Sexual Violence of People with
Disabilities
1
SEXUAL VIOLENCE PREVENTION NETWORK
FEBRUARY 26, 2010
NANCY M. FITZSIMONS, MSW, PHD
[email protected]
N. M. Fitzsimons, PhD, MSW - Minnesota State
University, Mankato
Much of the material for this
presentation is from the book:
2
FITZSIMONS, N. (2009). COMBATING VIOLENCE
AND ABUSE OF PEOPLE WITH DISABILITIES: A
CALL TO ACTION. BALTIMORE, MD: PAUL H
BROOKES PUBLISHING CO.
THE BOOK WAS WRITTEN FOR PEOPLE WITH
DISABILITIES AND ALLIES
(FAMILY, FRIENDS, ADVOCATES, PEOPLE
WORKING IN CRIMINAL JUSTICE, DISABILITY
SERVICES, VICTIM SERVICES,ADULT
PROTECTION SERVICES)
N. M. Fitzsimons, PhD, MSW - Minnesota State
University, Mankato
Prevention
3
GETTING TO THE
ROOT CAUSE OF
THE PROBLEM
N. M. Fitzsimons, PhD, MSW - Minnesota State
University, Mankato
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
4
Part 1: Overview of Disability
5
•P R E V A L E N C E
•D E F I N I T I O N S
•L A N G U A G E
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Prevalence of Disability
6
 United States (2005 data)
 54.4 million/18.7% have a disability
 11 million or 4.1% have a severe disability impacting ability to
perform ADLs/IADLS (Brault, 2008)
Note: Data on civilian non-institutionalized population age 5+
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Prevalence of Disability in U.S. by Age (StatsRRTC, 2007) (Civilian
non-institutionalized population age 5+)
7
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Prevalence of Disability in U.S. by Gender (StatsRRTC, 2007)
(Civilian non-institutionalized population age 5+)
8
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Prevalence of Disability in U.S. by Race (StatsRRTC, 2007) (Civilian
non-institutionalized population ages 21-64)
9
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Prevalence of Disability in U.S. by Type (StatsRRTC, 2007) (Civilian
non-institutionalized population age 5+)
10
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Defining Disability
11
 Legal definitions




Americans with Disabilities Act (federal)
Vocational Rehabilitation Act (federal)
Minnesota statute
SSDI/SSI (federal benefits)
Refer to the
Defining
Disability
Handout
 Medical definitions


International Classification of Diseases, Functioning and Disabilities
(ICD-10)
Diagnostic and Statistical Manual (DSM-IV TR)
 Educational definitions

Individuals with Disabilities Education Act
 Categorical vs. functional vs. social model
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Classifications (or diagnoses) provide a global
understanding but tell you very little about the individual.
12
Physical
Disability
Sensory
Mental
May be a
Developmental
May be a
Developmental
Cognitive
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Developmental
Intellectual
Words & Disability
N. M.
Fitzsimons,
PhD, MSW Minnesota State
University,
Mankato
WRITE DOWN THE WORDS THAT YOU THINK
ARE COMMONLY USED TO DESCRIBE PEOPLE
WITH DISABILITIES.
Very Negative
13
Neutral
Very Positive
The Power of Language/Words…
14
 The devaluation or marginalization of a person or
group begin with language (Snow, 2005, p. 112).
Negative
Beliefs &
Attitudes
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
What is missing from each of these former medical diagnoses?
15
 Feebleminded: low intelligence
 Moron: A mental deficient who may take a normal place in
society, but needs constant supervision.
 Imbecile: A mental deficient who may learn to communicate
with others, but is incapable of earning his own living.
 Idiot: A mental deficient who is incapable of learning and
understanding, is completely helpless, and requires constant
supervision (Snow, 2005, p. 111).
N. M. Fitzsimons, PhD, MSW - Minnesota State
University, Mankato
People First Language (PFL)
“WE ARE NOT OUR
DISABILITIES. WE ARE
PEOPLE FIRST.”
16
N. M. Fitzsimons, PhD, MSW - Minnesota State University,
Mankato
People First Language (PFL) (Snow, 2005, p. 114)
17
Instead of:
Say:
The handicapped or disabled.
People with disabilities/A person
with a disability.
He’s mentally retarded.
He has an intellectual disability.
He’s a quadriplegic/crippled.
He has a physical disability.
She’s confined to/wheelchair bound.
She uses a wheelchair/mobility
chair.
She’s Down’s; A mongoloid girl
She has Down syndrome (or she has
a diagnosis of Down syndrome)
Normal or healthy
child/adult/person.
Child/adult/person without
disabilities.
Brain damaged man
A man with a brain injury.
A non-verbal girl.
A girl who communicates with her
eyes/device/etc.
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Language and the Deaf Community
18
 The Deaf community prefers the terms Deaf and
Hard of Hearing



