An Examination of Abuse Prevention
Presented by Tricia Lund & Carolyn Broner
Sexual abuse is one of the most significant safety risks facing individuals with intellectual and developmental disabilities — occurring at a rate five times higher than in the general population. But if the vast majority of perpetrators are people already known to the victim, are we teaching the right skills? This session reviews the data on who is actually perpetrating abuse, examines what the ABA literature has focused on, and invites practitioners to consider whether our current approach is leaving our clients vulnerable.
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Learner ratings
from 28 learners
96% would recommend this CEU to other professionals in their field (24 responses)
“One speaker was exceptionally good whilst the other was very mediocre thus I wouldn't recommend this particular one to others but overall it's a solid 8/10”
— Reagan P.“yes, very thought provoking!”
— Mateo M.“very good”
— Ana S.“I think the presentation spoke in great detail about how sexual abuse plays a role on how a client performs during sessions in Applied Behavior Analysis. This topic is important in the field of ABA because behavioral specialists work directly with vulnerable populations (such as individuals with developmental disabilities or trauma histories) who face higher risks of victimization and may exhibit extreme maladaptive behaviors. Research shows that people with autism or different intellectual needs experience higher rates of maltreatment due to communication barriers, social isolation, and diffe”
— Cristina G.
About this CEU
Sexual abuse is one of the most significant safety risks facing individuals with intellectual and developmental disabilities — occurring at a rate five times higher than in the general population. But if the vast majority of perpetrators are people already known to the victim, are we teaching the right skills? This session reviews the data on who is actually perpetrating abuse, examines what the ABA literature has focused on, and invites practitioners to consider whether our current approach is leaving our clients vulnerable.
From the talk
What was covered
Most sexual abuse of people with IDD (intellectual and developmental disabilities) comes from someone they know. What the data says, and why stranger danger training misses it.
- Plan for double risk: adults with intellectual disabilities face sexual abuse at roughly twice the general rate.
- Audit your safety programs for who they target, not just whether the teaching method works.
- Add caregivers, direct support staff, peers, and dating partners to every abuse prevention program you write.
- Ask whether your learner can actually leave the situation your training tells them to leave.
- Teach judgment on purpose, using role play, varied examples, and practice in the real setting.
- Treat comprehensive sex education as abuse prevention, not as a separate or optional topic.
How Often Sexual Abuse Happens to People With IDD
Tricia Lund started with a simple goal: she wanted numbers she could trust. The research on sexual abuse and disability is messy. Rates jump around a lot from one study to the next. How a study defines abuse changes the rate it reports. So does who gets studied, and so does the way the data gets collected.
So she leaned on a meta-analysis (a study that pools many studies). One paper on its own can miss a lot. A narrative review only sums up a handful of papers and draws a judgment. A meta-analysis pulls data from many studies at once. The sample gets much bigger, so the answer gets more stable. The talk cited a meta-analysis by Ann Borowski.
Here is what that data showed. People with intellectual and developmental disabilities (lifelong disabilities that affect daily learning) face double the risk of sexual violence. That risk holds across their whole lifetime. For adults the picture gets worse. Rates for males also run higher than they do in the general population. That matters, because many abuse prevention studies have targeted females only. Risk climbs as support needs climb. People who need help with personal care face the greatest risk of all.
One in three adults with intellectual disabilities are going to experience sexual abuse.
From the talk — Tricia Lund & Carolyn Broner
Why the True Number Is Higher Than the Data Shows
That meta-analysis was solid, but the number it gives is still too low. Start with the definition problem. One study may count only unwanted touch. Another may also count things like sending naked photos. A narrow definition hides real harm, and it makes two studies hard to compare. That is one reason prevalence (how often something happens) stays so slippery here.
Then there is the person who does not know that it was abuse. Lund described a client who was abused by a peer in a school setting. He did not like what was happening to him. He also believed that was simply what friends did, so he never told anyone. Harm like that never reaches a single data set.
Reporting can also stall at any point along the way. A person may tell a parent, and the parent may never call the authorities. The case may never reach a court. Some of it just gets handled in house. Consent muddies the count too. Staff may report a consensual act between two adults as abuse. Staff may also wave off real harm because the two people are dating.
So there are instances of sexual abuse that happen but don't get reported because the individual didn't even know that it was abusive.
