Sexual abuse and intellectual disability

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Research published from 2000 to 2020 illustrates increased prevalence rates of sexual violence against people with intellectual disabilities, compared to the general population. [1] :61 The World Health Organization (WHO) [2] funded a study which concluded that 15% of the adult population worldwide in 2012 had a disability, putting them at increased risk of physical, sexual, and intimate partner violence. [3] Of that 15%, 6.1% had intellectual disability with 5.5% experiencing sexual violence. [3] In another 2012 report, the WHO found that worldwide, children with intellectual disabilities experienced a 4.6 times greater risk of sexual violence than those without disability. [4]

Contents

In the United States, the Bureau of Justice Statistics reported in the National Crime Victimization Survey the rate of sexual violence for those with an intellectual disability is five times higher than for those without any disability. [5] Both men and women with intellectual disabilities experience sexual violence that includes rape, sexual coercion without physical force, and sexual experiences without physical contact. [6] Perpetrators of sexual violence are not only strangers but can be caregivers, acquaintances, and intimate partners. [6] The perpetrator of the assault often determines if the crime will be reported. [7]

While people with intellectual disabilities experience sexual violence in many of the same ways as the general population, [8] :73 those with intellectual disability may be more vulnerable to sexual violence because of their dependence on others for economic support, personal care, and support with tasks associated with daily living such as bathing and eating. [6] They often encounter additional issues related to their disability and the environments in which they live. These additional issues can include questions around the ability to consent to sexual activities, [9] differential treatment before the law, and restricted access to proper support and recovery services. [10] Societal attitudes and beliefs about the sexuality of those with intellectual disabilities [11] and the validity or accuracy of their claims of abuse [10] are additional risk factors. Finally, racial and ethnic discrimination with disability discrimination increase the risk of sexual violence. [9]

Prevalence and incidence

There are large differences between the prevalence and incidence estimates from independent sources of research as it relates to this topic. Results are often impacted by many factors such as:

Morris (1999) reported that incidence data on sexual abuse of disabled children can be difficult to compile because:

The highest rate of occurrence of abuse happens within the place of residence of the persons with intellectual disabilities. [14] Other areas of frequency where abuse occurs were at the perpetrator's home and in other public places, such as public toilets. [14]

Understanding race and ethnicity factors in sexual assault incidence among those with an intellectual disability are vital for addressing differences between white and minority populations in victimization and intervention. [15] As in other health issues, intellectually disabled people from historically disadvantaged racial and ethnic groups face health disparity with poorer health outcomes than white populations with a disability. [16] However, race and ethnicity are often not reported in study samples looking specifically at sexual violence and intellectual disability. [17]

United States

In 2002, David Sorensen wrote that Americans with intellectual disabilities were four to ten times more likely to have acts of violence committed against them. [18]

In 1996 Dick Sobsey, associate director of the JP Das Developmental Disabilities Centre and Director of the John Dossetor Health Ethics Centre at the University of Alberta, concluded that 80% of 162 people with developmental and substantial disabilities who had been sexually assaulted had been sexually assaulted more than once. [19] Sobsey estimated that between 15,000 and 19,000 individuals with intellectual disabilities experience rape each year. [19]

According to 1995 guidance from the US Department of Justice, more than 90% of Americans with intellectual disabilities experienced some form of sexual abuse at some time in their lives; 49% experienced 10 or more abusive incidents. [20]

In his 1994 book Violence and abuse in the lives of people with disabilities: the end of silent acceptance?, Sobsey wrote that 68% of girls with intellectual disabilities and 30% of boys with intellectual disabilities will be sexually abused before their 18th birthday. [21] [ page needed ]

Sullivan and Knutson concluded in 2000 that children with intellectual disabilities were at slightly greater risk of sexual abuse than disabled children in general, who in turn were at 3.14 times greater risk of experiencing sexual abuse than non-disabled children. [1] : 61 

In 2007, Americans with intellectual disabilities were victims of approximately 47,000 rapes and sexual assaults. [22] Statistical data from 2009 to 2014 drawn from the Bureau of Justice Statistics, the rate of serious violent crime as in rape or sexual assault for persons with intellectual disabilities was more than three times the rate for persons without intellectual disabilities including a correlation of 40% of the time the victim was being taken care of by the person who sexually assaulted them. [23]

A 2010 study concluded that the largest group of identified perpetrators of sexual abuse is developmental disability service providers or caregivers. 87% of a sample from 874 surveys of individuals with intellectual disabilities reported that they had been sexually abused, and 67% had experienced vaginal or anal penetration. [24] The study also concluded that these service providers lacked basic knowledge about abuse, perpetrator characteristics, and facts about potential victims. [24]

