Violence Against Disabled Children
Children who live with a physical, sensory, intellectual or mental health disability are among the most
stigmatized and marginalized of all the world’s children. While all children are at risk of being victims of
violence, disabled children find themselves at significantly increased risk because of stigma, negative
traditional beliefs and ignorance.  Lack of social support, limited opportunities for education, employment or
participation in the community further isolates disabled children and their families, leading to increased levels
of stress and hardship.  Disabled children are also often targeted by abusers, who see them as easy victims.  

This report presents the findings of the Thematic Group on Violence against Disabled Children, convened by
UNICEF at UN Headquarters in New York providing comments and recommendations on violence against
disabled children to be made available for the UN Secretary General’s Report on Violence against Children.  
In this report, key issues on violence against children with disabilities will be reviewed.  Some of the issues
raised will be familiar to those who work on violence against children.  Other issues will be disability-
specific and even experts and advocates on violence against children may be unfamiliar with them or have
not thought deeply about the implications that such practices have in relation to violence against and abuse of
disabled children.

It is important to note that the factors that place disabled children at increased risk for abuse are often
related to social, cultural and economic issues, and not to the actual disability itself.  As such, interventions
that address violence and abuse against disabled children can and should be effective if implemented with
concern and resolve.

It should be noted at the outset that:
•        The number of children and adolescents with disability are significant. While calculations vary
depending on the specific definition of disability, using the World Health Organization’s definition of
individuals with a disability as individuals having a physical, sensory (deafness, blindness), intellectual or
mental health impairment, some 200 million children -  10% of the world’s young people – are born with a
disability or become disabled before age 19.
•        Disabled children must be included in all programs intended to end violence towards and abuse of
children.  Disabled children cannot wait until issues of violence and abuse are fully addressed in non-disabled
children.  The reasons for this are two-fold:  1) the lives of disabled children are no less valuable than the
lives of all other children and the short- and long-term consequences of violence and abuse for them are no
less severe; and 2) violence against children as a global problem will not be solved unless violence against the
world’s million of disabled children is included as part of the overall solution.

Background

According to researchers, children with physical, sensory, intellectual or mental health impairment are at
increased risk of becoming victims of violence.  While the amount of research available on this population is
extremely limited, particularly for disabled children in the developing world, current research indicates that
violence against disabled children occurs at annual rates at least 1.7 times greater than their non-disabled
peers. (1)  More targeted studies also indicate reasons for serious concern.  For example, one group of
researchers report that 90% of individuals with intellectual impairments will experience sexual abuse at some
point in the life, and a national survey of deaf adults in Norway found 80% of all deaf individuals surveyed
report sexual abuse at some point in their childhood.

The specific type and amount of violence against disabled children will vary depending upon whether it
occurs within the family, in the community, in institutional settings or in the work place.(4) There are
however, several key issues that appear time and again when such violence occurs.  Most striking is the
issue of reoccurring stigma and prejudice. Throughout history many – although not all – societies have dealt
poorly with disability.  Cultural, religious and popular social beliefs often assume that a child is born with a
disability or becomes disabled after birth as the result of a curse, ‘bad blood’, an incestuous relationships, a
sin committed in a previous incarnation or a sin committed by that child’s parents or other family members.

A child born in a community where such beliefs exist is at risk in a number of ways.   A child born with a
disability or a child who becomes disabled may be directly subject to physical violence, or sexual, emotional
or verbal abuse in the home, the community, institutional settings or in the workplace.  A disabled child is
more likely to face violence and abuse at birth and this increased risk for violence reappears throughout the
life span.  This violence compounds already existing social, educational and economic marginalization that
limits the lives and opportunities of these children.  For example, disabled children are far less likely than
their non-disabled peers to be included in the social, economic and cultural life of their communities; only a
small percentage of these children will ever attend school; a third of all street children are disabled children.  
Disabled children living in remote and rural areas may be at increased risk.

Settings

Violence in the home and family:
In societies where there is stigma against those with disability, research
indicates that some parents respond with violence because of the shame the child had brought on the family
or respond with violence because a lack of social support leads to intense stress within the family.  Among
the violent manifestations of this are:

Infanticide & mercy killings: Disabled children may be killed either immediately at birth or at some point
after birth; and sometimes years after birth.  The rational for such killings is either 1) the belief that the child
is evil or will bring misfortunate to the family or the community or 2) the belief that the child is suffering or
will suffer and is better off dead.  Often called “mercy killings” such murders are usually a response to
societal beliefs about disability and lack of social support systems for individuals with disability and their
family, not the actual physical condition of the child him or herself.  In ‘mercy killings’ a parent or caretaker
justifies withholding basic life sustaining supports (usually food, water and/or medication) or actively takes
the child’s life through suffocation, strangulation or some other means, with the intention of “ending
suffering.”  

What links such behaviors together is that the cause of death is not the child’s disability, but actions taken
on the part of the child’s parent or caretaker.   Importantly, the actions of the parent or caretaker are often
not taken in isolation.  The decision to end the life of a disabled child may be prompted either directly with
advice and counsel of medical, social, and religious leaders or family members.  It may be prompted
indirectly through lack of social, economic and medical support networks that leave parents feeling isolated,
depressed and desperate. Cases where parents decide to end the life of a disabled child because they
themselves are ill or aging and fear their child will be subjected to abuse or neglect after their own deaths are
particularly heartrending.  That communities often do not prosecute such forms of homicide or let the
perpetrator go with a reduced punishment is recognition from the surrounding society of the lack of support
and encouragement given to caring for and raising a disabled child.  Importantly, in some societies, there are
also often gender differences, with disabled girl infants and girl children more likely to die through ‘mercy
killings’ than are boy children of the same age with comparable disabling conditions.

