Intimate Partner Violence Among Help-Seeking Deaf Women: An Empirical Study

Abstract

Deaf women face heightened rates of intimate partner violence (IPV) compared with hearing women, yet limited research has focused on IPV among this population. Empirical studies are warranted to examine the unique experiences and resource needs of Deaf women, along with barriers excluding Deaf participants from IPV research and service provision. Our study addresses these gaps by providing a profile of 80 Deaf women attending an IPV program serving individuals with disabilities. Demographic and psychosocial characteristics, referral channels that led women to the program, and services sought post-referral are discussed to help guide best practices with Deaf survivors of IPV.

Keywords

intimate partner violence disabilities deaf

Introduction

Intimate partner violence (IPV) against women with disabilities is widespread and is associated with long-term physical and mental health problems (World Health Organization, 2011). Women with disabilities are abused at higher rates than either women without disabilities or men with disabilities (Breiding & Armour, 2015). Women with disabilities also remain in abusive relationships for longer periods of time (Nosek, Howland, Rintala, Young, & Chanpong, 2001), and are subject to more severe forms of abuse (Brownridge, 2009). Research on IPV in this population is in its infancy, with most study samples including women with a range of disabilities, thus precluding analysis of incidence within discrete disability groups (Hughes, Lund, Gabrielli, Powers, & Curry, 2011). Yet this distinction is essential, as disability-specific factors often guide appropriate prevention and intervention methods (Ballan et al., 2014). Research that treats women with disabilities as a homogeneous group further obscures the unique health concerns and accommodation needs of women with a range of disability types such as deafness.

Although Deaf women are subject to heightened rates of IPV compared with hearing women (Anderson & Leigh, 2011; McQuiller Williams & Porter, 2015; Pollard, Sutter, & Cerulli, 2014; Porter & McQuiller Williams, 2011, 2013), few investigations of IPV have focused specifically on Deaf and hard of hearing women. Consequently, hearing service providers lack awareness of the problem, and services equipped to meet the needs of Deaf women are scarce (Anderson, Leigh, & Samar, 2011). Research examining both the resource and service access needs as well as barriers to participation in research is warranted. The present study addresses this gap by examining the biopsychosocial characteristics and service utilization of Deaf¹ women attending a non-residential domestic violence program for women with disabilities.

Background: IPV in the Deaf Community

Prevalence of IPV within the Deaf community is uncertain, largely due to inconsistency in the definition of IPV across studies (Anderson et al., 2011). A national sample including both Deaf and hearing participants found lifetime prevalence rates of 27.1% for emotional abuse, 22.2% for physical abuse, and 16.9% for sexual abuse for Deaf women (Pollard et al., 2014). Additional studies have sampled specific populations, such as Deaf women receiving outpatient mental health services, and found lifetime rates of physical abuse as high as 56% (Johnston-McCabe, Levi-Minzi, Van Hasselt, & Vanderbeek, 2011). Although these studies have done much to advance research on IPV within the Deaf community, most have focused specifically on Deaf and hard of hearing college students (e.g., Anderson & Kobek Pezzarossi, 2012; Anderson & Leigh, 2011; Mason, 2010; McQuiller Williams & Porter, 2014; McQuiller Williams & Porter, 2015; Porter & McQuiller Williams, 2011, 2013; Schenkel et al., 2014). To determine the impact of IPV on the Deaf community throughout the life course, research must include broader samples.

Deaf women experience physical, sexual, psychological, and financial abuse similar to hearing women; however, they may also contend with forms of disability-specific abuse. For example, a perpetrator may restrict American Sign Language (ASL) instruction, deny access to a videophone or teletype device (TTY), or hide or damage hearing aids. A perpetrator can further manipulate assistive technologies by checking videophone logs, email, and text messages, or posing as the survivor via these mediums (Anderson, 2014). A hearing perpetrator may inflict emotional abuse by denigrating the woman’s auditory status or refusing to use sign language (Anderson, 2014). In addition, survivors may be cut off from IPV-related information and services, and undergo what Schild and Dalenberg (2012) refer to as “information deprivation trauma.” Information deprivation trauma (IDT) may occur when an abusive partner prevents a Deaf individual from obtaining resources or communicating with the outside world. It may also result from a more subtle denial of incidental opportunities to absorb knowledge via conversation, structured learning opportunities, and popular media, to which hearing individuals have access (Obinna, Krueger, Osterbaan, Sadusky, & DeVore, 2005). One result of IDT may be “low health literacy” (Anderson et al., 2011, p. 205), in which education regarding IPV dynamics is not communicated, and health-promoting interventions are inaccessible, creating another barrier to help-seeking among Deaf individuals. A similar dynamic arises when “limited legal literacy” (Mason, 2010, p. 82) occurs among ASL users, as language barriers limit the availability and effectiveness of the legal system for Deaf individuals.

