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Responding to Victims with Disabilities

Abstract: Until recently, the victimization of individuals with disabilities has not been a major focus of the victim-serving community. This chapter discusses the 1990 Americans with Disabilities Act and its requirements for the criminal justice system, as well as for agencies that receive federal funding, in meeting the needs of crime victims with disabilities. Programs that have been identified as providing outreach and services to victims with disabilities are cited. In addition, critical services for victims with disabilities are discussed, with a particular emphasis on what service providers and the criminal justice system can do to expand outreach and increase sensitivity to victims with disabilities.

Learning Objectives:

Upon completion of this chapter, students will understand the following concepts:
1. The scope of victimization of children, adults, and elderly with disabilities.

2. The complexity of the term "victims with disabilities" and an awareness of the range of disabilities, including physical as well as mental impairments.

3. A basic understanding of the Americans with Disabilities Act of 1990 and its implications for victims with disabilities.

4. The range of issues involved in providing victims' rights and services to victims with disabilities.

5. An awareness of the current practices and protocols that may inhibit victims, regardless of the nature of their disability, from fully accessing victim assistance services and support.

Statistical Overview

Introduction

The victimization of persons with disabilities is an urgent problem that has yet to be comprehensively addressed by public policy makers, the criminal justice system, and the victim-serving community. Research on the victimization of persons with disabilities consistently finds that this population group is more vulnerable to criminal victimization -- both by caretakers as well as strangers.

As a society, our knowledge of disabilities and our experience with persons with disabilities varies tremendously. One of the greatest challenges of providing outreach and assistance to victims with disabilities is the lack of knowledge by the criminal justice system and the victim serving community of the individual characteristics and special needs of the broad range of victims who have some type of disability. This chapter discusses the Americans with Disabilities Act and provides an overview of existing federal law with respect to providing services to victims with disabilities. In addition, strategies for working with victims with disabilities are also presented.

The term disability is very broad and is generally applied to individuals who have physical or intellectual impairments that affect communication, intellectual functioning, mobility, adaptive behavior, or the ability to live or work independently. There are a wide variety of conditions that can affect an individual and result in some form of disability. Age of onset, cause, and manifestation of a disability can be significant factors in treatment of persons with disabilities.

Developmental disabilities occur early in life and affect development, adaptive behavior, and learning (e.g., mental retardation or mental disability, as well as cerebral palsy and other neurologic conditions). Physical disabilities such as hearing or vision impairment can be congenital or occur later in life as the result of an illness, accident or other injury. Disabilities that affect mobility and the ability to function independently can also occur in conjunction with a congenital condition (e.g., cerebral palsy) or can occur in childhood, adolescence, or adulthood (e.g., spinal cord injury due to a car crash, assault, or accident).

In addition, some conditions occur predominately among the elderly and impair memory and intellectual functioning and affect independent living skills (e.g., Alzheimer's disease). And finally, the progression of many diseases can have severely disabling effects on an individual, resulting in limitations in activity and many aspects of daily functioning (e.g., heart disease, multiple sclerosis, etc.).

The effects of various forms of disability can range from mild to severe. The degree and type of accommodation needed for effective service provision for crime victims with disabilities also varies, depending upon the crime and its impact, the victim and his/her individual needs, and the victim's abilities and disability.

Another aspect to consider in any discussion of assisting crime victims with disabilities is working with victims who become disabled as a result of injuries sustained during the crime. Improvements in emergency medical response and the development of new medical technology have increased the likelihood that people who suffer severe injuries will survive incidents (e.g., accidents, assaults, car crashes, etc.) that have previously been thought of as fatal. Millions of people suffer injuries as a result of criminal victimization each year. Many crime victims who suffer severe injuries during the course of a crime must also cope with the long-term effects of a disability. Examples include assault victims who suffer gun shot wounds that cause spinal cord damage; victims of drunk or drugged drivers who suffer the loss of a limb or head injuries; infants who suffer the effect of "shaken baby syndrome" and sustain severe brain injury; and child victims of severe physical abuse. Providing assistance to crime victims who become disabled may require additional resources, a broader range of community referrals, and longer-term support. Coordination with other service providers, e.g., medical or rehabilitative care, may be necessary. In addition, financial remedies such as crime victim compensation, criminal restitution, and civil actions against the perpetrator and other persons responsible are very important in such cases.

The key principle in recognizing and responding to the needs of crime victims with disabilities is to respond to each victim with dignity and respect and consideration of the victim's safety, expressed concerns, and immediate needs, with whatever accommodation may be needed. It is also important to remember that intervention should focus on the victim's abilities, not disabilities. A more specific discussion of suggestions for working with crime victims who have various types of disabilities will be presented later in this chapter.

