People with intellectual disabilities can be both the victims and perpetrators of sexual violence (often termed sexual abuse), including child sexual abuse. Prevalence rates of sexual violence against people with intellectual disabilities are high when compared with the experience of the general population. Whilst people with intellectual disabilities experience sexual violence in many of the same ways as the general population, they may encounter additional issues relating to their impairments and / or the social environments in which they live. These can include increased vulnerability, questions around ability to consent to sexual activities, differential treatment before the law, social attitudes about intellectual disability and sexuality, and restricted access to suitable support and recovery services.
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Prevalence and incidence
There are large differences between the prevalence and incidence estimates from different pieces of research: results are affected by a number of factors:
Morris showed, in a British study in 1999, that incidence data on sexual abuse of disabled children can be difficult to compile because:
United States of America
Studies indicate that people with intellectual disabilities are four to ten times more likely to have acts of violence committed against them. Dick Sobsey, Associate Director of the JP Das Developmental Disabilities Centre and Director of the John Dossetor Health Ethics Centre, found that 80% out of 162 people with developmental and substantial disabilities who had been sexually assaulted had been sexually assaulted more than once.
Sobsey estimates that between 15,000 and 19,000 individuals with intellectual disabilities experience rape each year.
It is believed by some that 20% of females and 10% of males are sexually abused in the US every year. The percentage is even higher among people with disabilities. According to research, more than 90% of people with intellectual disabilities will experience some form of sexual abuse at some time in their lives. 49% will experience 10 or more abusive incidents.
Other studies suggest 68% of girls with intellectual disabilities and 30% of boys with intellectual disabilities will be sexually abused before their eighteenth birthday. According to research 15,000 to 19,000 people with intellectual disabilities are raped each year in the United States.
Sullivan and Knutson found, in 2000, that children with intellectual disabilities were at slightly greater risk of sexual abuse than disabled children in general, who in turn were at 3.14 times greater risk of experiencing sexual abuse than non-disabled children.
Britain
A study by McCarthy and Thompson in 1997 found a prevalence rate of 25% for men and 61% for women. A survey by Brown et al. of senior managers in 1992 found an incidence rate of 0.5 per thousand people with intellectual disabilities each year.
The Republic of Ireland
A study by Dunne and Power in 1990 found an incidence rate of 2.88 per thousand people with intellectual disabilities per year.
Risk factors
A number of factors put people with intellectual disabilities at an increased risk of sexual violence. Medical models of disability emphasise risks connected with the person's disability, while social models of disability focus on risks caused by the socially-created environment of the intellectually disabled person. Not all factors will apply to all people with intellectual disabilities, and some are not exclusive to people with intellectual disabilities.
People with moderate to severe intellectual disabilities, and those with additional physical disabilities, form the majority of learning disabled people experiencing sexual violence.
Perpetrator profile
Research suggests that 97% to 99% of abusers are known and trusted by the victim who has the intellectual disability. According to Sobsey and Doe's 1991 analysis of 162 reports of sexual abuse against people with intellectual disabilities, the largest percentage of offenders (28%) were service providers (direct care staff members, personal care attendants, psychiatrists). In addition, 19% of sexual offenders were natural or step-family members, 15.2% were acquaintances (neighbors, family friends), 9.8% were informal paid service providers (babysitters), and 3.8% were dates. Further, 81.7% of the victims were women, and 90.8% of the offenders were men.
McCarthy identifies people with intellectual disabilities who are current or past users of services as another significant group of perpetrators.
United States of America
Cases of sexual abuse are considered in many states to qualify as “sexual assault” under the law; sexual assault is often arbitrated through rape or sexual battery statutes. Cases of sexual assault are arbitrated differently according to individual state laws and statutes.
States often have statutes for the intellectually disabled person separate from the general sex offense statutes. Such separate statutes often hold the intellectually disabled person at a “higher standard” than the non-intellectually-disabled person; that is, the legal standards used to prove sexual consent will be stricter for the intellectually disabled individual.
As Deborah W. Denno, Ph.D., J.D., of the Fordham University School of Law explains,
“courts have applied vague, unworkable tests in determining a mentally retarded victim's capacity to consent; it would be unrealistic to suggest that a rigid, precisely defined standard could ever be effective in so amorphous an area as sexual relations.”
Capacity to consent
Six tests are used as such a standard to assess the legal capacity of the intellectually disabled individual to consent to sexual conduct. These are the tests of “nature and consequences”, “morality”, “nature of the conduct”, “totality of the circumstances”, “evidence of mental disability”, and “judgment”. Forty-nine American states use one of these six tests in reviewing cases of sexual abuse, with the exception of Illinois (which uses two tests).
Special protection
Intellectually disabled people do get special protection under US law. In the state penal code, a person is defined as mentally defective if they suffer from "a mental disease or defect which renders him or her incapable of appraising the nature of his or her conduct." The special protection granted to those with intellectual disabilities in these cases is akin to the statutory protection given to children. In cases of sexual abuse, actual consent is irrelevant, because the person is incapable of giving legal consent.
England and Wales
The Sexual Offences Act 2003 defines sexual offences in general, including those perpetrated against or by adults or children. The Act includes specific crimes against adults with intellectual disabilities or mental health conditions:
sexual abuse of vulnerable persons with a mental disorder. These include situations where:
Reported crimes
Daniel D. Sorensen, Chair of the Victims of Crime Committee, Criminal Justice Task Force for People with Developmental Disabilities estimates that less than 4.5% of crimes against people with intellectual disabilities in California are reported compared to the 44% of the general public who experience crimes. The Seattle Rape Relief Project program for victims of sexual assault with intellectual disabilities conclude that there is underreporting of sexual assaults of victims with intellectual disabilities that exceed underreporting with other populations. Several studies suggest 80-85% of criminal abuse of residents of institutions never reach the proper authorities. The studies have found that 40% of those criminally abused and 40% of non-abusing staff of care facilities studied are reluctant to come forward with criminal abuse issues for fear of reprisals or retribution from administrators. no
Effects of sexual violence
People with intellectual disabilities can be harmed by sexual violence. The harm is often worse when the violence takes place over a long period and the perpetrator is known to the survivor. The following effects have been reported, but may not be experienced by all learning disabled survivors of sexual violence: