Adopted by the APA Council of Representatives in August 2016. (Suggested citation is included with references.)
Whereas the published literature uses varying definitions of the terms disability and child maltreatment, often combines diverse forms of disability, and frequently assesses exposure to only one type of maltreatment, even though most children who are maltreated experience multiple forms (Hibbard et al., 2007; Turner et al., 2011; Sullivan & Knutson, 2000);
Whereas disability in children is generally defined in U.S. Federal law by the Individuals with Disabilities Education Act as including autism, intellectual disability, hard of hearing or deaf, speech or language disabilities, visual disabilities (including blindness), psychiatric disabilities (including schizophrenia), orthopedic disabilities, other health disabilities due to chronic or acute health problems (such as asthma, attention deficit disorder and diabetes), specific learning disabilities, and traumatic brain injury;
Whereas maltreatment is most commonly defined by American states as physical abuse, sexual abuse, neglect, and emotional maltreatment and more specifically by the U.S. Department of Health and Human Services (DHHS) as physical abuse, sexual abuse, emotional abuse, physical neglect, emotional neglect, educational neglect, any abuse, any neglect, and any maltreatment (Administration on Children, Youth, and Families, 2013; Sedlak et al., 2010);
Whereas U.S. children with disabilities are undercounted because not every child receives a clinical diagnostic assessment, and clinical data often do not match legal definitions, though reliable numbers are essential for the development of public health programs and services (Administration on Children, Youth and Families, 2013; Hibbard et al., 2007; Jones et al., 2012);
Whereas variation in the way states and DHHS define and collect data on disability status of abused or neglected children makes it problematic to accurately estimate prevalence rates of maltreatment among children with disabilities, and, thus, more difficult to prevent and combat the problem as well as provide services (Child Welfare Information Gateway, 2012; Kendall-Tackett et al., 2005);
Whereas a meta-analysis of 17 studies found that children with disabilities are a distinct high-risk group for physical and sexual abuse, and are almost four times more likely to be victims of violence than are children without disabilities; in particular, children with disabilities are 3.6 times more likely to be physically assaulted and 2.9 times more likely to be sexually assaulted than children without disabilities (Jones et al., 2012);
Whereas in 39 reporting states, child victims with disabilities accounted for 13.3% of all maltreatment victims in the U.S. in 2012 and were 1.5 times more likely to experience substantiated maltreatment two years after their first report than child victims without disabilities (Administration on Children, Youth and Families, 2013; Fluke et al., 2008);
Whereas children with disabilities are more likely to be seriously injured or harmed from assaults than children without disabilities, thus often further damaging already compromised health and development (Helton & Cross, 2011; Sedlak et al., 2010);
Whereas children with disabilities are over 2 times more likely to experience emotional neglect than children without disabilities, and that this is likely to be an undercount (Hornor, 2012; Sedlak et al., 2010);
Whereas children with multiple disabilities are at higher risk of abuse and neglect than children with single disabilities (Heinonen & Ellonen, 2013; Sullivan & Knutson, 2000);
Whereas the risk for abuse and neglect differs among disabling conditions so that not all forms of disability are associated with equivalent levels of risk, and that the level of risk differs by the type of victimization, for example, that children with conduct disorders and those with modest to severe speech and language disabilities are at increased risk of neglect, and physical, sexual, and emotional abuse compared both to children without disabilities and to children with visual disabilities and with autism (Spencer et al., 2005; Sullivan & Knutson, 2000; Turner et al., 2011);
Whereas there exists a lack of a strong empirical knowledge base on predictors and consequences of maltreatment of children with disabilities because of methodological challenges of sample selection, study design, statistical analysis, and inconsistent definitions (Jones et al., 2012; Leeb et al., 2012);
Whereas few studies consider additional risk factors, confounding factors and mediating and moderating variables for child maltreatment such as child characteristics (e.g., birth weight, gestational age, age at victimization, type and severity of disability, sex, gender nonconformity, intersecting identities, sexual orientation, nationality, race/ethnicity), family characteristics (e.g., economic resources and socioeconomic status, family structure, caregiver age, caregiver physical and mental health, disciplinary tactics), and external factors (e.g., social support, neighborhood residential mobility, geographical location, and population density , such as rural, frontier, remote, and/or urban) (Helton & Cross, 2011; Jaudes & Mackey-Bilaver, 2008; Jones et al., 2012; Mersky et al., 2009; Murphy, 2011; Turner et al., 2011);
Whereas parents of children with disabilities are more likely to report greater caregiving demands and high levels of parenting and emotional stress, depression and anger than parents of children without disabilities (Benson & Karlof, 2009; Neece et al., 2012; Resch et al., 2012; Solem et al., 2011);
Whereas social support and parent training for parents of children with emotional and physical disabilities has been found to facilitate attachment and decrease parental stress (Kazdin & Whitley, 2003; Rabineau, Mabe, & Vega, 2008; Solem et al., 2011; Vaughan et al., 2012);
Whereas n umerous studies have reported that the primary reasons for grandparents and other relatives assuming custodial care are abuse and neglect, frequently associated with parental substance abuse (Heller & Ganguly, 2002; Mccallion & Janicki, 2014; Smith & Dolbin-MacNab, 2013);
Whereas there is a strongly documented need for accessible, affordable, culturally competent, disability-competent, and evidence-based mental health services that are sensitive to youth and family strengths and needs (Gabrielli & Lund, 2021; Rabineau et al., 2008; Stancin & Perrin, 2014; Tolan & Dodge, 2005; Vaughan et al., 2012);
