THERE IS INCREASINGLY STRONG evidence that children with disabilities are at higher risk for maltreatment when compared to children without disabilities. There is also concern about the adequacy of child welfare services for children and parents with disabilities, particularly those disabilities that result in a communication impairment. This article describes a successful community practice effort in Los Angeles County that resulted in the establishment of a comprehensive array of linguistically and culturally competent child abuse prevention and treatment services for the maltreated deaf child and for the deaf parent at risk for child abuse perpetration. Social movement theory is used to analyze a change effort that was developed and implemented by a broad coalition of members of the Deaf and hearing communities. Elements of the problem, social movement theory, the coalition, the change strategy, and the results are described.
For several years, advocates for the Deaf community, researchers, and service providers have attempted to bring attention to the problem of maltreatment and the deaf child (Sullivan, Vernon, & Scanlon, 1987). These efforts have focused on examining the prevalence of maltreatment of deaf children (Knutson & Sullivan, 1993), risk factors related to maltreatment of deaf children (Embry, 2000; Mather & Mitchell, 1993; Sullivan & Knutson, 1998), child welfare system capacity to serve the deaf child and deaf parent (Kennedy, 1992; Ulgen & Petal, 1992), and models for effective child abuse prevention and treatment services for the deaf child and support services for deaf parents at risk to perpetrate child maltreatment (Embry, 1993; Sullivan, Scanlan, Brookhouser, Schulte, & Knutson, 1992).
The present article describes efforts in Los Angeles County, CA, conducted by the Advocacy Council for Abused Deaf Children (Advocacy Council) between 1990 and 1996 that resulted in significant reform of child welfare services for the deaf child and parent.' We review current literature regarding the maltreatment of deaf children, discuss child welfare services for deaf children and deaf parents, review central elements of social movement theory, and describe the Los Angeles County effort. This reform effort demonstrates that changes in the political/institutional structures, the ability to garner resources, and the ability to make claims that resonate with diverse stakeholder groups are essential to successful reform. In addition, this analysis of the efforts of a coalition among the Deaf community, child welfare specialists, researchers, private agencies, and public agencies extends the application of social movement theory described in the social work community practice literature (H. J. Rubin & I. S. Rubin, 2001; Weil & Gamble, 1995).
Maltreatment of the Deaf Child and the Inadequacy of Current Child Welfare Services
There is strong evidence that children with disabilities, including deaf children, are at increased risk for maltreatment when compared to children without disabilities.2 One study investigating the risk for maltreatment of children with disabilities examined a nationally representative sample of substantiated child maltreatment cases and found that the incidence of maltreatment among children with disabilities was 1.7 times higher than the rate for children without disabilities (Westat, Inc., 1993). Two investigations by Sullivan and Knutson-one using a hospital-based sample (1998) and one using a population-based sample (2000)-also found evidence of increased risk for maltreatment among children with disabilities. '!Tie hospital-based study found that children with communication disordersincluding deaf and hard of hearing children-were twice as likely to be maltreated when compared to children without disabilities. The population-based study examined maltreatment reports made to both child protective services and law enforcement agencies-a strategy more likely to identify both intrafamilial and extrafamilial child maltreatment than the Westat study-and found that children with disabilities were 3. …