SAFEST KID (A Sexual Assault Framework in Education to Support Trauma in Kids with Intellectual Disability): Delphi Study Development of a Model and Utilization

There is a grave need for additions to the school psychologist's toolbox to support students with intellectual disability (ID) and sexual trauma. These children are especially vulnerable to adverse life experiences overall and are at a particularly high risk of experiencing sexual abuse and resulting trauma. Children with ID are less likely to have their trauma symptoms identified by those around them, as symptoms do not always present in the same way as their neurotypical peers and trauma symptoms are more likely to be grouped into the rest of their disability through diagnostic overshadowing. Additionally, individuals with ID are at risk both from abuse perpetrated by individuals without ID and from other individuals with ID as well. New childhood trauma cases cost the US upwards of $124 billion per year, and the estimated cost of the total burden of untreated trauma is over $500 billion. This highlights the need for accessible sexual health and healthy relationship education within school systems to help intervene in this trauma cycle and ensure that children with ID are taught the necessary skills to understand interpersonal boundaries, consent, advocacy, and sexual rights, as well as how to form and maintain healthy relationships. For the population of children with ID, schools remain the place where they are most likely to have their mental health needs met, and schools are the place where they are most likely to receive any form of sexual health education. The epidemic of sexual abuse among the population of individuals with ID has recently come to light, and many of these individuals are at risk of suffering from resulting sexual trauma. Looking at systems-level change, preventative measures, and targeted adapted interventions, the model of SAFEST KID aggregates these components into one framework that provides guidelines for the transition to trauma-informed schools, integrated and developmentally tailored healthy relationship curricula, and a targeted individual intervention for use by school psychologists to support students with ID and sexual trauma. Manuscript Two showcases the results of the Delphi study regarding the viability of the SAFEST KID model, aggregating real-world knowledge and experience from a panel of experts. The Delphi study was conducted to collect input and insight from individuals with expertise in ID, childhood sexual trauma, and school systems to enhance the SAFEST KID model by incorporating both extensive existing topical research as well as the lived experience of professionals and practitioners in the field. A panel of experts was recruited and given multiple rounds of iterative questionnaires, generating consensus on a list of concepts that were used to answer the research questions, create a set of guidelines for adapting interventions for use with children with ID and sexual trauma, and augment the SAFEST KID model. The Delphi study investigated the research questions of how the SAFEST KID model is likely to be used, what are predicted barriers to implementation, and what realistic adjustments to its components are necessary. To conclude, Manuscripts One and Two highlight the overarching need within school systems to apply trauma-informed trainings across districts that consider developmental differences in child trauma presentations, to implement social-emotional learning and healthy relationship curricula across grade levels, and to have therapeutic evidence-based intervention tools ready for use by school psychologists to support the well-being of students with ID and sexual trauma. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]