Caldas SJ, Bensy ML. The sexual maltreatment of students with disabilities in American school settings. Journal of Child Sexual Abuse. 2014; 23 (4) : 345-66.
Keywords: Adolescent, Adolescent Behavior/psychology, Child, Child Abuse, Sexual/psychology/*statistics & numerical data, Child Behavior/psychology, Child Welfare/*statistics & numerical data, Crime Victims/psychology/*statistics & numerical data, Children with Dis
This study presents results from the first nationwide survey of students with …
This study presents results from the first nationwide survey of students with disabilities who were sexually maltreated in American schools. The Web survey results, which were mostly provided by caregivers, parents/guardians, and professional advocates, illuminate the types of sexual maltreatment committed, the characteristics of the victims and the abusers, where in the school setting the maltreatment occurred, the manner in which the maltreatment was reported, and the school's response to the maltreatment. More than two-thirds of the maltreated students experienced at least one form of contact sexual maltreatment, and fully 35% of all incidences of maltreatment occurred more than 10 times. The majority of the incidences of maltreatment were committed by school personnel.
Child Welfare Information Gateway. The Risk and Prevention of Maltreatment of Children with Disabilities. Washington, DC: US Department of Health and Human Services, Children’s Bureau. 2018.
Findley PA, Plummer SB, McMahon S. Exploring the Experiences of Abuse of College Students With Disabilities. Journal of Interpersonal Violence. 2016; 31 (17) : 2801-23.
Keywords: Adolescent, Adult, Cross-Sectional Studies, Persons with Disabilities/psychology/*statistics & numerical data, Female, Humans, Intimate Partner Violence/statistics & numerical data, Male, Physical Abuse/statistics & numerical data, Sex Offenses/statistics
Intimate partner violence and sexual assault of college students has garnered …
Intimate partner violence and sexual assault of college students has garnered increased attention and publicity. Current studies have focused primarily on general campus populations with little to no attention to students with disabilities. While studies suggest the rate of abuse of individuals with disabilities is similar or higher compared to the general population, there remains a lack of focus on this issue. Individuals with disabilities are at particularly high risk for abuse, both through typical forms of violence (physical, sexual, emotional, and economic) and those that target one's disability. In an effort highlight and explore this issue further, an exploratory study was conducted to learn the rates of abuse among university students who have identified as having a disability. This is a cross-sectional survey of 101 students of students with disabilities from a large northeastern public university. Experiences of abuse were measured through the use of the Abuse Assessment Screen- Disability (AAS-D) scale. Students were asked about experiences of physical, sexual, psychological, and disability related abuse within the last year and help seeking behaviors when an incident of abuse occurred. We found that 22 % of participants reported some form of abuse over the last and nearly 62% (n= 63) had experienced some form of physical or sexual abuse before the age of 17. Those who were abused in the past year, 40% reported little or no knowledge of abuse-related resources and only 27% reported the incident. Authors discuss implications results have for programs and policies on campus for individuals with disabilities.
Fong A, Friedlander R, Richardson A, Allen K, Zhang Q. Characteristics of children with autism and unspecified intellectual developmental disorder (intellectual disability) presenting with severe self-injurious behaviours. International Journal of Developmental Disabilities. 2024; 70 (3) : 518-529.
Objective: This study aims to delineate the characteristics of severe self-injur …
Objective: This study aims to delineate the characteristics of severe self-injurious behaviors (SIB) in a cohort of children with autism and unspecified intellectual developmental disorder (UIDD) (intellectual disability) and examine potential risk factors for developing SIB. Methods: A retrospective chart review studied characteristics of severe SIB in 30 children with autism spectrum disorder (ASD) and UIDD referred to a tertiary care center. Characteristics examined include genetic syndromes, brain MRI abnormalities, verbal ability, adaptive functioning, SIB frequency and severity, age of onset, number of psychopharmacological agents, irritability, hyperactivity, stereotypy, psychiatric and physical comorbidities, among others. Descriptive and bivariate analysis were applied to explore potential relationships between factors. Results: Children with severe SIB exhibit this behaviour with high frequency, inflicting moderate to severe injury. Most children in the study sample are non-verbal and have ASD (93.3%; n = 28) with psychiatric (96.7%; n = 29) and physical (90%; n = 27) comorbidities. Overall SIB improvement using the Clinical Global Impression, Improvement Score (CGI-I) was 3.0 (minimally improved). A minority were much or very much improved following appropriate intervention. Conclusions: The severity of SIB is much higher in this sample than previously noted in the literature. Severe SIB is associated with ADHD, early onset mood disorders, tics, avoidant restrictive food intake disorder and Obsessive-Compulsive Disorder.
