Risk Factors for Sexual Violence Among People with Cognitive and Developmental Disabilities

The Abuse Prevention Disability Task Force completed a literature review in 2018-2019 to identify risk factors associated with sexual violence and people with cognitive and developmental disabilities. Sexual violence (SV) primary prevention requires increasing protective factors and reducing/eliminating sexual violence perpetration risk factors; and though the Centers for Disease Control and Prevention have identified risk and protective factors for sexual violence perpetration, the research may not include people with cognitive and developmental disabilities. People with cognitive and developmental disabilities communicate using a variety of methods and some people do not use written or spoken “standardized” language. The result is hundreds of thousands of people are left out of scientifically designed SV data collection practices, such as NISVS and YRBSS. The task force literature review included science-based evidence (journal articles), practice-based evidence (toolkits), and practice wisdom (community resources) created after the year 2000.

These free and readily available resources reviewed (see citations below) generally associated risk factors with victimization and with disability increasing one’s risk for sexual violence victimization (as a result of structural inequities that place people with disabilities at greater risk). There were no clear findings to report beyond the CDC about risk and protective factors for perpetration. The task force organized the sexual violence risks for victimization across the social ecological model according to the level of their impact on people with disabilities, including cognitive and developmental disabilities. We are developing recommendations to pass along to those who are interested, so keep checking back.


References:

  • Alriksson-Schmidt, A. I., Armour, B. S., & Thibadeau, J. K. (2010). Are Adolescent Girls With a Physical Disability at Increased Risk for Sexual Violence? Journal of School Health, 80, 361–367. doi:10.1111/j.1746-1561.2010.00514
  • Basile, K. C., Breiding, M. J., & Smith, S. G. (2016). Disability and Risk of Recent Sexual Violence in the United States. American Journal of Public Health, 106(5), 928–933. doi:10.2105/AJPH.2015.303004
  • Cowley, Kelsey, Fellow, Self-Advocacy Resource and Technical Assistance Center. (2018). Starting the Conversation: A Toolkit for Self-Advocates to Talk About Sexual Violence in Their Community. Toolkit available online February 13, 2020 at: https://selfadvocacyinfo.org/resource/starting-the-conversation-a-toolkit-for-self-advocates-to-talk-about-sexual-violence-in-their-community/
  • Davis, Leigh Ann, M.S.S.S.W., M.P.A., L.A.D. (2019). Resources, People with Intellectual Disability and Sexual Violence. The Arc. Retrieved online at May 20, 2019: https://www.thearc.org/sslpage.aspx?pid=2457
  • Euser, S. , Alink, L. R., Tharner, A. , IJzendoorn, M. H. and Bakermans‐Kranenburg, M. J. (2016). The Prevalence of Child Sexual Abuse in Out‐of‐home Care: Increased Risk for Children with a Mild Intellectual Disability. Journal of Applied Research in Intellectual Disabilities, 29: 83-92. doi:10.1111/jar.12160
  • Fredriksen-Goldsen, Karen I., Hyun-Jun Kim, and Susan E. Barkan (2012). Disability Among Lesbian, Gay, and Bisexual Adults: Disparities in Prevalence and Risk. American Journal of Public Health 102, e16_e21. doi.org/10.2105/AJPH.2011.300379
  • Hughes K, Bellis MA, Jones L, Wood S, Bates G, Eckley L, McCoy E, Mikton C, Shakespeare T, Officer A. (2012). Prevalence and risk of violence against adults with disabilities: a systematic review and meta-analysis of observational studies. Lancet; doi:10.1016/S0410-6736(11)61851-5.
  • Keilty, J & Connelly, G. (2001). Making a statement: An exploratory study of barriers facing women with an intellectual disability when making a statement about sexual assault to police. Disability & Society, 16 (2), 273-291.
  • Krahn, Gloria L. PhD, MPH, Deborah Klein Walker, EdD, and Rosaly Correa-De-Araujo, MD, PhD (2015). Persons with Disabilities as an Unrecognized Health Disparity Population. American Journal of Public Health, Supplement 2, 2015, Vol. 105, No. S2., p. S198. Retrieved November 1, 2018 from: https://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.2014.302182
  • National Center for Injury Prevention and Control, Division of Violence Prevention (2020). Risk and Protective Factors. Accessed online May 20, 2019 at https://www.cdc.gov/violenceprevention/sexualviolence/riskprotectivefactors.html
  • Normand, C.L. and Sallafranque‐St‐Louis, F. (2016), Cybervictimization of Young People With an Intellectual or Developmental Disability: Risks Specific to Sexual Solicitation. Journal ofApplied Research in Intellectual Disabilities, 29:99-110. doi:10.1111/jar.12163
  • Plummer, S.-B., & Findley, P. (2012). Women With Disabilities’ Experience With Physical and Sexual Abuse: Review of the Literature and Implications for the Field. Trauma Violence Abuse 2012 13: 15. Accessed online May 21, 2019 at:
  • https://www.researchgate.net/profile/Patricia_Findley/publication/51787909_Women_With_Disabilities’_Experience_With_Physical_and_Sexual_Abuse/links/0deec5304c5a1c79d8000000.pdf
  • Taggart, L. & R. McMillan (2009). Listening to women with intellectual disabilities and mental health problems: a focus on risk and resilient factors. Journal of Intellectual Disabilities, 2009, vol 13(4) 321‒340. doi: 10.1177⁄1744629509353239
  • West Virginia Foundation for Rape Information and Services (2019). West Virginia S.A.F.E. Training and Collaboration Toolkit, Serving Sexual Violence Victims with Disabilities, B1.1 Sexual Violence 101. Sexual Victimization of Persons with Disabilities: Prevalence and Risk Factors Sexual Victimization of Persons with Disabilities: Prevalence and Risk Factors. West Virginia Foundation for Rape Information and Services. Accessed online May 20, 2019 at:
  • https://www.arcnj.org/file_download/eeead953-679c-4937-9f6e-596248f9261e

