READINGS
in Independent Living

People with Disabilities and Abuse

by Leslie Myers

Every 15 seconds a woman in this country is beaten and women with disabilities are not excluded from becoming a part of this statistic. Abuse is a major issue for women with disabilities. The instances of abuse of women with disabilities is estimated to range from 33% to 83% depending on the type of disability and the definition of abuse (Schaller and Lagergren, 1998).

Even though research has not agreed on whether the incidence of abuse against women with disabilities is greater than that of non-disabled women, research has shown that disability does change the experience of the abuse. Some examples of why the experience of abuse differs between women with disabilities and those without disabilities include the inaccessibility of battered women's shelters and hot-line counselors who are not knowledgeable about disability issues. Women with disabilities may also be more economically dependent and/or physically dependent on the abuser, which makes escape difficult. A woman with a disability may also be subjected to different forms of abuse, like the withholding of medications, orthotic equipment and the refusal to do personal care. There are difficulties within the legal arena that all battered women face, but when a woman has a disability that causes speech or communication difficulties or motor coordination difficulties (as in cerebral palsy), the police have been reported to dismiss the woman's claim of abuse by not taking the report seriously or by writing off the woman as being intoxicated. Women with disabilities also face a greater chance that the courts will find the abuser a more fit parent simply because of the woman's disability (Kaminker, 1997).

In 1987, the DisAbled Women's Network (D.A.W.N.) of Canada conducted a survey of 245 women with disabilities and found that 40% had been abused and 12% had been raped. Perpetrators of the abuse included their spouses and ex-spouses in 37% of the cases, strangers in 28%, parents in 15%, service providers in 10% and dates in 7% (Young, Nosek, Howland, Chanpong and Rintala, 1997).

It is hard to estimate the number of women and girls who have been raped in their homes, in institutions or on the streets. Investigations of long-term rehabilitation facilities found that women were being sterilized without their permission in order to hide the molestation that was occurring. In 1984, California community care facilities for the physically and mentally disabled and the elderly were investigated, and findings indicated that residents were being sexually abused and beaten on a daily basis (Asch and Fine, 1988).

The women and girls with disabilities that suffer the most severe and frequent abuses are:

  • Women with multiple disabilities
  • Women with developmental disabilities
  • Women with communication disabilities
  • Women who have a disability at birth or in early childhood

The more physicians and attendants or caregivers a woman depends on, the greater her risk of being abused. A girl with a disability is two times more likely to be sexually or physically assaulted than girls without disabilities, and the most dangerous place for her is in her own home. A girl with a disability is still at a high risk of being sexually and physically abused even if she is removed from the home and sent to foster homes or institutions. One of the reasons women with disabilities are at such high risk of being abused is the attitudes that society holds towards them. Women in general are seen as objects of aggression and control, and when a woman has a disability she is an easy target for rape and physical assault (Canadian Abilities Foundation, 1995).

Women with disabilities are often devalued by society because of both their gender and their disability. They are viewed by society as being physically and/or sexually undesirable, incapable of emotional caretaking and/or incapable of contributing to the economy. Nosek and Howland (1997) mention eight possible contributors to the increased vulnerability to victimization that affects women with disabilities:

    1. Increased dependency on others for long term care.
    2. Denial of human rights that results in the perception of powerlessness.
    3. Less risk of discovery as perceived by the perpetrator.
    4. The difficulty some survivors have in being believed.
    5. Less education about appropriate and inappropriate sexuality.
    6. Social isolation and increased risk of manipulation.
    7. Physical helplessness and vulnerability in public places.
    8. Values and attitudes within the field of disability toward mainstreaming and integration without consideration for each individual's capacity for self-protection.

What does any of this have to do with independent living centers? Independent living centers are often the point of contact for women and men with disabilities who are transitioning from an environment that is restrictive, secluded or segregated to one that is integrated and independent. They are in a position to supply the individual with information on abuse that they may not have received in their previous environment. Independent living for women and men with disabilities may raise special problems in the training and supervision of personal care attendants and assistants. Those independent living centers that offer personal care attendants and assistance services will need to pay attention to reports of abuse and domestic violence, perhaps modifying recruitment, training and supervision of attendants. Independent living centers may also need to assist people with disabilities with assertiveness training and self defense classes, as well as advocating for domestic violence and sexual assault centers to become accessible and to reach out to people with disabilities (Asch and Fine, 1988). Independent living centers can help by teaching the personnel at sexual assault and domestic violence agencies, other agencies that work with individuals with disabilities, the individuals with disabilities, family members, emergency room staff, police officials, the courts and anyone else that may be involved in the prevention, treatment and prosecution of abuse that individuals with disabilities are not exempt from abuse (they may even be considered among the most vulnerable populations) and that these individuals have the same rights to services as anyone else.

A person will face many barriers to disclosing the violence in his or her life, and independent living centers can help by listening and believing the story. Examples of some of the barriers people with disabilities face include:

     Fear. The offender may have an economic hold or have social power over the person with a disability which can keep her from disclosing the violence. The offender may be threatening to withdraw his/her services, hurt the person's family members or take away the person's children.

