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VIOLENCE AND ABUSE 

Violence and abuse towards women and children with disabilities is another area that has continues to receive a great deal of attention. Much of this literature continues to show that women with disabilities are at a much greater risk of being sexually and physically abused than other women. The resources included reflects these studies, both old and new, as well as writings that recognize the increased vulnerability of women and children with disability to abuse, suggestions and stories about what preventive measures can be taken and programs that work, and the personal stories and perspectives of women who have been abused.

Abramson, W. H., Emanuel, E. J., & Hayden, M. (Eds.). (2000, Fall). Feature issue on violence and women with developmental and other disabilities. IMPACT, 13(3). Minneapolis: Institute on Community Integration, University of Minnesota. Retrieved February 22, 2005 from: http://ici.umn.edu/products/impact/133/default.html.  

This feature issue of IMPACT examines violence as it affects women with disabilities–what is known, what isn’t known, and what needs to be done to prevent it and to help women recover from it. There are articles that offer strategies and ideas for bringing together disability service providers, sexual and domestic violence programs, law enforcement and the justice system, policymakers, researchers, and women with disabilities.

Alexander, R. W., Bradley, L. A., Alarcon, G. S., Tirana-Alexander, M., Aaron, L. A., Alberts, K. R., Martin, M. Y., & Stewart, K. E. (1998). Sexual and physical abuse in women with fibromyalgia: Association with outpatient health utilization and pain medication usage. Arthritis Care and Research, 11(2), 102-115.

Article about the relationship between sexual and/or physical abuse, health care utilization, and pain medication usage in female patients with fibromyalgia. Participants were 75 women with fibromyalgia. It was found that 57% reported a history of sexual or physical abuse. Compare to non-abused patients, abused patients reported significantly greater utilization of outpatient health care services for problems other than fibromyalgia and greater use of medications for pain (P<0.0! 25). Abused patients were also characterized by significantly greater pain, fatigue, functional disability, and stress, as well as by a tendency to label dolorimeter stimuli as painful regardless of their intensities. Additional analyses suggested that the high frequency of sexual/physical abuse was associated primarily with seeking health care for chronic pain rather than the fibromyalgia syndrome itself or genetic factors.

Allies for Women in Needs of Services. (2004, December). Violence against women with disabilities. Richmond, VA: Virginia Sexual and Domestic Violence Action Alliance. Retrived May 27, 2005 from http://www.vadv.org/disabilityrpt.pdf.  

Virginians Aligned Against Sexual Assault (VAASA) in partnership with Virginians Against Domestic Violence (VADV), and Global Organization of Feminists with Disabilities (GOFWD), received funds from the Office on Violence Against Women (OVW) to address the issues faced by women with mental health and cognitive disabilities, who have experienced sexual assault, domestic violence, and/or stalking. This partnership was one of only 18 recipients nationwide who received the Education and Technical Assistance Grants to End Violence Against Women with Disabilities in 2002. VAASA developed a study group, Allies of Women in Need of Services (AWINS), composed of mental health service providers, cognitive disability service providers, mental health consumers, and sexual and domestic violence service providers to conduct an assessment of domestic violence, stalking and sexual assault programs and mental health and cognitive disability service providers. This assessment addressed the frequency with which women with mental health and cognitive disabilities access domestic violence and sexual assault programs; the ability of service providers to identify domestic violence, sexual assault, and stalking among the women they serve; the extent of services provided; and the training, technical assistance, and resource needs of service providers. The assessment included two surveys and a series of focus groups.

Based on the results of the needs assessment, AWINS developed recommendations for protocols, services, training, and resources for disability service providers and sexual and domestic violence programs who serve women with mental health and cognitive disabilities who are the victims of sexual assault, domestic violence, and/or stalking. Local communities, state agencies, and service providers can use this report, including the recommendations, to enhance victim safety through specialized domestic violence, sexual assault, and stalking services for women with mental health and cognitive disabilities.

Ansell, K. (2005). Hitting home: Stories of disabled women. Ouch! Disability Magazine [Online]. Retrieved February 22, 2005 from: http://www.bbc.co.uk/ouch/closeup/hittinghome.shtml.  

This web site related the experiences of four disabled women featured in the Disbelief video produced last year by the Leeds-Interagency Project, an organisation providing support for women in Leeds who are experiencing domestic violence. Disbelief was the work of Jane Bethell. Bethell is herself a disabled woman, and her role is to provide support specifically for disabled women experiencing domestic violence, and to raise awareness of the particular issues disabled women face when they become victims of abuse. She believes that she is the only paid worker in the country with such a remit.

Barile, M. (1992/1993, Winter). Validation as prevention for women with disabilities. Women's Education des femmes, 8(1). Retrieved March 2, 2005 from http://www.nald.ca/canorg/cclow/newslet/1992/wint_v10/40.htm.  

“For survivors of violence, having their experiences denied by peers and others is a cruel and traumatic form of invalidation. One way to prevent violence is to stop denying that it happens. When the survivors are members of oppressed groups such as women with physical, intellectual, and/or psychiatric disabilities, women of color, older women, or women from minority ethnic backgrounds, their experiences tend to be invalidated by denial more often.”

