People with developmental disabilities have recently been identified as a group at risk of developing alcohol and drug addictions, as well as sexual exploitation and sexual abuse.
This is an under-researched area, so the ideas expressed are suggestions for parents to keep in mind, rather than evidence-based addiction prevention practices (although some are considered good practice for other reasons). At this point, little is known about how addictions develop in this population, except that there has been an escalation in the risk of addictive behaviors.
1. Expose Children to Healthy Community ActivitiesIn adulthood, your child with a developmental disability may have access to the community as easily as anyone else. Begin to regularly take your child to positive social environments, such as libraries, community center and gym activities, parks, places of worship, and preschool/playgroup settings. Giving your child a sense of belonging in the community will give them less of a need to seek out connection through places designed for addictive activities such as alcohol, drugs, sex clubs and gambling venues.
2. Use Social Stories to Teach Your Child About Trust
We often spend so much time trying to build trusting therapeutic and nurturing relationships with children with developmental disabilities, that we neglect to teach them how to distinguish between people they can trust, and those they cannot or should not trust.
While teaching children social compliance skills that will facilitate relationships, children with developmental disabilities must also learn when not to comply and how to assertively protect themselves from victimization. Social stories can help children learn that not everyone is their friend.
3. Teach Your Child to Understand and Trust Their EmotionsFear, anger, hurt and shame may be uncomfortable emotions, but ignoring or repressing them makes people more vulnerable to addictive behavior as a way of keeping these feelings out of awareness. Teach your child to label and express emotions in appropriate ways, and never criticize them for what they feel. Help them to trust their emotions as a way of distinguishing between healthy and unhealthy choices.
4. Teach Your Child to Cope with Discomfort and Disappointment
Try to minimize use of drugs to deal with discomfort and unwanted behaviors, which paves the way for future drug use. Frustration may be expressed through emotional and behavioral outbursts, particularly if your child lacks impulse control, is excessively bored or over-stimulated, or has difficulty with communication. Respond by teaching effective ways of dealing with emotion, providing appropriate outlets, making “substitute” choices when they cannot have what they want, and acknowledging feelings of disappointment.
Normalize refusal and build good boundaries by saying "no" to inappropriate requests on a regular basis, and provide your child with emotional support in coping with refusal from others.
5. Educate Your Child in Self-Responsibility
People with developmental disabilities may discover early in life that they can avoid taking responsibility for their own behavior. Others do things for a person with a disability out of pity, discomfort at watching the person struggle or because it is the easier way to get something done. This fosters chronic dependency and makes them vulnerable to the influences of others.
Learning self-responsibility can start early with simple tasks, such as retrieving a toy, closing the door when entering the home and cleaning up after themselves. When able, the child can help to become effective at exercising more complex skills, such as following through on choices, and apologizing for hurting others.
6. Increase Opportunities For Friendships and RelationshipsEncourage your child to make friends in healthy social settings. Talk and use nonverbal communication to discuss what makes them feel good and bad about friendship, label their emotions, and teach them to discriminate between people acting in their best (or cooperative) interests, and people acting selfishly or abusively. Wherever possible, encourage positive resolution to differences, but never force your child to remain friends with someone who has mistreated them - even if they may be temporarily lonely as a result.
7. Provide Your Child With Appropriate Sex EducationYour child should know the correct name and function of each body part as soon as possible. Help them understand about public and private places, including those on their bodies and those in their environments. They should know how to recognize if they are being sexually abused, in terms of physical acts. They should be encouraged to disclose any threatened, attempted or actual sexual abuse, and should be taken seriously if they do disclose. If they have been sexually abused, give them therapeutic and emotional support immediately, and on an ongoing basis, as needed. Follow through and report suspected or known abusers to law enforcement.
8. Do Not Make an Issue of RebelliousnessDrug users appear to walk the fine line between conformity and rebellion. Young people have a natural desire to rebel, which may be rewarded by users and punished by caregivers. Accept differences which are not harmful, particularly in terms of self-expression. Encourage acceptance of diversity, while instilling values of self-respect and self-responsibility. Teach these same values to your children, so they may more clearly evaluate the true nature of the diverse people they will meet in life. Central to understanding rebelliousness is practicing what you preach, so role model taking pleasure in self-respectful, healthy behaviors yourself.
9. Be Critical in Your Choice of Therapies and TherapistsStay aware of the risks to your child of becoming overly compliant, easy to manipulate, and dependent on others. Some therapies and therapists reinforce these tendencies, while others encourage independence. While a compliant and obedient child may be easier to manage initially, they may be more prone to rebelliousness later (which may surprise and anger parents), yet they can lack the tools to resist the manipulations of others, suffering preventable victimization as a result.
10. Discourage Manipulative Behavior in Your ChildPeople with disabilities sometimes learn to manipulate other people to get things and attention for free, and without giving anything back. In some cases, this is an adaptive way of coping with being in a powerless position. However, it can put them at risk for bargaining with sex, or accepting free drugs in adolescence and adulthood. Encourage your child to understand and participate in social reciprocity. Teach replacement skills that encourage your child to take responsibility for contributing something -- emotionally, physically, financially, etc -- for everything received in life.
11. Don't Inadvertently Train Your Child to be a People Pleaser
Behavioral therapies are useful in building social skills and developing more effective approaches to learning, as well as controlling unwanted behaviors in children with developmental disabilities. When controlling the child’s behavior is the primary objective, they may be conditioned to be overly compliant and “good,” and that this pleases people in authority.
People pleasers have a hard time saying "no." In order to resist peer pressure to engage in addictive behaviors, your child needs to feel self-confident and entitled to say "no." While it is important to teach them to consider the feelings of others, their own feelings about what is right for them must be respected, first and foremost.