Chapter 15 Victimization of Individuals with Disabilities

Abstract

Until recently, the victimization of individuals with disabilities has not received national attention, and few victim assistance programs offered services for these victims. With increased awareness of the issue and new federal initiatives in the executive and legislative branches, model programs to serve crime victims with disabilities are expanding. This chapter discusses the progress toward recognizing and meeting the needs of crime victims with disabilities. Requirements of the landmark federal legislation, the 1990 Americans with Disabilities Act, for the criminal justice system and private nonprofit victim assistance programs are outlined. New programs that have been designed to provide services to victims with disabilities are described, and federal law mandating that the issue be studied by the Department of Justice is discussed. In addition, guidelines are provided for the development of critical services in criminal justice and victim assistance programs.

Learning Objectives

Upon completion of this chapter, students will understand the following concepts:

• The scope and causes of victimization of individuals with disabilities.
  
  
• How the Americans with Disabilities Act of 1990 applies to criminal and juvenile justice and private nonprofit victim assistance programs.
  
  
• The primary thrust of recent recommendations of the 1998 OVC-sponsored National Symposium on Working with Victims with Disabilities for improving criminal justice and victim assistance programs.
  
  
• How to use appropriate terminology to effectively respond to victims with disabilities.
  
  
• Strategies for meeting the needs of crime victims with disabilities.

Statistical Overview

• Approximately 54 million Americans report some level of disability, and 26 million of them describe their disability as severe (Holmes 1999).
  
  
• Between 4 and 5% of Americans have a developmental disability, including mental retardation, autism, cerebral palsy, and severe learning disabilities (LaPlante and Carlson 1996).
  
  
• About 11 million women (29%) over the age of forty-five have conditions that limit their activities, compared with 9 million men (25%) (Hasler 1991) .
  
  
• Research consistently shows that women with disabilities, regardless of age, race, ethnicity, sexual orientation or class, are assaulted, raped, and abused at a rate two times greater than women without a disability (Sobsey 1994; Cusitar 1994).
  
  
• The risk of being physically or sexually assaulted for adults with developmental disabilities is four to ten times higher than it is for other adults (Ibid.).
  
  
• The FBI's Uniform Crime Reports show that in 1998, of the 9,235 reported bias-motivated offenses, 27 were motivated by disability bias--14 by anti-physical disability bias and 13 by anti-mental disability bias (FBI 17 October 1999, 60).
  
  
• Estimates indicate that at least 6 million serious injuries occur each year due to crime, resulting in either temporary or permanent disability. The National Rehabilitation Information Center has estimated that as much as 50% of patients who are long-term residents of hospitals and specialized rehabilitation centers are there due to crime-related injuries (Tyiska 1998).
  
  
• Research conducted by the National Center on Child Abuse and Neglect (NCCAN) in 1993 found that children with any kind of disability are more than twice as likely as children without a disability to be physically abused and almost twice as likely to be sexually abused. Of all children who are abused, 17.2% had disabilities (Crosse, Kaye, and Ratnofsky 1993).
  
  
• Child protective services caseworkers reported that the disabilities directly led to or contributed to child maltreatment in 47% of maltreated children with disabilities (Ibid.; Barnett, Miller-Perrin, and Perrin 1997).
  
  
• A national survey of 860 women found that women with and without physical disabilities were equally likely (62%) to experience physical or emotional abuse from husbands, live-in partners or other family members; however, for women with disabilities the abuse tends to last longer than for women without disabilities. Women with physical disabilities were also more at risk for abuse by attendants or health care providers (Young et al. 1997).
  
  
• A national research project on young male victims of sexual assault in Australia found that young men with intellectual disabilities are at greatest risk (Colman 1997).

Introduction

The prevention of victimization and the provision of needed services to individuals with disabilities who are victims of crime are urgent issues that have yet to be comprehensively addressed by public policy makers, the criminal or juvenile justice system, and victim assistance service providers. The lack of attention given these issues, until recently, illustrates the enormous gap that has existed between those who advocate for the rights of individuals with disabilities and those who work to ensure fundamental justice in the justice system and advocate for the rights of crime victims.

Throughout the last two decades, these two advocacy movements operated on parallel tracks and made significant gains on behalf of crime victims and individuals with disabilities. Achievements include the passage of significant legislation as well as enhanced and expanded services. As crime victim advocates sought to ensure that victims are "at the center of the criminal and juvenile justice systems," disability advocates sought full "inclusion" of individuals with disabilities in communities and services. Many of the accomplishments of the two movements have been achieved through the joint efforts of self-advocates in partnership with service providers and allied professionals.

Only recently have the crime victims movement and the disability rights movement intersected with a common concern and national focus. The common ground has expanded as our awareness of the victimization of individuals with disabilities has increased and the need to improve our response to victims with disabilities has become clear. A better understanding of the issues related to victimization and victim assistance for individuals with disabilities will enable justice professionals and crime victim advocates to extend the possibility of justice and healing in the aftermath of a crime to victims with disabilities. As a result of their shared concern, victims' rights advocates and service providers and disability rights advocates and service providers have begun to forge coalitions that ultimately will dramatically improve the treatment of crime victims with disabilities.

Causes of Disability

The term "disability" is very broad, and there is a wide variety of conditions that can affect an individual and result in some form of disability. Age of onset, cause, and manifestation of a disability can be significant factors in treatment of individuals with disabilities. The effects of a disability on major life activities can range from mild to severe. The degree and type of accommodation needed for effective service provision for crime victims with disabilities also varies, depending upon the crime and its impact, the victim and his/her individual needs.

Developmental disabilities occur early in life and have a life-long effect on development, adaptive behavior, and learning (i.e., mental retardation, cerebral palsy, severe learning disabilities, and other neurologic conditions). Historically, individuals with developmental disabilities were often placed in state-operated institutions as infants or children where they were isolated from family and society. When widespread physical, emotional, and sexual abuse and neglect of the "patients" in many public facilities were documented in the 1970s and early 1980s, advocates for individuals with developmental disabilities successfully launched the movement to "deinstitutionalize" people with developmental disabilities. "Mainstreaming"--enabling people with developmental disabilities to participate in the "mainstream of society" within the community--became the goal. As a result, community-based services, such as group homes, other assisted living arrangements, and day programs, have expanded tremendously in the last two decades. However, many individuals continue to live in state and private institutions, and issues related to their vulnerability to abuse and neglect remain a concern of family members and advocates. In addition, in recent years the victimization (sexual assault, financial exploitation, and emotional abuse) of people with developmental disabilities who live in the community has been identified as a concern.

The treatment and educational response to an individual's hearing loss or vision loss may vary, depending upon the cause, when it occurred, and whether the individual has any hearing or sight. Physical disabilities such as hearing or vision loss can be congenital or occur later in life as the result of an illness, accident, or injury due to a violent crime. Previously it was thought the best "special education" that children who were diagnosed with deafness or blindness at a young age could receive was in a special residential school away from family and community. Today, such education services are provided in local public schools. Differences in educational approaches for individuals who are deaf or hard of hearing or blind may result in these individuals being more comfortable with different methods of communicating or moving. For example, some individuals who are deaf or hard of hearing are comfortable with sign interpreters while others prefer lip-reading; some may be comfortable with written material while others are not. Some individuals who are blind use a cane; some do not. Not all people who are blind read braille; some use scanners to read written material and others are accustomed to readers.

Disabilities that affect mobility and/or the ability to function independently (i.e., spinal cord injury) can occur in conjunction with a congenital condition or can occur in childhood, adolescence, or adulthood as a result of an automobile accident or crash, diving, or other accident or injury. Rehabilitation for such injuries is often a lengthy, difficult process involving medical treatment, physical and occupational therapy, counseling, vocational training, and other support services. In addition, people whose lives are changed in this way experience countless adjustments as they adapt to changes imposed by the disability.

The likelihood that an individual will have a disability increases with age, in part because the progression of many diseases can have disabling effects that limit activity and many aspects of daily life (i.e., heart disease, multiple sclerosis, diabetes, and many others). In addition, some conditions that occur predominately among the elderly affect memory and intellectual functioning as well as the ability to care for oneself and live independently (i.e., Alzheimer's disease). Individuals with such conditions are often cared for at home by family members or treated in nursing homes or other care facilities.

