Recognizing and preventing sexual abuse

According to a study with 55,000 children in Nebraska, a child with any type of intellectual disability was four times more likely to be sexually abused than a child without disabilities (Sullivan & Knutson, 2000). While no specific numbers exist for individuals with autism, research suggests our community may be particularly vulnerable.

With this troubling information in mind, Autism Speaks is providing families with information regarding sexual abuse. Below you will find information from experts on:

  • information about risk factors
  • talking about sexuality and sexual abuse
  • tools to help prevent abuse, signs to look for to detect abuse
  • steps to take if a loved one has been abused
  • national services to call for help

Alarming new statistics

National Public Radio (NPR) ran a series of 7 stories examining the prevalence of sexual harassment and assault among people with intellectual disabilities.

Key points of the NPR series:  

  • People with intellectual disabilities are sexually assaulted at a rate seven times higher than those without disabilities. This number comes from data run for NPR by the Justice Department from unpublished federal crime data.
  • The NPR data show they are more likely to be assaulted by someone they know and during daytime hours.
  • Predators target people with intellectual disabilities because they know they are easily manipulated and will have difficulty testifying later. These crimes go mostly unrecognized, unprosecuted and unpunished. And the abuser is free to abuse again.
  • Police and prosecutors are often reluctant to take these cases because they are difficult to win in court.

How to talk about sexuality

While this can be a difficult topic, families are urged to address the dangers of sexual abuse in ways that are comfortable for them. Being aware and educating yourself and your loved ones will help to keep everyone safe.

Parents may feel anxious teaching their children about sexuality, especially children with autism. Some parents feel that it is less important to teach young adults with autism about sexuality with the assumption that it is unlikely to become a part of their lives. This is not the case.

Sexuality education from parents is very important for people with autism because they are less likely to learn about it from their peers, movies, or other similar sources. People with autism must know the difference between appropriate and inappropriate behavior, and to distinguish between the various types of healthy relationships.

Though the task may seem overwhelming, starting as EARLY as possible and being DIRECT as possible is best.

Sexuality instruction focuses first and foremost on personal safety and self knowledge. So while sexuality education may be both frightening and complex, it should be considered a key element of a comprehensive transition plan, when the goal is to be a safe, competent, and confident adult (Peter F. Gerhardt, EdD, expert on applied research across the lifespan).

Comprehensive sexuality education consists of instruction in three distinct content areas:

  1. Basic facts and personal safety
  2. Individual values 
  3. Social competence

Focusing on basic safety skills should be considered both necessary and appropriate for people on the autism spectrum.

These skills include:
  • closing and locking bathroom or stall doors
  • understanding personal privacy and who can and who cannot help you in the bathroom or with personal care skills
  • body part identification using adult terminology (e.g., penis instead of peepee)
  • using public restrooms independently
  • the restriction of nudity to personal bathroom or bedroom
  • the issue of personal space for both self and others

Sexuality education for people with autism is often regarded as a “problem because it is not an issue, or is an issue because it is seen as a problem.” (Koller, 2000, p. 126).

This means sexuality for people with autism is likely to be ignored until it becomes a problem. A better approach is to address sexuality as teaching the person to be safer, more independent and more integrated into their own communities. This can result in a more positive quality of life.

How to prevent sexual abuse

The National Child Traumatic Stress Network provides some helpful tips on protecting children from sexual abuse:

  • Teach children accurate names of private body parts.
  • Avoid focusing exclusively on “stranger danger.” Keep in mind that most children are abused by someone they know and trust.
  • Teach children about body safety and the difference between “okay” and “not okay” touches.
  • Let children know that they have the right to make decisions about their bodies. Empower them to say “no” when they do not want to be touched, even in non-sexual ways (e.g., politely refusing hugs) and to say “no” to touching others.
  • Make sure children know that adults and older children never need help with their private body parts (e.g., bathing or going to the bathroom).
  • Teach children to take care of their own private parts (i.e., bathing, wiping after bathroom use) so they don’t have to rely on adults or older children for help.
  • Educate children about the difference between good secrets (like surprise parties—which are okay because they are not kept secret for long) and bad secrets (those that the child is supposed to keep secret forever, which are not okay).
  • Trust your instincts! If you feel uneasy about leaving a child with someone, don’t do it. If you’re concerned about possible sexual abuse, ask questions.

The best time to talk to your child about sexual abuse is NOW

Warning signs of sexual abuse

Parents, caregivers and friends can protect their loved ones by learning certain signs that may indicate victimization. It is important to remember that each person is different and can show different signs. Recognizing possible signs of abuse can help you to assist the victim in getting help and stopping the abuse as soon as possible.

The American Psychological Association outlines behaviors common in children who have been abused:

  • An increase in nightmares and/or other sleeping difficulties
  • Angry outbursts
  • Anxiety
  • Depression
  • Difficulty walking or sitting
  • Withdrawn behavior
  • Pregnancy or contraction of a venereal disease, particularly if under age 14
  • Propensity to run away
  • Refusal to change for gym or to participate in physical activities
  • Regressive behaviors depending on their age (e.g., return to thumb-sucking or bed-wetting)
  • Reluctance to be left alone with a particular person or people
  • Sexual knowledge, language, and/or behaviors that are unusual and inappropriate for their age

Take it very seriously when a child reports sexual abuse by a parent or another adult caregiver.

For children with autism, the signs may manifest differently. In her article Sexual Abuse Of Children With Autism: Factors That Increase Risk And Interfere With Recognition Of Abuse, Dr. Meredyth Goldberg Edelson, of Willamette University, notes:

"Should a child with autism be sexually abused, the child's attempts to cope with or make sense out of that abuse may lead to an increase in the intensity and frequency of stimming behaviors, self-injurious behaviors, and repetitive behaviors behaviors or to the development of new behaviors that were not previously present."

For children with autism that wish to disclose their abuse, behavioral reactions to sexual abuse may develop. Unfortunately, these behaviors may be misinterpreted by others as merely a symptom of their autism. Therefore, the fact that the child was, or continues to be, sexually abused may be missed.

Getting help

Discovering that someone close to you is a victim of sexual abuse is devastating. Once you know, step one is to report the abuse.

  • If a child discloses abuse, it is critical to stay calm, listen carefully, and NEVER blame the child.
  • Thank the child for telling you and reassure him or her of your support.
  • Call for help immediately.

If you know or suspect that a child is being or has been sexually abused, please call:

Many communities also have Children’s Advocacy Centers (CACs) that offer coordinated support and services for victims of child abuse (including sexual abuse). For a state-by-state listing of accredited CACs, visit the National Children’s Alliance website.

After learning a loved one has been abused, it is critical to take proper steps to get them help. The effects of sexual abuse can be devastating for both the victim and their families.

There are a number of treatments for children who have been sexually abused, including:

  • Individual therapy
  • Family therapy
  • Group therapy
  • Trauma-focused cognitive behavioral therapy
  • Child-centered therapy

From American Psychological Association 

There is no “one size fits all” treatment for sexual abuse. For the autism community it may be necessary to consider preferred communication and behavioral supports. Try to work with professionals that have experience with autism or incorporate therapists that have worked with the person with autism before. Recovery is possible - children can be very resilient and with a combination of effective treatment and support from parents/caregivers, they do recover from abuse.