Barile, M. (2002, November). Individual-systemic violence: Disabled women's standpoint. Journal of International Women’s Studies, 4(1), 1-14. Retrieved February 22, 2005 from: http://www.vawnet.org/Intersections/AntiOpressionWork/
DisabledWomenStandpoint.php
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This article presents an insider reflection on questions of violence and women with disabilities. We explore reasons for the systemic omission of women with disabilities from mainstream research and from services addressing non-disabled women’s experiences. Several questions are postulated. Has segregation of women with disabilities from the mainstream rendered a large part of their experiences, including the experience of violence, invisible? Have misconceptions about the lives of women with disabilities contributed to exclusionary practices within the women’s movement?

This article further submits that violence against women with disabilities assumes many forms, both individual and systemic. It explores several factors, among these how exclusion of disabled women from mainstream services, coupled with the lack of appropriate funding for their organisations, and the poverty lived by individual women with disabilities; renders more difficult the task of these organisations to respond to member needs. The inaction that allows the cycle of poverty and violence to continue in the individual and collective lives of women with disabilities furthers institutional, system-based violence.

Bass, E., & Davis, L. (1994). The courage to heal: A guide for women survivors of child sexual abuse (3rd ed.). New York: HarperCollins.

This book is written for women who have been sexually abused as children and is one of the most comprehensive books on this subject. This is a very powerful book which is written by and for women survivors of child sexual abuse. It contains these women's stories of the abuse and the healing process and talks about the damage experienced by secrecy and silence. The book is in accessible and readable language and gives practical advice about the healing process, both for those who have been abused and their friends and lovers. The book does not focus on women with disabilities specifically but it includes them as a part of the main text. Although addresses and resources are included throughout the book the last part of the book lists a wide range of resources and advice that can be of value in the healing process as well as an annotated bibliography of readings on a variety of topics related to child sexual abuse. The bibliography includes readings about women with disabilities.

Beck-Massey, D. (1999). Sanctioned war: Women, violence, and disabilities. In S. Welner (Ed.), Women’s health and gynecological care [Special issue]. Sexuality and Disability, 17(3), 269-276.

Article arguing that the abuse of women with disabilities constitutes a "Sanctioned War," in which one gender is systematically decimated through power and control. In one way or another it is sanctioned by the society at large. The author catalogs numerous ways in which women are abused, and concludes that more work and agencies need to be recruited to join the fight against this Sanctioned War.

Bouhoutsos, J. C. (1984). Sexual intimacy between psychotherapists and clients: Policy implications for the future. In L. E. Walker (Ed.), Women and mental health policy (pp. 197 206). Newbury Park, CA: Sage Publications.

The author traces the problem of sexual intimacy between healers and their patients back to antiquity and gives a brief historical overview of attitudes towards such sexual activities. She reviews the research literature on therapist-client sexual involvement and finds, among other things, that the overwhelming majority of reported incidents occurs between male therapists and female clients, and that such sexual involvement with therapists has been shown to be harmful to client. The author goes on to state that complaints are very rarely filed and lists various reasons why female clients do not take actions to file complaints. She reviews clients' possibilities in filing complaints and lists the advantages and disadvantages of different courses of action. The chapter concludes by suggesting that prevention is the best solution, but prevention requires policy changes in many areas of the mental health system.

Canadian Abilities Foundation. (n.d.). Women with disabilities: Violence prevention resource guide. Toronto: Author. Retrieved February 21, 2005 from: http://www.enablelink.org/women/WOMEN.html.

The grim statistics on reported abuse indicate that women with disabilities face a much higher risk than the rest of the female population--perhaps twice as high. Many women with disabilities must rely on other people for physical assistance, financial support or decision-making that involves their care. This increases their vulnerability to physical, emotional and sexual abuse, and/or neglect.

However, the good news is that the number of violence prevention resources available to support women is steadily growing, and more and more of these are accessible to women with disabilities.

A print version (limited availability) may be available by writing to: Canadian Abilities Foundation, 489 College Street, Suite 501, Toronto, Ontario, M6G 1A5, E-mail: info@enablelink.org.  

Chang, J. C., Martin, S. L., Moracco, K. E., Dulli, L., Scandlin, D., Loucks-Sorrel, M. B., Turner, T., Starsoneck, L., Dorian, P. N., & Bou-Saada, I. (2003, September). Helping women with disabilities and domestic violence: Strategies, limitations, and challenges of domestic violence programs and services. Journal of Women’s Health, 12(7), 699-708.

Purpose: To describe the types of services provided to women with disabilities at community-based domestic violence programs in the state of North Carolina, the challenges faced, and strategies used to provide the services.

Methods: We conducted a statewide cross-sectional survey of community domestic violence programs and had a response rate of 85%.

Results: Of the participating programs, 99% provided services to at least one woman with a physical or mental disability in the preceding 12 months; 85% offered shelter services to women with physical or mental disabilities. Most respondents (94%-99%) reported that their programs were either somewhat able or very able to provide effective services and care to women with disabilities. The respondents also described challenges to serving women with disabilities, including lack of funding, lack of training, and structural limitations of service facilities. Strategies used by the programs to overcome these challenges were networking and coordinating care with organizations that specifically serve disabled populations.

Conclusions: Domestic violence programs in North Carolina provide services to women with disabilities but are faced with challenges stemming from limited funding, physical space, and training. Collaborations between domestic violence and disability service providers are necessary to improving the services and care delivered to women with disabilities who experience domestic violence.

Chenoweth, L., & Cook, S. (Eds.). (2001, April). Violence against women with disabilities [Feature issue]. Violence Against Women, 7(4).