DISABILITIES CAUSED BY VIOLENT CRIME

Millions of people suffer injuries as a result of criminal victimization each year, and many of these injuries cause long-term disabilities. Examples include assault victims who suffer gunshot wounds that cause spinal cord damage or blindness; victims of drunk or drugged drivers who suffer the loss of a limb, spinal cord injuries, or head injuries that cause traumatic brain injury; infants who suffer the effects of "shaken baby syndrome" and sustain severe brain injury and resultant developmental disabilities; children who are victims of severe physical abuse whose emotional and physical development is affected; or victims of domestic violence who sustain permanent injuries as a result of a single battering incident or repeated battering over a period of several years.

For many of these victims, the traumatic impact of the victimization is compounded by the life-changing impact of the disabling condition. The combination of these circumstances, imposed abruptly and unexpectedly, can have a profound emotional impact. Depending upon the disability, the impact may be seen in many areas. For example, mobility or the ability to live and travel independently may beaffected and loss of employment and change in economic status may result. In addition, the impact is felt by family members who also experience changes in relationships and "the loss" of the way their lives had been. While coping with medical or mental health treatments and rehabilitation and these unexpected life changes, individuals who acquire a disability as the result of a crime may also have to cope with involvement with the criminal or juvenile justice system as a victim and/or witness.

Sensitivity to the needs of these crime victims and their physical and emotional recovery process is essential to providing effective victim assistance. In addition to providing information about the status of the case and facilitating participation in criminal or juvenile justice proceedings, victim assistance may need to coordinate a broad range of community resources and referrals and long-term support. Coordination with other service providers (medical, rehabilitative, income assistance, housing, etc.) may be necessary. Financial remedies such as crime victim compensation, criminal restitution, and civil actions against the perpetrator and other persons responsible are very important in such cases.

Attitudes and Myths About Disabilities

There are tens of millions of Americans with disabilities, many of whom have been victims of crime and most of whom are at risk of being victims of crime. Societal attitudes toward individuals with disabilities often reflect negative stereotypes and a lack of knowledge. Attitudinal barriers are usually subtle but discernible. Examples include reactions of disgust, pity, or discomfort expressed both verbally and non-verbally, overtly and covertly.

Tyiska (1998) discusses three myths about individuals with disabilities that were identified at an OVC-sponsored national symposium held to discuss issues related to assistance for victims with disabilities. Each of these myths is based on negative stereotypes and interferes with many people's ability to relate and interact with individuals with disabilities.

• First, the "perception that people with disabilities are suffering," and should be extended charity and kindness instead of rights and responsibilities.
  
  
• Second, people with disabilities are not capable of making decisions for themselves and need others to manage their lives.
  
  
• Third, many people fear contact with people who have disabilities as if the condition were contagious. This stems from a fear of whatever is "unfamiliar" and different and a lack of information, knowledge, and experience. Anyone who is perceived as different from the "norm" is suspect and marginalized.

In 1990, Dick Sobsey outlined five "cultural myths" surrounding people with disabilities that serve to undermine their individuality and value as people, and even contribute to their vulnerability to abuse.

• The "Dehumanization" Myth: Labels such as "vegetative state" suggest that a person with a disability is something less than a full member of society and serves to dehumanize the individual. Thus, perpetrators may rationalize their abusive behavior as not really injuring another person.
  
  
• The "Damaged Merchandise" Myth: Similar to "dehumanization," this myth asserts that the life of the individual with a disability is "worthless" and thus he or she has nothing to lose. This thinking is aligned with advocates for euthanasia of children with severe disabilities, who rationalize that such killing is in the best interest of the child. For example, a well publicized case in Canada, argued in the courts through 1997, involved a father's so-called "compassionate homicide" of his thirteen-year-old daughter with cerebral palsy.
  
  
• The "Feeling No Pain" Myth: With this myth, people with disabilities are thought of as having no feelings or as being immune to pain and suffering. There is no basis for this myth and, in fact, individuals with disabilities experience the same range of emotions found in any person.
  
  
• The "Disabled Menace" Myth: Perceived as "different," individuals with disabilities are often considered unpredictable and dangerous, whether or not there is any foundation for the fear. Adherence to this myth may motivate people to prevent community facilities, such as group homes for adults with mental retardation, from being developed in their neighborhoods.
  
  
• The "Helplessness" Myth: Beliefs or perceptions that individuals with disabilities are "helpless" and unable to take care of themselves undermine their self-esteem and ability to take on decisions related to daily life. This in turn, makes the individual more vulnerable to abuse and manipulation.

These attitudes undermine the individual's self-advocacy and increase vulnerability. Sobsey suggests that "changing societal attitudes towards persons with disabilities" is important to long-term empowerment and the prevention of abuse. Through empowerment and self-advocacy, individuals with developmental disabilities will better be able to protect themselves from abuse or seek assistance to end it.

Scope of the Problem of Victimization of Individuals with Disabilities

There is no definitive or comprehensive source of information on the extent of the problem of victimization of individuals with disabilities. However, considerable research conducted over the last two decades consistently suggests that individuals with disabilities are as likely or more likely than nondisabled individuals to be victimized by crime. Research consistently reports that children and adults with disabilities are at much greater risk of physical, sexual, and emotional abuse (Sobsey and Mansell 1990, 1998; Sobsey and Doe 1991; Sobsey 1994, Sobsey et al. 1994; Doucette 1986; Crosse, Kaye, and Ratnofsky 1993; Baladerian 1991). In addition to the growing evidence of victimization, anecdotal evidence suggests that crimes against individuals with disabilities are seriously underreported, and that when it is reported, victims are not believed and cases are not prosecuted (Sorensen 1997; Petersilia 1997; Sanders et al. 1997). Finally, it appears that few victims with disabilities ever reach victim assistance programs for assistance and support.

In addition, concerns about violence against women with disabilities are growing among disability advocates and researchers (Chenoweth 1996; Young et al. 1997; Harness-DiGloria 1999). In 1995-1996, a survey was conducted by Berkeley Planning Associates under a federal grant entitledMeeting the Needs of Women with Disabilities: A Blueprint for Change. The survey sought input from women with disabilities about the importance of various research and policy issues. Issues relating to violence and abuse were rated as the number one priority of survey respondents.

THE VICTIMIZATION OF CHILDREN WITH DISABILITIES

The issue of child abuse and disabilities emerged in the mid-1980s; however the full extent of the problem was not known until a national study was mandated by Congress in 1988 (Crosse 1993). Early efforts in this area focused on the dual problem of the abuse of children with disabilities and the disabling effects of child abuse. Early programs combined the expertise of child abuse diagnostic and treatment specialists with the expertise of specialists in developmental and other disabilities in children:

• The Center for Child Protection-Children's Hospital and Health Center. In 1986, the Center for Child Protection in San Diego, California, developed one of the nation's first forensic assessment protocols for victims of sexual assault who have developmental disabilities. The Center offers specialized assessment and treatment to approximately 1,200 child victims of sexual assault each year, many of whom are disabled, including a four-week course for children who are scheduled to testify in court (Grayson 1992).

• Boys Town National Research Hospital, Center for Abused Children with Disabilities. The Center, located in Nebraska, provides evaluation and treatment for 250 to 500 abused children with communication disorders each year. It offers a short-term residential program, specifically for abused hearing-impaired children and their families, and is the only program of its kind in the nation. The Center employs staff with disabilities, who thus serve as role models for the children and parents. In addition, the Center has developed protocols for police and child protection workers which assist them in conducting investigations of abused children with disabilities (Ibid.).

• In 1991, Nora J. Baladerian, Ph.D., released a report from the Spectrum Institute in Culver City, California, entitled, Abuse Causes Disability. The report summarized the literature related to child abuse, its devastating impact, and the frequency with which children who are abused have disabilities. Dr. Baladerian called for a national program to combat the devastating and debilitating impact that child abuse has on children (Baladerian 1991).

