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Violence linked to vulnerable groups - Children with disabilities (English version)

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A journey through hard numbers and facts

Presentation by Karel Van Isacker at the National conference "Violence and the child of the 21st century - conceptual and practical challenges", 23-24 November 2017, Grand Hotel Plovdiv, Bulgaria

Organisers: University of Plovdiv "P.Hilendarski" ; State Agency for Child Protection, Municipality of Plovdiv

Published in: Education
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Violence linked to vulnerable groups - Children with disabilities (English version)

  1. 1. Violence linked to vulnerable groups Children with disabilities A journey through hard numbers and facts Karel Van Isacker, PhoenixКМ BVBA, Belgium
  2. 2. 2 different aspects • Violence against children with disabilities • Aggressive behaviour and violence by children with disabilities
  3. 3. Violence against children with disabilities • Children with disabilities face significant barriers to enjoying their fundamental rights. – They are often excluded from society, sometimes living in facilities far from their families. – They are also often denied access to basic services, such as health care and education. – They endure stigma and discrimination, as well as sexual, physical and psychological violence. Source: Violence against children with disabilities: legislation, policies and programmes in the EU (2015)
  4. 4. Let’s go back in history • The United Nations created two important documents. – the Convention on the rights of the child (20 November 1989) • Article 19, 1: States Parties shall take all appropriate legislative, administrative, social and educational measures to protect the child from all forms of physical or mental violence, injury or abuse, neglect or negligent treatment, maltreatment or exploitation, including sexual abuse, while in the care of parent(s), legal guardian(s) or any other person who has the care of the child.
  5. 5. Let’s go back in history • The United Nations created two important documents. – the Convention on the rights of people with disabilities (13 December 2006) • Article 16 – Freedom from exploitation, violence and abuse
  6. 6. Reminder! 2 conventions state that ... • Children with disabilities must be protected from violence. • Children and people with disabilities have the same rights to be part of society as everybody else. • Children and people with disabilities must be respected for who they are. • Important – All 28 EU countries signed the Children’s Rights Convention. – 26 EU countries + EU signed the Disability Rights Convention, only Ireland has not ratified the Convention.
  7. 7. Legislation patchwork • only 20 EU countries have laws against the use of physical punishment for children (incl. spanking or using canes). • the laws in some EU countries look at age when discussing violent crime, other countries look at disability, in some countries they look at age and disability.
  8. 8. In reality ... • “Many children” with disabilities are hurt by people who should care for them... but no real figures to substantiate this. • The UN “thinks” children with disabilities are affected by violence four times more than children with no disability (2012 study).
  9. 9. Where do they become victims of violence? • At home – Children with disabilities can be ignored by their families. Families can be tired because they do not get help. Families sometimes do not have enough money to look after children with disabilities. • At school – Children with disabilities are often bullied at school. – Some schools do not change the way they teach. – Teachers are not always trained how to teach these children. • In institutions – Violence also happens in institutions for children with disabilities. – People working in institutions sometimes use force to give medical treatments or make children do what the workers want. – Workers are also often tired as they have too much to do and do not know how to look after children with disabilities.
  10. 10. Other reasons • Financial worries: if a parent has to stop work to look after the child, a vicious circle of poverty can be initiated. Lack of financial state support . • Different ethnic groups : they may treat children with disabilities differently, but a child from this group may have difficulties to look for help. • Girls with disabilities can be victims of violence more often than boys. Sexual violence can be more common. Girls with an intellectual disability may be more at risk.
