AN EPIDEMIC OF VIOLENCE:
CRIME AGAINST PEOPLE WITH DISABILITIES
Daniel D. Sorensen
May 22, 2001
INTRODUCTION
Crime against people with substantial disabilities is a problem similar to violence against women; elder abuse and child abuse, but remains largely invisible and unaddressed. Studies consistently show that the level of violent crimes against children and adults with substantial disabilities is from four to ten times higher than against the general public. These studies also show that such crimes are reported at a much lower rate and that there are lower rates of prosecution and conviction.
Who are people with these disabilities? They include people with developmental disabilities (such as an intellectual disability or mental retardation, autism, cerebral palsy, epilepsy), traumatic brain injury, severe physical disabilities, major mental disorders, degenerative brain diseases (such as Alzheimer’s, Parkinson’s, Hunington’s), permanent damage from a stroke, organic brain damage and other substantial disabilities.
People with such disabilities are among those most at risk of violent and other serious crime.
IS THIS TRUE FOR PEOPLE WITH AUTISM?
There is almost no research on crime and violence specifically against people with autism. Some studies included people with autism in their study samples but usually in such small numbers that there is no way to know what specific rates of crime and abuse they may experience. It is by analogy that concern for the safety of people with autism is raised. It is difficult to believe that there is not a high rate of violent crime against people with autism as study after study finds very high rates of violent crime against people with developmental and other substantial disabilities.
Also, there are the personal stories and clinical experience.
A woman approached me after one of my talks in central California. She had a pre-teen daughter with autism who had been molested by her father. She reported this to the police who investigated. The child was interviewed at a special center for children. The forensic interviewer had been trained to interview children but not children with autism. The interviewer concluded that the child’s flat affect and refusal to make eye contact indicated that the abuse likely did not occur and that the child had likely been coached by the mother to make false accusations. The police ended their investigation and there was no prosecution. The court awarded the father weekends with his daughter. The mother was forced to allow the father to take the daughter to the child’s complaint of, “don’t let him take me, he will hurt me again.”
A forty-year-old man who is HIV positive was charged with aggravated sexual battery and knowingly exposing another person to a life-threatening disease. The victim was a young man with autism in his early twenties (let’s give him the name John) in the Kansas group home were the man worked. The man’s defense is that John agreed to have sex and therefor it was consensual sex between two adults. A psychologist hired to evaluate the mental capacity of the victim did not want to subject john to the trauma of continuing the interview so he ended it. The judge refused to dismiss the case, saying that the issue of competence to consent will be raised again after all the evidence has been presented during the trial.
A teacher in Florida was charged with five counts of child abuse in a 1997 accusation that she force fed, slapped, screamed at and insulated five children with autism, calling one “trailer trash”. She is being prosecuted not under statutes against physical abuse but under the “mental injury” section of the law. An appeals court threw out the trial on the grounds that “mental injury” was unconstitutionally vague. The Florida Supreme Court reversed this finding and the case will proceed.
I was called on to investigate a death in a residential home for young adults with autism. A young man, who we will call Bob, had been restrained by staff when he became very agitated. Three staff persons attempted to follow the restraint procedures. The young man was placed face down on the floor with one staff person to hold down his shoulders, one to hold down his waist and one to hold down his legs. They placed a blanket over his head to quiet him. Bob continued to struggle and then became still. He had vomited and choked to death on his vomit. The staff was young, well meaning but under trained. There were no charges made in this death.
A Florida elementary school teachers-aid was charged with assault of a six year old non-verbal girl with autism. The girl was sent home with bruises on her neck severe enough to prompt her doctor to call an abuse hot line. The doctor found that the girl had been grabbed around the neck or strangled, leaving bruises and fingerprints. The state attorney’s office decided not to press charges since their only witness is unable to talk and they concluded that they could not prove criminal intent. Since the incident, Alice has resumed wetting her bed.
Violent crimes are committed against children and adults with autism. It is also probable that these crimes occur at rates similar to those for other substantial disabilities.
THE RATE OF VICTIMIZATION
Research consistently finds that people with substantial disabilities suffer from violent crimes at rates many times higher than those for the general population. Sobsey, in a review of the research literature, concluded that the conservative estimate is that this population is over 4 times as likely to be victims of crime than are people without disabilities (Sobsey, 1996a). Sobsey also believes that the more accurate figure is between 5 to 10 times higher (Sobsey, 1996b).
