Abuse and neglect in psychiatrically hospitalized multihandicapped children

Characteristics of Children with Autistic Spectrum Disorders Served in Comprehensive Community-based Mental Health Settings

“…Children with ASD who receive services in mental health settings may have different profiles than those who receive services in other settings; however, it is still particularly troubling to note the proportion of children for whom a history of abuse and domestic violence was reported. Previous studies of abuse among hospitalized children with developmental disabilities and multiple handicaps have reported prevalence estimates of between 40 and 60% (Ammerman, Hersen, Van Hesselt, Lubetsky, & Sieck, 1994;Ammerman, Van Hasselt, Hersen, McGonigle, & Lubetsky, 1989). To our knowledge, although numerous case studies have been reported (Cook, Kieffer, Charak, & Leventhal, 1993;Perkins & Wolkind, 1991) and the consequences of physical and sexual abuse among this population delineated (Howlin & Clements, 1995;Tharinger, Horton, & Millea, 1990), no studies have presented either estimates of abuse specific to children with ASD, or estimates in a non-institutionalized developmentally delayed population.…”

Does Childhood Disability Increase Risk for Child Abuse and Neglect?

“…Finally, there is often little rationale for inclusion of a disability in one category over another. In his study of multihandicapped children admitted to a psychiatric hospital, Ammerman collapsed 16 psychiatric diagnoses into eight more general categories for analysis (Ammerman et al, 1989). Because the children in the study had multiple disabilities they could be represented in more than one category making attributions about the relationship between specific categories and outcomes problematic.…”

“…The ecological model posits that child maltreatment results from the confluence of multiple, transactional, nested forces in which the child, family, community, and culture interact to determine child experiences and outcomes. Thus, it is not a single element, such as child temperament or severity of disability or parental stress (e.g., Ammerman, van Hasselt, Hersen, McGonigle, & Lubetsky, 1989;Warfield, et al, 1999), or social factors stemming from the way children with disabilities are viewed and treated (Westcott, 1991;Westcott & Jones, 1999), that causes maltreatment but the complex interaction of child characteristics, parental stress, societal biases and other environmental factors that set the stage for maltreating behaviors (Masten, 1998;Sidebotham, 2001). However, to date there has been little empirical investigation of the specific elements within the social ecology of a child with disabilities or special health care needs that may increase risk for maltreatment.…”

Maltreatment of Children With Disabilities

“…Of those children, 60% had been physically abused, 45% had been neglected, and 36% had been sexually abused. 12 In a 2000 study of more than 4500 maltreated children, Sullivan and Knutson 13 observed children with disabilities to be 3.76 times more likely to be neglected, 3.79 times more likely to be physically abused, and 3.14 times more likely to be sexually abused when compared with children without disabilities. 13 Children with behavioral disorders were found to be at the highest risk of all types of maltreatment, and neglect was the most common form of maltreatment across all disability types.…”