What Can Be Done to Reduce the Risk of Abuse?
Overcoming fear and inertia to create resiliency and empowerment in those most at risk of sexual abuse victimization: children and adults with intellectual and developmental disabilities and other disabilities.
By Nora J. Baladerian, PhD
People with disabilities, both as children and adults, are abused at rates higher than the generic population. However, it seems that this information is not well-distributed either among professionals serving them or among parent groups, in general. I have found that talking about abuse is terrifying for parents. It is not that they do not want to know about it or acknowledge it, it is that they want it not to happen to their children.
This brief article will focus on what can be done to reduce the risk of abuse happening to one’s child (minor or adult.) It is also important to address how to heal from abuse when it occurs. I believe that “knowledge is power,” and have worked for many years to educate parents of children and adults with disabilities, not only to the risks of abuse in general, but on what can be done to reduce the risk of abuse for their child.
Many programs across the country have as their motto, “End Abuse” or “No More Abuse,” and other phrases that I believe are more aspirational than practical. Thus, several years ago, I decided that rather than aim for the total elimination of abuse on the planet, I would endeavor to reduce the risk of abuse happening to individuals, then, if and when it does happen, have a better outcome. I have taught many parents and caregiving agencies this approach and have had positive feedback when abuse and abuse attempts have later occurred.
There are a few mottos that I have embraced in this approach, such as “Knowledge is Power” among others. The Girl Scout’s “Be Prepared!” is useful. I would like to share the foundational thinking and then provide some examples of how this can be effective in reducing the risk of abuse and improving healing when it does occur.
“Zoe”
I like to use real-life stories to illustrate these concepts. The first is that of a nine-year-old girl who had been sexually abused over several years by close family members. She had been threatened by them not to tell her parents, and thus had kept her silence. However, both she (“Zoe”) and her sister (“Maria”), one day told their parents about the abuse. The mother and father were devastated, but primarily the mother, as these same family members had abused her when she was a child. She knew instantly that her children were telling them the truth. Now, not only did the mother feel bad for her children, but guilty for somehow not protecting them. She had believed that they would never do that to her children, not knowing that in general, perpetrators never stop; they just find more victims. (In telling this story at training programs, some have “blamed the mother” for not knowing that abusers never stop, but I do not blame her, as such information is not normally provided in general magazines or articles on trauma). Trauma therapy was provided for the children. For the mother, grief and trauma therapy was provided along with treatment for guilt (called, “irrational guilt” in such cases), to heal from this unbelievable travesty. I knew the children were feeling increasingly better. One day, Zoe had drawn a picture of her perpetrators in jail, then tore it into tiny pieces, then went to the restroom, flushed it down the toilet, and skipped joyfully back to the office! We did not schedule further appointments. I was so pleased for her and went home feeling good…until a thought hit me: “What about next time?” It was this question that caused me to design a risk-reduction program called: How to reduce the risk and impact of abuse. This approach is founded on how to respond to any “disaster” such as weather issues (storms, flooding, snow, etc.)
I designed a plan structure and had Zoe and her family return to design a specific plan for Zoe (and her sister) to evade or better survive another sexual assault. Everyone in the family had a role. The plan framework is simple:
• What should the family members learn before the next assault (attempt)?
• What should a sexual assault victim do during an assault?
• What should one do after an assault?
I called several rape treatment centers to find out their recommendations for how one would face an assault, but none had an answer for me. As a team, we designed a plan for these three stages of an assault (before, during, after). These were to be reviewed, and practiced, using non-traumatic activities to build and strengthen Zoe’s communication and emergency response skills.
We also designed a plan for the parents: What should they be doing to support Zoe in “story-telling” skills, for example, telling/communicating the story of going to the store to buy bread. We detailed the parent’s role in responding to a report by Zoe. These skills were to be practiced over time, thus also increasing Zoe’s communication skills with the family. Each family member also had to make a plan, to be able to understand any report of abuse.
It was about 6 years later that I received a call from Zoe’s mother. My heart sank when I heard her voice, as I feared that Zoe had again been assaulted. The mother told me that Zoe had very recently been sexually assaulted by the school bus driver (a new driver). She said Zoe was so excited at “how well she did” and wanted me to know what a heroine she was! The mother reported that it was the driver’s first day on the job, and he had changed the route so Zoe would be dropped off last. Zoe implemented her “during” skills during the assault, and upon getting home implemented her “after” skills. “During” skills were to become a “human video recorder” to be able to later report what happened. “After” skills were to immediately tell her mother what had happened, then prepare to go to the hospital for a forensic examination and interview with the police, among other post-assault recommendations to preserve evidence. The mother implemented her plan as well by calling the school, then the police, then taking Zoe to the hospital for treatment and forensic examination and evidence collection.