When Deaf women do reach out for IPV assistance, they may find service providers who are unfamiliar with Deaf culture and lack the knowledge or skills to ensure full accessibility of services, such as an inability to use an advertised TTY number. Providers may claim that interpreting services for Deaf clients are financially prohibitive, or wrongly assume that such services are unnecessary if the client can read lips or communicate in writing (Smith & Hope, 2015). Furthermore, they may lack training to interact effectively with a client via an interpreter (Crowe, 2013).

Interpreter confidentiality is also a concern for the Deaf community, which is very small and tight-knit. If both a perpetrator and survivor are Deaf, they may encounter the same interpreter at events within their community and utilize many of the same services and recreation outlets, making it difficult to maintain confidentiality if abuse is reported (Smith & Hope, 2015). In addition, there may be a sense of shame in disclosing abuse within such a small community (Mason, 2010). Given the overall lack of culturally Deaf organizations, survivors have few alternatives for socialization and support if a primary outlet becomes off-limits due to a perpetrator’s presence.

Any examination of barriers to help-seeking for survivors of IPV who are Deaf must also consider the impact of broader social perceptions about the Deaf community and culture. For example, audism is likely a factor in Deaf women’s experiences of help-seeking. Audism refers to the belief that Deaf individuals are inferior to those who are hearing and should be held to standards of success, behavior, and values established by the hearing community (Anderson & Leigh, 2011). Deaf culture and institutions are devalued, and the resulting discrimination may leave Deaf individuals fearful and mistrusting of hearing-dominated organizations and systems, including the criminal justice system (Smith & Hope, 2015). The insular nature of the Deaf community, combined with the effects of audism, may deter Deaf survivors from seeking help or reporting a perpetrator to the police.

To improve access to IPV services for Deaf survivors, hearing professionals must fully understand the dynamics of IPV in the Deaf community, respect the knowledge of Deaf survivors, and strive to accommodate them on both programmatic and cultural levels. There have been multiple calls for research to address these service gaps (e.g., Cerulli et al., 2015; Johnston-McCabe et al., 2011; Pollard et al., 2014). Beyond prevalence rates, studies investigating the various dynamics of IPV against Deaf women are needed (Anderson et al., 2011), particularly the response and resources available to those experiencing it. More awareness is vital regarding factors related to disclosure of abuse and help-seeking behavior, as well as the effectiveness of IPV programs designed specifically to serve Deaf individuals (Pollard et al., 2014). This information will help service providers address IPV among individuals who are Deaf in a manner that is culturally competent and comprehensive. Furthermore, as previously noted, many of the studies on IPV and Deafness conducted to date have focused on college students. This is an important area to study, but insight into other diverse components of the Deaf population would significantly broaden understanding of the problem.

Our study addresses these gaps by expanding the population of research focus, and provides a profile of Deaf survivors attending an IPV program specifically serving individuals with disabilities. Demographic and psychosocial characteristics of Deaf women receiving services from this agency, including abuse dynamics, perpetrator characteristics, and previous service utilization, are examined. In addition, the referral channels that brought women to the program, along with services sought post-referral, guide best practices related to the help-seeking behaviors of Deaf survivors of IPV.

Method

This study examines the clinical files of female Deaf survivors of IPV with disabilities who received services from the Secret Garden, a disability-specific non-residential IPV program of Barrier Free Living, Incorporated. The Secret Garden is located in New York City, and is one of a limited number of U.S.-based domestic violence programs dedicated exclusively to serving survivors with disabilities. The agency’s disability focus includes a comprehensive Deaf services component. All staff are competent in using videophone and relay services, and receive regular training on Deaf culture and IPV in the Deaf community. Two of the Secret Garden’s social work staff are Deaf, providing counseling, advocacy, and case management services in ASL. Interpreters are present at all agency events, allowing Deaf clients to interact with all program participants. Clients of the Secret Garden may be self-referred or referred from outside service agencies. Client eligibility criteria include: (a) current or previous experience of domestic violence,² (b) a diagnosed or self-identified disability, and (c) a minimum age of 18 years.

Data collection commenced in January 2010 following Columbia University’s Institutional Review Board (IRB) granting an exempt review under category 4. Data collection ended in February 2011. Upon the Principal Investigator’s transfer to the City University of New York (CUNY), a determination was made that the CUNY IRB review was not required.

