A journey through hard numbers and facts
Presentation by Karel Van Isacker at the National conference "Violence and the child of the 21st century - conceptual and practical challenges", 23-24 November 2017, Grand Hotel Plovdiv, Bulgaria
Organisers: University of Plovdiv "P.Hilendarski" ; State Agency for Child Protection, Municipality of Plovdiv
This PowerPoint helps students to consider the concept of infinity.
Violence linked to vulnerable groups - Children with disabilities (English version)
1. Violence linked to
vulnerable groups
Children with disabilities
A journey
through hard
numbers and
facts
Karel Van Isacker, PhoenixКМ BVBA, Belgium
2. 2 different aspects
• Violence against children with disabilities
• Aggressive behaviour and violence by children
with disabilities
3. Violence against children
with disabilities
• Children with disabilities face significant
barriers to enjoying their fundamental rights.
– They are often excluded from society, sometimes
living in facilities far from their families.
– They are also often denied access to basic
services, such as health care and education.
– They endure stigma and discrimination, as well as
sexual, physical and psychological violence.
Source: Violence against children with disabilities: legislation, policies and programmes in the EU
(2015)
4. Let’s go back in history
• The United Nations created two
important documents.
– the Convention on the rights of the child (20
November 1989)
• Article 19, 1: States Parties shall take all appropriate
legislative, administrative, social and educational
measures to protect the child from all forms of physical
or mental violence, injury or abuse, neglect or negligent
treatment, maltreatment or exploitation, including sexual
abuse, while in the care of parent(s), legal guardian(s) or
any other person who has the care of the child.
5. Let’s go back in history
• The United Nations created two
important documents.
– the Convention on the rights of people with
disabilities (13 December 2006)
• Article 16 – Freedom from exploitation, violence
and abuse
6. Reminder! 2 conventions
state that ...
• Children with disabilities must be protected from
violence.
• Children and people with disabilities have the same
rights to be part of society as everybody else.
• Children and people with disabilities must be
respected for who they are.
• Important
– All 28 EU countries signed the Children’s Rights Convention.
– 26 EU countries + EU signed the Disability Rights Convention,
only Ireland has not ratified the Convention.
7. Legislation patchwork
• only 20 EU countries have laws against
the use of physical punishment for
children (incl. spanking or using canes).
• the laws in some EU countries look at
age when discussing violent crime, other
countries look at disability, in some
countries they look at age and disability.
8. In reality ...
• “Many children” with disabilities are hurt
by people who should care for them...
but no real figures to substantiate this.
• The UN “thinks” children with disabilities
are affected by violence four times
more than children with no disability
(2012 study).
9. Where do they become
victims of violence?
• At home
– Children with disabilities can be ignored by their families. Families
can be tired because they do not get help. Families sometimes do
not have enough money to look after children with disabilities.
• At school
– Children with disabilities are often bullied at school.
– Some schools do not change the way they teach.
– Teachers are not always trained how to teach these children.
• In institutions
– Violence also happens in institutions for children with disabilities.
– People working in institutions sometimes use force to give medical
treatments or make children do what the workers want.
– Workers are also often tired as they have too much to do and do not
know how to look after children with disabilities.
10. Other reasons
• Financial worries: if a parent has to stop work to look after the
child, a vicious circle of poverty can be initiated. Lack of financial
state support .
• Different ethnic groups : they may treat children with disabilities
differently, but a child from this group may have difficulties to look
for help.
• Girls with disabilities can be victims of violence more often than
boys. Sexual violence can be more common. Girls with an
intellectual disability may be more at risk.
16. Some statements
• “There is general intolerance of different people, ‘weaker’ people.”
(Provider of outpatient and inpatient healthcare services, Lithuania)
• “When you ask someone if individuals with disabilities should have the
right to be a part of the majority population, no one says no. But
face-to-face with the matter in their daily lives, some people feel that ‘it
won’t be possible’ or ‘we don’t have to’ [include them]. So actually we
can look at this as a certain form of hidden aggression, […] a sort of
persevering in an intellectual stereotype that can actually create a
negative relationship with an individual without actually trying to rationally
understand him or her.” (Parents’ association representative, Czech
Republic)
• “Individuals with disabilities are perceived by economically active people
as a burden more often in a time of crisis, because maybe this
[economically active] person is having trouble finding a job himself.”
