Child Abuse and Special Needs or Behavioral Challenging Children

Introduction

     Children with a disability are at greater risk for abuse or neglect by their parents or caregivers both in and out of foster care. The higher need demands, along with greater stressors and anxiety for the caregivers, all contribute to this risk (Wymbs, Et Al 2008). The existing systems that are in place to support parents and caregivers are overburdened and inefficient to meet the need. The inadequate systems and lack of social support put more pressure on caregivers or parents to face the struggles alone. Roughly 4% of all cases of reported child maltreatment involved a child with a physical or cognitive disability (Health, 2009).

  Discussion  

  Biological or foster parents of children with special needs are often dedicated caregivers, but the demands and stress placed on them can be overwhelming and contribute to unintentional or intentional neglect and abuse (Datta, 2002). There are societal risk factors such as isolation, discrimination and program cuts that increase that risk. Families tend to be isolated from natural societal support systems and respite opportunities that can put a child at risk for abuse or neglect. Thinking of a child with a physical or cognitive disability as asexual, society may not give them the same personal safety training that most children receive in elementary school (Tharinger D, 1996). And finally, children who already feel devalued by society believe that they are not worthy of care and respect and are less likely to disclose their abuse or neglect.

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  There are family and parental risk factors also linked to in abuse in special needs children.  A family may not be able to accept or deal with their child’s disability and direct their anger over the loss of a “normal” child toward the disabled child (Wikler, 1981).  The parents may lack the education, or coping skills needed to care for their child. When a child exhibits challenging, or extreme behaviors parents are more likely to exert unnecessary control or physical punishment. The needs of the child may influence parent’s employment or income possibilities. All these stressors can cause a parent to strike out physically or emotional to the child they see as the source of the problem. In some cases, it is the non-disabled children in a family that are neglected or abused as a result of the stressors and demands that a special needs child places on the parents or caregivers.

Research supports that there are child related risk factors as well.  While no child is ever responsible for their maltreatment there are characteristics that do put them at higher risk for abuse and neglect (Datta, 2002).  The child may not be able to communicate that they are being abused, or their caregivers may not notice signs and symptoms due to common daily exposure to symptoms, like tantrums or withdraw.  Some children must rely on their caregivers for basic daily needs and may not know when a behavior is inappropriate. Children with special needs have also been taught to obey their caregivers and are very reluctant to disclose. And just like in all cases of abuse and neglect, children are afraid that reporting any type of abuse will hurt their parent or caregiver. Unfortunately, for the child, discovery of their abuse is usually the result of extremely obvious physical signs like pregnancy, venereal disease, severe physical injury or death. The behavioral signs like sudden changes in behavior that re-enact the abuse or other behavioral signs do not necessarily alert the untrained caregivers to possible abuse. Even more problematic is that professionals providing services to children with disabilities have too often attributed clear signs of abuse to the child’s special needs or disability (Johnson, 2012). 

When we look for causes of child abuse and neglect, we find common themes such as stress, inadequate coping skills, substance abuse, poverty, and lack of positive parenting skills and generational history of abusive behaviors. All these themes are also linked to abuse within children with special needs.  But if we look at that population specifically, we will find that the stress, financial burdens, burnout risk and substance abuse risk all increase when caring for a child with a disability or challenging behaviors.

It is no surprise that families and caregivers of special needs children need more social support than most. The need for respite services is high but unfortunately within social service budgets it is often some of the first funds cut. This lack of respite care can create caregiver burn out and stress reactions that can lead to unintentional and sadly intentional abuse or neglect.  No parent or caregiver is ever totally prepared to care for a child with physical, cognitive or psychological disabilities. The parents can simply become overwhelmed by the day to day demands of caring for a child with a special need.

A study by the National Institute of Health found that parents of children diagnosed with ADHD show a higher rate of divorce 22.7 percent compared to 12.6 percent than couples without a diagnosed child (Brian T. Wymbs and William E. Pelham, 2008). In another study at the University of Wisconsin (Hartley SL, 2010) children with an ASD parents or caregivers had a higher rate divorce than the comparison group.  Looking at these two studies the number of single parent households with special needs children is higher than average.  Lack of family, social and systems support is a big risk factor for these children, parents and caregivers.                                            Given all the increased risk factors in the lives of children with disabilities, the efforts for prevention and education should also be increased.  Just like in the non-disabled population prevention, not just after care of the abused child is the real objective. There needs to be a multifaceted approach to the prevention, education and services provided for families of child with special needs.