In adherence with the Health Insurance Portability and Accountability Act (1996), the Secret Garden destroys client files after a case has been closed for 7 years. Therefore, client files opened during the service period spanning January 2002-December 2009 (n = 1,056) were reviewed. This study focuses on the client files of females who self-identified as Deaf survivors of IPV (n = 80).

The Secret Garden’s main intake form provided our primary source of data. A uniform data collection sheet was created for the purposes of the study, listing each variable to be recorded verbatim from client files. A team of four research assistants, all previously employed or interning at the agency, also reviewed additional materials from the Secret Garden’s client records including psychosocial intake forms, mental status exams, progress notes, medical records, and police reports. The research assistants worked together and regularly checked for consistency across variables when recording data. After the research assistants reviewed all files and completed the data collection forms, the data were transferred to an Excel spreadsheet for analysis. Random checks were performed to ensure the data were entered into Excel correctly from the data collection forms.

Variables included in the current analysis are as follows: age, race/ethnicity, hearing status, primary language, marital status, occupational status, source of income, parental status, education level, relationship with the perpetrator, types of abuse perpetrated, duration of abuse, referral source, referrals made, and involvement with police, legal, social, and medical services due to abuse. For referral source, “health care provider” includes professionals working within both medical and mental health facilities. “Criminal justice entity/legal services” refers to those working within criminal justice settings such as the police or assistant district attorneys, as well as those working in civil legal settings such as family court. “Social service agency” refers to non-profit and/or private agencies providing a range of general social services. With these variables providing the focus of analysis, the following research questions guided this study:

Research Question 1: What are the demographic and psychosocial characteristics of help-seeking Deaf survivors of IPV?

Research Question 2: What types of abuse are considered most severe by Deaf survivors, and what additional aspects of abuse (e.g., severity and duration of abuse, relationship with the perpetrator) are relevant to survivors’ needs?

Research Question 3: What are the referral channels leading Deaf survivors to seek IPV assistance, and what additional services are needed after assistance is sought?

Data Analysis

Data analysis was conducted using R 3.1.2. We report frequencies and percentages for all outcomes. Percentages represent the percentage of available responses for each reported item. Because the amount of missing data varied across items, we report the frequencies for all possible responses. The number of missing cases is thus the sample size (n = 80) minus the sum of all frequencies. One exception to this is binary responses in which a single frequency and percentage are reported, which provides sufficient information to derive the number of non-missing cases.

Study hypotheses were analyzed descriptively and with Fisher’s exact test where appropriate. The Fisher’s exact test was used to test hypothesized relationships between two categorical variables. A significant effect indicates a relationship between the variables (i.e., the variables are not independent of each other). Casewise deletion resulted for any participant who did not respond to both questions used in the Fisher’s exact test. Although we acknowledge that there is the possibility of Type I error as a result of conducting five null-hypothesis significance tests, we did not adjust p values due to the limited statistical power to detect effects without p-value adjustments. Because the values of the study data are due to the characteristics of a unique and difficult to access subpopulation that has not been previously presented in the literature, we elected to present unadjusted p values as a heuristic guide. Either the presence or absence of statistical significance in this sample should be interpreted with caution.

Results

Statistical results are reported in this section, as well as Tables 1 -3. A more thorough interpretation of these results follows in the “Discussion” section. Table 1 details results related to the first research goal, characterization of demographic and psychosocial characteristics of help-seeking Deaf survivors of IPV. The sample of women profiled is diverse, with nearly three quarters (74.0%) identifying as non-White, and almost half (39.3%) born outside of United States. Three quarters (78.2%) of this sample reported education levels of high school or less, and 82.2% were unemployed at the time of referral. The main source of income reported was Social Security Disability (SSD)/Supplemental Security Income (SSI) and/or public assistance, with 12.7% reporting no income.

Table 1.

Sample Demographic and Psychosocial Characteristics.

	n (%)^a
Race/ethnicity
Black	31 (42.5)
Hispanic	20 (27.4)
Asian	3 (4.1)
White	19 (26.0)
Born outside the United States	24 (39.3)
Age (years)
20-29	15 (19.4)
30-39	22 (28.6)
40-49	21 (27.3)
50-59	14 (18.2)
60+	5 (6.5)
Hearing status
Deaf	52 (65.0)
Hard of hearing	28 (35.0)
Primary language
ASL	46 (57.5)
Not ASL	34 (42.5)
Highest level of education
Less than high school	14 (30.4)
High school diploma/General Education Diploma (GED)	22 (47.8)
Some college	7 (15.2)
College degree	3 (6.6)
Children
Has children	55 (71.4)
Children in common with perpetrator	37 (78.7)
Lost custody of children	10 (21.7)
Involvement with New York City Administration for Children’s Services	13 (35.1)
Lives with children	36 (49.3)
Marital status
Married	14 (20.3)
Divorced	4 (5.8)
Separated	12 (17.4)
Single	36 (52.2)
Other	3 (4.3)
Of married women: Married to perpetrator (n = 31)	26 (83.9)
Occupational status
Employed	11 (17.7)
Unemployed	51 (82.2)
Source of income
Supplemental Security Income/Social Security Disability and/or public assistance	45 (63.4)
Wages	10 (14.1)
No income	9 (12.7)

Note. ASL = American Sign Language.

