Sex Disabil (2009) 27:187203

DOI 10.1007/s11195-009-9134-z
ORIGINAL PAPER

Responses to Situations of Sexual Abuse Involving

Teenagers with Intellectual Disability
Nareadi Phasha

Published online: 23 September 2009

Springer Science+Business Media, LLC 2009

Abstract This paper reports on significant findings from an ongoing study on the care
and support services for sexually abused individuals with intellectual disability in South
Africa. Only one aspect of the study is presented here, namely the professionals views
regarding responses to situations of sexual abuse involving a group in question. So far, data
presented in this study were obtained by means of interviews conducted individually and in
groups, with participants recruited from the police services and schools that cater particularly for learners with intellectual disability. Findings revealed that sexual abuse among
teenagers with intellectual disability is widespread. The responses are discussed under
three broad areas, namely: protocols, reporting and preventive efforts. The findings will be
available for use in maximizing care and support services for sexually abused people with
intellectual disability in South Africa.
Keywords

Intellectually disabled teenagers
Sexual abuse
South Africa

Introduction
An increase in the number of efforts aiming at helping society understand sexual violence
in South Africa is notable, as are attempts to maximize appropriate community responses
to such situations. However, little is said about such issues amongst the people with
intellectual disability. These are people commonly regarded as having intellectual, mental
or developmental disability. People classified as such are considered not to be in possession
of the range of intellectual skills and attributes required by the mainstream [59]. The
condition could be congenital or acquired, and mild, moderate, severe or profound.
An extensive library search at three universities yielded limited scholarly research
covering sexual abuse/violence and disability in South Africa, and a disturbing issue was
the studies preference for physical disability over intellectual disability. An example of

N. Phasha (&)
School of Human Sciences, University of South Africa, P.O. Box 392, Pretoria 0003, South Africa
e-mail: nare_phasha@yahoo.co.uk

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such included a ground-breaking study in this area conducted for the Centre for the Study
of Violence and Reconciliation in South Africa [31]. Although the study used a small
sample of nine participants, it revealed serious forms of gender-based violence amongst
females with physical disability and their difficulty in accessing the justice system, for the
rather prosaic reason that the architectural structures of the buildings were not accommodative of their special needs. Another study carried out in Lesotho as a project of the
African Regional Sexuality Resource Centre, in collaboration with the Health Systems
Trust and the University of KwaZulu Natal [29], revealed inaccessibility to sexuality
education, for people with physical disability expected not to know anything about sexuality matters. Although these studies are useful to understand responses to people with
disability, they do not provide a perspective on the situation from people with intellectual
disability themselves.
The exception was Dickman and Rouxs study [13], carried out at a mental health
facility in the Western Cape Province. Its purpose was to investigate the speed and the
outcomes of sexual abuse cases involving people with intellectual disability, and to
comment on the nature of cases being prosecuted. Authors reviewed 94 files obtained from
the mental health facility, police services and the court. They were in the age range of 6
and 40 years of whom 38 were children under the age of 16 years (age of consent in South
Africa at the time of study). All these cases involved people classified under mental
retardation [DSM-IV], 46 mild, 28 moderate and 26 either severely or profoundly retarded. About 89% of the cases were perpetrated by people known to the victimized person
[family, friends and neighbours or people having connection with the family of the victim.
The findings revealed that: (a) arrest was made within one week or two, and (b) the
conviction happened within 2 years of being reported. As the cases of this study were
facilitated by the mental health facility, the situation may be different for those who are not
linked to any such type of a facility, in particular Black townships, the reason being that
they have inherited the problems of the past in terms of facilities, including child protective
services. Moreover, they may have their own beliefs regarding appropriate responses to
sexual abuse of teenagers with intellectual disability. Again, Dickman and Roux [13] have
only looked at the response by the justice system, thus leaving out other protective and
treatment professionals: families, school personnel, social welfare agencies, psychologists,
health service personnel and the community at large. In this light, the current study should
be seen as an attempt to add to the literature by focusing on the responses by families and
professionals other than the justice system. Such findings are important for contributing
towards a community-approach for caring and supporting sexually abused individuals with
intellectual disability. A community approach is aligned to South African legislation with
regard to responses to situations of sexual abuse involving young persons. This mandate is
clearly spelled out in the following legislation: The Child Care Act [36], The Prevention of
Family Violence Act [39]; The Film and Publications Act [38]; and The Constitution of
South Africa [35]. Ostensibly, this mandate renders care and support for sexually victimized individuals a serious community issue, requiring proactive intervention by every
person whose lives and professional responsibilities bring them closer to the group in
question. Indeed, when community members work collaboratively in formulating solutions
to the problems within their own settings, resources become readily and increasingly
available, as does support for each participating member.
Although the statistical reports on sexual abuse in South Africa do not mention crimes
committed against individuals with intellectual disability, the UNICEF report [57] on
violence against disabled children indicates that the annual rates of sexual crimes committed against them in the developing countries is 1.7 times greater than those committed