On a macro level raising national and governmental awareness of the problem can lead to increased program funding in area like respite, in home services, and behavioral health care. If we take a meso level approach, then the focus is on community-based interventions.  Promoting inclusion of children with disabilities and challenging behaviors into everyday life will relieve stress on not only the parents, but the social isolation of the child. Creation of local advocacy and parent support groups will help link caregivers with resources, support networks and skill development in opportunities. Community education that places value on children with disabilities or challenging behaviors can create a positive outlook for the future and potential societal contribution these children represent.  Awareness training for caregivers, teachers and medical personal about the signs of abuse, neglect and sexual abuse specifically in a child with special needs, can help identify a child faster and improve treatment outcomes.

The micro level includes the parents, siblings, teachers and other caregivers of children with disabilities and challenging behaviors.  Increasing the knowledge of a child’s diagnosis, development and specific issues can decrease anxiety and frustrations.  Connecting the families to the right resources can support the loving nurturing safe care that all children need regardless of a disability. Strengthening the parent/caregiver interactions through communication techniques, or assistive communication will reduce frustrations and improve attachment.   Coordinating respite care within the family, local support groups or even friends can give a feeling of support and acceptance. By giving the parent or caregiver a break from the demands of caring for a child with a disability or severe behavioral disorder you reduce the stress, anxiety and potential risk for abuse and neglect.  Children also need a break from their parent, the child needs to interact with other people and places in their community by giving the child an experience without their parents you are fostering independence and a broader world view.

   Increasing communication skills and modeling healthy relationships and social interactions is extremely important in prevention of abuse and neglect among children with special needs. Teaching children about the risks of abuse and neglect and ways to communicate with others can help prevent maltreatment within this population. Educating a child with a disability about personal safety such as “good touch, bad touch” will reduce their risk factors of being sexually abused. Finding resources to provide financial, childcare and housing support will reduce risk factors associated with child abuse and neglect.

     The number of adults children with disabilities and behavioral disorders are exposed to is an important prevention of nonfamilial.  Carefully screen individual who are applying to work with children with disabilities including a full criminal and child protective services background check.  Train caregivers in positive behavior management techniques that limit the use of restraint or isolation.

Conclusion

      Parents and caregiver of special needs children love, care and nurture their child just like any other parent. Unfortunately, there are unique stressor, care demands and financial burdens associated with parenting or caring for a child with a physical, cognitive, or psychological disability. These unique risk factors are what create a high risk of abuse and neglect among this population. Societal attitude of values and false assumptions also contribute to the higher likelihood that a disabled child will be abused, neglected or sexually assaulted in their live time compared to their non-disabled cohorts.  Creating programs and support systems both on the macro and meso will reduce the risk factors and help change social ideas that these children have less value in the community.  Education among parents, teachers, caregivers, medical professionals and even the children will open communication and prevention strategies needed to keep children safe. And finally finding a way to help alleviate caregiver burnout will generate a more cohesive family and leave time for all the positive nurturing and family experience that every child deserves regardless of a disability or not. 

References

] Tharinger D, H. C. (1996). Sexuality education of children and adolescents with developmental disabilities. American Academy of Pediatrics, 275-281.

Brian T. Wymbs and William E. Pelham, J. B. (2008). Rate and predictors of divorce among parents of youth with ADHD. Journal of Consulting and Clinical Psychology, 735-744.

Datta, R. a. (2002). Burden among the caregivers of children with intellectual disability: Associations and risk factors. Journal of Learning Disabilities, 337-350.

Hartley SL, B. E. (2010). The relative risk and timing of divorce in families of children with an autism spectrum disorder. Journal of Family psychology, 449-457.

Health, U. D. (2009). Child Maltreatment. Washington DC: Children’s Bureau.

Justice, U. D. (2009, July). ADA.Gov. Retrieved from ADA.GOV: http://www.ada.gov/cguide.htm

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PhD., E. H. (2004). Children and Caregivers: the role of Resilience. Jinan: International Council of Psychologists.

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Seltzer, R. N. (2009). Parental Stress With Special-Needs Children. Journal of Health and Social Behavior, 180-197.

Services, D. o. (2012). The Risk nd Prevention of Maltreatment of Children with Disabilities. Washington DC: Children’s Bureau.

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