مروری بر ماهیت و ریسک فاکتورهای بدرفتاری با کودکان با معلولیت

نوع مقاله : مقاله مروری

نویسندگان

1 کارشناس ارشد کاردرمانی، گروه کاردرمانی، دانشگاه علوم بهزیستی و توانبخشی، تهران، ایران

2 دکتری تخصصی کاردرمانی، دانشیار و عضو هیئت علمی، گروه کاردرمانی، دانشگاه علوم بهزیستی و توانبخشی، تهران، ایران

3 دکتری تخصصی کاردرمانی، استادیار، گروه کاردرمانی، دانشگاه علوم بهزیستی و توانبخشی، تهران، ایران

چکیده

مقدمه و اهداف
حدود 13 درصد از کودکان، در طبقه کودکان با معلولیت جای می­گیرند. بدرفتاری با کودکان و بزرگسالان با معلولیت شایع است. شناسایی ماهیت و ریسک­فاکتورهای بدرفتاری، به شناسایی کودکان و خانواده­های در معرض خطر کمک کرده و اجرای مداخلات در راستای پیشگیری و درمان این کودکان را تسهیل می­کند. پژوهش حاضر با هدف شناسائی ماهیت و ریسک­فاکتورهای بدرفتاری با کودکان با معلولیت انجام شده است.
مواد و روش ­ها
در مطالعه مروری حاضر، جستجوی کلیدواژه­های بدرفتاری؛ آزار؛ غفلت؛ معلولیت؛ کودک و ریسک­فاکتور در پایگاه­های داده: PubMed, Scopus, ProQuest, Elsevier, Springer, Cochrane, Ovidو موتور جستجوی Google Scholar، در بازه­ی زمانی 1960 تا 2015 انجام شد. مطالعات پژوهشی، متاآنالیز و مرور سیستماتیک که در مورد بدرفتاری با افراد زیر 18 سال دارای معلولیت فیزیکی، روانی و ذهنی انجام شده بود، وارد مطالعه شد.
یافته ­ها
با توجه به معیارهای ورود، چکیده 79 مقاله بررسی و در نهایت 26 متن کامل مورد بررسی دقیق قرار گرفت. تقریباً تمام مطالعات متفق بودند بدرفتاری با کودکان با معلولیت بیشتر از کودکان سالم رخ می­دهد. بر اساس تحقیقات گذشته می­توان ماهیت و ریسک­فاکتورهای بدرفتاری را در سه طبقه­ی ویژگی بدرفتاری، ویژگی قربانی و ویژگی عامل بدرفتاری بررسی کرد. داده­ها در این زمینه­ها پراکنده است و تحقیقات مختلف نتایج مختلفی را در این زمینه­ها گزارش کرده­اند. در مورد ویژگی قربانی می­توان وجود معلولیت­های رفتاری را ریسک­فاکتور مهمتری برای بدرفتاری با کودک معرفی کرد. معلولیت کم­شدت­تر و معلولیتی که در ظاهر کودک نمایان نباشد، باعث افزایش خطر بدرفتاری خصوصاً آزار جنسی می­شود. در مطالعات مختلف، والدین، پرسنل مدارس، همسالان و غریبه­ها به عنوان عامل بدرفتاری معرفی شدند.
نتیجه ­گیری
تفاوت در تعریف معلولیت، بدرفتاری و روش تحقیقی که در مطالعات مختلف به کار رفته است، باعث گردید نتیجه­گیری قاطعی در مورد ریسک­فاکتورهای بدرفتاری با کودک با معلولیت صورت نگیرد، اما می­توان احتمال داد فقدان مهارت والدگری در والدین و همچنین سن کمتر و معلولیت کم­شدت­تر در کودک –فارغ از نوع معلولیت- با احتمال بالاتری جزو ریسک­فاکتورهای بدرفتاری هستند. مطالعات کمی که در کشورهای آسیایی انجام شده است، ممکن است نشان­دهنده­ی آمادگی کمتر این کشورها برای مقابله با این مسئله اجتماعی باشد.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Review of Nature and Risk Factors for Maltreatment of Children with Disabilities