Percentages represent the percentage of valid responses.

Table 2.

Abuse Dynamics/Perpetrator Characteristics.

	n (%)^a
Relationship with perpetrator of abuse
Current/former intimate partner	64 (83.1)
Family member	10 (12.9)
Other	3 (3.9)
Type of abuse reported as most severe incident of abuse^b
Physical abuse involving weapon	6 (13.6)
Physical abuse not involving weapon	25 (56.8)
Financial	1 (2.3)
Verbal/emotional	7 (15.9)
Sexual	5 (11.4)
Type of abuse reported as most recent incident of abuse^c
Physical abuse involving weapon	5 (15.1)
Physical abuse not involving weapon	21 (63.6)
Financial	1 (3.0)
Verbal/emotional	6 (18.1)
Sexual	0 (0.0)
Most recent incident of abuse same as most severe	50 (62.5)
Duration of abuse/presenting problem
Less than a year	7 (14.0)
1-3 years	12 (24.0)
4-6 years	9 (18.0)
7-9 years	5 (10.0)
10+ years	17 (34.0)
Referral source
Criminal justice entity/legal services	26 (36.0)
Social service agency	34 (47.2)
Health care provider	8 (11.1)
Self-referral	4 (5.5)

Percentages represent the percent of valid responses.

Most severe incident of abuse is based on client’s self-report of what was considered to be the most severe incident of abuse perpetrated.

Most recent incident of abuse based on incident of abuse that occurred in closest proximity to client’s referral to the Secret Garden.

Table 3.

Referral Channels and Service Utilization.

Referrals made to additional services	Yes	No
Legal	31 (47.0)	35 (53.0)
Housing	36 (54.5)	30 (45.5)
Financial	24 (36.3)	42 (63.6)
Child-focused	6 (9.1)	60 (90.9)
Vocational	6 (9.1)	60 (90.9)
Health care services	15 (22.7)	51 (77.3)
Disability-focused	9 (13.6)	57 (86.4)
Other	10 (15.2)	56 (84.8)
Services accessed prior to referral	Yes	No
Received medical attention due to abuse	24 (40.0)	36 (60.0)
Called police due to abuse	49 (83.1)	10 (16.9)
Has current order of protection	36 (62.1)	22 (37.9)
Contingency tables (n [column percentage])^b
Perpetrator Relationship × Order of Protection	OOP	No OOP
Intimate partner is perpetrator^a	34 (94.4)	15 (71.4)
Family member	2 (5.6)	6 (28.6)
Client Has Children × Order of Protection	OOP	No OOP
Client has children	28 (77.8)	13 (59.1)
Client does not have children	8 (22.2)	9 (40.9)
Referral Source × ASL Users^c	No ASL	ASL
Health care provider	3 (7.1)	5 (16.7)
Social service agency	31 (73.8)	8 (26.7)
Criminal justice entity/legal services	8 (19.0)	17 (56.7)
Referral Source × Type of Most Severe Incident	Physical	Other
Health care provider	2 (7.4)	1 (8.3)
Social service agency	14 (51.9)	4 (33.3)
Criminal justice entity/legal services	11 (40.7)	7 (58.7)
Type of abuse experienced by those previously seeking medical attention	Received attention	Did not Receive attention
Physical	15 (75.0)	15 (55.6)
Other	5 (25.0)	12 (44.4)

Note. ASL = American Sign Language; OOP = order of protection.

Significant by Fisher’s exact test (p = .042).

Percentages represent the percent of valid responses.

Significant by Fisher’s exact test (p < .001).

Table 2 presents findings related to the second research goal, an assessment of abuse dynamics and perpetrator characteristics, addressing the types of abuse relevant to survivors’ needs. The perpetrator of abuse was most often identified as a current or former intimate partner (83.1%), with physical abuse not involving a weapon being the most common type of abuse for the most severe incident of abuse (56.8%) and most recent incident of abuse (63.6%). The most recent incident of abuse was the same as what was considered the most severe for over half of study participants (62.5%). Study participants also endured abuse over long periods of time, with over a third (34.0%) reporting abuse duration of ten years or more.

