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Abuse, Social Pressure, and Decision-Making: Researchers Study Issues Confronting Women with Mental Retardation

Though the movement toward inclusion has meant that people with mental retardation are living and working in open community settings, it has also brought up new demands to balance independence with the need for protection in unfamiliar settings.

Linda Hickson, Professor of Education and Director of TC's Center for Opportunities and Outcomes for People with Disabilities and Ishita Khemka, Research Associate with the Center, have noted that the incidence of abuse among individuals with mental retardation, especially women, "is alarmingly high," however, with the proper training strategies they can learn to protect themselves against abuse and to interact more positively in social situations.

The research, according to Hickson, was inspired and triggered by the 1993 Glen Ridge, N.J., criminal case concerning a young woman with mild mental retardation who was lured into a basement of a home by high school athletes and raped. Hickson recalls that the "defense attorneys were taking advantage of the young woman's mental retardation and by leading her to answer in ways that supported their case." Hickson kept bringing her eye-witness accounts of the trial to her seminar students.

"In trying to figure out what makes people with mental retardation so vulnerable in situations like Glen Ridge, we found ourselves gravitating more to the social interpersonal area of research."

Khemka says that the Glen Ridge case illustrates the fact that people with mental retardation have a difficult time handling social pressure, coercion or abuse. She adds, "The public seemed to be asking whether people with mental retardation were prepared to be on their own and whether we, as educators in the field, were doing the job of providing them the skills they really need?"

Both Hickson and Khemka maintain that part of the problem is that people with mental retardation have not been allowed to make choices and have a limited repertoire of appropriate responses, especially in situations involving social conflict. Now that they find themselves out in the community on their own, they need to develop the skills that will keep them safe and enable them to resist social pressure.

Khemka emphasizes that their research has shown that "due to a history of learned helplessness and social failure, they [people with mental retardation] don't feel that they have the power to effect change and they have lower perceptions of control and self-efficacy."

Hickson says they have been approaching their research from two fronts: focusing on understanding decision-making processes with a goal toward developing a model of decision-making; and designing "effective interventions and supports that can help people with mental retardation make better decisions in a variety of domains like substance abuse prevention and the prevention of sexual, physical and verbal abuse, as well as a wide variety of interpersonal situations."

The research, therefore, not only concentrates on the study of gender abuse prevention but also on empowerment issues among female adolescents and adults with developmental disabilities. Khemka's dissertation, entitled "Increasing Independent Interpersonal Decision Making Skills of Women with Developmental Disabilities in Response to Social-Interpersonal Situations Involving the Potential for Abuse," explores alternative frameworks for decision-making training within the arena of abuse prevention. The dissertation won her the 1997 dissertation award from the Academy on Mental Retardation and the Irwin Goldstein Award for the best dissertation in special education at TC in 1998. Goldstein, who earned his MA in 1947 at TC, spent his career working in special education in the New York City schools. According to Hickson, Khemka's dissertation also received the honor of Ph.D. with distinction.

Just prior to the doctoral convocation, at a luncheon for special education graduates, Mrs. Riva Goldstein, Irwin Goldstein's widow, presented Khemka with the award. "Linda Hickson is always talking about striving for excellence," Khemka said. "That is why I am here today."

How was the research conducted? "In the past," Khemka says, "we interviewed women by telling them about scenarios of problem situations and then asking them what they thought the persons in the situations should do. Now we actually present these scenarios via video and have focused on problem scenarios that involve interpersonal decision making skills. We probe for their ability to recommend prevention focused decisions in response to such situations."

Khemka looked at situations of sexual, physical, and verbal abuse and evaluated the effectiveness of alternative approaches to training that would lead to better decision making skills for women with mental retardation. She found that an integrated cognitive and motivational strategy, which combined teaching specific decision-making steps along with assisting the women to generate personal values and self-protective goals, was most effective.

The other thing the research highlighted was the women found situations of verbal abuse more difficult to handle than situations of sexual or physical abuse. Khemka says, "Abuse is not necessarily inflicted by strangers or people unknown to them. We found that that the participants were having problems of dealing with situations of verbal abuse by family members, friends, acquaintances, and caretakers. Much of the training was geared to helping them understand issues of abuse and that they have a say, even if they are dependent on others."

Hickson, speaking about Khemka's contribution to the field of research says, "She [Khemka] is really committed to conducting the research where it will make a difference to the lives of people with mental retardation."

That means that their next step will be to start a support group of women, some of whom have participated in Khemka's training. According to Hickson, "We will be asking the women to bring in their real-life situations and we will work with them to apply decision-making strategies and monitor the outcomes to fine tune their strategies." They are also going to compare the results of their program to other types of supports and interventions.

Khemka is looking forward to support groups and what they may mean to decreasing the rate of abuse of individuals with mental retardation. " We need to prevent the abuse before it actually happens…to be proactive in preventing abuse. I would like to see some of our participants actually speaking up for themselves and increasing their ability to use self-protective strategies."

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