Assess risks and indicators
Assess for risk factors (eg, residential living) and for possible indicators of abuse, exploitation, and neglect (see background).93
Recommended
Empirical Ecosystem Expert Experiential
Abuse, exploitation, and neglect of people with IDD occur more commonly compared with the general population.92-95 These are often perpetrated by people known to the victim.92, 94 They include emotional, verbal, physical, or sexual abuse, and financial exploitation.96 Abuse can present as unexplained changes in physical health (eg, malnutrition97) or mental health (eg, anxiety, depression) as well as changes in behaviour (eg, withdrawal, disruptive behaviour, inappropriate attachments, sexualized behaviour).98 Neglect can present as a recurring pattern of inadequate care (eg, missed appointments, nonengagement and nonadherence).99
Report abuse
Report suspected abuse, exploitation, or neglect to the appropriate authorities (eg, police, or for Ontario, via ReportON).100, 101
Recommended
Empirical Ecosystem Expert Experiential
Abuse, exploitation and neglect of people with IDD occur more commonly compared to the general population.92-95 These are often perpetrated by people known to the victim.92, 94 They include emotional, verbal, physical or sexual abuse and financial exploitation.96 Abuse can present as unexplained changes in physical health (eg, malnutrition 97) or mental health (eg, anxiety, depression) as well as changes in behaviour (eg, withdrawal, disruptive behaviour, inappropriate attachments, sexualized behaviour).98 Neglect can present as a recurring pattern of inadequate care (eg, missed appointments, non-engagement and non-adherence).99
Refer victims
Refer all victims of abuse, exploitation or neglect to appropriate local resources and services for support 99, especially those with expertise in working with people with IDD.
Recommended
Empirical Ecosystem Expert Experiential
Abuse, exploitation and neglect of people with IDD occur more commonly compared to the general population.92-95 These are often perpetrated by people known to the victim.92, 94 They include emotional, verbal, physical or sexual abuse and financial exploitation.96 Abuse can present as unexplained changes in physical health (eg, malnutrition 97) or mental health (eg, anxiety, depression) as well as changes in behaviour (eg, withdrawal, disruptive behaviour, inappropriate attachments, sexualized behaviour).98 Neglect can present as a recurring pattern of inadequate care (eg, missed appointments, non-engagement and non-adherence).99
ReportON
Find local ways to report abuse, exploitation, and neglect of people with intellectual and developmental disabilities. For example, in Ontario, ReportON is a telephone line, and email address and TTY line for the public to report suspected abuse or neglect of adults with intellectual and developmental disabilities. ReportON does not replace existing internal protocols related to your profession’s obligations to report abuse and neglect. If you suspect the abuse or neglect might be criminal in nature, please contact the police first, followed by ReportON.
Learn how to implement these guideline recommendations into your practice from selected articles in the special issue on primary care of adults with intellectual and developmental disabilities in Canadian Family Physician, Vol 64 (suppl 2): S1-78, April 2018:
HELP for behaviours that challenge in adults with intellectual and developmental disabilities
- Sobsey,D. Family violence and people with intellectual disabilities. Ottawa: National Clearinghouse on Family Violence, Public Health Agency of Canada. 2002.
- Beadle-Brown J, Mansell J, Cambridge P, Milne A, Whelton B. Adult protection of people with intellectual disabilities: Incidence, nature and responses. Journal of Applied Research in Intellectual Disabilities. 2010;23(6):573-84.
- Hughes RB, Lund EM, Gabrielli J, Powers LE, Curry MA. Prevalence of interpersonal violence against community-living adults with disabilities: A literature review. Rehabilitation Psychology. 2011;56(4):302-19.
- Hughes K, Bellis MA, Jones L, Wood S, Bates G, Eckley L, et al. Prevalence and risk of violence against adults with disabilities: A systematic review and meta-analysis of observational studies. Lancet. 2012;379(9826):1621-9.
- Ombudsman Ontario. Nowhere to turn: Investigation into the ministry of community and social services’ response to situations of crisis involving adults with developmental disabilities. 2016. August.
- Franssen JJL, Maaskant MA, van Schrojenstein Lantmande Valk,Henny M.J. Qualitative study of malnutrition in people with intellectual disabilities. Journal of Policy and Practice in Intellectual Disabilities. 2011;8(4):239-46.
- Northway R., Melsome M., Flood S., Bennett D., Howarth J., Thomas B. How do people with intellectual disabilities view abuse and abusers? Journal of Intellectual Disabilities. 2013;17(4):361-75.
- Robinson S, Chenoweth L. Preventing abuse in accommodation services: From procedural response to protective cultures. Journal of Intellectual Disabilities. 2011;15(1):63-74.
- Ontario Ministry of Community and Social Services. ReportON [Website]. 2017. Accessed 2017 Oct 25.
- Fudge Schormans A, Sobsey D. Maltreatment of children with developmental disabilities. In: Brown I, Percy M, editors. A comprehensive guide to intellectual and developmental disabilities. Baltimore, MD, US: Paul H Brookes Publishing; 2007. p. 467-87.
