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Abuse, Violence, and Disability

Articles

Violence and Abuse in the Lives of People with Disabilities
By Dr. Gregor Wolbring (1994)

Women are most frequently affected by domestic violence and abuse, but men with disabilities also are frequently abused. Children are sexually abused, beaten, humiliated and intimidated by adults mostly from the family or friends of the family. Disabled people are abused mostly by caregivers whether it is the family or other disability service providers. Perpetrators of sexual abuse in the case of disabled people are e.g.:

15-25% natural family members
15% acquaintances and neighbors
30 % disability service providers
0-5% strangers 

If we compare the abuse and violence against disabled people with the abuse and violence against women and children the question arises whether their is a difference in the situation for disabled people versus the situation of other victims such as women and children. I will try to illustrate that the situation for disabled people is worse than for the other victims in at least 3 major points.

1) Disabled people are the highest risk group for abuse and violence and society isn't even aware of the problem

2) Support for disabled victims is much less available than for non disabled victims

3) The abuse and violence against disabled people is much more commonly accepted and less frequently punished than for the other victims groups 

To point 1)

In the case of abuse of disabled people, society is absolutely not aware of the extent of abuse against disabled people.

A variety of studies exist which show that disabled people are likely to be in higher risk of being abused than non disabled people.

Sobsey & Varnhagen found that the risk of people with disabilities is at least one and a half times as high as for other people. When only more severe forms of abuse are considered that risk may be three or more times as high as the risk for people without disabilities. We now know that children with disabilities are more likely to be abused than other children and have strong evidence that adults disabilities are more likely to victims of violence. There are a long list of studies indicating the relative risk for children with and without disabilities. Crosse, Kaye , and Ratnofsky (1993) provide the methodologically strongest evidence. Using a nationally representative American sample of 1,788 abused children in a prospective study. They found that children with disabilities were 1.67 times as likely to be abused than other children, based on all categories of abuse and neglect. They were 1.75 times as likely to be sexually abused and 2.09 as likely to be physically abused. The authors of this study suggest that their estimates are conservative, based on their models suggesting that suggested that milder disabilities were probably underdiagnosed in the sample and that institutional abuse was largely excluded because of the nature of the sample. In addition, the relative risk is not steady across ages. The risk for children with disabilities under age 1 is 1.20 times as great and the risk for other children, but for children between 14 and 17 years old, the relative risk has climbed to 2.77 times. This suggests that risk of violence in adulthood may be even higher. Although there are fewer and less well-controlled studies of adults, the available data seem to bear this out. Wilson and Brewer (1992) report an Australian study suggesting that violent crime victimization is 10 to 12 times more frequent for people with developmental disabilities than for other adults. 

As the last survey I would like to mention the one carried out by DAWN CANADA. 381 disabled women took part in a suicide and abuse survey carried out by DAWN Canada, a disabled women's organisation.
In that survey the following numbers were found. 51.1% of the women had experienced sexual abuse; 66.3% had experienced emotional abuse; 43.1% had experiennced neglect; 34.8% had experienced abandonment.

So the first difference between the abuse of children or women and disabled people is in the numbers. Disabled people are much more likely to be victims. 

To point 2)

To my knowledge no support programs exist which are able to deal with the specific abuse histories of disabled people and no coherent policy exist from federal or provincial governments. And that despite the fact that the problem of violence and abuse against disabled people is greater than against women or children. And also no public awareness exist about that problem. 

Effects of Violence

A variety of emotional disorders and symptoms have been described among victims of violence. Many of these have been documented among people with disabilities as well as those who do not have disabilities. We compared counsellors' descriptions of behavioral symptoms in a group of 43 sexually abused children with developmental disabilities and 43 sexually abused children without disabilities. The groups were matched for chronological age and gender because there is a higher percentage of males among abused children with disabilities and they have a higher mean age. While the overall number of symptoms (possible sequelae) was slightly greater for the children with disabilities, there were no significant differences in the frequency of the vast majority of sequelae between the groups. The few categories where there were significant differences appeared to be as likely related to disability itself as to the response to abuse. For example, many more children with disabilities were described as having problems with neatness. 

As seen in the following table, these 13 findings were reported in at least 25% of the sexually abused children with disabilities. Although most occurred with greater frequency in this group than in the control group, most of these differences were not statistically significant. The differences in the frequencies that do exist might be related to differences in the intrusiveness of the abuse or to differences in coping strategies and resilience. 