Goldberg AP, Tobin J, Daigneau J, Griffith RT, Reinert SE, Jenny C. Bruising frequency and patterns in children with physical disabilities. Pediatrics. 2009; 124 (2) : 604-9.
Keywords: Activities of Daily Living/classification, Adolescent, Body Mass Index, Braces, Child, Child, Preschool, Contusions/diagnosis/*epidemiology/etiology, Cross-Sectional Studies, Children with Disabilities/*statistics & numerical data, Education, Special, Fem
OBJECTIVE: We obtained normative data on bruising in children with physical …
OBJECTIVE: We obtained normative data on bruising in children with physical disability in functioning and evaluated factors associated with bruising in this population. METHODS: We studied children with physical and/or cognitive disabilities who attend a school that provides comprehensive services. Over a 15-month period, the children had skin examinations, including external inspection of the genitalia and anus. For each child, we gathered information on demographics, medications, growth measures, medical conditions, equipment used, and muscle tone. Functional independence in basic mobility, self-care, and social communication was assessed by using the Functional Independence Measure for Children (WeeFIM). Results were compared with a previously studied nondisabled or "typical" population of children. RESULTS: Fifty children and adolescents 4 to 20 years of age had 2 skin examinations. There was no relationship between the number of bruises and the child's age, race, or BMI. Overall, our subjects were more likely to have at least 1 bruise noted than nondisabled children from a comparable study. There was no significant relationship between the number of bruises and functional mobility, self-care, cognition, or muscle tone. The bruising locations in our study group were different from those of nondisabled children. However, in both groups bruises were rarely found on the neck, ears, chin, anterior chest, or buttocks. CONCLUSIONS: The children in our study were different from nondisabled children in the frequency and pattern of their bruising. Areas uncommonly bruised in typical children were also uncommonly bruised in the disabled children. Although increasing age and mobility clearly make a difference in the number of bruises a typically functioning child sustains, these factors are not relevant when evaluating bruises on a child with disabilities. Other factors such as muscle tone, cognition, and equipment should be considered when evaluating a child with significant disabilities who presents with bruises.
Goudie A, Narcisse MR, Hall DE, Kuo DZ. Financial and psychological stressors associated with caring for children with disability. Families, Systems & Health : the Journal of Collaborative Family Healthcare. 2014; 32 (3) : 280-90.
Keywords: Caregivers/*psychology, Child, Children with Disabilities/*psychology, Family Health, Female, Humans, Long-Term Care/*economics/psychology, *Stress, Psychological/economics/psychology, Surveys and Questionnaires
The magnitude of stress and associated health consequences experienced by …
The magnitude of stress and associated health consequences experienced by caregivers compromises their ability to effectively provide care to children, especially children with disability. We used latent class analysis of data from the 2010 Ohio Family Health Survey and identified 3 distinct classes of caregivers based on patterns of responses to 15 financial and psychological stresses they experienced. Compared with children residing in households in which caregivers experienced very little or no stress, children with disability were twice as likely to reside with caregivers with high levels of financial stress and almost 3.5 times as likely to reside with caregivers with high levels of financial stress and very high levels of psychological stress than typically developing children. Reducing caregiver stress is a critical step to ensuring the best health outcomes possible for children with disability. We identify the heterogeneity that is present in the population of caregivers by virtue of patterns of responses to various financial and psychological stressors. Children with disability are more likely to live in households in which a greater number of stressors affect caregivers. Different confounders are also associated with the latent classes of stress we identify. This is an important implication when determining the right interventions to target to the right subpopulations.