I asked if Zoe and the family would like to come in for some trauma therapy. The mother laughed and said, “NO! Zoe is so proud of herself for masterfully managing all of the steps of her plan (before, during, after) that she does not need to come in! She is calling everyone to tell them how well she did in this terrible situation. She wanted me to call you to let you know.”
It was particularly of note that because Zoe had immediately communicated to her mother what had occurred, and the mother, implementing her part in the plan, immediately called the school. The school immediately had called the police, who (fortunately) arrived at the school before the bus driver returned. Thus, evidence was present and available for collection in the bus and from the perpetrator. He was immediately arrested and placed in jail. This contributed greatly to Zoe’s well-being even though she had been assaulted.
This taught me the importance and value of having a plan for a disaster. I learned that the value of an individualized approach is effective to address communication and other issues that may have interfered with a quick disclosure/reporting of abuse.
“Daniel”
Another teenager I worked with (we’ll call him “Daniel,”) has Down syndrome and a mild intellectual disability, and is verbal. He had also been a victim of sexual assault and was brought to the sessions by his aunt, as his mother and father were deceased. He was only 13 or 14 and was known for being one who “does what he is told” without much resistance, as are many young persons with intellectual disabilities (ID). However, we did talk about his earlier assault how powerless he had felt at first and how later he was angry and embarrassed. We completed his trauma treatment and he no longer felt bad about what had happened to him, but, I thought, “what about next time?”
Those who work and live with individuals with ID know that for the most part, they are not “allowed” to say “No” to an adult or person in charge of them (temporarily with changing shifts, etc.). Perpetrators know this too, so we designed an intervention in which he could say “Yes” to any request, even if it felt bad, following it with, “and I’m going to tell my Mom.” We role-played with me asking him to give me money, go for a walk with me, etc., with his answer being “OK, and I’m going to tell my Mom.”
Several months later, the aunt called and told me the following. Daniel had gone to summer camp, and upon returning told her that there was a “creepy guy” who had many times asked Daniel to go with him to see something “really cool!” Daniel followed his feeling, and said to him, “OK, and I’m going to tell my mom!” The man said, “No, this is our secret…you don’t have to tell her.” To which he responded, “OK…and I’m going to tell my mom.” He finally gave up and Daniel returned home, where he told his aunt about this “creepy guy” and how he had evaded going with him. The aunt called the camp director to report this. She later called me to let me know that Daniel was the only child not molested by this “creepy guy.” Daniel felt so proud of himself and so empowered for having been able to successfully manage a difficult situation.
Since that time, I have assisted many families in designing risk reduction plans, employing the communication skills of the individual, and supporting the parents in knowing that such things can and do happen, and they can benefit from designing, implementing, and practicing a plan to survive and survive well. In Zoe’s case, she not only survived but felt empowered and wanted “everyone” to know what a great job she had done, as well as Daniel!
I do not want readers to become frightened but rather empowered to be able to create a plan for their children (minors and adults) to know how to respond to attempts to abuse and to report this to their parents or other person who may be supporting them. I am in the process of re-editing my book called “The “Risk Reduction Guide Book”© which provides additional ideas and plan guides for a variety of living and work situations.
After a recent conference in which I provided training on designing a risk reduction plan, the conference director contacted me to tell me that he had just received a call from a mother who had attended the program. Rather than focusing on abuse, she used the plan to address how to respond to her son’s seizures. She designed her plan and trained her son’s staff how to implement the plan. Only a few weeks later, he again had a significant seizure episode and the staff implemented their new plan. She later reported to the conference director that the first responders told her that had her staff not been so well trained, her son may not have survived this episode.
I was so pleased that she applied what she had learned to a completely different but essential problem, and had great success, and by overcoming fear and dread of a terrible problem successfully helped her son.
Nora Baladerian, PhD
About the Author
Nora J. Baladerian, PhD is a licensed psychologist and licensed marriage and family therapist (MFT) in Los Angeles, CA. She has worked with individuals with intellectual/developmental disabilities since 1974, beginning as a case manager at Harbor Regional Center in Torrance, CA. She attended Antioch University to earn her PhD She augmented her education by taking courses in human sexuality and qualified as an AASECT sex educator, and provides sex education programs to individuals with I/DD and their families. She is bilingual (Spanish) and produces presentations and translates most of her books.
With funding from the US Dept of Justice, Office for Victims of Crime in collaboration with the Arc of Riverside County, she produced two law enforcement training DVD’s one on how to interview people with disabilities and one on how to conduct an effective and sensitive first response. In addition, she hosted ten national conferences on this topic. In her private practice she specializes in supporting crime victims with disabilities as well as the general population treating trauma victims primarily.