Do not use “hearing impaired”
The Deaf community does not consider themselves impaired
hearing is not of primary importance
 Many people fall somewhere between “small d” and
“big D”

Identity is a personal choice that may change over time
(Bowman & Waech, personal communication, 2009)
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
The Platinum Rule
N. M.
Fitzsimons,
PhD, MSW Minnesota State
University,
Mankato
TREAT OTHERS THE WAY
THEY WANT TO BE
TREATED.
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
20
Language is a source of power and
control and, as such, to be contested:
words need to be won.
Jenny Corbett in Bad-Mouthing
N. M. Fitzsimons, PhD, MSW - Minnesota State
University, Mankato
Part 2: Understanding the
Problem
21
SERVING CRIME VICTIMS WITH
DISABILITIES: END THE SILENCE
INSTITUTE ON DISABILITIES
TEMPLE UNIVERSITY
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Crimes Against People with Disabilities
22
 Bureau of Justice Statistics, Crimes Against People with Disabilities,
2007 (Civilian non-institutionalized population):
http://www.ojp.usdoj.gov/bjs/pub/pdf/capd07.pdf
 716,000 nonfatal violent crimes
 Rape, sexual assault, robbery, aggravated assault, simple assault
 1/3 were serious violent crimes
 47,000 rapes
 79,000 robberies
 114,000 aggravated assaults
 2.3 million property crimes
 Household burglary, motor vehicle theft, property theft
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Crimes Against People with Disabilities
23
 Bureau of Justice Statistics, Crimes Against People
with Disabilities, 2007 (Civilian non-institutionalized
population):

Nonfatal violent crimes against persons with disabilities was 1.5 times
higher
 Rape or sexual assault was 2 times higher
 Females with disabilities higher rate than males with disabilities
 Males with disabilities higher rate than females without a disability
 Persons with cognitive disabilities higher rate than people with any other
type of disability
 Youth 12-19 2 times higher than youth without disabilities
 Half perpetrated against people with multiple disabilities
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Offenders
24
 Most common perpetrators known by victim (Catalano,
– spouses, partners, family members, paid care
providers (Abramson, 2005; Carlson, 1998; Hassouneh-Phillips & Curry, 2002;
2004)
Milberger et al., 2003; Oktay & Tompkins, 2004; Powers et al., 2002 as cited in
Fitzsimons, 2009).


People connected to person because of their disability
Male offenders– physical and sexual violence

People with DD: Male perpetrators 88% to 96% (Brown, Stein & Turk, 1995;
Brown & Turk, 1994; Furey, 1994; Furey & Niesen, 1994)


Female offenders - neglect
Peer-on-Peer (Brown & Turk, 1994; Crossmaker, 1991; Furey & Niesen, 1994: McCarthy & Thompson,
1996 as cited in Fitzsimons, 2009)

People with ID/DD in group living and sheltered work environments
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Settings
25
 Most likely setting is “home” (Brown & Turk, 1994; Furey, 1994;
Hassouneh-Phillips & Curry, 2002; Milberger et al. 2003; Power et al., 2002; Saxton et
al., 2001 as cited in Fitzsimons, 2009)
 Disability service settings (Gilson, Cramer & DePoy, 2001a; Sobsey,
1994 as cited in Fitzsimons, 2009)
INCREASED RISK
associated with greater
exposure to the service
delivery system.
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Your Own Vulnerability to Sexual Violence
26
Minimal
Vulnerability
Moderate
Vulnerability
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Extreme
Vulnerability
Vulnerable Adult
27
 “A person who is [18 or older] being mistreated or is in danger of
mistreatment and who, due to age and/or disability is unable to protect
himself or herself” (National Center on Elder Abuse, 2005, para. 3 as cited in
Fitzsimons, 2009, p. 28).
 State definitions:


