attempts to address the issue. The Crime Victims with Disabilities Awareness Act of 1998 mandated the inclusion of disability status in the U.S. National Crime Victim Survey. It also mandated that research be conducted to address crimes against individuals with disabilities, including children. See the report at http://www.nap.edu/catalog/10042.html.

The Child Abuse Prevention and Treatment Act (CAPTA) is a law that helps prevent children from being abused, including those with disabilities. Since 1974, this law has been part of the federal government’s effort to help states and communities improve their practices in preventing and treating child abuse and neglect. CAPTA provides grants to states to support child protective services (CPS) and community-based preventive services, as well as research, training, data collection, and program evaluation. (see http://www.cwla.org/advocacy/2003legagenda09.htm for more information).

http://www.thearc.org/NetCommunity/Document.Doc?&id=144
By Leigh Ann Davis, M.S.S.W., M.P.A.
Assistant Director of Professional & Family Services