In 1993, the National Center on Child Abuse and Neglect (NCCAN) released the findings of a comprehensive national study entitled A Report on the Maltreatment of Children with Disabilities. The Report was prepared in response to Section 102(a) of the Child Abuse Prevention, Adoption, and Family Services Act of 1988 (P.L. 100-294). The study focused on maltreated children who had physical, intellectual, or emotional disabilities. Much of the information in the Report is based on data collected from a representative sample of thirty-five child protective service (CPS) agencies, which provided information on all cases of substantiated maltreatment of children over a six-week period in 1991. Information was collected on cases involving 1,834 children whose maltreatment was substantiated. The study found the following:

• An estimated 23 out of 100 children in the United States are maltreated each year.
  
  
• Of children who are abused, 17.2% had disabilities, and of all children who were sexually abused, 15.2% had disabilities.
  
  
• Abused children with disabilities were more likely to be male and generally older than children without disabilities who were abused.
  
  
• The incidence of maltreatment (number of children maltreated annually per 1,000 children) among children with disabilities was 1.7 times higher than the incidence of maltreatment for children without disabilities. (The rate was 2.1 times higher for children who were physically abused; 1.8 times higher for sexually abused children; and 1.6 times higher for neglected children.)
  
  
• The disabilities directly led to or contributed to child maltreatment in 47% of maltreated children with disabilities. The most common disabilities noted were emotional disturbance, learning disability, physical health problems, and speech or language delay or impairment. (Crosse, Kaye, and Ratnofsky 1993).

Based on the results of this study, six recommendations were made:

1. Risk assessment approaches used in child protective services (CPS) agencies should include the child's specific disabilities as a risk factor.

2. CPS caseworkers should be educated on the relationship between maltreatment and disabilities, on identifying disabilities, and on making appropriate referrals for children with disabilities.

3. Professionals who come into contact with children with disabilities should be educated on the relationship between maltreatment and disabilities, on identifying disabilities, and on making appropriate referrals for children with disabilities.

4. State and federal systems that report information on cases of child maltreatment should include uniform information on whether or not children have disabilities.

5. Caseworkers in CPS agencies and professionals in other settings should provide specialized services to prevent maltreatment in families who have children with disabilities.

6. Future research should continue to study the relationship among child maltreatment, race/ethnicity, and disabilities, and on the causal relationship between disabilities and maltreatment (Crosse, Kaye, and Ratnofsky 1993).

Response to Crime Victims with Disabilities

The victimization of individuals with disabilities was largely overlooked on the national level prior to passage of the Americans with Disabilities Act of 1990 (42 U.S.C. 12101). The ADA provided a new framework for governmental and nonprofit agencies responding to individuals with disabilities. Since its implementation, the Department of Justice and other federal agencies have initiated a variety of efforts to provide information to state and local criminal and juvenile justice agencies and victim assistance programs on the intent and requirements of the Act. However, despite these efforts, many programs that serve crime victims lack a full understanding of whether their program is covered by the Act andwhat is required. The two sections of the Act that are of particular importance to justice systems and victim assistance programs are described below. Other significant national efforts and legislation pertaining to individuals and victims with disabilities are also described.

THE AMERICANS WITH DISABILITIES ACT OF 1990

On July 26, 1990, landmark federal legislation, the Americans with Disabilities Act (ADA) (Pub. L. 101-336; 42 U.S.C. 12101), was enacted to provide comprehensive civil rights protection to people with disabilities in the areas of employment, public accommodations, state and local government services, and telecommunications. A fundamental purpose of the ADA is to promote the full integration of individuals with disabilities into the "mainstream" of society.

In the legislation, Congress articulated a number of findings (Section 12101), which include the following passages:

• historically, society has tended to isolate and segregate individuals with disabilities, and, despite some improvements, such forms of discrimination against individuals with disabilities continue to be a serious and pervasive social problem;
  
  
• discrimination against individuals with disabilities persists in such critical areas as employment, housing, public accommodations, education, transportation, communication, recreation, institutionalization, health services, voting, and access to public services;
  
  
• unlike individuals who have experienced discrimination on the basis of race, color, sex, national origin, religion, or age, individuals who have experienced discrimination on the basis of disability have often had no legal recourse to redress such discrimination;
  
  
• individuals with disabilities continually encounter various forms of discrimination, including outright intentional exclusion, the discriminatory effects of architectural, transportation, and communication barriers, overprotective rules and policies, failure to make modifications to existing facilities and practices, exclusionary qualification standards and criteria, segregation, and relegation to lesser services, programs, activities, benefits, jobs, or other opportunities;
  
  
• census data, national polls, and other studies have documented that people with disabilities, as a group, occupy an inferior status in our society, and are severely disadvantaged socially, vocationally, economically, and educationally;
  
  
• individuals with disabilities are a discrete and insular minority who have been faced with restrictions and limitations, subjected to a history of purposeful unequal treatment, and relegated to a position of political powerlessness in our society, based on characteristics that are beyond the control of such individuals and resulting from stereotypic assumptions not truly indicative of the individual ability of such individuals to participate in, and contribute to, society;
  
  
• the Nation's proper goals regarding individuals with disabilities are to assure equality of opportunity, full participation, independent living, and economic self-sufficiency for such individuals; and
  
  
• the continuing existence of unfair and unnecessary discrimination and prejudice denies people with disabilities the opportunity to compete on an equal basis and to pursue those opportunities for which our free society is justifiably famous, and costs the United States billions of dollars in unnecessary expenses resulting from dependency and nonproductivity.

The requirements of two specific sections of the ADA are especially important for government-based and private nonprofit programs that serve victims of crime. These sections are Title II, which coverspublic entities and Title III, which covers public accommodations, including private entities that own, operate, or lease places of public accommodation.

Qualified individuals with disabilities. The ADA extended broad civil rights protection to people with a wide range of disabilities. U.S. Department of Justice regulations that implement Titles II and III (28 CFR Part 35 and 36) provide the following definitions:

• Disability, with respect to an individual, is defined as:
  
  
  • A physical or mental impairment that substantially limits one or more of the major life activities of such individual.

  • A record of such impairment.

  • Being regarded as having such an impairment.
    
    
  If a person meets any one of the three criteria listed above, then the person is covered by the Act. Major life activities include functions such as caring for one's self, performing manual tasks, walking, seeing, hearing, speaking, breathing, learning, and working.
  
  
• Under this definition, the term physical impairment means any physiological disorder or condition, cosmetic disfigurement, or anatomical loss affecting one or more of the following body systems:
  
  
  • Neurological.

  • Musculoskeletal.

  • Special sense organs.

  • Respiratory (including speech organs).

  • Cardiovascular.

  • Reproductive.

  • Digestive.

  • Genitourinary.

  • Hemic (blood).

  • Lymphatic.

  • Skin and endocrine.
    
    
• The term mental impairment means any mental or psychological disorder such as:
  
  
  • Mental retardation.

  • Organic brain syndrome.

  • Emotional or mental illness.

  • Specific learning disorders.
    
    

  Although no comprehensive list of all of the specific conditions that would constitute physical or mental impairments exists, the ADA is thought to cover hundreds of disabling conditions. Examples of specific physical or mental impairments covered by the ADA include such contagious and noncontagious diseases and conditions as:
  
  

• Orthopedic, visual, speech, and hearing impairments.
  
  
• Cerebral palsy.
  
  
• Epilepsy.
  
  
• Muscular dystrophy.
  
  
• Multiple sclerosis.
  
  
• AIDS/HIV infection (symptomatic or asymptomatic).
  
  
• Cancer.
  
  
• Heart disease.
  
  
• Diabetes.
  
  
• Mental retardation.
  
  
• Specific learning disabilities.
  
  
• Emotional illness.
  
  
• Tuberculosis.
  
  
• Drug addiction.
  
  
• Alcoholism.
  
  

Title II of the ADA: Nondiscrimination on the Basis of Disability in State and Local Government Services. Title II of the ADA prohibits discrimination on the basis of disability by public entities, and extends the nondiscrimination mandate of section 504 of the Rehabilitation Act of 1973 to all state and local government services regardless of whether the entity receives federal financial assistance. This includes all activities, services, and programs of state legislatures, courts, town meetings, police and fire departments, motor vehicle licensing, and employment.