Credit

Research conducted and post written by  Cierra Olivia Thomas-Williams, Prevention Specialist, Indiana Coalition Against Domestic Violence (ICADV), cwilliams@icadvinc.org. Infographics created by Kat Chappell, Outreach and Operations Manager, Indiana Governor’s Council for People with Disabilities, kchappell@gcpd.in.gov. Post edited by Skye Ashton Kantola (she/they), Assistant Director at Multicultural Efforts to End Sexual Assault, kantola@purdue.edu.

Emails may have changed. Please contact Cierra Olivia Thomas Williams at Nothing Without Us Collective for the latest contact information.

Respected By Keaun Brown

I was four years old when doctors told my mother I would likely never be able to speak, that my hearing loss was worsening instead of improving. I don’t remember their faces, or even the meaning of the words they used. What I remember instead is the soundless crinkle of tissue paper beneath me as I sat on the exam table, staring at the roll and wondering how something 

meant to refill itself could seem so endless. It’s strange what stays with you from childhood. It wasn’t until later—when my mother asked how I would feel about learning American Sign Language—that the discomfort sharpened into something heavier. I didn’t have the language for it then, but I understood enough to feel defective, like something that needed correction. 

The cubbies at the Indiana School for the Deaf were impossibly bright, splashed in neon greens and blues. One was purple, and I coveted it quietly, too nervous to ask. We were only there for a few weeks before moving back to New Jersey, yet that space has lingered in my memory far longer than it should have. For something so consequential, it’s the colors and the way the cafeteria dwarfed my small body that remain clearest. What fades are the details of instruction; what lingers are the emotions. I felt the tension of standing apart from my neighborhood friends. I noticed the sideways glances when I tried to sing along, or the way people startled when I whispered—something I wouldn’t understand until much later was anything but quiet. 

The awareness of difference settled into me early. It lived in my chest and stomach before it ever reached my vocabulary. “Rainbow” was the newest word I had learned, and I was proud of its length, its complexity. Still, it failed me. No combination of letters could explain the loneliness I carried. I began concealing my ASL homework, refusing to sign even at home, and avoiding lessons whenever possible. In my mind, learning ASL felt like confirmation—evidence that I was crossing a line I couldn’t uncross. It felt permanent, visible, undeniable. I convinced myself that if I resisted hard enough, if I stayed quiet enough, I could reverse whatever made me different. I prayed for change. I prayed to God and bargained at night with the stars, hoping either by divine miracle or sheer effort, I could return me to some reimagined version of myself one that was normal. 

