Dr. Jo Coombs, Clinic a l Psyc holog ist Ne urode ve lopme nt Se - PowerPoint PPT Presentation

Child Se xual Abuse (CSA) in Pe ople Affe c te d by L e ar ning Disabilitie s (L D): ife span Impac t Ac r oss the L Dr. Jo Coombs, Clinic a l Psyc holog ist Ne urode ve lopme nt Se rvic e s (NdS), Your He a lthc a re (YH) 23 rd Ja nua ry 2018

Why Conside r CSA in Pe ople with L e ar ning Disabilitie s? Co nsiste nt e vide nc e o f inc re a se d risk a nd pre va le nc e of a ll forms of a buse in c hildre n a nd a dults with le a rning disa b ilitie s.

Why Conside r CSA in Pe ople with L e ar ning Disabilitie s? I nc re a se d risk a nd pre va le nc e is re la te d to a c o mple x inte rpla y o f fa c to rs: I ndividua l • Multiple impa c ts o f disa b ility • E xpe c ta tio ns a nd a c tio ns o f o the rs Co mmunity • L a rg e a nd c ha ng e a b le suppo rt ne two rks – lo ng -te rm d e pe nd e nc y • Ac c e ss to info rma tio n a nd suppo rt • Po we r imb a la nc e s: so c ia l, le g a l Cultura l • De pe nde nc y a nd pro te c tio n

Inc re a se d Risk/ Pre va le nc e : Individua l F a c tors Impa c t of disa bility Cog nitive a nd Communic a tion Skills – Und e rsta nd ing a b o ut • a ppro pria te / ina ppro pria te so c ia l inte ra c tio n, re la tio nships, se xua lity a nd se xua l b o und a rie s. Co mmunic a tio n d iffic ultie s – c o mmunic a ting to o the rs a nd b e ing und e rsto o d . s – De pe nd e nc y o n o the rs fo r c a re a nd suppo rt, Inc r e a se d De pe nde nc y on Othe r • inc lud ing intima te pe rso na l c a re ; d e pe nd e nc y ma y le a d to se nse o f po we rle ssne ss, a c q uie sc e nc e . Se nse of Se lf – Inte rna lise d d e va lua tio n, lo w-se lf e ste e m, po o r se lf-c o nc e pt, • d ise mpo we rme nt, iso la tio n fro m so c ie ty. tunity – L a c k o f so c ia l a wa re ne ss a b o ut he a lthy re la tio nships, d e sire to Soc ia l Oppor • b e ‘ no rma l’ a nd in a re la tio nship a t a ny c o st, limite d a nd c ha ng ing so c ia l suppo rt ne two rks.

Inc re a se d Risk/ Pre va le nc e : Community F a c tors s: Ove rpro te c tio n o f pe o ple with le a rning E xpe c ta tions a nd Ac tions of Othe r • d isa b ilitie s le a d s to ‘ und e r-pro te c tio n’ ; b e lie fs o f o the rs a b o ut whe the r se xua l a b use c a n a ffe c t pe o ple with le a rning d isa b ilitie s – linke d to a ssumptio ns o f ‘ a se xua lity’ o f pe o ple with le a rning d isa b ilitie s; c a re r a s pe rpe tra to r – ma y b e se e n a s ‘ he ro ’ a nd no t b e lie ve d to b e a pe rpe tra to r; d ia g no stic o ve rsha d o wing – c ha ng e s a ttrib ute d to d isa b ility. ks: Diffic ultie s e sta b lishing lo ng -te rm, trusting L a r g e a nd Cha ng e a ble Suppor t Ne twor • re la tio nships with o the rs, sta ff turno ve r ma y inc re a se risk o f a b use a s suppo rte d b y lo ts o f d iffe re nt pe o ple , pre ssure o n time le a d s to mo re fo c us o n “d o ing ” ra the r tha n “b e ing ” with pe o ple with L D – re d uc e s trust-b uilding a nd o ppo rtunitie s fo r d isc lo sure a nd suppo rt. t: L e ss like ly to re c e ive e d uc a tio n re la te d to se x, Ac c e ss to Infor ma tion a nd Suppor • re la tio nships a nd se xua l b o und a rie s, limite d a c c e ssib le se rvic e s, la c k o f a wa re ne ss a b o ut se rvic e s.

Inc re a se d Risk/ Pre va le nc e : Cultura l F a c tors ote c tion: Powe r Imbalanc e s, De pe nde nc y and Pr • Co ntinue d so c ia l disa dva nta g e pe rpe tua te inc re a se d risk o f ha rm a nd a b use . So c ia lly te nd to b e de pe nde nt o n de ple ting pub lic a lly-funde d g o ve rnme nt syste ms o f suppo rt whic h ma y me a n le ss like ly to a c c e ss a ppro pria te suppo rt. Diminishing re so urc e s in so c ia l a nd he a lthc a re se rvic e s ma y me a n mo re inc o nsiste nc y in so c ia l suppo rt, limite d o ppo rtunitie s fo r a ppro pria te so c ia l, e mo tio na l a nd he a lth suppo rt. L e gal Disadvantage : L e g a l disa dva nta g e re la te d to • individua l, c o mmunity a nd c ultura l fa c to rs (c o mmunic a tio n, b e lie fs a nd a ttitude s to wa rds pe o ple with L D fro m le g a l syste m, whe the r c o nside re d re lia b le witne sse s, a c c e ssib ility to g o o d le g a l a dvic e a nd re pre se nta tio n) a nd the diffic ultie s o f the g e ne ric le g a l syste m in kno wing ho w to c o mmunic a te with a nd suppo rt pe o ple with le a rning disa b ilitie s.