The articles published in this issue include: 

  • "Bring My Scooter So I Can Leave You": A Study of Disabled Women Handling Abuse by Personal Assistance Providers
  • Linking the Assessment of Self-Reported Functional Capacity With Abuse Experiences of Women With Disabilities 
  • "Is It Meant to Hurt, Is It?" Management of Violence in Women With Developmental Disabilities 
  • The Investigation of Abuse and Women With Disabilities: Going Beyond Assumptions

Cole, S. S. (1984). Facing the challenges of sexual abuse in persons with disabilities. Sexuality and Disability, 7(3/4), 71 88.

This article addresses causes, myths, and prevention of sexual abuse of people with disabilities. The author represents the view that sexual abuse has more to do with oppressive use of power than it has to do with sex. This leads her to examine the links between power structures, oppression and abuse, as well as the links between various forms of oppression. She states that it is essential to identify and change societal beliefs and norms which permit sexual abuse and exploitation to continue. The power structures in our society provide males with more power than females, able-bodied persons with more power than people with disabilities, and so on. This makes the less powerful, such as women, children, and people with disabilities likely candidates for sexual abuse. The author also draws parallels between incest within the family and sexual abuse of people living in residential facilities. Among the parallels are: (1) the abuser is usually someone the victim is physically or emotionally dependent on; (2) the perpetrators are frequently respected members of their communities; and (3) the victim can have confusing and conflicting feelings of love and hate towards the perpetrator. Among preventive measures the author recommends are increased public awareness of how common sexual abuse is, assisting parents and staff to feel comfortable about all aspects of sexuality, identifying societal norms that contribute to abuse, and training and education for parents, caregivers, professionals, and individuals with disabilities.

Cramer, E. P., Gilson, S. F., & DePoy, E. (2003). Women with disabilities and experiences of abuse. Journal of Human Behavior in the Social Environment, 7(3-4), 183-199.

A qualitative study of disabled & non-disabled professionals & survivors of abuse revealed a range of types of abuse endured by disabled women, some of which were unique to that population. Two major themes emerged from data analysis: vulnerable beginnings & complexity of abuse. Three sub-themes are encompassed within complexity of abuse: active abuse, abuse through image, & contextual abuse by social service/legislative systems. The authors present data essential to an informed assessment & analysis of abuse that considers the person-in-environment circumstances of women with disabilities. Implications for future research & the human behavior in the social environment curriculum are discussed.

Cross, P., & Anello, B. (2003, March). Disclosure of records workshop for women with disAbilities and Deaf women. North Bay, Ontario: DAWN Ontario & Ontario Women's Justice Network (OWJN). Retrieved March 14, 2005 from http://dawn.thot.net/workshops/disclosure.html.  

This is an online version of a Canadian workshop designed to assist women with disAbilities and Deaf women make informed decisions regarding their therapeutic, medical and personal records. It focuses on how these records might be used in a variety of legal proceedings in which women who have experienced violence might become involved.

Curry, M. A., Hassouneh-Phillips, D., & Johnston-Silverberg, A. (2001). Abuse of women with disabilities: An ecological model and review. Violence Against Women, 7(1), 60-79.

Women with disabilities are at increased risk for emotional, physical, and sexual abuse. They are also at risk for experiencing disability-related abuse from multiple sources. This problem is compounded by the social context of disability, including pervasive discrimination and stereotyping by society. This article highlights the problem of abuse of women with disabilities and examines the state of the science through a review of literature. An ecological model is presented that examines relevant individual, environmental, and cultural factors. The authors hope that this article will stimulate awareness of this problem and future research in this important arena.

Curry, M. A., & Navarro, F. (2002, February). Responding to abuse against women with disabilities: Broadening the definition of domestic violence. Health Alert, 8(1), 1-5. San Francisco, CA: Family Violence Prevention Fund. Retrieved February 22, 2005 from: http://endabuse.org/programs/healthcare/files/HA_9_1.pdf.  

“It is critical that health care providers recognize and respond to an expanded definition of domestic violence when serving women with disabilities. Women with disabilities tend to suffer from additional types of abuse, for longer durations, and at the hands of a greater number of perpetrators.”

Disbelief [Film]. (2004). Leeds, UK: Leeds-Interagency Project.

Disbelief has been produced to raise awareness of the issue of disabled women experiencing violence from men they know. The film runs for 20 minutes and features four disabled women who have experienced violence from men they know. The women talk about their experiences of violence and the difficulties and barriers they encounter when seeking help and support. A resource/training pack accompanies the video and can be used with agency staff or women’s groups to explore the issues raised by the video in greater depth. To order a copy of Disbelief or for more information on LIAP's work with disabled women experiencing domestic violence, telephone Jane Bethell at LIAP 0113 234 9090, or e-mail jane.bethell@leeds.gov.uk.

Erwin, P. E. (2000, July). Intimate and caregiver violence against women with disabilities. Minneapolis: Battered Women’s Justice Project-Criminal Justice Office. Retrieved February 22, 2005 from: http://www.bwjp.org/documents/Erwin-diswomenformatted1.htm.