Categorical – considered a vulnerable adult based residence/services received
Functional – considered a vulnerable adult based upon…
 Physical or cognitive disability + functional ability + impaired ability to protect self
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Vulnerable Adult in Minnesota (Minn. Stat. § 626.5572, Subd. 21)
28
Categorical part of definition
Any person, 18 years of age or older, who:
 Is a resident or inpatient of a facility
 Receives services at or from a facility required to be licensed to serve adults
 Receives services from a home care provider required to be licensed or from
a person or organization that exclusively offers, proves, or arranges for
personal care assistances services under the medical assistance program, or
Functional part of definition
 Regardless of residence or whether any type of service is received, possess a
physical or mental infirmity or other physical, mental or emotional
dysfunction that:
 impairs the individual’s ability to provide adequately for the individuals
own care without assistances, including the provision of food, shelter,
clothing, health care, or supervision, and
 Because of the dysfunction or infirmity and the need for assistance, the
individual has an impaired ability to protect the individual from
maltreatment
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Vulnerability and People with Disabilities
29
 Do not assume that every person with a disability is…
(really most people with a disability are…)







A “vulnerable adult” under state statute
Equally vulnerable
Unable to assess her or his own risk
Unable to protect his or her self
Unable to make informed decisions about his or her life and
future
Unable to make choices about what is in her or his best
interest
Dependent upon other for physical and financial care and
support
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Sexual violence may be occurring…
30
 A direct or coded disclosure of sexual violence
 Torn or missing clothing
 Genital or urinary pain/injury to a person’s genitals, rectum,
mouth, or breasts

Signs or complaints of infection, bleeding, bruising, injury, scarring,
redness, pain, irritation
 Signs of forced restraint
 Key red flags are human bite marks, rope marks, and burn marks
 Frequent physical illness with no clear cause
 stomach ache, sore throat, vomiting
 Nightmares, sleep problems
 Fear response to a specific person/specific people, group of
people with common characteristics, to a specific place
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Sexual Violence & People with Intellectual/Developmental
Disabilities
31












A person who is not known to be sexually active or unable to give
informed consent to sexual relations gets a sexually transmitted disease
or becomes pregnant
Regression to childlike behavior (e.g., urinating or defecating on self)
Elective mutism (i.e., refusing to speak)
Sudden loss of independent living skills
Physical and/or verbal aggression toward others
Acting out the abuse
Non-sexualized self-abusive behaviors
 head-banging, self-biting, cutting
Sexual aggression towards others
 Sexually explicit talk/threats/harassment, grabbing or touching
genitals, buttocks, or breasts
Problematic sexual behaviors
 putting harmful objects into genitals, self-exposure, masturbation
causing injury
Running away
Verbal comments that suggest being threatened or told to keep quiet
A secretive “special” relationship with another person, particularly one
involving bribery, trickery, or coercion
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Ask about
changes in
behavior or
engagement
in behaviors
atypical for
the person.
Caregiver Power and Control
32
N. M. Fitzsimons, PhD, MSW - Minnesota State
University, Mankato
Integrated Ecological Theory of Abuse
(Sobsey, 1994 as cited in Fitzsimons, 2009, p. 27)
33
Potential Victim
Potential Offender
Environment
Culture
Impaired physical defenses
Need for control
Emphasizes Control
Devalues victims
Impaired communication
Authoritarian
Attracts abusers
Objectifies victims
Lacks critical information
Low self-esteem
Isolated from society
(physical &/or social
isolation)
Teaches compliance
Learned helplessness
Displaced aggression
Provides awarded models of
aggression
Emphasizes
vulnerabilities
Learned Compliance
Exposed to abusive
models
Covers up allegations
Reinforces aggression
Underdeveloped sense of
personal space
Little attachment to victim
Has many care providers
Denies problems
Dependency
Devaluing attitudes
Transient care providers
Discourages attachment
Desire to please or be accepted
Impulsive behavior
Dehumanizes potential
victims
Discourages solutions
Few alternatives to exploitation
Eliminates non-abusers
Clusters risk
Discourages attachment
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
The Prevention Institute
http://www.preventioninstitute.org/tool_s
pectrum.html
Part 3: Barriers & Prevention
N. M.
Fitzsimons,
PhD, MSW Minnesota State
University,
Mankato
34
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Ecological Model of Prevention (Lee, Guy & Perry, 2008)
35
Individual Level
Person’s knowledge, attitudes, behavior, history,
demographics or biology
Relationship Level
Influence of parents, sibling, peers, intimate
partners, care providers, service providers
Community Level
Norms, customs, experiences with local
institutions
Societal Level
Broad social forces (inequalities, oppression,
organized belief systems, relevant public
policies)
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Connecting Barriers to Primary Prevention (refer to
Sexual Violence of People with Disabilities: Primary Prevention Worksheet
36
Level of Spectrum
Ecological Model
Influencing Policy and
Legislation
Enacting laws and
policies that support
healthy community
norms and a violencefree, barrier free,
inclusive society for
people with disabilities.
Societal Level
Broad social forces
(inequalities,
oppression, organized
belief systems, &
relevant public
policies).
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Barriers
Primary Prevention
Personal (Individual) Barriers
37
“The lack of knowledge and skills and the negative
thoughts, feelings, beliefs, and fears within a person that
result in disempowerment” (Fitzsimons, 2009, p. 89)
Types
 Learned helplessness
 Low self-esteem
Caused by,
 Self-blame
reinforced
 Sense of responsibility to others
by, and
 Fear of retaliation
perpetuated
 Fear of the unknown
by systemic
 Denial
barriers.
 Lack of knowledge and skills
 Poverty
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Learned Helplessness
38
 “The belief that one’s actions have no influence on
future outcomes” (Sobsey, 1994, p. 164 as cited in Fitzsimons, 2009, p. 91)
Learned
Helplessness
Compliance
Training
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Learned
Compliance
Learned Compliance
39
“What do you think happens when people reinforced
for complying with the instructions of parents,
teachers, bus drivers, and other care providers –
really anyone in a position of authority – encounter
someone who wants to sexually assault them?
Sexually exploit them? What are the chances that
they will resist? What are the chances they will
know what is happening to them is wrong –
criminal? What are the chances that they will
report the sexual violence?”
(Fitzsimons, 2009, p. 92).
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
The Rules people with disabilities (particularly people with ID/DD)
often have to live by.
40