Physical violence, sexual, emotional and/or verbal abuse of the disabled child in a violent
household:
 While many parents are violent towards children where no disability exists, when a disabled
child lives in a violent setting his or her disability often serves to compound and intensify the nature and
extent of the abuse.  For example, a mobility impaired child may be less able to flee when physically or
sexually assaulted.  A child who is deaf may be unable to communicate about the abuse he or she faces to
anyone outside his or her household, unless these outsiders speak sign language or understand the home
signs the child uses.  (And when the abuser is the one interpreting the child’s statement to someone outside
the household, this further limits the child’s ability to report abuse or ask for help).  A child who is
intellectually impaired may not be savvy enough to anticipate a parent’s growing anger or know when to
leave the room to avoid being struck.

Theory of child induced stress leading to violence:  Several theories of child abuse state that a disabled
child faces increased risk as the result of child-produced stress.  It is hypothesized that this cycle of
increasing tensions can begin long before the child is diagnosed as having a disability.   For example, a child
with a hearing impairment may be regarded as disobedient; a child with vision problems may not make eye
contact and appear to be unresponsive, a child with a neurological disorder may be difficult to comfort or
feed.  Other researchers suggest that parents who become violent towards their disabled child are reacting
not to the child’s condition alone, but to the social isolation and stigma they encounter from surrounding
family, friends and neighbors. Parents of disabled children often lack social supports as family and friends
distance themselves;  they can find no school willing to take their child or they live in communities where
there are few or no social services to help them with their child’s needs. It is possible that both child-
produced stressors and social isolation are compounded to produce a stressful and potentially violent
situation in a household coping with a disabled child.  It is also true that not all households with disabled
children are violent and even within the same communities there are coping mechanisms in some families
that prevent violence, while children with identical disabilities in other households are subjected to violence.  
As with many aspects of violence towards disabled children, at this point, much more research is needed to
allow us to adequately understand the factors that inhibit or foster violence towards these children.

Neglect as a precursor to violence:  Parents may respond to the stress of caring for a disabled child with
neglect rather than active violence, however when this neglect involves denial of food, medicine and other
life sustaining services, it must be considered a form of violence.  For example:

Neglect in providing basic/life sustaining care: The disabled child in a household may receive less food,
medical care or other services.   This can be subtle, for example, parents or caretakers may wait a few
additional days before spending scarce money for medicine or the child may receive less food or less
nutritious food than his or her sibling.  The response can also be direct: refusal to continue to feed, house or
cloth a child after he or she has been disabled. Such neglect can lead to further impairments in a vicious
feedback feed back cycle in which the disabled child continually loses ground developmentally.

Neglect to provide disability-specific care: Disability-specific health concerns are exacerbated through
neglect.  For example, bed sores go unattended resulting in a potentially deadly systemic infection or a
disabled child who needs assistance eating will become malnourished because no one takes enough time to
adequately feed him or her.

Refusal to intervene: Family, neighbors, health care professionals or social service experts may be aware
that a disabled child is being abused by parents or caretakers in the home, but are unwilling to intervene,
rationalizing such violence by citing stress on parents or lack of alternative care arrangements.  While
deciding when to intervene to stop violence against children in the home is an issue in many societies, the
neglect highlighted here is when a community does not stop violence against a disabled child that would be
considered intolerable if perpetrated against a non-disabled child.  

Gender specific neglect:  Such neglect may be further exacerbated by gender – for example, in a study
from Nepal, the survival rate for boy children several years after they have had polio is twice that for girl
children, despite the fact that polio itself affects equal numbers of males and females. Neglect, in the form of
the lack of adequate medical care, less nutritious food or lack of access to related resources, is the apparent
cause of these deaths.

Violence and abuse linked to social isolation.    

Child is shunned within the household, with few family members talking to him or her or overseeing his
or her safety

The child is not allowed to leave the house or household compound.  In some cases, the child is kept
home to ensure his or her own safety, as parents fear that the child may be struck by a cart or abused by
someone in the neighborhood.  But in many other instances a child is kept isolated because the family fears
the reaction from other members of the community.  Children in some communities are kept shackled in
windowless storerooms, hot household courtyards or dark attics for weeks, months or years, often with
little or no interaction, even by those within the household.  Next door neighbors may not know of the child’
s existence and family members across town may be told that the child has long since died.

Abuse by support staff within the home – Parents and caretakers of disabled children must often call
upon informal networks of family, friends and neighbors or formal networks of in-home nursing and
attendant care to help with child care, rehabilitative or medical support.  

In such instances: Physical, sexual, verbal and emotional abuse may take place by caregivers without the
parent’s knowledge or while the parent is away.

Parents may be aware of or suspect abuse, but feel there are no alternatives to help with the care of the
disabled child and thus be unwilling to admit, confront or cancel the services they receive.  

Barriers to intervention: Social service and child advocacy agencies may be aware that a disabled child is
the victim of violence or neglect, but choose to keep that child in the household because there are few or no
alternative foster care or safe, temporary residential care facilities that are disability accessible or willing to
take in a disabled child The response of disabled children themselves to on-going violence within the home is
dictated by a number of factors. They may be:

•        Unaware that the abuse and neglect is unacceptable – in part because unlike the non-disabled child,
they have little contact with others outside the household.
•        Be aware that this type of behavior is unacceptable, but be unable to physically contact or
communicate with individuals outside the household who could help them
•        Be aware that this type of behavior is unacceptable, but fear loss of relationship with care giver or
family member.   While this is an issue for many children in violent households, for disabled children
dependent on their abusers for physical care, communication with the outside world or other disability-
specific concerns, these issues are more complex.
•        Be aware that this type of behavior is unacceptable, seek to alert authorities, but are not listened to or
believed.

Violence in Educational and Custodial Settings

Millions of disabled children around the world spend part or all of their lives in institutional settings, be it in
schools within their communities, disability-related residential schools, institutions or hospitals, or in the
criminal justice system.  In all cases, being disabled increases and compounds their risk for becoming
victims of violence.