“In the 1990s the Federal government passed two pieces of legislation that had a major impact on the disabilities rights movement and the battered women’s movement in the United States. The Americans with Disabilities Act (ADA) of 1992 and the Violence Against Women Act (VAWA) of 1994 served notice that both communities were being afforded new protections, new resources, and renewed recognition by the Federal government. The ADA significantly broadens the scope of what is considered a disability and guarantees access to jobs and public places (Section, 1998) for the approximately 54 million Americans with disabilities (Tyiska, 1998). The VAWA adds several federal domestic violence crimes and provides for a civil rights remedy for victims of sexual assault and domestic violence. However, at the intersection of disability and domestic violence is a population of women that has been rendered invisible by a lack of services in the battered women’s movement and a lack of recognition of the violence in their lives by disability service providers. In the words of one researcher, the experiences of violence against women with disabilities have been neither voiced nor heard. (Chenoweth, 1997).”

Fawcett, B. (2002, September). Convergence or divergence? Responding to the abuse of disabled women. The Journal of Adult Protection, 4(3) 24-33.

This paper examines three competing perspectives about appropriate positionings for disabled women in relation to abuse. It concludes that structural oppression must be challenged and proposes that the issue of disabled women and abuse is worthy of much greater attention and collaborative discussion.

Fiduccia, B. W., & Wolfe, L. R. (1999, March). Violence against disabled women. Washington, DC: Center for Women Policy Studies. Retrieved January 2, 2004 from http://www.centerwomenpolicy.org/report_download.cfm?ReportID=4.  

This Research and Data in Brief report summarizes available data and research on the prevalence of violence in the lives of women and girls with disabilities, including domestic abuse and battering, sexual abuse and rape, and forms of violence masked as socially accepted treatment.

Gilson, S. F., DePoy, E., & Cramer, E. P. (2001, April). Linking the assessment of self-reported functional capacity with abuse experiences of women with disabilities. In L. Chenoweth, & S. Cook (Eds.), Violence against women with disabilities [Feature issue]. Violence Against Women, 7(4), 418-431.

Women with disabilities are abused at rates similar to or greater than their nondisabled counterparts. Compared with nonabused women, women abused by an intimate partner have a greater risk of being disabled or having an illness that affects their activities of daily living. Although disabled women experience similar forms of abuse to those of nondisabled women, some forms of abuse are unique to disabled women due to the limitations that the disability itself presents. This article presents a conceptual analysis of abuse of disabled women & discusses assessment procedures that can assist in identifying abuse & informing service delivery. We propose a model of abuse assessment for women with disabilities composed of three elements: traditional assessment anchored on the Power & Control Wheel that encompasses the unique forms of abuse that disabled women experience; comprehensive functional assessment through self-reporting & self-rating; & attention to heterogeneity with regard to cultural sensitivity, structure of reporting, & nature of disability.

Goldson, E. J. (1997, August). Commentary: Gender, disability, and abuse. Child Abuse & Neglect, 21(8), 703-705.

Commentary on the prevalence of abuse among people with disabilities, especially women, and serves as an introduction to Sobsey et al. which immediately follows this commentary.

Greenley, D., Lodholz, T., Myers, L., Nichols, N., Spangler, D., Sweet, M., & White, C. (2004, April). Cross training workbook: Working together to end violence against women with disabilities in Wisconsin. Madison, WI: Violence Against Women with Disabilities Project of Wisconsin. Retrieved February 22, 2005 from: http://www.w-c-a.org/pdfs/vawaworkbook.pdf.

This publication is a workbook that begins with brief background information on domestic violence, sexual assault, stalking, and women with disabilities. It truly is a workbook that acknowledges and encourages you to individualize a process that you can and will use, wherever you are, on your own and as part of an organization, to address the needs of each person who might need your help. There are issues and questions raised throughout these materials. When you see questions, we encourage you to pause long enough to consider them on your own and with others. Spend some time with someone else who cares as you do about these issues. Ask others what they think, what they need, what they have experienced, what they want to learn, who they know who might be an additional resource. Other publications from this group are available on their web site at: http://www.w-c-a.org/pages/VAWA.html.

Hassoueh-Phillips, D. & Curry, M. A. (2002, Winter). Abuse of women with disabilities: State of the science. Rehabilitation Counseling Bulletin, 45(2), 96-104.

Women with disabilities experience abuse at similar or higher rates than women in the general population. In addition to experiencing emotional, physical, and sexual abuse, women with disabilities may also experience disability-specific forms of abuse for prolonged periods of time and from multiple perpetrators. To promote awareness of this serious problem, this article offers a brief overview of the general domestic violence literature and a critical review of existing research regarding the abuse of women with disabilities. Following these reviews, we offer an overview of practical implications and existing resources in this important area.

Hendey, N., & Pascall, G. (1998, June). Independent living: Gender, violence and the threat of violence. Disability & Society, 13(3), 415-427.

In what ways is independent living for young adults with disabilities compromised by violence and its threat? A qualitative study of 42 young adults with severe physical disabilities explored their perceptions and concerns about independent living, access to services and the meeting of needs. Young women especially experienced difficulties about leaving home, because of their own and their parents' fears about vulnerability; some who did leave home experienced highly restricted social lives because of anxiety about neighbourhood violence. Few had established partnerships, but violence and sexual abuse from partners emerged as an issue for which there is little policy. Control and abuse within caring relationships are serious issues for those who need personal care. Violence and lack of protection may undermine independent living, especially for women.

Hoog, C. (2003, January). Increasing agency accessibility for people with disabilities: Domestic violence agency self-assessment guide. Seattle & Olympia, WA: Washington State Coalition Against Domestic Violence. Retrieved February 22, 2005 from: http://www.wscadv.org/Resources/Disability_self_assessment.pdf.

