Sexual abuse in children and adolescents with intellectual disability

The present authors conducted a study of the occurrence of victimization an d the perpetration of sexual abuse among 43 in-patients with intellectual d isability aged between g and 21 years who were admitted to a child and adol escent psychiatric inpatient department over a period of 5 years. A retrosp ective case-note review was employed that explored the nature and severity of abuse in relation to the age, gender and level of disability. The preval ence of abuse or abusive behaviour, i.e. 14% of 300 admissions, did not cha nge over time. In 13 out of the 43 cases, the issue of sexual abuse was ide ntified after admission. Victimization alone occurred in 21 cases, perpetra tion alone in six cases, and both victimization and perpetration in 16 case s. Fifty per cent of the victims had been abused by a member of their close or extended family. Most cases (62%) were adolescents. There was only one instance of a victim being abused by a female. However, there were five gir ls who were perpetrators, all of whom had previously been victims. By contr ast, 11 out of the 17 male perpetrators had been victims. Despite difficult ies of disclosure, it was possible to establish that severely disabled pati ents had suffered sexual abuse. The present data support theories which (1) recognize gender differences in sexual abuse patterns and (2) have a devel opmental perspective, incorporating the influence of adolescence.