Australia and New Zealand Journal of Developmental Disabilities 1991, Vol. 17, No. 2, 229-236.

INVISIBLE VICTIMS: SEXUAL ASSAULT OF PEOPLE WITH A N

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INTELLECTUAL DISABILITY
MOIRA CARMODY 1 Social Policy Consultant
& Educator
This paper discusses the tack of attention which has been given by helping professionals, police, welfare and legal systems concerning the sexual assault of adults who are intellectually disabled. Reasons why people with intellectual disability are particularly vulnerable to sexual assault are also explored. A research project conducted in 1989-1990by the author for the NSW Women's Co-ordination Unit is described and the major findings discussed.

The 1988 Australian Bureau of Statistics survey of disability in Australia revealed a total of 2.5m Australians or 15.6 per cent of the population were identified as having a disability. Other studies (Cocks, 1985) indicate approximately 3 per cent of our population has an intellectual disability. A person with an intellectual disability is generally considered as someone whose intellectual functioning is significantly lower than the norm. Ninety per cent of people with an intellectual disability are mildly disabled. Adults who have a mild level of intellectual disability" may work in open or sheltered employment, live independently or with family, friends or in a residential facility. The majority of these people have no additional physical or sensory disabilities. There is a continuing struggle for people with an intellectual disability, their parents and the staff who work with them. This struggle involves gaining greater acceptance of their abilities and rights for increasing independence. At the same time, there is an often realistic concern about people with disability being taken advantage of or exploited. Exploitation can take many forms such as restricting people's access to training programs, information about their legal rights and responsibilities, opportunities to develop relationships and financial, physical and sexual exploitation. The discussion of sexual assault of people with an intellectual disability needs to be considered within the framework of all peoples' right for protection from exploitation. Sexual assault is first and foremost a criminal offence. It has been increasingly accepted in the last fifteen years that sexual assault is a serious social problem confronting all societies and many individuals in these societies. People with intellectual disabilities are part of these societies and unfortunately are also susceptible to experiences of sexual violence. However, historical trends in the treati Address for correspondence: Ms Moira Carrnody, Blacktown College of TAFE, Main Street, Blacktown, 2145.