More specifically, the ADA prohibits a public entity from excluding or denying the benefits of services, programs or activities to a "qualified individual with a disability," on the basis of the disability. A "qualified individual with a disability" means an individual with a disability who meets the "essential eligibility requirements" for the services or participation in the programs or activities, regardless of whether reasonable modifications are needed to do so. In other words, any individual who would normally be eligible for a service that is offered (for example, counseling or information and referral provided by a victim assistance program) cannot be denied that service just because the person has a disability.

In order to ensure access to all government-sponsored programs, services and activities must make reasonable modifications to policies, practices, or procedures. This includes the removal of architectural, communication, and transportation barriers and the provision of auxiliary aids and servicesto ensure that communication with individuals with disabilities is as effective as communication with others.

Communication
State and local government programs must ensure effective communication with individuals with disabilities by providing appropriate auxiliary devices. A wide range of devices is currently available that afford an individual with equal opportunity to participate in programs and services. In determining the most appropriate auxiliary communication aid, service providers should defer to the preference of the individual whenever possible.

The types of devices or services that facilitate communication vary significantly. A particular device or service may be preferred by some and yet be completely inappropriate for others with the same type of disability. For example, some people who are deaf prefer sign language interpreters while others do not sign at all. A public entity may not charge an individual with a disability for the use of any auxiliary aid.

The following examples of auxiliary aids and services make aurally delivered material available to individuals with hearing impairments:

• Qualified interpreters, note takers, transcript services, written materials, assistive listening devices, telecommunications devices for the deaf (TDDs), videotext displays, closed caption decoders, and telephones compatible with hearing aids.

The following examples of auxiliary aids and services make visually delivered material available to individuals with visual impairments:

• Qualified readers, taped texts, audio recordings, brailled materials, and large print materials.
  If provision of the auxiliary aid would result in a fundamental alteration of the nature of the service, program, or activity or is an undue financial or administrative burden, public entities are not required to provide them. However, public entities are still required to provide another auxiliary aid, if available, that would not have these results.

Other Barriers to Accessibility
Public entities must ensure that individuals with disabilities are not excluded from services, programs, or activities because buildings are not accessible. Where possible, barriers should be removed. The public entity may comply with the program accessibility requirement by delivering services at alternate accessible sites, providing an aide or personal assistant, or providing the service at an individual's home. Government programs may not provide access by physically carrying an individual with a disability (for example, up a flight of stairs), except in "manifestly exceptional" circumstances. While it is not necessary to remove physical barriers, such as stairs, in all existing buildings, any newly constructed or renovated buildings must be free of all architectural and communication barriers that restrict access or use by individuals with disabilities.

The purpose for the removal of barriers and the use of communication aids is to:

• Make services and programs accessible to, or usable by, individuals with mobility, manual dexterity, hearing, or visual impairments in the most integrated setting possible.
  
  
• Promote the inclusion of people with disabilities in programs, services, and activities of all public entities.
  
  
• Ensure that individuals with disabilities enjoy any right, privilege, advantage, or opportunity received by others who receive any aid, benefit, or service.

Separate programs or services provided to people with disabilities are not permitted in most instances unless the separate programs are necessary to ensure that the benefits and services are equally effective. Even when such programs are available, an individual with a disability still has the right to choose to participate in the regular program. Further, programs may not have criteria that "tend to" screen out people with disabilities.

Title III: Nondiscrimination on the Basis of Disability by Public Accommodations and in Commercial Facilities. Title III of the ADA prohibits discrimination on the basis of disability by public accommodations and requires that public accommodations and commercial facilities (including social service agencies) be designed and altered to meet accessibility standards. The definition of public accommodation in Title III includes twelve categories of facilities, one of which is "social service center establishments." Implementing regulations (28 CFR Part 36) specifically include rape crisis centers, substance abuse treatment centers, and homeless shelters among the types of establishments that are included.

The requirements of Title III are similar in intent to those of Title II. Public accommodations must satisfy the following requirements:

• Provide services in an integrated setting, unless separate measures are necessary to ensure equal opportunity.
  
  
• Make reasonable accommodations in policies, practices, and procedures that deny equal access to individuals with disabilities, unless doing so would fundamentally alter the nature of the services.
  
  
• Furnish auxiliary aids when necessary to ensure effective communication, unless undue burden or fundamental alteration would result.
  
  
• Remove structural and architectural communication barriers in existing facilities where readily achievable--"easily accomplished and able to be carried out without much difficulty or expense."
  
  
• Provide readily achievable alternative measures when removal of barriers is not readily achievable.
  
  
• Maintain accessible features of facilities and equipment.
  
  
• Ensure that newly constructed public accommodations and commercial facilities should be convenient to get to, enter, and use for all patrons or employees with disabilities.

MEETING THE REQUIREMENTS OF THE AMERICANS WITH DISABILITIES ACT

In The Americans with Disabilities Act and Criminal Justice: An Overview, Rubin (1993) suggests the following questions to determine whether a governmental agency is meeting the requirements of the ADA:

• Are any modifications to the agency's policies, practices, or procedures necessary to ensure accessibility?
  
  
• Do any eligibility criteria eliminate or tend to screen out a qualified individual with a disability from enjoying the benefits of these programs, services, or activities?
  
  
• Do any policies or practices segregate persons with disabilities from others participating in these programs, services, or activities?
  
  
• Are any of these programs, services, or activities delivered at a location or facility that has the effect of denying persons with disabilities the right to enjoy the benefits of these programs, services, or activities?
  
  
• If alternative services are offered to persons with disabilities, are these benefits unequal to those offered to the public at large?

Rubin suggests that if the answer to any of these questions is "yes," the agency may need to revise the way it offers its programs, services, or activities.

For further information about ADA compliance, please refer to the Additional Resources at the end of this chapter.

NATIONAL LEVEL EFFORTS

On the national level, little attention was given to the issue of how to respond to crime victims with disabilities until the year the ADA was passed. By 1990, the crime victims' discipline had achieved significant recognition and VOCA funding had enabled crime victim assistance and compensation programs to expand services and increase in number. Several milestones that illustrate the victim service field's growing awareness and concern about addressing the needs of victims with disabilities are noted below:

• In 1990, the National Organization for Victim Assistance (NOVA) first helped to bring awareness to the many obstacles faced by disabled victims seeking services with its publication entitled Responding to Disabled Victims of Crime in 1990 (Tyiska 1990).
  
  
• In 1992, the National Resource Center on Child Sexual Abuse (NRCCSA) published a comprehensive series of articles, written by research and practitioner experts, on the sexual abuse of children with disabilities. In addition, the Center's annual National Symposium on Child Sexual Abuse regularly features a training track on child victims with disabilities (Baladerian 1992; Pawelski 1992; Sobsey 1992; Tobin 1992).
  
  
• In 1993, with support from the Office for Victims of Crime, the National Center for Victims of Crime (NCVC) developed a training curricula entitled Differently-Abled Victims of Crime that provides extensive information on how to provide specialized services and information to disabled crime victims (Gregorie 1994).
  
  
• In 1993, the National Center on Child Abuse and Neglect (NCCAN) released findings from a comprehensive national study entitled A Report on the Maltreatment of Children with Disabilities. The study focused on maltreated children who had physical, intellectual, or emotional disabilities. It found a significant correlation between maltreated children and abuse and offered key recommendations for responding to abused children with disabilities (Crosse, Kaye, and Ratnofsky 1993).
  
  
• After the passage of The Americans with Disabilities Act in 1990, the National Institute of Justice (NIJ), within the U.S. Department of Justice, launched an initiative to examine the implications of the ADA for criminal justice agencies at the state and local levels. In 1993, NIJ published The Americans with Disabilities Act and Criminal Justice: An Overview as a bulletin in its Research in Action publication series (Rubin 1993).
  