Don’t get anyone else in trouble
Obey the rules…don’t be a troublemaker
Always obey anyone who acts “in charge”
Act nice
Don’t get angry
Don’t ask for much
Other’s opinions are important – not yours
It is bad, dangerous, noncompliant to:




Be assertive
Have an opinion
Say “no”
Assert one’s right
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Can result in
being labeled
as having a
“BEHAVIOR
Problem”
Low Self-Esteem
41
 “Failure to live up to the mythical standard of
independence may have a negative impact on the
sense of self-worth” of people with disabilities
(Fitzsimons, 2009, p. 93).
 Difference is often viewed negatively and people
who are different are often viewed as second-class
citizens
 Narrow standard of feminine beauty in our society
 Ratcheting up of the masculine ideal (Katz, 2006)
 Poor body image can lead to self-hate and a greater
willingness to accept abusive treatment (HassounehPhillips & McNeff, 2005)
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Sense of Responsibility to Others
42
 Some families rely on the disability related cash
benefits of adult or minor-age children to support
the family.


SSDI
SSI (Supplemental Security Income)
 If the abuser is the primary money earner, the victim
or other family members may not report the sexual
abuse in order to ensure the economic viability of the
family (Fitzsimons, 2009)
 In some cultures strong pressure upon women to
“fix” and “preserve the family”.
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Fear of the Unknown
43
 “There is real danger when you go to those people
[APS]…they think that their answer to protect the
[person with a disability] is to take them out of their
home and the next thing they find themselves in a
nursing home…they look at it as poor victims who
need to be protected…they take your independent
life…and put you in a disabled person’s prison” (Saxton
et al., 2006, p. 13 as cited in Fitzsimons, 2009, p. 79).
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Lack of Knowledge and Skills
44
 Where to get help
 How to make healthy decisions about sexual activity