Non-residential schools:  Sadly, victimization of disabled children in school can begin even before the child
enters the schoolhouse door:

•        
Traveling to and from school:  Because educational facilities for disabled children are rare, many
children travel long distances to school.  Reports of physical and sexual abuse by those responsible for
transportation to and from school are common.  For example, a recent study in the United States reported
that 5% of all disabled students reporting sexual abuse were abused by bus drivers on their way to or from
their schools. (7)   
•        
Physical threat of violence: Disabled children are often bullied, teased or subjected to physical
violence (being beaten, stoned, spit upon, etc.) by members of the community on their way to and from
school
•        
Victims of crime: Disabled children are often targeted by predators on their way to and from
school.   For example, perpetrators of violent crimes, including robbery and rape, often target students on
their way to schools for the disabled, believing them to be more vulnerable and less likely or able to report
crime or abuse.  Students with sensory impairments (deafness or blindness) and students with intellectual
disabilities seem to be at particular risk.

Violence Inside the Classroom

•        Teachers: Disabled children are often beaten, abused or bullied by teachers, particularly untrained
teachers who do not understand the limitations of some disabled children.  Children with intellectual
disabilities and children with hearing impairments are particularly at risk, but reports worldwide find that all
disabled children are potential victims. Sexual abuse by teachers is also widely reported for both male and
female students.
•        
Fellow students: Teachers that humiliate, bully or beat children not only directly cause harm to the
child, but model such behavior for other children in their classroom, who may follow the teacher’s lead in
physically harming, bullying and socially isolating the targeted disabled child. Sexual abuse by fellow
students is also a concern and is often linked to physical violence and bullying behaviors by such classmates.
•        
School staff: Individuals who work as teacher’s aides or attendants for disabled children, or help
transport, feed or care for such children, are often underpaid, overworked and largely unsupervised.  While
many who undertake such career choices do so out of the best of motives, others choose these jobs
because it allows easy access to the most vulnerable of children.  A study from the US, found that 11% of
all those working as teachers’ aides, transportation staff or school janitorial staff in programs that served
disabled children had previous criminal records, many related to child abuse or sexual abuse.
•        
Lack of reporting mechanism:  Few schools have mechanisms in place that allow students, parents
or caregivers to complain about violence or victimization.  This is all the more serious because in many
communities there are only a handful of schools or educational programs that are available for disabled
children.  Parents/caregivers or children may hesitate to complain about violent or abusive behavior in the
school, fearing that they will be dismissed from a program when no alternative exists.  Of equal concern,
few schools have systems in place to allow school staff to report abuse they have observed on the job.

•        
Violence in Residential schools:  In a number of countries, children with specific types of
disabilities, (particularly children who are deaf, blind or intellectual impaired) are educated in residential
schools, where they may live away from their families for months or years.   In addition to the potential for
victimization noted above for disabled children in the classroom, additional concerns for violence against
disabled children must be noted for residential schools:
•        Housing at residential schools: Children who live in dormitories or are boarded out with local families
are often subject to both physical violence and sexual abuse.
                    
Institutions  

In many countries, disabled children are placed in institutions at birth or as toddlers and remain there until
death.  It is important to note that while institutions continue to be considered the norm for disabled children
in many countries, in fact, until two hundred years ago, few institutions existed. Prior to the establishment
of institutions, it was expected that disabled children would remain with their families, living in the
community throughout their lifespan.   In recent years, a growing number of Disability Rights advocates as
well as human rights advocates and experts in law, pediatrics, public health and rehabilitation have called for
the closing of institutions for disabled children and a return to community-based living.  Certainly all available
data show that children in institutions do far worse socially, educationally, medically and psychologically
than children raised in supportive community settings.  While institutionalization itself can have serious
physical and psychological effects on children, violence against disabled children in institutions is of grave
concern – and particularly widespread.  Globally, the following issues appear with frequency:

Victims of violence:  Disabled infants, children and adolescents in institutions around the world are
routinely subjected to physical violence and sexual, verbal and emotional abuse by staff, visitors and fellow
patients.

Profound neglect - (neglect to the point where it is life threatening):  Disabled children are often kept
in environments that can only be described as inhumane.  Institutions for disabled children are often at the
bottom of government priority lists and lack adequate funding, consistent support or oversight from
government or civil society.  Institutions are often overcrowded, unsanitary and suffer from lack of both
staff and resources which leads directly to avoidable suffering and death.  Among abuses reported within the
past several years that should be noted in any discussion of violence against disabled children are:

Dangerous facilities that foster violence:  In many institutions, infants, children and adolescents with
disability are kept in overcrowded wards. These children have little or no physical contact with caretakers,
lying for hours or days unchanged on urine soaked mattresses and suffering from undernourishment and
malnutrition.  They receive little or no stimulation in the form of individualized adult attention, toys or
attempts at toilet training, self-care or education.   Children who are considered demanding or troublesome
may be inappropriately restrained - chained to their beds, straight jacketed, have plastic soda bottles taped
over their hands, beaten or medicated so they do not disturb the staff.   Accounts of disabled children being
placed in cages, cells or pits come from institutions around the world.

Such conditions are not only inhumane in themselves but are also an invitation to further violence: reports of
physical violence and sexual, verbal and emotional abuse by staff, visitors and other patients in these
facilities come from institutions on every continent.   A Human Rights Watch Report found the death rate
among institutionalized disabled children in several countries in Eastern Europe was almost twice that for
children in the general population and for disabled children who are kept at home; in Chinese orphanages,
where a significant proportion of all admitted children are disabled, the mortality rates in some institutions
over the life of the children in their care, exceeds 75%.

Under-staffing of institutions: One consequence of the lack of adequate funding, severe understaffing,
with staff/ patient ratios in some facilities for disabled children reaching more than one hundred children for
each adult staff member.  As noted above, children are not only left unattended for long periods of time
during the day, but overnight entire wards are often unattended or padlocked with only a skeletal night shift
to oversee facilities with hundreds of children.  There is often no oversight, and physical and sexual abuse in
such instances is rife.   

Staffing of institutions for disabled children presents an additional problem. Because such work is
demanding, low paying and lacks social status, administrators must often settle for staff that is unskilled and
increasingly overworked. Among the regularly reported issues that arise with such staff are the following:

Lack of understanding of child capabilities: Staff who lacks training and background on disability can be
quick to lash out at disabled children either because of frustration with the job or lack of understanding
about the limitations of the children in their charge.  Training of staff around issues of violence or abuse is
rare or non-existent, meaning that the problems are not addressed.