  
• In 1994, Dick Sobsey's books, Violence and Abuse in the Lives of People with Disabilities: The End of Silent Acceptance and Violence and Disability: An Annotated Bibliography, were published. The texts extensively review literature on violence and abuse toward individuals with disabilities and provide guidance for prevention of abuse and victimization. Although much of the material focuses on individuals with developmental disabilities and abuse in institutions, the books give new weight to the overall issue of victims with disabilities.
  
  
• In 1997, the Victims of Crime Committee of the Criminal Justice Task Force for People with Developmental Disabilities in Sacramento, California, issued its report outlining evidence of the high rates of violent and criminal victimization of people with developmental and other substantial disabilities (including mental retardation, autism, cerebral palsy, epilepsy, traumatic brain injury, severe major mental disorders, degenerative brain disease such as Alzheimer's, Parkinson's, and Huntington's, permanent damage from stroke, organic brain damage, and others). These high rates of victimization, coupled with underreporting of the crimes and low rates of prosecution and conviction, led the Committee to develop fifty-nine recommendations to improve the reporting, investigation, and prosecution of such crimes. In addition, the group called for multidisciplinary teams to provide victim support and numerous measures to prevent abuse and victimization by service providers. Finally, the Committee recommended that the Bureau of Justice Statistics include information on victims with developmental and other substantial disabilities in its Crime Victimization Survey. Members of the Committee, including Daniel Sorensen, chair, and Joan Petersilia, presented the recommendations to the California legislature and to members of Congress (Criminal Justice Task Force 1997).
  
  
• On October 27, 1998 the President signed the Crime Victims with Disabilities Act of 1998 which represents the first effort to systematically gather information on the extent of the problem of victimization of individuals with disabilities. This legislation directs the Attorney General to conduct a study on crimes against individuals with developmental disabilities within eighteen months. In addition, the Bureau of Justice Statistics must include statistics on the nature of crimes againstindividuals with developmental disabilities and victim characteristics in its annual National Crime Victimization Survey by 2000. The legislation was sponsored by Senator Mike DeWine (OH), a former prosecutor, and represents an unprecedented level of attention to an often overlooked crime victim group.

VOCA ASSISTANCE GUIDELINES: PROVISIONS THAT ADDRESS SERVICES TO VICTIMS WITH DISABILITIES

In 1997, the Office for Victims of Crime modified the VOCA Assistance Guidelines that give direction and guidance to the states and territories administering VOCA funding to strengthen its message regarding services to victims with disabilities. According to the Office for Victims of Crime, VOCA administrators are strongly encouraged to require state and local programs to meet the needs of disabled crime victims. In the 1997 VOCA Guidelines, allowable costs to accommodate the needs of crime victims with disabilities are addressed as follows:

• 1997 VOCA Guidelines (IV.E.2.d.). The costs of furniture, equipment (such as braille equipment or a TTY for the deaf), or minor building improvements that make victims' services more accessible to persons with disabilities are allowable.
  
  
• 1997 VOCA Guidelines (IV.E.2.g.). VOCA funds generally should not be used to support contract services. At times, however, it may be necessary for VOCA subrecipients to use a portion of the VOCA grant to contract for specialized services. Examples of these services include assistance in filing restraining orders or establishing emergency custody/visitation rights (the provider must have a demonstrated history of advocacy on behalf of domestic violence victims); forensic examination of a sexual assault victim to the extent that other funding sources are unavailable or insufficient; emergency psychological or psychiatric services; or sign and/or interpretation for the Deaf or for crime victims whose primary language is not English.

THE FIRST NATIONAL SYMPOSIUM ON WORKING WITH VICTIMS OF CRIME WITH DISABILITIES

The Office for Victims of Crime within the U.S. Department of Justice provided funding to NOVA to host a two-day "Transfer of Knowledge" symposium on the needs of victims with disabilities. The symposium convened experts (including victims of crime with disabilities) from the fields of disability rights and services, crime victims advocacy and services, and research, January 23-24, 1998, to discuss issues related to the extent of victimization of people with disabilities and how to improve the capacity and preparedness of victim service providers to respond effectively to the needs of crime victims with disabilities.

Highlights of the symposium discussions were published in an OVC Bulletin, entitled Working with Victims of Crimes with Disabilities (Tyiska 1998). The Bulletin represents the first attempt to outline recommendations for crime victim and disability advocates, service providers, and Department of Justice agencies with regard to this important topic. The Symposium participants developed fifteen recommendations for criminal justice agencies and victim service programs, eight recommendations for disability rights specialists, ten recommendations for OVC, and five recommendations for otherDepartment of Justice agencies. Excerpts from the recommendations for criminal justice and victim assistance programs are as follows:

Accessibility.
1. Criminal justice agencies and victim service programs should receive training on the requirements of the Americans with Disabilities Act and should support its vigorous enforcement. Such agencies and programs should take advantage of technical assistance that is available and abide by the letter as well as the spirit of the law, ensuring equal access to the justice system.

2. When full implementation is not immediately achievable, criminal justice agencies and victim service programs should initiate a transition plan that focuses on obtaining accessibility by a specified date. Such compliance plans are mandated under Titles II and III, and should guide the development of incremental steps toward accessibility.

3. Criminal justice agencies and victim assistance programs should be proactive in acquiring technology that would help crime victims with disabilities to be informed, present, heard, and understood when they communicate with law enforcement officers, prosecutors, judges, and victim advocates, through all phases of the criminal justice process. (Note: VOCA funds may be used to cover the costs of acquiring assistive devices and other necessary efforts that enable victim service providers and crime victims to communicate effectively.)

4. Once the agency is accessible and staff is trained, criminal justice agencies and victim assistance programs should publicize their ability to work with crime victims with disabilities by putting the universal symbol of access (a line drawing of a wheelchair) and a TDD/TTY number on all literature, promotional materials, and business cards issued by the agency.

Training and networking.
5. Criminal justice and victim assistance personnel should receive training on disabilities, including instruction on disability cultures. In addition, criminal justice and victim assistance programs should enlist qualified people with a wide range of different disabilities to lead the development of policies and programs designed to assist crime victims with disabilities.

6. Criminal justice and victim assistance programs should reach out to local disability service organizations, providing information about victims' rights and services.

7. Criminal justice and victim assistance programs should develop coalitions, as well as cross training and joint training opportunities, with disability advocacy and service programs to build better working relationships and to improve mutual understanding of each others' programs and services.

Improved policies, procedures, and protocols.
8. Agencies should implement or extend streamlined interviewing and intake procedures so that crime victims with disabilities, particularly those with cognitive or communication disabilities, do not have to undergo repeated interviewing in different locations. A multidisciplinary approach involving law enforcement, prosecution, victim assistance, and others as needed, in victim-friendly environments would be far more effective as well as cost-efficient.

9. Agencies should develop and implement specific protocols on disclosures, confidentiality, and safety for crime victims with disabilities, particularly where there is potential for retaliation by a caregiver or a disability services agency. For example, when a crime victim with a disability reports to law enforcement or others that he or she is being victimized by a caregiver, the victim should be provided assistance with relocating or obtaining an emergency replacement caregiver.

10. Criminal justice and victim assistance programs should incorporate into existing policies, procedures, and protocols the specific inclusion of persons with disabilities who are victims or witnesses of domestic violence, sexual violence, child abuse, impaired driving crashes, survivors of homicide victims, or other violent personal crimes, and economic crimes.

In conclusion, the author notes that although few networks exist that link victim service providers with their counterparts in the field of disability, such linkages at the local level hold the greatest hope for policy and programmatic changes that will improve services for crime victims with disabilities. Such a partnership, built on mutual respect and a willingness to share knowledge and ideas, will strengthen the ability of victim and disability advocates to ensure that all crime victims are afforded fundamental justice and access to quality, comprehensive services.

RESEARCH FROM THE NATIONAL INSTITUTE OF JUSTICE

In 1997, the National Institute of Justice (NIJ) released a report entitled Americans With Disabilities Act: Emergency Response Systems and Telecommunications Devices for the Deaf. As part of NIJ's Research in Action series, the report summarizes results and lessons learned by the incorporation of telecommunication devices for the Deaf through TDD capability in Denver, Colorado's 911 telephone emergency response services.