Helton JJ, Lightfoot E, Fu QJ, Bruhn CM. Prevalence and Severity of Child Impairment in a US Sample of Child Maltreatment Investigations. Journal of Developmental and Behavioral Pediatrics : Jdbp. 2019; 40 (4) : 285-292.
Keywords: *Adaptation, Psychological, Adolescent, Affective Symptoms/epidemiology, Behavioral Symptoms/*epidemiology, Child, Child Abuse/*statistics & numerical data, Child Protective Services/*statistics & numerical data, Child, Preschool, Developmental Disabiliti
OBJECTIVES: Although there is agreement that childhood disability is both a …
OBJECTIVES: Although there is agreement that childhood disability is both a risk and result of maltreatment, the extent of disability in the child welfare system remains unclear. Our objective is to determine the prevalence and severity of child impairment in a national sample of child abuse and neglect investigations in the United States. METHODS: We used data from the National Survey of Child and Adolescent Well-Being II, a study of 2644 children older than 3 years who were subjects of child abuse and neglect investigations. Groups of children were identified by latent profile analysis using continuous standardized measures of intelligence, emotional or behavioral impairments, adaptive behaviors, and social skills. RESULTS: Whether the child remained in home or was removed to foster care after an investigation, 3 classes of children were identified: (1) slightly over one-tenth were in an intellectual disability subgroup characterized by marked intellectual impairments alongside delays in daily living functioning, (2) over one-third were in an emotional or behavioral impairment subgroup characterized by both frequent and severe internalizing and externalizing behaviors, and (3) slightly over half were in a typically developing subgroup. CONCLUSION: When using standardized measures of disability, nearly half of the children investigated by child protection in the United States are not typically developing. These findings suggest that those working for the child welfare system need to be attentive to the complex needs of children with intellectual disabilities and emotional or behavioral impairments and their families, many of whom are under significant stress.
Hershkowitz I, Lamb ME, Horowitz D. Victimization of children with disabilities. The American Journal of Orthopsychiatry. 2007; 77 (4) : 629-35.
Keywords: Child, Child Abuse/statistics & numerical data, Child, Preschool, Crime Victims/*statistics & numerical data, Developmental Disabilities/*epidemiology, Children with Disabilities/*statistics & numerical data, Female, Humans, Male
Children with disabilities (CWDs) are more likely to be victims of child abuse …
Children with disabilities (CWDs) are more likely to be victims of child abuse but may have more difficulty than their typically developing (TD) peers reporting their experiences. In this study, the authors examined the characteristics of abuse reported by CWDs based on forensic statements made by 40430 alleged abuse victims, 11% categorized as children with minor disabilities, and 1.2% categorized as children with severe disabilities. Proportionally more of the CWDs than of the TD children were allegedly victims of sexual rather than physical abuse. CWDs failed to disclose abuse and delayed disclosure more often than TD suspected victims. CWDs were more likely than TD children to be abused by parent figures and to experience physical abuse resulting in body injury or serious sexual offenses, including those involving penetration, repeated abuse, use of force, and threats. Higher levels of disability were associated with increased risk of sexual abuse. Both the heightened incidence of severe abuse among and the failure to disclose abuse by CWDs should be sources of considerable concern to social welfare and criminal justice agencies.
Hirota T, King BH. Autism Spectrum Disorder: A Review. Jama. 2023; 329 (2) : 157-168.
