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Home > The Risk and Prevention of Maltreatment of Children with Disabilities > The Risk and Prevention of Maltreatment of Children with Disabilities: What Can Be Done to Prevent Abuse and Neglect of Children With Disabilities?
The Risk and Prevention of Maltreatment of Children with Disabilities
Bulletin for Professionals
What Can Be Done to Prevent Abuse and Neglect of Children With Disabilities?As Ammerman and Baladerian (1993) state, "The physical, emotional, and financial costs of abuse and neglect are so great as to make prevention the number one priority in the effort to eliminate maltreatment of children" (p. 9). If abuse or neglect does occur, it is important to report, investigate, and treat the problem. But it is equally important to address efforts to prevent abuse and neglect. Prevention may be aimed at the general public (known as primary prevention) or targeted specifically to families considered at risk of child maltreatment (known as secondary prevention). (A third form of prevention, not covered in this document, is known as tertiary prevention and is designed to prevent maltreatment from reoccurring.) Because different, interrelated factors can contribute to child maltreatment, different, coordinated prevention strategies are needed. A multifaceted approach may be the most effective. Approaches may be parallel, in which separate programs are implemented for children with disabilities, or integrated, in which the needs of children with disabilities are accommodated in generic programs serving all children. Prevention at the Societal Level One of the first steps in prevention is raising awareness of the problem. Heightened awareness can lead to more funding for research and prevention programs and better programming to combat the problem. The National Symposium on Abuse and Neglect of Children with Disabilities (1995) recommended that 10 percent of Federal funds for child abuse awareness be devoted to disability issues. Most experts in the field also recommend coordination among relevant parties to ensure that prevention efforts are comprehensive. Governments, services providers and local communities can work together to support families that have children with disabilities, and professionals from many fields can collaborate (Rogow & Hass, 1999). Educators and health care professionals, who are often in contact with children with disabilities, can be trained to understand the problem and their role in preventing it (Wolcott, 1997). One study found that 92 percent of special educators would attend specialized training if it were made available (Orelove, Hollahan & Myles, 2000). At the societal level, prevention efforts often focus on changing societal attitudes about children with disabilities. The National Symposium on Abuse and Neglect of Children with Disabilities (1995) and Sobsey (1994) recommend promoting inclusion of children with disabilities into everyday life. Steinberg & Hylton (1998) add recommendations including the encouragement to value children with disabilities, see them as individuals and share responsibility for their well-being. Sobsey (1994) adds recommendations such as educating others specifically about people with disabilities, challenging negative attitudes and behaviors and personalizing interactions. Mitchell and Buchele-Ash (2000) advocate enacting legislation that supports prevention and protection of children with disabilities. For example, the Federal Crime Victims with Disabilities Awareness Act of 1998 was enacted to increase awareness of crimes committed against people with disabilities (including child abuse and neglect), collect data, and develop strategies to address the needs of this population. Mitchell and Buchele-Ash also advocate for adoption of more prevention measures and provision of self-protection education for children with disabilities. Family-focused Prevention Efforts Because much of the maltreatment of children with disabilities occurs within families, many prevention efforts focus on services to families. Goals of family-focused prevention efforts include increasing knowledge and understanding about the child's development; strengthening parenting skills; improving awareness of, and access to, resources; reducing isolation; and developing positive coping skills (Kragthorpe, et al., 1997; Rycus & Hughes, 1998; Steinberg & Hylton, 1998). Services can either be offered to all families that have children with disabilities or to families considered to be at risk of maltreating their children. One service offered to all families that have children with disabilities is the Individualized Family Service Plan (IFSP). The IFSP is required by the Individuals with Disabilities Education Act (IDEA) for families and their young children with disabilities from birth to age 5. The IFSP includes a multidisciplinary assessment, goal setting and planning, linkage to services, and coordination and monitoring of services (Jones, et al., 1995). Parent involvement is critical to ensure that the plan addresses all of the family's identified needs. The case management component of the IFSP is an important one. Case managers can advocate for and help coordinate a myriad of resources needed by families (National Symposium on Abuse and Neglect of Children with Disabilities, 1995; Rycus & Hughes, 1998). These services can include educational, medical, and recreational programs for the children; financial assistance for the families; respite care; counseling; and parenting programs. Parenting programs may provide information about the child's disability and realistic expectations for the child's development and may teach positive parenting skills (Ammerman, 1997; Rycus & Hughes, 1998; Sobsey, 1994). One type of family-focused prevention program that is available to at-risk families that have children with disabilities involves home-visits by trained professionals or para-professionals (Jones, et al., 1995). (Home visitation programs are also widely available for many types of at-risk families.) Home visitation programs often start before or soon after the birth of a child to help build