Barriers to Services for Victims with Disabilities

The Americans with Disabilities Act of 1990

The Americans with Disabilities Act is a clear and comprehensive national mandate for the elimination of discrimination against individuals with disabilities.

Paula Rubin, Visiting Scholar
National Institute of Justice

In 1990, the Americans with Disabilities Act (ADA) was enacted by Congress to protect the employment and accessibility rights of persons with disabilities (42 U.S.C. 12101). The intent of Congress in adopting this broad sweeping legislation was to remove barriers to employment, transportation, telecommunications, as well as public accommodations and services for persons with disabilities.

The law defines individuals with disabilities as meeting one or more of the following criteria:

Physical Impairment

The ADA defines a physical impairment as "any physiological disorder or condition, disfigurement, or anatomical loss affecting one or more of the following body systems." (Gregorie, 1994)

Neurological
Musculoskeletal
Special sense organs
Respiratory
Cardiovascular
Reproductive\digestive
Genitourinary
Hemic
Lymphatic
Skin and endocrine

A few examples of specific physical or physiological disorders or conditions that encompass these types of impairments include the following: (Gregorie, 1994)

Cerebral palsy
Epilepsy
Muscular dystrophy
Multiple sclerosis
AIDS/HIV infection
Cancer
Heart disease
Diabetes
Mental Impairment
The ADA defines mental impairments as any mental or psychological disorder including the following: (Gregorie, 1994)

Mental retardation
Organic brain syndrome
Emotional or mental illness
Specific learning disorders

Title II of the Americans with Disabilities Act

Title II of ADA, in effect since January of 1992, establishes the responsibilities of those who provide public services in meeting the requirements of the Act. The ADA states that individuals with disabilities may not be subject to discrimination by a public entity:

Under this important law, a person with a disability can not be denied access to services, programs, or activities associated with a public entity.

Public entities include federal, state and local governments and their related departments and agencies.

Title II applies to any government agency regardless of its size. Government agencies are required to ensure that their programs, services, and activities are accessible to persons with disabilities. However, full compliance of the Act's requirements has been hampered over the past several years due to the "undue hardship" clause. The Act states that if modifications to making buildings or offices accessible poses an "undue hardship," then every effort must be made to make the modifications, but full accessibility to persons with disabilities is not mandatory for existing buildings. However, any new construction must implement all requirements for accessibility for persons with disabilities.

Meeting the Americans with Disabilities Act Requirements

In The Americans with Disabilities Act and Criminal Justice: An Overview, Rubin suggests the following questions to determine whether a governmental agency is meeting the requirements of the ADA:

Are any modifications to the agency's policies, practices, or procedures necessary to ensure accessibility?

Do any eligibility criteria eliminate or tend to screen out a qualified individual with a disability from enjoying the benefits of these programs, services, or activities?

Do any policies or practices segregate persons with disabilities from others participating in these programs, services, or activities?

Are any of these programs, services, or activities delivered at a location or facility that has the effect of denying persons with disabilities the right to enjoy the benefits of these programs, services, or activities?

If alternative services are offered to persons with disabilities, are these benefits unequal to those offered to the public at large?

Rubin suggests that if the answer to any of these questions is "yes," the agency may need to revise the way it offers its programs, services, or activities.

Response to Crime Victims with Disabilities

The victimization of persons with disabilities was largely overlooked on the national level prior to passage of the Americans with Disabilities Act of 1990 (42 U.S.C. 12101). The ADA served as a "wake-up call" for the federal government and national organizations to respond to victims with disabilities. Several efforts have since been undertaken to provide information to state and local criminal justice agencies and victim assistance programs on the necessary steps to come into compliance with the Act's requirements.

Research on criminal justice agency response to victims with disabilities, curriculum development, and national training efforts have been undertaken with support from the U.S. Department of Justice. However, most experts acknowledge that these efforts are in their preliminary stages. Little research is available on the actual rate of victimization of crime victims with disabilities, model intervention services, and appropriate criminal justice responses, such as improving reporting rates, sensitive interviewing techniques, and adaptation to facilitate victim participation.

National Efforts

State and Local Outreach to Victims with Disabilities

Several notable efforts to establish and enhance services for crime victims with disabilities are highlighted below.