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against their non-disabled counterparts. In addition, international literature reveals that

people with intellectual disability are facing increased risks of sexual assault, as compared
to their non-disabled counterparts [1, 16, 46, 51]. Their exclusion from campaigns that
target sexual and reproductive health issues [30], combined with the prevailing misperceptions against them, render them vulnerable to rape, particularly in communities that still
hold on to the belief that sleeping with a virgin can cure HIV/AIDS infection [17]. They
are incorrectly assumed to be promiscuous or oversexed [60]. They are also considered
to be sexually inactive, unlikely to use drugs or alcohol, at less risk of violence or rape than
their non-disabled peers [17], and as childlike [20]. Other factors associated with their
increased risks to sexual abuse include: (a) lack of understanding of abuse; (b) the extreme
pressure to acquiesce out of fear; (c) a need for the abusers acceptance or having a
dependent relationship with the abuser [40]; (d) communication skills deficits [10] and; (e)
a belief by perpetrators that this population will not be considered as reliable witnesses on
their own behalf [60].
The literature further stipulates that, despite their vulnerability to sexual violence, care
and support services for sexually victimized individuals with intellectual disability remain
a serious concern as professionals often respond negatively to their situations. Health
centers frequently fail to provide adequate or factual information about sexual and
reproductive issues [60]. They are not provided with a way to work through or talk about
their traumatic experiences in therapeutic settings, as therapists are often not trained in
non-verbal mindbody healing modalities that do not require an intellectual processing
component of the therapy [40]. The justice system also fails them because it does not
always recognize their capabilities as reliable witness of their own abuse, especially in case
of individuals with poor communication skills and reduced capacity to recall and articulate
incidents. Moreover, they may not have the capacity to fight for their legal rights [43].
School programs offer them less instruction about sexuality matters [2], and teachers often
feel unprepared to handle such issues [19]. Campaigns about sexual and reproductive
issues do not consider people with intellectual disability as a target group [30], and risk
reduction programs do not reach them [60]. Consequently, there arises an impression that
service providers fail to connect intellectual disability and sexual abuse, and also the notion
that such problems are not serious among the group in question.
Matters pertaining to sexual violence, including care and support services for victimized
individuals with intellectual disability, merit priority if South Africa is serious about
recognizing human rights as including people with disability in general. The international
conventions require nations to provide appropriate care and support services to all children
and teenagers in an equitable and non-discriminatory manner. Such rights are clearly stated
in the United Nations Convention on the Rights of the child [56], ratified by South Africa
in 1990. The rights of individuals with disability are further emphasised in the following:
the Declaration on the Rights of Disabled Persons [53], the Standard Rules on the
Equalization of Opportunities for Persons with Disability [54], the Principles for the
Protection of Persons with mental illness and the Improvement of Mental Health Care [52]
and the World Programme of Action Concerning Disabled Persons [55]. South Africas
commitment to the international Conventions is clarified in the Constitution [35], Act 108,
which guarantees people with disability the right to non-discrimination and access to basic
services. To ensure that the goals are realized, the White Paper on Integrated National
Disability Strategy [37] identifies that: (a) disability issues be integrated into government
plans and programmes; (b) disability programs be co-ordinated at all levels of government;(c) a capacity-building strategy be built to ensure that its recommendations are
implemented at all levels of government; and (e) public education and awareness program

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to combat discrimination attitudes towards people with disability be implemented. Within

the education arena, the White Paper 6 on inclusion of learners with special needs [11]
gives recognition to sexual abuse as one of the barriers to equal education, and thus calls on
education centres to play a proactive lead in providing support to victimised individuals.
Furthermore, the White Paper 6 on inclusion of learners with special needs, states that
where services are inadequate, the school should mobilize relevant support services to
ensure that victimized learners benefit optimally from their schooling [11]. In this light,
this paper focuses on special attention to responses to sexual abuse involving teenagers
with intellectual disability.
First, we need to understand what relevant role players believe about their world.
Therefore, three aspects are pertinent in this study: (a) meanings given to objects/human
beings; (b) interpretation of symbols (language/actions), and (c) how human beings
arrive at the interpretations of the meanings [12, 41]. Although views may differ, the
end-product of this study is to be an in-depth description of responses to situations of
sexual abuse involving teenagers with intellectual disability. Specifically, facts about the
phenomenon under study are presented along with factors that contribute to the understandings, and an explanation about how such factors interact with each other to influence the understanding.

