EPSDT Care for Kids Newsletter

Sexual Abuse and Children with Disabilities
Beverly J. Saboe, RN, MN, Assistant Professor of Nursing
Clinical Nurse Specialist, Department of Pediatrics Child Protection Program;
and Staff Nurse, Integrated Call Center, University of Iowa Hospitals and Clinics
Winter 2003

About 30% of the more than 3 million child abuse reports made each year in this country are “substantiated,” that is, founded or confirmed. Nationally, about 10% of these reports involve sexual abuse. In Iowa in 2001, about 970 children were sexually abused.

In 2000 in the US, parents were the abusers in 79% of all cases, regardless of the type of abuse. Parents were the abusers in 45% of all cases of sexual abuse (DHHS National Child Abuse and Neglect Data Systems, 2000).

Disability can lead to abuse, and abuse can lead to disability

In 47% of cases, workers thought that the disability led to or contributed to the abuse.
In 37% of the cases, social workers believed that abuse had caused the disability.

Abuse and disability

Research suggests that children with disabilities are 4 to 10 times more likely to be abused than children without disabilities. A number of factors may increase the risk of abuse for these children, including increased dependency on others for personal care, caregiver attitudes toward children with disabilities, and increased stress due to financial and personal care pressures related to the child’s disability.

The most comprehensive study of all forms of child abuse to date, released in 1993 by the US Department of Health and Human Services Office of Child Abuse and Neglect, found that 14.1% of maltreated children had one or more disabilities. Children with disabilities were abused nearly twice as often as children without disabilities. In 47% of the cases, workers thought that the disability led to or contributed to the abuse.

In 37% percent of the cases, social workers believed that abuse had caused the disability. A recent study by Sullivan and Knutson (2000) found that children with disabilities were 3.4 times more likely to be mal-treated than their non-disabled peers. Abuse often took several forms, and sometimes included sexual abuse.

People, including health professionals, do not want to believe that children, and particularly children with disabilities, are abused or neglected. The signs of abuse demonstrated by children with disabilities are the same as those in the general population of children without disabilities:

The nature of a child’s disability may make discovery of the abuse extremely difficult. The child may not be able to tell what happened, or may not perceive what occurred as abuse. Sometimes abuse is not suspected until it produces undeniable physical signs (such as pregnancy, venereal disease, physical injury) or obvious behavioral signs (such as re-enactment of the abuse).

Nearly half of all abused children receive no treatment or services following assessment for abuse...

US Department of Health and Human Services, 2000

The US Department of Health and Human Services reported in Child Maltreatment 2000 that nearly half of all abused and neglected children receive no treatment or services following assessment of abuse allegations.

Current public policy tends to focus on treating children after they are abused, rather than on preventing abuse. Existing child abuse prevention programs need to address the needs of children with disabilities and their families. Parents need to be informed of the risks of abuse of their children with disabilities. Curriculum materials are available to teach children with disabilities age- and developmentally-appropriate assertiveness skills, risk reduction strategies, and personal safety skills.

Keeping Our Children Safe: A Booklet for Caregivers and Providers of services for Children with Developmental Disabilities to Reduce the Risk of Abuse. Bissada, A et al. (2000).

Maltreatment and disabilities: A population-based epidemiological study. Sullivan, PM & Knutson, J. (2000). Child Abuse and Neglect, 24(10), 1257-1273.