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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

• According to the U.S. Department of Justice, there are approximately 43 million individuals with disabilities in the United States. (Rubin, P. (1993). "The Americans with Disabilities Act and Criminal Justice: An Overview, National Institute of Justice." Research in Action, p.1)
• Research conducted by the National Center on Child Abuse and Neglect (NCCAN) in 1993 found that of all children who are abused, 17.2 percent had disabilities. Of all children who were sexually abused, 15.2 percent had disabilities. The NCCAN study also found that abused children with disabilities were more likely to be male and generally older than children without disabilities who were abused. (Crosse, S., Kaye, E., & Ratnofsky, A. (1993). A Report on the Maltreatment of Children with Disabilities. Washington, DC: National Center on Child Abuse and Neglect, Administration on Child, Youth, and Families, Administration for Children and Families, U.S. Department of Health.)
• The incidence of maltreatment (number of children maltreated annually per 1,000 children) among children with disabilities was 1.7 times higher than the incidence of maltreatment for children without disabilities. (Ibid.) Of the maltreated children with maltreatment-related injuries, child protection case workers reported that maltreatment directly contributed to, or was likely to have led to disabilities, for 62 percent of the children who experienced sexual abuse, 48 percent of children who experienced emotional abuse, and 55 percent of children who experienced neglect. (Ibid.)
• Research consistently shows that women with disabilities, regardless of age, race, ethnicity, sexual orientation, or class, are assaulted, raped, and abused at a rate of two times greater than women without disabilities. (Sobsey, 1988, 1994; Cusitar, 1994; Stimpson & Best, 1991; DisAbled Women's Network (DAWN), 1988.)
• People with developmental and other severe disabilities represent at least 10 percent of the population of the United States. Of this population group: 1.8 percent of individuals have developmental disabilities; five percent of individuals have adult onset brain impairment; and, 2.8 percent of the individuals have severe major mental disorders. (Sorenson, D. (1996, November). "The Invisible Victim." The California Prosecutor, Vol. XIX, No.1.)

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

• There are many reasons why persons with disabilities may not report crime or encounter difficulties in accessing victim services. For example:
  
  
• Communication barriers: Many criminal justice and victim assistance programs do not have basic access to telecommunication systems (TDD and TTY systems) for deaf victims that facilitate communication, enabling them to more easily report a crime and learn about victim services. Few programs offer victims' rights and services information in Braille or through audio-recorded information so that blind victims can more readily access assistance.
• Mobility barriers: Many criminal justice and victim assistance programs have not yet examined the barriers of accessibility to victims in wheelchairs, or to other mobility-impaired crime victims. Special transportation and assistance should be provided for these victims to allow them an opportunity to fully exercise their rights to participate in criminal justice proceedings or to access emergency services, such as a shelter.
• Dependency issues: Often, crime victims with disabilities do not report their victimization because it is inflicted upon them by caretakers -- family members or by staff within facilities and institutions designed to assist them. They are dependent on those who abuse them and may be unable to report the crime. Also, victims may have limited communication abilities due to mental impairments and may lack the ability to verbalize their victimization.
• Isolation and fear: Many battered women, sexual assault victims, and child victims experience a sense of isolation and fear that they will be blamed for their victimization because of the nature of the victimization and the relation with the perpetrator. These concerns are intensified for victims of these crimes who have disabilities and who are essentially cut off from services due to communication and/or mobility barriers. Moreover, when victims with disabilities are abused by a member of their own "community," these concerns multiply. For example, a deaf battered woman abused by her deaf husband may find that few programs exist within the deaf community to assist her. Turning to the "hearing community," which has little experience with her particular circumstances, for assistance may increase her sense of isolation.

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:

• The individual has a physical or mental impairment that substantially limits one or more of the major life activities of an individual. Major life activities include functions such as walking, seeing, hearing, speaking, breathing, learning, and working.
• The individual has a record of such impairment.
• The individual is regarded as having such an impairment.
• The ADA covers at least 900 different disabilities. In order to provide a sense of the comprehensive range of disabilities covered under the Act, a brief summary of the types of physical and mental disabilities defined under the ADA follows.