In some cases, people with developmental disability are unable to disclose sexual abuse due to the physical or emotional limitations imposed by their disability, leading to the caregivers taking advantage of their intellectual disabilities. [22]

Britain

A study by McCarthy and Thompson in 1997 found a prevalence rate of 25% for men and 61% for women. [25] : 71  A survey by Brown et al. of senior managers in 1992 found an incidence rate of 0.5 per thousand people with intellectual disabilities each year. [8] : 71 

The Republic of Ireland

A study by Dunne and Power in 1990 found an incidence rate of 2.88 per thousand people with intellectual disabilities per year. [26] : 71 

Spain

A study by Gil-Llario, Morell-Mengual, Ballester-Arnal and Díaz-Rodríguez in 2017 found a prevalence rate of 2.8% for men and 9.4% for women. [27] Among the women who were abused, only 52.9% trusted someone enough to tell them about what had happened. Of these, 28.6% preferred to tell a close relative, 57.1% told an educator and 14.3% talked to a friend about it. Of the men, 80% decided to talk about their experience of abuse. Half of them (50%) told their father or mother, 25% talked to an educator and 25% discussed the matter with a close relative.

Another Spanish study indicates that the prevalence of sexual abuse is 6.10% when it is self‐reported (9.4% in women and 2.8% in men) and 28.6% when it is reported by professionals (27.8% in women and 29.4% in men). [28]

Risk factors

A number of factors put people with intellectual disabilities at an increased risk of sexual violence. Medical models of disability emphasize risks connected with the person's disability, while social models of disability focus on risks caused by the socially-created environment of the intellectually disabled person. [29] : 16  Not all factors will apply to all people with intellectual disabilities, and some are not exclusive to people with intellectual disabilities.

People with moderate to severe intellectual disabilities, and those with additional physical disabilities, form the majority of learning-disabled people experiencing sexual violence. [31] : 5 

Detection of sexual abuse risk

Perpetrator profile

Research suggests that 97% to 99% of abusers are known and trusted by the victim who has the intellectual disability. [33] According to Sobsey and Doe's 1991 analysis of 162 reports of sexual abuse against people with intellectual disabilities, the largest percentage of offenders (28%) were service providers (direct care staff members, personal care attendants, psychiatrists). In addition, 19% of sexual offenders were natural or stepfamily members, 15.2% were acquaintances (neighbors, family friends), 9.8% were informal paid service providers (babysitters), and 3.8% were dates. Further, 81.7% of the victims were women, and 90.8% of the offenders were men. [36]

Law

United States

Cases of sexual abuse are considered in many states to qualify as "sexual assault" under the law; sexual assault is often prosecuted through rape or sexual battery statutes. Cases of sexual assault are prosecuted differently according to individual state laws and statutes.

States often have statutes for the intellectually disabled people separate from the general sex offense statutes. Such separate statutes often hold the intellectually disabled person at a "higher standard" for consent than the non-intellectually-disabled person; that is, the legal standards used to prove sexual consent will be stricter for the intellectually disabled individual. [37]

As Deborah W. Denno of the Fordham University School of Law explains:

Courts have applied vague, unworkable tests in determining a mentally retarded victim's capacity to consent; it would be unrealistic to suggest that a rigid, precisely defined standard could ever be effective in so amorphous an area as sexual relations. [37]

Six tests are used as such a standard to assess the legal capacity of the intellectually disabled individual to consent to sexual conduct. These are the tests of "nature and consequences", "morality", "nature of the conduct", "totality of the circumstances", "evidence of mental disability", and "judgment". Forty-nine American states use one of these six tests in reviewing cases of sexual abuse, but Illinois uses two tests. [37]

Test nameDescriptionStates using this test
Nature of the conductThe individual must understand the sexual nature of any sexual conduct and the voluntary aspect of such activity, but does not have to understand the nature and consequences of such sexual activity, or the morality of the conduct. [37] California, Delaware, Florida, Kentucky, Louisiana, Maine, Montana, Nebraska, Nevada, New Hampshire, New Jersey, North Carolina, North Dakota, Ohio, Oregon, Rhode Island, South Carolina, Texas, Utah: 38% of the US.
Nature and consequencesSimilar to the medical informed consent doctrine in which the patient must understand both the nature and consequences of a procedure; the individual must also understand the risks of behavior, including possible negative outcomes. [37] Alaska, Arizona, Arkansas, Indiana, Iowa, Kansas, New Mexico, Oklahoma, Pennsylvania, Tennessee, Vermont, Virginia, Wyoming: 26% of the US.
MoralityThe individual must have a moral understanding of the sexual activity and also understand the nature and consequences of sexual conduct. [37] Alabama, Colorado, Hawaii, Idaho, Illinois (with Totality of circumstances test), New York, Washington: 14% of the US.
Totality of circumstancesAll the facts surrounding the case are weighed up, to determine the cause of the incident.[ citation needed ] Illinois (with Morality test).
Evidence of mental disabilityA method, rather than a statute, which allows for the court to consider evidence of disability. [37] Connecticut, Maryland, Massachusetts, Michigan, Mississippi, Missouri, South Dakota, West Virginia, Wisconsin: 18% of the US.
JudgmentAscertains whether the individual can exercise judgment regarding consent to sexual activity. [37] Georgia, Minnesota