Method
Participants perspectives, thoughts, actions and feelings, as well as their context, are
important aspects in this study. Within the qualitative paradigm, this is described as: (a) an
attempt to capture the sense that lies within, and that structures what we say about what we
do; (b) an exploration, elaboration and systematization of the significance of an identified
phenomenon; and (c) the illuminative representation of the meaning of a delimited issue or
problem [3]. The current investigation followed procedures aligned to Grounded theory
method, the idea behind which is to generate theory by means of an iterative process
involving continual sampling and analysis of qualitative data gathered from concrete
settings, such as unstructured data obtained from interviews, participant observation and
archival research [18, 33]. Grounded theory method permits generation of ideas based on
the data rather than a preconceived hypothesis, and it is analyzed by means of specific
coding procedures [8, 48]. In addition, explanations are formed from proposed relationships among concepts, and further developed through additional instances of data, whilst
the researcher is continuously engaged in data comparison [8, 16, 45]. This strategy is
considered appropriate for a topic on which relatively little is known or been written about.
Selection of Participants
The strategy for selecting participants involved an array of referral and theoretical sampling. Theoretical sampling is theory-driven, necessitating theory-building from the
emerging data and the selection of a new sample to examine and elaborate on the theory
[24]. In other words, the selection of participants is guided by themes emerging from the
collected data. The researcher can decide to further explore the themes with the current
sample or with a new sample. In this way, the study invited only those participants whose
inputs could contribute to the development of a theory. Referral strategy facilitated location of participants by peers (colleagues) or people known to them. In a cost effective way,
participants were individuals whose services permit them regular interaction with sexually

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abused teenagers with intellectual disability. The sample consisted of participants namely:
4 police officers based at the Social Crime and Victim empowerment Unit of the local
police unit; at the special schools, participants included: 2 school nurses; 4 caregivers and
10 educators belonging to school-based support teams.
Procedures
Recruitment of participants began as soon as permission to undertake the study had been
granted, and ethical clearance was obtained from relevant authorities. In initial meetings
with each participant before the actual data collection sessions, they were informed of the
purpose of the study, clarified participants rights to protection, volunteer participation and
withdrawal without penalty or negative consequences. Each was offered an opportunity to
ask questions before signing a consent form. Issues of anonymity and confidentiality were
also clarified and pseudonyms were chosen. Each participant was given a summarized copy
of the research proposal to peruse in their own time, before making a decision about their
participation. Initial interviews clarified each participants professional responsibilities in
relation to people with intellectual disability, and to set up a date for the actual interview
session. Participants were informed about the counsellor who had been appointed to them
for emotional support. Also a list of local counselling agencies was compiled and given to
each participant.
Due to time constraints and different professional responsibilities, they participated in
different types of interviews. For example, school nurses and caretakers were interviewed
individually, whereas the police officers and educators participated in focus interviews. All
interviews took place at participants places of work during lunch times or after working
hours. They lasted for at least an hour, depending on their availability and schedules. A
summary of the interviews was drawn up with participants after the interviews. This
process permitted collaborative formulation of tentative themes, which was later renamed
and sent back to participants for final checking (trustworthiness). A final paper, which
transcribed their words verbatim subsequently sent to them for comments and checks on
accuracy.
Instruments
Interviews permitted flexibility and, most importantly, gave participants the freedom to
express themselves in their own ways and use language of their choice, for example,
English, Tswana and Northern Sotho. This facilitated an exploration of the phenomena
studied. As stated by Charmaz [7], the study was able to pursue a lead as soon as an idea or
issue emerged. The interview was guided by a few questions which focused on responses
to sexual abuse involving teenagers with intellectual disability.
Individual Interviews
Two school nurses and school caregivers participated in individual interviews, which
began with a reminder about their rights and a warning that the topic may evoke some
negative emotions. If they wished to terminate the interview were informed to do so. They
were given a telephone number of the counsellor that they could contact should they wish
to, also a list of other relevant resources in their community. Interviews were in a face-toface manner, which provided an opportunity to negotiate closeness and intimacy with

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them. The interviewer also sensed participants openness to talk about the research topic
and to vent their frustrations, particularly with certain reactions that made it difficult for
them to execute properly their child-protective responsibilities. The opening question was:
Tell me about the responses to situations of sexual abuse involving teenagers with
disability.
Focus Groups
A group of police officers (4 in number) and two groups of teachers from each schools
participated in the focus interviews (5 members in each group). The focus group permits
data collection through group interaction on a topic determined by the researcher, and in
this way, participants get to query each other and explain to each other [28]. Unlike other
strategies, focus group encourages participants to talk to one another (about the topic
determined by the researcher), as opposed to answering the researchers questioning. Thus,
it facilitates expression of differing opinions and viewpoints [23, 28]. Moreover, they
permit probing, and allow participants to build upon the responses of others [14, 44]. For
this study, the strategy complemented information generated through individual interviews.
Data Analysis
As in any other qualitative research, data collection and analysis were carried out simultaneously to avoid any chance for collecting unfocused data that does not reveal anything
new [8]. Following an interview with each participant, the tape was played on a number
of occasions to capture what was emerging. The process permitted identification of tentative themes and relationships which were further explored in the interviews that followed. Themes were refined and renamed when comparing participants views. The second
phase of analysis started as soon as transcripts became available. Once more data was
broken into bits, classified, and interconnections were established so as to provide a
detailed explanation. Context within which phenomena occurred was also taken into
consideration [7, 47].