1997 VOCA Assistance Guidelines:
Provisions that Address Services to Victims with Disabilities


While the programs discussed above provide excellent examples of innovative efforts to serve crime victims with disabilities, it appears that many victim assistance programs in the United States still do not offer specialized services, information, and outreach for victims with disabilities. Consequently, the Office for Victims of Crime made special modifications to its 1997 VOCA Assistance Guidelines to give direction and guidance to the states and territories administering VOCA funding. According to the Office for Victims of Crime, VOCA administrators are strongly encouraged to require state and local programs to meet the needs of crime victims with disabilities. In the 1997 VOCA Guidelines, allowable costs to accommodate the needs of crime victims with disabilities are addressed as follows:

Project Funding:

Justice for Deaf Victims of Domestic Violence and Sexual Assault

In 1997, the Office for Victims of Crime (OVC) awarded a grant to the Abused Deaf Women's Advocacy Services (ADWAS) in Seattle, Washington to develop a training and technical assistance package for five cities across the country. This project originally started in Seattle (see chapter text) providing services and support for deaf victims of domestic violence and sexual assault. With OVC support in 1997-1998, ADWAS will work with the deaf communities in Boston, Austin, Minneapolis, Rochester, New York, and San Francisco to replicate its successful program. (OVC, 1998).

Assisting Crime Victims with Disabilities

In 1997, the Office for Victims of Crime (OVC) awarded grant funding to the National Organization (NOVA) for a project that conducted a two-day transfer of knowledge symposium on the topic of assisting crime victims with disabilities in January, 1998, in Arlington, Virginia. Experts from the disability advocacy, victim assistance and research fields met to develop recommendations for improving the capacity and preparedness of victim service providers to respond effectively to the needs of crime victims with disabilities. The findings from the Symposium will be disseminated to the field during the summer of 1998 as an OVC Bulletin. NOVA will also develop camera-ready education literature for victim assistance programs, including a general informational brochure on the impact of crime targeting crime victims with disabilities and an informational guide for victim assistance professionals with suggestions on how to improve services to crime victims with disabilities. These materials will be distributed through the Office for Victims of Crime Resource Center.

Research from the National Institute of Justice

In 1997, the National Institute of Justice (NIJ) released a report entitled Americans With Disabilities Act: Emergency Response Systems and Telecommunications Devices for the Deaf. As part of NIJ's Research in Action series, the report summarizes results and lessons learned by the incorporation of telecommunication devices for the deaf through TDD capability in Denver, Colorado's 911 telephone emergency response services. (NCJ-151177, as cited in
Office for Victims of Crime Resource Center, Products, Publications, and Online Services Catalog, Winter, 1998.)

The Victimization of Children with Disabilities

In 1993, the National Center on Child Abuse and Neglect (NCCAN) released the findings of a comprehensive national study entitled A Report on the Maltreatment of Children with Disabilities. The study focused on maltreated children who had physical, intellectual, or emotional disabilities. Much of the information in the Report is based on data collected from 35 Child Protective Services (CPS) agencies that were statistically selected to be representative of a national sample. Each of the agencies was asked to provide information on all cases of substantiated maltreatment of children over a six-week period in 1991. Information was collected on cases involving 1,834 children whose maltreatment was substantiated.

The study found:

In addition, CPS agencies reported that of maltreated children with maltreatment-related injuries:

Based on the results of this study, six recommendations were made:

Priorities of Women with Disabilities

In 1995 through 1996, a survey was conducted by Berkeley Planning Associates under a federal grant entitled, Meeting the Needs of Women with Disabilities: A Blueprint for Change. The survey sought input from women with disabilities about the importance of various research and policy issues. Issues relating to violence and abuse were rated as the number one priority of survey respondents.

The survey was distributed to over 200 knowledgeable women with disabilities in the United States. Out of the 200 surveys, 104 responded. The women were of all ages and lived in all areas of the United States. The survey's findings concluded that abuse and violence were the most important research topics. Respondents felt that this area had received little attention from service providers and policy makers. Additionally, the respondents identified two key information needs that should be addressed:

Recommended Terminology

In the 1993 National Institute of Justice publication entitled The Americans with Disabilities Act and Criminal Justice: An Overview, author Paula Rubin developed a list of appropriate terminology to use in working with persons with disabilities entitled "What's in a Name." Many terms used to describe certain disabilities evoke stereotypes and can be dehumanizing to the individual. Rubin emphasizes that appropriate terminology has changed significantly since the 1973 Rehabilitation Act was signed into law. At that time, the term "handicapped" was used to describe persons with disabilities. She states that today, individuals with disabilities have indicated their preference for the term "disability" (Rubin, 1993). Rubin recommends the following terms to avoid with suggested substitutes:

Avoid: Instead, say:

Recommendations for Working with Crime Victims with Disabilities

In 1994, the National Victim Center, with support from the Office for Victims of Crime, developed a comprehensive training curriculum entitled "Differently-Abled Victims of Crime" as part of the Center's Focus on the Future - A Systems Approach to Prosecution and Victim Assistance (Gregorie, 1994). The curriculum includes recommendations that address many critical areas of concern, such as facilitating communication and accessibility to services for crime victims with disabilities. Gregorie notes that victim service providers are not expected to be experts on disabilities. However, a basic understanding of the needs of crime victims with disabilities is necessary in order to provide assistance in both criminal justice and community-based programs.

