Sexual abuse in children and adolescents with intellectual disability.
Sexual abuse is common among young in-patients with ID, and those who later offend were usually victims first.
01Research in Context
What this study did
Doctors looked at the kids and teens with intellectual disability who were admitted to a hospital unit. They counted how many had been sexually abused or had abused someone else.
The team used hospital records. They noted age, gender, and any history of abuse.
What they found
Fourteen out of every 100 admissions were linked to sexual abuse. Most of the time the child was the victim.
Girls were victims more often. When a child had hurt someone else sexually, that child had usually been abused first.
How this fits with other research
Noordenbos et al. (2012) studied adult men with ID who offended. They also found high rates of childhood sexual abuse, especially among men who committed sex crimes. The pattern matches: abuse often comes before offense.
Carter et al. (1995) looked at adults with learning disabilities. They saw the same link: past abuse was tied to later sexual behavior problems. The new study shows the pattern starts in childhood.
Winburn et al. (2014) summed up caregiver fears about sexuality in ID. Their review reminds us that staff discomfort can hide abuse signs. The numbers in Fox et al. (2001) give staff a clear reason to act anyway.
Why it matters
If you work with kids or teens with ID, screen for sexual abuse at intake. Watch for signs in girls especially. When you see sexual behavior problems, ask who hurt that child first. Early help can stop the victim-to-offender path.
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02At a glance
03Original abstract
The present authors conducted a study of the occurrence of victimization and the perpetration of sexual abuse among 43 in-patients with intellectual disability aged between 9 and 21 years who were admitted to a child and adolescent psychiatric in-patient department over a period of 5 years. A retrospective case-note review was employed that explored the nature and severity of abuse in relation to the age, gender and level of disability. The prevalence of abuse or abusive behaviour, i.e. 14% of 300 admissions, did not change over time. In 13 out of the 43 cases, the issue of sexual abuse was identified after admission. Victimization alone occurred in 21 cases, perpetration alone in six cases, and both victimization and perpetration in 16 cases. Fifty per cent of the victims had been abused by a member of their close or extended family. Most cases (62%) were adolescents. There was only one instance of a victim being abused by a female. However, there were five girls who were perpetrators, all of whom had previously been victims. By contrast, 11 out of the 17 male perpetrators had been victims. Despite difficulties of disclosure, it was possible to establish that severely disabled patients had suffered sexual abuse. The present data support theories which (1) recognize gender differences in sexual abuse patterns and (2) have a developmental perspective, incorporating the influence of adolescence.
Journal of intellectual disability research : JIDR, 2001 · doi:10.1046/j.1365-2788.2001.00293.x