3.1 Abuse of Disabled Children: Guidance
- Communication and decision making
- Protecting disabled children
- Indications of abuse / neglect
- Attitudes towards disabled children
- Safeguarding disabled children and responding to concerns
- Deprivation of liberty
- Criminal Procedings
- Related Policies, Procedures, and Guidance
Disabled children are children first and foremost, and are therefore subject to all Working Together guidance and to other Buckinghamshire Safeguarding Children Board (BSCB) policies, procedures and guidance. Disabled children have the same rights as non-disabled children to be protected from harm and abuse.
However, research has found that disabled children are three to four times more likely to be abused and neglected than non-disabled children (Jones et al 2012; Sullivan & Knutson 2000). They are also more likely to experience multiple types and occurrences of abuse (Sullivan and Knutson 2000). Disabled children can be abused and neglected in ways that other children cannot, and they have additional needs and face both additional and specific risks and barriers to their protection. These include:
Various definitions of disability are used across agencies and professionals. Whatever definition of ‘disabled’ is used, the key issues are the impact of abuse or neglect on a child’s health and development, and how best to safeguard and promote the child’s welfare.
This guidance is relevant to children and young people who have physical, sensory and learning disabilities, as well as children and young people with autistic spectrum conditions (ASC) and attention deficit hyperactivity disorder (ADHD).
Communication and decision making
Guidance emphasises the critical importance of communication with disabled children. This includes recognising that all children communicate preferences if they are asked in the right way by people who understand their needs and have the skills to listen to them (Marchant and Page, 1992).
The participation and involvement of children and young people in decision-making about their own welfare and in the services they receive is a legal requirement under the Children Act (1989 Section 1(3)). However, it is known that for disabled children, this is less likely to happen.
In order for disabled children to participate in decisions about their safety and welfare, it is essential that resources and time are made available to allow their voice to be heard. Many disabled children or young people need alternative or additional means of communication to understand and to express themselves. The best practice for disabled children is for a worker with appropriate communication skills to be allocated.
All reports that are written about a disabled child or young person should include their views, wishes and feelings, and how they have been ascertained.
Professionals must identify barriers to accessing services and aim to make information available to disabled children and young people, and their parents and carers. This information should take account of the child or young person’s impairment, as well as the child or young person’s and parents’ preferred formats.
Protecting disabled children
“Dependency on a wide network of carers and other adults is the everyday experience of some disabled children in order that their medical and intimate care needs such as bathing and toileting can be met. The large number of adults involved and the nature of the care needs both increase the risk of exposure to abusive behaviour and make it more difficult to set and maintain physical boundaries. Some disabled children grow up to accept damaging, demeaning or over restricting treatment from others because they have never known anything more positive. There is also the possibility that disabled children may be schooled into accepting others having access to their bodies.” (Safeguarding Disabled Children Practice Guidance DFEE 2009.)
The Children and Families Act (2014) places a duty on local authorities to promote children’s wellbeing as it relates to:
Disabled children are included in this duty and in order to assess their needs, the Children and Families Act (2014, Section 37), expects that local authorities will produce and maintain an education, health and care plan to coordinate a child’s needs.
It is important that agencies provide coordinated services and support around a child and family at the earliest stage to effectively safeguard and promote the welfare of disabled children and to prevent deteriorating outcomes.
Disabled children are likely to have poorer outcomes across a range of indicators, including low educational attainment, poorer access to health services, poorer health outcomes and more difficult transition to adulthood. They are more likely to suffer family break-up and are significantly over-represented in the populations of Looked After Children and young offenders.
Where disabled children are Looked After, they are more likely to be placed in residential care rather than family settings, which in turn increases their vulnerability to abuse.
Families with disabled children are more likely to experience poverty and children with special educational needs are more likely to be excluded from school (Miller and Brown, 2014).
Disabled children may be particularly vulnerable for a number of reasons:
 Franklin, A, Raws, P and Smeaton, E (2015) Unprotected, overprotected: meeting the needs of young people with learning disabilities who experience, or are at risk of, sexual exploitation.
Indications of abuse / neglect
In addition to the universal indicators of abuse / neglect, it is important to consider additional indicators and vulnerabilities for disabled children. All professionals who come into contact with children and young people with disabilities are in a position to identify indicators that the child may be suffering or may be at risk of significant harm. A child or young person’s disability should always be considered when considering whether significant harm might be indicated. For example a bruise in a site that might not be of concern on an ambulant child or young person, such as the shin, might be of concern on a non-mobile child or young person.
Other particular issues relating to disabled children and young people that may also lead to a risk of being abused or exploited include:
Attitudes towards disabled children
Attitudes in society and among professionals working with children can lead to a view that abuse of disabled children does not happen or that disabled children are in some way less harmed by abuse. This in turn undermines the safeguarding of disabled children.
Negative approaches can lead to discrimination and, in turn, may guide professionals to be less likely to act on their concerns. Reasons for this include:
(Murray and Osborne, 2009; Ofsted, 2009, 2012; Stalker and McArthur 2012; Stalker et al. 2010).
Safeguarding disabled children and responding to concerns
Safeguards for disabled children are essentially the same as for non-disabled children, but in addition should include:
Children who are living away from home may be particularly vulnerable, e.g. those in residential care homes, residential schools and healthcare settings.