Keywords: Adult, Child, Humans, Attention Deficit Disorder with Hyperactivity/complications/drug therapy, *Autism Spectrum Disorder/complications/diagnosis/epidemiology/therapy, Central Nervous System Stimulants/therapeutic use, Irritable Mood, United States/epidem
IMPORTANCE: Autism spectrum disorder (ASD), characterized by deficits in social …
IMPORTANCE: Autism spectrum disorder (ASD), characterized by deficits in social communication and the presence of restricted, repetitive behaviors or interests, is a neurodevelopmental disorder affecting approximately 2.3% children aged 8 years in the US and approximately 2.2% of adults. This review summarizes evidence on the diagnosis and treatment of ASD. OBSERVATIONS: The estimated prevalence of ASD has been increasing in the US, from 1.1% in 2008 to 2.3% in 2018, which is likely associated with changes in diagnostic criteria, improved performance of screening and diagnostic tools, and increased public awareness. No biomarkers specific to the diagnosis of ASD have been identified. Common early signs and symptoms of ASD in a child's first 2 years of life include no response to name when called, no or limited use of gestures in communication, and lack of imaginative play. The criterion standard for the diagnosis of ASD is a comprehensive evaluation with a multidisciplinary team of clinicians and is based on semistructured direct observation of the child's behavior and semistructured caregiver interview focused on the individual's development and behaviors using standardized measures, such as the Autism Diagnostic Observation Schedule-Second Edition and the Autism Diagnostic Interview. These diagnostic measures have sensitivity of 91% and 80% and specificity of 76% and 72%, respectively. Compared with people without ASD, individuals with ASD have higher rates of depression (20% vs 7%), anxiety (11% vs 5%), sleep difficulties (13% vs 5%), and epilepsy (21% with co-occurring intellectual disability vs 0.8%). Intensive behavioral interventions, such as the Early Start Denver Model, are beneficial in children 5 years or younger for improvement in language, play, and social communication (small to medium effect size based on standardized mean difference). Pharmacotherapy is indicated for co-occurring psychiatric conditions, such as emotion dysregulation or attention-deficit/hyperactivity disorder. Risperidone and aripiprazole can improve irritability and aggression (standardized mean difference of 1.1, consistent with a large effect size) compared with placebo. Psychostimulants are effective for attention-deficit/hyperactivity disorder (standardized mean difference of 0.6, consistent with a moderate effect size) compared with placebo. These medications are associated with adverse effects including, most commonly, changes in appetite, weight, and sleep. CONCLUSIONS AND RELEVANCE: ASD affects approximately 2.3% of children aged 8 years and approximately 2.2% of adults in the US. First-line therapy consists of behavioral interventions, while co-occurring psychiatric conditions, such as anxiety or aggression, may be treated with specific behavioral therapy or medication.
Jones L, Bellis MA, Wood S, Hughes K, McCoy E, Eckley L, Bates G, Mikton C, Shakespeare T, Officer A. Prevalence and risk of violence against children with disabilities: a systematic review and meta-analysis of observational studies. Lancet (London, England). 2012; 380 (9845) : 899-907.
Keywords: Adolescent, Child, Child Abuse/*statistics & numerical data, Child Abuse, Sexual/statistics & numerical data, *Children with Disabilities, Humans, Prevalence, Violence/*statistics & numerical data
BACKGROUND: Globally, at least 93 million children have moderate or severe …
BACKGROUND: Globally, at least 93 million children have moderate or severe disability. Children with disabilities are thought to have a substantially greater risk of being victims of violence than are their non-disabled peers. Establishment of reliable estimates of the scale of the problem is an essential first step in the development of effective prevention programmes. We therefore undertook a systematic review and meta-analysis to synthesise evidence for the prevalence and risk of violence against children with disabilities. METHODS: For this systematic review and meta-analysis, we searched 12 electronic databases to identify cross-sectional, case-control, or cohort studies reported between Jan 1, 1990, and Aug 17, 2010, with estimates of prevalence of violence against children (aged ≤18 years) with disabilities or their risk of being victims of violence compared with children without disabilities. FINDINGS: 17 studies were selected from 10,663 references. Reports of 16 studies provided data suitable for meta-analysis of prevalence and 11 for risk. Pooled prevalence estimates were 26·7% (95% CI 13·8-42·1) for combined violence measures, 20·4% (13·4-28·5) for physical violence, and 13·7% (9·2-18·9) for sexual violence. Odds ratios for pooled risk estimates were 3·68 (2·56-5·29) for combined violence measures, 3·56 (2·80-4·52) for physical violence, and 2·88 (2·24-3·69) for sexual violence. Huge heterogeneity was identified across most estimates (I(2)>75%). Variations were not consistently explained with meta-regression analysis of the characteristics of the studies. INTERPRETATION: The results of this systematic review confirm that children with disabilities are more likely to be victims of violence than are their peers who are not disabled. However, the continued scarcity of robust evidence, due to a lack of well designed research studies, poor standards of measurement of disability and violence, and insufficient assessment of whether violence precedes the development of disability, leaves gaps in knowledge that need to be addressed. FUNDING: WHO Department of Violence and Injury Prevention and Disability.