(NHRB representative, Czech Republic)
17. • “People with disabilities have been spoken about publicly as being
expensive, […] that they are drawing all the financial resources from the
other areas. […] I think it can lead to hostility and increased
stigmatisation as demanding and selfish.” (DPO representative,
Denmark)
• “We are probably not doing enough around integration at an early stage,
so a lot of people become adults without actually having integrated and
mixed with and understood people with disability.” (NGO representative,
United Kingdom)
• “First of all, awareness. There is a great need for systematically raising
public awareness, of promoting a change of attitudes by a variety of
programmes targeted at all ages… The thing is that the greatest
challenge faced by our society nowadays is the fact that we’re failing to
meet the new challenges our children have to handle and they lack good
examples in their own family.” (Child rights expert, Bulgaria)
• “I think that hostility comes from the lack of understanding [and] the
feeling of superiority. If this person is deprived, he is nothing, I am great.”
(Therapist in an NGO, Bulgaria)
• “Some teachers are willing to provide [support], but they really feel quite
alone.” (Public authority representative, Bulgaria)
18. • “The leading reason for violence is isolation. Regardless which group of
children are placed in an institution, isolated and labelled – they will in
any case turn into ‘objects’ and into targets of negative societal views.
[…] Institutions see [children with disabilities] as ‘physical objects’, and in
their understanding of humane treatment, this [is reflected in] care
towards these children.” (Physician, Bulgaria)
• “The mind-set in society is most difficult and slow to change through the
years. These children were hidden for long years. They were usually
hidden in institutions, away from populated areas […] and society; even
our children are not used to seeing them, to accepting them.” (Children’s
advisor and expert, Bulgaria)
• “Very often we are surprised by the people [with disabilities] themselves
because in certain situations they don’t regard such acts as being
discriminatory against them. This is why they don’t often lodge a
complaint.” (Public authority representative, Portugal)
• ”People […] think that no-one wants to have sex with someone with a
disability. Therefore people believe that nothing can happen to them.”
(NGO representative, Sweden)
19. • “The parents are ashamed that they gave birth to such a child, someone
with ‘defects’, who is not like the others and is not deserving. The child
him/herself honestly believes that he/she is unable and does not deserve
more and that he/she is just that – a bad child.” (Representative of NGO
working on inclusive education, Bulgaria)
• “If you take into account that one of [children with disabilities’] needs is to
not be singled out as special all the time, then it would be good if that
were not the case in an anti-bullying programme either.” (NGO
representative, the Netherlands)
• “Serious forms of violence are met at schools as usually older students
harass younger ones or children who are physically weaker or shyer than
other children, so such negative acts are actually a result of complex
reasons and influences, where a particularly important factor is attitudes
in society and tolerance towards violence.” (Ministry official, Bulgaria)
• “Unfortunately this aggression which is directed towards the child leads
sometimes to the creation of negative attitudes in the child and he/she
refuses to go to school. Then very often they isolate these children in the
individual form of education i.e. the school comes to their homes, but this
isolates them because for children with disabilities the most important
thing is […] to achieve social skills [and not be] locked at home.” (NGO
representative, Bulgaria)
20. • “It is true that children who are now integrated in [mainstream] education
face resistance. Parents of other children do not want to have a child
with disability in their children’s class.” (NHRB representative, Bulgaria)
• “Very early the children internalise that they are not like the other
children, that they are ‘worse’ and ‘more stupid’ because they do not
cope with the school material, and that they are spoiled, lazy and, when
at school, they already know that they are not worthy.” (Representative
of an NGO working on inclusive education, Bulgaria)
• “[Socioeconomic position] is the biggest factor that determines whether
you will or will not get good care, whether you will or will not get a good
education, whether you can or cannot sufficiently participate in society.
With children with disabilities that is just exponentially more.” (Healthcare
inspectorate representative, the Netherlands)
• “Unfortunately there is more and more evidence that children are being
bullied because of poverty. Poverty compounds these issues for children
with disability.” (NHRB representative, United Kingdom)
• “Being a foreign person with disabilities is one of the worst possible
situations because s/he has the double face of difference.”
(Representative of the national teachers’ support organisation, Italy)
21. • “Most complaints reflect the fact that in poor
families, especially those with disabled children,
neglect and hostility manifests more often. I have
worked on cases where mothers claim that the
siblings of her disabled child have developed an
aggressive attitude to their little sister because
they believe that most of the family income gets
invested into overcoming her impairment. So,
social services should account for that.” (NHRB
representative, Bulgaria)
Any violence inflicted on disabled children will further
induce their disability level, increase rehab & recovery
challenges, and induce their resistance against
treatment effects.