Finding Percent of Abused Children.. with Disabilities // 

[Percent of Abused Children without Disabilities]

Aggressive behavior 58% [47%]

Poor self-esteem 53% [51%]

Inappropriate anger 51% [35%]

Poor sense of personal safety 44% [14%]

Nightmares 42% [37%]

Lack of sexual information 40% [0%]

Emotional detachment 40% [40%]

Dissociative episodes 37% [28%]

Inappropriate touching 33% [19%]

Inappropriate sexual comments 30% [9%]

Regression 30% [21%]

Few friends 30% [19%]

Easily led 27% [12%]

Self-abuse 26% [7%]

Again as a last survey I would like to mention the one carried out by DAWN CANADA. 381 disabled women took part in a suicide and abuse survey carried out by DAWN Canada, a disabled women's organisation. The first round of analysis shows that 58.7% of the women who responded to the questionnaire had thought about killing themselves. Abuse is strongly related to suicidal feelings.

This is the second difference. Suicide prevention programs exist for a variety of victims (children, women) and minorities as for example the natives. Hardly any suicide prevention programs exist which tailor towards the special need of disabled people and no awareness is raised in society that disabled people are actually the group of society which is the most likely one to be abused. 

 To point 3)

Punishment of abuse

Offences against disabled people are often treated less serious than offences against women and children. Different euphemisms are used to describe crimes against disabled people and against women and children and the different use helps to provide a rationale for reclassifying serious crimes especially those committed within human services, into mere "administrative infractions". 

For example

general term Term applied to disabled victims

Assault Psychological abuse, threat

Battery Abuse, punishment procedure, aversive treatment,

physical prompting, assistance, guidance

Crime Infraction

Homicide Euthanasia, neglect, medical discrimination

Murder Euthanasia,neglect,assisted suicide, allow to die

Rape Abuse, professional misconduct

Sexual assault Abuse, professional misconduct

 It is essential that we classify these crimes properly and respond to them as serious offenses in order to deter their future occurrence.

One example:

On 24 November 1993, Robert Latimer murdered his 12 year old daughter because she was severely disabled. Her father had planed the death over several days. Tracy had cerebral palsy. THe Latimers had recently been notified that there would soon be a permanent place in a local institution for her. Instead, Tracy's father decided that she should die. On 16 November 1994, Latimer was convicted of second degree murder and given the minimum sentence of life with eligibility for parole in 10 years. (Update: He won an appeal at the supreme court of Canada and is now scheduled for retrial.) Among sections of the Canadian media he has become a folk hero: the Latimers had already served a sentence during the 12 years of Tracy's life; Latimer made a parent's decision to end his child's suffering, why should he be prosecuted

The Latimer case shows very clear that society measures in two different ways crimes against disabled people and against non disabled people. For example take the case that Latimer would have 10 kids no money lived in the slums no hope to come out of that and he would have decided to kill his kids because they have no future with parents who can't support them. Under the same conditions he would have been convicted of first degree murder as it was a premeditated act. But it was not enough that Latimer has got the lowest punishment; he is now appealing for aquittal claiming that he has done it only to the good of the girl.

In summary I would like to say that disabled people are at higher risk to be abused the offenders are likely to be treated more lightly and society's awareness of the situation of disabled people related to abuse is lower than with the nondisabled people. Therefore we need to increase awareness, increase support programs for disabled people and equal the treatment of offences in front of the justice system.

REFERENCES

Ammerman, R. T., Van Haslett, V. B., Hersen, M., McGonigle, J. J., & Lubetsky, M. J. (1989). Abuse and neglect in psychiatrically hospitalized multihandicapped children. Child Abuse & Neglect, 13, 335-343.

Crosse, S. B., Kaye, E., & Ratnofsky, A. C. (1993). A report on the maltreatment of children with disabilities (Contract No: 105-89-1630): National Center on Child Abuse and Neglect.

Fernald, E. E. (1909). The imbecile with criminal instincts. Journal of Psycho-Asthenics, 14(1), 16-38.

Kerlin, I. N. (1889) Moral imbecility. Proceedings of the Association of Medical Officers of American Institutions for Idiotic and Feeble-Minded Persons. pp. 32-37.

Romans-Clarkson, S. E., Mullen, P. E., Walton, V. A., & Herbison, G. P. (1988, April 16). Impact of sexual and physical abuse on women's mental health. The Lancet, 841-845.

Sobsey, D., & Varnhagen, C. (1991). Sexual abuse, assault, and exploitation of Canadians with disabilities. In C. Bagley (Ed.), Preventing child sexual abuse Toronto: Wall and Emerson.

Wilson, C., & Brewer, N. (1992). The incidence of criminal victimisation of individuals with an intellectual disability. Australian Psychologist, 27(2), 114-117.