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 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

• On the national level, the National Organization for Victim Assistance (NOVA) first helped to bring awareness to the many obstacles faced by victims with disabilities seeking services with its publication entitled Responding to Disabled Victims of Crime in 1990 (Tyiska, 1990).
• In 1992, the National Resource Center on Child Sexual Abuse (NRCCSA) published a comprehensive series of articles, written by research and practitioner experts, on the sexual abuse of children with disabilities in its NRCCSA News. In addition, the Center's annual National Symposium on Child Sexual Abuse regularly features a training track on child victims with disabilities (Baladerian, Pawelski, Sobsey, and Tobin, 1992).
• In 1993, with support from the Office for Victims of Crime, the National Victim Center (NVC) developed a training curricula entitled Differently-Abled Victims of Crime that provides extensive information on how to provide specialized services and information to crime victims with disabilities (Gregorie, 1994).
• In 1993, the National Center on Child Abuse and Neglect (NCCAN) released findings from 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. It found a significant correlation between maltreated children and abuse and offered key recommendations for responding to abused children with disabilities (Crosse, 1993).
• After the passage of The Americans with Disabilities Act in 1990, the National Institute of Justice, (NIJ) within the U.S. Department of Justice launched an initiative to examine the implications of the ADA for criminal justice agencies at the state and local levels. In 1993, NIJ published The Americans with Disabilities Act and Criminal Justice: An Overview as a bulletin in its Research in Action publication series (Rubin, 1993).
• The Office for Victims of Crime within the U.S. Department of Justice recently provided funding to the NOVA to host a two-day "Transfer of Knowledge" symposium on the needs of victims with disabilities in the fall of 1997.

State and Local Outreach to Victims with Disabilities

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

• Abused Deaf Women's Advocacy Services, Seattle, Washington: More than 25 years ago, Marilyn Smith -- deaf since age six -- was brutally raped. Her recovery was needlessly long and lonely due to a complete lack of assistance services for the deaf. In 1986, Ms. Smith founded Washington state's Abused Deaf Women's Advocacy Services (ADWAS), which offers a 24-hour crisis line, counseling and legal advocacy for deaf and deaf-blind victims of sexual assault and domestic abuse. Many staff members and volunteers are hearing impaired individuals who offer a special sensitivity to the needs of deaf victims. The program has developed training for both deaf and hearing crime victim advocates, and has published educational materials targeted specifically for deaf adult and youth victims (Reno, 1996).
• The Midwest LEAD Institute -- Leadership Through Education and Advocacy for the Deaf (MLI): The Institute has developed a program to provide culturally and linguistically appropriate crisis intervention and counseling services to deaf victims of domestic violence. With support from VOCA funds, MLI provides volunteer sign language interpreters for shelters and agencies, and has established a 24-hour 800 crisis line for deaf victims of violent crime. MLI also developed a manual entitled Breaking the Silence - A Manual on Domestic Violence and the Deaf Community to help shelters and other agencies to meet the needs of their deaf clients (Marshall, 1997).
• The Parent Advocacy Coalition for Educational Rights Center (PACER): The Center is a coalition of 19 Minnesota disability organizations which is staffed primarily by persons with disabilities, as well as by parents of children or adults with disabilities. PACER has developed a special program to help teach children with disabilities about child abuse. The project, entitled "Count Me In," reaches over 14,000 school children each year. Over 30 trained volunteers take life-sized puppets to schools to promote understanding of children with disabilities and help children feel comfortable with children with disabilities. These puppets are also used to teach children with disabilities about child abuse (Grayson, 1992

• The Center for Child Protection - Children's Hospital and Health Center: In 1986, the Center for Child Protection in San Diego, California developed one of the nation's first forensic assessment protocols for victims of sexual assault who have developmental disabilities. The Center offers specialized assessment and treatment to approximately 1,200 child victims of sexual assault each year, many of whom have disabilities, including a four-week course for children who are scheduled to testify in court (Ibid.).
• Boy's Town National Institute for Communication Disorders in Children: The Institute, located in Iowa, has established a Center for Abused Handicapped Children. The Center provides evaluation and treatment for 250 to 500 abused children with communication disorders each year. It offers a short-term residential program, specifically for hearing-impaired abused children and their families, the only program of its kind in the nation. The Center employs staff who have disabilities, which serve as role models for the children and their parents. In addition, the Center has developed protocols for police and child protection workers to assist them in conducting investigations of abused children with disabilities (Ibid.).
• State Efforts: According to a series of regional meetings the Office for Victims of Crime conducted with state VOCA Administrators in January of 1997, some states are funding unique and creative programs to reach out to underserved crime victims with disabilities. For example, Colorado is funding a unique program for domestic violence victims with disabilities. The state plans to conduct technical assistance on domestic violence victims with disabilities with the support of Violence Against Women Act funds in 1997. Connecticut is providing services for deaf and hearing impaired sexual assault victims through a grant with the statewide sexual assault coalition (VOCA Administrators Regional Meeting Report, 1997).