Table 3 presents results for the third research goal, an assessment of the referral channels to and from the Secret Garden, as well as services utilized by Deaf survivors of IPV prior to referral to the program. The most common referral sources were criminal justice and/or legal services or social service agencies. Referral sources varied based on whether women used ASL (p < .001); however, there was not a significant relationship between referral source and the type of the most severe incident of abuse (p = .668). There was not a significant relationship between the type of abuse experienced and whether the woman had previously sought medical attention (p = .226). Among those who received medical attention for abuse, 75% reported experiencing physical abuse; yet only 7.4% of those reporting physical abuse were referred to the Secret Garden by a health care professional. The greatest number of referrals to outside agencies were for legal, housing, and/or financial services, far outpacing any other resources.

Most women (83.1%) reported calling the police due to abuse prior to arriving at the Secret Garden, and 62.1% of women already had an order of protection (OOP) at the time of referral. There was a significant relationship between having a current OOP and the intimate partner being the perpetrator (94.4% of the OOP cases; p = .042), but there was not a significant relationship between having a current OOP and having children (77.8% of the OOP cases had children; p = .149).

Discussion

The results of this study underscore the diversity of backgrounds and life experiences of Deaf women experiencing IPV. It is important for researchers and practitioners to consider the intersection of various identities, including race, ethnicity, gender, age, disability, social class, and immigration, as these identities shape the opportunities available to women as they consider their options when addressing IPV (Child, Oschwald, Curry, Hughes, & Powers, 2011). The ability to find and access appropriate services may be further challenged when clients present with a range of unique issues, such as when a Deaf survivor has immigration-related concerns and faces barriers related to both communication and citizenship (Cerulli et al., 2015).

A survivor’s education history has an impact on resource knowledge and vocational options. Three quarters of this sample reported education levels of high school or less and 84% were unemployed. This finding highlights the need for accessible vocational and educational services for Deaf survivors to facilitate independence from abuse. Economic security and stable housing are likewise necessary to establish independence. Thus, it is not surprising that our study found the two most common referrals to outside agencies included housing and financial services. The need for financial services, such as emergency rental assistance or aid in applying for public assistance, suggests the precarious economic status of survivors of IPV and Deaf women in general. The demand for housing could also be reflective of the dearth of Deaf-accessible low-income housing and domestic violence shelters. Deaf-accessible housing needs include doorbells and smoke alarms equipped to visually notify Deaf residents when activated, and high-speed Internet service to allow for videophone technology and language accessibility (National Association of the Deaf, 2014).

The majority of this sample did not attend college, indicating that researchers’ current focus on college students neglects a large population of Deaf survivors. The need for research examining the experiences of Deaf women with less than a college education is further indicated by National Health Interview Survey findings that show women who are Deaf are less likely to have a bachelor’s degree or higher than those who have no difficulty hearing (Schoenborn & Heyman, 2008). Furthermore, the age of women in our sample reinforces the importance of examining Deaf women throughout the life course, with 52% above the age of 40, and 24.7% above the age of 50. Study participants were also abused over long periods of time, with over a third reporting abuse duration of 10 or more years. Although this finding could be related to the age of women in the study, the long duration of abuse could also be due to the lack of IPV services available to Deaf women, isolation from knowledge of such services and/or related support, or reluctance to seek help due to fears of angering the perpetrator or bringing shame to oneself and the community (Mason, 2010).

The most recent incident of abuse was the same as what was considered the most severe for more than half of study participants, indicating that an escalation in severity of abuse may have prompted women to seek help. However, contradicting the notion that Deaf survivors lack access to legal recourse and are distrusting of the criminal justice system (Smith & Hope, 2015), most women reported calling the police due to abuse prior to arriving at the Secret Garden and already had an OOP at the time of referral. This may speak to the severity of abuse the women in this study experienced, a sophisticated knowledge of legal resources among study participants, or a positive relationship between local law enforcement and the Deaf community. The Secret Garden’s collaborative relationship with law enforcement entities throughout New York City, including District Attorney’s Offices and Family Justice Centers, has likely facilitated greater access to the criminal justice system for Deaf survivors. Of those with a current OOP, an intimate partner was the perpetrator in every case, and 77.8% also reported having children. The presence of children and concern for their safety may have further motivated women to contact criminal justice entities to obtain an OOP (Ballan et al., 2014).