“Providing domestic violence services to people with disabilities challenges our thinking about the experience of abuse and our strategies for reform. We can be proud of Washington State and its excellent policies against abuse. We are doing enough, it would seem, but it is not enough for people with disabilities. There aren’t many practical tools available for domestic violence programs for improving accessibility. The Coalition developed this tool specifically for you to increase your program’s ability to work with people with disabilities. By increasing our capacity to work with victims who have a disability, we engage in creative and resourceful advocacy with every individual who seeks justice and safety. This self-assessment guide is intended to assist domestic violence programs in evaluating their accessibility to victims with disabilities in their community.”

Keilty, J., & Connelly, G. (2001, March). Making a statement: An exploratory study of barriers facing women with an intellectual disability when making a statement about sexual assault to police. Disability & Society, 16(2), 273-291.

Many women with intellectual disability become the victims of sexual assault. Despite this, anecdotal evidence suggests that few cases are prosecuted. This qualitative study looks at the barriers that arise at the crucial first step toward the prosecution of a complaint - making a statement to the police. In this study, sexual assault workers and members of the New South Wales police service in the greater Sydney area, Australia, were interviewed to identify the barriers that arise when women with intellectual disability decide to make a statement to police following sexual assault. The study's findings demonstrate a need for greater awareness within the police service of police policies and procedures, and legislation, as well as greater co-operation between the police service and other organisations, which have an impact on the lives of women with intellectual disability. 

Khemka, I. (2000). Increasing independent decision making skills of women with mental retardation in simulated interpersonal situations of abuse. American Journal on Mental Retardation, 105(5), 387-401.

Study evaluating the effectiveness of two training approaches for increasing the independent decision-making skills of 36 women with mild mental retardation (MR) in response to hypothetical interpersonal situations involving abuse. Participants were randomly assigned to a control group or one of two training approaches: a decision-making training approach that addressed both cognitive and motivational aspects of decision-making, and one that included only instruction on the cognitive aspect of decision-making. It was found that although both training approaches were effective compared to the control condition, the combined motivational and cognitive training approach was superior to the cognitive-only training approach.

la Rivière-Zijdel, L. (2002, November). Empowerment, self-esteem, self-defence: No longer a passive offer! Retrieved January 15, 2006 from http://www.kvindermedhandicap.dk/Speech%20Lydia.htm.

This is text of a presentation made at workshop in Copenhagen, Denmark, on self-defense for women with disabilities.

"To understand the value of self-defence for disabled women and girls we have to explore its origin, its general usage in the struggle against violence that women suffer and the different factors that are intertwined with the concept such as the emancipation of women, the gender differences and the emancipation of disabled people. Therefore a terse synopsis of the history of self-defence and martial arts, an exploration of the emancipation movements of women and disabled people, besides inside in oppression theories, are necessary to understand the effect it specifically has on disabled women and girls. Self-defence is more than only using your voice or learning to hit or kick; it is a powerful tool when it is learned and taught with a profound knowledge of all types of violence, discrimination and oppression that disabled women can become victim of."

Li, L., Ford, J. A., & Moore, D. (2000). An exploratory study of violence, substance abuse, disability, and gender. Social Behavior and Personality, 28(1), 61-71.

Using a random sample of 1,876 individuals with disabilities, this study examines disabilities between victimization as a result of violence, substance abuse, disability, and gender. Multivariate analyses reveal that women with disabilities are more likely to be victims of substance abuse-related violence than are male counterparts. Some disability conditions such as disability onset, multiple disabilities and chronic pain - are significantly associated with violence for both men and women with disabilities. For people with disabilities, this study finds that victims of substance abuse-related violence are more likely to have their own substance abuse problems than are those who have not been victimized. The authors discuss several issues relevant to a better understanding of violence, substance abuse, disability and gender.

Little, L. (2004, April). Domestic violence programs and women with disabilities (FPG Snapshot 15). Chapel Hill, NC: University of North Carolina at Chapel Hill, Frank Porter Graham Cihld Development Institute. Retrieved March 12, 2005 from http://www.fpg.unc.edu/~images/pdfs/snapshots/snap15.pdf.

The issues of violence against women with disabilities and the potential lack of services for such victims are of particular concern when one considers the proportion of women in the US who have a disability. This Snapshot is based on “Helping Women with Disabilities and Domestic Violence: Strategies, Limitations, and Challenges of Domestic Violence Programs and Services.”

McFarlane, J., Hughes, R. B., Nosek, M. A., Groff, J. Y., Swedlend, N., & Mullen, P. D. (2001, November). Abuse Assessment Screen-Disability (AAS-D): Measuring frequency, type, and perpetrator of abuse toward women with physical disabilities. Journal of Women’s Health & Gender-Based Medicine, 10(9), 861-866.

