Several studies have sought to determine whether individuals with limited mobility have an increased risk of venous thromboembolism. One study of adult patients with multiple sclerosis found a high rate of deep venous thrombosis (43.9%) of patients, with 24.2% of patients having a history of venous thromboembolism [38]. However, in a sample of para- and tetraparesic patients institutionalized for long durations, no thromboembolisms were observed despite additional risk factors including orthopedic surgery, bone fractures, and hormonal therapy in 60% of participants [39]. Researchers have hypothesized that quadriplegia during childhood may reduce venous lakes, decreasing blood stasis and allowing for a closer to normal risk of venous thromboembolism when compared to patients who acquire quadriplegia later in life [40]. In addition, spasticity may play a role in preventing DVT in patients with limited mobility [39]. No studies to date have examined the risk of venous thromboembolism among adolescents with limited mobility on hormonal contraception. Thus, the risks and benefits of available methods should be discussed with families prior to initiating a hormonal method of contraception, and a thorough history for patient and familial risk factors should be conducted. If patients and families opt to proceed with combined oral contraceptives, first- and second-generation COCs are optimal given their better clotting profile compared to third- and fourth-generation progestin-containing contraceptives. Further data is necessary to identify whether adolescents with limited mobility are at increased risk of venous thromboembolism when taking hormonal contraceptives .

Adolescents with disabilities are often not viewed as targets for sexual abuse by their family and other members of their community. However, because their intellectual limitations may prevent them from identifying an advance as inappropriate or disclosing the abuse to a caregiver or other adult, some perpetrators may view adolescents with disabilities as an easy target [41]. One study demonstrated that women with severe disability impairments were four times more likely to be sexually assaulted than women with no reported disabilities. Children with disabilities often have limited access to critical information pertaining to personal safety and sexual abuse prevention, and parents of children with disabilities may object to a sexual education curriculum on human sexuality for their adolescents [42]. Pediatricians and pediatric and adolescent gynecologists can help to educate parents about normal sexual development and encourage them to advocate for their children to have appropriate sexual education in the school setting [43]. In the school setting, individualized educational plans (IEPs) can be set up to include human sexuality education geared at an appropriate intellectual level [44]. For example, educational activities can involve parents, teachers, and other care providers and may include role-play, visual aids, and frequent repetition of simple concepts and tasks.

At the University of Michigan, Dr. Elizabeth Quint and colleagues have developed counseling strategies to help prevent abuse. The circle of life helps explain relationships to youth with developmental disabilities. The inner circle involves parents and those closest to the child with the developmental disability, with the explanation that those family members would be appropriate to kiss or hug. The next circle might involve extended family, who it might be appropriate to hug. Next would be peers, teachers, and others in daily life, who it might be appropriate to say hello and give a handshake. Acquaintances might get a wave, while strangers might just be observed but not touched or engaged in conversation. Another example per Dr. Quint and colleagues is the No-Go-Tell strategy , where children with developmental disabilities—and all younger children—are taught their own first line of defense: “say No” to unwanted or unexpected contact, tell the person to “Go away”, and then “Tell” someone, no matter what they are told by the perpetrator. This No-Go-Tell strategy can help prevent a cycle of abuse with a developmentally challenged child or adolescent.