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COPYRIGHT 2006 Pro-Ed
The prevalence of sexual abuse and domestic violence among women with disabilities is at least as high as the rates experienced by women without disabilities. However, according to anecdotal accounts and preliminary research, many victim service agencies are inaccessible and do not provide appropriate support and services for people with disabilities. This study examined the physical and programmatic accessibility of 55 rape crisis, sexual assault, and domestic violence agencies throughout Pennsylvania. Findings suggest that most programs had several accessibility structures in place, such as ramps and accessible restrooms. However, fewer programs had less well-known physical and programmatic accessibility features in place to ensure equal access to services. Recommendations focus on cross-system collaboration to provide access to victim services by all victims, including those with disabilities.
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The prevalence of sexual abuse and domestic violence among women with disabilities is difficult to determine due to low levels of reporting and data collection limitations (Aiello, 1986; Baladerian, 1991). However, research has shown that women with disabilities are at least as likely (Nosek, Howland, & Young, 1997) or more likely to be physically, sexually, and/or emotionally abused than women without disabilities. According to Stimpson and Best (1991), more than 70% of women with disabilities have been victims of sexual violence at some time in their lives. In addition to physical, sexual, and/or emotional abuse, women with disabilities may be confronted by a perpetrator who withholds their medicines, personal hygiene care, assistive technology supports, or orthotic equipment (Young, 1997). Victimization of women with disabilities is not restricted to any specific disability. Persons with disabilities as diverse as intellectual disabilities (Chamberlain, Rauh, Passer, McGrath, & Burket, 1984; Sobsey, 1994; Stromsness, 1993), learning disabilities (Bryan, Pearl, & Herzog, 1989), blindness (Rounds, 1996), and deafness (Sullivan & Knutson, 1998; Swartz, 1995) are victimized. Persons with intellectual disabilities, communication disabilities, and significant behavioral problems seem most vulnerable to victimization (Doren, Bullis, & Benz, 1996; Schwartz, McFadyen-Ketchum, Dodge, Pettit, & Bates, 1999; Sullivan, 2000).
Several studies (Nosek et al., 1997; Sobsey & Doe, 1991) indicate that victimization of persons with disabilities is more likely to be chronic than it is for persons without disabilities. Victims with disabilities are also more likely to know their perpetrator. According to Sobsey and Doe's (1991) study of people with intellectual disabilities, 19% of perpetrators were family or stepfamily, 15.2% were acquaintances, and a dramatic 44% were persons known to the victim through disability services or programs, including service providers, medical staff, transportation staff, foster parents, and peers who interacted with the victim at a specialized program. Thirty-six percent of abuse occurred in settings encountered because the individual had a disability (e.g., disability-related programs, residential settings). Similarly, studies of victims who are hard-of-hearing or deaf found that family members and persons encountered through disability services were the most likely perpetrators and that settings related to disability services placed persons at particular risk (Furey & Niesen, 1994; Sullivan & Knutson, 1998).
In this article the term accessibility is used in a broad manner, including facility physical accessibility and program accessibility. Program accessibility includes service provision access, such as communication facilitation and the knowledge, awareness, and skill of staff regarding issues and in providing services to persons with disabilities.
Given the high rates of abuse and the likelihood that perpetrators are family members, personal assistants, or support staff, it seems essential that women with disabilities have access to victim services such as rape crisis centers and domestic violence programs, including counseling, legal services, and emergency and transitional housing. However, many victim service agencies are inaccessible and do not provide appropriate support and services for people with disabilities (Baladerian, 1991; Carlson, 1997; Nosek et al., 1997; Sobsey, 1994). Most information on inaccessibility of victim services is anecdotal. However, several studies have documented that inaccessibility is pervasive within victim services. A study of domestic violence programs and shelters in northern Nevada (Carson City Center for Independent Living, 1999) found that every program fell short of complying with the Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act of 1973 standards. In their study of 170 victims of sexual assault who had developmental disabilities, Mansell, Sobsey, and Calder (1992) found that almost half of the victims surveyed had difficulty obtaining any treatment and often did not receive necessary accommodations. Sobsey and Doe (1991) found that 50.4% of their respondents felt victim services failed to provide accommodations and 22.8% felt victim service agencies made inadequate attempts to meet special needs.
Among the greatest barriers to accessibility are limitations in staff awareness of the broader issues of accessibility and disabilities, negative or ambivalent attitudes about providing greater access, lack of knowledge of the prevalence and incidence of sexual victimization within the disability community, and limited recognition of the sexuality of people with disabilities. Professionals and society at large too often consider people with disabilities to be asexual and therefore do not view issues of sexual and domestic violence as relevant to the lives of people with disabilities (Aiello, 1986; Baladerian, 1991; Gill, 1996; Nosek et al., 1997). Professionals may also reject the concept that women with disabilities can be victims of crimes at the hands of their partners, family members, personal care assistants, support staff, and public or paratransit drivers. When violence does occur, staff may feel empathy toward the offender and view the incident as an interpersonal problem rather than a crime. According to the Violence Against Women project (Carson City Center for Independent Living, 1999), "general service providers and disability service providers fail, 80% of the time, to recognize domestic violence as an issue where a woman also has a disability" (p. 2). Providers tend to think in terms of "case management" and show compassion for the offending partner, family member, personal care assistant, or support staff, who tends to be perceived as "needing a break."
In addition to negative attitudes concerning sexuality and victimization, staff and policymakers may hold naive understandings of accessibility, believing accessibility requires only a ramp and perhaps an accessible bathroom. Rather, accessibility requires that people with disabilities are (a) aware of the availability, location, and types of the services (or can find out about them if needed); (b) physically able to enter and move through the building; (c) able to access all printed materials (materials should be available in alternate formats); and (d) able to understand and meaningfully participate in the services offered.
Buildings are required to comply with ADA guidelines, in addition to state laws and local ordinances. This necessitates more than a ramp. It requires, for example, that the entrance door be at least 32 inches wide, have less than a 1/4-inch-high threshold, and be easily opened with a closed fist.
Access to services and programs, as well as physical access, is also essential. Programmatic accessibility, such as the publication of materials in alternate forms (e.g., large print, Braille, audiotape), availability of personal assistants and sign language interpreters, and staff trained in communicating with people who have receptive or expressive language difficulties, is imperative for persons with disabilities (Carson City Center for Independent Living, 1999; Nosek et al., 1997).
Staff attitudes...
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