An interview questionnaire was presented to a multiethnic sample of 511 women, age 18 64 years, at public and private specialty clinics to determine the frequency, type, and perpetrator of abuse toward women with physical disabilities. The four-question Abuse Assessment Screen Disability (AAS-D) instrument detected a 9.8% prevalence (50 of 511) of abuse during the previous 12 months. Using two standard physical and sexual assault questions, 7.8% of the women (40 of 511) reported abuse. The two disability-related questions detected an additional 2.0% of the women (10 of 511) as abused. Women defining themselves as other than black, white, or Hispanic (i.e., Asian, mixed ethnic background) were more likely to report physical or sexual abuse or both, whereas disability-related abuse was reported almost exclusively by white women. The perpetrator of physical or sexual abuse was most likely to be an intimate partner. Disability-related abuse was attributed equally to an intimate partner, a care provider, or a health professional. This study concludes that both traditional abuse-focused questions and disability-specific questions are required to detect abuse toward women with physical disabilities.

Monahan, K. & Lurie, A. (2003, Winter). Disabled women sexually abused in childhood: Treatment considerations. Clinical Social Work Journal, 31(4), 407-418.

There is a dearth of literature addressing the issues presented in the treatment of adult disabled women who were victims of childhood sexual abuse. This article focuses on the pertinent issues involved in clinically treating this population, such as the meaning of the traumatic event of sexual abuse for the individual, the disability & how it may have impacted her in terms of dependence, body integrity, & sexuality. Coping strategies & case examples are presented & possible countertransferential reactions are examined.

Nosek, M. A., & Howland, C. A. (1998, February). Abuse and women with disabilities. Harrisburg, PA: National Resource Center on Domestic Violence. Retrieved February 22, 2005 from http://www.vawnet.org/DomesticViolence/Research/VAWnetDocs/
AR_disab.php
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This paper highlights the prevalence of violence against women with disabilities, examining abuse interventions, and offering a critique of studies. It addresses sexual, emotional and physical abuse. It describes abuse experiences of women and girls in non-institutional and institutional settings, as well as abuse by strangers, intimate partners, family members, health care workers and attendants.

Nosek, M. A., Howland, C. A., & Hughes, R. B. (2001). The investigation of abuse and women with disabilities: Going beyond assumptions. In L. Chenoweth, & S. Cook (Eds.), Violence against women with disabilities [Feature issue]. Violence Against Women, 7(4), 477-499.

This article delineates issues that should be considered by investigators endeavoring to conduct empirically sound research on abuse and women with disabilities. These issues include (a) incorporating in the research design variables that assess increased vulnerability; (b) using literature-based definitions that distinguish emotional, physical, sexual, and disability-related abuse; (c) using population-based sampling methodologies; (d) securing informed consent; (e) maintaining confidentiality; (f) installing safety measures to protect study participants and project staff from retaliation; (g) making special efforts to include women with disabilities from minority backgrounds; (h) using appropriate, validated, disability-sensitive screening instruments; (i) understanding the legal requirements for reporting abusive incidents; (j) implementing abuse studies in clinical settings; and (k) including formative and summative evaluations in outcome studies of abuse interventions. To increase the capacity of battered women's programs to serve women with disabilities, considerably more needs to be known about interventions that are most effective for this population.

Pardeck, J. T., & Rollinson, P. A. (2002). An exploration of violence among homeless women with emotional disabilities: Implications for practice and policy. Journal of Social Work in Disability and Rehabilitation, 1(4), 63-73.

This research found a high incidence of violence among homeless women with emotional disabilities. The study reports 82% of the homeless women with emotional disabilities had a history of violence in their lives. The most common form of violence was physical; the least common was sexual abuse. The practice and policy implications for these findings are discussed. It is suggested that the Olmstead v. L.C. (1998) ruling under the Americans with Disabilities Act might force states to provide better services to homeless women with a history of violence and emotional disabilities.

Perry, D. & Whiteside, R. K. (2002, April). Recontextualising violence: Children, 'disability' and gender. Northbridge, WA, Australia: People 1st Programme (PIP). Retrieved March 1, 2004 from http://www.people1stprogramme.com.au/files/
Recontextualising_Violence.pdf
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“Violence and abuses of all kinds are increasingly publicly acknowledged as widespread in many societies. While it is important to recognise ‘groups’ of people who may be regarded as ‘at risk’ or most likely to be subjected to various forms of abuse, it is also important to look for revealing continuities and interrelationships with regard to reasons why people are violated at all. Until quite recently, various professions and disciplines have focused upon violence and abuse in contexts relevant to their particular areas of expertise with some reluctance to pose these larger often difficult and highly confronting social and political questions. There are however, signs that a broadening perspective is emerging and that the focuses of varying forms of analysis and research must be interrelated within wider frameworks.”

Poore, G. (1995). Voices heard, sisters unseen [Film]. New York: Women Make Movies.

Voices Heard, Sisters Unseen is a powerful and inspirational videotape showing how survivors of domestic violence are working to change the way the system treats battered women in search of justice and safety. Interviews, poetry, dance and music combine to present a feminist analysis about how courts, police and social services 're-victimize' battered women who are deaf, disabled, lesbians, prostitutes, HIV-positive and without official immigrant status. Voices Heard, Sisters Unseen is an important call for multi-issue activism and an integrated response to services for battered women. An education guide is available online at: http://www.wmm.com/Catalog/study/vhsu.htm.

Raye, K. L. (1999, August 4). Violence, women and mental disability. Washington, DC: Mental Disability Rights International. Retrieved February 22, 2005 from: http://www.mdri.org/report%20documents/violencewomenmd.doc.

