Sexual abuse occurs across the population and affects people with and without disabilities. In cases involving people with intellectual and/or developmental disabilities (IDD), however, increased risk factors result in increased incidence of sexual abuse. When considering the issue of sexual abuse of people with IDD, it is critical to be able to define both intellectual and developmental disabilities and sexual abuse. An awareness of prevalence, risk factors, abuse manifestations and systemic response is needed to fully understand the sexual abuse of people with IDD.
A developmental disability is defined as a severe, chronic disability that is attributed to a mental or physical impairment or a combination of mental and physical impairments and is manifested before the person attains age 22. Developmental disabilities result in substantial functional limitations in three or more of the following areas of major life activity: self-care, receptive and expressive language, learning, mobility, self-direction, capacity for independent living, and economic self-sufficiency. Although many people with developmental disabilities have an intellectual disability, not all do. An intellectual disability is defined as limited intellectual functioning (IQ 70 or below) and impaired functioning in practical, social, and conceptual behavior.
Sexual Abuse Defined
Sexual abuse is generally viewed as a continuum of sexual behaviors intended for the sexual gratification of the perpetrator. The sexual abuse continuum is identified as starting with nudity and extending to sexual intercourse. Other behaviors along the continuum include disrobing, observation of the victim, exposure to pornographic materials, sexual photography and/or video of the victim, genital exposure, exhibitionism, kissing, fondling, masturbation, fellatio, cunnilingus, dry intercourse, penetration of the rectal opening or vagina by fingers or objects, and penile penetration of the vaginal or rectal opening.
Research has consistently shown that people with developmental disabilities are at increased risk for sexual victimization, particularly those individuals whose developmental disability includes an intellectual limitation. Experts in this area report that a large percentage of individuals with IDD experience sexual assault or abuse at some point in their lifetime. Numerous reasons have been identified for the increased rates of sexual abuse among this population, including lack of personal privacy, potential difficulty discerning whether or not an act is abusive, difficulty in the area of communication, risk of not being believed, and a sense of social powerlessness.
Intense personal supports that involve activities of daily living such as toileting, bathing, and other personal care practices are situations those without disabilities do not frequently encounter, therefore placing the individual with IDD at increased risk. Those who provide supports to a person with an IDD may include family and friends, defined as informal caregiver networks. Support people could be known to the person through professional service agencies and compose a network of formal caregivers. Research results have indicated that most abuse is perpetrated by a person who is known to the individual with a disability through an informal or formal caregiver network.
Signs and Symptoms
A person who has been sexually abused may show both physical and behavioral signs of abuse. Physical manifestations of abuse may include bruising, a sexually transmitted disease, and genital discomfort. In addition to physical symptoms, a person may exhibit a change in behavior that could include crying, substance abuse, depression, sexually inappropriate behavior, and difficulties in other areas of life. A person who has experienced abuse may also appear afraid of a person and could possibly disclose the abuse.
People with intellectual and/or developmental disabilities who are the victims of sexual abuse have historically been overrepresented and underserved. In the past and in some locations still today, there has been discrimination and apathy related to cases involving victims with IDD, resulting in low rates of arrests, prosecutions, convictions, and appropriate service provision.
Prosecution and Victim Advocacy
In recent years, significant effort has been exerted to improve the systemic response in these cases. Targeted education and training have been developed and delivered to law enforcement officers, prosecutors, judges, child welfare workers, and sexual assault victim advocates and service providers. Many people with IDD are able to effectively participate in the court process and the prosecution of the perpetrator. Often these perpetrators have multiple victims, and failing to vigorously prosecute the perpetrators results in a larger wake of victimization. While law enforcement and prosecutors work to improve their knowledge about working sexual abuse cases involving people with IDD, judges must also be knowledgeable and willing to convict perpetrators. Systemic response is complete only when victims of sexual assault who have IDD can also be served by victim advocacy groups. Often victim advocates are not prepared to provide support and services to people with IDD nor are they connected to the advocacy agencies that typically do provide supports and services (e.g., ARC).
Although people with IDD have the right to seek prosecution of the person who sexually assaulted them, they do not have to. As with all people, victims with IDD should always be given the opportunity to make an informed choice about whether or not to make a police report, press charges, and participate in the prosecution of the perpetrator(s).
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