Funny enough, it kind of happened 

To this day, the doctors have absolutely no idea what happened, they told my mom I was some miracle, who knows the details. All I do know, is that after a nurse tried a new form of speech therapy she was playing around with, I started to be able to process and understand sounds. Speech, albeit labored and heavily impeded, came shortly after. The details of that story are for another time, another essayette. The point is, I had believed this truth that I was broken, I had believed this truth that all I needed was to be fixed- I had believed the lie. For years, I had absorbed the idea that I was incomplete, that repair was the only path to belonging. This shift felt like proof. Even though I was still hard of hearing, still navigating systems built to accommodate me, I believed I could finally shield myself. Normalcy became a performance, a layer of protection. If I could blend in well enough, if I could work hard enough, if I could just be enough- maybe I wouldn’t have to justify my existence. 

That belief followed me into adulthood. I rejected accommodations, even when they would have supported me. I chose struggle over visibility, silence over explanation. I avoided hearing aids, worried they would expose what I worked so hard to conceal. For a long time, I convinced myself I wasn’t disabled at all, took the disability checks my mom received for me as a state error that had yet to be corrected. I had invested so much in appearing unaffected that I never questioned why that mattered so deeply. 

A caution road sign reading improvement ahead

Knowing them changed how I understood myself. Dr. Clark showed me that language could be a site of connection rather than correction, that communication did not have to be justified to be valid. Dr. Cannon taught me that access was not something to be begged for or earned, but something structurally owed—and that refusing it was not strength, but learned self-erasure. Xie showed me, in the most ordinary way possible, that visibility did not have to be dramatic to be powerful. Together, they made it impossible for me to continue believing that my difference needed to be hidden in order for me to be respected. 

For the first time, I could see how much of my life had been organized around the fear of being noticed as disabled. I had mistaken silence for resilience and invisibility for safety. I had worked tirelessly to perform normalcy, never stopping to question who that performance was meant to serve. Meeting people who lived fully, openly, and unapologetically in their bodies forced me to confront the cost of that performance—and how much of myself I had abandoned to maintain it. 

Empowerment did not arrive as a sudden revelation, but as a slow undoing. It came from allowing myself to ask for what I needed without apology. From recognizing that accommodations were not evidence of inadequacy, but tools for equity. From understanding that my disability was never the problem—my internalized belief that I had to be fixed was. I began to imagine what my childhood might have looked like if difference had been normalized instead of pathologized, if Black ASL users had been visible, if the people around me had known even the simplest gestures of inclusion. 

I still think about that four-year-old on the exam table, staring at the tissue paper roll and believing something about his body was wrong. I wish I could tell him that he was never broken, never incomplete, never in need of repair. That his voice—spoken, signed, or otherwise—would always be enough. Reclaiming that truth has reshaped the way I move through the world. And while I can’t rewrite my past, I can live in a way that refuses to disappear. That, more than anything, is what empowerment has come to mean for me.

About the Author

A young Black man with glasses and a green shirt, looking down in a side profile.

Image Description: A young Black man with glasses and a green shirt, looking down in a side profile.

Keaun Michael Brown is a student at Indiana University Indianapolis currently studying Africana Studies and Political Science. Post baccalaureate, he intends to further his work in the local non-profit sector at his current position at Flanner House, as well as continue his career as a poet, artist, and community storyteller. In his spare time, he can be found listening to MF DOOM, watching Pacers basketball, or at Lete’s Injera Cafe in Haughville.

Automatic Allies: Surrounded by the Support Everyone Disabled Deserves By Trevor Darley

In 2023, world-renowned oncologist Dr. Lawrence Einhorn and his highly skilled surgical teammate Dr. Clint Cary removed the last chunk of the formerly 9 pound cancerous abdominal tumor I’d been battling on and off for years. Unfortunately, the next year, I began to be haunted by a condition I’ll call “Ghost of Cancer”: devastating, life-threatening damage related to the grafts that replaced my two largest blood vessels. The best efforts of yet another world-renowned entity- the Mayo Clinic- kept me safe for only a few weeks. The Ghost of Cancer’s fury ravaged my already damaged body, and when the dust settled, my right leg was left with two enormous wounds, and I lost the ability to lift my right foot (a severe case of a condition called drop foot).

When I returned to IUPUI (a name I refuse to stop using despite the messy divorce of IU and Purdue) in the fall of 2025, I had a visible disability: leg wraps up to my knee and a four-wheeled walker for mobility. When the meager progress I’d made over the last 10 months completely came undone, I began to need a wheelchair often, and I was placed back on an extremely visible device called a wound vac, which consists of a long tube connecting my leg to a loud machine worn like a purse. As a longtime member of IUPUI’s tight-knit community, I knew I would be treated kindly, but I never could have anticipated how often my peers would go above and beyond to help. 