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ment and care of people with intellectual disabilities has often failed in preparing them for the challenges of daily living including protection from sexual assault. The following discussion will focus on the issues concerning the sexual assault of adults with an intellectual disability. It will be shown that people with an intellectual disability are particularly vulnerable to being sexually assaulted and that the systems designed to assist them are failing to recognise or address their specific needs. Incidence of sexual assault Accurate statistics concerning the prevalence and incidence of sexual assault among people who are intellectually disabled are difficult to obtain. Most disability services do not collect data on this issue. Police figures are also inaccurate as there is no specific data collection which identifies the presence o fan intellectual disability. The NSW Bureau of Crime and Statistics that monitors sexual assault matters before the courts has indicated no specific data are collected that identifies whether the victim has an intellectual disability. The New South Wales (NSW) Department of Health recently instituted disability as a specific item in it's data collection of the patterns of referral to Sexual Assault Services. This collection commenced in January 1989. Figures for the first six months of 1989 reveal significant numbers of people with an intellectual disability requiring the assistance of Sexual Assault Services. Of the 855 adults referred to Departmental Sexual Assault Services, 55 or 6.4 per cent were intellectually disabled. These figures are likely to be an underestimate of the actual incidence of sexual assault of disabled people. It is anticipated that referrals will increase as both sexual assault and disability workers become more aware of the need to intervene in these matters. The majority of victims in the sample experienced vaginal, anal and oral penetration. The use of weapons such as knives, ropes or blunt instruments was low; similiar to the experience of child sexual assault victims. The vast majority of assaults took place in either the victim's or assailant's home which is consistent with profiles of sexual assault for the general population. Police action was anticipated in only a third of cases despite the nature of the crimes committed. The Family Planning Association of NSW has been in the forefront of running sex education training programs for people with an intellectual disability for over ten years. Educators have been increasingly alarmed by the number of participants in courses who have been sexually assaulted. In precourse interviews in 1989 with fourteen participants, workers concluded twelve participants had been sexually assaulted. This opinion was reached from the information voluntarily provided by participants, the nature of the crimes committed and the reactions of the participants to the experience. The alleged offenders were personnel working with clients, family members, fellow residents or employees. Overseas research into the incidence of sexual assault of people with disabilities provides evidence that the problem is of significant proportions. A survey of noninstitutionalized population of eighty seven female adolescents conducted 1984 in Cincinnati, USA revealed sexual assault or incest occurred in one third of the mildly delayed group (sic) and a quarter of the moderately delayed group (sic). Hard (1986) found 83 per cent of women and 32 per cent of men had been sexually assaulted out of a group of 95 people with intellectual disabilities. The Centre for Women's Policy Studies (1984), estimated that 100,000 people with disabilities were raped in the United States in 1981, and that the occurrence of other forms of sexual assault against people with disabilities was considerably higher.
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A Victorian study Silent Victims:A Study of People with Intellectual Disabilities as Victims of Crime (1988) prepared for the Office of the Public Advocate, revealed the high incidence of sexual assault amongst people with an intellectual disability. Nineteen agencies agreed to monitor their cases of alleged crime against people with an intellectual disability during the last quarter of 1987. The agencies included government and non-government organisations. Of the 144 alleged crimes reported to agencies during the study period 130 involved sexual offences. The researchers concluded:
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The data suggest(s)stronglythat sexualoffencesand physicalassaultare the mostfrequently recordedcrimesagainstintellectuallydisabledpeople(p.14). From contact with the agencies involved, there was strong evidence of underreporting of crimes by people with intellectual disabilities and by workers. A number of authors have documented the incidence of sexual assault of people with disabilities by agency personnel, care takers and family members. (Aiello, 1986: Berkman, 1986; Seattle Rape Relief Developmental Disabilities Project; 1979, 1980) Aiello reports of her own clinical experience of working with over ninety men, women and children with disabilities. In only one case was the victim attacked by a stranger. This situation highlights the particular vulnerability of people with an intellectual disability to sexual assault. Vulnerability to Sexual Assault. There a number of factors which make people with an intellectual disability particularly vulnerable to sexual assault. There are in existence a number of false assumptions about people with an intellectual disability. For example: that no-one would take advantage of a disabled person, that any form of sexual contact is enjoyed by people with an intellectual disability who are more easily stimulated sexually than other people or that people with an intellectual disability have impaired sexuality. There is a range of attitudes and values in the area of human relations and sexuality. This is overlaid with concern to protect people with an intellectual disability from exploitation. This concern needs to be balanced with the person's right to live a full and 'normal' life, including the right to sexual expression. An understanding of sexual behaviour is a crucial requirement in ensuring that people with an intellectual disability" are protected from sexual assault. While sexual assault is primarily a crime of violence, the sexual component of the assault distinguishes if from other forms of assault. If people with an intellectual disability are not made aware of their own sexual feelings and their rights to choose or not choose sexual partners, confusion and the possibility of sexual exploitation is increased. A lack of sex education and opportunities to develop a sexual identity results in confusion, and uncertainty about what is acceptable behaviour from other people. It is not possible to protect people from sexual assault unless they have an understanding of their own bodies and human anatomy. Any discussion of sexual assault is most useful within a discussion of the range of appropriate and exploitative sexual behaviour. Many people with intellectual disabilities have restricted social lives. This can result in increased dependence on family and caregivers and a lack of contact with people of their own choosing. It also limits their contact and knowledge of protection or victim support services. Opportunities for developing friendships and sexual relationships maybe severely restricted by living in an institutional setting. Limited experience of social situations and relationships encourages a naive belief in the good intentions of other people. This may result in an inappropriate reliance on

