Across the country, people with intellectual and developmental disabilities (IDD) are being harmed inside the very systems that exist to protect them. Abuse, neglect, and coercive practices occur in group homes, shared living arrangements, day programs, and even within oversight agencies themselves. When these harms happen, they are too often minimized, reframed, or dismissed—not because the trauma is unclear, but because ableism shapes how disability systems interpret suffering.
The consequences are not theoretical. They are lived.
One adult with high‑acuity needs endured multiple assaults in a state‑funded day program.
He was slapped on the back, sexually assaulted, punched, and verbally degraded. In other previous incidents, because of frequent bathroom trips related to Crohn’s disease, staff placed him in a belt tied so tightly he could not remove it, leaving marks on his skin and preventing him from pulling down his pants.
These were not isolated events. They were part of a pattern of disregard for bodily autonomy, medical needs, and basic human dignity.
When his family brought up their concerns, a senior Department of Developmental Services (DDS) official responded with a question that captured the deeper cultural problem:
“That was over five years ago. Why can’t you let that go?”
No one would say this about a nondisabled adult who had been assaulted. No one would say this to a parent whose child had been harmed in a school, hospital, or nursing home. No one would expect them to “let it go” simply because time had passed. But in disability services, trauma is routinely treated as an inconvenience, a distraction, or a family’s inability to “move on.” This is ableism in its purest form: the belief that people with IDD experience harm differently, or that their trauma matters less.
What the research tells us and what it doesn’t
Evidence shows that people with disabilities are at significantly higher risk of abuse and neglect than the general population. A growing body of work is also beginning to document trauma‑informed care for individuals with intellectual and neurodevelopmental disabilities.
What the Adverse Childhood Experiences (ACE) study shows and what it doesn’t
The CDC–Kaiser Adverse Childhood Experiences (ACE) studies demonstrate that early exposure to abuse, neglect, and household adversity is strongly associated with lifelong behavioral, psychological, and health consequences in the general population.
Emerging IDD‑specific research suggests similar patterns may occur for people with intellectual and developmental disabilities.
But we do not have research on the specific trauma experienced by people harmed inside Department of Developmental Services (DDS) systems.
We do not have studies on:
- The long‑term impact of repeated injuries or assaults in group homes and day programs
- The trauma of being unable to communicate pain, fear, or what happened, especially for individuals with limited or no verbal communication.
- The trauma caused by medical neglect, preventable suffering, or punitive responses to disability‑related needs
- The trauma families experience when their loved one returns home injured, ill, or changed
- The systemic conditions that allow abuse to occur and recur
- How to train and support staff to recognize and respond to trauma in individuals with intellectual and developmental disabilities (IDD) and in their families
This isn’t just a gap in the literature; it’s an accountability failure. We cannot prevent what we refuse to measure, and we cannot build trauma‑informed systems without evidence on what effective staff training looks like for supporting individuals with IDD and their families. It also helps explain why dismissive responses from leadership can spread: when a senior DDS official suggests a family should “let that go,” it signals to the workforce that trauma is negotiable and that families’ concerns can be minimized. In positions that shape culture and practice, leaders should know better.
Why we need a research center for trauma in IDD
A dedicated center could finally do what no state agency has done: measure and study the trauma experienced by people harmed in disability services, including those with significant communication barriers. It could develop validated tools to identify trauma, track outcomes over time, and distinguish trauma responses from “behavior” in ways that improve care rather than punish. It could also examine the institutional conditions that allow abuse to persist and recur across group homes, shared living arrangements, day programs, oversight agencies, and provider leadership, including staffing, training, oversight, reporting failures, and cultural norms that normalize harm. Ultimately, it could use that evidence to design and test prevention and treatment models that reduce harm and support recovery for individuals with intellectual and developmental disabilities (IDD) and their families.
Such a center would give survivors and families what they rarely receive from disability systems: recognition, evidence, and a practical path to prevention and healing.
It would help the field stop mislabeling trauma responses as “behavior,” “noncompliance,” or “complexity,” and start measuring what happened, what it cost, and what supports actually help people recover.
It would also make it possible to hold systems accountable by identifying patterns across providers and settings, testing training approaches that change practice, and tracking whether reforms reduce harm over time. If we are serious about safety and dignity for people with intellectual and developmental disabilities (IDD), we need a research center with the mandate, expertise, and independence to study abuse-based trauma and translate findings into standards, oversight, and care. Families, advocates, and policymakers can help by asking their state leaders to fund this research, require transparent reporting of injuries and allegations, and adopt trauma-informed training and oversight standards across providers. They can also ask their U.S. Representative or Senator to request a Government Accountability Office (GAO) study on high-acuity disability housing, supports, and services, including safety, oversight, and trauma-informed practice.
Sources and further reading:
- Luiselli, J.K. Trauma-Informed Care of Persons with Intellectual and Neurodevelopmental Disabilities: Introduction to the Special Section. Adv Neurodev Disord 9, 463–464 (2025).
- Langtree, Ian C. (2009, updated 2025/06/23). Child Neglect in Disabilities: Systemic Gaps and Urgent Reforms Needed. Disable World. https://www.disabled-world.com/disability/awareness/child-abuse-disabilities.php
- Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine, 14(4), 245–258. https://doi.org/10.1016/S0749-3797(98)00017-8
One thought on “Hidden Trauma in Disability Services”
For a person with both a physical illness and intellectual disabilities to be treated this way is horror enough. For their parent to then have their child’s pain minimized with dismissive comments by DDS staff is unacceptable and sadly all too common. Why is this allowed?