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Harold Johnson/Michigan State University Christine Pawelski/Teachers College – Columbia University 3/30/2011 27 th National Symposium on Child Abuse Huntsville, AL
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Harold Johnson/Michigan State UniversityChristine Pawelski/Teachers College – Columbia University3/30/201127th National Symposium on Child AbuseHuntsville, AL

1. Reality Check: An identification of your current realities in relation

individuals with disabilities who are suspected, or confirmed to be victims of abuse.

2. Knowledge Base: A summation of what we know concerning the prevalence

and risk factors re. individuals with disabilities that have experienced maltreatment.

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3. Broad Attempts at SolutionsPolicy, Model and Resource Development examples

4. Community of Learners Critical resources and strategies to enhance maltreatment

prevention and professional response in relation to children with disabilities

ResourcesContact Information

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How often do you work with individuals with disabilities?

How do you document the frequency of this work?

Is there one particular type of person with a disability that you see most frequently? (e.g. ID, ASD, ADHD, HI/D,etc.)

What is the greatest problem you face in working with individuals with disabilities?

How do you address those problems?

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What additional knowledge, skills and support would help you to be even more effective in this type of

Where do you now go for information and support in relation to individuals with disabilities that are suspected/confirmed to have been victims of maltreatment?

Incidence: Disabilities

Number of U.S. Citizens with disabilities (2009 Census Data) = 36,150,710 = 12% of the total U.S. population of 301,472,074)

Individuals w/ disabilities: Under 18 yrs: 2,907,117 18-64 yrs: 19,054,587 65+ yrs: 14,189,006

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Incidence (cont.) Frequently cited study concerning the incidence of

maltreatment experienced by children with disabilities: Sullivan, P.M., & Knutson, J.F. (2000). Maltreatment and disabilities:

A population-based epidemiological study. Child Abuse & Neglect, 24(10), 1257-1273.

50,278 children enrolled in the Public schools of Omaha, Nebraska, during the 1994-1995 school year.

“Analyses of the circumstances of maltreatment and the presence of disabilities established a 9% prevalence rate of maltreatment for nondisabled children and a 31% prevalence rate for the disabled children.”

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Incidence (cont.) U.S. Dept. of Health & Human Services: Child

Maltreatment 2009 - Victims With a Reported DisabilityPresents the number and percent of victims with a reported disability, including different types of disabilities

2009 data, with 44 states reporting, indicated that 53,514 children with disabilities were victims of maltreatment.

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Incidence (cont.) Fourth National Incidence Study of Child Abuse and

Neglect (NIS-4): Report to Congress, January 2010

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Important to note that this was the FIRST TIME disability info included in the report.

Incidence (cont.) NIS-4 2010 (cont.) Summary finding...children with a confirmed

disability are at less risk for maltreatment than their nondisabled peers.

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Is this finding correct, or an artifact of the data collection

process?

Incidence (cont.) Maltreatment of Children With Disabilities

Hibbard, Desch, & American Academy of Pediatrics Committee on Child Abuse and Neglect and Council on Children With DisabilitiesPediatrics, 119(5), 2007

“Current data on incidence and prevalence of maltreatment in children with disabilities are limited by varying definitions of disability and lack of uniform methods of classifying maltreatment. Nonetheless, children with disabilities and special health care needs are at increased risk of child maltreatment.”

= confusion in identification and reporting serve to underreport instances of maltreatment

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Incidence (cont.) Marge, Dorothy, K. (Ed.) (2003). A call to action:

Ending crimes of violence against children and adults with disabilities. A report to the nation A Call to Action.pdf “This is a Report to the Nation on ending crimes of violence

against children and adults with disabilities. This document is a collation and analysis of information from the National Conference on Preventing and Intervening in Violence Against Children and Adults with Disabilities that was conducted on May 6 – 7, 2002 and from an independent review of the clinical and research literature. This Conference represented the first attempt to address, at the national level, both domains of prevention and intervention in violence against children and adults with disabilities of all types.” p. 3

