Sexual abuse and the deaf community: an overview

1
Sexual abuse and the deaf community an overview

• Jacob Casselden - Actor
• Sally Austen - Clinical Psychologist

2
Child sexual abuse

• is the sexual exploitation of a child under the
  age of 18, who is not developmentally capable of
  understanding or resisting the sexual contact, or
  who may be psychologically, physically or social
  dependent upon the offender. The sexual contact
  ranges from body exposure to penetration. Victims
  can be both male and female. ODay (1983)

3

• Born deaf into a hearing family hearing family
  encouraged not to sign, but try to bring up their
  son orally.

4
Deaf children in hearing families

• Oral v manual debate
• Children need language, not specifically speech
• Language deprivation
• Cognitive
• Emotional
• Social
• Families may not share a language

5

• Went to a Deaf residential school aged 3
  parents did not have enough language to explain
  what was happening and why Ben would be leaving
  home during the week.

6
Deaf education

• Mainstreaming v Deaf school
• Deaf schools
• Distance may necessitate boarding
• Leave home before language established
• Pass on Deaf Culture and British Sign Language
• Risk of institutionalisation
• Mainstreaming
• Closer to home
• May have less deaf specific resources
• May not have a deaf peer group

7

• At school, initially all seemed to be going well.
  Aged 7, attention from male houseparent
  presents, time watching his TV, money.
• Houseparent started giving Ben hugs that become
  increasingly intimate and eventually ending up
  with forcing Ben to masturbate him.
• Pattern of behaviour continued on a regular basis.

8
Prevalence of sexual abuse

• Significantly higher in disabled (including deaf)
  children compared to non-disabled children.
• 7.3 of victims of child abuse have disabilities.
• 68 more likely to be a victim of abuse if
  disabled.

9
Deaf child greater risk home

• Their care is more stressful and costly
• Impaired mother-child bond
• Child is less able to meet parental expectations.
• Require special care that exceeds the parental
  resources.
• Resentment may lead parent to reject or
  institutionalise the child (attendant risks of
  institutionalised abuse)

10
Deaf child greater risk others

• Deaf child wont tell communication,
  disempowered, more desire to please
• Family rely on more trusted others
• Paedophiles attracted to caring professions
• Child has less sex education or knowledge about
  abuse
• Societys negative attitude gives the abuser
  permission

11
The known abuser

• Children and adults with disabilities are more
  likely to know their abuser

12
Institutions harbour abuse

• Isolated from formal or informal support systems.
• Relies on others to communicate with outside
  world
• Child and family rely on the institution for
  special services

13

• Ben realised this was happening to more than one
  boy at school, both older and younger boys.
• Incidents then occur between Ben and older boys
  at the school (likely to have also been abused)
  awareness that older boys bullying younger boys
  for sexual favours.

14
Victims and perpetrators

• Many perpetrators have been abused
• One third of perpetrators are under 18
• Boundaries get blurred between abuse and sex
  play
• Gets harder to speak out as some of the contact
  is consensual and issues of shame.
• Creates problems for recovery

15

• Aged 9 tries throwing notes over the wall saying
  'bad man HELP!' - only English capable of. No
  response.
• Tries to talk to parents but they don't
  understand what he's signing.

16
Disclosing abuse

• Dont know what is happening is abnormal
• Shame and guilt
• Fear they wont be believed
• Fear of threats from abuser
• Fear of serious consequences eg father put in
  gaol, the child put in foster care.
• They dont have the vocabulary or a shared
  language with parents

17
Spotting abuse

• In a signing child it is imperative that those in
  the position to spot abuse know what to look for
  audiology staff, GPs, dentists, teachers.
• Use formal interpreters rather than family
  members or school personnel to interpret so the
  child has confidentiality.

18

• At that point Ben starts breaking things at home,
  having tantrums, increasingly aggressive.
• At school he underachieves and is keen to leave
  school which he does at 16. Leaves school with
  no academic qualifications, very poor English
  skills, little speech but good expressive BSL.
• Did a Youth Training Scheme, however dropped out
  and spent much of his 20s mixing socially with
  Deaf friends, drinking heavily and partying
  feels in retrospect he was trying to 'escape'.

19
Abuse and childrens behaviour

• Sexually inappropriate (seductive) behaviour
• Aggressive or violent behaviour
• Juvenile delinquency, drug, alcohol
• Avoidance behaviours, fears, anxiety
• Wetting, soiling, sleep disturbances
• Running away, acting out
• Clinging, crying, depression

20

• Met his Deaf wife aged 22 and married later that
  year. They have two hearing children, a boy and
  a girl.
• Ben started manual work in a car factory aged 22
  and stayed in this job for many years.

21
Abuse and everyday life

• Sexual abuse doesnt show try to forget
• Think it is normal even as adult
• Think it doesnt affect you
• Think it own fault so no right to complain
• For some it will be not trouble them
• For others it re-surfaces

22

• By mid 30s experiencing anxiety and depression
  and increasing periods off work. Trigger for his
  depression seemed to be when his son reached the
  age he was when he was abused.
• Started drinking heavily.
• Loses his job.

23
Abuse and mental health problems

• Alcohol and drug abuse
• Mental illness
• Depression
• Anxiety
• Personality disorder
• Psychosis
• Aggressive or violent behaviour
• Avoidant behaviours

24

• Sees GP no interpreter used and GP prescribed
  anti-depressants which were of no real benefit
  and situation exacerbated by heavy alcohol use..
• Accessed therapy (CBT) through Occupational
  Health, with an interpreter and expected to
  'confront his guilt'. Disengaged quite early on
  from therapy. Raises further issues about his
  role in relation to the abuse.

25
Poor access to services 1

• Physical health services
• Primary mental health
• Therapy

26

• Aged 40, Ben's son receives school award for
  'most improved pupil'. Ben initially pleased but
  then reflects on son's success relative to his
  own failure and goes out drinking heavily on his
  own. Wife increasingly worried when he hasn't
  returned home by 4am. Police find Ben weeping,
  drinking and trying to cut his wrists with a
  broken bottle.

27

• Police hold Ben under a section 136 and arrange a
  MHA assessment the next morning. Hearing
  assessment team with no experience of assessing
  Deaf people section Ben and a diagnosis of
  personality disorder is given.
• Eventually Ben is taken on by a local community
  mental health team who aren't able to offer him
  much meaningful support. He is given heavy and
  sedating medication which causes significant
  weight gain.

28
Poor access to services 2

• Secondary service
• Misdiagnosis
• Personality disorder
• Mistreatment
• Tertiary services

29

• An interpreter informs the mental health team of
  the existence of a specialist service. Funding
  is agreed for an initial assessment. Ben is
  assessed, and a reduction of medication is
  suggested along with long term therapy.

30
Appropriate mental health care Equality of
access

• Experienced staff
• Clients chosen language
• Treatment options
• Reasonable distance
• Waiting times

31

• Ben has now been awaiting funding agreement for 9
  months.

32
Prevention

• Sex ed in the right language
• Empowerment, assertiveness, survival stragegies
• Independent thinking instead of compliance
• Eradicate isolation so less likely to respond to
  any old attention