“This article describes the numerous human rights violations perpetrated against women with mental disabilities, such as arbitrary detention in psychiatric institutions, the failure to protect women with mental disabilities against physical and sexual violence and the arbitrary denial of reproductive and parental rights. Without attention from the international human rights community, women with mental disabilities will continue to endure abuse, violence and violations of their human rights. This article also presents a series of policy recommendations aimed at improving governments’ treatment of and responses to women with mental disabilities, involving the advocacy community in addressing these human rights violations and providing mechanisms for the protection and empowerment of women with mental disabilities.”

The Roeher Institute. (1995). Harm's way: The many faces of violence and abuse against persons with disabilities. North York, ON: Author.

This study focused on violent or abusive circumstances experienced by people with disabilities and the impact of this on their lives. These circumstances include physical, sexual, emotional, and verbal abuse; denial of rights, necessities, privileges, and opportunities; and failure to respond to complaints of abuse and violence. The information for this study came from a Canadian survey of people with disabilities, and from interviews and focus groups with service providers, police, advocates, and family members. Also included as sources of information are a review of the literature on this topic and Canadian case law and statutes.

The author identifies factors which can contribute to such abuse, such as negative social stereotypes concerning disability and having caregivers who may lack adequate support and training. Also considered are issues of disclosure and identification of violence and abuse as well as responses (legal and otherwise) to the problem after it has been disclosed. Recommendations are offered for policy, program reform, statutory reform, providing information to concerned parties about the issue, and increased support from communities.

Salthouse, S., & Frohmader, C. (2004, September 15-17). 'Double the odds' - Domestic violence and women with disabilities. Paper presented to the 'Home Truths' Conference, Sheraton Towers, Southgate, Melbourne, Australia. Retrieved March 1, 2005 from http://www.wwda.org.au/odds.htm.

“There is a high incidence of violence against women with disabilities. It is extensive and of a pervasive nature. Yet until recent years, there has been a profound silence around the experiences of violence among women with disabilities. The issues for women with disabilities have largely been excluded from most generic policies and from responses to the issue of women and violence. Women with disabilities are largely invisible in both the disability and women's movements. All these factors combine to produce a situation where women with disabilities are relegated them to a position of extreme marginalisation and consequently, to increased risks and experiences of violence.”

Shaw, C., & Proctor, G. (2005, November). Women at the margins: A critique of the diagnosis of Borderline Personality Disorder. Feminism & Psychology, 15(4): 483–490.

“The diagnosis of borderline personality disorder (BPD) is applied predominantly to women and, in particular, to survivors of childhood sexual abuse. In this article, we argue that this diagnosis distracts from the aetiological importance for psychological distress of the experience of childhood sexual abuse, and that it pathologizes survivors. We have developed our understandings of the psychiatric response to women’s distress within very different locations in the psychiatric power structure–one as service survivor with a diagnosis of BPD, one as a clinical psychologist. Yet, differently located as we are, we both believe that the diagnosis of BPD individualizes and pathologizes women for their responses to oppression, because of its fundamental failure to locate and understand distress within its social context. We draw on feminist, postmodern and anti-psychiatric critiques in order to present and develop our shared perspective on the diagnosis of BPD, and challenge health professionals and wider society to locate survivors’ distress within the context of sexual violence and gender power relations in society.”

Senn, C. Y. (1988). Vulnerable: Sexual abuse and people with an intellectual handicap. North York, ON: The Roeher Institute.

The author of this book claims that while sexual abuse has become a major issue in recent years, the sexual abuse of people with an intellectual handicap (i.e., mental retardation) has been virtually ignored in the public discussion and policy-making around the issue.

The author explores the myths surrounding sexual abuse and the myths surrounding people with mental retardation. The book focuses both on children and adults and the author shows how the myths surrounding disability contribute to the vulnerability of people with disabilities. This vulnerability seems to be well recognized, yet the author reports that it is almost impossible to get accurate measures of either prevalence or incidence of sexual abuse. Through a review of the literature which contributes to the understanding of sexual abuse of individuals with mental retardation the author suggests: (1) when sexual abuse is reported, 99% of the victims are assaulted by people known to them, (2) only 20% of assaults are reported, and (3) depending on the sampling and information gathering techniques used, estimates range from 25% to 83% of women, and up to 32% of men, with mental retardation have experienced sexual abuse. The author concludes that children with disabilities are at higher risk for sexual abuse than other children and adolescents, and that girls and women with disabilities are the most likely victims.

The author describes ways people with mental retardation used to indicate that they have been sexually abused and explores treatment and prevention issues. The book also addresses issues such as inaccessibility of services for individuals with mental retardation, offenders who have mental retardation and legal issues in sexual abuse of children. The book concludes with recommendations to protect individuals with mental retardation from sexual abuse.

This book is, to the best of my knowledge, the first comprehensive study of sexual abuse of people with mental retardation.

Sequeira, H., & Halstead, S. (2001, April). "Is it meant to hurt, is it?" Management of violence in women with developmental disabilities. In L. Chenoweth, & S. Cook (Eds.), Violence against women with disabilities [Feature issue]. Violence Against Women, 7(4), 462-476.

The use of seclusion, restraint, and rapid tranquilization for people with developmental disabilities is controversial. A statistical analysis of 3,767 such incidents, involving 82 clients with developmental disabilities, is presented along with semistructured interview material completed following personal experience of emergency intervention. Women were involved in a disproportionately high number of incidents. It was found that women had a significantly higher probability of being given rapid tranquilization following a violent incident. In contrast, seclusion was more likely to be used with men. Interviews with women demonstrated a commonly held understanding of interventions as punishment and expressions of intense anger and anxiety. The study highlights the importance of including the perspectives of people with developmental disabilities in care planning and staff training.