ADMINISTRATION ON DEVELOPMENTAL DISABILITIES INITIATIVES

The Administration on Developmental Disabilities (ADD) in the U.S. Department of Health and Human Services has given new priority to the issue of preventing victimization and improving the response to individuals with developmental disabilities who are victims of crime. In 1998, ADD funded nine discretionary grants primarily to university affiliated programs which specialize in providing services and training to professionals who work with individuals with developmental disabilities. A list of the programs, which are located around the country, along with their major goals is provided below:

• End the Silence. The Institute on Disabilities at Temple University is conducting a three-year initiative called End the Silence funded by the Administration on Developmental Disabilities at the U.S. Department of Health and Human Services. The program approaches crime against people with developmental and other disabilities as a problem similar to violence against women, child abuse, and elder abuse. End the Silence recognizes that while much progress has been made in these three areas, crimes against people with disabilities continues to be largely invisible and unaddressed in mainstream criminal justice. Part of the initiative is devoted to self-advocacy. Individuals with disabilities, including victims, are taking an active role in developing the training material on sexual abuse awareness and are participating in the pilot training programs.
  
  Program goals are to:
  
  
  • Develop and disseminate focused training curricula.

  • Develop communication boards with understandable vocabulary and symbols to convey risk prevention strategies and disseminate them to individuals with significant cognitive and speech disabilities and/or assist these individuals in reporting sexual abuse when it occurs.

  • Pilot test the training curricula for law enforcement, victim service providers, prosecutors, families, and allies in a five-county area around Philadelphia.

  • Conduct research and advance systemic change.

  • Conduct a national public awareness campaign on the victimization of individuals with disabilities.
    
    
• Coalition on Disability and Abuse: Equity and Equality Under the Law, Institute on Disability and Human Development/University of Illinois at Chicago, Chicago, IL. The purpose of this project is to promote equal treatment by the criminal justice system of crime victims with developmental disabilities by developing, piloting, and disseminating a modular training curriculum for representatives of the criminal justice system, human service providers, and self-advocacy organizations.
  
  
• Project Equality: Obtaining Justice Under the Law for People with Developmental Disabilities, Center on Aging and Developmental Disabilities/University of Miami, Miami, FL. Criminal justice personnel are required to make reasonable accommodations to assist individuals with developmental disabilities who encounter the justice system as victims of crime. This project will develop training materials for criminal justice professionals and self-advocates. Self-advocates will receive training about their right to participate in the criminal justice system and their entitlement to appropriate victim assistance and crime prevention strategies.
  
  
• Invisible Victims of Crime-Individuals with Developmental Disabilities, Vermont Protection and Advocacy, Montpelier, VT. This project is a collaborative effort among organizations representing people with developmental disabilities and key criminal justice agencies. The purpose of the project is to educate criminal justice personnel, allied service providers, and people with developmental disabilities in understanding and responding to the problem of crime and violence against people with developmental disabilities.
  
  
• Advocacy, Collaboration, and Training (ACT) For Justice, A. J. Pappanikou Center/ University of Connecticut, Storrs, CT. The ACT for Justice Project is designed to eliminate physical and attitudinal barriers that prevent an equitable response from the justice system in Connecticut when crimes are committed against consumers with developmental disabilities. Project objectives are (1) conduct research and data collection regarding the nature, type, incidence, extent, and setting of crimes; identify risk factors associated with victims and characteristics of perpetrators; (2) increase responsiveness to reports of crimes against individuals with developmental disabilities; (3) develop methodologies that will promote an increase in self-advocacy behaviors among consumers, effecting a reduction in risk of victimization; (4) promote equitable prosecution and sentencing of perpetrators of crimes against persons with developmental disabilities; and (5) develop and disseminate a model for collaborative, interagency training that can be adapted and implemented throughout other communities in Connecticut and the United States.
  
  
• Safety First: Sexual and Domestic Violence Prevention and Response Strategies for Women with Developmental Disabilities, Metropolitan Organization to Counter Sexual Assault, Kansas City, MO. This collaborative project of the Metropolitan Organization to Counter Sexual Abuse (MOCSA), Rose Brooks Center (a domestic violence service agency), the University of Missouri-Kansas City University Affiliated Program, and criminal justice organizations has as its goal the improvement of safety, independence, and productivity of women with developmental disabilities through enhancement of the current network that addresses domestic violence and sexual abuse and the enhancement of the consumer's ability to prevent this violence.
  
  
• The Arc of Maryland, Annapolis, MD. The Arc of Maryland, in partnership with The Arc of Southern Maryland and The Arc of the United States, proposes to develop, pilot, and evaluate an 8-12 class gender violence prevention curriculum for women and adolescent girls with developmental disabilities.
  
  
• Personal Safety Awareness Center, Travis County Domestic Violence and Sexual Assault Survival Center, Austin, TX. The Personal Safety Awareness Center (PSAC) will create a statewide abuse/violence prevention and intervention program for persons with disabilities. The project objectives include increasing awareness of Texans with disabilities, families, caregivers, and disability service providers about domestic violence; increasing accessibility of domestic violence/crisis services; and increasing access to counseling/support services for family violence victims who have disabilities and their families.
  
  
• Women with Developmental Disabilities Violence Project, Oregon Health Sciences University, Portland, OR. The goal of this project is to design, demonstrate, and evaluate a coordinated community education program to empower women with developmental disabilities to prevent, recognize, and address violence.

Terminology

Over the last two decades "accepted" terminology related to disabilities has changed significantly. The term "mainstreaming" was used a decade or more ago to refer to enabling individuals with disabilities, particularly children who had been placed in separate special education classes, to participate and receive services in their public school or community. More recently, the term "inclusion" is used to convey the practice of including people with disabilities in "regular" programs or services, instead of special/separate services. "Least restrictive environment" refers to the optimum environment with the least amount of restriction in which the individual with a disability can learn, develop, and function as independently as possible. For example, an individual with a developmental disability may live in a group home that offers fewer restrictions and more opportunities for independence and community involvement than does living in an institution.

At the time of enactment of the 1973 Rehabilitation Act, the terms "handicapped" and "people with handicapping conditions" was used to describe people with disabilities. In 1990 when the Americans with Disabilities Act was passed, "individuals with disabilities" was commonly used throughout thestatute and its implementing regulations to refer to the entire population of people who are covered by the protections conveyed in the Act.

Despite this usage in legislation and laws, one important message is clear: an individual with a disability may be very comfortable with some terms and very uncomfortable with others. The "disability community" is not a single entity with a single set of preferences or concerns about terminology or treatment. In fact, it encompasses a very diverse group of individuals with disabilities and their family members. It is so diverse because literally hundreds of physical and mental conditions that limit major life activities, to a mild or severe degree, are covered by the ADA (for example, diabetes, mental illness, cerebral palsy, and learning disabilities, all of which may be associated with mild or very severe disabilities). Thus, there is no single source of information on terminology that is comfortable to all individuals with disabilities.

INDIVIDUALIZED RESPONSE

The best way to show sensitivity and respect for the preferences of a crime victim who has a disability is to ask the individual which terminology he or she is most comfortable with. For example, some individuals who have a loss of hearing are deaf, while others may have some hearing or be "hard of hearing." The terms "deaf" or "hard of hearing" may be more preferable to an individual than the term "hearing impaired." To ensure that the terms you use are not offensive, ask the individual victim for guidance on his or her individual preferences. Many terms used to describe disabilities or individuals with disabilities evoke stereotypes that are negative and dehumanizing to the individual. For example, terms such as "deaf and dumb," "disabled," or "wheelchair-bound" have a negative connotation and yet have been used by many people to describe individuals with disabilities. Such terms should not be used.

When designing services for individuals with disabilities, victim assistance providers should be mindful that many advocates for crime victims with disabilities regard the terms "special needs" or "special services" as negative and inappropriate. They point out that victims with disabilities simply want the services to which they are entitled and request reasonable accommodations to ensure that they are accessible. They do not want "special services," they want appropriate and accessible services that are individualized to meet their needs (Tyiska 1998).