Australia

Special protection

Intellectually disabled people get special protection under Australian law. In the penal code, a person is defined as mentally defective if they have "a mental disease or defect which renders him or her incapable of appraising the nature of his or her conduct." The special protection granted to those with intellectual disabilities in these cases is akin to the statutory protection given to children. In cases of sexual abuse, actual consent is irrelevant, because the person is incapable of giving legal consent. [38]

England and Wales

The Sexual Offences Act 2003 defines sexual offences in general, including those perpetrated against or by adults or children. The Act includes specific crimes against adults with intellectual disabilities or mental health conditions:

sexual abuse of vulnerable persons with a mental disorder. These include situations where:

  • they are unable to refuse because of a lack of understanding,
  • they are offered inducements, threatened or deceived, and
  • there is a breach of a relationship of care, by a care worker; [39]

Reported crimes

In 2002 Daniel D. Sorensen, Chair of the Victims of Crime Committee, Criminal Justice Task Force for People with Developmental Disabilities estimated that less than 4.5% of crimes against people with intellectual disabilities in California were reported compared to the 44% of the general public who experience crimes. [18] In the same year, the Seattle Rape Relief Project program for victims of sexual assault with intellectual disabilities concluded that there was under-reporting of sexual assaults of victims with intellectual disabilities that exceeded under-reporting with other populations. [18] In 1990, several studies[ which? ] suggested 80–85% of criminal abuse of residents of institutions never reached the proper authorities. The studies concluded that 40% of those criminally abused and 40% of non-abusing staff of care facilities studied were reluctant to come forward with criminal abuse issues for fear of reprisals or retribution from administrators. [40]

Effects of sexual violence

Sexual violence harms people with intellectual disabilities like those without intellectual disability (ID). [41] The harm is often worse when the violence occurs over a long period or if the individual has experienced multiple traumatic events throughout their lives. [31] [42] A lower developmental level can increase the risk of harm and if the perpetrator is known to the survivor. [41] [31] The following effects have been reported, but may not be experienced by all learning disabled survivors of sexual violence:

Those with intellectual disabilities face the same challenges reporting incidents of sexual assault as those without ID. [43] Survivors of sexual assault experience fear of retaliation or of not being believed. [43] They may lack knowledge of sex and so are unsure of what happened to them. [43] Society continues to perpetuate the myth that the survivor is to blame for the crime committed upon their body. [43] Additionally, individuals with intellectual disabilities can find it challenging to communicate when sexual abuse occurs or has occurred in the past due to impairments with understanding and expressing language. [42] Barriers to communication [42] [43] and a lack of validated measures to assess for sexual assault in developmentally and intellectually disabled adults [42] makes it imperative for medical providers, family members, and caregivers to recognize some of the behavioral changes that could indicate sexual abuse is occurring or has occurred. [42] [41] [43] The following are behavioral changes that have been seen in some but not all victims of sexual abuse with ID:

Treatment

Treatment of sexual assault starts with awareness that those with disabilities, predominantly intellectual disabilities, are at higher risk and, therefore, more vulnerable to violent crime. [7] Understanding that individuals with intellectual disabilities are at increased risk for sexual assault, health professionals can screen for sexual violence when treating clients. Screening for sexual assault improves health outcomes with timely intervention and treatment. [6]

Individuals with intellectual disabilities who have experienced trauma such as sexual assault are at greater risk for more severe trauma-related distress, including PTSD. [45] Effective treatments focus on teaching individuals to cope with the trauma and overcome fear, anxiety, isolation, and reduce the cumulative effects of reliving the event. [45] Evidence-based recommendations for treating trauma-related distress and Post-traumatic stress disorder for adults and children with developmental and intellectual disabilities are interdisciplinary treatment approaches. [45] Clinicians should be trained in sexuality, intellectual disability, and treating abuse. [46] Pharmacological treatments are effective. [47] Psychotherapy using cognitive behavioral therapy and eye movement desensitization have been useful in populations with intellectual disabilities. [47] One intervention that was most effective at reducing trauma symptoms was establishing changes in a person's daily environment to avoid traumatic cues. [45]

Screening and training of caregivers, clinicians, and care staff improve prevention. [48] Sexual education and sexually appropriate behavior and assertiveness training can increase sexual abuse prevention. [48]

Clinicians and caregivers can advocate and educate others on disability and sexual abuse prevention to improve outcomes for preventing and treating sexual assault for those with intellectual disabilities. [48]

See also

Related Research Articles

Sexual assault is an act of sexual abuse in which one intentionally sexually touches another person without that person's consent, or coerces or physically forces a person to engage in a sexual act against their will. It is a form of sexual violence that includes child sexual abuse, groping, rape, drug facilitated sexual assault, and the torture of the person in a sexual manner.