Whereas geographic access to social services within communities influences child maltreatment, such that urban neighborhoods in which residents have geographic access to mental health and substance abuse have lower rates of parental neglectful behaviors, and that CPS workers report that case families with children with disabilities in rural areas often suffer from few geographically available social services and providers, long driving distances, and lack of transportation (Lightfoot & LaLiberte, 2006; Maquire-Jack & Klein, 2015);
Whereas research on bullying victimization has found higher rates among students in special education than students in general education, and increased verbal abuse, relational, and physical aggression directed against students with disabilities (including learning, physical, and psychological) than against their peers without disabilities (Blake et al., 2014, , 2016a,b; Hartley, Bauman, Nixon, & Davis, 2015; Mishna, 2003; Rose, Monda-Amaya, & Espelage, 2011);
Whereas there is a need for disability-related training for mandated reporters of suspected child abuse or neglect and for collaboration between child protective services and organizations that provide services to children with disabilities (Lightfoot & LaLiberte, 2006; Manders & Stoneman, 2009; Shannon & Tappan, 2011; Ziviani et al., 2013);
Whereas there is no standard approach in Child Protective Service (CPS ) agencies to managing cases involving children with disabilities, and a lack of coordination and collaboration which results in critical gaps in the provision of integrated services to maltreated children with disabilities and their families (Horwath & Morrison, 2007; Lightfoot & LaLiberte, 2006; Shannon & Tappan, 2011; Ziviani et al., 2013);
Whereas services recommended for families of children with disabilities in suspected child abuse cases are more likely to be child-focused than caregiver-focused than those for families of children without disabilities, and that CPS workers have been reported to empathize with abusive parents of children with disabilities, especially those with emotional/behavioral disabilities, as well as to acknowledge lack of information regarding disabilities (Corr & Santos, 2017; Lightfoot & LaLiberte, 2006; Manders & Stoneman, 2009; Shannon & Tappan, 2011);
Whereas in agreement with the Convention on the Rights of Persons with Disabilities (CRPD), adopted by the United Nations General Assembly in December 2006, and which the APA has affirmed; and the Indian Child Welfare Act, passed by the U.S. Congress in 1978, all children, including those with disabilities, are entitled to care and out-of- home placement that takes into account their culture, ethnicity and disability status (UNICEF, 2007; Indian Child Welfare Act, 1978);
Whereas formal partnerships among federal agencies, professional associations, and families and caregivers would facilitate the transfer of knowledge among research, practice, and policy related to children's mental health (Corr & Santos, 2017; Proctor et al., 2009);
Whereas there is clear evidence that child maltreatment is not only a national but also an international problem and that there is general consensus across many nations that child abuse should be prevented and that children with disabilities are especially vulnerable (Krug, Dalhlberg, Mercy, Zwi, & Lozano, 2002; Westcott & Jones, 1999);
Therefore be it resolved that the American Psychological Association:
Recommends a national strategy to accurately count the number of children with disabilities who are maltreated. The federal government needs to standardize definitions of disability and child maltreatment, data collection methodologies, and recordkeeping across all the states and territories;
Encourages both national and international research to clarify the current state of knowledge regarding maltreatment of children with disabilities. Such research should add disability status to all studies of child maltreatment and to evaluation studies of child maltreatment interventions, utilize consistent definitions of disability and child maltreatment, identify multifactorial risk factors for child maltreatment, assess the impact of multiple types of maltreatment on children with disabilities, and identify the multiple-service needs of children with disabilities and their families;
Encourages the further development and provision of effective evidence-based family-focused prevention and interventions such as early childhood services, home visiting programs, the medical home model, parent and grandparent support groups, and respite care that build on the strengths of the child and family. Such programs should address family quality of life, such as reducing stress, isolation, depression, and anger, teaching caregivers positive behavior management techniques and coping strategies, and providing families practical support such as transportation, identification of service providers, and financial support.
Recommends that such services as described above should be appropriate to child characteristics such as developmental level, physical and sensory ability, gender, and intersecting identities and to caregiver characteristics such as physical and mental health to prevent and address the sequelae of child maltreatment;
Recommends that all programs for maltreated children and their families need to be disability accessible and embedded in communities with high rates of child protective services involvement and low rates of geographical access, whether urban, rural, or suburban, and also offered alternatively through telephone and computer when feasible for both providers and family members;
Recommends the consistent inclusion of students with disabilities in bullying intervention programs, given their elevated level of risk of victimization;
Recommends the development of enhanced, disability-relevant training for CPS workers and all mandated reporters of suspected child abuse or neglect regarding crisis response, specifically, the identification and treatment of maltreated children with disabilities, and the utilization of investigation teams and foster care services that include disability specialists;
Strongly encourages collaboration between professionals in the child maltreatment and disability communities (e.g., lawyers, law enforcement personnel, child advocates, mental health professionals), and dissemination of research on the special needs of maltreated children with disabilities to both of these groups and to education and training programs in psychology.