Disability Inclusion in Child Protection and Gender-Based Violence Programs

Women's Refugee Commission
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Disability Inclusion in Psychosocial Support Programs in Lebanon:

Guidance for Psychosocial Support Facilitators

February 2018

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ACKNOWLEDGEMENTS

This resource is a product of a partnership project between the Women's Refugee Commission (WRC) and UNICEF Lebanon entitled “Strengthening child protection and gender-based violence prevention and response for women, children, and youth with disabilities”. The overall goal of the project is to improve violence prevention and response programming for at-risk groups of women, girls, and boys with disabilities.It builds on existing initiatives of gender-based violence (GBV) and child protection (CP) actors to systematically advance disability inclusion across the CP and GBV prevention and response sectors in Lebanon.

This resource has been developed based on the findings of a needs assessment conducted in 2017 which:

Other resources developed in the project include:

The WRC and UNICEF Lebanon thank the following organizations and stakeholders for their contributions to the project, including participation in consultations, the needs assessment and feedback or review of tools and guidance:

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CONTENTS

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INTRODUCTION

Approximately 15 per cent of any community may be persons with disabilities. 1 There may be even higher rates of disability in communities affected by crisis or conflict, 2 as people acquire new impairments from injuries and/or have reduced access to health care. In Lebanon, it is estimated that 900,000 persons are living with disabilities. 3 Studies demonstrate that children with disabilities are at a greater risk of experiencing physical and sexual violence than children without disabilities. 4 They may be hidden in communities due to stigma and discrimination and excluded from school and other educational opportunities. Adolescent girls and boys with disabilities, particularly those with intellectual disabilities, may be excluded from activities that increase their knowledge about violence, sex and healthy relationships, as well as from peer networks that might protect them from violence. 5

The Lebanon Crisis Response Plan (LCRP) 2017 — 2020 recognizes that children with disabilities are at a higher risk of violence, abuse and exploitation, both inside the home and in the wider community, with women and girls with disabilities being among the most vulnerable to GBV. Both the LCRP and the Ministry of Social Affairs National Plan to Safeguard Children and Women in Lebanon 2014 — 2015 highlight commitments to strengthening national protection, child protection (CP) and GBV systems ensuring that women, girls and boys at risk and survivors of violence, exploitation and abuse have access to improved and equitable prevention and response services. 6 7

A needs assessment conducted in 2017 confirmed that women, children, and youth with disabilities in Lebanon and their caregivers are facing a range of risks that affect their mental health and psychosocial (MHPSS) well-being, with refugees with disabilities often reporting signs of distress related to either witnessing and / or surviving some form of conflict-related violence. The most common MHPSS risks identified were:

Community-based PSS activities, targeting vulnerable children through culturally appropriate activities such as drama, crafts, storytelling and sports, and focused PSS activities for children and adolescents who are survivors or at medium to high risk of child protection violations, are critical to directly supporting women, children, and youth with disabilities, as well as identifying and referring individuals to more specialized MHPSS support as needed.

Purpose of the Resource

Disability Inclusion in Psychosocial Support Programs in Lebanon: Guidance for Psychosocial Support Facilitators is designed to support PSS Facilitators to strengthen inclusion of children and adolescents 6 with disabilities in a range of PSS activities, including community based and focused activities. It includes guidance, key actions and tools to improve outreach and identification of children with disabilities for PSS activities; to adapt existing PSS activities; and to support children and adolescents with disabilities who are at medium to high risk of child protection concerns.

How to use this Resource

The material presented in this resource can be adapted and integrated into organizational guidance, tools and trainings. This resource complements, and should not be used in isolation to, existing PSS guidance and training in Lebanon, including:

Furthermore, PSS Facilitator's are reminded to follow all standard operating procedures when working with survivors of violence, including the Standard Operating Procedures (SOPs) for the Protection of Juveniles in Lebanon — Operational toolkit (2015) and the Inter-Agency Standard Operating Procedures (SOPs) for SGBV Prevention & Response in Lebanon (2014).

The resource contains four parts or modules which build on each other and target different PSS actors:

PART 1: DISABILITY CORE CONCEPTS

It is important for all PSS actors to recognize persons with disabilities, and to understand different approaches that can be applied when working with persons with disabilities in the community. See Tool 1: Principles and Guidelines for Disability Inclusion in PSS Programs.

1.1 Concept of disability

The definition of disability continues to evolve over time. It is important to remember that persons with disabilities are not a homogenous group; they have different capacities and needs and contribute in different ways to their communities. 9

The national Lebanese Law 220/2000 defines a person with a disability as “a person whose capacity to perform one or more vital functions, independently secure his personal existential needs, participate in social activities on an equal basis with others, and live a personal life that is normal by existing social 7 standards, is reduced or non-existent because of partial or complete, permanent or temporary, bodily, sensory or intellectual functional loss or incapacity, that is the outcome of a congenital or acquired illness or from a pathological condition that has been prolonged beyond normal medical expectations.” 10

Article 1 of the UN Convention on the Rights of Persons with Disabilities (CRPD) states:

“Persons with disabilities include those who have long-term physical, mental, intellectual or sensory impairments which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others.” 11

An impairment is a problem in the body's structure or function. 12 Impairments may be physical, intellectual, psychosocial and sensory.

Disability, however, is not just a health problem or impairment. Societal attitudes and a person's environment have a huge impact on their experience of disability and their access to our activities.

Improving access and inclusion for people with disabilities requires interventions to remove these different types of barriers in our PSS activities.

1.2 Models of Disability

There are different ways in which society may view or interact with persons with disabilities that can result in their exclusion or inclusion in our society. There are four different approaches or “models” that describe how members of society view or interact with persons with disabilities:

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Both the charitable and medical models result in other people making decisions for persons with disabilities and keeping them separate from society. This may be more pronounced for children and adolescents with disabilities whose age also affects their power in decision-making at individual levels, but also in relationships, households, and communities.

