Child Sexual Abuse Prevention Tools for Children with Disabilities
These FAQs were compiled in partnership with the Chicago Children’s Advocacy Center and with the expert review of Dr. Scott Modell, Deputy Commissioner Tennessee Department of Children’s Services.
Why are children with disabilites at higher risk for sexual abuse?
Children with disabilities face a much higher risk of sexual abuse compared to their peers without disabilities [6, 9]. Their vulnerability is due to many factors. One major factor is that adults are hesitant to provide sex education to children with disabilities. This lack of access to key information puts children with disabilities at-risk of abuse.
Additionally, children with disabilities often depend on others for assistance with daily activities such as hygiene and other intimate tasks. If they don’t already have knowledge of safe and unsafe behaviors, and if they don’t have someone they can turn to for questions, then this further increases their risk.
Some children with disabilities communicate in ways which are not typical. They may sign, gesture, use sound, or say things in a certain way. There may be only a few people who know how to decode what a child is communicating. This impacts a child’s ability to disclose abuse or to seek help. And, this potentially increases the likelihood of abuse among children with disabilities [5]. Children with disabilities can lack social support. They may also face misunderstandings about their sexual behaviors. These factors, too, increase their risk of abuse.
Children with intellectual and developmental disabilities are particularly vulnerable due to challenges in social skills, decision making, and judgment difficulties stemming from their disability. Those living in institutions face heightened risk due to 1:1 personal care situations, communication barriers, and lacking information about healthy sexual development.
After experiencing trauma, children with disabilities may exhibit similar symptoms as children without disabilities. However, due to difficulties in communication or identifying feelings, parents or caregivers may struggle to recognize these effects, often attributing changes to behavioral issues [1].
To address these challenges, a Risk Reduction Workbook for Parents offers guidance on developing individualized response plans tailored to each child's unique abilities and deficits, aimed at mitigating the psychological impact following an assault [2].
Why would a child with a disability need to be taught about sex?
Education on healthy relationships, which includes “sexuality education” rather than just “sex education”, is essential life education for all people. Yes, even people with disabilities.
Sexuality education is more than just talking about intercourse. Sex education includes information on sexual health and safety, pleasure, consent, anatomy, interpersonal relationships, dating violence, and sexual diversity [4]. This information helps all people live full, intentional lives. Even though healthy sex education is important for all people, there are roadblocks which stop children with disabilities from getting this important information.
One of these barriers is an older belief that all people with disabilities are asexual. This isn’t the case. People with disabilities are sexual, and they need this information just as much as any other child. Teaching all children, regardless of disability status, about sexuality is important because it equips them with age-appropriate information. Kids with knowledge about their own bodies are better positioned to engage in mutually safe and fulfilling sexual relationships when appropriate for their age and stage. Knowledge about healthy sexuality is so much more than a fail-safe against inappropriate behavior—it is a tool for life empowerment which all kids deserve.
Other barriers to child sexual abuse prevention for children with disabilities include overprotection, inadequate support and training for educators, unclear responsibilities, the diverse nature of disabilities, and competing priorities [7].
Children with developmental disabilities may struggle with understanding social rules and norms, like distinguishing between appropriate private and public behaviors [8]. Struggling with concepts like this makes kids with developmental disabilities more vulnerable to sexual abuse. This is one more reason why these children need sexual education.
Teaching these concepts in a developmentally appropriate manner gives children with disabilities necessary information about their bodies and development. Teaching kids this information is a part of a safe adult’s role. Education is prevention.
Healthy sexuality education also makes it less likely that these children will behave in ways that are offensive/harmful—healthy sexuality education makes children more aware of what is safe and okay. When children with disabilities don’t get access to the information they need, this increases their risk and it is a missed opportunity for prevention.
What are the best tools to talk about healthy sexuality with a child with limited speech?
Some children with disabilities may be limited, verbally. They may also communicate using signs, voiced devices, typing, other gestures, pictures, expressive sounds, etc. A combination of communication methods, like using body part words and along with gestures may be most useful. One example of this would be to say a body part word, and then gesture how to clean that area while also saying, “clean”.
