Research published from 2000 to 2020 illustrates increased prevalence rates of sexual violence against people with intellectual disabilities, compared to the general population.Sullivan, P. and Knutson, J. (2000) 'Maltreatment and disabilities: a population based epidemiological study.' Child abuse and Neglect 22, 4, 271 – 288, cited in Higgins, M. and Swain, J. (2010), Disability and Child Sexual Abuse, Jessica Kingsley Publishers.:61 The World Health Organization (WHO) funded a study which concluded that 15% of the adult population worldwide in 2012 had a disability, putting them at increased risk of physical, sexual, and intimate partner violence. Of that 15%, 6.1% had intellectual disability with 5.5% experiencing sexual violence. In another 2012 report, the WHO found that worldwide, children with intellectual disabilities experienced a 4.6 times greater risk of sexual violence than those without disability.
In the United States, the Bureau of Justice Statistics reported in the National Crime Victimization Survey the rate of sexual violence for those with an intellectual disability is five times higher than for those without any disability. Both men and women with intellectual disabilities experience sexual violence that includes rape, sexual coercion without physical force, and sexual experiences without physical contact. Perpetrators of sexual violence are not only strangers but can be caregivers, acquaintances, and intimate partners. The perpetrator of the assault often determines if the crime will be reported.
While people with intellectual disabilities experience sexual violence in many of the same ways as the general population,:73 those with intellectual disability may be more vulnerable to sexual violence because of their dependence on others for economic support, personal care, and support with tasks associated with daily living such as bathing and eating.Brown, H., Stein, J. and Turk, V. (1995) 'The sexual abuse of adults with learning disabilities: Report of a second two-year incidence survey.' Mental Handicap Research 8, 1, 3–24, cited in Michelle McCarthy, Sexuality and Women with Learning Disabilities, Second Edition, Jessica Kingsley Publishers, 1999. They often encounter additional issues related to their disability and the environments in which they live. These additional issues can include questions around the ability to consent to sexual activities, differential treatment before the law and restricted access to proper support and recovery services.National Sexual Violence Resource Center. (2018). Crimes against people with disabilities fact sheet [Resource Guide]. Societal attitudes and beliefs about the sexuality of those with intellectual disabilities and the validity or accuracy of their claims of abuse are additional risk factors. Finally, racial and ethnic discrimination with disability discrimination increase the risk of sexual violence.
Prevalence and incidence There are large differences between the prevalence and incidence estimates from independent sources of research as it relates to this topic. Results are often impacted by many factors such as:
Differences in how sexual abuse is defined, and which experiences are counted as abuse for research purposes. Who is asked about the abuse: reported prevalence and incidence are lower if service managers, staff or case notes are consulted, and higher when people with intellectual disabilities are asked directly. Whether abuse rates for men and women are combined or calculated separately. Differences between the groups of people selected to take part in the research.
Morris (1999) reported that incidence data on sexual abuse of disabled children can be difficult to compile because:
Parties reporting the incident may not agree on the impairment of the disabled child. Information may not be recorded consistently. Some children with mild or moderate intellectual disabilities may not be registered with the services that usually record abuse incidents.Morris, J. (1999) 'Disabled children, child protection systems and the Children Act.' Child Abuse Review 8, 91–108, cited in Michelle McCarthy, Sexuality and Women with Learning Disabilities, Second Edition, Jessica Kingsley Publishers, 1999.
The highest rate of occurrence of abuse happens within the place of residence of the persons with intellectual disabilities. Other areas of frequency where abuse occurs were at the perpetrator's home and in other public places, such as public toilets.
Understanding race and ethnicity factors in sexual assault incidence among those with an intellectual disability are vital for addressing differences between white and minority populations in victimization and intervention. As in other health issues, intellectually disabled people from historically disadvantaged racial and ethnic groups face health disparity with poorer health outcomes than white populations with a disability.Blick, R. N., Ellsworth, D. W., Havercamp, S. M., & Kornblau, B. L. (2015). The double burden: Health disparities among people of color living with disabilities [Report]. Ohio Disability and Health Program. nisonger.osu.edu/ODHP However, race and ethnicity are often not reported in study samples looking specifically at sexual violence and intellectual disability.Browne, A., Agha, A., Demyan, A., & Beatriz, E. (2016). Examining criminal justice responses to and help-seeking patterns of sexual violence survivors with disabilities (Document No: 250196) [Report]. U.S. Department of Justice.
United States In 2002, David Sorensen wrote that Americans with intellectual disabilities were four to ten times more likely to have acts of violence committed against them.