Developmental disability is a diverse group of chronic conditions, comprising mental or physical impairments that arise before adulthood. Developmental disabilities cause individuals living with them many difficulties in certain areas of life, especially in "language, mobility, learning, self-help, and independent living". Developmental disabilities can be detected early on and persist throughout an individual's lifespan. Developmental disability that affects all areas of a child's development is sometimes referred to as global developmental delay.

<span class="mw-page-title-main">Complex post-traumatic stress disorder</span> Psychological disorder

Complex post-traumatic stress disorder is a stress-related mental disorder generally occurring in response to complex traumas, i.e., commonly prolonged or repetitive exposures to a series of traumatic events, within which individuals perceive little or no chance to escape.

Rape is a traumatic experience that affects the victim (survivor) in a physical, psychological, and sociological way. Even though the effects and aftermath of rape differ among victims, individuals tend to suffer from similar issues found within these three categories. Long-term reactions may involve the development of coping mechanisms that will either benefit the victim, such as social support, or inhibit their recovery. Seeking support and professional resources may assist the victim in numerous ways.

Sexual abuse or sex abuse is abusive sexual behavior by one person upon another. It is often perpetrated using physical force, or by taking advantage of another. Sexual abuse is a term used for a persistent pattern of sexual assaults. The offender is referred to as a sexual abuser. Live streaming sexual abuse involves trafficking and coerced sexual acts, and/or rape, in real time on webcam.

<span class="mw-page-title-main">Rape</span> Type of sexual assault usually involving sexual intercourse without consent

Rape is a type of sexual assault involving sexual intercourse, or other forms of sexual penetration, carried out against a person without their consent. The act may be carried out by physical force, coercion, abuse of authority, or against a person who is incapable of giving valid consent, such as one who is unconscious, incapacitated, has an intellectual disability, or is below the legal age of consent. The term rape is sometimes casually inaccurately used interchangeably with the term sexual assault.

Sibling abuse includes the physical, psychological, or sexual abuse of one sibling by another. More often than not, the younger sibling is abused by the older sibling. Sibling abuse is the most common of family violence in the US, but the least reported. As opposed to sibling rivalry, sibling abuse is characterized by the one-sided treatment of one sibling to another.

Child-on-child sexual abuse is a form of child sexual abuse in which a prepubescent child is sexually abused by one or more other children or adolescents, and in which no adult is directly involved. While this includes one of the children using physical force, threats, trickery or emotional manipulation to elicit cooperation, it also can include non-coercive situations where the initiator proposes or starts a sexual act that the victim does not understand the nature of and simply goes along with, not comprehending its implications or what the consequences might be.

As defined by the United States Department of Veterans Affairs, military sexual trauma (MST) are experiences of sexual assault, or repeated threatening sexual harassment that occurred while a person was in the United States Armed Forces.

Child sexual abuse (CSA), also called child molestation, is a form of child abuse in which an adult or older adolescent uses a child for sexual stimulation. Forms of child sexual abuse include engaging in sexual activities with a child, indecent exposure, child grooming, and child sexual exploitation, such as using a child to produce child pornography.

<span class="mw-page-title-main">Sexuality and disability</span>

Sexuality and disability is a topic regarding the sexual behavior and practices of people with disabilities. Like the general population, these individuals exhibit a wide range of sexual desires and adopt diverse methods of expressing their sexuality. It is a widespread concern, however, that many people with disabilities do not receive comprehensive sex education, which could otherwise positively contribute to their sexual lives. This roots from the idea that people with disabilities are asexual in nature and are not sexually active. Although some people with disabilities identify as asexual, generalizing this label to all such individuals is a misconception. Many people with disabilities lack rights and privileges that would enable them to have intimacy and relationships. When it comes to sexuality and disability there is a sexual discourse that surrounds it. The intersection of sexuality and disability is often associated with victimization, abuse, and purity.

Disability abuse is when a person with a disability is abused physically, financially, sexually and/or psychologically due to the person having a disability. This type of abuse has also been considered a hate crime. The abuse is not limited to those who are visibly disabled or physically deformed, but also includes those with learning, intellectual and developmental disabilities or mental illnesses.

