Preventing Abuse of Individuals with IDD
Linda Hickson and Ishita Khemka
Unprecedented levels of inclusion and community participation have opened up exciting opportunities for individuals with intellectual and developmental disabilities (IDD), including a wide range of jobs in the community, independent and supported living arrangements, recreational activities, and friendships and intimate relationships. However, sometimes these opportunities have been associated with high levels of risk to their personal safety and well-being.
It is well-documented that individuals with IDD experience markedly higher rates of all types of abuse and victimization compared with individuals without disabilities. Furthermore, the most startling statistic is that between 97 and 99 percent of the abuse is perpetrated by individuals that are known and likely trusted by the person with IDD. Perpetrators may include intimate partners, family members, caregivers, and other service providers. As such, adults with IDD may face a great many threats to their personal safety in their everyday lives. Because these threats may occur in the context of their intimate relationships or when they are on their own in the community, individuals with IDD cannot count on the protection or intervention of others to keep them safe. They need the tools to protect themselves.
Although increased awareness of the vulnerability of individuals with IDD has led to a proliferation of commercially available materials aimed at preventing abuse, the effectiveness of most of these materials has not been established. A series of curriculum development projects at Teachers College, Columbia University, led by Linda Hickson and Ishita Khemka of St. John’s University and supported by the New York State Developmental Disabilities Planning Council (DDPC), have addressed this need by developing and evaluating the Effective Strategy-Based Curriculum for Abuse Prevention and Empowerment (ESCAPE-DD).
ESCAPE-DD is based on the premise that stopping abuse or escaping from an abusive situation typically involves decision making. However, research by Hickson, Khemka, and their colleagues has shown that people with IDD have serious limitations in a range of decision-making skills that can jeopardize their health and safety in situations of abuse. For example, in one study, adults with mild and moderate IDD recommended effective decisions in situations of abuse only 50 percent of the time compared with adults without disabilities who recommended effective decisions 91 percent of the time.
Drawing upon this work, the original ESCAPE curriculum was developed, evaluated, and found to be effective with women with intellectual disabilities. This original ESCAPE curriculum formed the basis for the current ESCAPE-DD version of the curriculum, which is applicable with men as well as women with IDD. In a recent study by Hickson and Khemka with colleagues Harriet Golden and Katerina Chatzistyli at AHRC New York City, in which 58 adults with mild and moderate IDD were randomly assigned to a group that received ESCAPE-DD or to a wait-list control group, it was found that the adults who received ESCAPE-DD produced more self-protective decision-making responses (84 percent) than the control group (63 percent).
In an earlier project, which was funded by the New York State DDPC, Teachers College and AHRC New York City conducted six regional train-the-trainer workshops throughout New York State in which 178 service providers received training in domestic violence and abuse prevention, as well as hands-on training with the ESCAPE-DD curriculum. In a subsequent project, funded by the New York State DDPC, the ESCAPE-DD Staff Training DVD and Curriculum CD package was developed and field-tested. This package has become established as an effective and widely used intervention approach and is available free of charge upon request from the DDPC. A currently ongoing project (also funded by the DDPC) will support the updating and revision of the ESCAPE-DD curriculum and related assessment instruments in light of recent theory and research. The project will culminate in the development and evaluation of a sustainable, web-based version of the revised/updated curriculum, to be entitled ESCAPE-NOW, which will be available in early 2015.
To access the ESCAPE-DD materials, see: http://www.tc.columbia.edu/oopd/index.asp?Id=ESCAPE+DD+Curriculum&Info=ESCAPE+DD+Curriculum
For more information on ESCAPE-NOW, contact Linda Hickson, (firstname.lastname@example.org).