    Isolation. Some people with disabilities have had little or no contact with anyone other than their caregivers, particularly when they live in institutions. When a caregiver becomes the offender, the person is left with few or no options.

    Lack of Access. People with disabilities do not have full access to violence-related support services. When they do not know that the services exist or cannot gain access to them, they have little opportunity to tell someone about the violence in their lives.\

    Credibility. People with disabilities are often considered to be less competent and less reliable as witnesses simply because they have a disability (Cusitar, 1994).

Providing people with disabilities effective victim services requires service providers to adequately assess survivors, including asking questions about disability-related issues. Service providers need to be trained to recognize and effectively respond to the individual's needs related to the disability, and disability service providers need to be trained to recognize and respond to physical and sexual trauma. The barriers to services need to be eliminated by providing "barrier-free" information and referral services, ensuring the physical accessibility of the agency, providing 24-hour access to transportation, interpreters and communication assistance; and providing trained personnel to monitor risks and respond to victims who are receiving services through disability programs. Special legal protection against abuse may be needed when the person with a disability depends on caregivers at home or in institutions (Nosek and Howland, 1997).

Nosek (1996) discusses the actions which social service workers and clinicians can take to help prevent the sexual abuse of people with disabilities. These actions include:

Learning to recognize the signs of abuse, such as:

  • The types of injuries either reported or observed.
  • Behavioral extremes, like hyperactivity and/or mood swings.
  • Sleep disturbance like nightmares.
  • Eating disturbance or loss of weight.
  • Somatic disorders.
  • Fear of intervention.

Listening to, believing and acting on accounts of abuse.

Doing everything within your power to create opportunities for quality personal assistance.

Doing everything in your power to prevent institutionalization.

Acknowledging the sexuality of people with disabilities.

Acknowledging the basic human rights of people with disabilities.

Teaching a healthy questioning of authority figures.

Teaching independent behaviors.

Teaching healthy sexuality.

Reinforcing a positive sense of self.

"There is an asexual, dependent, passive stereotype of women with physical disabilities that,
in many ways, may lie more at the root of the vulnerability to sexual abuse
faced by this population than the disability itself."(2)
 

REFERENCES

Asch, A, and Fine, M. (1988). Introduction: Beyond pedestals. In M. Fine and A. Asch (1988). Women with disabilities: Essays in psychology, culture and politics (pp. 1-37). Philadelphia, PA: Temple University Press.

Canadian Abilities Foundation (1995). Confronting violence against women. Abilities Magazine (22) Spring.

Cusitar, L. (1994). Strengthening the links: Stopping the violence. Toronto: The DisAbled Women's Network (DAWN).

Fine, M. and Asch, A. (1988). Women with disabilities: Essays in psychology, culture and politics. Philadelphia, PA: Temple University Press

Fisher, B. and Galler, R. (1988). Friendship and fairness: How disability affects friendship between women. In M. Fine and A. Asch. Women with disabilities: Essays in psychology, culture and politics (pp.172-194). Philadelphia, PA: Temple University Press.

Kaminker, L. (1997). No exceptions made: Violence against women with disabilities. New Mobility. pp. 48-55.

Nosek, M.A. (1996). Sexual abuse of women with physical disabilities. In D. M. Krotoski, M.A. Nosek and M.A. Turk (Eds.). Women with physical disabilities: Achieving and maintaining health and well being (pp.153-173). Baltimore: Paul H. Brookes Publishing Co., Inc.

Nosek, M.A. and Howland C. (1997). Sexual abuse and people with disabilities. In M.L. Sipski and C.J. Alexander. Sexual function in people with disability and chronic illness (pp. 577-594). Gaithersburg, Maryland: Aspen Publishers, Inc.

Schaller, J. and Lagergren Frieberg, J. (1998). Issues of abuse for women with disabilities and implications for rehabilitation counseling. Journal of applied rehabilitation counseling, 29 (2), pp. 9-17.

Young, M.E., Nosek, M.A., Howland, C., Chanpong, G. and Rintala, D.H. (1997). Prevalence of abuse of women with physical disabilities. Archives of physical medicine and rehabilitation. (78). pp. S34-S38.

 

Contact Information

Leslie Myers from IndependenceFirst in Milwaukee, Wisconsin, and Peg Calvey from LEAP/CIL in Elyria, Ohio, have been trying to bring together centers for independent living across the country working on the issue of abuse in the lives of individuals with disabilities. Both of these agencies have programs on domestic violence and/or sexual assault. For more information, contact:

Leslie Myers, M.S., C.R.C., C.D.V.C.
IndependenceFirst
600 West Virginia, Suite 301
Milwaukee, WI 53204
(414) 291-7520 (V/TTY); (414) 291-7525 (Fax)
lmyers@independencefirst.org

Margaret "Peg" Calvey
LEAP/Center for Independent Living
2100 North Ridge Road
Elyria, OH 44035
(440) 324-3444 (V); (440) 324-2113 (TTY)
(440) 324-2112 (Fax)

1. From Fisher and Galler (1988) pp.180-181.

2. Nosek (1996) p. 170.

 



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