22.
23. Needed steps
• More people with disabilities need to be
told about what to do when they are
victims of violence.
• More professional people like teachers,
social workers, need to be able to
recognise violence.
24. Spotlight on Bulgaria
• Childhood for everyone
– In 2010, Bulgaria adopted a “Vision for deinstitutionalisation of children”,
which aims to close down all 137 institutions for children and to provide
alternative community services for all vulnerable children by 2025.
– Link: Bulgaria, State Agency for Child Protection, see:
http://sacp.government.bg/detstvo-za-vsichki
• Coordination mechanism for interaction on cases of child abuse
or children at risk of abuse and for interaction in crisis intervention
– The coordination mechanism is in place since 2010. When notice of abuse is
given, it requires a designated caseworker to conduct an investigation within
24 hours and convene a meeting with a multidisciplinary team, including a
wide range of professionals, and, in some cases, municipality
representatives, the regional police department, the regional healthcare
centre, the child’s personal doctor, the director of the school, kindergarten or
other service-providing unit, and others.
– Link: Bulgaria, State Agency for Child Protection, see:
http://sacp.government.bg/deinosti/sporazumenie-deistvia-deca-risk/.
25. Available material
• Making life a safe adventure - Strengthening families
of children with disabilities to prevent maltreatment
– A multidisciplinary team from various DPOs prepared a booklet
on preventing the maltreatment of children with disabilities in
domestic environments. It highlights the importance of the family
and of its strength and needs, and seeks to counter feelings of
frustration, omnipotence or superiority among professionals by
providing them with a concrete and – perhaps for some – new
perspective on their work.
– The booklet primarily targets professionals whose work involves
supporting the well-being of children with disabilities and their
families.
– The booklet was funded under the Daphne programme and is
available in English, Estonian, German, Greek, Italian, Latvian,
Polish and Portuguese.
– Italy, AIAS Bologna, see:
http://www.aiasbo.it/progetti/daphne/daphne_publications.html.
26. Available material
• Childhood, Disability and Violence - Empowering
disability organisations to develop prevention
strategies
– This booklet aims to promote awareness among associations
and cooperatives of people with disabilities and their families
about the issue of domestic violence against children with
disabilities. As such it is basically concerned with emancipation
and with helping these organisations to develop their own view
on the phenomenon. The booklet targets leaders and staff
members of disability organisations that want to discuss the
issue of maltreatment within the organisation or with their
external network and it provides quality information written by
peer organisations.
– The booklet was funded under the Daphne programme and is
available in English, Estonian, German, Greek, Italian, Latvian,
Polish and Portuguese.
– Italy, AIAS Bologna, see:
http://www.aiasbo.it/progetti/daphne/daphne_publications.html.
27. Aggressive behaviour and
violence by children with
disabilities
• We all have a reactivity to situations that produce anger, fear, or
threat as examples, and most of our instinctive reaction is to
protect ourselves physically.
– Within those patterns of reaction, aggression is a frequent one.
• Aggressive behaviour is common among youth, especially young
children.
• However, families and health professionals can take steps to help
reduce violence and aggression.
– Stay calm
– Praise positive behaviour
– Work with the child’s health professional.
28. • Examples of physical aggression:
– Biting
– Hitting
– Kicking
• Examples of verbal aggression:
– Saying “no” to parents’ or teachers’ rules
– Screaming or shouting
– Using foul language
• Anger or frustration of toddlers is usually reactive or
impulsive in response to something that has happened
to them.
• As children grow and develop more advanced
language, social skills, and planning ability, proactive
or planned aggressive behaviour may become more
common.
29. • Children with disabilities
– Not more violent or aggressive than other children.
– However:
• Some children may feel a lot of frustration related to their
disability.
• This frustration is sometimes shown through aggression or even
self-harming behaviours, such as banging their head or cutting
their skin.
– Other children have conditions that are more directly
connected to aggressive behaviour.
• E.g. children with ODD (Oppositional Defiant Disorder) are often
annoyed and angry, and they argue with adults in order to gain
control.
• Children who have a learning disability, or autism, or ADHD or
something very similar, may have episodes of explosive
emotional overload where they physically attack their family,
often focussing on their own mother.
30. – Many reasons for aggression problems.
• Everyone has times when they get frustrated or angry, and
children should be taught that frustration is normal.
• It is best to try to understand the reasons behind the
aggression and violence.
• Knowing this will help parents and health professionals
work toward reducing the problems; teaching the child
ways to cope with frustration should be part of this plan.