Targeting of children:  The low pay, low social status, long hours and hard working conditions in many
institutions means that workers are hard to find and administrators are quick to hire anyone. Background
checks on personnel often are not done.  This allows some individuals, intent on harming or sexually
exploiting children, to regularly seek work in such institutions. As is the case of caregivers and workers in
day schools and special education programs cited earlier, individuals with criminal histories of child abuse
and sexual exploitation are attracted to jobs that allow them easy access to children.  Severe understaffing,
lack of oversight and reluctance to prosecute abuse against disabled children; make institutions particularly
susceptible to these staffing problems.  Reports also indicate that because of lack of a registry or oversight
of such predators when an abusive employee is discovered it is not uncommon for that individual to be fired
from one institution and soon turn up working at another institution for disabled children nearby.

Lack of discrete facilities for children: In many institutions, disabled children are cared for on the same
floors or in the same wards as adults.  In fact, in some institutions, adult patients are pressed into service to
help care for disabled infants and children. This is particularly true in mental health facilities and institutions
for those with intellectual impairments.  In overcrowded and poorly staffed institutions, oversight or
guidance of adult patients as they care for disabled children is rare.  The opportunities for abuse are rife and
common, further compounded by the fact that the adult patients, now abusing the disabled children, may
themselves have been victims of similar violence when first institutionalized as children.

Lack of heat and food: Under-funding creates other risks for disabled children.  For example, because it is
widely believed that individuals with intellectual disabilities and mental health impairments cannot feel the
cold, to save money, in some institutions in Eastern Europe, even in the dead of winter, the heat is routinely
turned off overnight.

Lack of oversight/ monitoring: Many institutions have historically been set in isolated areas far from urban
centers.  While the tranquil country existence was at one time believed to be beneficial to patients and staff,
such locations also assure that there will be few visits from family, and little oversight by government,
public health officials, members of the general public, or the press. Even institutions in the middle of large
urban areas routinely isolate children from the surrounding community through         tightly restricted
visiting policies that deny easy access to family, community leaders and the press.  

Children in such institutions are often further isolated when they are rarely or never allowed to leave the
grounds of the institution.  Indeed, many urban schools are surrounded by high walls or fences to make sure
that the children are visually as well as physically and socially isolated from the urban landscape that
surrounds them. The result is that in institutions where violence is a problem, oversight from the wider
community has historically been difficult to         maintain and even today, this presents major challenges
that must be addressed.  Moreover, few institutions have any internal reporting or oversight mechanism that
would allow staff or visitors who witness abuse to report it.  Even fewer institutions have any internal
mechanism that would allow children who are being abused to report the abuse to responsible parties within
or outside of the institution to ensure that their complaints are investigated and acted upon.

In addition, children in institutions may hesitate to identify their abusers for the same reasons that children
are afraid to identify abusers in their household or in the community: They fear physical, sexual or         
psychological reprisal; they fear loss of attention or affection from         individuals on whom they have
come to depend; they fear they will not be         believed and they fear that they will be blamed or otherwise
embarrassed         or humiliated.

Guardianship: Mechanisms for children to report abuse by staff do not exist in many countries.  This is
further complicated where institutions hold legal guardianship over disabled children.  In such situations, the
right to request outside review or intervention to end violent situations can be denied by the very institution
in which the abuse is occurring, on the grounds that the institution holds the legal guardianship over the
abused individual and is therefore entitled to decide for that individual what services or interventions are
needed.

The Criminal Justice System

While disabled children are often discussed in terms of special education and institutionalization, it is
important to note that disabled children are also disproportionately represented in the criminal justice
system.  Furthermore, once in the system, they often fare far worse than their non-disabled peers. Such
findings have been reported since the early work of Gunnar Dywad in the 1940s, when it was found that a
significant number of children in the criminal justice system in Europe and the United States were
intellectually disabled or had mental health impairments.

Disabled children are at risk for a number of reasons.  They are more likely than their non-disabled peers to
have no schooling available or to leave school early due to abuse and lack of appropriate educational
opportunities and because of this, are much more likely to wind up on the streets.  Indeed, as noted earlier,
UNICEF estimates that perhaps a third of all street children may have some type of disability. (12) Once on
the streets they are at risk of being talked into taking part in criminal activities often by non-disabled
individuals who see them as pawns. For example:

•        Psychologists suggest that because many disabled children have been socially marginalized growing
up, they are more easily talked into things because they are particularly anxious to please others and to feel
included.    
•        Such children are at increased risk of being caught and incarcerated, as they are less adept than their
non-disabled peers in discerning when to run from the police and less capable of talking their way out of
situations when stopped and questioned or picked up as vagrants.
•        Such children are also often less adept then their peers in understanding what they need to do and say
once they are in the criminal justice system, thus lessening their chances to get out of trouble, explain their
actions to lawyers or counselors or making a compelling witness in front of a jury
•        Once incarcerated, either in an adolescent facility or an adult prison, such children are at risk of
bullying and violence.  They are also at greatly increased risk of sexual exploitation.

Additional concern:
•        Human rights organizations report that in some countries where large and growing numbers of street
children are considered a threat to the urban life, there have been systematic killing of these children by the
police death squads.   Disabled street children – less likely than their non-disabled peers to protect
themselves or flee from the police, may be at increased risk in such situations.

Community Based Violence

In the preceding sections various forms of violence against disabled children in the family and household
have been identified, as well as risks in educational and custodial institutions.  Children with disability
however, are also part of the wider community and unfortunately here as well, are at increased risk for
violence.   Stigma and prejudice allows some members of the community to see disabled children as easy
targets of rage, anger or sexual aggression.  They are at increased risk because they are physically
vulnerable and in some cases, emotionally needy.  Also importantly, disabled children are vulnerable because
the current systems of protection that societies have in place for other children are inaccessible to or
unresponsive to many disabled children.