The social and rights-based models, however, put persons with disabilities at the center of decisions that affect them, and emphasize the removal of barriers to ensure equal access and opportunities. These approaches are aligned with the principles and approaches for child protection, which highlight that children are rights-holders, with skills and capacities to contribute to their families, peers, communities, and to our programming. 14

Previous needs assessments in Lebanon have highlighted that family members, communities and service providers all view children and adolescents with disabilities through medical or charitable models, failing to recognize other social factors, such as age and gender, that may increase their vulnerability to child protection concerns. 15

1.3 Rights of Children with Disabilities

Both the Convention on the Rights of Persons with Disabilities (CRPD) and the Convention on the Rights of the Child (CRC) highlight the active participation of children with disabilities in the community. Children with disabilities should have access to services that are “age-, gender- and disability-sensitive.” 16 Exclusion of children with disabilities from existing programs and activities, whether inadvertent or purposeful, is therefore a form of discrimination. 17 PSS program staff must recognize the 9 diversity of the populations they serve, including the different risks faced by girls and boys with different types of disabilities at different life stages, and by those living in households with persons with disabilities. The inclusion of children and youth with disabilities and those affected by disability in PSS activities is critical to reducing their protection risks and supporting their mental health and psychosocial well-being. Inclusion of children with disabilities in PSS programming is a core dimension of programming — not something “special” or separate.

1.4 Addressing Attitudes & Assumptions Related to Children and Adolescents with Disabilities

Children and adolescents with disabilities face multiple forms of discrimination and stigma in their community which reduces their access to PSS activities. Below are some common assumptions that are often made by service providers, caregivers and community members about children and adolescents with disabilities, along with the findings that challenge these assumptions.

Common Assumptions Findings & Facts
Disability is the most important issue for children with disabilities

Children and youth with disabilities have life experiences, dreams and goals like other children and youth, and, when asked, may identify simply as friends, daughters, sons, sisters, brothers and so forth. They are exposed to the same stigma, discrimination and inequality based on age and gender as other girls, boys, young women and young men. Yet, these factors are often overlooked, as program staff, families and communities prioritize the disability-related needs of this group. 18

“We want to learn things, we want to go to school, we want to make friends, and we want to be productive. Someday, some of us want to be wives and mothers. But people forget about girls with disabilities. They forget we have goals and dreams.”

— Bolia, 16-year-old girl living in Burundi

You can tell if someone has a disability by looking at them. Some disabilities are visible — for example if a person uses a wheelchair. Many disabilities, such as psychosocial and intellectual disabilities, may not be visible. However, people with these types of disabilities may still be stigmatized in communities and experience discrimination.
Children with intellectual disabilities can't make their own decisions. Like other children, children with intellectual disabilities have the right to participate in decisions that affect them. Even children with more profound communication difficulties may understand everything that is being said to them, and with appropriate support, may be able to indicate their wishes and preferences to others.
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Children and adolescents with disabilities are not at risk of gender-based violence. Studies demonstrate that children with disabilities 3–4 times more likely to experience all forms of violence than their non-disabled peers, and 3 times more likely to experience sexual violence. 19 Adolescents with intellectual disabilities are particularly vulnerable to sexual violence, 20 and yet they are excluded from many programs and activities that would help them to learn about safe sexual relationships.
Persons with disabilities need a lot of additional support and adaptations to participate in our activities.

Most persons with disabilities require very few adaptations to participate in our activities. They just need to be invited and given the chance to participate. Individuals with disabilities are the experts in the type of support and adaptations needed and can advise you appropriately.

“I tell people not to feel badly for me and not to baby me ... I go to the park and do things on my own — sometimes I need help with my wheelchair, but that's about it.” — Young woman with multiple disabilities in Baalbek

Children with disabilities are safer in residential facilities. Globally, research demonstrates that persons with disabilities who are living in residential institutions are at higher risk of sexual violence than those living in the community. 21
Children with disabilities will be harmed or get sick by coming to our activities.

During the needs assessment in Lebanon, none of the children or caregivers that we consulted reported harm from attending PSS activities. Instead, they shared that attending activities and/or coming in for services had a positive impact on their communication skills, their mental and physical health, and helped to expand their peer networks. 22

“Now I see that when they come home, they are more at ease. They talk to me more. They used to be so sad and so shy. I knew they had many things in their head.” — Father of two girls with disabilities attending PSS activities in Lebanon

PRIMING YOUR OWN ORGANIZATION TO BE INCLUSIVE — PSS actors should engage in learning activities that reflect on their attitudes and assumptions about children and adolescents with disabilities. Supervisors can encourage this process by having community volunteers and PSS Facilitators engage in an initial activity to assess their attitudes and assumptions, and from there start open conversations about ideas and beliefs in relation to persons with disabilities. See Tool 3: PSS Facilitator Attitudes Relating to Disability & GBV.

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1.5 Recognizing skills, capacities and contributions of persons with disabilities

Children and adolescents with disabilities are not a homogenous group; they have different capacities and needs, and contribute in different ways to their families, households and communities. In keeping with a rights-based approach, it is critical to profile the skills, capacities and contributions of persons with disabilities in PSS programming.

At a community level, community volunteers and PSS facilitators can identify individuals with disabilities and their family members who have particular skills, whether it be creative skills such as drawing or drama, or communication skills, such as the capacity to facilitate discussions with community members. Collaborate together on activities so that you are profiling the skills and capacities of this group, over time influencing community attitudes towards persons with disabilities.

At an individual level, it is also important to look for skills and capacities, especially among children with more profound physical and communication disabilities. Participation will look different for every individual, and vary according to their personal preferences, the type of activity and how familiar they are with program staff and peers. Program staff should take the time to watch, listen, talk and interact with individuals to learn more about them, what their preferences are, and their skills and capacities. It is also important to avoid setting rigid standards for “participation.” Everyone has something to contribute — this may be a picture, a gesture or a detailed discussion — all of which should be valued and recognized in efforts to engage meaningfully with children and youth with disabilities. Identifying how someone communicates, what they like and dislike, and what they can and can't do, can help you to identify strategies for their inclusion in PSS activities. See Tool 4: Identifying Skills and Capacities of Children with Disabilities.

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PART 2: PSS OUTREACH AND IDENTIFICATION OF “AT RISK” CHILDREN WITH DISABILITIES

This section of the guidance will support community volunteers / mobilizers and PSS actors to effectively identify children with disabilities for inclusion in community-based PSS activities, as well as those who may require more tailored focused PSS interventions.

2.1 Vulnerable versus Medium-High Risk Children with Disabilities in Lebanon

Law 422 on the Protection of Juveniles in Conflict with the Law or At Risk, defines a child at risk as: a child exposed to 1) exploitation or threat to health/safety/upbringing; 2) Sexual abuse or physical violence that exceeds non-harmful measures; 3) begging and on the streetsChildren with disabilities have been identified as a “vulnerable group” for prioritization in community-based PSS interventions. . 23 Given the high-level of violence, abuse and exploitation experienced by children and adolescents with 13 disabilities globally, PSS actors must be aware of and alert to the possibility that a child with disabilities may also be considered “medium to high risk” and require referral also to Focused PSS activities.