Care also should be taken with regard to the term "victim" when working with crime victims with disabilities. The term "victim" has been used with a negative connotation to refer to many medical conditions, for example "victim of heart disease" or "victim of cancer." Many disability advocates have fought to overcome this label, and its use following criminal victimization may add an additional burden due to prior experience. This may be a significant issue for some, and not a concern for others. Again, the best way to ensure sensitive treatment of a crime victim is to ask about individual preferences.

Guidance for Working with Crime Victims with Disabilities

While no all-encompassing, up-to-date curriculum that outlines strategies for working with all victims with disabilities is currently available, the following section offers guidance for victim assistance service programs on addressing the needs of crime victims with disabilities. These recommended strategies incorporate many of the ideas contained in Gregorie's Focus on the Future (Gregorie 1994) and the recent OVC Bulletin, Working with Victims with Disabilities (Tyiska 1998).

The best method of determining what accommodations people with different disabilities need in order to access services is to solicit the input of individuals with different disabilities regarding how to make a program or facility accessible. Contacting local organizations that provide services to individuals with various types of disabilities and inviting their guidance and collaboration in assessing accessibility and planning improvements are essential to achieving a truly accessible victim service program--a program that is barrier-free in both architecture and communication access.

SPECIFIC SUGGESTIONS FOR SERVING CRIME VICTIMS WITH DISABILITIES

• Treat victims with disabilities with compassion, dignity, and respect.
  
  
• Ask the individual victim how you should communicate most effectively with him/her.
  
  
• Address and speak directly to the victim, even if he/she is accompanied or assisted by a third party.
  
  
• Ask the individual victim about whether or what type of physical assistance the individual would prefer, before offering an arm or hand for support or to guide.
  
  
• Address the victim's safety, expressed concerns, and immediate needs first.
  
  
• Ask the individual victim if he/she has any transportation or other needs that will require individualized services or arrangements and then attempt to make arrangements to meet those needs.
  
  
• Don't tell the victim with a disability that you admire his/her courage or determination for living with his/her disability.
  
  
• With regard to most accommodations, take your cue from the victim.
  
  
• When communicating with an individual who is hard of hearing and who prefers to speech-read, face the person directly when speaking. Be sure you have the person's attention before you begin speaking. Speak slowly and distinctly, but not unnaturally. Avoid gesturing and reduce background noise, which may be distracting. Speak in a normal tone of voice without shouting.
  
  
• When using a sign language interpreter, have him or her sit next to you so that the hearing impaired victim can easily shift his/her gaze back and forth from the interpreter to you.
  
  
• As with all victims, it is appropriate to assist victims with disabilities in becoming acquainted with the physical surroundings of your office and, if necessary, the courtroom where he or she may be coming for interviews and/or hearings.
  
  
• When greeting or meeting with a person who is blind or has very limited vision, indicate your presence verbally, identify yourself by name, and speak in a normal tone. If others are also present, ask each person to identify himself/herself. This will enable the blind person to associate the voice with the name and know the relative location of each person.
  
  
• When giving directions to someone who is blind or has very limited vision, be as clear and specific as possible. Make sure to identify obstacles in the direct path of travel. To be most helpful, ask the individual, "I would be happy to give you directions. How should I describe things?"
  
  
• Do not assume that a victim who uses a wheelchair or walker needs your assistance entering a room. Provide mobility assistance only if you are asked.
  
  
• Be aware that a person's wheelchair is a part of his/her body space and needs to be treated as such. Do not stand too close to the wheelchair, as this could block the individual's movement with the wheelchair if he or she wanted or needed to move about.
  
  
• When working with a person with a developmental disability, give the individual time to respond. Rapid or intense questioning is likely to cause confusion. Talk slowly and calmly, using easy-to-understand language with clear, concise concrete terms. Do not use complex sentences.
  
  
• Obtain expert consultation on how best to communicate with individual victims with developmental disabilities and victims with serious mental illness.
  
  
• Depending on the victim's level of mental disability, the victim's parent or guardian should be present when meeting with the victim in the office or at another location.

GETTING PREPARED-PROACTIVE STEPS YOUR PROGRAM SHOULD TAKE

• Establish contact, exchange information, and develop a list of local and state organizations and service providers that have expertise in working with individuals with various types of disabilities to provide consultation and to provide information and referral to crime victims.
  
  
• Develop a training program for staff to enhance their understanding of individuals with various disabilities in order to better understand the needs of crime victims with disabilities.
  
  
• Develop a resource directory of qualified professional (including court certified) interpreters for assistance with deaf victims or others who need facilitated communication.
  
  
• Enlist the assistance of service providers and individuals with disabilities in assessing your program's architectural and communication accessibility and in designing appropriate accommodations. Also, tap such individuals and organizations for suggestions on how to make individuals with disabilities aware of the availability and accessibility of services for crime victims with disabilities.
  
  
• Ensure that the courtroom and offices are physically accessible to all victims, especially those who may use a wheelchair or walker or who have limited stamina for walking.
  
  
• Be aware of the location of wheelchair ramps and accessible restrooms so that you can direct the victim to these facilities, when needed.
  
  
• Install a TDD or a TTY telephone or become familiar with the operation of and use a relay service to make your program accessible for deaf victims.

Innovations in Training

UNDERSTANDING MENTAL RETARDATION: TRAINING FOR LAW ENFORCEMENT

A three-hour training curriculum, Understanding Mental Retardation: Training for Law Enforcement, provides police officers with information about victim and offender issues involving people with this disability. The training includes a fifteen-minute video, program materials, hand-outs, and references for background reading. The ARC of the United States, 500 E. Border Street, Suite 300, Arlington, TX 76010 (817-261-6003) (Davis August 1998).

RESPONSE PROTOCOLS FOR THE MALTREATMENT OF CHILDREN WITH DISABILITIES

The National Center on Child Abuse and Neglect at the Department of Health and Human Services has sponsored the development of a curriculum to provide trainers with a framework for teaching victim service providers about the maltreatment of children with disabilities. Responding to Maltreatment of Children with Disabilities: A Trainer's Guide is made up of five modules that include an introduction to disabilities; the relationship between maltreatment and disabilities; assessment protocols; child protective services practices for children with disabilities; and risk reduction. The training curriculum specifically addresses myths about disabilities; impact of disability on communication and culture; incidence and prevalence of abuse and neglect; signs of abuse and neglect; and medical examination practices. The curriculum manual provides a lecture guide, participant guides, trainer's texts, transparencies or Power Point slides, and videotapes for each module (Steinberg, Hylton, and Wheeler 1998).

SEXUAL ABUSE OF CHILDREN AND ADULTS WITH DISABILITIES

The Disability, Abuse & Personal Rights Project (DAPR) has developed sensitive forensic interviewing protocols for use by criminal justice professionals with victims of sexual assault who have cognitive and communication impairments. A curriculum for police making first response is currently under development. For disability service providers, DAPR has developed training on the identification and reporting of sexual assault. They have also developed training on risk reduction strategies for parents of and individuals with cognitive and communication impairments. They are currently working with the California State Board of Control (SBOC) and child protective services to change the child victim data collection system to include the reporting and tracking of children with disabilities who are sexually assaulted, and children who are disabled as a result of abuse. In addition, DAPR coordinates a national conference, conducts research, and generates articles, documents, and guidebooks on sexual assault primarily of children and adults who have developmental handicaps. Related subjects include: sexual abuse, other types of abuse, sexuality of persons with disabilities, parenting issues, protections of sexual civil liberties, and other civil rights. Issues related to abuse, such as perpetrators with developmental disabilities, and the onset of disability as a result of abuse, are also addressed. Disability, Abuse & Personal Rights Project, Spectrum Institute, P.O. Box T, Culver City, CA 90230 (310-391-2420) www.disability-abuse.com.

KEEPING YOURSELF SAFE AT HOME, AT WORK, AND IN THE COMMUNITY

Keeping Yourself Safe at Home, at Work, and in the Community is a 5-hour risk reduction program specifically designed to aid victim service and disability professionals in educating people withdevelopmental disabilities about sexual abuse and personal safety strategies. A professionally developed training video (open and closed caption) and curriculum entitled Your Safety...Your Rights II has expanded this curriculum to include material appropriate for adults with physical and sensory disabilities. Both curricula contain modules for training staff who work with people with disabilities to identify abuse and handle disclosures. Network of Victim Assistance, 16 North Franklin Street, Doylestown, PA 18901 (215-348-5664; TDD 215-348-2963).