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:

• 1997 VOCA Guidelines (IV.E.2.d.). The costs of furniture, equipment, or minor building improvements that make victims' services more accessible to persons with disabilities, such as braille equipment or a TTY for the deaf, are allowable.
• 1997 VOCA Guidelines (IV.E.2.g.) Contracts for Professional Services. VOCA funds generally should not be used to support contract services. At times, however, it may be necessary for VOCA subrecipients to use a portion of the VOCA grant to contract for specialized services. Examples of these services include assistance in filing restraining orders or establishing emergency custody/visitation rights (the provider must have a demonstrated history of advocacy on behalf of domestic violence victims); forensic examination of a sexual assault victim to the extent that other funding sources are unavailable or insufficient; emergency psychological or psychiatric services; or sign and/or interpretation for the deaf or for crime victims whose primary language is not English.

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:

• An estimated 23 out of 100 children in the United States are maltreated each year.
• Of children who are abused, 17.2 percent had disabilities; and of all children who were sexually abused, 15.2 percent had disabilities.
• Abused children with disabilities were more likely to be male and generally older than children without disabilities who were abused.
• The incidence of maltreatment (number of children maltreated annually per 1,000 children) among children with disabilities was 1.7 times higher than the incidence of maltreatment for children without disabilities.

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

• Maltreatment directly contributed to, or was likely to have led to disabilities, for 62 percent of the children who experienced sexual abuse, 48 percent of children who experienced emotional abuse, and 55 percent of children who experienced neglect (Crosse, 1993).
• The Report was prepared in response to Section 102(a) of the Child Abuse Prevention, Adoption, and Family Services Act of 1988 (P.L. 100-294). This law requires NCCAN to:
  

• Report the incidence of child abuse among children with disabilities.
• Identify relationships between child abuse and the children's disability.
• Report on the incidence of children who have developed disabilities as a result of child abuse or neglect.

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

• Risk assessment approaches used in CPS agencies should include the child's specific disabilities as a risk factor.
• CPS caseworkers should be educated on the relationship between maltreatment and disabilities, on identifying disabilities, and on making appropriate referrals for children with disabilities.
• Professionals who come into contact with children with disabilities should be educated on the relationship between maltreatment and disabilities, on identifying disabilities, and on making appropriate referrals for children with disabilities.
• State and federal systems for reporting information on cases of child maltreatment should include uniform information on whether or not children have disabilities.
• Caseworkers in CPS agencies and professionals in other settings should provide specialized services to prevent maltreatment in families with children with disabilities.
• Future research should continue to study the relationship among child maltreatment, race/ethnicity, and disabilities, and on the causal relationship between disabilities and maltreatment (Crosse, 1993).

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:

• The development and dissemination of materials for women with disabilities and service providers about caretaker abuse.
• The dissemination of information to abuse and violence programs about their legal requirements to serve women with disabilities, as well as how service providers can become more accessible to victims with disabilities (Berkeley Planning Associates, 1997).

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:

• Handicapped, invalid, disabled Person(s) with disabilities
• Victims of epilepsy, arthritis Officer Smith has epilepsy.
• Lt. Jones has arthritis.
• Deaf-mute, deaf and dumb Deaf, hearing impaired, speech impaired
• Confined to wheelchair, wheelchair user, Mobility impaired
• users of wheelchairs, wheelchair bound
• Cripple, crippled Physical disability, mobility impaired
• Use name of disability (e.g. polio)
• Deformed Physical disability
• Retarded, slow, stupid Mental disability
• Slow, stupid, illiterate Specific learning disability, dyslexia
• Officer Day has dyslexia.
• Spastic fits Seizures
• Captain Collins has epilepsy