The following table describes the risks faced by children with disabilities and their caregivers (identified through the needs assessment) and how this relates to risk categories for PSS activities. 24 25

“Vulnerable” “Medium to high risk”

Children with disabilities

All children with disabilities are considered a vulnerable group for inclusion in Community-Based PSS activities. This includes children with physical, intellectual and sensory disabilities.

Children with disability and survivors of abuse and exploitation

Parents of children with disabilities report that both girls and boys with intellectual disabilities are at risk of sexual violence in the community.

Children living in poor conditions (housing; IS's, CS) plus lacking basic needs

Refugee children with disabilities are living in households with added socioeconomic stress. Community mobilizers report that this is increasing the risk that adolescent girls with disabilities will engage in begging on the street, face violence in the home and /or be married before 18 years.

Children forced into child marriage

There are reports that adolescent girls with disabilities are being married early, before their disabilities make them “undesirable”.

Out of school children

Most children with disabilities, especially those with intellectual disabilities, are not accessing education. This is more pronounced for refugee children with disabilities.

Children with high level of psychosocial distress

Some refugee children and young people with intellectual disabilities who have witnessed violence are demonstrating a deterioration in their communication and social skills, as well as their ability to undertake personal hygiene and daily care.

Adolescents and young people with new physical disabilities (due to injuries and / or worsening medical conditions) report feeling depressed, with some reporting suicidal ideations and attempts.

Child caring for his / her sibling

Adolescent girls often play a role in caring for a person with disabilities in a household.

Children engaged in the Worst Forms of Child Labor

Community workers and GBV actors report examples of adolescent girls with disabilities are being forced into begging on the street, exposing them to added risks of sexual abuse and exploitation.

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Children experiencing bullying or harassment

Children with disabilities are facing bullying and physical violence in the community, leading some parents to consider residential institutions.

Children witnessing abnormal and potentially traumatic events

Refugee children with disabilities, like other refugee children, have witnessed violence and other traumatic events.

A note about parents of children with disabilities: Many mothers described difficulties adjusting to having a child with disabilities, often leading to fear and depression about the future — for them and their child. 26

2.2 Reaching Children with Disabilities and their Parents

Community volunteers / mobilizers and PSS facilitators should target children with disabilities and their parents for information and awareness raising on PSS activities.

Identify children with disabilities and parents in your community

We are interested in identifying children with different types of disabilities, including:

There are three essential steps to effectively identifying children with disabilities and their parents in your community:

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Step 1: Liaise with key people and different groups in the community who might be helpful in identifying children with disabilities and their parents to engage in PSS activities. These groups could include:

Step 2: Ask existing program participants if they have family members and / or neighbors who have disabilities or know of any children with disabilities that you can meet and share information about activities.

Step 3: House-to-house visits are essential to reaching children with disabilities and parents, especially those who are isolated in their homes, ensuring that they have the same information about PSS activities as other members of the community. It is also a good way to build trust with individuals and caregivers, and to identify any additional support required to access community activities. Even if the individual declines to participate in activities during the first home visit, you should return later to answer any questions, and / or to share information about new PSS programs and activities as they are available.

Engaging parents and families of children with disabilities

Community mobilizers / volunteers and PSS staff should seek to understand the concerns, priorities and goals not only of children with disabilities, but also of parents and others who may be taking on caregiving roles for children with disabilities. As mentioned above, many parents have their own PSS 16 needs, and they may be more open to fostering the participation of children with disabilities in PSS activities, if their own needs are also being considered and addressed.

It is critically important to engage caregivers of children and youth with more profound disabilities, including parents and siblings, who may be worried about their participation in PSS activities. Invite parents to come and observe activities so they can get to know you, ask questions and plan. Also invite siblings, cousins and other peers to age and gender appropriate PSS activities with the child with disabilities. By engaging wider family units, PSS actors can both support and strengthen communication and healthy relationships among caregivers, children with disabilities and other family members.

Lastly, parents of other children already attending activities can be valuable allies in convincing parents of children with disabilities about the benefit of PSS activities. Consider an information session bringing parents of children with disabilities together with other parents who can share positive perspectives and strategies to foster participation.

2.3 Safe Identification & Referral of “At Risk” Children with Disabilities

All children with disabilities should be prioritized for community-based PSS activities. Where children with disabilities are identified to have specific risks, they should be referred to focused PSS activities, and / or case management services.

Referrals to Focused PSS activities

Children with disabilities may experience all of the medium — high risks identified under Law 422 on the Protection of Juveniles in Conflict with the Law or At Risk (e.g. being involved in any of the worst form child labor or being an unaccompanied or separated child). 27 Any child with disabilities experiencing these risks should be referred to age- and gender-appropriate Focused PSS activities. Needs assessment findings suggest that children with disabilities who are particularly vulnerable to these risks include those who are:

It is important to engage children and adolescents with disabilities, as well as non-offending parents (i.e. parents who are not involved in violence or abuse against the child), in decisions about referral to Focused PSS activities. Some children with disabilities may prefer to attend such activities with a trusted friend or support person. Let the child decide who they trust and want to involve.

Referrals to case management and specialized support

The four main indicators of individuals requiring specialized support 28 and some disability considerations are described below:

Indicator 29 Disability considerations
The distressed person has life-threatening injuries requiring urgent medical care. Make sure that any assistive devices remain with the individual, and do not separate them from trusted caregivers or support people — This may add to their distress.
The distressed person is so distraught that they cannot take care of their basic needs or those of their children. Some persons with intellectual disabilities may demonstrate regressive behaviors or deterioration in function (e.g. stop talking and / or requiring assistance with toileting when they were previously independent). Ask caregivers and family members: “Has there been any change in the amount of assistance that [insert name] needs for daily care?” — This may indicate that they need specialized mental health support.
The distressed person may hurt themselves. Research demonstrates that persons with disabilities are four times more likely than those without disabilities to attempt suicide. 30 If a person with disabilities expresses thoughts about ending their life, they should be referred to a case manager for more individualized assessment and support.
The distressed person may hurt other people. Children with disabilities are not any more violent or aggressive than other children. However, some children with intellectual disabilities may feel frustration related to their disability. This frustration is sometimes shown through aggression or even self-harming behaviors, such as banging their head or cutting their skin. Other children who have limited communication may use a range of behaviors to express how they are feeling. Find a safe, quiet space for children who are demonstrating aggression, and try understanding the reasons behind these behaviors. 31 See notes on Psychological First Aid below.
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You should seek out information about the types and availability of additional support and refer to the designated case management agency in accordance Standard Operating Procedures. All standard steps from the Inter-Agency SOPs for SGBV Prevention and Response in Lebanon, the National Child Protection SOPs, and Law 422 should be followed. No exceptions to these SOPs should be made in the case of children with disabilities. If a staff member is unclear of how to proceed with a specific case, they should immediately contact their supervisor for assistance (ideally, without disclosing any confidential information on the case).

