Teaching social skills to help developmentally disabled students avoid sexual abuse (initial study)
Funded by the National Institute on Drug Abuse
Scientist(s):
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As many as 90% of men and women with mental retardation/developmental disability (MRDD) will experience some form of sexual victimization in their lifetime. As for minors, 16–30% of MRDD boys and 39–68% of MRDD girls will be sexually victimized by age 18. Nearly half (48%) of the perpetrators of this sexual abuse are people the victims have been taught to trust: paid caretakers and service providers.
The consequences of sexual abuse are the same for persons with MRDD as they are for the general population: depression, social withdrawal, aggressive or noncompliant behavior, and inappropriate sexual behavior themselves. Unfortunately, having been taught to be compliant and do what they are being told, especially by authorities, makes MRDD students doubly vulnerable to abuses of power by paid or volunteer caregivers.
Sexual Abuse Prevention for Female Special Education Students: Interactions with Staff is a multimedia CD-ROM with a very simple point-and-click interface that most MRDD adolescents can manage independently. Those who are not familiar with the use of a computer mouse receive instruction in how to accurately point and click; a remediation loop repeats until they achieve mastery. The program then proceeds to explain a simple "thumbs up" picture for "yes" and a "thumbs down" picture for "no." Once students master the interface tutorial, they are ready to view the program.
Sexual Abuse Prevention was developed with input from parole/probation officers (to understand the expected patterns of sex offenders) as well as parents, teachers, and 21 MRDD teens. From this formative research, a single "decision-rule" was developed: Physical contact by paid/volunteer caregivers within the boundary of the "red zone" (breasts to upper thighs) is unnecessary unless medically required. Teaching this guideline to students involves several preskills.
First, viewers are taught about the red zone, an area not dissimilar to a strike zone on a batter in baseball. To verify that they can correctly and consistently identify the red zone, viewers are shown animations of a hand resting within the red zone on clothed males and females. Viewers are then asked to respond by clicking on the thumbs up button if the hand is in the red zone or thumbs down if it is not in the red zone. Once the viewer has correctly identified the red zone, the hand moves to touch areas outside the red zone, and a similar question is posed. Mastery of this concept means viewers can correctly identify in-red-zone and out-of-red-zone touching.
The program teaches other preskills such as distinguishing between staff (people paid to take care of you; volunteers are the same as staff) and nonstaff, and distinguishing between sexual touching, necessary (e.g., medical) touching, and unnecessary touching. Viewers are taught to put these preskills together into the rule that "physical contact by paid/volunteer caregivers within the boundary of the red zone (breasts to upper thighs) is unnecessary unless medically required."
Last, the program teaches viewers strategies for responding to unnecessary staff touching in the red zone. These skills apply not only to students being touched by staff, but also to staff members requesting students to perform unnecessary red zone touch. Strategies presented include saying "stop," getting away, telling someone, and continuing to tell people until you know you are safe.
This study focused on teaching young MRDD females how to protect themselves against sexual abuse from staff. Forty-one female MRDD high school students with mild to moderate retardation participated in the evaluation. From the beginning, 71% of the group (29) already knew how to accurately point and click a mouse. The remaining 12 successfully achieved mastery by using the onscreen mouse tutorial. All the participants successfully completed the interface training (explaining the thumbs up and thumbs down buttons) and were able to view the rest of the program independently.
To test program effectiveness, students were given two surveys: one before viewing the program, and the same one presented after viewing the program. The survey consisted of a video simulation test and a series of yes/no answers. Participants in the evaluation were shown four brief video stories depicting staff casually touching a student. An evaluator from the Oregon Center for Applied Science, Inc., asked participants questions about each story. The first question was whether the touching behavior was "okay" or "not okay." The evaluation participant was then asked to describe what she would do if she were the student in the video story. After this, the evaluation participant was shown two video endings to the story: one with correct responses and one with incorrect responses. For each ending, the participant was asked if the onscreen student’s response was "okay" or "not okay." In addition to this video simulation test, participants were asked questions to measure knowledge about topics such as their ability to distinguish between sexual touching and medically necessary touching.
After completing this first survey, participants watched the CD-ROM program and then completed a second survey using the same four video stories, interview questions, and knowledge questions. In all, students spent from 30 to 60 minutes answering both surveys and watching the program.
Participants in the evaluation showed significant improvements in their understanding of important skills they must have to protect themselves from abuse by paid or volunteer caregivers. They had significantly greater recognition of inappropriate touching by staff. They could describe significantly more strategies for responding to inappropriate touching and showed significant gains in their ability to identify correct and incorrect responses by the onscreen video students. On the basis of these positive results and the ability of all the MRDD participants to view this multimedia program independently, the National Institute of Child Health and Human Development has funded an expanded study.
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