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care-givers and a desire to be compliant and please other people. Limited access to written material may reduce people's access to sexual assault prevention material. Government departments and other agencies have largely failed to produce information which uses simple language or is produced in other mediums such as audio tapes or visual material. Limited verbal skills may hinder attempts at disclosing the assault or being understood due to a difficulty in communicating verbally. Some people with intellectual disabilities may have limited mobility that can result in an inability to escape from unwanted sexual advances. It may also result in an increased reliance on family, or residential workers. In NSW the difficulties experienced by people with an intellectual disability who were sexually assaulted were identified by the state Sexual Assault Committee in 1989. Some earlier initiatives by committed workers resulted in the development of a training program for health workers regarding sexual assault and intellectual disability (Department of Health, NSW, 1988) and a child protection curriculum for children with an intellectual disability (NSW Department of School Education 1989). However there was no co-ordinated policy direction on the issue of sexual assault of people with an intellectual disability. As a result, the NSW Women's Coordination Unit obtained Ministerial approval in late 1989 to conduct a six month investigative project and produce a discussion paper followed by a final report containing recommendations for action by government. (Carmody, 1990 a, b) The project revealed an alarming lack of awareness by government departments and disability organisations of the needs of people with an intellectual disability who experienced sexual assault. While some of this ignorance can be attributed to a failure to recognise the pervasiveness of sexual assault, the remainder appears to come from a denial of basic human rights. Discussion with disability workers, parents and people with an intellectual disability in residential and occupational settings revealed significant dissatisfaction with how sexual assault allegations were approached. During the investigation phase of the project a variety of responses by agencies to sexual assault allegations was revealed. These included: * Agencies ignoring the allegation; * Requesting the alleged offender to leave or terminating their employment without a formal investigation; * Requesting the victim leave the facility or harassment of the victim; * Notifying the police and arranging for crisis care for the victim; * Conducting an internal agency investigation and taking action accordingly; * Interrogating the victim in front of other staff members and or the alleged offender; * A failure to ascertain what the victim wished to do about the sexual assault and assisting them in carrying out the decision; * Notifying the licensing body, in this case the Department of Family and Community Services and requesting a formal investigation. Of particular concern for practitioners were frequent instances where the victim did not receive counselling and medical services at the time of the disclosure or referral to services occurred many weeks after the crisis. This often resulted in the victim requiring longer term treatment. It is also resulted in difficulties for the police obtaining evidence and statements from witnesses at the time of the assault or revelation.

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The Victorian (OPA, 1988c) study found that people with an intellectual disability are often reluctant to report crimes to police due to previous bad experiences or repercussions which had followed such reports. Constant experience throughout their lives of being powerless in the face of authority also played a role. Some people with a disability may be unaware that they are a victim of a crime or that they are entitled to seek police assistance. Problems are also experienced by police in interviewing witnesses who have an intellectual disability. Interviewing groups disadvantaged by language, cultural or communication difficulties is not new. Procedures have been put in place to involve language interpreters and some use has been made of interpreters for the deaf. The Anunga Rules developed in 1976 were drawn up to provide guidelines for interviewing Australian Aborigines. The Office of the Public Advocate in Victoria has recommended the extension of these guidelines for use with people with an intellectual disability. Consideration needs to be given to similar provisions in other states. The role of the police interview is often confusing to many victims of crime (Shapland et al., 1985). This can result in difficulties for the person with an intellectual disability and the police. A person under stress can often have difficulties in explaining clearly what has occurred. If this person has an intellectual disability they may have more than usual difficulty in communicating in a stressful situation. Threats against the victim made by the offender may also hinder disclosure of details. If the person also has a speech impediment or problems in expressive language further problems are encountered. Witnesses to the sexual assault may also have an intellectual disability which may pose additional problems for the police investigation. Language used by police and a lack of knowledge of the appropriate words to express the nature of the sexual assault may also hinder clear statement taking. Difficulties in understanding conceptual terms and memory problems may make the person with an intellectual disability appear as an unreliable witness. Police have no guidelines for alternative forms of interviewing and are trained to follow a set procedure of official language and structuring of questions. In June 1988 Victorian Police Standing Orders were amended outlining the procedures to be followed for interviewing people with an intellectual disability. Some of the provisions made in the new standing orders include the presence of a third person to facilitate communication during an interview and the recognition that this should apply to both suspects and witnesses, the need for particular care to be exercised in questioning, and the need for the interview to take place as soon as poss: ible after the matter has come to the attention of the police.'