– But, while these children are often mostly wonderful
for the vast majority of the time...
• When something triggers them, the level of violence they
are capable of is frightening in the extreme.
31. – Aggressive or violent behaviour can be a very
difficult and discouraging issue to manage
• Especially for special needs parents and caregivers.
– Violent behaviours hinder progress in
• Education
• in becoming mature in personal independence
and social skills.
32. IASO (Immature Adrenaline
Systems Over-reactivity),
Aggressive Behaviour*
• Who is affected?
– Autism spectrum (hyperfunctioning of local neural
microcircuits in the brain which produce
hyperreactivity and hyperplasticity, over 50%
affected**)
– Bipolar disorder
– Developmental disabilities
– Obsessive compulsive disorder
– And ... children without disabilities
*See “Hope for the Violently Aggressive Child”, by Dr. Ralph Ankenma, 2014
** https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4160737/
33. • Aggression is not part of most mental
illnesses, but ...
– Mental illness can set the stage for
aggression to occur more often and more
unpredictably as a secondary symptom.
– How?
• Autism and other developmental disabilities
hinder normal maturing of the adrenaline arousal
system (an instinctual, physical response to
crisis or danger.)
• An immature or dysfunctional adrenaline arousal
system more easily triggers aggressive rage and
violence, sometimes in unexpected situations.
34. – Adrenaline over-reactivity (alpha type):
• Becomes more violent if there is any attempt to hold or
restrain them
• Personality seems changed, i.e. becoming hateful with
swearing and threatening.
• Threatens to kill or harm others or claims to hate people
they love
• Aggression seems focused and deliberate toward
particular people or targets
• Eyes may appear dilated, unfocused, or nonresponsive
• Does not apologize or seem remorseful
• Denies certain behaviors happened or seems not to
remember the event
35. – Adrenaline over-reactivity (beta type):
• Certain adults can calm the child quickly by talking to or
holding them
• Has sudden explosions of anger when frustrated
• Randomly hits out at whatever is nearby
• Says that they tried to stop but could not
• Becomes flushed (face or body reddens)
• Apologizes or seems remorseful
• Complains that their heart was beating fast or hurting
during the episode
• During episodes or when excited, has hand or finger
tremors
• Bites or picks at fingernails or skin
• During episodes is unusually strong
• Is usually very physically active
• Tends to run a high resting heart rate (90 beats per minute
or above)
36. How to solve?
• Looking at the aggressive behaviour as an ABC sandwich:
– Antecedents: these are ‘triggers’ for the aggressive or self-injurious
behaviour
– Behaviour: this is the way your child responds to the trigger
– Consequences or ‘rewards’: this is what your child gets out of
behaving aggressively, like being allowed to go on with a favourite
activity, or to leave a stressful situation.
• A better long term strategy is to:
– Prevent the behaviour by avoiding situations that trigger it
– Teach your child to express his needs in a more positive way
– Ignore self-injurious behaviour and reward your child when he
expresses himself in a more positive way.
37. • No single way to reduce aggression and
violence in all children
– Medication such as adrenaline blockers in (see
IASO)
– Try to create an environment in which violence and
aggression are less common
• Walk the talk! Do not use aggression or violence yourself.
• Do your best to keep your home life calm, supportive, and respectful.
• If your child is acting aggressively, reinforce alternative or competing
behaviours. For example, have a drawing pad handy, or play a game that
requires your child’s calm attention.
• Be sure to praise good behaviour immediately and often.
• Help your child articulate his or her feelings. Talking through their
emotions helps children of all ages.
• Work with your child to develop strategies to calm him or her when he or
she feels scared, angry, or frustrated.
38. • For some children, it is best to explain consequences for
misbehaviour ahead of time. It is important that the child
understands the consequences before they are enforced.
• Once you have set up consequences, enforce them! If bad
behaviour is not addressed regularly, it may continue or even get
worse.
• Notice when and where your child is most aggressive or violent,
and try to avoid those places.
• Tell your child’s healthcare providers as many details about your
child’s behaviour as possible. He or she will be able to offer tips
and work with you to develop a plan.
40. Good references
• 2009 Violence Exposure Among Children with Disabilities.pdf
• 2012 Prevalence & Risk Factors of Violence against Children with
Disabilities (Sys. Rev. & Meta-analysis).pdf
• 2015 Sexual Abuse involving Children with intellectual
Disabilities.pdf
• WHO 2005 Summary Report Violence against Disabled
Children.pdf