نویسندگان [English]

  • Sepeide Kashefi 1
  • Nazila Akbarfahimi 2
  • Mehdi Rassafiani 3
1 MSc., Department of Occupational Therapy, University of Social Welfare & Rehabilitation Sciences, Tehran, Iran
2 Associate Professor, Department of Occupational Therapy, University of Social Welfare & Rehabilitation Sciences, Tehran, Iran.
3 Assistant Professor, Department of Occupational Therapy, University of Social Welfare & Rehabilitation Sciences, Tehran, Iran
چکیده [English]

Background and Aims: About 13% all of children suffer from disabilities. Maltreatment of children and adults with disabilities is a common practice. The identification of the nature and risk factors for maltreatment helps identify the children and families at risk and facilitate intervention to prevent and treat these children. The present study was conducted to identify the nature of and risk factors for maltreatment of children with disabilities.
Materials and Methods: In the present narrative review, the keywords including: maltreatment, abuse, neglect, disability, children, and risk factors were searched among databases including Springer, Elsevier, ProQuest, Scopus, Ovid PubMed, Cochrane, and the search engine Google Scholar, in the period between 1960-2015. Empirical studies, meta-analysis, and systematic reviews with the emphasis on maltreatment of children (below 18 years) with mental, physical, and psychological disabilities were selected.
Results: Totally, 822 potentially relevant studies were found and 79 abstracts were examined. Finally, 26 full texts were included. Almost all studies confirmed that children with disabilities are at a significantly greater risk of maltreatment compared with those without disabilities. According to the literature, the nature of and risk factors for maltreatment can be examined under three categories: maltreatment characteristics, victim characteristics, and perpetrator characteristics. There is sporadic data in this field and different studies have reported different results on the subject. Probably behavioral disabilities are the most important risk factor for maltreatment. Low level disabilities that have not outward appearance may cause increaseed risk of maltreatment, especially sexual abuse. Parents, school staffs, peers, and strangers were identified as perpetrators of maltreatment.
Conclusion: Different definitions of disability and maltreatment as well as different research methodologies used in the studies have made it impossible to reach a decisive conclusion about risk factors for maltreatment of children with disabilities; however, there is the probability that lack of parenting skills as well as young age and less serious disabilities of children, regardless of the type of disability, are among the risk factors for maltreatment. A few studies conducted in Asian countries indicated that they are not prepared to deal with this social issue.

کلیدواژه‌ها [English]