Legano LA, Desch LW, Messner SA, Idzerda S, Flaherty EG; COUNCIL ON CHILD ABUSE AND NEGLECT; COUNCIL ON CHILDREN WITH DISABILITIES. Maltreatment of children with disabilities. Pediatrics. 2021; 147 (5) : 401-411.
Over the past decade, there have been widespread efforts to raise awareness …
Over the past decade, there have been widespread efforts to raise awareness about maltreatment of children. Pediatric providers have received education about factors that make a child more vulnerable to being abused and neglected. The purpose of this clinical report is to ensure that children with disabilities are recognized as a population at increased risk for maltreatment. This report updates the 2007 American Academy of Pediatrics clinical report "Maltreatment of Children With Disabilities."Since 2007, new information has expanded our understanding of the incidence of abuse in this vulnerable population. There is now information about which children with disabilities are at greatest risk for maltreatment because not all disabling conditions confer the same risks of abuse or neglect. This updated report will serve as a resource for pediatricians and others who care for children with disabilities and offers guidance on risks for subpopulations of children with disabilities who are at particularly high risk of abuse and neglect. The report will also discuss ways in which the medical home can aid in early identification and intervene when abuse and neglect are suspected. It will also describe community resources and preventive strategies that may reduce the risk of abuse and neglect.
Li Q, Li Y, Zheng J, Yan X, Huang J, Xu Y, Zeng X, Shen T, Xing X, Chen Q, Yang W. Prevalence and trends of developmental disabilities among US children and adolescents aged 3 to 17 years, 2018-2021. Scientific Reports. 2023; 13 (1) : 17254.
Keywords: Humans, Child, Adolescent, Developmental Disabilities/epidemiology, *Autism Spectrum Disorder/epidemiology, Prevalence, *Learning Disabilities/epidemiology, *Attention Deficit Disorder with Hyperactivity/epidemiology, *Intellectual Disability/epidemiology
Developmental disabilities prevalence seem to be high in countries around the …
Developmental disabilities prevalence seem to be high in countries around the world. It's worth understanding the most recent prevalence and trends of developmental disabilities. The objective of this study is to examine the prevalence and trends of developmental disabilities of US children and adolescents. A total of 26,422 individuals aged 3-17 years were included. Annual data were examined from the National Health Interview Survey (2018-2021). Weighted prevalence for each of the selected developmental disabilities were calculated. The prevalence of any developmental disabilities in individuals was 16.65% (95% CI 16.03-17.26%), prevalence of attention deficit/hyperactivity disorder (ADHD), learning disability (LD), autism spectrum disorder (ASD), intellectual disability (ID), and other developmental delay were 9.57% (95% CI 9.09-10.06%), 7.45% (95% CI 7.00-7.89%), 2.94% (95% CI 2.67-3.21%), 1.72% (95% CI 1.51-1.93%), and 5.24% (95% CI 4.89-5.59%), respectively. Significant increases were observed for other developmental delay (4.02-6.05%) and co-occurring LD & ID (1.03-1.82%). Findings form this study highlight a high prevalence of any developmental disabilities, although no significant increase was observed. The prevalence of other developmental delay and co-occurring LD & ID were significantly increased. Further investigation is warranted to assess potentially modifiable risk factors and causes of developmental disabilities.
Murphy N. Maltreatment of children with disabilities: the breaking point. Journal of Child Neurology. 2011; 26 (8) : 1054-6.