When making the decision to refer the child to another level of support, the informed consent of a non-offending parent or caregiver (i.e. those who are not involved in violence or abuse against the child) is required. Explain to the child in simple language. Please see an example below of an Easy-To-Read description of case management:

They can get free support with things like health, the law and a safe place to live.

Someone will help them with this. For example, someone called a case worker. They know how to give people the right support.

They know about the support people can get.

Extracted from: Women's Refugee Commission (2017) Working with adults and children in Lebanon who have been hurt or treated very badly. The Picture Communication Symbols ©1981–2016 by Mayer-Johnson LLC a Tobii Dynavox company.

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Psychological First Aid — Some disability considerations

Psychological first aid (PFA) provides initial support to people in crisis situations to reduce their distress. Not every child who has experienced or is at risk for a child protection violation will demonstrate distressing behaviors, but it is common for individuals to feel anxious, fearful, depressed, confused or demonstrate behavior problems. While PFA can be used when meeting children who are distressed in the community, it may also be used for children who require continuous comfort and support to moderate some of the presenting distressing symptoms (e.g. during PSS activities).

Some considerations for children with disabilities when implementing the Look, Listen, and Link principles 32 are:

LOOK

LISTEN

LINK

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PART 3: INCLUDING CHILDREN WITH DISABILITIES IN PSS ACTIVITIES

Children with disabilities have the right to participate in the same PSS programs and activities as their peers. This section provides some practical strategies that can be implemented by PSS facilitators to support access and inclusion of children with disabilities in both Community-based and Focused PSS activities.

3.1 Identifying and addressing barriers to our PSS activities

Children with disabilities face a range of barriers when participating in PSS activities. The main barriers identified by children with disabilities and their parents are attitudinal, with far less communication, environmental and policy or administrative barriers. The following table summarizes the types of barriers and some suggested strategies to address them:

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ATTITUDINAL BARRIERS

Examples:

Negative stereotyping of children with disabilities, social stigma and discrimination by staff, families and community members.

PSS actors may not invite children with disabilities to activities because they perceive that they need “specialist care”; think that it will take too long and too many resources; and / or are worried that that they will do harm.

Parents may not realize the importance of PSS activities, and instead prioritize health and rehabilitation interventions for their children with disabilities.

When they are invited to PSS activities, adolescents with intellectual disabilities may drop out because they are placed into groups that are not appropriate to their age and gender.

Potential Strategies:

See Tool 5: Inclusive Outreach Messages for Community Volunteers / Mobilizers and PSS Facilitators.

COMMUNICATION BARRIERS

Examples:

From written and spoken information, including media, flyers and meetings, and complex messages that are not understood by children with disabilities.

These barriers are exacerbated if a child and their parents have been isolated from the community, making them unable to access informal information networks from other children and parents.

Potential Strategies:

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ENVIRONMENTAL OR PHYSICAL BARRIERS

Examples:

Such as transportation, buildings, and toilet facilities are not accessible for persons with disabilities.

Potential Strategies:

POLICY AND ADMINISTRATIVE BARRIERS

Examples:

Rules, polices, systems and other norms may disadvantage children with disabilities.

Rules about the functional capacity of children, such as being able to go to the toilet on their own, may disadvantage children with disabilities.

Policy and administrative barriers may also be the result of how staff interpret and implement policies and procedures. For example, staff may incorrectly assume that all children with disabilities are sick and / or at risk of harm, using such policies to exclude children with disabilities.

Potential Strategies:

Children with disabilities, their peers, and parents can all provide valuable information about barriers to PSS activities and effective strategies to address these barriers. The following are some suggested steps and questions that PSS facilitators can use when consulting with the community on PSS programs and activities:

3.2 Communication Strategies

In most cases, persons with disabilities can communicate directly with staff with no adaptions, or relatively small adaptions. In other cases, it may be more difficult to determine the best way to communicate with the individual, and additional steps may be required. It is important when working with persons with disabilities that you take time to watch and listen. Each time you meet the person you will learn something new about them and understand better how they communicate and what they mean. 33

Use respectful language. Different language is used in different contexts to describe disability and to refer to persons with disabilities. Some words and terms may carry negative, disrespectful or discriminatory connotations and should be avoided in our communications. The Convention on the Rights of Persons with Disabilitiesis translated into many languages, including Arabic, and can be a useful guide to correct interpretation of different disability terms. 34

Organizations of persons with disabilities (DPOs) can also provide guidance on the terminology preferred by persons with disabilities in a given country. Additionally, the national Lebanese Law 220/2000 can provide additional helpful guidance proper terminology.

DPO leaders in Lebanon have suggested the following terms to be the most respectful and most commonly accepted terms in Arabic:

Person with disability شخص ذو اعاقة
Person with physical disability شخص ذو إعاقة حركية
Person with intellectual disability الشخص ذو اعاقة ذهنية
Person with mental/psychosocial disability الشخص ذو اعاقة فكرية
Person with hearing impairment ذوي الإعاقة السمعية
Down syndrome تثلث الصبغية 21/ متلازمة داون
Autism التوحد
Person with autism الشخص ذو توحد
Support person الشخص الداعم
Person with visual impairment شخص لديه اعاقة بصرية،
Blind Person شخص كفيف أو مكفوف
Person with low vision شخص ضعيف البصر
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Be sensitive to any negative language being used by parents, family members and other children towards a child with a disability. Present a good example to others and rephrase in positive language as appropriate. The table below provides some examples of how to rephrase in respectful language:

AVOID... CONSIDER USING...