and intimate relationships
Personal safety skills
Risk reduction
Assertiveness skills
Effective communications skills
Problem-solving skills (Fitzsimons, 2009, p. 99)
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Definition & Types of Systemic Barriers
45
 “Organizational and
societal obstacles that
perpetuate violence and
abuse of people with
disabilities and make it
difficult to end abusive
relationships and
situations” (Fitzsimons, 2009,
Types:
 Economic barriers
 Attitudinal barriers
 Service System barriers
 Communication barriers
 Physical barriers
p. 210).
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Economic Barriers: Poverty rate of noninstitutionalized working
age people with a disability (StatsRRTC, 2007 as cited in Fitzsimons, 2009, p. 68)
Attitudinal Barriers
47
 “The myths, negative attitudes, and stereotypes
about people with disabilities that result in the
denial of equal opportunity, equal protection under
the law, and equal participation in community life”
(Fitzsimons, 2009, p. 79).
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
People First – “Whole Human Beings”
48
 Dehumanization - “The actions, attitudes and
beliefs associated with treating a person or a group of
people as less than human” (Sobsey, 1994, p. 310 as cited in
Fitzsimons, 2009, p. 80)
Used as an excuse for abusive treatment
 If people are not “whole human beings” they don’t have
to be treated with dignity and respect.
 “Do unto others as you would like done unto you” doesn’t
apply if you believe that the others are not really like you.

N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Sensitivity to Physical and Emotional Pain Associated with Victimization
49
 “A psychiatrist testified that a woman with autism
who was sexually assaulted at the residence of
which he was the director could not have been
injured by the assault because people with autism
do not have feelings.” (Baladerian, 1997, p. 81 as cited in Fitzsimons,
2009, p. 81)

Belief - people with intellectual and developmental
disabilities suffer less harm because
Don’t fully understand what happened to them
 Experience pain and trauma differently (McCarthy & Thompson, 1996;

Sobsey & Mansell, 1990)
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Sexuality and People with Disabilities
50
People with disabilities are subject to many different
and contradictory beliefs…
 Asexual
 Sexually unattractive
 Sexually promiscuous
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Sexually Promiscuous
51
 In a study of women with intellectual disabilities, a
police officer was quoted as saying, “Just like
rabbits. They seem to have a higher sex drive than
other people. They seem to get sexual very young,
and have a high sex drive. Maybe they have
something to prove” (Keilty & Connelly, 2001, p. 280 as cited in
Fitzsimons, 2009, p. 84).
N. M. Fitzsimons, PhD, MSW - Minnesota State
University, Mankato
Perception of Credibility
52
 Whether or not a person is viewed as credible determines
how reports of crime victimization will be handled by
people working in the disability services, vulnerable adult
advocacy and protection, victim services, and criminal
justice systems” (Fitzsimons, 2009)
Perhaps the most
important need of
all people who are
crime
victims/survivors is
the need to be
BELIEVED!
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Adult Protection Services System Barriers
53
 Limited knowledge about people with disabilities
 Questioning of the credibility of victims based on




their disability
Lack of adequate funding for services
Large caseloads
Poor coordination of services
Disempowering practices of APS workers and the
APS system (Baladerian, 1997; Nosek et al., 1997; Saxton et al., 2006; Sobsey,
1994 as cited in Fitzsimons, 2009)
 Too often deal with violence, abuse and
exploitation as a social service issue, rather than a
criminal offense.
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Disability Services Barriers
54
 Overprotection (Baladerian, 1997; Carlson, 1997; Chenowith, 1997; Collins &
Valentine, 2003; Cramer et al., 2003; Powers et al., 2002; Saxton et al., 2001)
 Failure to recognize abusive situations (Cramer et al., 2003;
Galpin & Parker, 2007; Nosek et al., 1997)
 Disbelief of the victim (Baladerian, 1997, 2005; Calderbank, 2000;
Cramer et al., 2003; Galpin & Parker, 2007; Saxton et al., 2006)
 Disbelief of non-abusing care providers when reports
are made (Calcraft, 2007; Cambridge, 1999)

Retaliation against staff who “break the silence”
 Attributing claim of abuse to the disability (Cramer et al.,
2003)
(as cited in Fitzsimons, 2009)
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Criminal Justice System Barriers
55
 Limited knowledge about people with disabilities
 Questioning of the credibility of victims based on
their disability
 Lack of motivation to investigate crimes and
prosecute cases
 Respond to people with disabilities based on
negative attitudes, myths and stereotypes
 Inconsistent and narrow definitions of crimes
(Baladerian, 1997; Davies et al., 2006; Guidry Tyiska, 1998; Hook, 2001a,
2001b; Keilty & Connelly, 2001; Milbeger et al., 2003; Nosek et al., 1997;
Powers et al., 2002; Saxton et al., 2001; Sobsey, 1994 as cited in Fitzsimons,
2009)
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Communication Barriers
56
Lack of…
 Written materials in alternative formats
 Qualified sign language interpreters
 Knowledge on how to use a test telephone (TTY) or
telecommunication device for the deaf (TTD)
 Knowledge about the telephone relay service

