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Women with disabilities

Last edited: September 14, 2012

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Women and girls living with disabilities often face additional marginalization in their experiences of abuse as well as specific barriers to accessing services, due to:

  • economic and/or physical dependence on the abuser, which challenges efforts to escape (particularly within institutional settings);
  • suffering from forms of abuse specific to women living with disabilities (e.g. withholding of medications, orthotic equipment, and/or the refusal to provide personal care), which are less-documented and may not be explicit within legal definitions of abuse;
  • lack of or limitations in physical accessibility of shelters for women with disabilities;
  • perceptions by service providers that they cannot provide services for women with disabilities given their resource or capacity limitations;
  • hotline or shelter counsellors who do not have knowledge of disability-related issues;
  • lack of programming informed by and implemented in consultation with women with disabilities or misinterpretation of their needs in escaping and overcoming the abuse they have experienced;
  • gaps in collaboration between disability organizations and service providers supporting survivors, as well as assumptions by each group that survivors are served by the other;
  • low sensitivity among law enforcement personnel or other service providers, who may not inquire about abuse by caretakers, or disregard reports from women with speech/communication or motor coordination disabilities (e.g. cerebral palsy), assuming they are intoxicated or are not  serious in their claims; and
  • biases among judicial personnel and courts, who may provide preferential treatment to the abuser in child custody due to the victim’s disability (CROWD, 2011; Nosek, 2001; Barile, 2002; Myers, 1999 as cited in Hoog, 2003).

By engaging women with disabilities and their advocates to better understand their specific experiences and needs, shelter service providers can work to reduce barriers to access and improve service delivery for women with disabilities.

Effective services for survivors with disabilities can be supported through institutional and system-wide efforts which:

  • Provide adequate assessment of survivors, with particular focus on the socially-constructed barriers and discriminatory attitudes affecting their experiences, as part of their disability-related issues. Services should be designed to be relevant and accessible to women with diverse disabilities.
  • Develop policies, procedures and budgets written to specifically include the issue of provision of services to women with disabilities who have experienced domestic violence, sexual assault or other forms of abuse. Such mechanisms ensure women with disabilities can access quality services which are integrated in the agency’s operations rather than receiving ad hoc services which rest on the particular
    service provider’s knowledge of or ability to address the intersections of abuse and disability.
  • Ensure that staff are trained to recognize and effectively respond both to areas of need related to the disability, and to physical and sexual trauma (such as integrating disability-specific concerns related to personal care attendants or abuse related to neglect into risk assessment and safety planning). This should include skills for both responding to survivors and conducting effective outreach to women with disabilities.
  • Raise awareness of the issue in the public discourse, which is equally important to help women and others identify experiences of abuse and community resources available to survivors. This is also critical to help shift some of the stigma and attitudinal barriers experienced by women.
  • Provide increased centralization of information, which can provide clarity on the linkages between disability and relevant survivor services, and specific contacts who can speak to both issues. Such information should be accessible through a variety of public spaces in the community (bulletin boards, health care facilities, police departments, victim advocate offices, etc.) and utilize television, radio and
    other mass communication channels.
Example: The Safer and Stronger Program (United States)

The Safer and Stronger Program used an anonymous Audio Computer-Assisted Self-Interview (A-CASI) tool to provide a women with disabilities a tailored, accessible and anonymous method to self-screen for abuse. The tool aims to increase awareness of abusive situations, provide safety planning strategies and information about community resources. It was implemented with 305 women who evaluated it as ‘an accessible and safe method for disclosing abuse’ and demonstrated increased awareness 3 months after completing the assessment (Oschwald in Robinson-Whelen). The assessment is self-paced and offers a choice of audio, text, and American Sign Language questions, with the assessment responsive to participant answers regarding their particular needs. Video clips of survivors with various disabilities are integrated throughout and provide affirming messages and information on warning signs and safety promoting strategies. The initiative also increased accessibility of the screening tool through provision of childcare, transportation and personal assistance for participants, although challenges identified include the cost of tool development and inaccessiblility to women with sensory disabilities.