Parents and the child’s teacher/team member should review for themselves, and with the child, basic safety rules about the appropriate level of help needed in toileting and other activities of daily living (ADLs) with each other and the child. It’s important to have ongoing conversations about which activities of daily living the child may need assistance with, and what exactly that assistance looks like. Support teams should review available health and safety materials, too. And, these should be available to the child in whatever communication format they use. At least one safety goal should be on the child’s Individual Education Plan.
It is not uncommon for people with disabilities to be taken advantage of in a way that is disguised as “helping behavior” [3]. If words and gestures for body parts are reviewed, as well as what level of hands-on help is needed, it is possible that a child who has limited expressive communication, with cognitive disabilities, can indicate or “tell” when an inappropriate touch has occurred. And just like with all children, consistency is important. Keep language, gestures, and helping behaviors the same at school, residential programs, and at home.
It is also important that caregivers/parents have conversations with their children who have a disability about what consensual relationships, whether physical or not, look like. This means talking about how much touch is safe, and how much exploration and intimacy are safe. Sexual interest and curiosity are natural parts of development for all children. This is why ongoing conversations about boundaries and consent are important to have as early as possible, and as regularly as possible.
Learn More
- Safety Planning for Families of Children with Disabilities
- For Parents of Children with Disabilities: How to Protect Your Child from Sexual Abuse in Program Settings
- For Parents of Children with Disabilities: How to Talk to Your Child to Reduce Vulnerability to Sexual Abuse
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References
[1] American Psychological Association Trauma Division. (2023). Developmental disabilities [PDF]. Retrieved from https://apatraumadivision.org/wp-content/uploads/2023/11/developmental-disabilities.pdf
[2] Baladerian, N. J. (2013). A risk reduction workbook for parents and caregivers of children and adults with intellectual and developmental disabilities. Los Angeles, CT: The Disability and Abuse Project of Spectrum Institute. https://tomcoleman.us/publications/2013-survey-report.pdf
[3] Chrastina, J., & Večeřová, H. (2020). Supporting sexuality in adults with intellectual disability—a short review. Sexuality and Disability, 38, 285-298. https://doi.org/10.1007/s11195-018-9546-8
[4] Goldfarb, E. S., & Lieberman, L. D. (2021). Three decades of research: The case for comprehensive sex education. Journal of Adolescent Health, 68(1), 13-27. https://doi.org/10.1016/j.jadohealth.2020.07.036
[5] Legano, L. A., Desch, L. W., Messner, S. A., Idzerda, S., Flaherty, E. G., ABUSE, C. O. C., ... & Yin, L. (2021). Maltreatment of children with disabilities. Pediatrics, 147(5). https://doi.org/10.1542/peds.2021-050920
[6] Mailhot Amborski, A., Bussieres, E. L., Vaillancourt-Morel, M. P., & Joyal, C. C. (2022). Sexual violence against persons with disabilities: A meta-analysis. Trauma, Violence, & Abuse, 23(4), 1330-1343. https://doi.org/10.1177/1524838021995975
[7] Michielsen, K., & Brockschmidt, L. (2021). Barriers to sexuality education for children and young people with disabilities in the WHO European region: a scoping review. Sex Education, 21(6), 674-692. https://doi.org/10.1080/14681811.2020.1851181
[8] Roden, R. C., Schmidt, E. K., & Holland-Hall, C. (2020). Sexual health education for adolescents and young adults with intellectual and developmental disabilities: recommendations for accessible sexual and reproductive health information. The Lancet Child & Adolescent Health, 4(9), 699-708. https://doi.org/10.1016/s2352-4642(20)30098-5
[9] Sullivan, P. M., & Knutson, J. F. (2000). Maltreatment and disabilities: A population-based epidemiological study. Child Abuse & Neglect, 24(10), 1257-1273. https://doi.org/10.1016/s0145-2134(00)00190-3