Emphasizing the impairment or condition before the person

For example: Disabled person

Focus on the person first, not their disability

For example: Person with disabilities

Negative language about disability

For example:

Instead use neutral language

For example:

Referring to other people as “normal” or “healthy” Try using “persons without disabilities”

Use a strengths-based approach. Do not make assumptions about the skills and capacities of children with disabilities — this can negatively affect the way we communicate and interact. Just like all children, they have different opinions, skills and capacities. Look at what the child with a disability can do. This can often give us insight into how they can communicate and participate in your activities.

Ask for advice. If you have questions about what to do, how to do it, what language to use or the assistance you should offer — ask them. Ask children with disabilities, their parents and their siblings or friends for advice about their preferred communication method.

You have the skills already — Be creative! You have many skills that you can use with children with disabilities. Every day you are listening to, communicating with and supporting girls and boys who are all different in their own ways. All of us use speech, writing, pictures and posters, and activities, as well as emotions and gestures, to both convey and understand information. Different approaches may work better with each individual. Try different approaches and see what works best.

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Everyone is different! Some strategies you may not have thought of...

Children with disabilities are creative and have lots of different ways of communicating. Here are some examples from projects in other countries:

Communication Toolbox — Letting individuals and groups decide what works best for them

There are lots of ways to contribute to a discussion, and for children and young people to share their concerns and ideas. Build a “Communication Toolbox” which provides options for different ways that children might like to communicate. Don't decide for them — Let them choose what works best for them.

A “Communication Toolbox” can include:

Drawing and artwork — Groups can make a poster using pens, paper and other materials. Include stickers of different shapes and textures, and / or tactile paint, so that children with vision impairments can recognize different parts of the poster.

A picture library — Images and photographs can be used to facilitate discussion. They can also be sorted into different groups under signs that you place on the wall. These signs can include symbols and facial expressions representing places they like / don't like or feel safe / unsafe.

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A sound library — A collection of short audio recordings of local sounds and interactions between people. Children can listen to these recordings and pick ones which they would like to use for discussion.

Photography — Children can borrow a camera and take photos that will help them to share the concerns of girls and boys with disabilities. They can take pictures of places they like / don't like or feel safe / unsafe. They can also take pictures of people and places that they trust and know that they can go to for help; things that make them feel happy and sad; and ways in which they deal with difficult emotions.

A guided tour — Children with disabilities can also take you and others around the community, documenting the places that they like / don't like or feel safe / unsafe. They can take their own photos as they move around the community to help explain this.

Story in a bag — Give the children a bag with familiar objects in it that they can use to tell a story. These should be everyday objects, like a drinking cup, a toy or ball, or a pen and a book. These objects can represent different places and / or activities that children like or don't like in the community and can help them to communicate about the topic. Children can also add their own objects to the bag.

Table: Using tools with children with different types of impairments 39

Tool Physical impairment Blindness and low vision Deaf and hearing impairment Intellectual impairment Comments
Drawing and artwork

✘ Not suitable for children who are blind.

✓ May suit some children with low vision.

Tactile paint and colorful stickers may help children who are low vision to navigate a visual map.
The picture library

✘ Not suitable for children who are blind.

✓ May suit some children with low vision.

This is especially useful with children with hearing disabilities, as well as those with intellectual disabilities.
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The sound library

✘ Not suitable for children who are Deaf

✓ May suit some children who are hard at hearing, if used with a headset.

This is particularly useful with children who are blind. They may also want to record their own voice and reflections on places where they feel safe / unsafe.
Photography

✘ Not suitable for children who are blind.

✓ May suit some children with low vision, as photographs can be easily enlarged.

Photography is a great way to capture the lived experiences of children with disabilities, both at home and in the public sphere. It may not be immediately apparent why a child has taken a certain photograph — explore this by looking for themes across photos and asking questions of peers and siblings.
A guided tour ✓ Length of tour should be adapted to capacity of those in the group. All children have a right to move around their community — even those who require assistance can be included in this activity, as it will highlight the interaction of individual, relationship and community level factors that affect their access and inclusion.
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Story in a bag This is especially useful with children with more profound communication difficulties and for those with vision impairments who can use objects that they can feel to document their own experiences.

Children can pick and mix different tools and identify different roles for each person in the group based on their skills and capacities. For example, some people may not feel so confident speaking, but they can take photos; others may need assistance to move their wheelchair around the community, but they can take good notes; maybe there is an object or place that they know makes another person in their group happy — they can collect that and put it in the “Story in a Bag” or visit that place in the Guided Tour.

Give children time to engage with the different tools. Let them look at the tools, touch them and talk about them. Then ask them to explain what they have chosen and how they might like to adapt and / or combine the activities.

3.3 Identifying skills and capacities of children with disabilities

At an individual level, it is also important to look for skills and capacities, especially among children with more profound physical and communication disabilities. Identifying how someone communicates, what they like and dislike, and what they can and can't do can help you to identify strategies for their inclusion into community activities. Furthermore, building trust with individuals and their families can enhance disclosure processes and foster safer identification of those at-risk or experiencing violence.

Some general principles that will help you to identify the skills, capacities and communication preferences of children with disabilities include: 40

See Tool 4: Identifying Skills and Capacities of Children with Disabilities which provides suggested questions to help PSS workers establish more effective communication with individuals with profound communication impairments, as well as to identify skills and capacities that can be used to foster participation and inclusion in PSS activities.

3.4 Fostering a “safe” environment for children with disabilities

All PSS actors are responsible for ensuring a safe environment for children who are accessing their activities. This includes ensuring that activities are held in a location that can be reached safely by children and their families; that the space is free of hazards that could cause harm (e.g. sharp objects, uncovered electricity plugs, etc.); that the space is accessible to all children; and that children feel safe, comfortable and respected. 41 There are a few simple actions that that PSS facilitators can take to make children with disabilities feel welcome and build a safe environment in their activities.

Before the Activity

During the Activity Facilitation

After the Activity

Safety Scenarios and Appropriate Responses

PSS facilitators and parents may have concerns about how to handle health and safety issues with children with disabilities when attending their activities. It is important to stress that children with disabilities are not more likely than any other child to be injured or hurt during PSS activities; as such most standard procedures for safety will address any concerns. The following examples are concerns raised by PSS facilitators during the needs assessment, with some guidance about appropriate prevention and response actions:

Safety Concern Prevention Action or Response
Children with disabilities may be too unwell to participate in activities.

Children with disabilities should not be considered sick or unwell. However, all children become unwell on occasions. Most illnesses will be minor and just require rest and recovery. Some children may need to visit a doctor for medical advice. If you suspect that a child with disabilities is currently unwell:

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Children with disabilities may fall over and get hurt.