Socially sanctioned violence: Stigma against children who are disabled can result in socially sanctioned
violence against these children in the community.  Such violence is sometimes perpetrated by those who feel
that such children are a threat to others through words, actions or their very existence.   Often, violence is
perpetrated by those who feel that such children have little value and so consider them easy victims for
physical harm, sexual abuse or other forms of aggression.  Violence can come at the hands of adults, but it
can also come at the hands of non-disabled children and teenagers – who can physically, sexually, verbally
and emotionally (tease and bully) abuse such disabled children.  While violence by non-disabled young people
is sometimes done by individuals, groups or gangs of non-disabled children can be particularly cruel to their
disabled peers. Importantly, socially sanctioned violence does not mean that everyone in a community will be
violent towards disabled children, but it does mean when such violence occurs, many will not intervene to
stop it and often, will look on the child’s suffering as ‘normal’ or even as something that is amusing or
entertaining.

Easy victimization:  Disabled children are often victims of violence         because they are easily harmed.  
Some are physically unable to protect themselves         or flee from their attackers.  Children who are deaf
may be unable to report what has happened to them to family or police if these people do not speak sign
language.  Blind children who are victims of physical violence or rape often have a hard time describing their
aggressors in ways that others can understand – (although they are often able to provide a great deal of
information if people around them take the time to listen to their descriptions).   Children who are
intellectually disabled or mentally ill may have a difficult time providing coherent descriptions of those who
have harmed them.  

The Need for Social inclusion: Additionally, research indicates that many disabled children, already
marginalized and stigmatized, are desperate to make friends and be included.  Because of their need to feel
included, some may be more easily manipulated, and be willing to put up with physical violence, sexual
abuse or bullying, as long as these fragile young people are allowed to hang around and feel included.

Inaccessibility of legal services:  In many countries, the criminal justice system is inaccessible to those
with disabilities.  Police stations and court houses that can only be entered by steps are inaccessible to        
wheelchair users and a lack of sign language interpreters bar deaf individuals from reporting crimes. The
lack of explanation and support for individuals with intellectual disabilities or mental health problems means
that many individuals with these disabilities find the act of reporting violence or giving testimony against an
abuser or otherwise seeking justice is too complicated to pursue.  Compounding this, as noted earlier,
individuals with disability and their families tend to be far poorer than other members of the population, and
this poverty can severely limit the ability of disabled children and their families to afford legal services.

Lack of knowledge about disability within the legal system: While inaccessibility is a significant barrier
to seeking retribution or protection from violence under the law for individuals with a disability, equally
troubling is the fact that disabled children are rarely believed when they do seek help. All too often, charges
of violence or rape from individuals with a disability are dismissed by the police or judges who are unfamiliar
with disability –with the assumption that a ‘misunderstanding’ has occurred or that individuals with disability
are easily confused.  Even more troubling is the assumption that a child or adolescent with disability is
unable to tell ‘right’ from ‘wrong’ or to decide themselves what they want and do not want done to their
bodies.  Even when police, lawyers and judges recognize that violence or rape is no less traumatic for the
disabled child than for the non-disabled child, it is often assumed that they will not make good witnesses on
their own behalf, and they are discouraged from pressing charges.  Indeed, in a number of countries,
individuals with certain types of disability are barred from presenting testimony in court, swearing an oath or
signing their names to legal documents.   In a climate such as this, those who seek to perpetrate violence
against children often seek out disabled children, as there is little or no consequence, even if the abuse
should come to light.  To put it bluntly, violent individuals and sexual predators specifically target disabled
children because they are often able to get away with it.

Community based – disability specific risks: In addition to the risks encountered in community settings
noted above, there are some types of violence and abuse that are disability-specific:
                          
Virgin rape and the AIDS epidemic:  The folk belief that individuals with sexually transmitted diseases,
(including HIV/AIDS) can rid themselves of the infection if they have intercourse with a virgin poses a
particular risk for disabled children.  In most societies, individuals with a disability are incorrectly believed to
be sexually inactive – hence virgins.  Published reports indicate that in many countries, HIV-positive people,
desperate to rid themselves of the infection, are targeting individuals with disability for rape.   Disabled girls
and young women are at particular risk – as are disabled boys and young men.
    
Exorcism and related traditional practices: Belief that a child is born with a disability or becomes disabled
as the result of witchcraft, evil spirits or being inhabited by the Devil is widespread in many societies in both
developed and developing countries.  Attempts to ‘heal’ a child by driving evil forces out through severe
beatings, starvation or other forms of violence, such as wrapping children for hours or days in blankets to
the point of suffocation or subjecting them to fire, extreme heat or cold or other treatments that can cause
injury or death, is unacceptable but widespread.  Such violence against disabled children causes not only
serious injury and death but also can do profound psychological damage to the child involved.

Unnecessary or unproven surgical and medical treatments: Use of unnecessary or unproven surgical
and medical interventions that cause injury or death to disabled children is of great concern.  While there are
many surgical and medical interventions that are warranted, certain         practices are allowed for disabled
children that would not be tolerated for non-disabled children.  Often such practices are used without
oversight or review by clinicians, hospital administrators, or members of the general public when disabled
children are involved.   

Electroshock therapy: while the short and long-term adverse effects of electro-convulsive shock therapy
treatment has caused the treatment to be banned in many countries, particularly where children are
concerned, such treatment is still regularly used on disabled children and adolescents with mental health
impairments. Because it is believed that such children cannot feel pain, in some institutions electroshock
therapy continues to be applied to disabled children without benefit of anesthesia or muscle relaxants in
direct violation of both international law and established medical protocols.  The questionable use of such
treatment is further underscored by the fact that there are reports that this treatment is being used on
disabled children in institutions where drastic understaffing may result in decisions to perform electroshock
therapy on children who are more active or need more attention.  To give electroshock therapy to a child in
lieu of appropriate or needed nurturing or supervision because of limited budgets and drastic understaffing is
unacceptable.