Sources: Powers et al. 2009. Interpersonal Violence and Women With Disabilities: Analysis of Safety Promoting Behaviors; Powers et al.’s 2009b; Oschwald et al, 2009; Robinson-Whelen et al. 2010.

  • Eliminate barriers to services by providing:
    • Physical access to the facility (e.g. ramps for wheelchairs; automatic doors; pictures; brail and other supports) and procedures that are sensitive to the needs of women with disabilities.
    • Policy exceptions to allow for service dogs, interpreters and personal care assistants as well as personal attendant services and independent living support, among others.
    • Specialized information and referrals, which involves asking affected women the type of information they would like to receive; the settings and format that such information should be available; and how they would like to receive support services (within the community; at home; at a specific institutional settting, or other).
    • 24-hour access to transportation, interpreters, and assistance with communication (e.g. listening devices, real-time captioning, and readers).
    • Training for staff working in disability services to understand issues of gender-based violence, and to monitoring risks and responding to victims. Beyond general awareness of the issue, this may include helping caretakers to develop specific skills, such as identifying signs of trauma or responses to trauma (which might be otherwise associated with aggression).
  • Support access to special legal protection against abuse, for example, in cases of dependence on home caregivers or institutions. Consideration should also be given to economic and financial interventions to promote women’s independence and self-efficacy, which may involve credit schemes, entrepreneurial skills training and advisory services for women to develop niche markets, where feasible.

The Safety Awareness Programme for Women with Disabilities (ASAP for Women) in the United States aims to help prevent sexual and domestic violence against individuals with disabilities by raising awareness of women with diverse types of disabilities, who may or may not have experienced abuse, and educating and training disability service providers, domestic and sexual violence staff and criminal justice personnel with custom-designed presentations and workshops. The intervention also provides organizational guidance on enhancing accessibility to persons with disabilities and helping reduce their risks of abuse.

Implemented with 213 women from ten centres for in independent living (CILs) across eight states, the programme involves eight, two and one-half hour interactive sessions delivered over eight weeks, covering safety awareness, self-advocacy, the nature and dynamics of interpersonal violence, safety promoting behaviors, safety planning strategies, and healthy relationships. The curriculum is based on the Stop the Violence, Break the Silence, a training guide developed by SafePlace. It promotes physical and literal accessibility by designing universally accessible materials – using alternative print formats (e.g. large print, Braille, and electronic versions), and arranging for sign language interpretation services designed to increase protective factors. The initiative aims to enhance women’s self-efficacy with regard to their safety and decision-making as part of empowering them and reducing their vulnerability to violence.

A pilot evaluation of the initiative found it accessible, relevant and feasible for women with wide range of disabilities, having notable positive effects on women’s confidence to promote their own safety and reducing participants’ social isolation by fostering healthy relationships, expanding networks of non-abusive relationships, and strengthening effective communication.

Sources: Hughes et al., 2010; A SafePlace Disability Services; Powers, et. al., 2009.
  • Establish linkages and strengthen interagency collaboration with disability organizations to ensure holistic and appropriate support is available to women who have experienced abuse (McClain, 2011; Powers, et. al., 2009; Thomas: 6; Domestic Violence Resource Centre Victoria, 2008; Focht-New, 2004; Hague, et. al, 2003; Nosek, 1998 as cited in Hightower & Smith, 2002; Hoog, 2004; Safety First Initiative – Strategic Plan, 2008, Kansas).
Example: Physical accessibility standards for women’s shelters

The following strategies and guidelines from the United States can be used to inform the planning and design of shelters with improved physical accessibility. Where possible, shelters should:

  • Be established in areas which are accessbile by public transportation (e.g. there is a bus stop close to the shelter and wheelchair accessible buses); as well as have a safe route from the bus stop to the shelter.
  • Ensure there is parking and parking lots with designated disability spaces that are: marked by clear signs; sufficient in size (96” wide with a 60” aisle); built on level ground and paved; and connected to the shortest possible accessible route to the building.
  • Create pathways or walkways to the shelter which are paved; at least 44 inches wide; and free from:
    • obstructions such as fire hydrants or trees, which may narrow the width;
    • abrupt edges or surface breaks which create more than ½inch height difference;
    • overhanging objects (e.g. tree branches or signs, lower than 79 inches); and
    • ground gratings with openings over ½ inch wide.
  • Provide entrances to the building and the front door, which have:
    • signs identifying the accessible entrance to the building, if different from the main entrance;
    • a ramped entry to the shelter; and
    • well-lit walkways which are kept clear of hazards (e.g. ice, snow, leaves, trash or other debris).
  • Ensure all doors to the shelter:
    • have an opening with at least 32 inches of clearance;
    • have a threshold (on the floor) of less than ½ inch high;
    • are easy to open (not excessively heavy);
    • can be opened without turning the doorknob (i.e. have lever-type handles, push plates, or automatic openers); and
    • where automatic doors are used, they remain open for at least 3 seconds; and have at least 60 inches of level space on each side of the door.
  • Design shelter hallways which are:
    • at least 44 inches wide;
    • free of obstacles or protrusions (i.e. fire extinguishers, water fountains) that extend more than 4 inches from the wall or that may not be detected with a cane;
    • covered with sufficient lighting and securely fastened rugs or mats; and
    • marked with signs to note alternative routes to all amenities if there is a barrier in the hallway
  • Ensure there is a way for a person in a wheelchair to get around stairways to any amenities, without assistance (e.g. ramp, chair lift, or alternate route).
  • Provide ramps which have a gentle slope, including at least a 2 inch curb to prevent a wheelchair from slipping off where there is a drop-off at any point in the ramp; and at least a 5 foot by 5 foot space where a wheelchair can rest if there is a door at the top of the ramp.
  • Design elevators to have a cab at least 54 inches deep by 68 inches wide, with doors providing at least a 32-inch wide clearance; elevator controls which are marked with raised lettering, braile and/or audible signals for women with visual impairments; and less than 54 inches high so that a person in a wheelchair an operate them.
  • Create meeting rooms and bedrooms which have enough space for people in wheelchairs to navigate the room; and are well-lit.
  • Provide telephone access to residents in an unobstructed area with clearance of at least 30 inches by 48 inches in front of it; are no more than 48 inches above the floor; and equipped with push-buttons for dialing.
  • Ensure bathrooms are large enough for a wheel-chair to turn around in (at least 51 inches); have grab handles in the toilet stalls; include sinks which are at least 30 inches high and have a clear space underneath for a person in a wheelchair to get their leg under the sink and reach the handles; and keep soap dispensers, towels and other items no more than 48 inches from the floor.
  • Establish security features which:
    • include audible alarm systems equipped with flashing lights; 
    • post the emergency evacuation plan in an accessible area; and
    • consider a range of disabilities (e.g. cognitive, sensory, visual, auditory, and mobility imparments) in emergency evacuation plans.
  • Ensure important information, such as resident rights and responsibilities, complaints procedures, etc. are available in written, audio and were possible brail formats.

Source: adapted from “Accessibility: Ramps, ADA Bathrooms and a Whole Lot More!”. Washington State Coalition against Domestic Violence, 2009; Smith & Harrell S., 2011; and Hoog, 2004

 

Tools:

Model Protocol: Screening Practices for Domestic Violence Victims with Disabilities. (Hoog for the Washington State Coalition Against Domestic Violence, 2010). This tool provides guidance on how to examine, revise and expand screening and intake processes to include questions about accommodating needs of women with disabilities. Available in English.

Forced Marriage and Learning Disabilities: Multi -Agency Practice Guidelines (R. Clawson, P. Vallance in conjunction with the Forced Marriage Unit, 2010). These practice guidelines are for frontline practitioners and volunteers within agencies that work with children and adults with learning disabilities. Based on the context within the United Kingdom, they offer an overview of forced marriage among people with disabilities; and guidance related to consent and other promising practices for supporting survivors of forced marriage. Available in English. 