Some children with disabilities may move differently to others, but this does not mean they are more likely to get hurt. If you notice that a child has difficulty moving:

If a child falls over during an activity:

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Some children experience seizures.

About 1 out of 10 people has had a seizure. That means seizures are common, and one day you might need to help a child during or after a seizure. Seizures are not a reason to exclude children from PSS activities.

If a parent or child says that they sometimes have seizures, try to gather some more information about:

There are many types of seizures. Most seizures end in a few minutes. If a child has a seizure during an activity, one facilitator should stay with the child having the seizure, while the other facilitator continues suitable activities with the other children. It is important to make space for the child having a seizure, and to not have everyone crowded around them. Explain to the other children what is happening and reassure them.

To help a child who is having a seizure, DO the following:

DO NOT do any of the following things:

Seizures do not usually require emergency medical attention. Only call an ambulance or urgent medical assistance if one or more of these are true:

Extracted from: Center for Disease Control and Prevention (n.d.) About Epilepsy — Seizure First Aid.

https://www.cdc.gov/epilepsy/basics/first-aid.htm

After the seizure, ask the child if they would like to continue with activities, rest for a while, or go home. Make sure that they have someone with them, and let their parents know what happened.

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Children with disabilities may be physically or emotionally harmed by other children.

During the needs assessment in Lebanon, none of the children or caregivers that we consulted with reported harm from attending PSS activities. Instead, they shared that attending activities and/or coming in for services had a positive impact on their communication skills, their mental and physical health, and helped to expand their peer networks.

PSS facilitators should work to create safe environments where children accept each other and their differences. Please see the activities mentioned earlier in this section, as well as other activities in the Focused PSS and Community-Based PSS Facilitator's Guide.

Where children are exhibiting violent behaviors towards children with disabilities, it may be necessary to change the activities, separate them into a different group and / or refer the child who is exhibiting violent behaviors for more individualized support, such as case management.

Children with disabilities may harm themselves.

Some children with intellectual disabilities may feel a lot of frustration related to their disability. This frustration is sometimes shown through self-harming behaviors, such as banging their head or cutting their skin. Find a safe, quiet space for children who are demonstrating self-harm, and try understanding the reasons behind these behaviors. 42

If a child expresses thought about ending their life, they should be referred to a case manager or mental health practitioner for more individualized assessment and support. See notes on Psychological First Aid below.

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Note: If a child has life-threatening injuries and / or becomes unconscious or unresponsive, you should seek urgent medical care.

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PART 4: SUPPORTING CHILDREN WITH DISABILITIES WHO ARE MEDIUM TO HIGH RISK

As mentioned earlier, there are some children with disabilities and caregivers who face medium to high risk of protection concerns and should be included in Focused PSS activities that are tailored to address these specific risks — most commonly survivors of abuse and exploitation; child marriage; high levels of psychosocial distress; and engagement in the Worst Forms of Child Labor. Children with disabilities should be included in the same groups as non-disabled peers who are experiencing similar risks.

This section provides additional information for Focused PSS Facilitators about the groups of children with disabilities and caregivers that are most likely to require Focused PSS support. It is provided as background information to support Focused PSS Facilitators to recognize and tailor activities to the needs and emotions of participants.

4.1 Children and adolescents with new disabilities

People who acquire a new disability face significant transition in their lives. They face restrictions in daily activities, while concurrently testing and developing new coping strategies. They also have to deal with a range of new challenges, including the attitudes of others relating to their disability.

In the needs assessment conducted in 2017, young men and women with disabilities disclosed that they had attempted suicide during their adolescent period. These individuals had acquired new disabilities, as a result of illness and injury, after which they experienced discrimination and stigma, as others would express pity and shame about their situation:

“I got so tired of people being sad for me that I think that is what made me sad for myself” — Young woman with a new disability

They also reported changes in peer networks and feeling depressed as they adjusted to their life as a person with disabilities. A young man described the breakdown of his relationship with his girlfriend, as well as confusion and a lack of information from professionals about his sexual health following his injury. 43

Coping and adjusting to a disability is an individualized process — some individuals will develop coping strategies in a relatively short amount of time, while others require more time to adjust — two people with similar impairments may have very different outcomes and experiences. 44

Some of the stages that people go through when adjusting to a new disability include:

A child with a new disability may experience fatigue, negative emotions, a sense of powerlessness, and even confusion. Focused PSS can support them to develop coping skills and emotional supports, while providing opportunity to strengthen peer networks that foster their emotional and mental health wellbeing. It is important to remember that children with new disabilities are also very resilient — The majority of persons with new disabilities adjust in ways they never believed possible. 45 Focused PSS Facilitators and peers can play a critical role in highlighting their new abilities to cope with challenging situations, building confidence, creativity and capacity.

4.2 Children and adolescents with intellectual disabilities

Children and adolescents with intellectual disabilities may experience psychosocial distress due to bullying, harassment and / or witnessing violence. Yet these risks are rarely identified and / or addressed through Focused PSS activities. Children and adolescents with intellectual disabilities will exhibit the same signs of psychosocial distress as other children, including changes in communication and social interactions, but these signs often goes un-recognized as parents and service providers incorrectly assume these signs are related to their disability.

Parents of children and young people with intellectual disabilities who are refugees living in Lebanon report deterioration in their skills and behaviors, which they attribute to these individuals having witnessed violence. The most common ways in which this affects children and young people with disabilities is through a change in their communication and social skills — parents described how children have stopped speaking, and / or become socially withdrawn — not wanting to speak with others or join activities with peers. There was also a couple of more severe examples where young people with intellectual disabilities, who were once independent with their self-care and engaging with peer networks in their community, were now needing full assistance with personal hygiene, such as toileting and washing. 46

“In Syria, he used to go visit his Aunt, but his health deteriorated when he heard the shelling. He used to go shower himself, and now he is not even going to the toilet on his own.” — Mother of a young man with intellectual disabilities

