Addressing intimate partner violence with female patients with chronic physical disabilities: the role of physical therapists.

BACKGROUND: Women with disabilities are at heightened risk of intimate partner violence, experiencing higher rates of physical and sexual violence than women without disabilities. Women with disabilities are also at risk of sustaining additional chronic injuries and debilitating conditions associated with intimate partner violence. Physical therapists strive to enhance the well-being and quality of life of individuals experiencing impairments, activity limitations, and/or participation restrictions due to physical health concerns. This professional focus places physical therapists in an important position to identify adverse life situations such as intimate partner violence which seriously degrades the well-being, quality of life, and physical health of patients. PURPOSE: Physical therapists encounter numerous individuals with disabilities in their practice, and given the high rates of intimate partner violence within this population, it is important that physical therapists are aware of how to identify and respond to this issue. CONCLUSION: This article provides background on the problem of intimate partner violence among women with chronic physical disabilities, and explores assessment, practice, and education guidelines intended to assist physical therapists address intimate partner violence with their patients.IMPLICATIONS FOR REHABILITATIONWomen with disabilities are at a heightened risk of intimate partner violence compared to women without disabilities, and are also at risk of sustaining associated chronic injuries and debilitating conditions.Given the high rates of intimate partner violence among individuals with chronic physical disabilities, it is important that physical therapists are able to identify and respond to this issue.Physical therapists possess specialized skills to improve the functioning and overall health of patients, and could assist patients with chronic physical disabilities to escape abusive relationships. Knowledge of intimate partner violence-focused screening, assessment, and trauma-informed practice skills would strengthen skills in this area.

Occupational Deprivation Among Female Survivors of Intimate Partner Violence Who Have Physical Disabilities.

IMPORTANCE: Women with disabilities face a heightened risk of intimate partner violence (IPV) compared with those without disabilities. The damaging impact of IPV compromises the ability of survivors with disabilities to competently and independently engage in daily occupations. OBJECTIVE: To examine the impact of occupational deprivation on survivors of IPV who have physical disabilities. DESIGN: The findings presented in this article are part of a larger qualitative study. Semistructured interviews were conducted over the course of 18 mo, primarily focusing on questions related to four areas: abuse experience and risk assessment, use and nonuse of self-protective strategies, necessary support services, and impact of disability in relation to these phenomena. SETTING: A nonresidential domestic violence agency serving people with disabilities located in New York City. PARTICIPANTS: Twenty-five women with physical disabilities receiving services from a domestic violence agency that specializes in assisting people with disabilities. RESULTS: The findings reported here focus on educational, vocational, financial, and physical barriers to occupational engagement faced by IPV survivors with disabilities. CONCLUSION AND RELEVANCE: The occupational deprivation experienced by IPV survivors with disabilities can entrap women in abusive relationships, preventing them from independently supporting themselves and their children. Occupational therapy practitioners can provide education and interventions that increase their ability to live independently. WHAT THIS ARTICLE ADDS: This article provides a novel consideration of how occupational therapy practitioners can help survivors with disabilities escape IPV through occupational engagement.

Intimate Partner Violence and Women With Disabilities: The Role of Speech-Language Pathologists.

This article is a call to action for speech-language pathologists to address the overlooked problem of intimate partner violence (IPV) among women with communication disorders (CDs). The article aims to heighten awareness of the higher rates of IPV in women with disabilities compared to those without, and to identify types of CDs that can result from IPV. The article provides background on CDs and IPV and delineates the role speech-language pathologists can play in identifying abuse and assisting patients to disclose IPV. Practice recommendations are provided, including enhanced IPV assessment for women with CDs, best practices for intervention emphasizing a trauma-informed approach, and the importance of collaboration and appropriate referrals.

Supporting female survivors of intimate partner violence with disabilities: Recommendations for social workers in the emergency department.

Intimate partner violence (IPV) is a pervasive problem with grave consequences. Women with disabilities are among the most vulnerable groups disproportionately affected, with higher IPV rates than either women without disabilities or men with disabilities. The emergency department (ED) in particular affords a gateway into health services for female survivors of IPV, placing ED social workers in a prime position to observe potential signs of IPV and connect survivors to further assistance. This article explores the critical role ED social workers can fill in addressing the needs of female survivors of IPV with disabilities. We begin by providing background on the characteristics of IPV among women with disabilities, followed by a discussion of the opportunities and challenges inherent to assessing and intervening with survivors. We conclude by outlining recommendations for working with female survivors of IPV with disabilities in EDs, using our previous research on the topic as a guide.

The sexuality of young women with intellectual and developmental disabilities: A neglected focus in the American foster care system.

Youths with intellectual and developmental disabilities (ID/DD) are overrepresented in the American foster care system and experience heightened rates of pregnancy compared to their nondisabled peers. Yet limited information is known about sexually active or pregnant young women with ID/DD in foster care. Consequently, important healthcare needs of this population are not adequately addressed. This article explores sexuality education and sexual healthcare for female adolescents in foster care with ID/DD and recommends practice guidelines to support and prepare their emergent sexual development.

Intimate Partner Violence Among Men With Disabilities: The Role of Health Care Providers.