Promising Practices

• Abused Deaf Women's Advocacy Services (ADWAS), Seattle, Washington. In 1986, Marilyn Smith founded Washington state's Abused Deaf Women's Advocacy Services (ADWAS), which offers a twenty-four-hour crisis line, counseling and legal advocacy for deaf and deaf-blind victims of sexual assault and domestic abuse. Most staff members and volunteers are deaf or hard of hearing. The program has developed training for both deaf and hearing crime victim advocates and has published educational materials targeted specifically for deaf adult and youth victims. In 1997, the Office for Victims of Crime (OVC) awarded a grant to ADWAS to develop a training and technical assistance package for five cities across the country, to create and expand services for deaf women who are victims of sexual assault and domestic violence, and to provide follow-up technical assistance on-site to replicate its successful program.

  After the first year of this project, twenty-three deaf women from five separate communitites (the San Francisco Bay area, Minneapolis, Rochester, New York, Boston, and Austin, Texas) were undergoing training for the development of services for deaf women who are victims of sexual assault and domestic violence. ADWAS staff delivered follow-up technical assistance on-site in each of the communities. At the close of 1998, all five communities were preparing to offer a twenty-four-hour crisis line and basic services to victims during 1999. During the next phase of this project, OVC will fund ADWAS to assist the development of programs for deaf women in additional communities, including Washington, DC, Des Moines, Iowa, Burlington, Vermont, and Flint/Detroit, Michigan.
  
  

• The Midwest LEAD Institute-Leadership Through Education and Advocacy for the Deaf (MLI). The Institute has developed a program to provide culturally and linguistically appropriate crisis intervention and counseling services to deaf victims of domestic violence. With support from VOCA funds, MLI provides volunteer sign language interpreters for shelters and agencies, and has established a twenty-four-hour 1-800 crisis line for deaf victims of violent crime. MLI also developed a manual entitled Breaking the Silence--A Manual on Domestic Violence and the Deaf Community to help shelters and other agencies meet the needs of their deaf clients (Marshall 1997).
  
  
• The Parent Advocacy Coalition for Educational Rights Center (PACER). The Center is a coalition of nineteen Minnesota disability organizations that is staffed primarily by persons with disabilities as well as by parents of children with disabilities. PACER has developed a special program to help teach disabled children about child abuse. The project, entitled "Count Me In," reaches over 14,000 school children each year. Over thirty trained volunteers take life-sized puppets to schoolsto promote understanding of children with disabilities and help children feel comfortable with disabled children. These puppets are also used to teach disabled children about child abuse (Grayson 1992).
  
  
• The Bronx Independent Living Services Crime Victims and Domestic Violence Programs, Bronx, New York. The BILS Crime Victims Program provides assistance to all types of crime victims with disabilities. Victim assistance services include crisis intervention; assistance with the state crime victims compensation application; assistance with housing, Medicaid, or Public Assistance; accompaniment to police stations and courthouses; supportive counseling; information and referral to community service programs; information about the progression of cases through the criminal justice process; support groups; interpreters for sign language and Spanish; a wheelchair lift van for transportation; barrier-free entry to court buildings, shelters, and offices where people can assist victims; and community education and advocacy.
  
  
• Barrier Free Living, Inc. (BFLI), New York City. As one of the first Independent Living Centers to offer services to domestic violence victims with disabilities, the BFLI offers shelter to domestic violence victims with disabilities and counseling, skills training, court accompaniment, advocacy, and assistance in finding alternative housing. Sign interpreter services and Spanish-speaking staff are available to assist with communication. In addition, van transportation is available.
  
  
• Hennepin County Attorneys Office, Minneapolis, Minnesota. Working closely with the local police departments, the Hennepin County Attorneys Office developed Police and People with Disabilities, a training program that promotes more effective treatment of individuals with disabilities.
  
  
• Domestic Violence Access Project, State of Hawaii. Using Violence Against Women Act grant funding, the Hawaii Attorney General's Office supports a statewide effort to link domestic violence programs with programs that serve individuals with disabilities. The linkages are designed to enable shelter programs to receive training on disabilities and make accommodations to increase accessibility to programs.
  
  
• Enhancing Your Interactions with People with Disabilities. This American Psychological Association (APA) brochure targets victim service providers, mental health providers, advocates, and psychologists and assists them in the development of improved communication skills with people with disabilities. Enhancing Your Interactions with People with Disabilities addresses three critical areas:
  
  
  • Initial approaches to people with disabilities. The effective use of language in portraying their condition lays the groundwork for the success of further communication. Words mirror prevailing attitudes, and societal attitudes are the fundamental barriers that people with disabilities must overcome to have successful interactions.
    
    
  • Communication issues. To reduce anxiety when interacting with people with specific disabilities, the brochure offers specific advice on how to communicate with deaf individuals, the visually impaired, the speech impaired, and individuals with mobility impairments.
    
    
  • Compliance. To meet the legal and ethical obligations as set forth by The Americans with Disabilities Act, and to better serve the needs of individuals with disabilities, the brochure offersguidelines and advice on service requirements, referrals, physical barriers to office access, and specials aids to enhance communication.
    
    
  The brochure is available by mail from APA or in an alternative form on its Web site. American Psychological Association, 750 First Street NE, Washington DC 20002 (800-374-2721).
  
  
• All Walks of Life. The mission of this Texas-based, nonprofit organization is to empower social solutions for people with disabilities. They believe that the vulnerability of people with disabilities attracts predators, and that whenever there is a reduction in an individual's mobility or life skills, there is an increased risk of violence and repetition of violence unless measures are taken to prevent it. All Walks of Life promotes the position that people with disabilities can and should engage in prevention solutions, that they are capable of being responsible for self-awareness that they live in a violent culture, and that they should learn violence prevention skills that will help them compensate for their vulnerability. The All Walks of Life Web site includes useful resources and links relating to violence and violence prevention for people with disabilities. All Walks Of Life, 9106 Benthos, Houston, TX 77083 (281-495-9226).

Web Sites

• The National Information Center for Children and Youth with Disabilities (NICHCY). Sponsored by the U.S. Department of Education, Office of Special Education Programs, NICHCY is a national information and referral center on disabilities and disability-related issues for families, educators, and other professionals that emphasizes services to children and young adults, age twenty-two years or under. State resource sheets that help locate organizations and agencies that address disability-related issues serving children and youth can be found through NICHCY, P.O. Box 1492, Washington DC 20013 (800-695-0285).

• Disability Resources, Inc. Disability Resources, Inc., a nonprofit organization, maintains the Disability Resources Monthly (DRM) Guide to Disability Resources on the Internet, an extensive online resource established to promote and improve awareness, availability, and accessibility of information that can help people with disabilities. It serves individuals with disabilities through a multidisciplinary network of service providers and consumers, targeting their services and publications to libraries, disability organizations, independent living centers, rehabilitation facilities, educational institutions, and health and social service providers. The DRM WebWatcher maintains an extensive database of disability-related resources (links to Web sites, documents, databases, and other informational materials) in order to perform customized searches, including a page for victims of abuse who have disabilities.

Victimization of Individuals with Disabilities Self-Examination

1. Identify the types of victim assistance programs that are covered under Title II of the ADA and name two ways that compliance issues may arise for such programs.

2. Who is considered to be a "qualified individual with a disability" under Title II or Title III of the Americans with Disabilities Act?

3. Since enactment of Section 504 of the Rehabilitation Act, must all government programs, regardless of whether they receive federal funding, meet the anti-discrimination requirements of the Act?

4. What are some of the obstacles faced by crime victims with disabilities in receiving victim assistance services?

5. You have just received a case file involving a victim who is deaf and has been referred to your program for services. Name three important factors you will consider in planning your response.

6. List four agencies or organizations in your community that you believe would be helpful in assisting your office to assess how "barrier-free" your programs and services are, and include one reason why you would tap the expertise of each.