Keywords: Child, Child Abuse/classification/*psychology, Children with Disabilities/*psychology, Family/*psychology, Humans, Prevalence, Risk Factors
The maltreatment of children with disabilities is a serious public health issue. …
The maltreatment of children with disabilities is a serious public health issue. Children with disabilities are 3 to 4 times more likely to be abused or neglected than are their typically developing peers. When maltreated, they are more likely to be seriously injured or harmed. As alarming as these numbers are, they likely underestimate the problem. Children with disabilities encounter all 4 types of abuse: physical, sexual, neglect, and emotional. Here, the author discusses risk factors associated with the maltreatment of children with disabilities, which, as expected, include both child and family factors.
Peer JW, Hillman SB. Stress and resilience for parents of children with intellectual and developmental disabilities: a review of key factors and recommendations for practitioners. JPolicy Pract Intell Disabil. 2014; 11 (2) : 92-98.
Keywords: developmental disabilities, intellectual disability, parenting, resilience, stress
Parents of children with intellectual and/or developmental disabilities …
Parents of children with intellectual and/or developmental disabilities experience more stress in comparison to parents of normally developing children. Chronic stress could negatively influence parents' health while also impacting their ability to meet their child's needs. Despite this, there is a subset of parents who remain resilient in the face of significant stress in their lives. Knowledge of the factors that promote parental resilience could positively impact the services these families receive. The authors conducted a systematic review of research article databases and found support for coping style, optimism, and social support as resilience factors for parents of children with intellectual and/or developmental disabilities. Awareness of variables that promote resilience for parents of children with intellectual and/or development disabilities is likely to inform clinical practice through offering new avenues for clinical focus in all phases of family-centered care.
U.S. Department of Health & Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children’s Bureau. Child Maltreatment 2022. 2024.
Zablotsky B, Ng AE, Black LI, Blumberg SJ. Diagnosed Developmental Disabilities in Children Aged 3-17 Years: United States, 2019-2021. Nchs Data Brief. 2023; (473) : 1-8.
Keywords: Child, Humans, *Autism Spectrum Disorder/diagnosis/epidemiology, Developmental Disabilities/epidemiology, *Intellectual Disability/diagnosis/epidemiology, Prevalence, United States/epidemiology, Child, Preschool, Adolescent
Developmental disabilities are common in children in the United States, and the …
Developmental disabilities are common in children in the United States, and the prevalence has increased in recent years (1). Timely estimates are necessary to assess the adequacy of services and interventions that children with developmental disabilities typically need (2). This report provides updated prevalence estimates for diagnosed autism spectrum disorder, intellectual disability, and other developmental delay among children aged 3-17 years from the 2019-2021 National Health Interview Survey (NHIS), with differences in prevalence examined between years and by sex, age group, and race and Hispanic origin. Estimates are also presented for any developmental disability, defined as having had one or more of these three diagnoses.
Zand DH, Pierce KJ, Nibras S, Maxim R. Parental risk for the maltreatment of developmentally delayed/disabled children. Clinical Pediatrics. 2015; 54 (3) : 290-2.
Keywords: Adult, Child Abuse/*statistics & numerical data, Child, Preschool, Children with Disabilities/*statistics & numerical data, Female, Humans, Infant, Male, *Parents, Risk, Young Adult
The US Department of Health and Human Services
(2012) has reported that 27.1% …
The US Department of Health and Human Services
(2012) has reported that 27.1% of children younger than 3 years comprise more than one quarter of all maltreatment cases.
' It has been widely reported that children
with developmental delays/disabilities are at higher risk for maltreatment than typically developing children.?' It has been documented that these children are at a 1.7 times greater risk than children without disabilities.' While the American Academy of Pediatrics has published multiple reports and guidelines on child maltreat-ment, little information is available on specific, modifiable areas of parental risk. Such information is critical when providing relevant anticipatory guidance to the parents of high-risk children. The present brief report begins to fill this gap by identifying parental risk areas for the maltreatment of their developmentally delayed/disabled child and making specific recommendations for pediatric anticipatory guidance to this unique group of parents.