From the talk — Tricia Lund & Carolyn Broner
Who Is Actually Perpetrating the Abuse
Prevention has to follow the perpetrators. Aim at the wrong ones and you end up teaching the wrong skills. The talk laid out who the data actually points to. The list includes peers with disabilities, relatives, and non relatives the person already knows. It also includes direct support staff, partners, and professionals who work with them. Strangers are on the list too. They are just not at the top of it.
Two groups on that list get missed the most. The first is peers with disabilities. Harm can come from someone who shares a diagnosis, a group home, or a day program. We tend to assume a person with a disability is always the victim, never the one causing harm. The real picture is more complex than that. The second is partner abuse (harm from a dating partner). Rates are high and the signs can be subtle. A dating label makes it easy to stop looking.
Then there is the group we hire to help. A 2021 study by Hartrow, Elias, and Davis put numbers on this. One in three perpetrators was a family member or an acquaintance. And 44 percent of perpetrators had a care provider relationship with the victim. These are not strangers lurking outside a building. These are people that families and service systems let in.
Predators can have any title, any role, right?
From the talk — Tricia Lund & Carolyn Broner
Why Stranger Danger Training Misses the Real Risk
The talk also reviewed a survey of BCBAs (certified behavior analysts). It listed a long set of safety risks and asked how serious each one was. Ratings ran from one, meaning no real risk, up to five. Abduction and sexual abuse both landed high on that scale. So the field already knows this risk is there and worth programming for.
A second table asked how those safety skills actually get taught. Behavior skills training topped the list (teach, model, practice, then give feedback). Below it sat discrete trial teaching (short, repeated teaching trials), prompting, reinforcers, and video modeling. Behavior skills training has a clear shape. The clinician teaches the person to spot the unsafe moment. Then the person learns a response, like saying no or saying stop. Then the person learns to go report it to someone familiar.
That package works well against a stranger with a lure. Relationship abuse does not arrive in that shape. Most of the research here has used strangers as the only threat. It rarely teaches that an acquaintance or a caregiver could be the one causing harm. The second gap may matter even more. This training assumes the person can leave. Someone who relies on a caregiver for daily care often cannot leave at all.
But if we're teaching a child to recognize abuse that's happening in relationships, it's going to be a little bit more nuanced than that.
From the talk — Tricia Lund & Carolyn Broner
Knowing the Rule Is Not the Same as Using It
Carolyn Broner took the next stretch with a different question. Not just what works, but what is missing. She was clear on one point first. There is no direct evidence that rule based ABA (applied behavior analysis) strategies fail. The literature does point to limits. Skills learned in tidy, structured settings often do not carry into messy real relationships.
That gap has a name in our field: discrimination training (learning when a rule applies). A person needs to know when, where, and with whom a skill fits. Following a rule about not talking to strangers is easy. Reading a moment with a peer, a caregiver, or a relative takes judgment. Rules teach what to do. They do not teach how to decide.
Most studies run inside controlled settings. Classroom programs do improve what people know about boundaries. People can state the rule and pick the right answer on a worksheet. That does not mean the behavior shows up when it counts. We have very little data on how these skills hold up in natural, relationship based settings. That gap exists partly because studying it ethically is hard. The field has also barely touched interoceptive awareness (noticing signals inside your own body).
So the absence of evidence here is not reassurance.
From the talk — Tricia Lund & Carolyn Broner
Where the Mismatch Leaves the Learner
Put the three pieces together. The risk is high. The risk is mostly relational. And there is a real gap between what we teach and what gets used in daily life.
If harm happens inside relationships, and we teach safety as a stranger problem, the match is off. What we teach does not line up with how harm actually happens. That difference does not stay on paper. It lands on the person we serve.
So the question changes shape. It is no longer whether behavior analysis works on safety skills. It is what a person actually needs to know and do to stay safe inside real relationships.
And when there's a mismatch between instruction and environment, the learner is the one who carries the risk.
From the talk — Tricia Lund & Carolyn Broner
What to Teach Instead: Boundaries, Warning Signs, and Preferences
So what takes the place of stranger danger? Broner named three areas to build. Boundaries cover what is and is not okay in physical and social contact. Warning signs cover behavior that flags risk even when the person is familiar. Preferences cover the plain split between I like this and I do not like this. That last one becomes the base for consent and for self advocacy (speaking up for your own needs).