  • Maltreatment
  • Disability
  • risk factor
  • children

مراجع

1.   Crooks, C.V. and D.A. Wolfe, Child abuse and neglect, in Assessment of childhood disorders, E.J. Mash and R.A. Barkley, Editors. 2009. p. 639-683.##
2.   Sandra, B. and S. M.D, Child psychiatry: Special areas of interest, in Kaplan and Sadock's Comprehensive Textbook of Psychiatry, B.J. Sadock, V.A. Sadock, and H.I. Kaplan, Editors. 2005, Lippincott Williams & Wilkins. p. 3792-3805. ##
3.   Equality act 2010: United States. p. 4-5. ##
4.   National center for educational statistics. [cited 2015; Available from: https://nces.ed.gov. ##
5.   Ammerman, R.T., V.B. Van Hasselt, and M. Hersen, Maltreatment of handicapped children: A critical review. Journal of Family Violence, 1988. 3(1): p. 53-72. ##
6.   Benedict, M.I., et al., Reported maltreatment in children with multiple disabilities. Child Abuse & Neglect, 1990. 14(2): p. 207-217. ##
7.   Chan, K.L., C.R. Emery, and P. Ip, Children with disability are more at risk of violence victimization: Evidence from a study of school-aged chinese children. Journal Interpers Violence, 2014. ##
8.   Jaudes, P.K. and L. Mackey-Bilaver, Do chronic conditions increase young children’s risk of being maltreated? Child Abuse & Neglect, 2008. 32: p. 671-681. ##
9.   Kvam, M.H., Is sexual abuse of children with disabilities disclosed? A retrspective analysis of child disability and the likelihood of sexual abuse among those attending Norwegian hospitals. Child Abuse &
Neglect, 2000. 24(8): p. 1073-1084. ##
10. Sullivan, P.M. and J.F. Knutson, The association between child maltreatment and disabilities in a hospital-based epidemiological study. Child abuse & Neglect, 1998. 22(4): p. 271-288. ##
11. Sullivan, P.M. and J.F. Knutson, Maltreatment and disabilities: A population-based epidemiological study. Child Abuse & Neglect, 2000. 24(10): p. 1257-1273. ##
12. Crume, T.L., et al., Underascertainment of child maltreatment fatalities by death certificates, 1990–1998. Pediatrics, 2002. 110(2): p. e18-e18. ##
13. Glaser, D., Child abuse and neglect and the brain—A review. Journal of Child Psychology and Psychiatry, 2000. 41(01): p. 97-116. ##
14. Davidson, D.A., Physical abuse of preschoolers: Identification and intervention through occupational therapy. American Journal of Occupational Therapy, 1995. 49(3): p. 235-243. ##
15. Egeland, B., L.A. Sroufe, and M. Erickson, The developmental consequence of different patterns of maltreatment. Child Abuse & Neglect, 1983. 7(4): p. 459-469. ##
16. Howard, A.C., Developmental play ages of physically abused and nonabused children. American Journal of Occupational Therapy, 1986. 40(10): p. 691-5. ##
17. Oates, R.K., A. Peacock, and D. Forrest, Development in children following abuse and nonorganic failure to thrive. American Journal of Diseases of Children, 1984. 138(8): p. 764-767. ##
18. Sylvestre, A. and C. Mérette, Language delay in severely neglected children: A cumulative or specific effect of risk factors? Child Abuse & Neglect, 2010. 34(6): p. 414-428. ##
19. Hoffman-plotkin, D. and C.T. Twentyman, A multimodal assessment of behavioral and cognitive deficits in abused and neglected preschoolers. Child Development, 1984: p. 794-802. ##
20. Turner, H.A., et al., Disability and victimization in a national sample of children and youth. Child Maltreatment, 2011. 16(4): p. 275-286. ##
21. Govindshenoy, M. and N. Spencer, Abuse of the disabled child: A systematic review of population‐based studies. Child: Care, Health and Development, 2006. 33(5): p. 552-8. ##
22. Verdugo, M. and B. Bermejo, The mentally retarded person as a victim of maltreatment. Aggression and Violent Behavior, 1997. 2(2): p. 143-165. ##
23. Briscoe-Smith, A.M. and S.P. Hinshaw, Linkages between child abuse and attention-deficit/hyperactivity disorder in girls: Behavioral and social correlates. Child Abuse & Neglect, 2006. 30(11): p. 1239-1255. ##
24. Hadianfard, H., Child abuse in group of children with attention deficit-hyperactivity disorder in comparison with normal children. International Journal of Community Based Nursing and Midwifery, 2013. 2(2): p. 77-84 [In Persian]. ##