Furthermore, children and adolescents with intellectual disabilities — both girls and boys — are at a higher risk of sexual abuse, with parents highlighting this as the most immediate and urgent risk during the needs assessment in Lebanon. 47 Along with physical signs of abuse, such as bruises, sexually transmitted diseases and / or pregnancy, the other two primary indicators are reports from the child 41 that abuse has occurred and changes in the child's behavior. 48 Children with intellectual disabilities who are survivors of sexual abuse may have psychosomatic symptoms, such as stomach aches, headaches, seizures and problems with sleeping. Common psychological consequences include depression, anxiety, panic attacks, low self-esteem, shame and guilt, irrational fear, and loss of trust. Behavioral difficulties include withdrawal, aggressiveness, self-injurious and sexually inappropriate behavior. 49 “Challenging behaviors” are often attributed to the child's disability and leads to exclusion from activities that might support the child to better understand and express what they have experienced and how they are feeling. All children who experience sexual violence, even those with complex communication difficulties, should have access to counselling and psychosocial support. 50

4.3 Caregivers of children with disabilities

Working with parents and caregivers, as well as children with disabilities, is cirtical in ensuring the psychosocial needs of children with disabilities are met. In the needs assesssment in 2017, many mothers described difficulties adjusting to having a child with disabilities, often leading to fear and depression about the future — for them and their child. There were some isolated examples where caregivers reported resorting to residential care for children with disabilities, which may expose such children to further risk and exclusion in society. 51

Caregivers are people first and foremost with their own perspective, needs and feelings. Care-giving is a complex role, and caregivers may have conflicting feelings — they may feel guilty, resentful, angry, afraid, concerned and as though they have failed, especially when the child they care for has experienced abuse. They may prioritize the needs of the child with disabilities above everything else, including themselves, which can be difficult for others in the household. They may also have unmet needs of their own, particularly if they carry the full responsibility for care with no one to support them. For female caregivers, caring for a child with disabilities comes in addition to the many other responsibilities and duties expected of them at home.

Caregivers are also exposed to the threat and reality of violence, and PSS Facilitators should pay attention to their safety concerns. Caregivers are most often women and adolescent girls, meaning they already experience disadvantage within the household and community, and are likely over-burdened with domestic responsibilities, including the care of children and the elderly. Care-giving can also be a very isolating experience, especially for mothers of children with disabilities who are less likely to have access to opportunities outside the home. PSS activities may be opportunity to discuss how female caregivers of children with disabilities may be exposed to violence both inside and outside the home, and work with them to plan for safety and access to services.

Providing good support for caregivers is one of the most effective ways to improve the safety and well-being of children with disabilitiesIt may be useful to work separately with caregivers, creating a safe space for them to talk about the issues that affect them, their own emotions — positive and negative — without feeling that they are being demanding or selfish, or that they are not properly heard. It is also important to recognize that feelings about being a caregiver are complex, and it is normal to feel frustration, resentment and anger, along with love and concern. Helping mothers to develop ways to understand and manage these feelings can be very helpful in strengthening the core relationship between the caregiver and the child with a . 42 disability. 52

Practical tips to support caregivers

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Notes

1 World Health Organization & World Bank (2011) World Report on Disability. http://www.who.int/disabilities/world_report/2011/en/

2 Handicap International & HelpAge International (2014) Hidden Victims of the Syrian Crisis: Disabled, Injured and Older Refugees. http://d3n8a8pro7vhmx.cloudfront.net/handicapinternational/pages/454/attachments/original/1397045203/Hidden_Victims_of_the_Syrian_Crisis—disabled__injured_and_older_refugees.pdf?1397045203

3 This estimate is determined using a global estimate that 15% of any population will be persons with disabilities (WHO & World Bank, 2011), and that the population of Lebanon is approximately 6 million people (World Bank, 2016, https://data.worldbank.org/indicator/SP.POP.TOTL?locations=LB).

4 UNICEF (2013) State of the World's Children: Children with Disabilities. https://www.unicef.org.uk/publications/sowc-report-2013-children-with-disabilities/

5 Women's Refugee Commission & International Rescue Committee (2015) “I see that it is possible”: Building capacity for disability inclusion in gender-based violence programming in humanitarian settings. http://wrc.ms/i-see-that-it-is-possible

6 Government of Lebanon & the United Nations (2017) Lebanon Crisis Response Plan 2017–2020. http://www.3rpsyriacrisis.org/wp-content/uploads/2017/01/Lebanon-Crisis-Response-Plan-2017–2020.pdf

7 Building Resilience and Development Programme: The MoSA National Plan to Safeguard Children and Women in Lebanon 2014–2015.

8 Women's Refugee Commission & UNICEF (2017) Disability Inclusion in Child Protection and Gender-Based Violence Programs. Training Needs Assessment Report: Psychosocial Support (PSS) Programs, November 2017.

9 UNHCR. (2011). Working with persons with disabilities in forced displacement. http://www.unhcr.org/publications/manuals/4ec3c81c9/working-persons-disabilities-forced-displacement.html

10 UNESCO (2013) Social Inclusion of Young Persons with Disabilities (PWD) in Lebanon. http://www.unesco.org/new/fileadmin/MULTIMEDIA/FIELD/Beirut/images/SHS/Social_Inclusion_Young_Persons_with_Disabilities_Lebanon.pdf

11 The United Nations (2006) Convention on the Rights of Persons with Disabilities. https://www.un.org/development/desa/disabilities/convention-on-the-rights-of-persons-with-disabilities.html

12 World Health Organization (n.d.) Health Topic: Disabilities. http://www.who.int/topics/disabilities/en/

13 Interagency Gender-Based Violence Case Management Guidelines: Providing Care and Case Management Services to Gender-Based Violence Survivors in Humanitarian Settings. (2017) https://reliefweb.int/sites/reliefweb.int/files/resources/interagency-gbv-case-management-guidelines_final_2017_low-res.pdf

14 Global Protection Cluster — Child Protection Working Group (2012) Minimum Standards for Child Protection in Humanitarian Action. http://cpwg.net/minimum-standards/

15 WRC (2013). Disability Inclusion in the Syrian Refugee Response in Lebanon. http://wrc.ms/disability-inclusion-syrian-refugees

16 The United Nations (2006) Convention on the Rights of Persons with Disabilities. https://www.un.org/development/desa/disabilities/convention-on-the-rights-of-persons-with-disabilities.html

17 UNHCR. (2011). Working with persons with disabilities in forced displacement. http://www.unhcr.org/publications/manuals/4ec3c81c9/working-persons-disabilities-forced-displacement.html

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18 Women's Refugee Commission & International Rescue Committee (2015) “I see that it is possible”: Building capacity for disability inclusion in gender-based violence programming in humanitarian settings. http://wrc.ms/i-see-that-it-is-possible

19 Jones et al. (2012) Prevalence and risk of violence against children with disabilities: A systematic review and meta-analysis of observational studies, The Lancet, 380 (9845), pp. 899–907. http://dx.doi.org/10.1016/S0140–6736(12)60692-8

20 World Health Organization & World Bank (2011) World Report on Disability. http://www.who.int/disabilities/world_report/2011/en/

21 World Health Organization & World Bank (2011) World Report on Disability. http://www.who.int/disabilities/world_report/2011/en/

22 Women's Refugee Commission & UNICEF (2017) Disability Inclusion in Child Protection and Gender-Based Violence Programs. Training Needs Assessment Report: Psychosocial Support (PSS) Programs, November 2017.