Source: International Online Resource Centre on Disability and Inclusion (Handicap International). This website is a centralized resource for practitioners, academics and advocates in development and humanitarian settings. The website features introductory resources, statistics from regional contexts, as well as research sections specific to cross-cutting issues (gender, violence), health and functional rehabilitation, education, livelihoods, social inclusion, humanitarian settings.  Available in English.

Getting Safe Against the Odds (Domestic Violence Resource Centre, Victoria). This guide is for service providers in the family violence and disabilities fields. It is informed by the experiences of survivors with disabilities and provides practical tips for individual workers and agencies to improve the safety of their clients. Based on the lessons of the Violence Against Women with Disabilities Project, the guide includes information for agencies to plan interventionsl, screen and conduct risk assessments and safety planning, as well guidance on supporting protective measures such as orders of protection and coordinated responses. Available in English.

Guidelines for Creating Barrier-Free Emergency Shelters (Handicap International, 2009). This tool provides guidance for designing shelters accessible to all members of a community. Based on the context of Nepal and focused on emergencies, the guidance can be adapted as needed to other shelter settings. Available in English.

Getting Free from Abuse: A Guide for Women with Disabilities (Domestic Violence Resource Centre, Victoria, 2008). This online guide is for women with disabilities. It provides information and tools for identifying the warning signs of abuse by a partner, a family member, caretakers, or others; presents background information on abuse and domestic violence, its impact and how to seek help. The guide features stories andinsights from survivors with disabilities and is accompanied by a guide for service providers. This guide is avaialable in Arabic, English, Greek, Mandarin or Vietnamese.

Increasing Agency Accessibility for People with Disabilities: Domestic Violence Agency Self-Assessment Guide (Hoog for the Washington State Coalition Against Domestic Violence, 2004). This resource provides guidance on how to complete a programme self-assessment and plan for improvements in access and service for women with disabilities. Survey tools for self-assessment are included. Available in English.

Braille Brochure on Family Protection Law in Jordan, for Women with Visual Impairments. Outlines the provisions of the Family Protection Law in Braille. The brochure was drafted by several legal experts and was presented as part of a workshop for visually impaired people. For more information, contact Karama.

Open Minds Open Doors Manual (National Coalition Against Domestic Violence, 1996). This manual provides specific guidelines for programming to address violence against women with disabilities (e.g. implementing accessibility modifications according to the requirements of the Americans with Disabilities Act, and increasing sensitivity and responsiveness among program staff of the needs of survivors) Available in English.

The Accessibility Responsiveness Review Tool (UMKC Institute for Human Development, Rose Brooks Center, and Metropolitan Organization to Counter Sexual Assault, 2006). This tool provides a framework for domestic violence, sexual violence, and disability service organisations to review the inclusivity, accessibility and responsiveness of their services to women with disabilities. Developed for practitioners based on the context in the United States, it provides a background on the linkages between policy and services, the impact of workplace culture, and the value of collaborative partnerships. The guide outlines guiding questions, suggestions and practical ideas for organizations to review the quality of their services around five key areas: inclusive practices, communication, environment, and policies accessibility and building capacity of organizations. Available in English.

More Than Just A Ramp - A Guide for Women's Refuges to Develop Disability Discrimination Action Plans (Women with Disabilities Australia, 2007). This Booklet, part of the Resource Manual on Violence Against Women With Disabilities, is a step by step guide for women's refuges (and other similar services) to develop disability discrimination act action plans. An Action Plan identifies barriers which may result in discrimination against women with disabilities who need to use a service. The Action Plan recommends strategies to eliminate these barriers and devise ways for monitoring and evaluating the plan's implementation. The Booklet provides detailed information on how to re-orient services to better meet the needs of women with disabilities experiencing, or at risk of experiencing violence. The Booklet contains case studies from Australia which highlight the types of discrimination experienced by women with disabilities when seeking shelter. Available by purchase in English.

The Survivor's Handbook (Jackie Barron for Women’s Aid, 2009). This handbook provides practical support and information for women experiencing domestic violence, with basic guidance on every aspect of seeking support. The resource includes a specific section on disability and provides help-seeking links relevant to women with different communication impairments. The handbook is supplemented by informational video messages. Available in English, among other languages as well as an audio version.