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Incidence (cont.) Marge, Dorothy, K. (Ed.) (2003) (cont.) “After a comprehensive review of the literature on the topic of

children with disabilities who become victims of violence, Sullivan (2002) stated, “The lack of data on the victimization of children and youth with disabilities is universal across the major criminal justice and child maltreatment databases mandated, compiled, and maintained by the federal government.” She continued by indicating that this lack of information has been the major barrier for understanding the scope and characteristics of violence and disability.” (p. 39)

Note this statement was followed by a review of the literature re. the incidence of maltreatment experienced by individuals with disabilities. An updated review of the literature re. this topic can be found at the The National Children's Advocacy Center, CALio Library , Bibliography “No 10 - Child Abuse Victims with Disabilities”

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Incidence (cont.)

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Incidence (cont.) Child Maltreatment in Deaf College Students: An Analysis

of the Prevalence, Characteristics, and Clinical Outcomes D. L. Burnash, G. Rothman-Marshall, & L. S. Schenkel, 44th Annual

Convention: Cognitive Behavior Therapy, San Francisco, Nov. 19, 2010

Key: “CM” = childhood maltreatment

Reported instances of CM among deaf and hard of hearing (D/HOH), versus hearing (H) participants.

H D/HOH X² Value

Emotional Abuse

93 (29%)

52 (48%)

X²=12.68, p<.0001

Physical Abuse

57 (18%)

43 (40%)

X²=21.34, p<.0001

Sexual Abuse

41 (13%)

34 (31%)

X²=19.07, p<.0001

Emotional Neglect

99 (31%)

47 (44%)

X²=5.39, p<.05

Physical Neglect

60 (19%)

48 (44%)

X²=27.67, p<.0001

Participants (N=425) were college students, 317 hearing (H) and 108 deaf (D) and hard of hearing (HOH), (M age 21.2 years, SD 4.6).

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Incidence (cont.) “Take –Away” Points: There is a significant and consistent difference

concerning the incidence of maltreatment, as experienced by individuals with disabilities as, documented within: the 2010 NIS-4 Report to Congress & the 2009 U.S. Dept. of

Health & Human Services Child Maltreatment - Victims With a Reported Disability

empirical investigations, & documented news reports.

The difference is due to inconsistencies in the identification and reporting of maltreatment experienced by individuals with disabilities.

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Incidence (cont.) This difference indicates the need for a more effective

data collection process concerning the number of individuals with disabilities who are suspected/confirmed victims of maltreatment.

SO….is it possible to do better here?

The process begins by asking one question concerning all suspected/confirmed victims of maltreatment, ages birth through 21: Does the individual have a “Individual Family Service Plans”

(IFSP) [birth trough 5 yrs], or an “Individual Education Plan” (IEP) [ 5-21 years].

Is this “doable” and if so, what information do you think such a question could yield, and how would you suggest the resulting information be collected and shared?

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Why are individuals with disabilities at greater risk for maltreatment? Some Child Based Factors: Impaired communication skills that limit their ability to disclose , be

understood, and believed, thus they are “safer” targets for abusers.

Lack of privacy (e.g., at residential schools) and social isolation

Lack of education concerning sexuality and self-protection

Used to being touched by adults for physical assistance, teaching, and interacting + lack of clarity re appropriate and inappropriate types of touching

Relative social immaturity of some students may lead them to demonstrate behaviors that are misunderstood by others (Project Ability: Demystifying Disability in Child Abuse Interviewing)

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Some System Based Factors: Reduced ability to understand children’s disclosure

statements.

Lack of awareness that children with disabilities are at higher risk for neglect and abuse + “risky” situations + knowledge of how to recognize and respond to behavioral indicators that suggest a child may have experienced abuse

Lack of expectation that children with disabilities need information re. sexuality.

