Child, Youth and Emerging Adult Service, Centre for Addiction and Mental Health, Toronto, ON, Canada.
University of Toronto, Toronto, ON, Canada.
J Child Psychol Psychiatry. 2017 Oct;58(10):1114-1121. doi: 10.1111/jcpp.12723. Epub 2017 Apr 13.
Despite emerging evidence for an association between communication disorders and maltreatment, little research has examined sexual abuse characteristics or disclosure experiences among individuals with language disorder (LD). Given that communication difficulties may constitute a barrier to disclosure, the disclosure experiences among individuals with and without communication difficulties may also differ.
Five-year-old children identified with a language and/or speech disorder from a nonclinical community sample and a control group were followed to adulthood in a prospective longitudinal study. At age 31, participants completed a behaviorally specific questionnaire on experiences of sexual abuse and questionnaires on disclosure experiences and social reactions to disclosure. Due to low endorsement of sexual victimization among male participants and low sample size, results are reported for women only and exclude nine participants with speech disorder without LD. Participation rates were 28 of 40 in the LD cohort and 45 of 51 controls. Sexual victimization severity was defined using an index combining five indicators (duration, invasiveness, relationship to perpetrator, coercive tactics used, and number of perpetrators). Subthreshold sexual victimization was defined as a single, noncontact incident with a perpetrator unknown to the child; experiences with greater severity were classified as child sexual abuse.
Among women who reported sexual victimization by age 18, invasiveness and overall severity were greater in the LD cohort than in the control cohort. Women in the LD cohort (43%) were more likely than controls (16%) to report child sexual abuse, excluding subthreshold experiences. There were no differences between cohorts in probability of disclosure, latency to disclosure, or social reactions.
Women with a history of child LD in a nonclinical sample reported substantial child sexual abuse experiences. Implications for understanding associations between LD and mental health and for prevention and early intervention are discussed.
尽管有越来越多的证据表明沟通障碍与虐待之间存在关联，但很少有研究调查语言障碍（LD）个体的性虐待特征或披露经历。由于沟通困难可能构成披露的障碍，因此具有和不具有沟通困难的个体的披露经历也可能不同。
从非临床社区样本中确定有语言和/或言语障碍的 5 岁儿童，并在一项前瞻性纵向研究中跟踪至成年。在 31 岁时，参与者完成了一份关于性虐待经历的行为特定问卷，以及一份关于披露经历和对披露的社会反应的问卷。由于男性参与者性受害的报告率较低且样本量较小，因此仅报告女性参与者的结果，且排除 9 名无 LD 的言语障碍参与者。LD 队列的参与率为 40 名中的 28 名，对照组为 51 名中的 45 名。性受害严重程度使用结合五个指标（持续时间、侵犯性、与施害者的关系、使用的强制策略和施害者的数量）的指数来定义。阈下性受害定义为与儿童不相识的施害者的单次非接触事件；严重程度更高的经历则被归类为儿童性虐待。
在 18 岁前报告遭受性侵害的女性中，LD 队列的侵犯性和总体严重程度均高于对照组。LD 队列中的女性（43%）比对照组（16%）更有可能报告儿童性虐待，不包括阈下经历。两个队列在披露的可能性、披露的潜伏期或社会反应方面没有差异。
在非临床样本中，有儿童 LD 病史的女性报告了大量的儿童性虐待经历。讨论了这些发现对理解 LD 与心理健康之间的关联以及对预防和早期干预的影响。