23 Guidance Notes — PSS Intervention in Lebanon — Final version 2017

24 Women's Refugee Commission & UNICEF (2017) Disability Inclusion in Child Protection and Gender-Based Violence Programs. Training Needs Assessment Report: Psychosocial Support (PSS) Programs, November 2017.

25 Women's Refugee Commission & UNICEF (2017) Disability Inclusion in Child Protection and Gender-Based Violence Programs. Training Needs Assessment Report: Gender-Based Violence (GBV) Programs, November 2017.

26 Women's Refugee Commission & UNICEF (2017) Disability Inclusion in Child Protection and Gender-Based Violence Programs. Training Needs Assessment Report: Psychosocial Support (PSS) Programs, November 2017.

27 Guidance Notes — PSS Intervention in Lebanon — Final version 2017

28 Adolescent Emotional Wellbeing Curriculum: Facilitator's Guide (2017)

29 WHO with War Trauma Foundation and World Vision International (2011) Psychological First Aid: Guide for Field Workers. http://www.who.int/mental_health/publications/guide_field_workers/en/

30 Meltzer et. al. (2012) The influence of disability on suicidal behavior, European Journal of Disability Research, 6 (1), pp. 1–12. https://doi.org/10.1016/j.alter.2011.11.004

31 Center for Disease Control and Prevention (n.d.) Safety and Children with Disabilities: Aggressive Behavior and Violence. https://www.cdc.gov/ncbddd/disabilityandsafety/aggression.html

32 WHO with War Trauma Foundation and World Vision International (2011) Psychological First Aid: Guide for Field Workers. http://www.who.int/mental_health/publications/guide_field_workers/en/

33 Women's Refugee Commission & International Rescue Committee (2015) Building Capacity for Disability Inclusion in GBV Programming in Humanitarian Settings: A Toolkit for GBV Practitioners. http://wrc.ms/iseethatitispossible-gbv-toolkit

34 The United Nations (2006) Convention on the Rights of Persons with Disabilities (Arabic). http://www.un.org/disabilities/documents/convention/convoptprot-a.pdf

35 Women's Refugee Commission & International Rescue Committee (2015) “I see that it is possible”: Building capacity for disability inclusion in gender-based violence programming in humanitarian settings. http://wrc.ms/i-see-that-it-is-possible

36 Women's Refugee Commission & ChildFund International (2016) Gender-based Violence Against Children with Disabilities: A Toolkit for Child Protection Actors. http://wrc.ms/gbv-youth-disabilities-toolkit

37 Women's Refugee Commission & International Rescue Committee (2015) “I see that it is possible”: Building capacity for disability inclusion in gender-based violence programming in humanitarian settings. http://wrc.ms/i-see-that-it-is-possible

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38 Women's Refugee Commission & ChildFund International (2016) Gender-based Violence Against Children with Disabilities: A Toolkit for Child Protection Actors. http://wrc.ms/gbv-youth-disabilities-toolkit

39 Adapted from: Elena Jenkin, Erin Wilson, Kevin Murfitt, Matthew Clarke, Robert Champain & Laine Stockman, Inclusive practice for research with children with disability: A guide(Melbourne: Deakin University, 2015). http://www.voicesofchildrenwithdisability.com/

40 Women's Refugee Commission & International Rescue Committee (2015) Building Capacity for Disability Inclusion in GBV Programming in Humanitarian Settings: A Toolkit for GBV Practitioners http://wrc.ms/iseethatitispossible-gbv-toolkit

41 Terre des Hommes — Italy (2017) Community Based Psychosocial Support (2018) Guidelines for Community Volunteers — Final Draft

42 Center for Disease Control and Prevention (n.d.) Safety and Children with Disabilities: Aggressive Behavior and Violence. https://www.cdc.gov/ncbddd/disabilityandsafety/aggression.html

43 Women's Refugee Commission & UNICEF (2017) Disability Inclusion in Child Protection and Gender-Based Violence Programs. Training Needs Assessment Report: Psychosocial Support (PSS) Programs, November 2017.

44 Stuntzner & Hartley (2014) Resilience, coping, & disability: The development of a resilience intervention. Ideas And Research You Can Use: VISTAS 2014. https://www.counseling.org/docs/default-source/vistas/article_44.pdf?sfvrsn=10

45 Wendy Taormina-Weiss (2012) Psychological and Social Aspects of Disability. https://www.disabled-world.com/disability/social-aspects.php

46 Women's Refugee Commission & UNICEF (2017) Disability Inclusion in Child Protection and Gender-Based Violence Programs. Training Needs Assessment Report: Psychosocial Support (PSS) Programs, November 2017.

47 Women's Refugee Commission & UNICEF (2017) Disability Inclusion in Child Protection and Gender-Based Violence Programs. Training Needs Assessment Report: Psychosocial Support (PSS) Programs, November 2017.

48 Davis (2009) Abuse of Children with Intellectual Disability. http://www.thearc.org/what-we-do/resources/fact-sheets/abuse

49 Davis (2009) People with Intellectual Disability and Sexual Violence. https://www.thearc.org/what-we-do/resources/fact-sheets/sexual-violence

50 Davis (2009) People with Intellectual Disability and Sexual Violence. https://www.thearc.org/what-we-do/resources/fact-sheets/sexual-violence

51 Women's Refugee Commission & UNICEF (2017) Disability Inclusion in Child Protection and Gender-Based Violence Programs. Training Needs Assessment Report: Psychosocial Support (PSS) Programs, November 2017.

52 Women's Refugee Commission & International Rescue Committee (2015) Building Capacity for Disability Inclusion in GBV Programming in Humanitarian Settings: A Toolkit for GBV Practitioners http://wrc.ms/iseethatitispossible-gbv-toolkit