Medicated to assure compliance: Similarly of concern, is when disabled children are heavily medicated by
staff in institutions and hospitals because there is too little staff to tend to their needs, or when they are
heavily medicated so that they will be unable to defend themselves from physical violence or sexual assault.

Routine hysterectomies: Yet another example of medical malpractice that falls within the scope of this
Report is the practice of routinely giving young girls with intellectual impairments or mental health concerns
hysterectomies.  Girls as young as 7 or 8 still undergo such operations, with reports of this practice coming
within the past five years from both Eastern Europe and Australia.  Two reasons are usually given when this
practice occurs:  1) the operation is being done to ensure that these young girls will not begin to menstruate,
thus avoiding the ‘unnecessary’ demands that would otherwise be placed on caretaker time and energy and
2) the operation will ensure that the young woman will not become pregnant.  Such concerns speak to the
problems of understaffed institutions and the lack of sexual education for disabled girls, as well as the
assumed risk of rape for young women both in institutions and the community. There is no medically
justified need for such a major, life-altering operation.

Violence in the Workplace

Because disabled children frequently receive no formal education, their working lives often begin earlier than
those of their non-disabled peers.   Furthermore, because they are rarely trained or apprenticed for a specific
trade or skill, they are often sent to work at the most menial jobs, constituting some of the harshest forms of
child labor.  While it is known that many disabled children are in the workplace, little information on these
children exists because most find work in informal sectors of society - as house servants, farm workers, in
shops or in factories.

Documentation of violence against disabled children in the workplace is therefore limited.  However,
knowledge from other realms of disability research can provide some insight.  For example, those disabled
children who are unable to work as quickly as their non-disabled coworkers, or those who are unable to
hear to understand or follow directions, are at risk of being beaten and bullied.  Because finding and keeping
work for individuals with disability is difficult in most societies - (i.e.: even in developed countries, the
unemployment rate for adults with disability often is above 80%) – disabled children and adolescents have
little voice in the workplace and are at risk not only for physical, sexual and verbal abuse, but are also less
likely to report such abuse or to quit should they be abused.

Disabled children used as beggars:  Worldwide, the most common form of employment outside the
household for disabled children may be begging:
•        Disabled children are regularly used to generate income through begging.  Some are placed on the
streets to beg by their own families, some are sold by their families to others who keep stables of disabled
children in organized rings of beggars.  Either way, reports and anecdotes from dozens of countries indicate
that such children are routinely subjected to violence both in order to keep them on the streets and once on
the streets, by members of the general population, who see such children as easy prey.   Furthermore, it is
reported that disabled children used as beggars are often subjected to physical abuse and torture in order to
make them appear more pathetic and worthy of charity.

Disabled children sold into prostitution: While poverty and lack of alternatives lead many families to give
or sell their children into prostitution, some disabled children are specifically sought out because of their
disabilities under the assumption that their disability will make them more compliant and/or less able to call   
for help.  
•       
 In Thailand, there are reports of proprietors of houses of prostitution specifically seeking out deaf
girl children and adolescents, with the idea that such young people will be less able to communicate their
distress or find their way back to their homes in a world where their customers, employers or fellow sex
workers are able to speak sign language.  
•       
 In Taiwan, a recent study found that the proportion of child prostitutes who had mild developmental
disabilities was six times greater than what might be expected from the incidence in the general population.
•        
In Kosovo, there is a trade in prostitution linked to mental health facilities.  In a country where girls
and adolescents in mental health institutions are automatically transferred to adult mental institutions as they
grow into adulthood, one of the few ways to get out is for these girls to agree to be sold into prostitution.  
The selling of these girls into prostitution is done by staff at the mental health facilities.

Work as a precursor to disability : The harshest forms of child labor, where children are forced to work
in mines or factories, farms and boats, can also lead non-disabled children to become disabled.   Where
children are subject to serious accident and injury, exposed to disabling chemicals, tied to looms or machines
for hours each day, disability will occur.  And once disabled, the child will be at increased risk for all the
various forms of violence against disabled children noted throughout the rest of this report.

An Additional Area of Concern

While the preceding discussion has dealt specifically with the impact of violence on children with disability,
the Thematic Group also makes note of the fact that violence itself is often a precursor to disability:

Violence as a precursor to disability in the household: Violence towards children is frequently not an
isolated event but an outgrowth of a violent household. A pregnant woman who is beaten, punched, kicked
or otherwise physically abused has a higher probability of giving birth to a child with permanent brain injury
or neurological damage. Such a child, born into an already violent household, will be at risk for ensuing
physical, sexual, verbal and emotional abuse, further compounding the initial injuries sustained in utero.

Mental Health Implications:  A child who is physically abused runs the risk of sustaining life-long
physical, sensory or intellectual impairments.  In addition, the mental health ramifications of sustaining such
an injury are largely un-researched at this time, but are assumed to be significant.

Link between sexual abuse and mental illness: A child who is sexually abused has significantly
increased probability of subsequent mental health problems throughout the lifespan.  Children and
adolescents with mental health concerns are regularly targeted for additional physical and sexual abuse as
well as institutionalization – (where sexual and physical abuse is rife), so once a child is sexually abused she
– or he – is at risk of entering a continuing downward spiral of victimization and abuse.

Violence as a precursor to disability in the community:  Violence against children at the community
level also results in permanent disability.  For example:
    
Intentional maiming as acts of aggression:  Warfare against civilian populations takes no more terrible
form than in the intentional maiming of children.  Chopping off of arms and legs, blinding or otherwise
intentionally disabling children has been widely reported over the past decade.

Recommendations

Fostering increased awareness of violence against disabled children within the international,
bilateral and NGO communities.

Disabled children should be on every agenda –including those of UN agencies and multilateral, bilateral and
NGO organizations.  For that reason, training, awareness and consistent inclusion of disabled children
should be a routine part of all programs and projects through the United Nations family of organizations and
their affiliates.  Training of UN leadership and staff is needed if we are to ensure that disability is consistently
on the agenda.  In much the same way as issues such as ‘the girl child’ has been brought to the fore,
disability training must be fostered by UN leadership at this critical junction in time.