Legislative provisions. The key issue which needs to be confronted regarding legislation is the benefits and disadvantages of special provisions within criminal codes concerning sexual assault of people with an intellectual disability. It has been argued by some legal people that sufficient protection for victims is contained in sexual assault laws to ensure people with an intellectual disability obtain their rights. Further, to create separate provisions stigmatises people with an intellectual disability. The counter arguments point to the problems that all victims of sexual assault experience in court matters. It is argued that without special provisions, the specific problems of people with an intellectual disability and their heightened vulnerability to sexual assault are ignored. While appropriate legislative protections are important, their

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benefit to victims of sexual assault are limited if adequate procedures are not in place to address the initial complaint and the police procedures for interviewing people with an intellectual disability. This problem is further compounded by the inconsistent way in which allegations are addressed or ignored by disability services. The current situation results in many complaints not coming to light or a failure to proceed due to the concern that people with an intellectual disability will not be competent witnesses.
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The Court System. As stated previously, few matters involving sexual assault of people with an intellectual disability reach the court system. When they do reach court the experience can be one of confusion and mystification. This is true for the general population. However, it is even more difficult for people with an intellectual disability. For example, in a recent court case involving three women with intellectual and physical disabilities who had lived all their lives in a residential facility, their first experience of visiting either the city of Sydney or a court house, occurred when their sexual assault counsellor took them to court to familiarise them with the court surroundings prior to a committal hearing in which they would give evidence, Delays in cases being heard before the courts have been the subject of much debate in NSW. The difficulties caused by long gaps in time before court appearances pose particular difficulty for people with an intellectual disability whose grasp of abstract concepts such as time may be hazy and whose short or long term memory may be affected by their disability, People who may have poor literacy skills do not have the benefit of refreshing their memory of the events surrounding the sexual assault by reference to their written statements. This further disadvantages them in their role as witness for the prosecution. Prosecution of sexual assault matters involving a victim with an intellectual disability is a complex matter which requires additional preparation by the prosecutor. Heavy caseloads are placed on prosecutors, However, if the person with an intellectual disability is to be able to participate effectivelyin the proceedings and for justice to be done, additional time should be allocated to allow the detailed preparation required in these cases, Cross-examination of witnesses is seen as an essential component to ensure natural justice. The language and purpose of cross-examination is thoroughly confusing for the majority of witnesses. A NSW study (Brennan & Brennan, 1988) of language used in courts in relation to child sexual assault matters highlights the difficulties of child witnesses fully understanding the intention of questions and therefore providing often contradictory answers. Similiar experiences occur for people with an intellectual disability. The role of expert witnesses needs to be considered also. In a recent court case the full psychological assessment of the person with an intellectual disability was not presented until all other evidence has been presented. This substantially hindered the courts understanding of the person's abilities and the nature of their intellectual disability. All the previous evidence would have been located in a more realistic context if this evidence was heard first. A failure to do this greatly reduced the person with an intellectual disability's capacity to be understood. Future Directions. People with an intellectual disability are particularly vulnerable to sexual assault

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arising from a historical reluctance to recognise the incidence of sexual assault and attitudes which fail to prepare them adequately for the challenges ofdailyliving and social relationships. These factors have resulted in many people with an intellectual disability being invisible victims of sexual assault. Increasing societal awareness of sexual assault is now resulting in an examination of the specific problems facing people who are intellectually disabled and experience sexual assault. Currently, systems designed to assist them or enforce their rights are failing. Research of the residential, police and legal systems in NSW and Victoria highlight some of the ways in which people with an intellectual disability are disenfranchised and therefore more vulnerable to sexual assault. The next step is to use this knowledge to make sure people with an intellectual disability receive prompt and sympathetic redress if they are sexually assaulted.