Results
Participants shared a sentiment that sexual abuse amongst people with intellectual disability is widespread, and the home, which is supposed to be a safe haven, has in fact
become a hub for horrendous forms of potential abuse. The most vulnerable group is out
of school population, a category which include over-aged learners, those living in communities with limited educational facilities that cater specifically for their special needs,
and those whose parents cannot afford school fees or transport to schools. Reasons suggested by the caregiver at a special school where these populations spent most of their
times without the supervision of a carer at home or on the streets. They were easily enticed
by small tokens, such as sweets, money and food.
Overall, the response by professionals and families to situations of sexual abuse
involving teenagers with intellectual disability is problematic. The family response was
particularly mentioned by both the educators as the most problematic, and one that hindered effective intervention by other protective and treatment services. The findings as

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discussed under three main headings, namely: (a) reporting, (b) protocols, and (c)
preventive efforts.
Reporting
Families rarely report sexual abuse involving a person with intellectual disability, irrespective of the victims relationship to the alleged perpetrator. Suspected and identified
reports often reach the law enforcement agencies through neighbours and educators. Other
incidents of sexual abuse are brought to the attention of the police by health professionals.
Often such instances are identified in a situation related to pregnancy and/or a diagnosis of
a sexually transmitted disease. Sexual abuse committed against a person with intellectual
disability remains a family affair, for various reasons such as: (a) keeping it a secret; (b)
neglect (c) preference for traditional methods for dealing with the problem; (d) beliefs
about a cure for intellectual disability; and (e) trivialisation of the problem.
Concealment
Attempts to keep the problem a secret are common when a person with intellectual disability has been sexually abused by a close relative, such as a sibling, uncle, a parent (step
and biological), and/or a mothers boyfriend. In such a situation, some family members
often pretend as if nothing has happened. The incident will neither be mentioned nor
discussed at home or anywhere else. The idea is to ensure that it does not leak in any way
to either the police or social welfare agencies. Any attempt by the victim to disclose is
strongly opposed, either by denying and/or dismissing the report. This was clear in Bettys
words, a counselor working at a counseling unit of the law enforcement agency:
If the offender is a family member, the incident is kept a secret [Ke gore ba e
bethelela gona moo]. They hide it and it just becomes a family issue, and no one
will mention it. A parent will duck and dive about the sexual abuse and go to an
extent of making it look like the abused person is making senseless stories because of
his/her disability. A parent would sayyou know how this person isyou cannot
take him/her seriously, this person is mentally retarded.
A member of the police working in the Social crime prevention unit echoed the
statement:
They cover it up, and nobody would say a word about it. Even if the child reports to a
non-abusive relative, they would prefer to deal with it as a family, especially when
the perpetrator is the breadwinner. They keep it a secret and they could not care less
whether it affects the person or not.
Clearly, the familys attempts to conceal sexual abuse involving a person with
intellectually disability are motivated by the fear of subjecting the perpetrator to police
interrogation or investigation. The family is quite aware that if the victim does not get
their support the crime will never reach any law enforcement agency. Such responses are
common amongst poorer families, who are economically dependent on the perpetrator or
on the victims disability grant. They are aware that if the perpetrator could be jailed the
family would loose its main source of income. Families, who depend solely on the
victims disability grant, fear that the child protective services could find an alternative
placement for the teenager, and thus the grant would be lost. For these reasons, they
prefer to protect the alleged perpetrator at the expense of the victimized teenager. The