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

• Look directly at the victim when addressing him/her. Deliberately averting someone's gaze is impolite and can be uncomfortable. Tension is only increased when you avoid eye contact.
• Feel free to ask a victim with a disability how you should act or communicate most effectively with him/her, if you have any doubt about the appropriateness of the situation.
• Address and speak directly to the victim with a disability, even if he/she is accompanied or assisted by a third party.
• Feel free to offer physical assistance to a victim with a disability such as offering your arm if the need arises, but do not assume the victim will need it or accept it.
• Ask a victim with a disability if he/she has any needs that will require special services or arrangements, and then attempt to make arrangements to meet those needs.
• Don't stare at or avoid looking at a visible disability or express sympathy for the victim's disability.
• Don't tell the victim with a disability you admire his/her courage or determination for living with his/her disability. The victim with a disability does not want to be thought of as unusually brave or as a super hero.
• Don't avoid humorous situations which occur as a result of a disability. Take your cue from the victim.

Strategies for Responding to the Needs of Hearing Impaired Victims

• Create a list of referral services for hearing impaired victims. For crisis counseling backup services, check with the State Department of Mental Health, as they usually have specialized counselors available for deaf persons in emergency situations.
• Develop a resource directory of qualified professional (court certified, if possible) interpreters for assistance with hearing impaired victims. Do not rely on friends or family members -- remember, there is no literal translation from English to sign language.
• Have a court-certified interpreter assist you in putting together an informational program brochure for hearing impaired crime victims to ensure that deaf victims will understand the information provided.
• Install a TDD or a TTY telephone to make your program accessible for hearing impaired victims. Training on this equipment is readily available.
• There may be cases in which the victim is a hearing juvenile whose parents are hearing impaired. An interpreter should be secured for communication with these parents in and out of the court. This should be done any time members of the victim's immediate family are hearing impaired.

Tips for Effective Communication with Hearing Impaired Victims

• Directly face a person who is speech reading. Make sure your face is at the victim's eye level. Speak slowly and distinctly, but not unnaturally. Avoid gesturing around the face, since that is distracting during speech reading.
• Avoid having bright or glaring light behind you when addressing a speech reader because the shadows that are cast render your lips invisible.
• If you are eating, chewing, smoking, etc., while talking to a hearing impaired victim, your speech will be much more difficult for the victim to understand.
• Reduce background noises during conversation. Close the office door or turn off any radio, etc., if necessary.
• A sign language interpreter should be properly positioned. He/she should sit next to you so that the hearing impaired victim can shift his/her gaze back and forth from the interpreter to you easily.
• Speak in a normal tone of voice without shouting.
• Do not refer to a deaf person as "deaf and dumb." The ability to speak and/or communicate effectively is unrelated to an individual's ability to hear.
• It is not necessary to avoid using "hear" with a deaf person.
• It is appropriate to tap the hearing impaired person on the shoulder or to wave your hand to get visual contact. Get the hearing impaired person's attention before you start speaking to him/her.
• If a hearing impaired person has obvious difficulty understanding something, find a different way of saying the same thing rather than repeating the original words over and over.

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

• Whenever a visually impaired person enters your office, immediately indicate your presence verbally, approach him/her, and give your name.
• When speaking to a visually impaired person, use a normal tone and pace your speech patterns; it is not necessary to speak louder. Do not stop talking when a blind person is approaching you because he/she relies on the sound of your voice for direction.
• Speak directly to a visually impaired victim, not to a third party who may accompany the victim.
• When a blind person enters your office, it may be helpful to extend your arm to take and guide the victim to a chair. Then, place his/her hand on the back of the chair and tell the victim whether "the chair has arms" in order to direct the victim as he/she sits down.
• If there are other individuals in your office, a blind person may be unaware of this. Introduce each person by name and indicate where they are sitting in the room relative to where the blind person is seated.
• If you must leave the visually impaired person's presence for some reason, tell him/her you are leaving for awhile.
• It is not necessary to avoid using the words "see," "look," or "blind" with a visually impaired person because he/she is used to these words also.
• When giving a visually impaired persons directions, be as clear and specific as possible. Make sure to identify obstacles in the direct path of travel. Since some visually impaired persons have no visual memory (having been blind since birth), be careful of using descriptions containing numbers of feet or yards, rather use the number of steps for a distance measure. If you are unsure of just how to direct a visually impaired person, say something like, "I would be happy to give you directions. How should I describe things?"