National governments, regional authorities and local municipalities must take leadership in
ensuring that violence against disabled children does not take place.   

This can be done through a number of mechanisms, including:
•        
Legislation: Where legislation does not exist to define, track and prosecute violence against disabled
children, such legislation must be put into place.
•        
Enforcement of existing laws and regulations regarding violence against children: In many
countries, laws are already on the books regarding violence against children.  Unfortunately, such laws are
often not enforced when it comes to violence against disabled children.  It is imperative that disabled
children receive full protection under existing law, both in the home and in the community as well in
educational facilities and institutional settings.
•      
  Protection of disabled children should extend across ministries with social welfare, health,
education and others, working cooperatively to provide oversight for and protection for disabled
children at risk.
 A Council on Disability with enough power and authority to assure that changes are made
– (with part of the staffing being by individuals with disability themselves) is one mechanism that should be
considered by governments to improve integrative and collaboration between the various agencies charged
with the protection of children in general and the protection for and provision of services to disabled children
in particular.
•        
Tracking: A system of tracking disabled children throughout the system should be put in place by
government, to assure that disabled children are protected.  In many countries, disabled children are not
registered at birth – in some cases because their families do not want to call public attention to the child, in
other cases because government officials believe that such children will die early and do not take the trouble
to register them.  Formal education is also rare for most disabled children, with the result being that they
cannot be tracked through school records or reports.  Lack of birth certificates, school records and other
‘social’ document impedes our ability to ensure services and support gets to these children and that there is
oversight to ensure they do not become victims of violence and abuse.        
•        
Funding:  Governments are often the sole or most significant funder to programs, schools and
institutions that serve disabled children.  Where violence against such children is on-going, the ability to
allocate and withhold funds may be a viable option to ensure that change will take place.
•        
Public education:  Government can do more than simply create laws and track violence through
various agencies.  Governments, working in conjunction with civil society, families of disabled children and
disability advocacy groups, can take the lead in advocating social change to ensure inclusion of individuals
with disability throughout society.  Through mass media campaigns, leadership by government officials at all
levels and progressive legislation and funding that increases the inclusion of disabled children in schools and
communities, governments have the ability to shape and redefine better and more inclusive attitudes towards
disabled children – thus lessening the likelihood that they will become victims of violence or abuse.
•        
Training of government officials:  Elected leaders and government officials charged with preventing
violence against disabled children must understand the issues involved and the problems faced by this
population.  Yet government officials may know no more about disability than members of the general
society and often will share the same misperceptions.  For this reason, training of government officials and
staff is fundamental to any effort that seeks to eliminate violence against the disabled child.

Civil society must be at the forefront of public campaigns to improve the lives of individuals with
disability and foster inclusion as a major component in the campaign against violence towards
disabled children:  

While the role of international organizations and government agencies are crucial in addressing the epidemic
of violence against disabled children (Recommendations 2 and 3), this cannot be done without a significant
leadership role also being taken by organizations, community leaders and members of civil society.

Civil society must work with families of disabled children and disability advocacy groups to take a leading
role in advocating change to ensure inclusion of individuals with disability throughout society.  Through
mass media campaigns, collaboration with government officials at all levels, advocacy for progressive
legislation and funding that increases the inclusion of disabled children in schools and communities, civil
society has the ability to shape and redefine better and more inclusive attitudes towards disabled children –
thus lessening the likelihood that they will become victims of violence or abuse.

In this realm, civil society can play a particularly important role in addressing community attitudes and
behaviors. Repeatedly, traditional stigma and prejudice towards individuals with disability is cited as a key
factor that allows, and in some cases justifies, violence towards disabled children. Traditional stigma and
prejudicial beliefs about disability must be addressed and changed in order to stop the violence.  Groups
throughout civil society –working in collaboration with parents’ organizations and disability advocacy groups
must begin to address the underlying issue of prejudice if progress is to be made.   Public information
campaigns, advocacy and public discussion of the issue has already brought about significant improvements
in attitudes towards disability in a number of countries.  Use of the mass media have great potential to
change attitudes towards disability (for example, the television series Sesame Street and South Africa’s ‘Soul
City’) have raised awareness about disabled children. The specific issue of violence against disabled children
– why it is unacceptable, how to recognize it, how to report it – can be specifically identified as a key area
for such a public discourse.

People responsible for or working with disabled children must be made aware of the risk of violence.

There is a tremendous need to train people working with disabled children to identify and intervene when
violence occurs.  Governments can play a lead role in collaboration with civil society – including disability
advocacy organizations – to provide training on disability in general, and violence against those with disability
in particular, at local, regional and national levels.  Where high schools, universities and technical colleges are
government sponsored, the responsibility of training the work force that will provide services for disabled
children rests even more heavily on government officials, who have the capability of ensuring that the issue
of violence against disabled children is presented in the course of the professional education.  Among the
groups of professionals and professionals-in-training that can be reached are:

•        support staff working with children in families
•        Teachers, teachers aids, transportation staff and others working with children in schools,
rehabilitation facilities, institutions and so forth;
•        Administrative, medical and support staff at clinics, hospitals, rehabilitation facilities and institutions
•        Members of the criminal justice system – police, lawyers and judges

There is a need for oversight of administrators, professionals, staff and volunteers and for
workable, comprehensive reporting mechanisms.
Government should play a role in oversight of
administrators, professionals, staff, volunteers and all others who work with disabled children.  There
should include:

Background checks of all individuals who work with disabled children and adolescents.
•        Establishment of functioning reporting mechanisms to ensure that any abuse is reported in a timely
and confidential manner and all such reports are immediately followed up on.
•        Enforcement – Equally as important, government has the responsibility to protect disabled children
from violence through its role in establishing and enforcing professional standards and licensing
requirements.  

