Recognizing Trauma In Individuals With Intellectual Disabilities

From talking to a wide number of parents, care-givers, family members, healthcare professionals and the like, recognizing trauma in individuals who are intellectually delayed, or those who may be nonverbal, is a big concern; “What if something happens and we can’t tell?,” “What if they can’t express what’s going on and it continues?” The list of questions and concerns over this one topic are endless and I’ll admit, I’ve thought about it myself. As a mother of a daughter who has Down syndrome, the very last thing I want to think about is the possibility of some kind of abuse occurring and my daughter unable to tell me about it.

So what can we do? We educate ourselves on the signs and symptoms of abuse and the steps we take if it does occur.


The West Virginia Integrated Behavioral Health Conference and Nora J. Baladerian, PH.D., have put together a list to help. (You can read the full presentation here.) (1)

Overview Key Points:

  • Approximately 25% of children with disabilities acquired the disability as a result of abuse.

  • 52% of neglected children acquire a permanent disability.

  • According to the Justice Department Data, individuals with a disability are over seven times more likely to become victims of sexual abuse. (2)

  • Over 90% of the perpetrators are in an authorized care providing position.

  • Abuses more frequently occur at home, during transportation or at work or school.


How To Identify Abuse (depends on the type of disability and the type of abuse):

Physical Abuse:

Signs of physical abuse in people with and without disabilities are the same, BUT

  • Sometimes the signs are ignored because they think it’s due to the person’s disability

  • The individuals disability can sometimes cause conditions that mimic signs of abuse

  • Physical neglect can lead to exacerbation of the symptoms of the disability

Sexual Abuse:

Physical signs of sexual abuse in people with and without disabilities are the same, BUT

  • May have changes in mood

  • Unexplained STDs and pregnancy

Emotional Abuse:

Essentially the same in people with and without disabilities, BUT

  • Unexplained depression, anxiety, withdrawal, fears an reenactments may occur

Signs of Trauma:

  • Mood, conduct, communication

  • Regression from skills already mastered

  • Does not want to go to certain locations or see certain people

  • Questions related to sex and pregnancy are asked

  • Eating and sleeping preferences change

  • Clothes are soiled or torn

  • Weight loss or gain

  • Replicating assault on oneself

  • Self-harm

  • Indications of STDs

  • Irritability or anger

  • Withdrawal

  • Depression

  • Onset of new fears

  • Change in energy

  • Sleep disturbances

  • Change in interests

  • Signs of PTSD

How Can You Know For Sure?

  • ASK (Make sure you have the time to listen, an effective response, and suggestions for help.)

  • Don’t ask and then leave

  • Treatment

  • Psychotherapeutic Intervention

  • Realistic preparations for future assaults and a Risk Reduction approach


Although some information in the presentation is outdated (from 2013) there’s still a lot of great information to help guide you in the event trauma occurs. Other information, such as which questions to ask, is also available within the presentation.

While we never wish for any kind of trauma or abuse to happen, it is always better to be prepared to handle it in the best and most effective way possible in the event that it does.


  1. Baladerian, N. J., PH.D. (2013). Disability and Abuse Project [Scholarly project]. In West Virginia Department of Health and Human Resources. Retrieved July 19, 2019, from IBHC Presentations/Day 3 Workshops/Healing the Trauma.pdf

  2. Shapiro, J. (2018, January 08). The Sexual Assault Epidemic No One Talks About. Retrieved July 19, 19, from