Children with Special Needs

Key Points:

(a) Violence against children with special needs may be more frequent, but there is very limited research and evidence on this; (b) Reports of violence against children with special needs are significantly lower than the actual occurrences; (c) Children with special needs often have difficulties that prevent them from reporting abuse; (d) Abuse may have existed before the disability or may be a consequence of abuse; (e) Children with special needs are victims of all forms of violence, including sexual abuse; (f) In children with special needs, signs of abuse often go unrecognized, as symptoms are frequently attributed to their general condition.

Identification

Distinguishing between symptoms of abuse and symptoms of disabilities is often challenging. For example, increased seizures in a child with epilepsy may be due to stress from abuse or withdrawal of anticonvulsant medications. Identifying fabricated or induced conditions can also be difficult. However, recognizing and diagnosing abuse in children with special needs is possible since they display similar behavioral and physical signs as other abused children, including:
• Pathological or sexual behaviors that may indicate sexual abuse;
• Bruising and other physical injuries;
• Anxiety and discomfort;
• Self-harm;
• Vaginal or rectal bleeding;
• Sexually transmitted infections, pregnancy;
• Signs of neglect, including growth and developmental delays not linked to organic causes;
• And more.

Communication

For identifying abuse in children with special needs, professionals must have specific skills to communicate with them. For example, specialists in alternative communication methods are invaluable when working with children with communication difficulties.
• Children with mild to moderate intellectual disabilities can recall details helpful in identifying abuse. Studies indicate that mental age is an optimal guideline.
• Children with Down syndrome often have issues with language and verbal memory but may excel in recalling visual and spatial details.
• Children with autism spectrum disorder (ASD) face challenges in recalling personal or social aspects due to language and social perception difficulties. They also struggle to mislead interviewers.
• Children with Williams syndrome have relatively well-developed language skills but find it challenging to understand and recall visual and spatial details.
Interviewing Guidelines for Children with Intellectual and Developmental Disabilities When interviewing children with intellectual and developmental disabilities, typical child interview guidelines should be applied, along with the following adjustments:
(a) Gather information on the child's strengths and weaknesses to plan the interview accordingly;
(b) Ask simple, short questions at a moderate pace;
(c) Prioritize open recall, which tends to yield more accurate information;
(d) Avoid repeating questions;
(e) Provide appropriate support (such as an intermediary) and accommodations (like more frequent breaks).