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Abuse and Neglect of Children with Disabilities

Sally M. Rogow

Children with disabilities suffer emotional and physical abuse. The more severely disabled the child, the higher the rate of abuse and neglect. (Sullivan and Knutson, 2000; Fryer, 1993; Sobsey, 1994) Abuse takes place in public and private care facilities. Under-funding, high caregiver turnover, lack of appropriate training, overmedication with psychotropic drugs, use of physical restraints, and isolation are characteristics of environments where abuse takes place. Abuse deprives children of essential social and learning experiences, which deprive them of opportunities to grow, develop, and learn.

Severe depression, withdrawal and unresponsiveness are products of living without continuity of relationships and validation of feelings and experiences. Hostile or indifferent treatment stands in the way of healthy social and emotional development. (Garbarino, Guttman, and Seeley, 1986; Hart, Germaine, and Brassard, 1987)

Parental dependence on professionals and narrowly defined medical and treatment models obscure identification of abuse among children with disabilities. Rigid categories of disability too often determine service eligibility. Referral of children from one service agency to another and untrained, uninformed child care workers create crises in care. Lack of accountability on the part of treatment facilities makes it difficult to identify and treat children who are victims of abuse. (Sobsey, 1994)

Courts in both Canada and the US are currently hearing child maltreatment cases. The National Center on Child Abuse and Neglect in the US has called for renewed emphasis on comprehensive approaches. (Fryer, 1993) Allegations against residential schools in Canada are currently in the courts.

Attachment disorders, lack of connection with activities in the immediate environment, apprehension, passivity, and distress are not characteristics of disability but markers of abuse. Too often, words like “withdrawal,” “resistance,” and “acting out” are used as if they had little bearing on the intense inner turmoil and anxiety that arise from emotional abuse and neglect. (Rogow, 2001)

No diagnostic label can adequately explain behavior unless it also takes account of the environment in which the child is living. In order for children to have access to intervention and treatment, an inclusive system must be developed in which generic child protective services are linked with specialized agencies.

Developing a sense of personal identity does not happen when there is no continuity of personal relationships with adults. Attachment and bonding are basic to the achievement of a sense of personal identity. (Rogow, 2001) Children who experience emotional abuse and neglect are deprived of the opportunity to attain emotional competence and the ability to relate to other people, feel good about themselves, and be free of self-destructive or anti-social emotional expression. (Garbarino and Garbarino, 1987)

Social Attachment and Communication

The desire to communicate is a life-affirming act and making oneself understood is an issue of existence. For children who experience a world that cannot be clearly seen, touched, handled, or explored, language becomes a major means of learning about the world, making it essential to provide alternate means of communication such as sign language, and writing and communication devices. Children who live in socially isolated environments are deprived of the major means of acquiring and practicing language.

Treatment of Children who are Victims of Abuse

The fact that mistreatment of children with disabilities is rooted in different environments requires that programs be tailored for the specific social contexts in which maltreatment occurs. These need to be developed together with coordinated service arrangements and a range of supports that focus on competence rather than disability. (Rothery and Cameron, 1990) Socially responsive environments foster relationships and teach communication skills. Both individual and group approaches are effective. (Baladarian, 1995) There is only one valid criterion for judging the appropriateness of treatment and that is the progress the child is making.

Identification and Reporting

When abuse occurs, it must be identified and reported. To prevent children with disabilities from falling outside the scope of generic services, schools, residential, and treatment centers need to take responsibility for recognizing and reporting abuse. All staff in care facilities, foster homes, and group homes should have opportunities for in-service training, which includes abuse prevention as well as methods and strategies to help children develop positive relationships with adults and peers. Children with disabilities do not differ from other children in the kinds of experiences they need in order to grow and develop.

Building an Integrated System of Child Protection

Providing adequate protection depends on cooperation and collaboration between service organizations and child protective agencies. A consistent infrastructure capable of providing both support and intervention is badly needed. Consistent and comprehensive home support must be readily available to biological as well as foster families. Good home-support services focus on the whole family in an inclusive way.

Creative solutions to support services require only a willingness to undertake the effort to link services. Mental health services and abuse counsellors need access to training and consultation with specialists in the disability field. The actual integration takes place simultaneously on the agency level and the more informal individual casework level.

Children in care need advocates to represent them. Advocates must have complete access to all records and be able to express concerns without fear of reprisal. The medical community is critical and plays an important role in assessing, diagnosing, and reporting child abuse and neglect.

. Community partnerships formed on behalf of child clients strengthen the interventions provided and the agencies involved. Generic child-protection agencies with easy access to consultations and technical assistance will be poised to meet the special needs of children with disabilities. Managers and supervisors as well as front-line workers must have holistic perspectives of the children in their care.

Keys to Ending the Abuse

The key components of preventive services are family support programs, professional and caregiver training, and cooperation among and between service agencies.

Professional training courses for front-line child-care workers will enable pediatricians, social workers, and teachers to recognize emotional and psychological abuse. Collaboration and cooperation between and among service providers will achieve the necessary coordination of health, education, and social services. A community approach that includes children with disabilities will benefit the larger community by enhancing the sharing of limited resources. More importantly, it will benefit the children themselves by ensuring that they grow into adults capable of fulfilling their potential, as all children deserve to do.

A retired UBC professor of special education, Sally Rogow is the author of countless articles and books and the originator of The Person Within. (See sidebar.) She is currently working on a new book, which will be a valuable addition to our growing understanding of abuse of children with disabilities. She has also written about the treatment of children and young people with disabilities in Nazi Germany in a series called “Hitler’s Unwanted Children,” which can be read online at www.holocaust-trc.org/faces.htm . (Select Lesson Plans.) Her most recent book, Faces of Courage, is a collection of stories about young heroes during World War II and includes young heroes with disabilities.

Sources

Baladerian, NJ (1994) “Intervention and treatment of children with severe disabilities who become victims of abuse,” in Developmental Disabilities Bulletin, 22:2, pp.93-99.
Fryer, GE (1993) Child Abuse and the Social Environment, Boulder, Colorado: Westview Press.
Garbarino, J, Guttman, E, and Seeley, JA (1986) The Psychologically Battered Child, San Francisco: Jossey Bass.
Garbarino, J, and Garbarino, AC (1986) Emotional Maltreatment of Children, Washington, DC: National Committee on Prevention of Child Abuse.
Hart, SN, Germain, R, and Brassard, MR (1987) “The challenge: To better understand and combat psychological maltreatment of children and youth,” in Brassard, MR, Germain, R, and Hart, SN, ed’s, Psychological Maltreatment of Children and Youth, New York: Pergamon Press.
Rogow, S (2001) “Silent victims: emotional abuse and neglect of children with disabilities,” in International Journal of Special Education, 17:1, pp. 11-14.
Rothery, M, and Cameron, G (1990) Child Maltreatment: Expanding Our Concept of Helping, New Jersey: Lawrence Erlbaunm and Associates.
Sobsey, D (1997) Violence and Abuse in the Lives of People with Disabilities: The End of Silent Acceptance, Baltimore, MD: Paul H. Brookes Publishing Company.
Sullivan, PM, and Knutson, JF (2000) “Maltreatment and disabilities: a population-based epidemiological study,” in Child Abuse and Neglect, 4:10, pp. 1257-1273.