Abuse vs. Neglect
by Rebecca Klaw, MS, MEd., and Ronald N. Lebovitz, Esq.
First published in ABOARD's Autism Connection of PA Winter Newsletter 2013
As our national leaders grapple with budget issues, it is likely that government money needed to support persons with autism, whether in schools, in homes or in community-based housing, will decrease - probably in significant increments. This comes at a time when studies and census reports confirm that the number of individuals with autism is increasing, with many living in community-based homes at a greater risk of neglect and abuse.
Persons with autism are uncommonly vulnerable to neglect and abuse, including physical and sexual assaults, in large part because they are unable to speak out and may be unable to understand that they are being mistreated. It is crucial that we explore the signs from individuals with autism that might indicate mistreatment. Lastly, families and institutions need to discuss the remedies and options that are available when acts of neglect and abuse can occur.
What is Neglect?
Neglect usually refers to the failure of a responsible caregiver to deliver resources, services or treatment to a care dependent person who requires these to address his or her basic care needs. Title 18 Pa. C.S.A. Section 2713 creates criminal penalties for a caretaker who -
Intentionally, knowingly or recklessly causes bodily injury or serious bodily injury by failing to provide treatment, care, goods or services necessary to preserve the health, safety or welfare of a care-dependent person for whom he is responsible to provide care.
Providing care may be defined as ensuring the delivery of food, water, clothing, shelter or medication. But the concept of neglect is broader. It also includes the duty to supervise and protect a care dependent person. For example, many individuals with impaired judgment are at risk of elopement away from a safe environment and into dangerous locations such as a busy roadway. Failure to supervise them at all times can constitute neglect. Wherever the need for supervision and assistance is present - in feeding, toileting, bathing and recreational activities - the risk of neglect exists.
How is Abuse Different?
In contrast, abuse is commonly defined as deliberate acts committed by a care giver upon a care dependent person that cause physical and/or emotional harm, such as physical, sexual, verbal and/or emotional assaults. Acts of abuse can also include the inappropriate use of physical or chemical restraints. Additionally, isolating a care dependent person by restricting contact with family or placing a care dependent person to remain in a bedroom is a form of abuse.
How to Spot Neglect or Abuse
There is no single, simple answer to such a situation. Some signs of neglect and abuse include but are not limited to:
When neglect or abuse occur, it is imperative to make corrections in a fashion that causes no further trauma. This is particularly true with individuals with autism who have a strong need for sameness. Any change in a person's environment or routine, even if intended to be protective, can in itself be very distressing.
It is also essential to make sure that the victim of the neglect or abuse receives assessments and therapy designed to identify and treat any physical or emotional consequences arising from the neglect or abuse. The facility where the neglect or abuse took place must conduct a thorough, objective investigation of the facts and circumstances which allowed or caused the neglect or abuse to occur. Once understood, it is necessary for the facility or institution to undertake and implement corrective measures to minimize the risk that such abuse or neglect will occur again, including as appropriate additional training for staff members, development of policies and procedures and perhaps even changes in personnel. Lastly, there might be some situations when the victims of neglect and abuse need to pursue remedies and compensation through the judicial system.
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