References Allan Roeher Institute (1988). Vulnerable."SexualAbuse and Peoplewith an Intellectual Handicap. Canada: Author. Aiello, D. (1986). Issues and concerns confronting disabled assault victims. Sexuality and Disability, 7, 96-101. Australian Bureau of Statistics 1988, Disabled and Aged Persons, Canberra: Author. Berkman, A., (1986). Professional responsibility: confronting sexual abuse of persons with disabilities', Sexuality and Disability, 7, 89-95. Brennan, M. & Brennan, R.E. (1988). Strange Language: chiM victims under cross examination, Riverina Murray Institute of Higher Education. Carmody, M. (1990a). Sexual Assault of People with an Intellectual Disability- Discussion Paper. Sydney: NSW Women's Co-ordination Unit. Carmody, M. (1990b). Sexual Assault of People with an Intellectual Disability - Final Report. Sydney: NSW Women's Co-ordination Unit. Camblin, L.D. (1982). A survey of state efforts in gathering information on child abuse and neglect in handicapped populations. ChiMAbuse and Neglect, 6, 465472. Center for Women Policy Studies (1984). Sexual exploitation and abuse of people with disabilities. Response: To violence in the family and sexual assault, 7, 7-8. Cocks, E. (1985).An Introduction to Intellectual Disability in Australia, Victoria: STAR Victorian Action on Intellectual Disability. Department of School Education, (NSW) (1989). Child Protection:preventing child sexual assault for students with an intellectual disability. Sydney: Author. Department of Health, NSW, (1990). Adult Sexual Assault Data Collection JanuaryJune 1989. Sydney: Author. Department of Health, NSW (1989). Sexual Assault of Persons with a Developmental Disability: A Training Packagefor Health Workers, Sydney: Author. Disability Services and Guardianship Act (1987). Har& S. (1986). Sexual Abuse of the developmentally disabled: A case study. Paper presented at the National Conference of Executives of Associations for Retarded Citizens, Omaha, Nebraska. Kiehlbauch Cruz. V., Price-Williams, D., & Andron, L. (1988). Developmentally disabled women who were molested as children, Social Casework."The Journal of Contemporary Social Work, 69, 411-419. Karjicek, M.J. (1982). Developmental disability and human sexuality. Nursing Clinic North America, 17, 377-386.

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Law Reform Commission of Victoria (1986), Discussion Paper 2 - Rape andAllied Offences, Substantive Aspects, Melbourne: Author. Law Reform Commission of Victoria (1987). Discussion Paper 5 - Rape and Allied Offences: Procedure and Evidence, Melbourne: Author. Longo, R.E. & Gochenour, C. (1981). Sexual assault of handicapped individuals. Journal of Rehabilition July/August/September, 24-27. NSW Crimes Act (Sexual Assault Amendments) 1981, 1986, 1988, 1989. Office of the Public Advocate (1987). Finding the Way."Criminal Justice and the Person with Intellectual Disability, Melbourne: Author. Office of the Public Advocate (1988). Silent Victims:A Study of the DifficultiesEncountered by Fictims of Crime who are Intellectually Disabled, Melbourne: Author. Office of the Public Advocate (1988). The Right to be Heard: Obtaining Evidencefrom Intellectually Disabled People, Melbourne: Author. Office of the Public Advocate (1988). Finding New Ways:A Review of Services to the Person with an Intellectual Disability in the Victorian Criminal Justice System, Melbourne: Author, Schor, D. (1987). Sex and sexual abuse in developmentally disabled adolescents. Seminars in Adolescent Medicine 3, 1-7. Shapland, J. et al (1985). Victims in the Criminal Justice System, London: Gower Publishing House.

Biographical Details. Moira Carmody is a social worker who has worked with both people with an intellectual disability and victims of sexual assault. From 1983 she specialised in the area of sexual assault, working in victims services, training and from 1986-1989 she was the state Co-ordinator of Sexual Assault Services for the NSW Department of Health. Since then she has worked privately as a policy adviser and educator on sexual assault working with a range of agencies, government departments in NSW, other Australian states and New Zealand. Currently, she is teaching welfare students and undertaking research at the University of NSW for a doctoral degree on the issue of rape in NSW.