Men with disabilities experience higher rates of interpersonal violence (IPV) than either women or men without disabilities, yet research exploring this problem is limited. This retrospective descriptive study examines the clinical files of male survivors of IPV with disabilities who received services from the Secret Garden, a disability-specific nonresidential IPV program located in New York City. These data inform the role health care providers may fill in helping address IPV against men with disabilities. Abuse history, medical and mental health service utilization, and the channels through which men accessed IPV assistance were areas of focus for analysis. Data were analyzed descriptively and outcomes reported as frequencies and percentages. Results indicate that more than half of study participants were abused by an intimate partner (66.2%) and nearly two-thirds described an act of physical abuse as the most serious type of abuse perpetrated (71.7%). Nearly half (40.8%) had previous contact with medical providers due to abuse. The high prevalence of physical abuse in this sample has critical physical and mental health implications, and could further exacerbate already precarious health statuses. While nearly half reported previous contact with health care providers due to abuse, only 15.8% were referred for IPV assistance by a health care provider, indicating a missed opportunity to identify signs of abuse and direct survivors to additional resources.

Intimate Partner Violence Among Help-Seeking Deaf Women: An Empirical Study.

Deaf women face heightened rates of intimate partner violence (IPV) compared with hearing women, yet limited research has focused on IPV among this population. Empirical studies are warranted to examine the unique experiences and resource needs of Deaf women, along with barriers excluding Deaf participants from IPV research and service provision. Our study addresses these gaps by providing a profile of 80 Deaf women attending an IPV program serving individuals with disabilities. Demographic and psychosocial characteristics, referral channels that led women to the program, and services sought post-referral are discussed to help guide best practices with Deaf survivors of IPV.

Understanding the Experience of Stigma for Parents of Children with Autism Spectrum Disorder and the Role Stigma Plays in Families' Lives.

Stigma is widely perceived in the lives of families with autism spectrum disorder (ASD) yet large, systematic studies have not been undertaken. Following Link and Phelan's (Ann Rev Sociol 27:363-385, 2001) model, this study of 502 Simons Simplex Collection families details how different factors contribute to stigma and how each appears to increase the overall difficulty of raising a child with ASD. The model begins with the child's behavioral symptoms and then specifies stigma processes of stereotyping, rejection, and exclusion. Autism behaviors contribute both to the difficulty families experience raising a child with autism and to the stigma processes associated with those behaviors. Stigma also plays a significant role (.282, p < .001) in predicting how difficult life is overall for parents.

Is there concordance in attitudes and beliefs between parents and scientists about autism spectrum disorder?

There is no reported investigation comparing concordance in attitudes and beliefs about autism spectrum disorder between parents of children with autism spectrum disorder and scientists who research autism spectrum disorder. To investigate the level of concordance between these groups on causes of autism, priorities of research, perceived stigma, and disclosure of genetic test results, telephone interviews were conducted. Parents (n = 502) were recruited from the Simons Simplex Collection, and research scientists (n = 60) were recruited from investigators funded by the Simons Foundation. Response rates were notable (parents 91%, scientists 80%). Parents and scientists differed significantly regarding beliefs of the likely major cause of autism (p = 0.007) and priorities for further research (p < 0.001). Scientists believed in genetic causes while many parents believed in vaccines as the cause of autism. Parents (37%) were more likely to hesitate vaccinating their child (p < 0.001). In contrast, there was strong concordance regarding extent of perceived stigma (95% vs 92%) and preferences for disclosure of genetic test results, including incidental findings. While scientists believed communication important, paradoxically fewer than half reported it important for scientists to communicate directly with parents. Better communication between parents and scientists should improve mutual understanding and ultimately the health and well-being of children with autism spectrum disorder and their families.

Looking beyond prevalence: a demographic profile of survivors of intimate partner violence with disabilities.

The abuse of individuals with disabilities is a widespread problem that has received minimal attention in scholarly research on intimate partner violence (IPV). As a result, the literature offers neither a general demographic profile of IPV survivors with disabilities nor an examination of the relationships between IPV and individuals with specific types of disabilities. This article addresses these gaps by reporting the results of a retrospective case study review of 886 client files, covering an 8-year service period in a non-residential domestic violence disability program. The study examined key demographics along with familial, social, and contextual aspects of IPV among women with disabilities, and provides crucial information for service providers who must understand the multifaceted and unique needs of survivors. Findings are discussed in terms of their relevance to abuse-related outcomes and corresponding best practices with this population.

Self-defense among women with disabilities: an unexplored domain in domestic violence cases.

Women with disabilities are frequent victims of domestic violence, yet scant research has examined self-protective mechanisms that could mitigate this abuse. This article reviews prevalence and types of intimate partner violence against women with disabilities and explores the factors that leave this population at higher risk for abuse than nondisabled women. Barriers to self-protection against domestic violence for women with diverse disabilities are highlighted and the use of nonfatal force as self-defense is explored. A case example and considerations for enhancing self-protection strategies for women with disabilities experiencing intimate partner violence are provided.

Parental perspectives of communication about sexuality in families of children with autism spectrum disorders.

To explore the content of communication about sexuality between parents and children with autism spectrum disorders, semi-structured interviews were conducted with 18 parents of children ages 6-13. Content analysis and ethnographic summary were used to interpret the data. Findings suggest that parent's perceptions of a child's behaviors and comprehension are associated with the likelihood that communication occurs. However, parents recognize the risks their children experience, with the greatest fears being sexual victimization and misperceptions related to the intent of their child's behaviors. This study provides information on the nature of communication about sexuality in families of children with autism spectrum disorders and can help tailor interventions aimed at assisting parents to communicate sexuality information effectively.