The most common referral sources to the Secret Garden were criminal justice/legal services or social service agencies. The low referral rate among health care providers is surprising given the prevalence of physical abuse within this sample. This further highlights the importance of educating health care professionals about IPV in the Deaf community and signals a missed opportunity for health care providers to connect survivors to assistance. The Affordable Care Act mandates IPV screening and counseling for all female adolescents and adults as part of basic preventive health care services (Sebelius, 2012). Providers must ensure that such screening and counseling is fully accessible to Deaf patients.

The preponderance of criminal justice and social service referrals suggests that Deaf survivors are making contact with criminal justice entities either because of arrest or self-initiation, and are generally connected to social service agencies. This could be indicative of two dynamics: either Deaf survivors are making greater use of criminal justice and social service channels for IPV assistance prior to referral, or these entities are simply more adept at detecting IPV among clients and directing them to additional assistance when abuse is disclosed. A third possibility is that concerned third parties, such as family, friends, neighbors, or bystanders, have intervened and called the police to report IPV. The distinction is worth exploring further, as this information identifies pathways regarding how to best reach Deaf survivors.

Women who used ASL were primarily referred to the Secret Garden by social service agencies, with relatively few referrals via health care providers or criminal justice/legal entities. This could be reflective of the “low health literacy” (Anderson et al., 2011) and “limited legal literacy” (Mason, 2010) noted in earlier studies, as Deaf women may find themselves isolated from information related to these resources. It could likewise be that these entities were unequipped to communicate with ASL users, on both a technical and cultural level, and thus were unable to make a determination that a referral for IPV services was necessary.

Recent findings from a study of ASL-fluent service providers working with Deaf survivors of IPV observed that while service providers working with hearing survivors tend to be IPV specialists, those serving Deaf survivors tend to be “generalists, required to address an array of complicated needs for their clients due to their unique accessibility to ASL users” (Cerulli et al., 2015, p. 151). Because these providers tend to be housed in non-IPV-specific service agencies, they may find themselves working with both perpetrators and survivors, which presents troubling confidentiality concerns. Furthermore, these service providers stated that their agencies generally did not have a standard definition of IPV nor a standard method for screening or IPV. This underscores the need for IPV trainings within social service agencies serving Deaf individuals to aid clinicians in identifying IPV among their clients. Ideally, however, dedicated IPV providers for Deaf individuals ought to operate in spaces where perpetrators and survivors will not encounter each other. If the Secret Garden did not exist, it is likely that clients referred by social service agencies would have had their IPV-related needs addressed within these programs, possibly inadequately.

Finally, the communication requirements of Deaf survivors must figure into any IPV-focused intervention. If it is not possible to hire Deaf and/or ASL-fluent staff, agencies are urged to forge a close relationship with a local sign language interpreting agency. If using an interpreter with a client, try to arrange the same one for ongoing sessions to avoid requiring the client to repeatedly disclose sensitive personal issues to a new interpreter. A client may already be familiar and comfortable with an interpreter from previous encounters; if so, practitioners may further empower clients by asking whether they have any preferences when hiring an interpreter. As part of training efforts, providers need to understand that language and interpretation needs vary. Not all Deaf survivors are not all fluent in ASL. Child et al. (2011) remind practitioners that appropriate accommodations may differ widely among individuals sharing the same diagnostic label, as in the case of some Deaf clients needing a certified deaf interpreter, while others communicate simply in ASL. Language is a defining aspect of Deaf culture. Culturally competent services thus begin with respecting the language preferences of Deaf clients, and taking the steps necessary to ensure the client is able to communicate with a service provider in a manner suited to her needs.

Limitations

This article reports on an analysis of intake data entered into client files by Secret Garden staff who intended to use the information for internal monitoring of clients’ service needs. Some of the variables we were interested in examining either were not collected or were categorized differently than we would have chosen, thereby altering the questions we sought to answer. For instance, information regarding the hearing status of the perpetrator would have been highly informative, but was not routinely collected by the agency. We were further limited by missing information within client files for certain variables.

Because the extent of deafness was not always clearly indicated within client files (e.g., deaf in one ear, able to hear with the use of hearing aids), only women who identified as Deaf were included in the study sample. As a result, our data did not allow for analysis of the differences in experience and accommodation needs between women who are deaf and women who are hard of hearing.

Finally, the women included in this study were among the subset of Deaf survivors of IPV who were able to access professional support. Research examining those who are unable to access IPV services is sorely needed, as is research that uses nationally representative samples of the Deaf population (Smith & Hope, 2015).

Conclusion

This study illuminates the extent to which IPV affects Deaf women with diverse backgrounds and service-related needs. Deaf women present with varying language and interpreting preferences, familiarity with the criminal justice process, and knowledge of options to cope with IPV. The personal and organizational resources available to each woman, whether in terms of educational background, available income, or accessible housing, will figure into her response to IPV.