  11. 11. A child in a Russian state orphanage for children with disabilities. © 2011 Gordon Welters/laif /Redux
  12. 12. Some statements • “There is general intolerance of different people, ‘weaker’ people.” (Provider of outpatient and inpatient healthcare services, Lithuania) • “When you ask someone if individuals with disabilities should have the right to be a part of the majority population, no one says no. But face-to-face with the matter in their daily lives, some people feel that ‘it won’t be possible’ or ‘we don’t have to’ [include them]. So actually we can look at this as a certain form of hidden aggression, […] a sort of persevering in an intellectual stereotype that can actually create a negative relationship with an individual without actually trying to rationally understand him or her.” (Parents’ association representative, Czech Republic) • “Individuals with disabilities are perceived by economically active people as a burden more often in a time of crisis, because maybe this [economically active] person is having trouble finding a job himself.” (NHRB representative, Czech Republic)
  13. 13. • “People with disabilities have been spoken about publicly as being expensive, […] that they are drawing all the financial resources from the other areas. […] I think it can lead to hostility and increased stigmatisation as demanding and selfish.” (DPO representative, Denmark) • “We are probably not doing enough around integration at an early stage, so a lot of people become adults without actually having integrated and mixed with and understood people with disability.” (NGO representative, United Kingdom) • “First of all, awareness. There is a great need for systematically raising public awareness, of promoting a change of attitudes by a variety of programmes targeted at all ages… The thing is that the greatest challenge faced by our society nowadays is the fact that we’re failing to meet the new challenges our children have to handle and they lack good examples in their own family.” (Child rights expert, Bulgaria) • “I think that hostility comes from the lack of understanding [and] the feeling of superiority. If this person is deprived, he is nothing, I am great.” (Therapist in an NGO, Bulgaria) • “Some teachers are willing to provide [support], but they really feel quite alone.” (Public authority representative, Bulgaria)
  14. 14. • “The leading reason for violence is isolation. Regardless which group of children are placed in an institution, isolated and labelled – they will in any case turn into ‘objects’ and into targets of negative societal views. […] Institutions see [children with disabilities] as ‘physical objects’, and in their understanding of humane treatment, this [is reflected in] care towards these children.” (Physician, Bulgaria) • “The mind-set in society is most difficult and slow to change through the years. These children were hidden for long years. They were usually hidden in institutions, away from populated areas […] and society; even our children are not used to seeing them, to accepting them.” (Children’s advisor and expert, Bulgaria) • “Very often we are surprised by the people [with disabilities] themselves because in certain situations they don’t regard such acts as being discriminatory against them. This is why they don’t often lodge a complaint.” (Public authority representative, Portugal) • ”People […] think that no-one wants to have sex with someone with a disability. Therefore people believe that nothing can happen to them.” (NGO representative, Sweden)
  15. 15. • “The parents are ashamed that they gave birth to such a child, someone with ‘defects’, who is not like the others and is not deserving. The child him/herself honestly believes that he/she is unable and does not deserve more and that he/she is just that – a bad child.” (Representative of NGO working on inclusive education, Bulgaria) • “If you take into account that one of [children with disabilities’] needs is to not be singled out as special all the time, then it would be good if that were not the case in an anti-bullying programme either.” (NGO representative, the Netherlands) • “Serious forms of violence are met at schools as usually older students harass younger ones or children who are physically weaker or shyer than other children, so such negative acts are actually a result of complex reasons and influences, where a particularly important factor is attitudes in society and tolerance towards violence.” (Ministry official, Bulgaria) • “Unfortunately this aggression which is directed towards the child leads sometimes to the creation of negative attitudes in the child and he/she refuses to go to school. Then very often they isolate these children in the individual form of education i.e. the school comes to their homes, but this isolates them because for children with disabilities the most important thing is […] to achieve social skills [and not be] locked at home.” (NGO representative, Bulgaria)
  16. 16. • “It is true that children who are now integrated in [mainstream] education face resistance. Parents of other children do not want to have a child with disability in their children’s class.” (NHRB representative, Bulgaria) • “Very early the children internalise that they are not like the other children, that they are ‘worse’ and ‘more stupid’ because they do not cope with the school material, and that they are spoiled, lazy and, when at school, they already know that they are not worthy.” (Representative of an NGO working on inclusive education, Bulgaria) • “[Socioeconomic position] is the biggest factor that determines whether you will or will not get good care, whether you will or will not get a good education, whether you can or cannot sufficiently participate in society. With children with disabilities that is just exponentially more.” (Healthcare inspectorate representative, the Netherlands) • “Unfortunately there is more and more evidence that children are being bullied because of poverty. Poverty compounds these issues for children with disability.” (NHRB representative, United Kingdom) • “Being a foreign person with disabilities is one of the worst possible situations because s/he has the double face of difference.” (Representative of the national teachers’ support organisation, Italy)
  17. 17. • “Most complaints reflect the fact that in poor families, especially those with disabled children, neglect and hostility manifests more often. I have worked on cases where mothers claim that the siblings of her disabled child have developed an aggressive attitude to their little sister because they believe that most of the family income gets invested into overcoming her impairment. So, social services should account for that.” (NHRB representative, Bulgaria) Any violence inflicted on disabled children will further induce their disability level, increase rehab & recovery challenges, and induce their resistance against treatment effects.
  18. 18. Needed steps • More people with disabilities need to be told about what to do when they are victims of violence. • More professional people like teachers, social workers, need to be able to recognise violence.
