Literature analysis to determine the inclusion of children with disabilities in abuse interventions.

To the Editor: Children with disabilities are an understudied population in the field of child abuse. Sullivan and Knutson (2000) determined that, compared to children without disabilities, children with disabilities were maltreated at higher rates (31% vs. 9%) and more often experienced multiple forms of maltreatment (63% vs. 54.9%) and recurring rather than single episodes of maltreatment (71% vs. 29%). Given that family members were most often the perpetrator (from 53% to 92% of perpetrators, depending on abuse type), success of child abuse prevention/intervention programs should be examined for families with children with disabilities. In 2005, Kendall-Tackett, Lyon, Taliaferro and Little stated that children with disabilities rarely receive protection services because providers are unaware of the increased risk and the specialized needs of this population. In response, I examined research published in 3 journals during the 10-year period from 1998 to 2007. Included were all studies assessing prevention programs for at-risk families or intervention programs for children who had been maltreated by a family member; each study was coded for whether children with disabilities were included in the study sample. Disabilities included children having prenatal drug-exposure; fetal alcohol effects/syndrome; physical, developmental, or learning disabilities; or if the child was born preterm or of low birthweight. Of the 28 empirical studies examining prevention or intervention programs, only 7 included children with disabilities in the participant sample. An additional 5 mentioned disability as an abuse risk factor. Eight were prevention studies, four were intervention programs. It is concerning that so few abuse prevention/intervention programs include children with disabilities. Also, while many programs used risk assessments, disability status was not mentioned or considered; even while risk factors for child maltreatment may occur at greater rates among families with children with (versus without) disabilities (Fisher, Hodapp, & Dykens, 2008). Prevention studies need to be expanded to include families of children with disabilities. Beyond typical prevention programs, these families may need specialized services to teach appropriate parenting skills and responses to disability-related behaviors. Behavior plans written into the child’s Individualized Family Service Plan (IFSP) could also help parents handle a child’s difficult behaviors. Finally, it would also be helpful to design programs to educate children with disabilities about inappropriate interactions with others. This literature analysis highlights the need to evaluate the effectiveness of child abuse prevention and intervention programs for families with children with disabilities. Given the high rates of abuse experienced by this vulnerable population, more research should focus on specific ways to protect children with disabilities. Families of children with disabilities would benefit from prevention and intervention programs designed to teach them to raise a child with special needs, respond to challenging behavior, and seek help from appropriate sources. Programs could also help reduce stress and increase competency among parents of children with disabilities.