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Communication Environment & Movement/Mobility

Issues Related to the Communication Environment

Providers have difficulty expressing their lack of knowledge about disability. Providers have a difficult time engaging survivors with movement and mobility limitations about the nature of their limitations without feeling as if they are invading their privacy. Providers can learn specific questions to communicate to survivors in order to learn their specific needs relative to services and programs and individual requirements for safety.

Sexual assault examinations for people with functional limitations related to movement and mobility may prove challenging for the provider.  Providers may not be prepared to provide reasonable accomodations or they may overcompensate by helping the survivor without first asking if the survivor needs help.  Out of discomfort, the provider may rush through the examination which will not only cause additional distress to the victim, but may also result in the provider missing evidence and important information. 

Examples of Problems

  • A provider asks a survivor if the limitation she experiences is due to the assault.  When the survivor responds that it is not, the provider asks the survivor what caused the limitation.  The focus then becomes the suvivor's disability rather than the reason the survivor has sought out services from the provider.  The survivor is offended by what she perceives as the provider being nosy and chooses not to return for further services.
  • A survivor asks a provider for assistance with getting a cup of water from the cooler. The provider anxiously fills the cup and then asks the survivor if she needs help drinking the water.  The survivor feels patronized and taken aback by this overcompensation. 
  • A survivor misses several appointments over the course of several months.  On her fifth missed appointment, the provider cancels all future appointments. 

Suggested Solutions

  • Providers should only ask questions about the disability if it is relevant to the therapeutic process or to safety-planning.  For example, it is not inappropriate or intrusive if a provider wishes to discuss whether a survivor planned for what to do if certain assistance devices are destroyed.
  • During intake, assess the survivor's ability and need for assistance by discussing it thoroughly.  Only provide the assistance requested or accepted (ie, if you notice a survivor struggling, it is okay to offer her assistance; it is also okay if she refuses). 
  • Giving the individual personal control over lighting, temperature, placement of chairs, having soft pillows, an afghan, and something to eat and drink during intake or during a sexual assault examination can help reduce the anxiety of the experience.
  • Survivors with limited movement or mobility may not be able to keep appointments easily because of access problems encountered along the way. Make it clear that flexibility and accommodations in scheduling are available. Early morning appointments should be avoided especially for survivors that use a personal care assistant to get ready to go out.