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family could even resort to drastic measures for protecting the alleged perpetrator. The
educator indicated that if the recipient of the disclosure persists in reporting such a
matter to the police, family members might refuse to cooperate, and threats ensue:
Parents get furious and accuse us of interfering in their family businesses. One parent
told me thatI know where you live, what time you knock off from school, which
roads you use to come to school, and I will show you. These words discouraged me
from pursuing the childs matter.
Misconception About a Cure for Intellectual Disability
Misconceptions about the causes and cures for intellectual disability often encourage
some families to remain silent about the abuse involving a member. Special reference is
made to distorted belief that intellectual disability is an illness caused by a lot of dirty
blood in the persons brain, and that the condition can be cured only if that blood is released.
People who embrace such myths are reluctant to report sexual abuse involving a person with
an intellectual disability, hoping that the victim will get pregnant and loose dirty blood
during childbirth. Such parents fear that reporting sexual abuse involving a person with
intellectual disability could lead to termination of pregnancy. Drawing on religious or moral
antipathy to abortion, the perpetrators are able to distort logic into defending their concealment. Desperation to have the condition cured drives some families to the extent of
finding a man to make the intellectual disabled person pregnant. The majority of such
families lack the ability to distinguish between any forms of intellectual disability, let alone
those which may require specialized interventions, and so place distorted reliance upon
negative messages from the community. The school nurse highlighted that they object to
any advice to put the person with intellectually disability on birth control medication, or
provide them with any form of protection against sexually transmitted diseases:
There are strange beliefs amongst some parents regarding the cause of intellectual
disability and how the condition can be healed. They believe that the condition is
caused by too much blood in the brain, so if such a person gets pregnant, she will
loose that blood during childbirth. The child will then be cured. Soehthat is the
reason, some parents and grannies go to an extent of finding a man to sleep with an
adolescent with intellectual disability just to get her pregnant.
Traditional Ways of Dealing with the Problem
For those who choose to not conceal it, there are different ways of trying to deal with
discovered abuse. For some, a family matter means a preference for dealing with the
problem in ways other than modern preventive and treatment strategies. It may involve:
reporting the incident to the police and finding psychological therapy from social workers
and a psychologist. Families displaying such preferences often follow traditional ways,
such as a cleansing ceremony. An educator indicated that families call such a strategyU
ku gezwa [the cleansing], and further clarified it as follows:
The perpetrator is expected to plead guilty to the victims family and the perpetrators own family. The perpetrator will then be fined a certain number of cows or
goats, and apologizes to the family and the relatives for defiling the child. One of the
cows or goat will be slaughtered and the blood will be mixed with some herbs to
cleanse the victim.

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The other educator related how:

Some children are temporarily removed from school for some months (3 months)
and taken to a traditional or spiritual healer in the rural areas to be cleansed of such
bad luck.
Neglect
There are some families who display a could not care less attitude when a family
member with intellectual disability has been sexually abused. Such parents refuse to get
involved in anything that has to do with the victim, even if it is school-related. A teacher
describes the behavior of those parents as rejection, and they try very hard to dissociate
themselves from the child. It appeared to participants that such families have just kept the
person with intellectual disability for economic reasons (monthly social security allowance). A police officer said:
If it happens to a person with intellectual disability it is not reported, but if it happens
to a non-disabled person it gets reported immediately, even if the perpetrator is a
family member. With an intellectually disabled person it does not matter, the family
does not even bother to make a follow up.
One of the educators said:
They take advantage of these people because if it can happen to a non-disabled
individual, the situation changes altogether. No more questions likewho is going to
support us? Comments such as the child must just bear the situation are not
passed. They go to the police station right away.
Trivialization
Sexual abuse involving a teenager with intellectual disability is trivialized if both the
perpetrator and the victim have intellectual disability, even if the age difference is wide.
The perpetrator is often exonerated for the abuse on the assumption that s/he lacks an
understanding of what s/he is engaged in. Using an example of a recent incident, which
involved a 22 years old man with intellectual disability sexually abusing two 12 year old
girls with intellectual disability, the Caregiver [1] said that:
If both of them (referring to the perpetrator and the victim) have disability, most
parents just ignore it. There is a belief that they do not know what they are doing.
Anyway if you decide to report such a case it will be thrown out of the court. How
will the alleged perpetrator defend himself? People will just laugh at you.
Caregiver 3 corroborated the statement by indicating that:
That is not a problem at all. In fact most people just leave the matter (ignore) because
no one gets hurt.
Protocol
Educators stressed that procedures and guidelines set out by the Department of Education
make it difficult for them to respond appropriately to situations of sexual abuse, because
they are required to obtain parental consent to report any suspected or disclosed incident to