The following information on working with crime victims with disabilities has been drawn from Focus on the Future - A Systems Approach to Prosecution and Victim Assistance.

Guidance for Working with Crime Victims with Disabilities

Strategies for Responding to the Needs of Hearing Impaired Victims

Tips for Effective Communication with Hearing Impaired Victims

Strategies for Responding to the Needs of Victims
with Visual Impairments

There are many different types of visual impairments, and only a small fraction of these individuals are totally blind. Even if a person is determined legally blind, forms and shapes may still be distinguished. The National Victims Center estimates that 80 percent of all visually impaired persons have some remaining vision.

Visually impaired victims face a great deal of mobility problems. A visually impaired victim may need the use of a cane, a guide dog, or a sighted escort. It is essential that service providers recognize the importance of these aides to the victim, and efforts should be made to ensure that the appropriate accommodations are given to the victim. Transportation issues should be discussed to help the visually impaired victim to and from your office or court as necessary. It is also appropriate to allow the visually impaired victim to become acquainted with the physical surroundings of your office, as well as the courtroom if necessary, where he/she may be coming for interviews and/or hearings. Additionally, victim service providers should not assume that a visually impaired person wants a guided escort; rather the victim service provider should extend his/her arm to the victim while asking the victim if he/she wants guidance.

Tips for Effective Communication with Visually Impaired Victims

Effectively Responding to the Needs of Mobility Impaired Victims

The National Victim Center estimates that approximately six percent of the population has some form of mobility impairment. The disability is generally a result of congenital defects, diseases, accidents, military combat, or injuries received during a crime. Numerous physical conditions may result in a mobility impairment. Some examples would include: spinal cord injuries; cerebral palsy; muscular dystrophy; epilepsy; or, a combination of these conditions.

There are generally two types of barriers that persons with mobility impairments have in society: architectural and attitudinal. Examples of architectural barriers include stairways, doors that are too narrow to accommodate wheelchairs, sidewalk curbs, and an insufficient number of handicapped parking spaces. Attitudinal barriers are usually more subtle. Examples include, but are not limited to, reactions of disgust, pity, or discomfort expressed verbally and non-verbally.

Strategies for Responding to the Needs of Mobility Impaired Victims

Tips for Effective Service Delivery for Victims
with Speech Impairments

Mental Disability

Crime victims who have developmental or severe mental disabilities are extremely vulnerable to victimization and have often been overlooked by the criminal justice system. This population of victims typically has limited communication abilities that inhibit the victim from seeking help or even recognizing his/her victimization. All too often, victimization occurs at the hands of the caretaker, and reporting is further inhibited in these cases by the victim's disability and/or fear of perceived/real retaliation/isolation.

The National Victim Center estimated that approximately three percent of the population has mental disabilities. Mental disability may be congenital or it may have occurred after birth due to some other cause. It results in below average intellectual functioning and a limited learning capacity. However, it is not a mental illness. There are four levels of disability, and they range from mild disability to profound disability. Each level reflects the degree of difficulty a person has in learning. A person with a mild mental disability is likely to have difficulty learning but the person is usually capable of living alone. The National Victim Center states that as many as 90 percent of persons who have mental disabilities have minor difficulties in learning and functioning in society, and are in the mild to moderate range. Many individuals with severe or profound mental disabilities require constant care and often have physical disabilities and sensory/coordination impairments. Only a small percentage of people with mental disabilities live in institutions.

Some indicators of mental disability include:

Those who victimize persons with mental disabilities take advantage of the victim's friendly, trusting, and "eager to please" attitude. For example, the National Victim Center states that victims with disabilities are often targeted by their offender -- a person with a mental disability may be lured into a back alley and robbed simply because he/she was unable to recognize the danger of the situation. Similarly, a person with a mental disability may unknowingly be involved in a crime. There have been cases where individuals with mental disabilities have transported drugs unknowingly, thinking they were doing a friend a favor.

Tips for Effective Communication with Victims with Mental Disabilities

Increasing Sensitivity Through Training and Advisory Input

A key element to improving services to victims with disabilities is sensitivity training for those who are in the criminal justice and victim services field. Components of sensitivity training should include, but not be limited to:

Self Examination Chapter 21, Section 21

Responding to Victims with Disabilities

References

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