Trauma bonds are emotional bonds that arise from a cyclical pattern of abuse. A trauma bond occurs in an abusive relationship, wherein the victim forms an emotional bond with the perpetrator. The concept was developed by psychologists Donald Dutton and Susan Painter.

Disability hate crime is a form of hate crime involving the use of violence against people with disabilities. This is not only violence in a physical sense, but also includes other hostile acts, such as the repeated blocking of disabled access and verbal abuse. These hate crimes are associated with prejudice against a disability, or a denial of equal rights for disabled people. It is viewed politically as an extreme form of ableism, or disablism. This phenomenon can take many forms, from verbal abuse and intimidatory behaviour to vandalism, assault, or even murder. Although data are limited studies appear to show that verbal abuse and harassment are the most common. Disability hate crimes may take the form of one-off incidents, or may represent systematic abuse which continues over periods of weeks, months, or even years. Disabled parking places, wheelchair access areas and other facilities are frequently a locus for disability hate. Instead of seeing access areas as essential for equity, they are seen instead as 'special treatment', unjustifiable by status, and so a 'reason' for acting aggressively. Denial of access thus demonstrates a prejudice against equal rights for disabled people; such actions risk actual bodily harm as well as limiting personal freedom.

Patient abuse or patient neglect is any action or failure to act which causes unreasonable suffering, misery or harm to the patient. Elder abuse is classified as patient abuse of those older than 60 and forms a large proportion of patient abuse.

<span class="mw-page-title-main">Domestic violence in same-sex relationships</span>

Domestic violence in same-sex relationships or intragender violence is a pattern of violence or abuse that occurs within same-sex relationships. Domestic violence is an issue that affects people of any sexuality, but there are issues that affect victims of same-sex domestic violence specifically. These issues include homophobia, internalized homophobia, HIV and AIDS stigma, STD risk and other health issues, lack of legal support, and the violence they face being considered less serious than heterosexual domestic violence. Moreover, the issue of domestic violence in same-sex relationships has not been studied as comprehensively as domestic violence in heterosexual relationships. However, there are legal changes being made to help victims of domestic violence in same-sex relationships, as well as organizations that cater specifically to victims of domestic violence in same-sex relationships.

Betrayal trauma is defined as a trauma perpetrated by someone with whom the victim is close to and reliant upon for support and survival. The concept was originally introduced by Jennifer Freyd in 1994. Betrayal trauma theory (BTT), addresses situations when people or institutions on which a person relies for protection, resources, and survival violate the trust or well-being of that person. BTT emphasizes the importance of betrayal as a core antecedent of dissociation, implicitly aimed at preserving the relationship with the caregiver. BTT suggests that an individual, being dependent on another for support, will have a higher need to dissociate traumatic experiences from conscious awareness in order to preserve the relationship.

<span class="mw-page-title-main">Sexual assault of LGBT persons</span>

Sexual assault of LGBT people, also known as sexual and gender minorities (SGM), is a form of violence that occurs within the LGBT community. While sexual assault and other forms of interpersonal violence can occur in all forms of relationships, it is found that sexual minorities experience it at rates that are equal to or higher than their heterosexual counterparts. There is a lack of research on this specific problem for the LGBT population as a whole, but there does exist a substantial amount of research on college LGBT students who have experienced sexual assault and sexual harassment.

People with disabilities face 1.5 times more violence than people without disabilities. The perpetrators are often people known to the person with disabilities, such as their partners, family members, friends, or acquaintances. It is estimated that 15% of the world's population lives with disability and are more likely to be poor and socially excluded. Thus violence against people with disabilities has many dimensions.

<span class="mw-page-title-main">Violence against transgender people in the United States</span> Social and political issue in the U.S.

Violence against transgender people in the United States includes sexual, physical, and emotional violence. These acts of gender-based violence may result in the death of a transgender person. Transgender people are more likely to be violently attacked than cisgender ones. The murder rate for transgender individuals is estimated to be lower than that of cisgender people, though the trend is reversed for young Black or Latina transgender women. Between 2008 and 2020, 271 murders on trans people were reported in USA, giving c. 0.83 murders per 1,000,000 inhabitants and placing USA somewhere in the middle between "safe" and "unsafe" states, with reservation for inaccuracies and possible underreporting from some locations.