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the law enforcement and/or social welfare units. Apparently, other agencies, such as social
welfare, are also not expected to intervene without the consent of a family member.
Educators find such a procedure frustrating, especially if parents/family members are
unwilling to co-operate in reporting the matter to the relevant child protective services. A
teacher maintained that:
I once had a learner who disclosed to me that her father was abusing her. We referred
the learner to the school nurse for physical examination, and penetration was confirmed. As a school we took further steps by calling Childline tollfree number and
both parents. But when they arrived the mother mentioned that we cannot call the
police because if they jail this man who is going to support the family? We cannot
suffer because of one person. The child has to put up with the situation for the sake of
other members of the family. It does not matter with the child, she will come around.
Teacher B said:
Parents are doing all these things to their own children because they know that the
schools cannot take any action without their consent and moreover, they know that
the child cannot go on her own to report the case to the police station.
She further stated that:
Social workers are willing to help whenever we report a case of sexual abuse. But
they also want the involvement of parents and if you find that the parents are not
cooperative and therefore the case just ends up nowhere.
The school nurse A commented:
The protocol prescribed by the Department of Education is very restrictive, and it
contradicts the rules of the health professionals. Being a nurse at school, I am
compelled to follow the Department of Educations regulations, and that makes my
life very difficult. School personnel are not expected to touch a child when they are
sick but as a nurse I can do it. But now I am confused because I have been told that I
cannot do anything without the parents consent. The health professional guidelines
allow me to report to the police services especially if the child discloses to me but the
Education Department guidelines will ask if you have a proof. This leaves me in a
dilemma because I do not know what to do.
Preventive Efforts
Evidently, different child protective agencies have taken a number of preventive measures
in schools and in the community. These include a reporting system, awareness and educational programs. However, these strategies are not effective in getting across the messages because the targeted population often does not make the time to attend.
Identification and Reporting System
A system has been put in place by the judicial system to equip educators and the public
with skills to identify and report sexual abuse. The idea behind the initiative is to increase
safety on the part of the most vulnerable members of the societychildren, disabled and
women, and to encourage stakeholders to work collaboratively in preventing and
addressing this problem. A disappointing point was that only learners and teachers showed

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interest in the initiative. Families often find excuses not to attend the sessions. A police
officer explains the situation in the following excerpt:
In an attempt to rescue the situation with intellectual disability, especially those who
are still at school, the justice system in collaboration with police services have
introduced the reporting system, which aims to guide everybody on how to identifying early warning signs of abuse and how to report the problem. It aims to ensure
safety at home, on the way to and from school, and even at school. If this project is
taken serious we could have a wide spectrum of people working together towards
preventing the occurrence of sexual abuse because it encourages collaborationyou
know by all, and it explains who should be contacted if it happens, but we are
disappointed because you will never ever see any parent coming to the sessions
instead you will find teachers and these children. Then you ask yourself what exactly
are these people thinking, that is the reason I keep on saying that they do not care
about these people with mental disability. Sometimes when you go personally to
invite a parent that you know, she will sayI do not have time for that, I have to go
to work or attend funerals or weddings. It is discouraging indeed.
Educational Programs
The Department of Education has introduced a new learning area called Life Orientation,
the aim of which is to equip learners with life-skills. The learning area covers issues related
to sexual abuse and other health-related topics. However, many teachers prefer not to
handle such topics, rather they wish to have them dealt with by the school nurse or the
police. The schools decision to involve the police in crime-related issues was based on the
assumption that children are afraid of the police so they will be able to act accordingly and
with confidence whenever they are faced with an abusive situation. The school nurse also
indicated that:
We give them health talks but you will never know whether the messages are going
through because some of these learners experience difficulty in grasping information.
But we also use pictures. We also invite the police to speak to them, hoping that
children are afraid of them and so they will get through to them.
A policeman said:
The school has introduced the learning area called Life Orientation, which covers
issues pertaining to child crime. They invite us to speak to learners about child abuse,
drug abuse and other child-related crimes. Sometimes we are asked to conduct
searches, just to check if children are not in possession of drugs or any dangerous
instruments.
Community Awareness Program
The police and the educators organize awareness program aimed at deepening understandings of crime and disability. Such efforts were prompted by the communitys general
lack of knowledge and misunderstanding of intellectual disability, which manifests itself in
name calling, such as insane, mad people, outcast and the bewitched. They believe
that such negative statements affect the self-esteem of the children and instill in these
children feelings of shame. Also they make parents react with rejection towards these

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children. In this light, they felt that an awareness program would encourage positive
attitude and acceptance of these children.
A member of the police asserted that:
Together with the local nursing college, we hold awareness in the community where
we promote an understanding about disability issues. Those are conducted during
Disability Week and Child Protective Month, but it is disappointing because parents
hardly attend those programs.
A disappointing observation made by the police was parents poor attendance at such
programs. They are also offered during particular times.
Support Group
To complement the awareness programs, one special school has initiated a support group
for parents, to create a platform for them to share understanding and other issues relating to
intellectual disability. Participation in support groups is not limited to parents only, but also
to neighbors and other interested people in the community. It is envisaged that such kind of
an initiative will reduce name-calling and promote sensitivity towards these families.

