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Abuse Assessment Screen – Disability (AAS-D)

The Abuse Assessment Screen - Disability (AAS-D) was developed and tested to address the range of abuse experienced by women with physical disabilities.

1. Within the last year, have you been hit, slapped, kicked, pushed, shoved, or otherwise physically hurt by someone?
   
   YES    NO
   
   If YES, who? (Circle all that apply)
   
   
   • Intimate partner
   • Care provider
   • Health professionalr
   • Family member
   • Other
   Please describe: ___________________
2. Within the last year, has anyone forced you to have sexual activities?
   
   YES    NO If YES, who? (Circle all that apply)
   
   
   • Intimate partner
   • Care provider
   • Health professionalr
   • Family member
   • Other
   Please describe: ___________________
3. Within the last year, has anyone prevented you from using a wheelchair, cane, respirator, or other assistive devices?
   
   YES    NO If YES, who? (Circle all that apply)
   
   
   • Intimate partner
   • Care provider
   • Health professionalr
   • Family member
   • Other
   Please describe: ___________________
4. Within the last year, has anyone you depend on refused to help you with an important personal need, such as taking your medicine, getting to the bathroom, getting out of bed, getting dressed, or getting food or drink?
   
   YES    NO If YES, who? (Circle all that apply)
   
   
   • Intimate partner
   • Care provider
   • Health professionalr
   • Family member
   • Other
   Please describe: ___________________

Abuse Assessment Screen Disability (AAS-D) (circle YES or NO)

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Source: McFarlane, J., Hughes, R. B., Nosek, M. A., Groff, J. Y., Swedlend, N. & Dolen Mullen, P. (2001). Abuse Assessment Screen - Disability (AAS-D): Measuring frequency, type, and perpetrator of abuse toward women with physical disabilities. Journal of Women's Health & Gender-Based Medicine, 10 (9), 861-866. Reproduced with permission.

 

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