Someone holding a door open for a person in a wheelchair

Whenever I approached a door at a busy time, at least one person who noticed me stopped in their tracks to see how they could assist me, whether that meant holding a manual door, pressing the button on an automatic door, or asking whether I needed help with a large load of items. On one occasion, two strangers very quickly worked together to lift my wheelchair when it got stuck in a doorway. Another time, someone offered to push me up a steep incline, which would have saved a massive amount of time and effort if I hadn’t been feeling well at that moment. Notably, she asked, giving me a choice rather than automatically doing so; many well-intentioned people don’t realize how large of a mental (or even physical) blow getting pushed without permission can be, yet she automatically offered help in a way that maintained my sense of autonomy. Another day, a skateboarder zoomed ahead of me to hit a crosswalk button and followed me to hit the next one, which allowed me to get through the intersection quickly and safely. 

These acts of kindness, from small to large, had a profoundly positive cumulative effect; in times of extraordinary pain and discomfort, they allowed me to spare stamina, allowing me to study with a clearer head and save energy for critical chores (such as cooking). Paradoxically, relying on others in a dozen small ways throughout the day let me accomplish more and allowed me to feel more autonomous overall. I’ve become adept at opening stubborn doors by myself, but it’s much more satisfying to save the effort of a dozen doors to make a nice chicken dish.

Despite this positivity, the inevitability of my yearly health crisis greatly diminished my motivation to pursue long-term goals, especially physical goals like building strength. “Why go to the gym,” I asked myself, “if I’m going to lose all of my progress in mere weeks the moment I get sick again?” My first trip was very brief; I didn’t care to stick around once I got tired. On my second trip, a woman who could tell I had no idea what I was doing (after all, I hadn’t set foot in a gym in nearly two years) fixed my form, which made my little routine go from seemingly pointless to satisfying in an instant; it felt amazing to use muscles that had been dormant for months. On the way out of my third trip, the man who held the door told me to keep up the good work and, through a big smile, told me he was really glad to see that I showed up. Their kindness completely defeated the part of me that saw my goals as futile; after being unsure of my willingness to go to the gym even once, I now look forward to trips four, five, and beyond.

Anyone can make people with disabilities feel supported and valued. Any small act can contribute to a disabled person’s sense of wellbeing, community, and independence. I’m deeply grateful for the wonderful people in Indianapolis and beyond who’ve made the ups and downs of my health easier. I’ll do my part to pay it forward for those with mobility more limited than mine. My community helps me automatically, without me even needing to ask, so I humbly ask for just one thing: please show the kindness you give me to everyone, whether they have a visible disability or not. Your impact is far greater than you may expect.

About the Author

Portrait of Trevor, a young white man with curly brown hair, wearing a gray collared shirt against a beige background. He is looking into the camera with a slight smile.

Image Description: Portrait of Trevor, a young white man with curly brown hair, wearing a gray collared shirt against a beige background. He is looking into the camera with a slight smile.

Author Bio

Trevor is a 24-year-old student from the Indianapolis area. He lives with a leg disability due to damage caused by stage IV cancer. Passionate about disability and health advocacy, Trevor is studying Computer Science to make medical software more efficient and accessible. When his health allows, he also participates in other forms of activism on campus, such as sexual assault survivor advocacy. In his free time, Trevor enjoys photography and working on creative projects, including a guide to cancer.

Huddle Up With The GM! By Emry Himes

A cartoon of a smiling man dressed as a football coach with a headset and clipboard. The text "HUDDLE UP WITH THE GM!" is centered below him. Surrounding the coach are several encouraging phrases like "I am proud of you!" and "Well done!" A caption at the bottom explains that he is starting a podcast to help others feel good and recognize their "super powers."