Sobsey, D. (1994). Violence and abuse in the lives of people with disabilities: The end of silent acceptance? Baltimore: Paul H. Brookes Publishing Company.

Sobsey's book is a comprehensive study of the issue of disability, violence, and abuse. Once a registered nurse in a facility for people labeled developmentally disabled, Sobsey begins his book with his own personal reflections on the incidence of abuse. Combining this personal narrative with research and a literature review makes this work a valuable resource.

The book is divided into two sections. The first, Understanding Abuse, covers research and conceptual models of abuse. He reviews almost 30 studies that examined the relationship between abuse and disability, and also supplies data on characteristics of victims and offenders of sexual abuse (i.e., age, gender, disability level, situation of the victim, and age, gender, and means of access of the offender). Also included in this section is a chapter on caregiver abuse, which includes euthanasia, sterilization, institutionalization, slavery, and the use of drugs as a means of control. The last chapter in this section critiques the major models used to explain abuse

The second section of the book, Preventing Abuse, takes a multimodal approach to prevention. Suggestions on interventions include the individual, the caregivers, the environment, law enforcement, and society at large. These suggestions are practical and useful, and also helpful is the Appendix including names and addresses of people and agencies working in this field who can link interested people with valuable resources.

Sobsey, D., Gray, S., Wells, D., Pyper, D., & Reimber-Heck, B. (1990). Sexuality, disability, and abuse: An annotated bibliography. Edmonton, AB: University of Alberta, Severe Disabilities Program.

This annotated bibliography lists literature from a wide range of disciplines and perspectives relevant to sexual assault and abuse of people with disabilities. It is an attempt to provide a comprehensive review of the literature in this area and lists research studies, position papers, program descriptions, clinical reports, and media accounts. This should be an excellent resource for anyone looking for materials on sexual assault and abuse of people with disabilities.

Sobsey, D., Randall, W., & Parrila, R. K. (1997, August). Gender differences in abused children with and without disabilities. Child Abuse and Neglect, 21(8), 707-720.

Objective: Two questions were posed: (1) What are the proportions of boys and girls in various categories of substantiated child abuse? (2) Do the gender proportions differ for children with and without disabilities?

Method: Data collected by previous researchers from a demographically representative sample of U.S. child abuse reporting districts was analyzed. This included 1,249 case files involving 1,834 children. The number of girls and boys who did and did not have disabilities was identified for three age categories and for several categories of abuse. Chi-square analyses were used to determine whether there was a relationship between disability and gender for the various age and abuse categories.

Results: More boys were physically abused and neglected, but more girls were sexually abused. Boys with disabilities, however, were over-represented in all categories of abuse. Moreover, gender proportions among abused children with disabilities differed significantly from those found among other abused children. Although slightly more than half of abused children without disabilities were girls, 65% of abused children with disabilities were boys.

Conclusions: Boys represented a significantly larger proportion of physically abused, sexually abused, and neglected children with disabilities than would be expected from their respective proportion of abused and neglected children without disabilities. Several possible explanations for the observed gender and disability status interaction are discussed.

Strong, M. F., & Freeman, A. C. (1997). Caregiver abuse and domestic violence in the lives of women with disabilities. Berkeley, CA: Berkeley Planning Associates.

Consumer-focused booklet discusses domestic violence, theft, denial of services, and other problems encountered by women with disabilities who must rely on personal assistants or other caregivers. Provides suggestions and resources for women with abusive caregivers.

Swendlund, N. P. & Nosek, M. A. (2000). An exploratory study on the work of independent living centers to address abuse of women with disabilities. Journal of Rehabilitation, 66(4), 57-64.

Study of 36 independent living centers (ILCs) that participated in telephone interviews about their services for women experiencing abuse. Of the 36 respondents, 31 identified abuse as an important issue among their consumers. The problem mentioned most often was lack of physically accessible shelters and abuse intervention program offices. Other problems frequently mentioned includes: dependence on the abuser for economic support, personal care or both; a need for increased outreach to women with disabilities experiencing abuse; and a need for training of abuse intervention program staff and other service providers on disability-related issues.

Walker, L. E. (1984). Violence against women: Implications for mental health policy. In L. E. Walker (Ed.), Women and mental health policy (pp. 197-206). Newbury Park, CA: Sage Publications.

This chapter describes how the concern for women's safety from men's physical and sexual violence has been an important factor in promoting changes in mental health policies. The author provides a short historical overview of the responses to women who were victims of violence and sexual assaults and the increased awareness and recognition of the extent of violence and sexual abuse of women. The chapter outlines legal and psychological developments which have influenced a change in public policy. The author concludes that despite recent developments, the legal and the psychological systems still operate with sexist biases against women, especially those women who are victims of violence and sexual abuse.

Womendez, C., & Schneiderman, K. (1991). Escaping from abuse: Unique issues for women with disabilities. Sexuality and Disability, 9(3), 273-279.

This article recounts the experiences of women with disabilities who have suffered physical abuse and who found help at a shelter called Finex House in Jamaica Plains, Massachusetts. These stories have been told in order to help other women with disabilities who may be in similar situations. Specific problems facing women with disabilities are addressed, such as the accessibility, self protection, and shortage of such shelters.