References

  1. 1 2 Sullivan, P. and Knutson, J. (2000) 'Maltreatment and disabilities: a population based epidemiological study.' Child abuse and Neglect 22, 4, 271 – 288, cited in Higgins, M. and Swain, J. (2010), Disability and Child Sexual Abuse, Jessica Kingsley Publishers.
  2. ↑ World Health Organization (2011). "World Report on Disability". WHO Press.
  3. 1 2 Hughes, Karen; Bellis, Mark A; Jones, Lisa; Wood, Sara; Bates, Geoff; Eckley, Lindsay; McCoy, Ellie; Mikton, Christopher; Shakespeare, Tom; Officer, Alana (April 2012). "Prevalence and risk of violence against adults with disabilities: a systematic review and meta-analysis of observational studies". The Lancet. 379 (9826): 1621–1629. doi:10.1016/S0140-6736(11)61851-5. PMID   22377290. S2CID   42863537.
  4. ↑ Jones, Lisa; Bellis, Mark A; Wood, Sara; Hughes, Karen; McCoy, Ellie; Eckley, Lindsay; Bates, Geoff; Mikton, Christopher; Shakespeare, Tom; Officer, Alana (September 2012). "Prevalence and risk of violence against children with disabilities: a systematic review and meta-analysis of observational studies". The Lancet. 380 (9845): 899–907. doi:10.1016/S0140-6736(12)60692-8. PMID   22795511. S2CID   21485530.
  5. ↑ "Bureau of Justice Statistics (BJS)". www.bjs.gov. Retrieved 2020-10-15.
  6. 1 2 3 4 Basile, Kathleen C.; Breiding, Matthew J.; Smith, Sharon G. (May 2016). "Disability and Risk of Recent Sexual Violence in the United States". American Journal of Public Health. 106 (5): 928–933. doi:10.2105/AJPH.2015.303004. ISSN   0090-0036. PMC   4985079 . PMID   26890182.
  7. 1 2 Wissink, Inge B.; van Vugt, Eveline S.; Smits, Iris A. M.; Moonen, Xavier M. H.; Stams, Geert-Jan J. M. (2018-04-03). "Reports of sexual abuse of children in state care: A comparison between children with and without intellectual disability". Journal of Intellectual & Developmental Disability. 43 (2): 152–163. doi: 10.3109/13668250.2016.1269881 . ISSN   1366-8250.
  8. 1 2 Brown, H., Stein, J. and Turk, V. (1995) 'The sexual abuse of adults with learning disabilities: Report of a second two-year incidence survey.' Mental Handicap Research 8, 1, 3–24, cited in Michelle McCarthy, Sexuality and Women with Learning Disabilities, Second Edition, Jessica Kingsley Publishers, 1999.
  9. 1 2 Kramers-Olen, Anne (December 2016). "Sexuality, intellectual disability, and human rights legislation". South African Journal of Psychology. 46 (4): 504–516. doi:10.1177/0081246316678154. ISSN   0081-2463. S2CID   151386968.
  10. 1 2 National Sexual Violence Resource Center. (2018). Crimes against people with disabilities fact sheet [Resource Guide].
  11. ↑ Rittmannsberger, Doris; Weber, Germain; Lueger-Schuster, Brigitte (2020-02-24). "Social reactions to disclosure of sexual violence in female adults with mild to moderate intellectual disabilities: a qualitative analysis of four cases". International Journal of Developmental Disabilities. 68 (2): 136–146. doi: 10.1080/20473869.2020.1729017 . ISSN   2047-3869. PMC   8928797 . PMID   35309708.
  12. ↑ McCarthy, Michelle (1999). Sexuality and Women with Learning Disabilities (2nd ed.). Jessica Kingsley Publishers. ISBN   9781853027307.
  13. ↑ Morris, J. (1999) 'Disabled children, child protection systems and the Children Act.' Child Abuse Review 8, 91–108, cited in Michelle McCarthy, Sexuality and Women with Learning Disabilities, Second Edition, Jessica Kingsley Publishers, 1999.
  14. 1 2 McCarthy, Michelle; Thompson, David (June 1997). "A Prevalence Study of Sexual Abuse of Adults with Intellectual Disabilities Referred for Sex Education". Journal of Applied Research in Intellectual Disabilities. 10 (2): 105–124. doi:10.1111/j.1468-3148.1997.tb00012.x. ISSN   1360-2322.
  15. ↑ Lewis, Kaleea R.; Robillard, Alyssa; Billings, Deborah; White, Kellee (2019-05-19). "Differential perceptions of a hypothetical sexual assault survivor based on race and ethnicity: Exploring victim responsibility, trauma, and need for social support". Journal of American College Health. 67 (4): 308–317. doi:10.1080/07448481.2018.1472096. ISSN   0744-8481. PMID   29952734. S2CID   205584398.
