Wednesday, May 23, 2018

Many of you may have listened to the NPR series “Abused and Betrayed” earlier this year, which reported on sexual abuse of people with intellectual and developmental disabilities (I/DD). Here is information on how this affects people’s behavior and what care providers and church families can do. 

When someone with I/DD is assaulted, their behavior changes. Often it looks like the person is being uncooperative or aggressive. Care providers are not likely to know that a traumatic event has occurred, especially when the victim has communication difficulties. 

With this in mind, care providers must address the undesirable behavior in a manner that presumes it is a reaction to a traumatic event, either past or current. Typical behavioral changes that might occur after sexual assault may include: incontinence, refusals to go into certain areas, refusals to be with certain people, difficulty sleeping, crying, yelling, fearfulness, hypervigilant, nightmares, physical aggression, property destruction and self-injurious behavior; although the behavior change could be anything. 

Care providers should investigate possible medical reasons for undesirable behavior, which often requires extensive advocacy. Unfortunately, not all medical professionals are open to treating people with I/DD. 

Care providers must design behavioral supports that do not cause further trauma. This is referred to as “trauma-informed care.” 

Trauma-informed care means care providers never take things or activities away from someone as a response to undesirable behavior, other than for safety reasons, and only use physical restraint as a last resort to prevent immediate injury. 

As a reflection of your ministry, church families and care providers can strive to address undesirable behavior with unconditional, Christ-like love. When we do this, we can feel confident that we are supporting people in a manner that does not re-traumatize them. 

Using Universal Behavioral Supports – encouraging and positively reinforcing desirable behavior – is a good place to start, but additional behavioral supports are needed when someone has experienced trauma. 

Care providers and church families can also work to educate people on how to say “no.” Rather than implying “no” through undesirable behavior like hitting or property destruction, we want to help people learn to express their wishes safely. 

In general, people with I/DD who have been assaulted are not good at saying “no” or expressing resistance in any manner. To compound this issue, many providers in the I/DD field teach people that they should cooperate with anyone who seems like a staff person. 

Unfortunately, unquestioning cooperation can lead to victimization. 

Church families can help by being tolerant of different behavior and learn from care providers and individuals how best to interact with members of your congregation who have I/DD. If you have a concern, confidentially bring it to the care provider’s attention. 

Karen Fry has a Master’s degree in Clinical Psychology and is a Board Certified Behavior Analyst with almost 30 years in the I/DD field. Karen is available to Rejoicing Spirits congregations for brief consultation or training on behavioral and mental health issues. She can be reached at or (402) 896-3884 ext. 30303.