Discussion
A conclusion that can be drawn from the interviews is that certain responses by professionals and families towards sexual abuse involving teenagers with intellectual disability
are highly inadequate. However, unlike other studies that related inadequate professional
responses to lack of expertise in: (a) providing counseling for persons with intellectual
disability, (b) expertise required dealing with sexual assault, and (c) doubts that persons
with intellectual disability can be credible witnesses [21, 50]; the present study associates
the problem with organizational protocols, which require professionals to obtain parental
consent in order to intervene. This is so because families rarely cooperate with professionals, often clashing over the way sexual abuse should be handled. Hence, ultimately the
professionals leave the problem for the family to handle for fear of contravening organizational protocol, as that may cause them their jobs or result in them being reprimanded or
fined.
Whilst it is clear that rendering this problem a family affair offers the family an
opportunity to handle the sexual abuse in ways that best suit them, the following challenges
could be expected. Firstly, the victims safety may be compromised because people with
intellectual disability may not lay a charge on their own, and if they do, such reports are
often dismissed by the justice system and police who may believe that a misunderstanding
may have occurred [57]. On the same note, some families may coerce the victimized
teenager into denying the occurrence of the incident or giving a false statement about the
alleged abuse. If this occurs, his/her safety from further abuse by the perpetrator may be in
jeopardy. This is so because people with intellectual disability are dependent, fear abandonment and are vulnerable to the caregivers wishes [27]. Secondly, professionals
reaction may be interpreted as non-compliance to the mandate which requires every adult
whose work brings them closer to abused children to report to the social worker or police
station any disclosed or suspected sexual abuse. The mandate is unequivocally stated in the
Child Care Act [36] and the Prevention of Family Violence Act [39]. Lastly, the victim
who is not receiving support from the family in the allegation may have her/his sense of

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betrayal compounded when professionals withdraw their involvement in the matter.

Tendencies involving concealment, trivialization and neglect towards the allegation of
sexual abuse by a family member are common even in instances which involve a nondisabled person, particularly if the alleged perpetrator is a close relative. Different factors
are attributable to such actions. In some instances poverty tends to be a motivational factor.
Such a family may fear a loss of the only source of income, which may either be the
perpetrator or the victimized person with intellectual disability. As noted by Frye [15],
levels of poverty and unemployment in South Africa are significantly high with estimates
indicating that about 48, 5% of the 46 million population were living in poverty in 2002,
and in 2004, 41% of the working age population were unemployed. Although the number
of jobs grew from 9.5 million in 1995 to 11.6 million in 2004, The Global Network [49]
noted that the increase has failed to keep pace with the number of people seeking
employment. Furthermore, women are the most affected population. Such a deleterious
situation often renders women the poorest members of the population, dependant on their
male partners or relatives for financial support. Any sexual abuse allegation against the
breadwinner will be met with antagonism or secrecy, with the intention to protect him or
her from being jailed. Similarly, the family may fear that if the incident reaches the child
protection services, a victimized teenager may be removed to a place of a safety or a foster
home, and the monthly disability grant (social security) would be lost.
Negative perceptions about the law enforcement and justice system offer another
explanation as to why some families resort to concealment or trivialization of the alleged
sexual abuse involving a member with intellectual disability. Mistrust and skepticism
towards the police still exist among the black communities of South Africa. Such negative
feelings were created as a result of police practices during the previous Apartheid system.
According to Nowrojee and Manby [32], the polices roles were focused particularly on
protecting the interests of White people and suppressing political activism in Black
communities. Such practices led to ignorance of ordinary crimes in Black communities,
which occurred alongside incidences of torture and killings of Black men and women who
were involved in the political struggle against the Apartheid regime. For most families
such sad memories are still vivid, and have created great suspicion and hostility towards
police, hence a reluctance to report any crime-related activity to the police. With reference
to police treatment of victimized person, Mistrys report [26] on the victims and the
criminal justice in South Africa noted the following: (a) a lack of privacy in taking
statements when rape was reported, (b) police refusal to take statements when reporting
incidents of domestic violence, (c) police treatment of children as unreliable witnesses who
are prone to exaggeration. As a result, women who had experienced such negative reactions resorted to concealment as an attempt to protect the victim from further humiliation
and hostility from unsympathetic police and the justice system, as that would expose the
victimized person to secondary abuse.
Nowrojee and Manby [32] revealed that a decision to keep the problem under wraps
could be associated with a fear of social stigma. In African communities, where adults are
expected to act paternally and maternally to all childrento love, protect and nurture
sexual abuse of an teenager with intellectual disability can be met with intense social
stigma directed at both the victim and his/her family. Families living in such communities
may resort to extreme measures of concealment as disclosure may be viewed as not worth
potential humiliation by their own community members.
The influence of what constitutes human health; wellness and healthcare cannot be
ignored. According to Mabunda [22], societies worldwide have their own beliefs, customs,
and practices which influence diagnosis, prevention and curing of a disease, thus ensuring