Regular and systematic oversight of all existing schools and institutions that serve disabled children
should be instituted
and regular reports on the status of children in these institutions must be available to
the public for discussion and debate. Boards and committees which bring together representatives from
government, professional and civil society now provide oversight for many institutions.  However, such
oversight committees must also be broadened to include representatives of parent groups and disability
advocacy groups.  Not only should members of both these constituencies be part of any oversight boards,
but mechanisms must exist to ensure that their comments and concerns are given attention and weight. (Too
often, when included at all, these advocates are used as ‘window dressing’ not as serious and full
participants.  This is simply unacceptable).  

•        Such oversight should also routinely involve interviews with the children who live in these facilities
and a mechanism should be in place internally to handle complaints and concerns about violence or potential
violence or abuse.

•        Any board of oversight or review must establish a mechanism to allow                disabled children
within the institution itself to regularly report to and to participate in decisions made on their behalf.

•        
Guardianship – Finally, the issue of ‘guardianship’ must be addressed. Legal mechanisms need to be
created to end discriminatory guardianship laws and to empower disabled children and families of disabled
children to make their own decisions.   Disability must not be the basis for denial of legal standing.

Oversight in non-residential schools, community programs and places of employment:  Awareness of
the potential for violence against disabled children must be carried into all community venues – schools,
community programs and the workplace – wherever disabled children participate outside the home.   
Educators, professional and trade organizations, civic and religious leaders must establish guidelines within
their own organizations that ensure that disabled children will not only be included, but will be free from
harm when they are included. (Footnote B)

The expertise of Disability-led advocacy groups and parent organizations is invaluable; governments
and agencies should establish mechanisms to routinely involve them in all programs and projects
related to violence prevention:  

Over the past decades, two important, interrelated global movements have evolved around disability
advocacy:  disabled-led advocacy organizations founded and run by adults with disability and organizations
of parents on behalf of their disabled children and young adults.   Both groups have amassed an enormous
amount of expertise and established strong and effective networks at the local, national, regional and global
levels.  Both government and civil society seeking to end violence against disabled children would benefit
enormously by establishing strong links with these groups.    

Funding: It is also noted here that disability-led and parent advocacy groups are often drastically under
funded – and requests for collaboration, guidance and oversight to help prevent violence against disabled
children will further drain the scare resources of many of these groups.  Wherever possible, requests by UN
agencies, government, NGOs and civil society for collaboration should be accompanied by some support to
enable these non-profit organizations to take on the additional responsibilities.   

Families of disabled children and disabled children themselves must be empowered to advocate on
their own behalf.
An arena in which substantial change can be made is in the support and empowerment of
families with disabled children and disabled children themselves.  Such empowerment can be fostered by
both government AND civil society – and in fact, works best when supported through a collaboration of
government and civil society. In many societies, it is assumed that no one would hurt or abuse a disabled
child.  Parents, caretakers, educators and others who work with disabled children often overlook the need
for giving such children information about personal safety, including sex education.  Remaining uninformed
does nothing to protect children from violence or abuse.   Disabled children and adolescents must be taught
about violence and abuse – including what risks they face, how they can protect themselves, and how they
should report such behavior.

Families with disabled children must be included in all outreach efforts to end violence against
children in the home, and such interventions must address the special needs of such families.

Intervention in violent households is always challenging and inclusion of parents of disabled children in
general violence prevention and intervention efforts in imperative.  Additionally, there are several ways in
which government and civil society can work with parents to protect disabled children from violence.  For
example:

The need to provide better understanding about disabled child development for parents and families:
Parents of disabled children often receive little guidance or encouragement.  Basic information on disability
and child development would be helpful for many to establish realistic expectations of their child’s abilities
and limitations.  

Parental Awareness:  Many parents of disabled children are unaware that their children may be at risk for
violence in the school and the community.  They need information on how and when their child may be at
risk for violence, how they can intervene and how they can best advocate on their child’s behalf.  In both
cases, knowledge and empowerment can be fostered through many avenues, but certainly closer alliances
with disability advocacy groups, and disabled parent organizations, is an important place to start.   

More research must be undertaken to allow better understanding of patterns of violence towards
disabled children and improved knowledge of what constituted effective interventions for this
violence.

To address a significant social and human rights issue such as violence against disabled children, accurate
information is needed. Policy makers and advocates need to know how many individuals are affected, what
the pattern and nature of violence towards these children might be and what the short- and long-term
consequences of such violence are. Currently, there are only a handful of studies with useable data on
violence against disabled children.  Information on the epidemiological, medical and psychological
consequences of violence against these children is needed.

•        Government and civil society does little to track violence against disabled children.  As noted in the
preceding section, in many countries, disabled children are not included in existing population data bases.
Birth certificates, school records and other ‘social’ document are lacking and this impedes our ability
provide services and oversight to ensure these children do not become victims of violence and abuse.

•        Research for this population should be undertaken both as part of general studies on violence against
children and through targeted studies on violence against disabled children. Researchers need to better
understand what patterns of violence exist for children with disabilities in general and for children with
specific disabilities in particular.

•        Research is needed not only to identify where violence occurs but also how disabled children are best
able to live and thrive in safety, as well as to identify what policies, programs and practices most help these
children, their families and their communities.

Conclusion

This Thematic Group Report has concentrated on disabled children with the intention of underscoring the
severe risk they face through physical violence and sexual, emotional and verbal abuse.  While all children
are at risk, disabled children are at significantly increased risk.  The potential of governments, civil society,
concerned families and dedicated advocates to intervene is great – but the level of denial that is often greater
still.   Those charged with the protection of children must be aware and responsive to this crisis in child
health - ignoring or minimizing the problem is no longer acceptable.  Sadly in a world where the disabled
child rarely is treated the same as the non-disabled child, one of the few arenas in which they find
themselves on equal footing is as victims of violence.  The forthcoming Secretary General’s Report on
Violence against Children offers a unique opportunity to ensure that these millions of disabled children and
adolescents are no longer overlooked.

UN Secretary Generals Report on Violence against Children
Thematic Group on Violence against Disabled Children
Findings and Recommendations
Convened by UNICEF at the United Nations, New York
www.brighttots.com          Developmental Disorders          Autism          Parenting Issues