  19. 19. Spotlight on Bulgaria • Childhood for everyone – In 2010, Bulgaria adopted a “Vision for deinstitutionalisation of children”, which aims to close down all 137 institutions for children and to provide alternative community services for all vulnerable children by 2025. – Link: Bulgaria, State Agency for Child Protection, see: http://sacp.government.bg/detstvo-za-vsichki • Coordination mechanism for interaction on cases of child abuse or children at risk of abuse and for interaction in crisis intervention – The coordination mechanism is in place since 2010. When notice of abuse is given, it requires a designated caseworker to conduct an investigation within 24 hours and convene a meeting with a multidisciplinary team, including a wide range of professionals, and, in some cases, municipality representatives, the regional police department, the regional healthcare centre, the child’s personal doctor, the director of the school, kindergarten or other service-providing unit, and others. – Link: Bulgaria, State Agency for Child Protection, see: http://sacp.government.bg/deinosti/sporazumenie-deistvia-deca-risk/.
  20. 20. Available material • Making life a safe adventure - Strengthening families of children with disabilities to prevent maltreatment – A multidisciplinary team from various DPOs prepared a booklet on preventing the maltreatment of children with disabilities in domestic environments. It highlights the importance of the family and of its strength and needs, and seeks to counter feelings of frustration, omnipotence or superiority among professionals by providing them with a concrete and – perhaps for some – new perspective on their work. – The booklet primarily targets professionals whose work involves supporting the well-being of children with disabilities and their families. – The booklet was funded under the Daphne programme and is available in English, Estonian, German, Greek, Italian, Latvian, Polish and Portuguese. – Italy, AIAS Bologna, see: http://www.aiasbo.it/progetti/daphne/daphne_publications.html.
  21. 21. Available material • Childhood, Disability and Violence - Empowering disability organisations to develop prevention strategies – This booklet aims to promote awareness among associations and cooperatives of people with disabilities and their families about the issue of domestic violence against children with disabilities. As such it is basically concerned with emancipation and with helping these organisations to develop their own view on the phenomenon. The booklet targets leaders and staff members of disability organisations that want to discuss the issue of maltreatment within the organisation or with their external network and it provides quality information written by peer organisations. – The booklet was funded under the Daphne programme and is available in English, Estonian, German, Greek, Italian, Latvian, Polish and Portuguese. – Italy, AIAS Bologna, see: http://www.aiasbo.it/progetti/daphne/daphne_publications.html.
  22. 22. Aggressive behaviour and violence by children with disabilities • We all have a reactivity to situations that produce anger, fear, or threat as examples, and most of our instinctive reaction is to protect ourselves physically. – Within those patterns of reaction, aggression is a frequent one. • Aggressive behaviour is common among youth, especially young children. • However, families and health professionals can take steps to help reduce violence and aggression. – Stay calm – Praise positive behaviour – Work with the child’s health professional.
  23. 23. • Examples of physical aggression: – Biting – Hitting – Kicking • Examples of verbal aggression: – Saying “no” to parents’ or teachers’ rules – Screaming or shouting – Using foul language • Anger or frustration of toddlers is usually reactive or impulsive in response to something that has happened to them. • As children grow and develop more advanced language, social skills, and planning ability, proactive or planned aggressive behaviour may become more common.
  24. 24. • Children with disabilities – Not more violent or aggressive than other children. – However: • Some children may feel a lot of frustration related to their disability. • This frustration is sometimes shown through aggression or even self-harming behaviours, such as banging their head or cutting their skin. – Other children have conditions that are more directly connected to aggressive behaviour. • E.g. children with ODD (Oppositional Defiant Disorder) are often annoyed and angry, and they argue with adults in order to gain control. • Children who have a learning disability, or autism, or ADHD or something very similar, may have episodes of explosive emotional overload where they physically attack their family, often focussing on their own mother.
  25. 25. – Many reasons for aggression problems. • Everyone has times when they get frustrated or angry, and children should be taught that frustration is normal. • It is best to try to understand the reasons behind the aggression and violence. • Knowing this will help parents and health professionals work toward reducing the problems; teaching the child ways to cope with frustration should be part of this plan. – But, while these children are often mostly wonderful for the vast majority of the time... • When something triggers them, the level of violence they are capable of is frightening in the extreme.