Desire to reduce a child’s relative social isolation, combined with the previous identified factors, may serve to lower parent’s “guard” re. interactions between their child and other individuals. (Project Ability)

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Broad Attempts at Solutions

(a) MEDIA is the message related to Awareness

(b) GLOBAL POLICY DEVELOPMENT in many areas

(c) Direct training related to children with disabilitieswithin areas of child abuse (e.g. forensic interviewers, MDTs, CACs)

(d) MODEL and RESOURCE DEVELOPMENT

© 2009 Pawelski

Landmark United Nations

Convention on the Rights of Persons with DisabilitiesAdopted on December 13, 2006

This Convention, will be the first human rightstreaty of the 21st century. It took 4 years to complete and was finished in August, 2006. It was presented to the General Assembly in December and was opened to the 192 member states for ratification and implementation. It will enter into force when ratified by 20 countries.

Chairman:

Don MacKay (New Zealand)

It went into force on May 3, 2008!

To date it has 147 signatures from countries with 99 ratifications. President Obama signed the Treaty July, 2009…whether the U.S. will ever ratify it ???

This Convention is the first global effort to protect the human rights of individuals with disabilities by establishing standards for practice in terms of:

+ education

+ employment

+ housing

+ health

+ full accessibility

+ full inclusion in society and

+ protection from harm

(H.R. 4247) Keeping All Students Safe Act (Passed the House, March 3, 2010; now in the Senate S. 2860 (Dodd))is the first national effort to address this problem and ensure the safety of everyone involved – both students and school staff.

Specifically the legislation would:Prevent and reduce inappropriate restraint and seclusion by establishing minimum safety standards in schools, similar to protections already in place in hospitals and non-medical community-based facilities

“A 14-year-old Texas schoolboy who refused to stay in his seat died after a teacher wrestled him to the floor and lay on top of him. A 7-year-old California girl with Asperger’s syndrome was sat on, restrained, and secluded in a walled-off area. A hyperactive 8-year-old in Ill was bound to a chair, his mouth taped shut.

Across the country each year, thousands of school children—especially disabled ones—are restrained or isolated for misbehaving. The Government Accountability Office reported more than 33,000 incidents of restraint or seclusion last year at schools in Texas and California, two of only six states that track such data. Nineteen states have no regulations at all regarding the use of restraint and seclusion in schools.

FIRST RESPONDER TRAINING….taking hold throughout the United States

Many states are mandating training in autism for all First Responders to a Scene: Emergency Medical Services (EMS), Police, Fire Department

New Jersey launched Mandated Training, March 2010 with over 6,000 First Responders having completed it…thousands more expected to complete it.

EFFORTS CONTINUE TO EXAND IN THIS ARENA….AND TO BE SURE AND INCLUDE ALL DISABILITIES….not just Autism.

Colorado collaborating with NJ to use their training module and tailor it to their state.

Illinois also looking to collaborate with NJ to use their training module and tailor it to their state.

A New York university was just funded to develop a train the trainer First Responders which will be out in 2 years.

South Carolina has hosted sessions in their State on better responses to children with disabilities for First Responders.

Child Abuse and Children with DisabilitiesA New York State Perspective: 2004, 2007, 2008, 2010

©2005, New York State Office of Children and Family Services.

This initial interactive CD-ROM and now fully accessible website is produced by Teachers College, Columbia University. Its publication was made possible by a grant from the New York State Office of Children and Family Services to the New York State Child Advocacy Resource and Consultation Center, a program of Safe Horizon Inc. The contents are solely the responsibility of the authors and do not represent the official views or policies of the funding agency.