Possible Signs of Abuse in Pe ople with L D Physic al: Une xpla ine d c uts, b ruise s, b le e ding , injurie s to g e nita ls, inne r • thig hs, b o tto m. Une xpla ine d diffic ulty wa lking o r sitting . • Sta ine d a nd/ o r missing unde rwe a r, b e dline n. • Gyna e c o lo g ic al c o mplaints, e .g . pe lvic pa in, pa in during • inte rc o urse , fre q ue nt urina ry a nd/ o r g e nita l infe c tio ns. Pre g na nc y. • E motional and Be haviour al: Cha ng e in sle e ping pa tte rns. • Cha ng e in e mo tio nal sta te , b e ha vio ur, inc luding e xte rna lising • (e .g . a ng ry o utb ursts) a nd inte rna lising (e .g . withdra wal). F e a r o f g o ing o ut o r b e ing a lo ne , fe a r to wa rds c e rta in pe o ple • a nd/ o r diffe re nt re a c tio ns to spe c ific g e nde rs. Cha ng e s in se xua l b e ha vio ur (e .g . la ng ua g e , b e ha vio ur, • dre ss). Ne w e xpe nsive o b je c ts (je we lle ry, ne w pho ne e tc ). • Se c re c y re la te d to c o mpute r, pho ne . • Onse t o f b e ha vio ura l a nd me ntal he a lth diffic ultie s. • Se lf-injury a nd se lf-ha rm. • Ha rm (inc luding se xua lise d b e ha vio urs) to wa rds o the rs. •

Impac t of CSA Ac r oss the L ife span: Compounde d Diffic ultie s urthe r Abuse : Childre n with le a rning disa b ilitie s who ha ve e xpe rie nc e d a b use b e c o me a dults who F • ha ve e xpe rie nc e d a b use . T he inc re a se d risk a nd pre va le nc e o f a ll fo rms o f a b use in pe o ple with le a rning disa b ilitie s me a ns the y ma y e xpe rie nc e furthe r a b use la te r in life whic h c a n ha ve a c umula tive impa c t. Me ntal He alth: Pe o ple with le a rning disa b ilitie s a re a t a n inc re a se d risk o f e xpe rie nc ing me nta l • he a lth diffic ultie s a nd the e xpe rie nc e o f a b use furthe r c o mpo unds this risk. Re lationships with Othe rs: E a rly a b use c a n impa c t pe o ple ’ s vie ws o f the mse lve s, o the rs a nd the • wo rld, inc luding the de ve lo pme nt o f trust a nd intima te / pe rso na l re la tio nships whic h e nha nc e a nd e nric h o ur live s. xpe c t of Myse lf How I se e and What I E s How I se e and What I E xpe c t of Othe r How I se e and What I E xpe c t of the ld Wor

Impac t of CSA Ac r oss the L ife span: Positive Outc ome s s: Ca n Good Soc ia l a nd E motiona l Suppor t fr om T r uste d Othe r • impa c t po sitive ly o n pe o ple ’ s vie ws o f a nd trust in the mse lve s, the wo rld a nd o the rs. Ha ving g o o d , c o nsiste ntly a va ila b le a nd a ttune d suppo rt inc r e silie nc e a nd like liho o d e a se s futur e r tha t the pe rso n will a ppr he lp if ne e d e d a g a in. oa c h othe r s for ve ntions: Gro wing e vid e nc e fo r po sitive T he r a pe utic Inte r • impa c t o f a d a pte d the r ve ntions to he lp pe o ple a pe utic inte r with L D pro c e ss tra uma a sso c ia te d with CSA a nd o the r fo rms o f a b use . T he ra py a nd suppo rt c a n a lwa ys be a da pte d to suit the ne e d s o f a ny c hild , yo ung -pe rso n o r a d ult with a le a rning d isa b ility. t: So me pe o ple with L D a re a b le to a nd find it Pe e r Suppor • he lpful to o ffe r suppo rt to o the r pe o ple with L D who ha ve e xpe rie nc e d a b use . Pe o ple fe e l e mpowe r e d b e ing in the po sitio n o f “he lpe r” ra the r tha n a lwa ys b e ing “he lpe d ”.

Supporting Pe ople with L D who ha ve E xpe rie nc e d CSA: SE E N • Ac knowle dg e the po ssib ility tha t a b use c a n o c c ur; • Ra ise a wa re ne ss o f inc re a se d risk, sig ns a nd suppo rt fo r pe o ple with L D; • Know the pe o ple yo u suppo rt we ll; ook out fo r c ha ng e s; • L • Avo id dia g nostic ove rsha dowing .

Suppor ting Pe ople with L D who have E xpe r ie nc e d CSA: HE ARD Co nside r me tho ds o f • c ommunic ation (ve rb a l, no n-ve rb a l, a ug me nte d syste ms); Show the pe rso n yo u • unde rsta nd a nd b e lie ve the m a nd a re the re to he lp; iste n to the pe rso n a nd L • the ir diffe re nt fo rms o f c o mmunic a tio n; Voic e yo ur c o nc e rns. •