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health. UNICEF [57] noted that popular beliefs often assume that a disability results from a
curse, bad blood, an incestuous relationship, a sin committed in the previous incarnation or
a sin committed by a childs parent or other family members. Some are believed to have
been bewitched or in possession of evil spirits [5]. The family and a child born in a
community where such beliefs exist may be subjected to name-calling, mockery, humiliation and discrimination. Lack of support from community members may expose the
family to intense stress, which could ultimately drive the in desperation to find a cure. To
avoid a disgrace caused by societal beliefs, they may find themselves concealing the
alleged crime, hoping that it will lead to a cure.
Peoples preference for traditional ways of dealing with problem should not be taken
lightly, especially as any dismissal of it could be taken as constituting a lack of trust and
understanding by the establishment of the current African ways of dealing with abuse. As
noted by Rosen [42], people of African descent are often comfortable using services and
strategies that are in line with their belief systems, namely those underpinned by the
philosophy of Ubuntu. The services put at the center the elements of reconciliation, restoration and harmony [4], and thus discourage any vengeful behavior by the victims
relatives, prevent future occurrence of the abusive behavior and facilitate the victims
healing. This is in contrast with the modern ways of handling crimes, which involve
imposing a punishment by having the perpetrator jailed. The problem is that imprisonment
does not incorporate rehabilitation and counseling, as such services tend to be non-existent
in most correctional facilities, and thus render the strategy ineffective. Instead, what has
been observed are a large number of offenders returning to prison within 2 years of being
released, an assumption being that prisons leave them ample time to learn from each other
new ways for committing crime [4].

Recommendations
Procedures prescribed by the Department of Education which require educators to obtain
parental consent to intervene in cases of sexual abuse involving learners should therefore
be revisited. As they are, they may not facilitate proper and prompt response by professionals in charge in the absence of parents. Teachers in particular, play a surrogate parental
role in the absence of a biological parent, and this makes them the closest adults outside the
childrens homes [9]. Moreover, learners often share personal information with the
teachers [25]. These do not only make them possible recipients of learners disclosure of
sexual abuse occurring at home, but also persons from whom protection and support would
be sought. Recognizing this important position that educators hold in the childrens life,
organizational protocols should be aligned to the countrys legislation, which mandates
them to report any suspected or disclosed incident of child abuse to appropriate authorities.
An adoption of a community-based approach to dealing with sexual abuse of teenagers
with intellectual disability would be ideal. Sexual abuse is a community problem rather
than a family or an individual matter, and therefore requires the involvement of community
in addressing it. In this way, the availability of resources would increase, and there would
be a prompt and appropriate response to such situations. A victimized teenager will have
an entire community to look to for support, whilst families will have the same community
to account for in case of any attempt to conceal or ignore the disclosed or suspected abuse.
This form of approach is aligned to the African way of life, which is communal in nature,
and promotes social responsibility and solidarity, the duty of care, the virtues of sensitivity
and selflessness [34]. According to this view of life, a human being does not exist in

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isolation, but rather is an integral part of society and therefore can only exist corporately
[48, 58]. An experience of sexual abuse is therefore a societal problem. The pain, care and
support of a victimised person are shared with members with whom s/he is connected
rather than an individual or a family.
Distorted information around intellectual disability should be addressed by means of
community awareness programs and parent support groups. As revealed by this study,
current programs are irregular, meaning that they are offered during particular times, such
as Disability Week and Child Protection Month. Short-term programs are not always
effective in spreading the messages widely and cementing them in peoples minds. The
program should be ongoing and offered in various forms of methods available to the
community, so that they reach them all on an everyday basis. Information should raise
awareness that there are different forms of disabilities, and that all people have the same
rights, legally, morally and constitutionally. Programs should aim to promote understanding about intellectual disability, change perceptions about what it means to be human
and remove stigmatization, rejection and social exclusion of people wrongly perceived as
inferior. South Africa upholds the principles of social inclusion. Such information will
contribute towards better treatment and respect of all people and ultimately appropriate
responses to sex and sexuality in its entirety. The Life Orientation learning area is a move
in the right direction, but educators must be properly trained to deliver it effectively.
Conclusion
By focusing this investigation on the responses to sexual abuse involving teenagers with
intellectual disability, their plight is highlighted and the need for community-approach in
responding to their situation unquestionable. Sexual abuse is a community problem, and
therefore any effort which threatens a prompt and appropriate response by certain community members should be discouraged, particularly if the abuse involves the weakest
members of the society, such as people with intellectual disability. Structural issues,
societal misconceptions, attitudes and behavior towards individuals with intellectual disability should be challenged in any way possible to facilitate acceptance of such people and
appropriate treatment by the societal members.

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