While there is debate about the actual prevalence, people with disabilities are more likely to be abused than their nondisabled peers. There are a few reasons why and this is by no means an exhaustive list:
- They may exhibit behaviors that people assume require them to be restrained.
- They are “nonverbal” and unable to report the abuse
- The abuse is coming from a caregiver and if the victim reports the abuse, they may lose access to care
- When they do report abuse, they are not believed because they have a disability
- They have not learned the vocabulary to report abuse
- Words that will help them report abuse are not programmed into their communication devices
- They are unaware that what happened was abuse, so they do not report it as such.
- They are more likely to require assistance with self-care tasks (which can make it easier for those assisting them to abuse them)
- They are isolated and do not have a strong support system to help advocate for them
- There is over-focus on teaching “compliance”
In the minor reading I have done, I have found abuse prevention programs that focus on using behavioral skills training where individuals with disabilities are taught how to respond in a potentially abusive situation (this is modeled and then they do a role play practice). Some other curriculum teaches individuals how to make decisions that could decrease the likelihood that abuse would occur. In this curriculum, they look at scenarios and review what decisions should be made in order to stay safe. (“On a side note, while I agree that there need to be specific curricula and teaching practices to help individuals with disabilities, I don’t think that we should be putting all the responsibility on them to keep themselves safe.) However, the majority of curriculum that I have seen are not conducive to individuals with moderate/severe/profound disabilities; especially those that have communication deficits. Many of the programs I have seen use a lot of language and verbally mediated instruction.
The majority of my work is with adults who have disabilities; many of whom require help with basic self-care tasks. Unfortunately, this increases the likelihood that they will be abused. It can be difficult to teach the concepts of “private places” and “private parts” to people with disabilities who require extensive support. This is because, staff and caregivers often violate the privacy rules that we teach when we help with self-care tasks. When I teach the concept of private places, I teach that a private place may be “Private +1”. A “Private+1” place is a private location (i.e your bathroom) with an additional person that you choose who is helping you with very specific tasks. Then I go over what specific tasks my client will need help with and what that help will look like. For instance, if a client needs “help in the bathroom” we specifically talk about what that means; does it mean you need help wiping your bottom after a bowel movement or you just need help sitting on the toilet? If my client is able to wipe themselves independently, but a staff member/caregiver is coming in and saying they will help and starts touching my clients bottom, this should be a red flag.
We also talk about the people that will be coming in to help them. Unfortunately, due to the nature of living in a group home, my clients may receive help with self-care tasks from people they are not familiar with. There are specific strategies staff can use to help teach new staff members how to safely do this, but that is beyond the scope of this post. For now, we talk about how a variety of people will be helping and we describe what that “helping” should look like.
Lastly, we make a plan that includes trusted and safe people. We review that your “Safe” person does not have to be your family. If my client was abused/neglected by family members, I do not want to teach that their family is who they can go to for help. I avoid using phrases like “If someone hurts you, tell someone in your family”. We talk about their “chosen family”. We list the people in their life who they trust and are close with. It is vital to have your client list more than one safe person.
Some questions to consider:
- Am I specifically teaching vocabulary related to abuse prevention?
- What words/phrases should be included when teaching abuse prevention?
- Do I feel comfortable teaching this vocabulary (i.e. am I comfortable using the word rape, vulva or penis?)
Abuse prevention is a big topic, and one blog post isn’t going to do it justice. But I wanted to make sure that people have access to visuals or at least a jumping off point. If you are interested in visual/social stories to help you teach some of these concepts, check it out here:
