Assessing the damages in cases involving sexual abuse can be complex, especially when considering children and adolescents. These cases become even more challenging when factoring in children and adolescents with developmental disabilities or those who have difficulty expressing themselves verbally.
In this article, Licensed Clinical Psychologist, Dr. Staci Weiner shares the many factors that need to be considered when assessing damages, in relation to the individual’s age, developmental stage, cognitive, psychological, as well as social and emotional functioning.
Implications and Impact of Sexual Abuse on Children and Adolescents – Expert Article
The Centers for Disease Control and Prevention, National Center for Injury Prevention and Control works with State Health Departments to reduce violence and develop programs for injury and violence prevention. They define sexual violence as “a sexual act that is committed or attempted by another person without freely given consent of the victim or against someone who is unable to consent or refuse.” It is “unwanted sexual contact” which includes an incident in which the victim was made to penetrate a perpetrator, or noncontact of a sexual nature. Sexual violence can also occur when a perpetrator forces or coerces a victim to engage in sexual acts with a third party.
Tactics are strategies that the perpetrator uses to force a person to participate in or expose them to a sexual act. Examples of tactics can include taking advantage of a person’s weaknesses or vulnerability (in the case of a person with disabilities), false promises such as promising marriage or a relationship, intimidation, persuasion or verbal persistence, such as when the victim is being worn down by someone who repeatedly asks for sex, or verbal threats such as threats to end the relationship or spread rumors.
After a person is exposed to a sexually violent act, changes in psychological functioning can be either temporary (i.e., persisting for 180 days or less), intermittent, or chronic (i.e., likely to be on an extended and continuous duration persisting for a period greater than 180 days). At times, a victim experiences shock, detachment, difficulty concentrating, or withdrawal. Often, psychological functioning is significantly impacted including increases in or development of anxiety, depression, insomnia, eating disorders, or post-traumatic stress disorder. Furthermore, memory impairment, suicidal ideation, self-medication, self-mutilation, sexual dysfunction, and hypersexuality are factors that can develop after a person experiences a sexual trauma.
Sexual Abuse in Children and Adolescents with Disabilities
When sexual abuse occurs in children or adolescents with cognitive or developmental disabilities, assessing the damages as well as the details of the situation can be challenging. Unfortunately, symptoms of abuse, including “acting out” behavior can be falsely perceived to be a result of the disability rather than the trauma that has occurred. It is important for professionals to be aware of behaviors and social emotional cues that are often signals of trauma. Children and adolescents with disabilities can experience social powerlessness, which make them particularly vulnerable to exploitation. As a result, they may not be able to exert their will against the will of the offender. In some cases, the victim does not fully understand what is happening because of a developmental disability, a lack of experience, or a lack of knowledge.
Emotional and Psychological Repercussions
It is well recognized that the two factors of shame and guilt are the prime psychological injuries when discussing sexual assault. These repercussions are the result of internalization of the offense. Children often blame themselves and struggle with feelings of self-hatred, low self-worth, and perseverative thoughts that they are “bad” or have made a mistake. They may feel “dirty or damaged” due to the event. Some children report that they feel “numb” or “zombie like.” They may report feeling “dead” inside and unable to feel joy, to laugh or smile, or to feel positive for long periods of time. This can impact their ability to meet their basic needs of self-care.
Many psychological issues such as poor self-esteem, depression, anxiety, obsessive/compulsive thoughts or behavior, and enduring preoccupation with the event can occur as a result of the trauma; especially when considering children with low intellectual functioning, social skills deficits, and a lack of understanding of appropriate boundaries. Post-Traumatic Stress Disorder has been shown to be prevalent amongst children who have experienced sexual trauma. In addition, those with a history of sexual abuse have higher reports of debilitating fear, anxiety, insomnia, depression, as well as suicidal ideation and suicide attempts. Furthermore, an incident of sexual assault may serve to re-traumatize a child if the child has a history of past instances of physical, emotional, or sexual abuse. Therefore, when assessing children for damages, it is important to investigate past history of trauma as well as past and present symptoms of psychological trauma, especially suicidal ideation.
As a result of sexual trauma, children can experience significant fear and distrust of others, causing them to avoid socialization with peers, attend school, or participate in social events. Fear and distrust may lead to problems with intimacy and significant difficulty forming appropriate relationships. For example, victims of sexual abuse may be emotionally needy, and seek approval in an inappropriate manner. In addition, they may be intimidated easily, and put others’ needs before their own, causing them to have difficulty setting boundaries or limits. Furthermore, children may become hypervigilant of the potential of getting rejected or hurt by others, causing them to avoid interactions or isolate themselves socially. These damages can be assessed by understanding the child’s social patterns before the precipitating event and comparing these interactions to their social functioning after the event.
In the case of children with developmental or intellectual disabilities, behavioral issues often occur due to difficulty communicating their psychological pain as well as confusion about the trauma. These difficulties can lead to self-harm, suicidal ideation, and/or suicide attempts. Many adolescents feel hopeless, overwhelmed, and confused by the abusive actions, leading to acting out behavior such as running away, physical aggression or sabotaging relationships. Therefore, it is important to assess the child’s perspective before, during, and after the interaction in order to fully understand the maladaptive behavior as well as how this behavior is interfering with their daily functioning.
Investigating Sexual Abuse in Children and Adolescents
It is important to involve trained professionals such as psychologists when assessing the negative impact of sexual abuse trauma so we may better understand the devastating consequences of these events. The supervision practice at Robson Forensic includes psychologists, social workers, coaches, teachers, school administrators, nurses, lifeguards, rehabilitation professionals, and school transportation experts who speak to the standards of care for child and adult supervision in or affiliated with facility based programs and activities.
Submit an inquiry or call us at 800.813.6736 to discuss your case with an expert.
Dr. Staci Weiner is a licensed clinical psychologist and certified school psychologist with nearly 20 years of experience. She applies her expertise to forensic casework involving claims and personal injury litigation related to the diagnosis, identification, and treatment of children, adolescents, and adults in schools, mental health, and community settings. Dr. Weiner completed her doctorate in School/Clinical Psychology at Pace University, where she now teaches doctoral level Cognitive Behavioral Therapy classes as an adjunct professor. She is a Licensed Clinical Psychologist and Certified School Psychologist in New York State. She is a member of the American Psychological Association and National Register of Health Service Providers in Psychology.
CDC National Center for Injury Prevention and Control. Sexual Violence Surveillance: Uniform Deifnitions and Recommended Data Elements.
Cole, S.S. Facing the challenges of sexual abuse in persons with disabilities. Sex Disabil 7, 71–88 (1984)