family strengths from the beginning, and may continue until the child is 5 years old. "Home-based services … set the stage for services and support that are flexible, culturally competent, and responsive to family-identified needs…." (Sandall, 1997). Another type of family-focused programming is called Parent-to-Parent support. Parents of children with disabilities can trade information on resources and problem-solve together when agency people are not available (i.e., after working hours). Parents who are at risk of maltreating their children with disabilities can benefit by talking with other parents in similar situations (Jones, et al., 1995). They may express vulnerabilities and explore painful options with other parents in ways they wouldn't feel comfortable doing with a professional. A survey conducted in 1996 found that "Parent to Parent support increases parents' sense of being able to cope [and] … increases parents' acceptance of their situation" (Santelli, Turnbull, Marquis & Lerner, 1997, p. 78). In 1997, there were more than 500 local and 25 statewide Parent to Parent programs serving more than 35,000 parents nationally (Santelli, et al., 1997). When targeting prevention programs to at-risk families, Sobsey (1994) states that it is important to identify the risk factors in families so programs can set priorities and tailor services to individual families. Many professionals discuss the need to focus on reducing the effects of stress on families that have children with disabilities (Burrell, Thompson & Sexton, 1994; Crosse et al., n.d.; Struck, 1999). For example, Rycus & Hughes (1998) state that services must address three factors in the stress equation:
Family-focused prevention services are an important component in the overall effort to prevent abuse and neglect of children with disabilities. Tomison (1996) says that services should be available as long as a family needs them; once services are pulled out, the family that had been able to cope may fall apart. Public funding and medical insurance coverage are key factors in the availability, accessibility, and longevity of services delivered to families of children with disabilities. Child-focused Prevention Efforts Child maltreatment prevention programs are rarely made available or accessible to children with disabilities (Baladerian, 1994), often due to a lack of funding or a mistaken belief that this population does not need prevention information. In actuality, "[w]ithholding knowledge from individuals with disabilities concerning self-protection increases their vulnerability to abuse and neglect" (Mitchell & Buchele-Ash, 2000, p. 235). Ammerman and Baladerian (1993) say that child-focused prevention programs for children with disabilities should include sharing information about abuse (how to identify it, how to respond to it, how to tell others) and talking about feelings that may occur if abuse is attempted. In addition, Briggs (1995) states that parental involvement throughout the program is crucial to ensure all family members are aware of and support the program's teachings. A number of researchers talk about the need for more appropriate and accessible programming for children with disabilities (Baladerian, 1994; Kragthorpe, et al., 1997). Kragthorpe states that programs need to be inclusive and sensitive to ability levels, culture, and gender. Steinberg & Hylton (1998) recommend using developmentally appropriate concepts, concrete activities, and audiovisual aids. They also recommend, as does Baladerian in the National Symposium on Abuse and Neglect of Children with Disabilities (1995), that prevention programs for children with disabilities be ongoing rather than a one-shot effort; children with some disabilities may need lessons repeated frequently. Many programs provide specific information about abuse-what it is, how to recognize it, and what rights children have (Ammerman & Baladerian, 1993; Sobsey, 1994; Tobin, 1992). In addition to education, teaching assertiveness skills is often mentioned as a component of prevention efforts (Baladerian, 1994; Sobsey, 1994; Tobin, 1992). However, Baladerian (1994) cautions that simply telling children with disabilities to say "no" to an adult is often not useful because they are taught to strongly respect and comply with adults in authority. Finally, many abuse prevention programs teach safety and self-defense skills (Baladerian, 1994; Sobsey, 1994; Wolcott, 1997). However, Sobsey (1994) states "… it is important to recognize that many abused people with disabilities, as with other victims of abuse, face extreme power inequities that no amount of individual training can overcome" (p. 178). Prevention of Non-familial Abuse and Neglect Much of the literature examining prevention of non-familial abuse and neglect of children with disabilities focuses on the policies and procedures of agencies providing services to this population. These include careful screening of job applicants, training for staff in positive behavior management techniques, effective staff/client ratios, realistic staff expectations, strong supervision and support, and an explicit commitment to child protection (The Beach Center on Families and Disability, 1997; Kragthorpe et al., 1997; Sobsey, 1994; Steinberg & Hylton, 1998). The National Symposium on Abuse and Neglect of Children with Disabilities (1995) and Steinberg and Hylton (1998) also add that programs should have unannounced checks and investigations conducted by outside agencies. In addition, The Beach Center on Families and Disability (1997) adds that "An open environment that welcomes families has proven to be very effective in reducing abuse and neglect" (p. 2). Families can play a role in preventing abuse and neglect by other caregivers. Ammerman and Baladerian (1993) say that a parent getting to know and being involved with a child's caretakers can be a deterrent to maltreatment. They add that parents should tell people who care for and interact with the child that the child has been trained in abuse prevention techniques and should discuss abuse awareness with their child.
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