Petersillia (1998) estimates that roughly 5 million crimes are committed against people with developmental disabilities in the United States each year. She compares this with 8,000 hate crimes, 1 million elder abuse victims and 1 million spousal assault victims each year. The National Committee to Prevent Child Abuse survey indicated that over 1 million cases of child abuse are reported each year. The number of crimes against people with all types of disabilities would be four to five times greater than the number against people with developmental disabilities alone. This means that crime against all people with substantial disabilities may be higher than elder abuse, child abuse and spousal abuse combined.
Murry reported that a 1990 study of 150 people with a wide range of disabilities found that they had a 2 to 10 times greater risk of criminal abuse than people without disabilities.
Wilson and Brewer (1992) completed a study in Australia in which they took a sample of 174 adults with intellectual disabilities and compared their rates of criminal victimization to a sample of people without disabilities in that same community. They found that people with intellectual disabilities had a victimization rate for sexual assault 10.7 times higher than that for the nondisabled comparison group and 12.8 times higher for robbery.
These findings are consistent with other research. In a study by Hard (1986) of 95 adults with developmental disabilities in California, 83% of the women and 32% of the men in this sample had been sexually assaulted. Stromsness (1993) found through structured interviews of 27 women and men with mild mental retardation in four San Francisco Bay Area counties that just under 80% of the women and 54% of the men had been sexually abused at least once. These rates compare to 13% of women in the general population who have been victims of at least one rape in their lifetimes (Kilpatrick, Edmunds & Seymore, 1992).
In addition to these extremely high rates of sexual assault, there is evidence that people with developmental and other substantial disabilities are often sexually assaulted repeatedly. Sobsey and Doe (1991) found that 80% of a sample of 162 people with developmental and other substantial disabilities who had been sexually assaulted had been sexually assaulted more than once, while 49.6% had experienced 10 or more sexual assaults.
It is not just people with developmental disabilities who are experiencing these very high rates. In a survey of health providers who cared for victims of sexual assault with disabilities (Mullan & Cole, 1991), people with both mental retardation and a physical disability were identified as most vulnerable to sexual assault, with mentally ill persons a close second. A study of 278 randomly selected psychiatrically disabled residents of 30 large Los Angeles board-and-care homes found that 33% had been victims of violent crime over the previous 12 months (Lehman and Linn, 1984). The comparable rate for the general population in Los Angeles County at that time was 3.5%. This is a violent crime rate 9.5 times higher for this population. Lam and Rosenheck, 1998, in a study of over 1800 homeless persons with mental illness, found that forty-four percent had been victims of at least one violent crime during the two months prior to being questioned. This is a violent crime rate 13 to 20 times higher than that of the general population.
In another study of the lives of women with disabilities, a disabled women’s action group conducted research on the subject of crime and found that 70% of women with cognitive or physical disabilities had been victims of violence (Stimson and Best, 1991).
Children with disabilities also suffer higher rates of criminal abuse than children without disabilities. A major national survey of child abuse (A Report On the Maltreatment of Children with Disabilities, National Center on Child Abuse and Neglect) found that children with disabilities were 2.1 times as likely to suffer criminal physical abuse and 1.8 times as likely to suffer sexual assault. There are methodological weaknesses in this study that most probably led to a serious undercount of crimes against children with disabilities. This study relied on the opinion of child protective workers about whether there was a disability present and largely excluded extrafamilial abuse.
A more recent and methodologically sound study of over 50,000 children in Omaha schools during 1995 to 1996 found that children with disabilities suffered a rate of reported abuse 3.44 times greater than children without disabilities (Sullivan and Knutson, 1997). This study found that children with intellectual disabilities (or mental retardation) had rates of reported sexual abuse 4.0 times higher and reported physical abuse 3.8 times higher than children without disabilities. Inexplicably, this study found only a slightly higher rate for reported neglect for children with autism but no higher rate for reported sexual or reported physical abuse. This is a finding that I have difficulty in believing.
Other studies are consistant with the general findings. A reanalysis of data from a sample of 500 abused children in Baltimore between 1973 and 1984 revealed that children with disabilities had a rate of criminal abuse 4.43 times higher than those without disabilities (Sobsey and Doe, 1991). Finally, in a study of 55 hearing impaired multiply handicapped children examined by otolaryngologists through the Boys Town Center for Abused Handicapped Children, reported that 96 percent of the children had been sexually abused (Brookhouser, Sullivan, Scanlan, and Garabino, 1986).
REPORTING OF CRIMES
In addition to these high rates of victimization, there is evidence that crimes against people with substantial disabilities are often not reported. The components of the criminal justice system cannot take necessary action when not informed of crimes. Every police department, sheriff’s office and district attorney that we have consulted in California reported that they have very few cases involving victims with substantial disabilities, dramatically less than the relative rate of violent crime would predict. This is a practical and concrete indication that major crimes against people with substantial disabilities are being reported at a much lower rate than for the general population.
