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Monday, March 23, 2015

Giving room for disabled or deaf children to talk about abuse

A very interesting study has been released in the UK. Deaf and Disabled Children talk about Child Protection opens up an understanding of important barriers to these children being able to disclose child abuse. This is a vital issue as the risk of a child in this population being abused is much greater than other children. They can be a vulnerable population. The report notes in the Executive Summary:

The abuse of deaf and disabled children is underreported and often hidden and a range of myths and stereotypes surround the abuse they experience. These perpetuate the silence around such abuse and present barriers to help seeking, timely recognition and effective response.

What was most disturbing is that the children in the study spoke about trying to let people know that they were being abused. Yet, the problems were seen as being related to the disability.

As well as making clear disclosures, participants attempted to communicate their distress and seek help through challenging internalising and externalising behaviours and attempted suicides. However, these expressions of distress were often assumed to be related to the child’s impairment rather than an indication of abuse. While some children’s behaviour communicated distress, others became skilled at maintaining a silence about their experience over many years. Where disclosures were made, these were not always handled in a sensitive and supportive manner by adults, leaving children feeling disbelieved and disempowered. With regard to professional responses to disclosures of abuse, deaf and disabled people particularly valued continuity of support over a long period.  
When thinking about abuse, there is good evidence that populations who are particularly vulnerable may be targeted by abusers who then ingratiate themselves into the lives of the children. They also prey upon the communication weaknesses that the child may have to solidify the secrecy that these abusers typically seek. As one participant said on p.16 of the report:

I had to keep it as a secret. I didn’t know whom to trust to tell about what
happened to me... Jamila 6FC

What this research really opens up is our need to ask why is behaviour occurring and look beyond the obvious possibilities. We need to be willing to see abuse as one of the possible causes. This is not to now suggest a narrowing of considerations to abuse but rather an expansion of thinking to include abuse as an area to be explored.

Perhaps one of the most potent tools for disclosure of abuse is a healthy, supportive relationship with an adult who goes to lengths to listen - both to behaviour as well as other forms of communication. But also an adult who wonders why is something happening - why the distress? why the behaviours? why the anxiety? and so on. A good is seen on p. 14 of the report:

One participant whose abuse began at age eight attempted suicide at around age nine. She was admitted as a psychiatric in-patient, assessed and treated but at no time felt she was given an opportunity to disclose her
abuse. She explained:
… when I first started showing signs of mental illness I think someone should have sat down and asked me why ‘cause it’s not a normal thing for an 8 year old to do. Sara 1FA
 This lovely quote reminds us that we should ask what is normative at a stage of development. Just because someone has a disability does not mean that they will be abnormal in most aspects of development.

Like all children who disclose, these children also need to be believed. Too often that has not been the case. Increasingly we are seeing evidence that children have not been seen as truthful when telling about abuse. Inquiries in Canada, Australia and the UK are all coming up with indications that disclosures are not being given the credibility they require. On p. 17 of the report, this quote illustrates the point:

In some cases the abuse was compounded by the response to a disclosure, being perceived as punitive by the child. For example, one deaf woman who disclosed to her parish priest was dismayed when she was castigated by the priest and sent on a religious retreat. She explained:
… the priest told me that I shouldn’t tell stories like that and he must’ve spoke to
my father who was big in the Catholic society there and the priest came to my
house and said to my parents that I was, erm, a liar and I was telling stories and
they took me to a retreat to repent. Wendy 8FA

As the Adverse Childhood Experiences study has shown, abuse has long term implications. This is true of this population as well but they will add that impact on top of the impact of the disability.

The report has a number of recommendations that are worth reviewing. For me, in addition to hearing the child, I am impressed with the identification of how practitioners across various disciplines have a role. Inter disciplinary practice matters greatly. 

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