None of these three work as rigid rules. All of them depend on context. So the teaching target shifts. We stop teaching only what to do in a given moment. We start teaching how to read the moment itself. That is judgment, and it asks for flexible responding rather than recall.
For many of the people we support, judgment does not develop on its own. That means role play built on scenarios that mirror real interactions. It means peer discussion, so people hear other readings of the same event. It means practice in the settings where the skill will really be used. And it means many varied examples, because generalization (using a skill in new settings) has to be programmed.
Judgment has to be directly taught through multiple examples, varied contexts, and guided decision-making.
From the talk — Tricia Lund & Carolyn Broner
Sex Education as a Form of Abuse Prevention
Lund closed on the piece our field tends to skip. Many of us picture sex ed as anatomy and little else. The National Sex Education Standards cover far more ground than that. They include consent, healthy relationships, sexual development, gender identity and expression, and orientation. They also include sexually transmitted infections, interpersonal violence, sexual autonomy, and sexual decision making.
People with disabilities often get left out of all of it. When they do get it, it is often a watered down version. We teach the parts that are easy to teach. Labeling body parts is a very common stopping point. We rarely move on to bodily autonomy. We rarely teach someone to notice and trust their own cues of felt safety.
Lund also pushed back on her own slide. Sex ed is not only a puberty topic. Sexuality runs across a whole life, so the teaching should run that long too. Think back to the client who believed abuse was just what friends did. Teaching him what a healthy friendship looks like might have changed the outcome. So might teaching him that his body was giving him usable information. He also needed words to use in the moment.
So, as Carolyn mentioned, sex education is abuse prevention.
From the talk — Tricia Lund & Carolyn Broner
Common questions
How much more likely are people with IDD to be sexually abused?▾
The meta-analysis cited in this talk found double the lifetime risk of sexual violence compared to people without disabilities. For adults the rate is higher still, with one in three adults with intellectual disabilities experiencing sexual abuse. Risk rises further as support needs rise, and males are affected at higher rates than in the general population. Both presenters treat these numbers as an undercount.
Who commits most sexual abuse against people with disabilities?▾
Usually someone the person already knows and trusts. A 2021 study by Hartrow, Elias, and Davis found one in three perpetrators was a family member or acquaintance. The same study found 44 percent of perpetrators had a care provider relationship with the victim. The broader list also includes peers with disabilities, direct support staff, partners, and professionals. Strangers are real but are not the main pattern.
Why is prevalence data on sexual abuse in IDD so hard to pin down?▾
Studies define sexual abuse differently, so a narrow definition reports a smaller number. Some people do not recognize that what happened to them was abuse, so it never gets reported. Disclosures also stall partway, with a parent or an agency handling it in house. Confusion about consent in relationships skews the count in both directions.
Is behavior skills training enough for abuse prevention?▾
It has strong support for specific threats like stranger lures, and the talk does not argue that it fails. It does have two limits for relationship safety. The research mostly uses strangers as the threat, so learners never practice with familiar people. It also assumes the learner can leave, which is often untrue when the other person provides daily care.
What should I teach instead of stranger danger?▾
Build boundaries, warning signs, and personal preferences, then teach judgment on top of them. Use role play, peer discussion, and practice in the settings where the skill will be used. Include many varied examples, because generalization has to be programmed. Treat comprehensive sex education as part of the prevention plan, not a separate subject.
About the speaker
Tricia Lund is a licensed behavior analyst practicing in Texas, working with adults who live in group homes and residential facilities. She is also a licensed sexuality educator through ASECT (Association for Sexuality Educators, Counselors and Therapists) and a certified trauma professional, with more than 15 years across schools and clinics. Carolyn Broner is the owner and founder of Applied Behavioral Approaches and a licensed BCBA in Georgia, with over 25 years spanning K-12, post-secondary, and clinical settings.
This summary was generated from the recording’s transcript. Quotes are taken word for word from the talk.
What you'll learn
- 1Objectives: Identify the rate of sexual abuse experienced by individuals with IDD compared to the general population. Describe at least two reasons why accurate prevalence data on sexual abuse in individuals with IDD is difficult to establish. Identify the primary perpetrator populations responsible for sexual abuse of individuals with IDD. Explain at least two ways current ABA safety skills training may not reflect the actual risk landscape for individuals with IDD.
Concepts in this CEU
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