Our findings indicate that while Deaf women seek resources such as legal assistance and health care in response to IPV, these providers are not routinely referring Deaf women to IPV-specific services. Training on IPV within the Deaf community is thus necessary both within general community agencies serving Deaf individuals, as well as IPV agencies that may not be Deaf-specific. Ideally, IPV agencies with expertise serving Deaf individuals, such as the Secret Garden, will become universally available. Until then, research, advocacy, and outreach must continue to make this critical issue visible.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The research reported in this article was funded by the Loreen Arbus Foundation.

Notes

Author Biographies

Michelle S. Ballan is a professor of Family, Population and Preventive Medicine at Stony Brook School of Medicine, and professor of Social Welfare at the School of Social Welfare at Stony Brook University. Her research, teaching, and service are dedicated to individuals with intellectual and developmental disabilities and their families. She is the recipient of numerous awards, including the NASW NYC 2015 Mid-Career Exemplary Leader Award, the 2011 Early Career Award from AAIDD, and the Columbia University Presidential Teaching Award. She is principal investigator on several grants focused on disability research and has worked as a practitioner in various community settings with individuals with disabilities.

Molly Burke Freyer is a PhD candidate at New York University’s Silver School of Social Work. Her research focuses on multiple dimensions of intimate partner violence among women with disabilities, and she is currently the project director of a research study examining the use of self-protective methods among survivors of intimate partner violence with disabilities. She previously served as assistant director of Barrier Free Living’s Non-Residential Domestic Violence Program, and provided counseling and criminal justice advocacy to women with disabilities experiencing domestic violence.

Lauren Powledge is a licensed social worker based in New York City. She works at Mount Sinai Hospital in New York City with children and families with sickle cell disease and other complex genetic disorders. Her clinical interests are focused on the accessibility of medical services for individuals with developmental disabilities as well as integrative pain management for chronic illness. She serves as a co-preceptor in the Art and Science of Medicine at Icahn School of Medicine at Mount Sinai and co-facilitates the Youth Advisory Council at Mount Sinai Hospital. She holds a BA from Sarah Lawrence College and MSSW from Columbia University.

C. Nathan Marti received his PhD in psychology with a specialization in quantitative methods from the University of Texas at Austin. He was senior research associate and later an associate director at the Center for Community College Student Engagement, then worked as the manager of the Statistical and Mathematical Consulting Services at University of Texas at Austin before beginning his private consulting practice, Abacist Analytics. His projects have focused primarily on health-related outcomes for clients at academic institutions, private foundations, and health care organizations.

References

Anderson

M. L.

(2014). Intimate partner violence in the deaf community: 5 things you need to know & 5 things you can do. Psychiatry Issue Brief, 11, 1-3.

Anderson

M. L.

Kobek Pezzarossi

C. M.

(2012). Is it abuse? Deaf female undergraduates’ labeling of partner violence. Journal of Deaf Studies and Deaf Education, 17, 273-286. doi:10.1093/deafed/enr048

Anderson

M. L.

Leigh

I. W.

(2011). Intimate partner violence against Deaf female college students. Violence Against Women, 17, 822-834. doi:10.1177/1077801211412544

Anderson

M. L.

Leigh

I. W.

Samar

V. J.

(2011). Intimate partner violence and Deaf women: A review. Aggression and Violent Behavior, 16, 200-206. doi:10.1016/j.avb.2011.02.006

Ballan

M. S.

Freyer

M. B.

Marti

C. N.

Perkel

Webb

K. A.

Romanelli

(2014). Looking beyond prevalence: A demographic profile of survivors of intimate partner violence with disabilities. Journal of Interpersonal Violence, 29, 3167-3179. doi:10.1177/0886260514534776

Breiding

M. J.

Armour

B. S.

(2015). The association between disability and intimate partner violence in the United States. Annals of Epidemiology, 25(6), 455-457.

Brownridge

(2009). Situating research on safety promoting behaviors among disabled and deaf victims of interpersonal violence. Violence Against Women, 15, 1075-1079. doi:10.1177/1077801209340311

Cerulli

Pollard

R. Q.

Thew

Mastrocinque

J. M.

Raimandi

DeWindt

et al . (2015). What can we learn? Examining IPV service provision in the Deaf community. Journal of Community Psychology, 43, 142-155. doi:10.1002/jcop.21670

Child

Oschwald

Curry

M. A.

Hughes

R. B.

Powers

L. E.

(2011). Understanding the experience of crime victims with disabilities and deaf victims. Journal of Policy Practice, 10, 247-267. doi:10.1080/15588742.2011.605829

10.

