Abuse of Children with Disabilities
Facts to Consider
A recent American study found that caregivers abused children with disabilities 1.7 times more than children without disabilities. (1) Research in Canada suggests that the risk estimate of abuse of people with disabilities may be as high as five times greater than the risk for the general population. (2)
Parents of children with disabilities come from every social class and value system. They are as likely as any other person in society to subscribe, either consciously or unconsciously, to widespread negative myths about their child and his or her limitations.
Feelings of shame and denial may be so strong in some cultures that a child’s disability will be hidden by members of his or her family. As a result, the child may be denied access to normal developmental opportunities as well as important support or treatment.
Maltreatment and abuse of institutionalized children with physical and intellectual disabilities are well-documented facts in Canadian history.(3), (4) Protective measures are now in place in Canadian institutions to prevent the reoccurrence of these past events. However, children growing up in residential facilities continue to be at higher risk of abuse than children growing up in their own homes. (5)
What Is Child Abuse?
Child abuse occurs when a parent, family member, guardian, caregiver or other adult (teacher, doctor, neighbour, etc.) causes physical, sexual, emotional or psychological harm to a child, or places a child at serious risk of harm.
Child abuse always involves the misuse of power. Adults are more powerful than children – both physically and socially. Adults who use their power to help, guide and support the development of children are using their power appropriately. However, adults who punish children harshly, insult them, neglect their needs, abuse them physically or sexually, or ignore, isolate, ridicule, humiliate or manipulate them, are using their power in ways that are harmful and destructive to children.
Are Children with Disabilities More Vulnerable to Abuse?
For children with disabilities, the usual risk factors for child abuse (i.e. dependence and vulnerability), are intensified. Children who are unable to perform the same tasks as other children of their age are more vulnerable for many reasons:
Their inability to see, hear, move, communicate, dress, toilet or bathe themselves independently makes them vulnerable to rough, careless or intrusive personal care, or neglect of their personal needs.
These differences also make them vulnerable to unfair and disrespectful comparisons with siblings or other children of the same age. Needing help to do things others can do independently makes them vulnerable to low self-esteem – a major risk factor for abuse.
Their differences may make it difficult for them to participate in family and community activities without assistance, leading to social isolation from their natural peer group and adults other than their primary caregiver(s). Isolation is another major risk factor for abuse.
Their differences make it more likely that their personal care and even their residence will be provided by people who are not related to them, and/or who lack an affective relationship with them. (6) Being cared for outside the home is another major risk factor for abuse.
Children with intellectual or communication differences are vulnerable to being ignored, disbelieved or misunderstood if they attempt to report abuse.
Parents/caregivers of a disabled child may feel very much on their own. They may be stressed by ongoing health care needs, difficulties in finding suitable child care, financial burdens and social isolation, along with related difficulties such as depression and marital discord. Although the role of stress in triggering or causing abuse of children with disabilities is still controversial, studies indicate that caregivers who perceive themselves as severely stressed are more likely to commit abuse.
Children with disabilities are more likely to be viewed in terms of their disability. This places severe limits on a child’s sense of his or her own capabilities, interests and ability to dream and imagine future possibilities. Being depersonalized in this way makes a child vulnerable to some of the most severe forms of abuse, including homicide. (8)
Children with disabilities are often taught to be compliant with adults, especially at the doctor’s or therapist’s office or clinic. Compliance for intrusive or painful procedures that a child would naturally resist may sometimes be obtained through force, coercion or bribery. As a result, it becomes very difficult for a child to distinguish between legitimate and abusive adult demands. (9)
Myths abound regarding the sexuality of people with disabilities. People with disabilities are presumed to not have sexual feelings and desires like everyone else or, conversely, to be “over-sexed.” Children with disabilities, particularly intellectual disabilities, are presumed to not understand anything at all about their bodies, or to be “precocious” about sex. These myths place children at significantly increased risk of sexual abuse.
Children with disabilities may have reduced opportunity to set their own personal boundaries. For example, caregivers of either sex may have responsibility for undressing or bathing a child, regardless of the child’s chronological age or level of development.
What Can Be Done to Prevent Abuse of Children with Disabilities?
Prevention of child abuse is in everyone’s interest. The most vital component of prevention is a multi-level approach to education.
Children with disabilities, like all children, need training in safety, self-protection, healthy sexuality and assertiveness. Children need to know that they have a right to protect themselves and a right to tell an adult if they are not being protected or if their needs are not being met. Children need to understand clearly that they deserve to be treated with respect in every situation – at home, at school, in hospitals or treatment centres, in their social environments, etc.
