Date Presented 4/17/2015
Disability status places youth at risk of not only repeated victimization but also isolation from community life. Evaluating and addressing violence in the lives of youth with disabilities (YWD) can enhance our profession’s ability to address barriers to participation and to maximize independent living outcomes of clients.
SIGNIFICANCE: Participation in home and community life is essential to the health and well-being of youth with disabilities (YWD) and their families. Through participation in activities, youth forge friendships, gain knowledge, and develop socioemotional skills essential to mental health, academic achievement, and successful transition into adulthood. Given its salience to the health and development of YWD, participation has been recognized as a key health outcome by the World Health Organization’s International Classification of Functioning, Disability and Health: Children and Youth (ICF–CY) model. Studies in the general population suggest that youth who are victimized are less likely to participate in developmentally salient activities. Despite the evident link between victimization and participation among able-bodied youth, exposure to victimization has not been explicitly recognized as a barrier to participation among YWD. The developmental effects of victimization specific to YWD are a nascent area of research, and its effects on participation in salient activities during adolescence—a crucial developmental period—remain unknown. Such knowledge could assist occupational therapists to address a potential barrier to participation by marshalling the resources, supports, and services to prevent victimization and/or to address its psychosocial sequelae, including social withdrawal, to minimize its influence on transition to adulthood.
RESEARCH QUESTION: Does victimization affect participation in structured activities among YWD in the child welfare system (CWS)?
RATIONALE: YWD are significantly more likely to experience violence in multiple contexts. Although a sizeable body of research has documented participation disparities in organized activities between YWD and their typically developing peers, none of the researchers in the referenced studies considered victimization in their measurement of environmental barriers.
METHOD: Cross-sectional data were drawn from youth and parent baseline interviews in the National Survey of Child and Adolescent Well-Being—II (NSCAW–II). The sample consisted of 405 female adolescents and 270 male adolescents, aged 11 to 17 yr (M = 13.5 yr), residing with families throughout the United States. We explored the relationships between disability status, victimization, and participation using weighted logistic regression analysis. Child disability was identified on the basis of reported diagnostic medical conditions that met clinical and epidemiological guidelines for physical/health or neurodevelopmental disability (N = 247). Victimization was measured using the Parent–Child Conflict Tactic Scale—2 and the Child Health Illness Profile—Adolescent Edition. Participation level was assessed by the Child Behavior Checklist.
RESULTS: Controlling for all variables, the odds of YWD in the CWS reporting two or more victimizations were 120% higher (p < .01) than youth without disabilities. YWD in the CWS were almost twice as likely to report participation in one or fewer developmentally salient activities. Controlling for all other variables, the odds of restricted participation were 6.8 times higher (p < .05) for victimized YWD in the CWS.
CONCLUSIONS: YWD who report victimization are significantly less likely to participate in developmentally salient activities in comparison to their typically developing peers. Without coordinated efforts to prevent and address victimization of YWD in the CWS, there will be significant barriers to their participation and independent living outcomes.