  16. ↑ Blick, R. N., Ellsworth, D. W., Havercamp, S. M., & Kornblau, B. L. (2015). The double burden: Health disparities among people of color living with disabilities [Report]. Ohio Disability and Health Program. nisonger.osu.edu/ODHP
  17. ↑ Browne, A., Agha, A., Demyan, A., & Beatriz, E. (2016). Examining criminal justice responses to and help-seeking patterns of sexual violence survivors with disabilities (Document No: 250196) [Report]. U.S. Department of Justice.
  18. 1 2 3 Sorensen, David D (9 August 2002). "The Invisible Victims: an update of an article originally published in Prosecutor's Brief: the California District Attorneys Associations Quarterly Journal" (PDF).
  19. 1 2 3 4 5 6 Sobsey, D. Relative victimization risk rates: people with intellectual disabilities (unpublished manuscript). (1996) cited in Facts on Traumatic Stress and Children with Developmental Disabilities, National Child Traumatic Stress Network, Adapted Trauma Treatment Standards Work Group, via Government of Los Angeles County
  20. ↑ Valenti-Heim, D.; Schwartz, L. (1995). "The Sexual Abuse Interview for Those with Developmental Disabilities".
  21. ↑ Sobsey, Dick (1994). Violence and abuse in the lives of people with disabilities: the end of silent acceptance?. Baltimore u.a.: Brookes. ISBN   978-1557661487.
  22. 1 2 McEachern, Adriana G. (2012). "Sexual Abuse of Individuals with Disabilities: Prevention Strategies for Clinical Practice". Journal of Child Sexual Abuse. 21 (4): 386–398. doi:10.1080/10538712.2012.675425. PMID   22809045. S2CID   45421624.
  23. ↑ Harrell, E. (2016). Crime against persons with disabilities, 2009–2014 – Statistical Tables. Retrieved from https://www.bjs.gov/content/pub/pdf/capd0914st.pdf
  24. 1 2 Bowman, Rachel A.; Scotti, Joseph R.; Morris, Tracy L. (2010). "Sexual Abuse Prevention: A Training Program for Developmental Disabilities Service Providers". Journal of Child Sexual Abuse. 19 (2): 119–127. doi:10.1080/10538711003614718. PMID   20390782. S2CID   41153210.
  25. ↑ McCarthy, M. and Thompson, D. (1997) 'A prevalence study of sexual abuse of adults with intellectual disabilities referred for sex education.' Journal of Applied Research in Intellectual Disability 10, 2, 105–124, cited in Michelle McCarthy, Sexuality and Women with Learning Disabilities, Second Edition, Jessica Kingsley Publishers, 1999.
  26. ↑ Dunne, T. and Power, A. (1990) 'Sexual abuse and mental handicap: Preliminary findings from a community based study,' Mental Handicap Research 3, 111–125, cited in Michelle McCarthy, Sexuality and Women with Learning Disabilities, Second Edition, Jessica Kingsley Publishers, 1999.
  27. ↑ Gil-Llario, Mª Dolores; Morell-Mengual, Vicente; Ballester-Arnal, Rafael; Díaz-Rodríguez, Irene (2017). "The experience of sexuality in adults with intellectual disability". Journal of Intellectual Disability Research. 62 (1): 72–80. doi:10.1111/jir.12455. PMID   29159891. S2CID   22622944.
  28. ↑ Gil-Llario, Mª Dolores; Morell-Mengual, Vicente; Díaz-Rodríguez, Irene; Ballester-Arnal, Rafael (2018). "Prevalence and sequelae of self-reported and other-reported sexual abuse in adults with intellectual disability". Journal of Intellectual Disability Research. 63 (2): 138–148. doi:10.1111/jir.12555. PMID   30328163. S2CID   53521044.
  29. ↑ Hollomotz, Andrea, 2011, Learning Difficulties and Sexual Vulnerability, Jessica Kingsley Publishers
  30. ↑ Sobsey, D; Varnhagen, C. (1989). "Sexual abuse and exploitation of people with disabilities: Toward prevention and treatment". In Csapo M., Gougen L (ed.). Special Education Across Canada. Vancouver: Vancouver Centre for Human Developmental and Research. pp. 199–218.
  31. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 Mencap, Respond, UK Voice, 2001, Behind closed doors: preventing sexual abuse of adults with a learning disability, http://lx.iriss.org.uk/sites/default/files/resources/behind_closed_doors.pdf
