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Article Reviews

Groce, N.E. (1988). Special groups at risk of abuse: The disabled. In M.B. Straus (Ed.), Abuse and Victimization across the life span (pp. 223-239). Baltimore: Johns Hopkins University Press.

This article was chosen for review as it examined the range of research on abuse against persons with disabilities across the life span. A great deal of the literature on abuse against persons with disabilities focuses on one type of abuse in one part of the life span, i.e., sexual abuse against children with disabilities. The article was written 10 years ago, and therefore does not include subsequent developments in the literature. This review is not a critical review of the research conclusions of the article, but summarizes the main findings and themes.

The article consists of an overview and sections on the research on relating to child abuse, adults and parents with disabilities, and what can be done. The overall goal of the article is to present, integrate and draw conclusions on the available research on abuse across the life span.

One common barrier faced by persons with disabilities is that the majority, persons without disabilities population dictates societal norms about persons with disabilities rather than the disability itself. Most people are unaware and poorly informed about persons with disabilities, and this situation may not have markedly improved since the late 1980s.

Another factor that greatly impacts persons with disabilities is that they are at substantially greater risk for physical and sexual abuse and neglect compared to persons without disabilities. Parents of children with disabilities are often stressed. The majority of these parents are forced into becoming both informed and experts about medical, social and psychological aspects of disabilities. Some children born with disabilities are particularly difficult to care for despite support and information. It also appears that parents with disabilities of children with and without disabilities face special concerns and difficulties in their attempts to provide for their children in an environment that may poorly understand their efforts.

Review of research now shows that abuse and/or neglect may lead directly to disabling conditions. Both developmental disability and neurological impairment may result from abuse and neglect. "Multiple signs of brain damage, seizures, mental retardation, cerebral palsy, sensory deficits such as impaired hearing and vision, and learning disorders have all been conclusively linked to trauma or neglect (p.225)."

Examination of research on disabilities and child abuse reveals few baseline statistics. However, it has been found that children born with disabilities may result in increased stress for parents and this may result in greater cognitive deficits in children. Undiagnosed disabilities may attenuate, distort or even silence parent-child feedback cycles and result in poorer child care. A number of studies have shown that children with pre-existing disabilities have a higher incidence of abuse and neglect. Child abuse has also been linked to an eight times higher incidence of severely compromised intellectual functioning. If neglected children are added to the abused children, these children were 15 times more likely to have IQs in the extremely low range. Violent physical trauma to children has been found to be a causative factor in cerebral palsy. Neglected children tend to have language delays associated with cognitive deficits and very low levels of intellectual functioning.

Low socioeconomic status results in less protection for poor children and neglect. For children with disabilities, the risk of neglect may be even greater than risk of abuse. Some research suggests that children with severe disabilities are more likely to be neglected. Continuing abuse of children with disabilities compounds problems and further lowers their ability to function. Another painful consequence of abuse and neglect are the enduring psychological effects - including low self-esteem, a sense of helplessness, and feeling that others are in charge of their destiny.

The amount of research information on adults with disabilities is meagre. In general, not only are adults with disabilities at risk for physical and sexual abuse, issues such as sexuality, marriage, child bearing and parenting, and domestic violence are rarely adequately understood and addressed. In terms of violence in the home, spouses with disabilities are more likely to be victims of violence in their homes and have great difficulty accessing community programs. Those most dependent on others for their care are the most vulnerable and most frequently abused. Abuse is known to be prevalent in elderly women with multiple physical and cognitive difficulties. Data from rape centres suggest higher rates of sexual abuse among adults with disabilities. Given the difficulties of persons with disabilities in accessing services, dependence on others for care, and isolation, available data from rape centres underestimate the rates of sexual abuse experienced by adults with disabilities.

For parents with disabilities, common issues are the intergenerational transmission of abuse and parenting difficulties. Abuse may seem like a normal part of child rearing. Other social, emotional and financial stresses further affect how parents with disabilities parent. Parents with disabilities are often reluctant to reach out for help, sometimes fearing that their children will be taken away from them. For parents without disabilities, hallmarks of potential abuse and neglect include a history of family violence, isolation, and economic, social and psychological stress. Parents with disabilities may face these same stresses. Importantly, no data indicate that the rates of child abuse are different for parents with disabilities compared to parents without. When parents with disabilities express difficulties in these areas, they should not be dismissed.

Based on the research findings, the author recommends that families with children with disabilities need support and accurate information on their child's disability. Professionals working with children with disabilities and their parents need to be aware of and ready to assist when parents' abilities to parent are compounded by abuse or neglect.

Abuse prevention is no different for children with disabilities. Services (including baby-sitting and homemaking), respite care and activities outside the home are needed.

For adults, little literature is available in this area. Those dependent on others for support may be unwilling to report abuse or neglect for fear of retaliation or not being believed.

Persons with disabilities may not be seen to be credible witnesses and their cases may not be brought to trial. Persons with disabilities involved in legal proceedings need clear explanations of the judicial process. Women with disabilities are often particularly vulnerable where they are victims of violence and are unable to use existing community programs. These women need at least the same types of assistance as other victims. Finally, abusive persons with disabilities are often particularly marginalized, requiring both resources and outreach.

Mark Bodnarchuk, M.A.,
Research Associate, BCIAFV