25. Ouyang, L., et al., Attention-deficit/hyperactivity disorder symptoms and child maltreatment: A population-based study. Pediatrics, 2008. 153(6): p. 851-856. ##
26. Keshavarz V, N. and F. Keshavarzi A, Comparison child abuse between normal children and children with learning disabilities. Rehabilition, 2010. 11(3): p. 42-49 [In Persian]. ##
27. Sullivan, P.M., M. Vernon, and J.M. Scanlan, Sexual abuse of deaf youth. American Annals of the Deaf, 1998. 132(4): p. 256-262. ##
28. Akbas, S., et al., Characteristics of sexual abuse in a sample of Turkish children with and without mental retardation, referred for legal appraisal of the psychological repercussions. Sexuality and Disability, 2009. 27(4): p. 205-213. ##
29. Verdugo, M.A., B.G. Bermejo, and J. Fuertes, The maltreatment of intellectually handicapped children and adolescents. Child Abuse & Neglect, 1995. 19(2): p. 205-215. ##
30. Ammerman, R.T., et al., Abuse and neglect in psychiatrically hospitalized multihandicapped children. Child Abuse & Neglect, 1985. 13(3): p. 335-343. ##
31. Devries, K.M., et al., Violence against primary school children with disabilities in Uganda: a cross-sectional study. Bio Med Central Public Health, 2014. 14(1017). ##
32. Data & statistics for cerebral palsy: Prevalence and characteristics. 2015; National center on birth defects and developmental disabilities]. Available from: http://www.cdc.gov/ncbddd/cp/data.html#references. ##
33. Duan, G., et al., Physical maltreatment of children with autism in Henan province in China: A cross-sectional study. Child Abuse & Neglect, 2015. 48: p. 140-147. ##
34. Horne, B.V., Child maltreatment among children with specific birth defects: A population-based study, Texas 2002-2011. 2014, The University of Texas School of Public Health: Ann Arbor. p. 86. ##
35. Mandell, D., et al., The prevalence and correlates of abuse among children with autism served in comprehensive community-based mental health settings. Child Abuse and Neglect, 2000. ##
36. Kvam, M.H., Sexual abuse of children with disabilities: Summaries from four reports. 2004, Save the Children: Norway, Oslo. ##
37. Svensson, B., C.G. Bornehag, and S. Janson, Chronic conditions in children increase the risk for physical abuse - but vary with socio-economic circumstances. Acta Pediatric, 2011. 100(3): p. 407-12. ##
38. Ebeling, H. and H. Nurkkala, Children and adolescents with developmental disorders and violence. International Journal of Circumpolar Health, 2002. ##
39. Jaudes, P.K. and L.J. Diamond, The handicapped child and child abuse. Child Abuse & Neglect, 1985. 9(3): p. 341-347. ##
40. Dada, O.C., Physical abuse , sexual abuse, emotional abuse, and neglect as determinants of child abuse among persons with disabilitiese: counselling implication, in the KAPC –11th counselling conference. 2010: Safari Park Hotel, Nairobi, Kenya. ##
41. Kvam, M.H., Is sexual abuse of children with disabilities disclosed? A retrospective analysis of child disability and the likelihood of sexual abuse among those attending Norwegian hospitals. Child Abuse & Neglect, 2000. 24(8): p. 1073-1084. ##
42. Verdugo, M.A. and B.G. Bermejo, The mentally retarded person as a victim of maltreatment. Aggression and Violent Behavior, 1997. 2(2): p. 143-165. ##
43. Sellinger, M.H., An investigation of abuse in children with and without disability who are in or at risk for state custody. 2006, Vanderbilt University: Nashville, Tennessee. ##
44. Jones, L., et al., Prevalence and risk of violence against children with disabilities: A systematic review and meta-analysis of observational studies. The Lancet, 2012. 380(9845): p. 899-907. ##
دوماهنامه علمی - پژوهشی طب توانبخشی
دوره 7، شماره 1
فروردین و اردیبهشت 1397
صفحه 261-273

فایل ها

سابقه مقاله

  • تاریخ دریافت: 26 آبان 1395
  • تاریخ بازنگری: 03 بهمن 1395
  • تاریخ پذیرش: 16 خرداد 1396
  • تاریخ اولین انتشار: 01 فروردین 1397

هم رسانی

ارجاع به این مقاله

آمار