  32. ↑ Schaafsma, Dilana; Kok, Gerjo; Stoffelen, Joke M. T.; Curfs, Leopold M. G. (August 2014). "Identifying Effective Methods for Teaching Sex Education to Individuals With Intellectual Disabilities: A Systematic Review". The Journal of Sex Research . 52 (4): 412–432. doi:10.1080/00224499.2014.919373. PMC   4409057 . PMID   25085114.
  33. 1 2 3 4 Balderian, N (1991). "Sexual abuse of people with developmental disabilities". Sexuality and Disability. 9 (4): 323–335. doi:10.1007/BF01102020. S2CID   59276744.
  34. ↑ Taylor, M. and Carlson, G. (1993) "The legal trends: Implications for menstruation / fertility management for young women who have an intellectual disability.' International Journal of Disability, Development and Education 40, 2, 133–157, cited in Michelle McCarthy, Sexuality and Women with Learning Disabilities, Second Edition, Jessica Kingsley Publishers, 1999
  35. ↑ Gil-Llario, Mª Dolores; Ballester-Arnal, Rafael; Morell-Mengual, Vicente; Caballero-Gascón, Lorena; Castro-Calvo, Jesús (2020). "Development and Psychometric Properties of the Detection of Sexual Abuse Risk Screening Scale (DSARss)". Sexual Abuse. 32 (7): 850–877. doi:10.1177/1079063219858061. PMID   31248341. S2CID   195762775.
  36. ↑ Sobsey, D.; Doe, T (1991). "Patterns of sexual abuse and assault". Sexuality and Disability. 9 (3): 243–259. doi:10.1007/bf01102395. S2CID   71335300.
  37. 1 2 3 4 5 6 7 8 Morano, JP (June 2001). "Sexual Abuse of the Mentally Retarded Patient: Medical and Legal Analysis for the Primary Care Physician". Primary Care Companion to the Journal of Clinical Psychiatry. 3 (3): 126–135. doi:10.4088/pcc.v03n0304. PMC   181173 . PMID   15014610.
  38. ↑ Lombardi, Kate Stone (25 July 1993). "Rape and the Mentally Retarded". The New York Times.
  39. ↑ http://www.cps.gov.uk/news/fact_sheets/sexual_offences/, The Crown Prosecution Service, "Sexual Offences Factsheet", accessed 12/11/14
  40. ↑ Helm, R (1990). "Study finds abusers of disabled often their helpers". The Edmonton Journal . pp. C3.
  41. 1 2 3 Byrne, Gary (2020-09-24). "A Systematic Review of Treatment Interventions for Individuals With Intellectual Disability and Trauma Symptoms: A Review of the Recent Literature". Trauma, Violence, & Abuse. 23 (2): 541–554. doi:10.1177/1524838020960219. PMID   32969328. S2CID   221884526.
  42. 1 2 3 4 5 6 7 8 9 10 11 12 Mevissen, L.; de Jongh, A. (2010-04-01). "PTSD and its treatment in people with intellectual disabilities: A review of the literature". Clinical Psychology Review. 30 (3): 308–316. doi:10.1016/j.cpr.2009.12.005. hdl: 11245/1.325695 . ISSN   0272-7358. PMID   20056303.
  43. 1 2 3 4 5 6 McGilloway, Connie; Smith, David; Galvin, Rose (2020). "Barriers faced by adults with intellectual disabilities who experience sexual assault: A systematic review and meta-synthesis". Journal of Applied Research in Intellectual Disabilities. 33 (1): 51–66. doi:10.1111/jar.12445. ISSN   1468-3148. PMID   29532978.
  44. 1 2 3 4 5 6 7 8 Goodyear-Brown, Paris (2012). Handbook of child sexual abuse: Identification, assessment, and treatment . New Jersey: John Wiley & Sons Inc. pp.  8. ISBN   978-1-118-08292-8.
  45. 1 2 3 4 Mevissen, L.; de Jongh, A. (April 2010). "PTSD and its treatment in people with intellectual disabilities". Clinical Psychology Review. 30 (3): 308–316. doi:10.1016/j.cpr.2009.12.005. hdl: 11245/1.325695 . PMID   20056303.
  46. ↑ Baladerian, Nora J. (1991). "Sexual abuse of people with developmental disabilities". Sexuality and Disability. 9 (4): 323–335. doi:10.1007/BF01102020. ISSN   0146-1044. S2CID   59276744.
  47. 1 2 Byrne, Gary (2020-09-24). "A Systematic Review of Treatment Interventions for Individuals With Intellectual Disability and Trauma Symptoms: A Review of the Recent Literature". Trauma, Violence, & Abuse. 23 (2): 541–554. doi:10.1177/1524838020960219. ISSN   1524-8380. PMID   32969328. S2CID   221884526.
  48. 1 2 3 McEachern, Adriana G. (July 2012). "Sexual Abuse of Individuals with Disabilities: Prevention Strategies for Clinical Practice". Journal of Child Sexual Abuse. 21 (4): 386–398. doi:10.1080/10538712.2012.675425. ISSN   1053-8712. PMID   22809045. S2CID   45421624.
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