When disability and abuse intersect, we take action.


Excerpt from APA Guidelines for Assessment of
and Intervention with Persons with Disabilities

(Full Set of Guidelines)

Guideline 11: Psychologists strive to recognize that people with disabilities are at increased risk for abuse and address abuse-related situations appropriately.

People with disabilities are often vulnerable to violence and abuse (Hassouneh-Phillips & Curry, 2002; Horner-Johnson & Drum, 2006; Hughes, 2005; Sullivan & Knutson, 1998). Compared to youth without disabilities, children and adolescents with disabilities may be three to ten times more likely to be abused or neglected (Sullivan & Knutson, 2000), particularly those with behavior disorders, intellectual disabilities, communication disorders, or multiple disabilities (Sullivan & Knutson, 1998). Women with disabilities, especially older woman, are at elevated risk of abuse (Brownridge, 2006; Martin, Serte-Alvarez, Kepper, Meracco, & Prickers, 2006; Smith, 2008), and they experience abuse for longer durations than women without disabilities (Nosek, Foley, Hughes, & Howland, 2001). Although men with disabilities experience similar types of abuse, society often fails to recognize this (Saxton, McNeff, Powers, Curry, & Limont, 2006). People with disabilities are at risk for abuse because they are perceived to be powerless, easily exploited, and may be physically helpless, socially isolated, emotionally deprived, and/or sexually na´ve. Perpetrators have less risk of being discovered, and people with disabilities are less likely to be believed if they do report abuse or neglect (Andrews & Veronen, 1993; Nosek, Foley et al., 2001; Sobsey, 1994).

In addition to emotional, physical and sexual abuse, people with disabilities are vulnerable to disability-specific abuse. Violence against individuals with disabilities can include the withholding or excessive administration of medications, involuntary confinement, withholding or dismantling assistive equipment (e.g. wheelchairs), and withholding personal assistance for essential daily living activities such as eating and personal hygiene (Hughes, 2005; Nosek et al, 2001; Saxton et al., 2001). In institutional or community settings, individuals with disabilities who use personal assistance services experience a high incidence of neglect, verbal and/or physical abuse, and financial exploitation at the hands of their assistants (Oktay & Tompkins, 2004; Powers, Curry, & Oschwald, 2002).

Abuse and neglect may be the initial cause of a disability, may exacerbate an existing disability, and may contribute to depression and other emotional difficulties (Kendall-Tackett, Lyon, Taliaferro, & Little, 2005; Mitchell & Buchele-Ash, 2000; Olkin et al., 2006).

Nosek, Hughes, and Taylor (2004) suggest that psychologists:

a. know the signs, symptoms, and dynamics of disability-related violence, including the unique areas of vulnerability noted above;
b. screen for abuse and neglect, and intervene appropriately;
c. document the history of abuse and neglect;
d. discuss safety planning with clients, such as having a safe retreat, back-up personal care assistance, and social supports;
e. maintain current contact information for accessible local domestic violence/sexual assault programs and disability service providers (e.g., Centers for independent Living);
f. learn state mandatory reporting requirements for violence against people with disabilities including children, older adults, and dependent adults, and when appropriate involve the survivor throughout the reporting process; and
g. be aware of potential long-term consequences of reporting, including possible deterioration in quality of care and the need for accessible domestic violence shelters.


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