Crowe

T. V.

(2013). Intimate partner violence in the Deaf community. Journal of the American Deafness and Rehabilitation Association, 46, 71-84.

11.

Health Insurance Portability and Accountability Act of 1996, Pub. L. No. 104-191, 110 Stat. 1936. (1996).

12.

Hughes

R. B.

Lund

E. M.

Gabrielli

Powers

L. E.

Curry

M. A.

(2011). Prevalence of interpersonal violence against community-living adults with disabilities: A literature review. Rehabilitation Psychology, 56, 302-319. doi:10.1037/a0025620

13.

Johnston-McCabe

Levi-Minzi

Van Hasselt

V. B.

Vanderbeek

(2011). Domestic violence and social support in a clinical sample of deaf and hard of hearing women. Journal of Family Violence, 26, 63-69. doi:10.1007/s10896-010-9342-4

14.

Mackelprang

R. W.

(2010). Disability controversies: Past, present, and future. Journal of Social Work in Disability & Rehabilitation, 9, 87-98. doi:10.1080/1536710X.2010.493475

15.

Mason

T. C.

(2010). Does knowledge of dating violence keep deaf college students at Gallaudet University out of abusive relationships? Journal of the American Deafness and Rehabilitation Association, 43, 74-91.

16.

McQuiller Williams

Porter

P. L.

(2014). A comparison of Deaf college students’ and hard of hearing college students’ experiences and risk factors of psychological and physical abuse. SAGE Open, 4, 1-7. doi:10.1177/2158244013518930

17.

McQuiller Williams

Porter

P. L.

(2015). The relationship between child maltreatment and partner violence victimization and perpetration among college students: Focus on auditory status and gender. Journal of Interpersonal Violence, 30(13), 2304-2325.

18.

National Association of the Deaf. (2014). The battle for accessible housing [Web log post]. Retrieved from http://nad.org/news/2014/1/battle-accessible-housing

19.

New York State Coalition Against Domestic Violence. (2011). About domestic violence [Online information sheet]. Retrieved from http://www.nyscadv.org/about-domestic-violence/

20.

Nosek

M. A.

Howland

Rintala

D. H.

Young

M. E.

Chanpong

G. F.

(2001). National study of women with physical disabilities: Final report. Sexuality and Disability, 19, 5-39.

21.

Obinna

Krueger

Osterbaan

Sadusky

J. M.

DeVore

(2005). Understanding the needs of the victims of sexual assault in the deaf community: A needs assessment and audit. Retrieved from https://www.ncjrs.gov/pdffiles1/nij/grants/212867.pdf

22.

Pollard

R. Q.

Sutter

Cerulli

(2014). Intimate partner violence reported by two samples of deaf adults via a computerized American Sign Language survey. Journal of Interpersonal Violence, 29, 948-965. doi:10.1177/0886260513505703

23.

Porter

J. L.

McQuiller Williams

(2011). Auditory status and experiences of abuse among college students. Violence and Victims, 26, 788-798. doi:10.1891/0886-6708.26.6.788

24.

Porter

J. L.

McQuiller Williams

(2013). Dual marginality: The impact of auditory status and sexual orientation on abuse in a college sample of women and men. Journal of Aggression, Maltreatment & Trauma, 22, 577-589. doi:10.1080/10926771.2013.805175

25.

Schenkel

L. S.

Rothman-Marshall

Schlehofer

D. A.

Towne

T. L.

Burnash

D. L.

Priddy

B. M.

(2014). Child maltreatment and trauma exposure among deaf and hard of hearing young adults. Child Abuse & Neglect, 38, 1581-1589. doi:10.1016/j.chiabu.2014.04.010

26.

Schild

Dalenberg

C. J.

(2012). Trauma exposure and traumatic symptoms in deaf adults. Psychological Trauma: Theory, Research, Practice, and Policy, 4, 117-127. doi:10.1037/a0021578

27.

Schoenborn

C. A.

Heyman

M. S.

(2008). Health disparities among adults with hearing loss: United States, 2002-2006. Retrieved from http://www.cdc.gov/nchs/data/hestat/hearing00-06/hearing00-06.htm

28.

Sebelius

(2012, July 31). Giving women control over their health care [Web log post]. Retrieved from https://www.whitehouse.gov/blog/2012/07/31/giving-women-control-over-their-health-care

29.

Smith

Hope

(2015). Culture, language, and access: Key considerations for serving Deaf survivors of domestic and sexual violence. New York: Vera Institute of Justice.

30.

World Health Organization. (2011). World report on disability. Geneva, Switzerland: Author.