Protecting disabled children from abuse and neglect

In 2004 Stuart and Baines wrote that society was still in denial about the fact that disabled children are more likely to be abused than non-disabled children. Since the start of 2010 there have been at least seven serious case reviews involving disabled children and this year there were the disturbing findings of abuse and neglect in a number of hospitals and care homes for learning disabled people. So what does the research tell us?

We still know relatively little about the abuse of disabled children. Stalker et al found that we have very little up-to-date information available on the prevalence of abuse of disabled children in the UK. A large-scale US study of over 40,000 children found that disabled children were 3.4 times more likely to be abused or neglected than non-disabled children (Sullivan and Knutson). While UK research is limited, several studies indicate similar levels of abuse as in the US.

Brandon et al’s analysis of serious case reviews found 21 children who were disabled prior to the incident that led to the serious case review. This represented 8% of the 268 children who had been the subject of a serious case review in the period examined. Disabled children also seem more likely to be bullied. The Office of the Children’s Commissioner found that disabled children are twice as likely as their peers to become targets for bullies. The lack of self-esteem resulting from bullying can in itself make disabled children more vulnerable to abuse.

Attitudes to disability

In 2009 the Department for Children, Schools and Families published practice guidance on safeguarding disabled children that made it clear that disabled children have the same human rights as non-disabled children. The guidance also recognised that disabled children have additional needs caused by their impairments and vulnerability.

Practitioners need to act upon the issues that influence the safety of disabled children, but Cooke and Standen found significantly less intervention in respect of disabled children, especially regarding placement on child protection registers and protection plans. Attitudes and assumptions appeared to be a factor. Research by Kennedy identified the mistaken belief that disability protects from abuse and disabled children were less likely to be damaged by abuse than other children. Stalker et al highlights the risk of practitioners applying higher thresholds to disabled children as a result of over identifying with the child’s parents or carers, being reluctant to accept that abuse is taking place or seeing it as being attributable to the difficulties of caring for a disabled child.

Practitioners can also struggle to disentangle indicators of abuse or harm from the effects of a child’s impairment, according to Wescott and Jones. The Department of Health’s Assessing Disabled Children and their Families Practice Guidance sets out the issues to consider when assessing disabled children and their families.

Practitioners need to recognise that dependency on a wide network of carers is the everyday experience of some disabled children. This together with the nature of the medical and intimate care needs of some disabled children increases the risk of abuse and makes it more difficult for them to set boundaries. Clements and Read found that some disabled children grow up to accept damaging, demeaning or over-restrictive treatment because they have never known anything else.

Communication barriers

Many disabled children have difficulty reporting their worries, concerns or abuse (Morris; Franklin and Sloper). Ascertaining how and what a child communicates is key to safeguarding them whatever their level of impairment and the Report of the National Working Group on Child Protection and Disability (NSPCC) makes clear that practitioners need to ensure their definitions of communication are inclusive and not discriminatory. Practitioners must plan for and ensure effective communication with timescales and approach adapted to suit the individual child. The Communication Trust has published Other Ways of Speaking to support practitioners working with children whose speech is difficult to understand or who use non-verbal means of communication.

A number of studies suggest disabled children in residential care are particularly vulnerable due to the nature of institutional life and the isolation they may experience (Paul and Cawson).

Barriers also exist within the child protection system and in criminal justice. Stalker et al reported that disabled children were less likely than other children to be seen as credible witnesses, fewer cases involving disabled children went to court and courts sometimes failed to meet disabled children’s needs, with insufficient use of video recording and intermediaries. This is despite research clearly indicating that children with learning disabilities can provide forensically relevant information if appropriate methods are employed (Aarons and Powell).

Learning for social workers and care staff:

● Beliefs that minimise the impact of abuse on disabled children can lead to a failure to report abuse or neglect.

● Disabled children should be treated with the same degree of professional concern accorded to non-disabled children.

● Be prepared to challenge carers and ensure that abusive and restrictive practices do not go unrecognised.

● The child’s impairment should not detract from early multi-agency assessments of need that consider possible underlying causes for concern.

● Always ask when assessing a disabled child: “Would I consider that option if the child were not disabled?”

● Recognise the barriers to communication disabled children experience, be aware of different communication methods and where to seek specialist advice.

● Make it everyday practice for disabled children to make their wishes and feelings known and ensure they know how to raise concerns.

Learning for managers:

● Additional resources and time may need to be allocated if an investigation of potential or alleged abuse of a disabled child is to be meaningful.

● Basic training and awareness raising of the susceptibility of disabled children to abuse is essential for those working with disabled children.

● Promote a culture of consulting with, listening to and encouraging the participation of disabled children.

● Ensure disabled children with communication support needs can access helplines and advocacy services.

● Ensure there is clarity of responsibility for safeguarding disabled children between different teams within children’s social care and the safeguarding needs of children living away from home are prioritised.

● Make available to all staff up-to-date information about specialist advice and resources, experts, interpreters and court intermediaries and the funding to access these.

Chris Osborne is an independent consultant

References and key texts

Aarons N M, Powell M B (2003), “Reports of abuse from children with an intellectual disability. Current Issues in Criminal Justice, Vol 14, 3, pp257-268

Brandon M, Bailey S, Belderson P (2010), Building on the learning from serious case reviews: a two-year analysis of child protection data base notifications 2007-2009. Research report DFE- RR040

Clements L, Read J (2003), Disabled People and European Human Rights. The Policy Press

Cooke P, Standen P (2002), “Abuse and disabled children: hidden needs?”, Child Abuse Review, Volume 11, 1-18

Department for Children, Schools and Families (2009), Safeguarding disabled children: a resource for local safeguarding children’s boards. Download from http://bit.ly/sYmsm1

Department of Health (2000), Assessing Children in Need and their Families: Practice Guidance. Download from http://bit.ly/oE39Qs

Franklin A, Sloper P (2009), “Supporting the participation of disabled children and young people in decision making”, Children and Society 23, 1, pp3-15

Kennedy M (1992), “Children with severe disabilities: too many assumptions”, Child Abuse Review, 1, pp185-187

Morris J (1999), “Disabled children, child protection systems and The Children Act 1989”, Child Abuse Review, 8, 91-108

NSPCC in association with The National Working Group on Child Protection and Disability (2003), It Doesn’t Happen to Disabled Children: Child Protection and Disabled Children, NSPCC.

Office of the Children’s Commissioner (2006), Bullying Today: A Report by the Office of the Children’s Commissioner, OCC.

Paul A, Cawson P (2002), “Safeguarding disabled children in residential settings: What do we know and what we don’t know”, Child Abuse and Neglect, 11, pp262-281

Stalker K, Green Lister, Lerpiniere J, McArthur K (2010), “Child protection and the needs and rights of disabled children and young people: A scoping study”, University of Strathclyde. Available to download from: http://strathprints.strath.ac.uk/27036

Stuart M, Baines C (2004), Safeguards for Vulnerable Children, Joseph Rowntree Foundation.

Sullivan P M, Knutson J F (2000), “Maltreatment and disabilities: A population-based epidemiological study”, Child Abuse and Neglect, 24, pp1257-1273.

The Communication Trust (2011), “Other Ways of Speaking: supporting children and young people who have no speech or whose speech is difficult to understand”. Download from http://bit.ly/etJFrN

Wescott H L, Jones DPH (1999), “Annotation: the abuse of disabled children”, Journal of Child Psychology and Psychiatry, 40, pp497-506