I estimate that less than 4.5% of serious crimes committed against people with disabilities in California have been reported compared to 44% for the general population. This is based on an analysis of California’s adult Protective System data compared to National Crime Victimization Survey data.
There are other studies that support this conclusion. The Seattle Rape Relief Project program for victims of sexual assault with developmental disabilities concluded, based on their clinical experience, that there is underreporting of sexual assaults of victims with developmental disabilities that exceeds underreporting with other populations (Anderson, 1985). A study of 162 people with a range of disabilities found infrequent reporting of crimes to authorities (Sobsey & Doe, 1991). In the Wilson and Brewer (1992) study, 71% of crimes against people with more severe mental retardation went unreported. This compares with 56% of violent crimes that go unreported for the general population (National Crime Victimization Survey, 1999).
Similarly, several studies suggest 80-85% of criminal abuse of residents of institutions never reach the proper authorities (Powers, Mooney & Nunno, 1990). A University of Alberta study suggests one reason for this. It 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 (Helm, 1990). Administrators may fail to report a violent crime which could lead to negative publicity involving questions about their competence, damage their career or even lead to losing their jobs. Minimizing the severity of the reported abuse or deciding that it was unlikely that a crime occurred avoids such risks.
Reporting to “proper authorities” often includes reports to non-law enforcement agencies that result in administrative actions such as licensing sanctions or the firing of the suspect. The law in California and other states mandates reporting of serious crimes but administrators often determine were to send such reports by their interpretation of what actually occurred. Reports of incidents diverted from the criminal justice system are not part of the crime reporting data and represent an unequal remedy when compared to arrest, prosecution and incarceration.
James found a much higher rate of non-reporting in a study of people with developmental disabilities; a finding that is consistent with the idea that people with more severe disabilities are more vulnerable and less likely to report a sexual assault. This study found that only 3% of cases of sexual assault involving people with developmental disabilities are ever reported to authorities (James, 1988 as reported in Tharinger, Horton & Millea, 1990). This compares with a reporting rate of sexual assaults of from 16% (Kilpatrick, Edmunds & Seymore, 1992) to 28.3% (National Crime Victimization Survey, 1999) for the general population.
There is a widespread perception among people with developmental and other more substantial disabilities and their advocates that reporting crimes may often be useless (Sobsey and Doe, 1991).
POLICE FOLLOW UP AND PROSECUTION
There is also expert opinion and empirical evidence that, when reported, there are lower rates of police follow up, prosecution and convictions in these crimes. A range of possible explanations offers themselves. These cases are inherently difficult to investigate, prosecute and try. Criminal Justice personnel often lack the special skills and special training required for these cases. The cognitive and communication difficulties for some of these victims present special challenges including the unfounded assumption that such victims almost always make incompetent witnesses. Negative stereotypes and prejudices can interfere with fair consideration by the criminal justice system.
Sobsey (1994) reviewed a number of research studies on this topic and reported that they all agreed that convictions of offenders were rare in spite of the chronic and severe nature of the criminal abuse. A survey of 119 cases of sexual assault against people with mental retardation in Britain was consistent with these findings. It found that no action was taken in almost half the cases and prosecution or disciplinary action took place in only 18.5% of the cases (Brown & Turk, 1994). Another study (Sobsey and Varnhaggen, 1991) looked at sexual assaults of people with disabilities. It reported that 65% of cases reported to the police were not prosecuted because the police declined to press charges usually citing the victim as an incompetent witness. In another 18% of these cases, the prosecutor refused to pursue charges. In another 18%, the offender was never found. Many of the victims were dissatisfied with the legal action taken or denied. Sobsey (1996b) stated that overall there is not good prosecution of these cases but that it varies greatly across different criminal justice systems.
The worst danger is that predators may also believe they are unlikely to be successfully prosecuted. I was told by a clinician at Atascadero State Hospital, a forensic facility in California, that he overheard two sex offenders talking. One said to the other, “Get a job in the D.D. (developmental disabilities) system when you get out, it’s easy pickings.” Unfortunately, such people probably also hold that perception about the mental health system and other systems providing care for people with substantial disabilities.
CONCLUSION
The personal experience of people with substantial disabilities and their families, as well as empirical research, paints a picture of very high rates of violent and other major crime directed against citizens with disabilities. People with substantial disabilities represent a sizable portion of our population, suffer violent crime at substantially higher rates than most citizens and are less protected by the criminal justice system than other persons because of lower reporting rates for violent crime and lower prosecution and conviction rates. This is a situation that cannot be allowed to continue.
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Used with permission