Website went “live” September, 2007 http://childabuse.tc.columbia.edu

CURRENT PROGRESS:• 15,053 “hits” to the site with 11,365 unique visitors

• Majority from U.S., but 125 countries represented

• Developing statewide contacts: 18 complete, NY,IL, NC, FL, CT, NJ, MO, TX, NC, PA, MD, CA, NM,GA, VA, WI, MI, OH

• Ongoing Piloting of online training modules with multidisciplinary teams and pre-service social workers

• Just received funding to “pilot” an Advanced “Add-On” to our NYS Forensic Interviewing Trainingbeginning Fall, 2011

http://childabuse.tc.columbia.edu

Beginning in Fall, 2011 NYS Forensic Interviewing Training will be offering “advanced” opportunities for online and interactive training on Disabilities. Extending the “piloting” that was started previously,but we are now TYING it to the completion of the Basic Forensic Interviewing as a required pre-requisite. Movement toward establishing mandated criteria for knowledge and skill development.

Certificate of Completion available upon completion of the module.

The Butler Child Advocacy Center at the Children’s Hospital at Montefiore, Bronx, NY

Your Experience

Your Belief System

Your Knowledge

Quality of Info Presented

Nature of the Experience

Disability Factors

Environmental Supports

Comfort Level

Environmental Supports

Abilities of the Child

Interviewer Skill

Comfort Level

PROCESS CONSIDERATIONS….for Intervening

LEVEL I

Intake

LEVEL II

Reception Area

LEVEL III

The Interview

Developed and Piloted at CAC: Intake Information to gather Developed Activity Sheets for Wait Area Small Word Game (based on Anne Graffam Walkers concepts)

Developed Social Stories (3) Touch screen Listening Cart

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Disability Child Abuse Action Network (DCAAN)

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39This is an audio slideshare…15 minutes in length.

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ooVoo video conferencing technology

...enables synchronous audio/video connections between 2, to 6 individuals/sites

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http://www.oovoo.com/

“People say, ‘What is the sense of our small effort?’ They cannot see that we must lay one brick at a time, take one step at a time…A pebble cast into a pond causes ripples that spread in all directions. No one has a right to sit down and feel hopeless. There’s too much work to do” (Dorothy Day, social justice activist from Brooklyn)

...used the information from this presentation to engage a colleague in a discussion concerning maltreatment and individuals with disabilities.

...requested additional training concerning maltreatment and individuals with disabilities.

...identified, nominated and used “Bright Spots”to provide “just-in-time,” vs. “just-in-case” professional training and support

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...collaborated to form an online community of learners to document the ACTUAL incidence of maltreatment as experienced by individuals with disabilities as way to enhance the knowledge

...used such technologies as ooVoo to more effectively and efficiently share what we know

...decided to personally “act,” vs. simply talk about the risk and realities of maltreatment as experienced by individuals with disabilities 45

...how WE could ALL then make a difference in the lives of individuals with a disability who are more vulnerable to abuse.

JUST IMAGINE…

Research concerning the incidence, impact, and prevention of child abuse and neglect as experienced by children with disabilities http://deafed-childabuse-neglect-

col.wiki.educ.msu.edu/Lit+-+Full+Reference+List

Presentations concerning the incidence, causes, response, impact, and prevention of child abuse and neglect as experienced by children with disabilities http://deafed-childabuse-neglect-

col.wiki.educ.msu.edu/Presentations

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“Bright Spots” video presentations including: 1) frequently encountered problems & solutions; 2) key resources; and 3) areas of topical resource

http://deafed-childabuse-neglect-col.wiki.educ.msu.edu/Bright+Spot+-+Pilot

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The National Children's Advocacy Center, CALio Library , Bibliography “No 10 - Child Abuse Victims with Disabilities”

The New York State Child Abuse and Children with DisabilitiesWebsite http://childabuse.tc.columbia.eduIncludes guidelines for interviewing, video clips, updated peer-reviewed articles and resources, Disability contacts, etc. FREE REGISTRATION

Harold Johnson Professor Michigan State University – College of Education (517) 432-3926 [email protected] http://deafed-childabuse-neglect-col.wiki.educ.msu.edu/

Christine E. Pawelski Adjunct Associate Professor Teachers College, Columbia University (212) 678-3903 [email protected] http://childabuse.tc.columbia.edu/

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