Parents and others who contribute to a child’s care may need education and support, including special training relevant to a child’s particular physical, sensory or intellectual needs.
Parents/caregivers may also need education regarding the potential risks and signs of abuse. Their child may be at an increased risk of abuse from caregivers and others in the community. Learning to listen to a child is always important, especially if a child has a communication or intellectual disability. Children may communicate about abuse in indirect ways – through regressive behaviours, resistance, or angry “acting out” behaviour. Punishment for these behaviours is inappropriate and counter-productive.
Parents must also be very careful about choosing caregivers – and about observing their child’s response to these individuals. As well, parents can ask questions to assess the openness of professionals and care facilities to their ongoing involvement in their child’s care and development.
Professionals need to “unlearn” old myths that may negatively affect their attitudes toward children with disabilities and/or their families. Children with disabilities must be seen as individuals first, not as “diagnoses.”
Medical professionals need to take sufficient time and care to explain procedures and listen to objections, to ensure that the child’s cooperation reflects a genuine level of informed consent.
People working with children and families need to improve their ability to detect child abuse and neglect and to improve mechanisms for alerting authorities to intervene.
Our broader society must take responsibility for providing adequate support to families so that they can meet the needs of children who have disabilities. Because a disability often entails extraordinary expenses from birth and throughout life, resources must be made available so that families can access the qualified and reliable services and equipment they need – services such as respite care; equipment and medications needed for health, mobility, seeing, hearing and learning; as well as sensitive and responsive social services.
Reporting Abuse of a Child with a Disability
Although some people think that child abuse is a private family matter, it is not. Every member of the public has a responsibility to safeguard the well- being of all children, including children with disabilities.
Some adults find it easier to empathize with the caregiver than with the child with a disability. They may hesitate to judge a caregiver’s actions as abusive, wondering what they would do if they had to deal with the stress of caring for a child with disabilities. These self-doubts must be set aside when the dignity, safety or physical integrity of a child with a disability has been violated in any way. Children with disabilities are entitled to the same protection and security as all other children.
If you have reasonable grounds to suspect that a child is being abused or neglected, promptly report your concerns to the child welfare agency, provincial or territorial social services department or police force in your community. If necessary, a report can be made anonymously.
Reporting is not difficult or time consuming. In all cases, the person making the report is protected from legal action, provided the report is not made falsely or motivated by malice.
In The Community
Parents and/or caregivers of children with disabilities must not allow themselves to be held back by fear or shame in seeking help to deal with problems around self-control, anger or abuse. In many communities, support groups are already active. In others, all that may be needed is one person to take the lead in forming a new support group. Parents, caregivers and advocates for children with disabilities can obtain help and support by calling:
- Their local Association for Community Living
- Their local Independent Living Centre for people with disabilities
- Organizations dealing with specific disabilities, such as the Federation for Cerebral Palsy, the Spina Bifida and Hydrocephalus Association and the Epilepsy Association.
For other information on this topic, or to locate appropriate services, contact your local child welfare or social service agency, the police department, hospital, mental health centre, distress centre, or other community service organization that provides counselling and support to children and families. Many of these organizations are listed among the emergency telephone numbers on or near the first page of your local telephone directory.
(1) U.S. National Center on Child Abuse and Neglect, 1993, cited in D. Sobsey and G. Wolbring, Child Abuse and Disability, Rehabilitation Digest, Toronto, March 1996, p. 11
(2) D. Sobsey, Violence and Abuse in the Lives of People with Disabilities: The End of Silent Acceptance-, Paul H. Brookes Publishing Co., Baltimore, 1994, p. 35
(3) D. Park and J. Radford, From the Case Files: Reconstructing a History of Involuntary Sterilisation, Disability & Society, Vol. 13, No. 3, 1998, pp. 317-342
(4)H. Pringle, Alberta Barren, Saturday Night Magazine, Toronto, June 1997, pp. 30-37, 70, 74
(5) D. Sobsey, Violence and Abuse in the Lives of People with Disabilities: The End of Silent Acceptance-, Paul H. Brookes Publishing Co., Baltimore, 1994, p. 89
(6) D. Fréchette, Parent-Child Relationships – Parents, National Clearinghouse on Family Violence, Ottawa, 1993, p. 2
(7) H. L. Westcott, Abuse of Children and Adults with Disabilities, National Society for the Prevention of Cruelty to Children, London, UK, 1993, p. 33
(8) D. Sobsey, The Media and Robert Latimer, ARCHTYPE, Toronto, August 1995, p. 14
(9) Galbally, R., Child abuse and children with disabilities, Mental Health in Australia, 1993, p. 50