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

• Do not assume that the mobility impaired victim needs your assistance. An individual in a wheelchair or with a walker or braces will not normally require your help entering a room.
• Provide mobility assistance only if you are asked.
• Service providers should be aware that victims with mobility impairments may have difficulty opening doors, manipulating objects, may need special equipment, and help in getting from one place to another.
• Be aware that a person's wheelchair is a part of his/her body space and needs to be treated as such. Do not stand too close to the wheelchair, as this could block the mobility impaired victim's movement with the wheelchair if they wanted or needed to move about.
• One of the primary concerns in any case involving a mobility impaired victim or witness will be accessibility to the courthouse and other criminal justice system offices and facilities when necessary. Arrange for transportation to and from your office or the courtroom, if needed. Ask specific questions concerning the mobility impaired victim's travel needs so that you can arrange for the proper transportation prior to the time it will be required.
• Be aware of the location of wheelchair ramps and accessible restrooms so that you can direct the victim to these facilities, if needed.

Tips for Effective Service Delivery for Victims
with Speech Impairments

• Do not assume that a person with a speech impairment is intellectually impaired. There is no inherent connection between the two.
• Relax while listening. Your ear will adjust more quickly to the sound of the victim's speech.
• If you cannot understand the speech impaired victim's comment or response to a question, ask him/her to repeat what he/she has said. If you are still unable to discern what is being said, you might consider asking the speech impaired victim to write it out for you.
• You may lose valuable information if you do not follow up on answers or comments that are confusing or that do not make sense to you.

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:

• Communication problems and limited language skills.
• Reduced muscular control.
• Lack of adaptive or appropriate behavior skills.
• Possible inappropriate appearance.
• A tendency to express emotions through behaviors, due in part to their limited verbal ability.

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

• Be understanding, calm, friendly, patient and firm with a victim who has a mental disability.
• In some cases, the person with a mental disability may seem to react to situations in an unconventional manner or may appear to be ignoring you. The person is not being rude; he/she may just be slower in responding.
• Rapid or intense questioning is likely to cause confusion. Talk slowly and calmly, using easy-to-understand language with clear, concise concrete terms. Do not use complex sentences.
• Depending on the victim's level of mental disability, the victim's parent or guardian should be present when meeting with the victim in the office or at another location.

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:

• An overview of the ADA and its implications for the justice system.
• A victim impact panel featuring victims with disabilities, i.e. victims with visual and hearing impairments, victims who suffered catastrophic physical injuries as a direct result of crime, and victims with developmental disabilities. Note, victims should be allowed to tell their stories and offer suggestions on how criminal justice and victim service professionals can best meet their special needs. The victim impact panels should include time for questions from the audience.
• A review of existing guidelines for law enforcement, courts, prisons, paroling authorities, and victim service providers to ensure ADA compliance and to improve the physical accommodations for victims with disabilities.
• Review of existing agency educational/informational resources for victims, with informed discussions about how to make these existing resources more "user friendly" and useful for victims with disabilities.
• Training to increase understanding of disabilities and improve communication skills with victims who have physical or mental disabilities.
• Finally, non-profit and criminal justice-based agencies should designate an advisory position within the organization for representation by a victim who possesses a disability. That individual's unique perspective and input will go far towards accommodating the special needs of a victim with a disability, and improving the enforcement of his/her rights.

Self Examination Chapter 21, Section 21

Responding to Victims with Disabilities

• List three reasons why victims with disabilities are often ignored by the victim-serving community.
• The Americans with Disabilities Act (ADA) defined 'disabilities' -- what are the Act's major distinctions for defining persons with disabilities?
• The Act requires that certain changes, with respect to the services provided to crime victims with disabilities, should occur. What are these significant changes?
• What policies, programs, or procedures does your agency or organization have in place to identify the needs of and assist crime victims who have disabilities? What barriers exist that inhibit access by persons with disabilities?
• How could your agency engage victims with disabilities in efforts to develop new services or adapt current services to address the needs of victims with disabilities?

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