dial 7-1-1- anywhere in the U.S.
 Staff that know how to interact more effectively
with people who have cognitive disabilities or use
alternative modes of communication (Baladerian, 1997;
Carlson, 1997; Cramer et al., 2003; Gilson et al, 2001a; Merkin & Smith, 1995; Nosek
et al, 1997 as cited in Fitzsimons, 2009)
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Reasons for Increased Vulnerability
57













Often dependent on others for care and support (varying degrees) –
compounded by systemic barriers
Communication challenges (varying degrees) and barriers
Greater challenges in taking risk-reducing precautions or resisting abuse
compounded by systemic barriers
RISK is
SOCIALLY
Often lack economic independence (varying degrees)
CREATED
Stereotypes and negative attitudes
Less risk of discovery of as perceived by offender
Failure to be believed when a report is made
Lack of participation in violence and abuse education and personal
safety
Less education about sexuality and healthy intimate relationships
Fewer opportunities to engage in healthy interpersonal relationships
Social isolation - segregation
Overprotection
Physical barriers to accessing supports and services (Fitzsimons, 2009, p.
29)
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Your Ideas for Primary Prevention
58
Level of Spectrum Ecological Model
Influencing Policy and
Legislation
Enacting laws and
policies that support
healthy community
norms and a violencefree, barrier free,
inclusive society for
people with disabilities.
Barriers
Societal Level
Broad social forces
(inequalities,
oppression, organized
belief systems, &
relevant public
policies).
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Primary Prevention
1. Examine the premise of and efficacy of
vulnerable adult legislation.
2. Consumer- directed services
3. Background checks: policy, system, and
funding
4. Inclusive K-12 Comprehensive sexual
health/relationship education, with
supplemental education
5. Statutes use people first language –
exclude dehumanizing language
6. Mandatory training of professionals on
“disabilities”
7. Increased funding for Centers of
Independent Living and other selfadvocacy organizations.
8. Accessible, barrier-free public
accommodations – transportation.
9. Texas State School & Fight Club
Your Ideas for Primary Prevention
Level of
Spectrum
Changing
Organizational
Practices
Adopting regulations
and shaping norms
within organizations
to break down
barriers and to
sexual violence, and
improve safety for
people with
disabilities, enhance
well-being, and
eliminate oppression
and ableism.
59
Ecological Model Barriers
Community Level
Norms, customs,
experiences with local
institutions
Primary Prevention
1. Mission statement, vision and values convey
equality, respect, inclusivity, empowerment,
strengths – people with disabilities involved in
creating
2. Hire qualified people with disabilities at all
position levels
3. On-going employee training at all system levels
4. Policies/practice reward care providers for
supporting people to maximize strengths,
maximize and honor choices.
5. Policies and procedures to maximize privacy
6. Hiring practices that involve people with
disabilities in interviews and examine attitudes,
beliefs, and behaviors.
7. Agency publications, training materials, policies
and procedures that reflect people first
language , exclude dehumanizing language, and
positively portray people with disabilities.
8. Barrier-free, readily accessible services.
9. Texas State School & Fight Club
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Your Ideas for Primary Prevention
60
Level of Spectrum
Ecological Model
Fostering Coalitions and
Networks
Bringing together groups
and individual, including
collaborating as partners
with people with
disabilities, to break down
barriers, to change
organizational practices, to
influence policy and
legislation in order to
prevent sexual violence of
people with disabilities,
improve safety, enhance
well-being, and eliminate
oppression and ableism.
Relationship Level
Influence of parents,
sibling, peers, intimate
partners, service providers
(formal and informal/paid
and unpaid), neighbors,
and community members.
Barriers
Use relationships to make
community level and
societal level changes.
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Primary Prevention
1. Members of disability advocacy groups
serve as board members/advisory
councils.
2. Serve as a board member/advisory
council member of a disability service
provider/advocacy organization.
3. Work collaboratively to create sexual
health workshops
4. Assessable and inclusive
Community/neighborhood events (block
parties, Take Back the Night, National
Night Out)
5. Present at “disability” related
conferences
6. Attend/Present at Self-Advocacy
Conferences, People First Meetings