  26. 26. – Aggressive or violent behaviour can be a very difficult and discouraging issue to manage • Especially for special needs parents and caregivers. – Violent behaviours hinder progress in • Education • in becoming mature in personal independence and social skills.
  27. 27. IASO (Immature Adrenaline Systems Over-reactivity), Aggressive Behaviour* • Who is affected? – Autism spectrum (hyperfunctioning of local neural microcircuits in the brain which produce hyperreactivity and hyperplasticity, over 50% affected**) – Bipolar disorder – Developmental disabilities – Obsessive compulsive disorder – And ... children without disabilities *See “Hope for the Violently Aggressive Child”, by Dr. Ralph Ankenma, 2014 ** https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4160737/
  28. 28. • Aggression is not part of most mental illnesses, but ... – Mental illness can set the stage for aggression to occur more often and more unpredictably as a secondary symptom. – How? • Autism and other developmental disabilities hinder normal maturing of the adrenaline arousal system (an instinctual, physical response to crisis or danger.) • An immature or dysfunctional adrenaline arousal system more easily triggers aggressive rage and violence, sometimes in unexpected situations.
  29. 29. – Adrenaline over-reactivity (alpha type): • Becomes more violent if there is any attempt to hold or restrain them • Personality seems changed, i.e. becoming hateful with swearing and threatening. • Threatens to kill or harm others or claims to hate people they love • Aggression seems focused and deliberate toward particular people or targets • Eyes may appear dilated, unfocused, or nonresponsive • Does not apologize or seem remorseful • Denies certain behaviors happened or seems not to remember the event
  30. 30. – Adrenaline over-reactivity (beta type): • Certain adults can calm the child quickly by talking to or holding them • Has sudden explosions of anger when frustrated • Randomly hits out at whatever is nearby • Says that they tried to stop but could not • Becomes flushed (face or body reddens) • Apologizes or seems remorseful • Complains that their heart was beating fast or hurting during the episode • During episodes or when excited, has hand or finger tremors • Bites or picks at fingernails or skin • During episodes is unusually strong • Is usually very physically active • Tends to run a high resting heart rate (90 beats per minute or above)
  31. 31. How to solve? • Looking at the aggressive behaviour as an ABC sandwich: – Antecedents: these are ‘triggers’ for the aggressive or self-injurious behaviour – Behaviour: this is the way your child responds to the trigger – Consequences or ‘rewards’: this is what your child gets out of behaving aggressively, like being allowed to go on with a favourite activity, or to leave a stressful situation. • A better long term strategy is to: – Prevent the behaviour by avoiding situations that trigger it – Teach your child to express his needs in a more positive way – Ignore self-injurious behaviour and reward your child when he expresses himself in a more positive way.
  32. 32. • No single way to reduce aggression and violence in all children – Medication such as adrenaline blockers in (see IASO) – Try to create an environment in which violence and aggression are less common • Walk the talk! Do not use aggression or violence yourself. • Do your best to keep your home life calm, supportive, and respectful. • If your child is acting aggressively, reinforce alternative or competing behaviours. For example, have a drawing pad handy, or play a game that requires your child’s calm attention. • Be sure to praise good behaviour immediately and often. • Help your child articulate his or her feelings. Talking through their emotions helps children of all ages. • Work with your child to develop strategies to calm him or her when he or she feels scared, angry, or frustrated.
  33. 33. • For some children, it is best to explain consequences for misbehaviour ahead of time. It is important that the child understands the consequences before they are enforced. • Once you have set up consequences, enforce them! If bad behaviour is not addressed regularly, it may continue or even get worse. • Notice when and where your child is most aggressive or violent, and try to avoid those places. • Tell your child’s healthcare providers as many details about your child’s behaviour as possible. He or she will be able to offer tips and work with you to develop a plan.
  34. 34. Interesting (EU) projects that address these topics... • www.accessinteract.eu • www.games4competence.eu • www.isg4competence.com • www.inclusivemartialarts.eu • www.mypeermentor.eu • www.leisure4youth.eu • www.countto10.bg • www.teachers4refugees.eu
  35. 35. Good references • 2009 Violence Exposure Among Children with Disabilities.pdf • 2012 Prevalence & Risk Factors of Violence against Children with Disabilities (Sys. Rev. & Meta-analysis).pdf • 2015 Sexual Abuse involving Children with intellectual Disabilities.pdf • WHO 2005 Summary Report Violence against Disabled Children.pdf
  36. 36. Contact me • karel@phoenixkm.eu • +32 496 334056 • More info at www.phoenixkm.eu

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