Welcome to the eleventh installment of our Fall 2013 blog series: Trauma and Kids…A Primer for Pastors, Church Staff and Parents. Today, we’ll look at the unique challenges associated with helping kids with developmental disabilities following exposure to traumatic events.

In the last three years, I’ve spoken with two good friends who have children with autism spectrum disorders who were victims of sexual abuse. I found myself experiencing great frustration from my inability to refer them with confidence to anyone with extensive skill and experience in addressing the after-effects of abuse in kids with disabilities.

Unfortunately, I’ve learned that the need for treatment services for kids with developmental disabilities is greater than I’d ever imagined. A school-based research study found that children with disabilities are 3.4 times more likely to be maltreated than nondisabled peers. A hospital-based study reported that kids with disabilities were more than twice as likely to become victims of sexual abuse compared to peers without identified disabilities. A recent meta-analysis of the research literature reported that children with disabilities are 2.9 times more likely than children without disabilities to become victims of sexual abuse. Children with intellectual and/or mental health disabilities appear to be at the greatest risk, with a 4.6-fold greater risk of experiencing sexual abuse compared to age-matched peers.

I can easily think of a number of reasons why kids with developmental disabilities are at greater risk of experiencing traumatic abuse…

• Perpetrators will seek out children who lack the language/communication skills to report abuse, or the adaptive coping skills to avoid/escape an abusive situation.

• Kids with developmental disabilities are often more dependent upon adults for assistance in activities of daily living, including bathing, toileting and personal hygiene. They may be less likely to recognize inappropriate touch, or to be believed by authorities when they report inappropriate touch.

• Many kids with developmental disabilities are served in institutional settings where staffing and supervision are frequently inadequate. I’m shocked that in this day and age, kids with severe disabilities may be left unattended for extended periods in public schools, and many schools serving kids with disabilities lack cameras and basic security monitoring to ensure learning environments remain safe from children abusing other children.

• Families of children with disabilities experience high levels of stress and neglect, physical abuse and emotional abuse are often perpetuated within families. Sexual abuse is more commonly perpetrated by individuals outside the family.

• Kids with intellectual disabilities experience the physical changes associated with puberty at roughly the same age as typical peers, often with a less well-developed capacity for impulse control and emotional self-regulation. Precocious puberty is twenty times more common among children with developmental disabilities compared to age-matched peers.

So…what are some things we might suggest to parents of kids with disabilities seeking to protect their children from becoming victimized…or seeking to help their children after traumatic experiences have occurred?

First, parents have a responsibility to teach their children about appropriate and inappropriate touching and to the extent that their children are capable, provide them with language that will allow them to communicate any inappropriate touch they might experience. Second, parents need to become familiar with the signs and symptoms of sexual abuse in children with intellectual or developmental disabilities.

In terms of seeking help, if there’s not a clinician in your area with expertise in dealing with trauma in kids with developmental disabilities, I’d probably start with a clinician experienced in treating kids with developmental disabilities in general, followed by a clinician who treats kids who have been victims of trauma. I’d keep in mind that more people are likely to be involved in the evaluation of a child with developmental disabilities…teachers, therapists, aides, caregivers. For children with intellectual or language delays, modifications can be made in the application of trauma-focused CBT so that kids may still benefit from treatment.

Next: The twelve core concepts for understanding traumatic stress responses in children and families

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Confused about all the changes in diagnostic terminology for kids with mental heath disorders? Key Ministry has a resource page summarizing our recent blog series examining the impact of the DSM-5 on kids with mental health disorders. Click this link for summary articles describing the changes in diagnostic criteria for conditions common among children and teens, along with links to other helpful resources!