7. Co-sponsor disability awareness
community events
8. Mentor/support people with disabilities
to engage in self-advocacy, systems
change and run for public office.
Your Ideas for Primary Prevention
61
Level of
Spectrum
Ecological Model
Educating Providers
Informing providers,
including disability
services, victim
services, criminal
justice services, adult
protection services,
and a wide array of
other providers who
will transmit
knowledge and skills to
others and model
positive norms in order
to prevent sexual
violence of people
with disabilities,
improve safety,
enhance well-being,
and eliminate
oppression and
ableism.
Relationship Level
Influence of parents,
sibling, peers, intimate
partners, care
providers, service
providers (formal and
informal/paid and
unpaid), neighbors,
and community
members.
Barriers
Use relationships to
make community level
and societal level
changes.
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Primary Prevention
1. Provider education to eliminate stereotypes,
negative attitudes, beliefs about people with
disabilities .
2. Provider training to maximize strengths and
autonomy of people with disabilities – have people
with disabilities serve as trainers, facilitators,
speakers.
3. Provider training to change belief that people won’t
be victimized because there are externals systems
and family members to protect.
4. Fully include people with disabilities on
government, civic, faith, social service, victim
service boards/advisory committees as equal
partners.
5. Attend a self-advocacy conference as a participant.
6. Present at a self-advocacy
conference/meeting/workshop.
7. Include people with disabilities on citizen police
academies.
8. Include people with disabilities in diversity
education/awareness.
9. Create community-based multi-disciplinary - multiagency prevention/response teams.
Your Ideas for Primary Prevention
Level of Spectrum
Ecological Model Barriers
Promoting Community
Education
Reaching groups of
people within the
community with
information and
resources to prevent
sexual violence of people
with disabilities, promote
safety, broaden the
spectrum of allies within
the community, change
norms, and eliminate
oppression and ableism.
Relationship Level
Influence of parents,
sibling, peers,
intimate partners,
service providers
(formal and
informal/paid and
unpaid), neighbors,
and community
members.
62
Primary Prevention
1. Fully include people with disabilities on
government, civic, faith, social service, victim
service boards/advisory committees as equal
partners.
2. Include “disability” as one aspect of diversity in
K-12 diversity curriculum. Have people with
disabilities serve as
trainers/facilitators/speakers.
3. Collaborate with the arts community to use art
to break down barriers, challenge attitudes –
Aktion Theater.
Use relationships to
4. Educate the media to use people first language
make community
and not use dehumanizing –stigmatizing
level and societal
language when referring to people with
level changes.
disabilities.
5. Write letters to the editor, op-ed stories, alert
the media to stories that contribute to
eliminating oppression, negative attitudes,
stereotypes.
6. Include people with disabilities in citizen police
academies.
7. Books in the library about people with
disabilities positive images, stories.
8. “Celebretards” (play) & “The R Word” (video) –
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
prompted by the play
Your Ideas for Primary Prevention
63
Level of Spectrum
Ecological Model
Strengthening Individual
Knowledge & Skills
Enhancing the capacity of
people with disabilities to
prevent sexual violence.
promote safety, enhance
well-being, promote
relationships based on
equality and
interdependence, and
maximize the
empowerment and selfdetermination of people
with disabilities.
Individual Level
Person’s knowledge,
attitudes, behavior,
history, demographics
or biology
Barriers
N. M. Fitzsimons, PhD, MSW - Minnesota State University, Mankato
Primary Prevention
1. Train-the-trainer model – empower people
with disabilities to educate other people,
peer trainers.
2. Partners in Policy Making
3. Capital Fellowship Program
4. Support the self-advocacy and voices of
people with disabilities being heard. Letters
to the editor, meeting with elected officials.
5. Create a mentor program to support the
self-advocacy of people with disabilities.
6. Inclusive education
7. Teach people about the social model of
disability.
8. Expose people with disabilities and others
to positive role-model – leaders in the
disability rights movement.
My Contact Information
64
Nancy M. Fitzsimons, PhD, MSW
[email protected]
507-389-1287
Minnesota State University, Mankato
Department of Social Work
358 Trafton Science Center North
Mankato, MN 56001
N. M. Fitzsimons, PhD, MSW – Minnesota State University, Mankato