Teaching abuse-protection skills to people with intellectual, disabilities: a review of the literature.

Doughty et al. (2010) looked at every paper they could find on teaching abuse-protection skills to adults with intellectual disability. They found eight small studies that used behavioral skills training, or BST, to teach saying no, leaving, and telling. All eight worked with adults who had mild or moderate ID.

The review only covered English papers published up to 2009, so the pool was tiny and most subjects were white women in their thirties.

BST can teach adults with mild-moderate ID to refuse unwanted touch and to leave risky situations. The skills stuck when staff tested them right after training. No study checked if the skills still worked months later or if they worked with men, teens, or people with severe ID.

Fisher (2014) later showed the same BST package works for adults with Williams syndrome, lifting stranger-safety success from 14 % to 62 %. That study adds a new diagnosis to the tool kit but still used short follow-up.

Anonymous (2018) reviewed behavior-analytic fixes for sexual behavior problems in the same ID group. They also found positive short-term gains but warned no single method yet meets the Horner rules for evidence-based practice. The two reviews agree: BST helps, yet the field lacks big, long-term trials.

Waldron et al. (2023) mirrors the problem in a different safety area. Their review of falls-prevention in adults with ID also found only seven small studies and no clear guide for clinicians. Across safety topics, the evidence base for adults with ID remains thin.

If you serve adults with ID, you can keep using BST to teach refusal and escape responses, but treat it as pilot work. Add in-situ probes and longer follow-up in your own data. Push for agency approval to include males, younger adults, and people with severe ID in your programs so the next review has richer answers.