In 1996 Dick Sobsey, associate director of the JP Das Developmental Disabilities Centre and Director of the John Dossetor Health Ethics Centre at the University of Alberta, concluded that 80% of 162 people with developmental and substantial disabilities who had been sexually assaulted had been sexually assaulted more than once.Sobsey, D. Relative victimization risk rates: people with intellectual disabilities (unpublished manuscript). (1996) cited in Facts on Traumatic Stress and Children with Developmental Disabilities, National Child Traumatic Stress Network, Adapted Trauma Treatment Standards Work Group, via Government of Los Angeles County Sobsey estimated that between 15,000 and 19,000 individuals with intellectual disabilities experience rape each year.
According to 1995 guidance from the US Department of Justice, more than 90% of Americans with intellectual disabilities experienced some form of sexual abuse at some time in their lives; 49% experienced 10 or more abusive incidents.
In his 1994 book Violence and abuse in the lives of people with disabilities: the end of silent acceptance?, Sobsey wrote that 68% of girls with intellectual disabilities and 30% of boys with intellectual disabilities will be sexually abused before their 18th birthday.
Sullivan and Knutson concluded 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.
In 2007, Americans with intellectual disabilities were victims of approximately 47,000 rapes and sexual assaults. Statistical data from 2009 to 2014 drawn from the Bureau of Justice Statistics, the rate of serious violent crime as in rape or sexual assault for persons with intellectual disabilities was more than three times the rate for persons without intellectual disabilities including a correlation of 40% of the time the victim was being taken care of by the person who sexually assaulted them.Harrell, E. (2016). Crime against persons with disabilities, 2009–2014 – Statistical Tables. Retrieved from https://www.bjs.gov/content/pub/pdf/capd0914st.pdf
A 2010 study concluded that the largest group of identified perpetrators of sexual abuse is developmental disability service providers or caregivers. 87% of a sample from 874 surveys of individuals with intellectual disabilities reported that they had been sexually abused, and 67% had experienced vaginal or anal penetration. The study also concluded that these service providers lacked basic knowledge about abuse, perpetrator characteristics, and facts about potential victims.
In some cases, people with developmental disability are unable to disclose sexual abuse due to the physical or emotional limitations imposed by their disability, leading to the caregivers taking advantage of their intellectual disabilities.
Britain A study by McCarthy and Thompson in 1997 found a prevalence rate of 25% for men and 61% for women.McCarthy, M. and Thompson, D. (1997) 'A prevalence study of sexual abuse of adults with intellectual disabilities referred for sex education.' Journal of Applied Research in Intellectual Disability 10, 2, 105–124, cited in Michelle McCarthy, Sexuality and Women with Learning Disabilities, Second Edition, Jessica Kingsley Publishers, 1999. 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.Dunne, T. and Power, A. (1990) 'Sexual abuse and mental handicap: Preliminary findings from a community based study,' Mental Handicap Research 3, 111–125, cited in Michelle McCarthy, Sexuality and Women with Learning Disabilities, Second Edition, Jessica Kingsley Publishers, 1999.
Spain A study by Gil-Llario, Morell-Mengual, Ballester-Arnal and Díaz-Rodríguez in 2017 found a prevalence rate of 2.8% for men and 9.4% for women. Among the women who were abused, only 52.9% trusted someone enough to tell them about what had happened. Of these, 28.6% preferred to tell a close relative, 57.1% told an educator and 14.3% talked to a friend about it. Of the men, 80% decided to talk about their experience of abuse. Half of them (50%) told their father or mother, 25% talked to an educator and 25% discussed the matter with a close relative.
Another Spanish study indicates that the prevalence of sexual abuse is 6.10% when it is self‐reported (9.4% in women and 2.8% in men) and 28.6% when it is reported by professionals (27.8% in women and 29.4% in men).
Risk factors
A number of factors put people with intellectual disabilities at an increased risk of sexual violence. Medical models of disability emphasize 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.Hollomotz, Andrea, 2011, Learning Difficulties and Sexual Vulnerability, Jessica Kingsley Publishers Not all factors will apply to all people with intellectual disabilities, and some are not exclusive to people with intellectual disabilities.
Lack of understanding. Lack of social awareness and training that would help identify and anticipate abusive situations. Ingrained reliance on the caregiver authority figure. Long-term dependence on services and personal care. Emotional and social insecurities. Lack of capacity to consent to sexual activity. Lack of knowledge and training in sex education. Powerless position in society. Low self-esteem, contributing to powerlessness.Mencap, Respond, UK Voice, 2001, Behind closed doors: preventing sexual abuse of adults with a learning disability, http://lx.iriss.org.uk/sites/default/files/resources/behind_closed_doors.pdf Not realizing that sexual abuse can cause harm. Not being able to tell anyone about the abuse. Learned behaviour not to question caregivers or others in authority. Communication difficulties that hinder reporting abuse. Fear of not being believed, leading to non-reporting of abuse. Feelings of guilt or shame that prevent reporting of abuse.