Image Descriptions: The first image is a yellow poster featuring a cartoon illustration of a smiling man, referred to as “The GM,” dressed as a football coach with a headset, a “GM” logo on his jacket, and a clipboard showing a play diagram. Above him, various encouraging phrases like “WOW, YOU DID IT!”, “I AM PROUD OF YOU!”, and “I SEE YOU! I HEAR YOU!” are scattered like speech bubbles. The main text at the bottom reads “HUDDLE UP WITH THE GM!” followed by a caption: “THAT’S WHY I WANT TO START A PODCAST TO MAKE OTHERS FEEL GOOD ABOUT THEMSELVES AND RECOGNIZE THEIR SUPER POWERS!!”


cartoon of a smiling man dressed as a football coach with a headset and clipboard. The text "HUDDLE UP WITH THE GM!" is centered below him. Surrounding the coach are several encouraging phrases describing how PAC Services helps him, including: "Understand my options", "Focus on what I CAN do", "Feel seen, heard and respected."

Image Description: The second image is a green poster featuring a cartoon of a smiling man dressed as a football coach with a headset and clipboard. The text “HUDDLE UP WITH THE GM!” is centered below him. Surrounding the coach are several encouraging phrases describing how PAC Services helps him, including: “Understand my options”, “Focus on what I CAN do”, “Feel seen, heard and respected.” A caption at the bottom explains that with a waiver, he is reaching his goals and starting a podcast to help others recognize their “SUPER POWERS!”




About the Artist

A young man in his twenties with short brown hair. he is wearing a blue casual shirt with a tan hooded drawstring sweater over it. He is leaning on a brick wall with a smile on his face.

Image Description: A young man in his twenties with short brown hair. he is wearing a blue casual shirt with a tan hooded drawstring sweater over it. He is leaning on a brick wall with a smile on his face.

Artist Bio

Emry Cole McHugh Himes is a community leader from Southport, Indiana and the Inspirational Coach for the Franklin College Football Team, where he is known as the heart of the Grizzlies program. He is a Roncalli High School graduate, a participant in Franklin College’s Inspire program, and a longtime volunteer with organizations such as Best Buddies, Hope Gallery, and Special Olympics. Emry is also a Special Olympics athlete and 2025 Backstroke State Gold Medalist who loves music, dancing, sports, and bringing people together. 

What Real Support Looks Like to Me By Jody Michele

In my twenties, I needed support that was practical, consistent, and rooted in dignity.

I needed connection—real connection—not isolation disguised as independence. I needed transportation that allowed me to participate in community, work, and relationships. I needed the homes of my family and friends to be accessible. Why? Because relationships are deepened within homes, not confined to public spaces like restaurants and department stores.

I needed society not to pressure me to prove my worth or to be the representative of all people with disabilities. When I was eight years old, a teacher told me I had to work twice as hard to be seen as just as good as other children without disabilities. She said this after I made a C on a test. She told me that people would only see my wheelchair and hear my speech impediment caused by cerebral palsy—and that they would dismiss me. She said I had to excel at everything, not only for myself, but for the benefit of all people with disabilities.

That was an enormous burden to place on a child.

As I entered young adulthood, I needed people to actively counter that narrative. No one ever did. I needed permission to be an individual human being—not a symbol, not a lesson, not an inspiration. Had that happened, I believe I might have experienced more joy in my younger years.

I needed to live without the constant fear of losing my disability services—without the anxiety that one paperwork error, policy shift, or political decision could unravel my stability. Support should not be so fragile that it forces a person to remain in survival mode.

I needed politicians and community leaders to put action behind their words. Not performative allyship. Not promises during Disability Awareness Month. But policies, funding, and systems that reflected a genuine commitment to disabled lives.

I needed to see people with disabilities in positions of power. I needed visible proof that disabled people were valued and respected in this society.

I needed people to understand that I did not need to serve as their emotional dumping ground in exchange for my physical needs being met.

I needed organizations and businesses to recognize that if I was good enough to be an ongoing volunteer, then I was good enough to be compensated.

These were the things I needed then, and they are still what I need now, in my fifties. They are what people with disabilities need in order to be truly supported and empowered.

About the Author

A woman with short purple hair and glasses sits smiling in a powered wheelchair on a wooden deck outdoors. She wears a light blue sweatshirt, gray pants, and white sneakers, with trees and greenery behind her on a sunny day.

Image Description: A woman with short purple hair and glasses sits smiling in a powered wheelchair on a wooden deck outdoors. She wears a light blue sweatshirt, gray pants, and white sneakers, with trees and greenery behind her on a sunny day.

Author Bio

Jody Michele is an independent disability consultant and a co-author of “Disabling Leadership”.  She has both seen and unseen disabilities.