When children are placed in an emergency situation, all medical consents/needs and method of communication need to be clearly documented and provided to the setting.
Multi-agency protocols for times of transition must include a communication strategy and young people must be supported to participate in the development of their transition plans, particularly in their transition to adulthood.
Where there are safeguarding concerns in relation to a disabled child, they must receive the same level of protection from harm as any other child. Any professional who has a safeguarding concern about a disabled child, should follow the usual procedure for responding to concerns of abuse and neglect.
When making a referral to Children’s Social Care or Early Help, it is useful to consider the answers to the following questions:
Where the threshold has been met, First Response will liaise with the appropriate teams to determine who will commence a Section 47 Investigation under the Children Act 1989.
Extra resources may be necessary, especially where the child has speech, language and communication needs. For example, it may be necessary to obtain an assessment from a teacher and speech and language specialist as to the best way of working with the child. The child’s preferred method of communication must be given the utmost priority (Taylor et al, 2014).
The number of carers involved with the child should be established, as well as where the care is provided and when. At the Strategy Discussion, consideration should be given to appointing a support worker to consider any complex issues arising from the disability.
If a facilitator or interpreter is required, they should be involved when planning the investigation. Where there is an interview with the disabled child, consideration should be given to whether any additional equipment or facilities are required, and whether someone with specialist skills in the child’s preferred method of communication should be involved. All those involved in an investigation must ensure that they communicate clearly with the disabled child and the family, as well as with each other, as there are likely to a greater number of professionals involved.
Deprivation of liberty
Article 5 of the Human Rights Act states that ‘everyone has the right to liberty and security of person. No one shall be deprived of his or her liberty [unless] in accordance with a procedure prescribed in law’.
High levels of supervision and restrictions imposed due to a child's disability or behaviours could in some instances be considered a deprivation of liberty (and therefore abusive).
Local authorities must consider whether any children in need or Looked After Children are being deprived of their liberty, but are not able to provide consent to a deprivation of liberty on behalf of a child or young person.
Where children are not looked after, parents can give consent for deprivation of liberty if it falls within the zone of parental responsibility under the age of 16 years. Deprivation of liberty can also be lawful if warranted under statute (Section 25 of the Children Act, secure accommodation provisions).
For a young person aged 16-17, currently only the Court of Protection can authorise a Deprivation of Liberty, as parents or the Local Authority cannot consent to a confinement.
However, where a child is Looked After, different considerations apply even where the parents consent to deprivation of liberty. Their consent may be adequate where the child is accommodated under Section 20, but where the child is the subject of an interim care order or a care order, it is unlikely a parent could consent and nor can the local authority. This means that where there is a deprivation of liberty the local authority will usually need to seek leave of the High Court to make an order for the deprivation of the child’s liberty.
Whilst deprivation of liberty has been a key part of adult safeguarding for many years, this is a complex and developing area in terms of child safeguarding practice. Professionals working in Children’s Social Care should ensure that appropriate legal advice is sought where is possible that any child or young person may be deprived of their liberty. Further information is available in The Application of Deprivation of Liberty Safeguards (DoLs) in Children’s Services (January 2016).
There are special measures for safeguarding disabled children during criminal proceedings. The following issues need to be considered:
The Buckinghamshire Safeguarding Children Board provides multi-agency safeguarding training including specific training on protecting disabled children. Details can be found on the training section of the BSCB website.
- Children Act 1989, c. 41
- Children and Families Act 2014, c. 6.
- Department for Children, Schools and Families (2009) Safeguarding disabled children. Practice guidance.
- HM Government (2015) Working Together to Safeguard Children - A guide to inter-agency working to safeguard and promote the welfare of children.
- HM Treasury and Department for Education and Skills (2007) Aiming high for disabled children: better support for families
- Institute of Education (2013) Research Summary Two: Do Families with a Disabled Child Face Greater Socio-economic Disadvantage? And How Does the Risk of Disadvantage Vary with Age? Briefing Paper. London: Centre for Longitudinal Studies.
- Hoffman-Rosenfeld, J. (2014) Approaching the child abuse interview of a child with disabilities. Montefiore: Children’s Hospital at Montefiore
- Marchant, R and Page, M (1992) Bridging the gap: investigating the abuse of children with multiple disabilities. Child Abuse Review 1, 3, 179–183.
- NSPCC (2014) ‘We have the right to be safe ‘Protecting disabled children from abuse
- Ofsted (2009) Learning Lessons from Serious Case Reviews: Year 2.
- Ofsted (2012) Protecting Disabled Children: Thematic Inspection.
- Plotnikoff, J and Woolfson, R (2008) The “Go-between”: Evaluation of Intermediary Pathfinder Projects.
- Spencer, N, Devereux, E, Wallace, A, Sundrum, R, et al. (2005) Disabling conditions and registration for child abuse and neglect: a population based study. Pediatrics116, 3, 609–613.
- Stalker, K and McArthur, K (2012) Child abuse, child protection and disabled children: A review of recent research. Child Abuse Review 21, 1, 24–40.
- Stalker, K, Green Lister, P, Lerpiniere, J and McArthur, K (2010) Child Protection and the Needs and Rights of Disabled Children and Young People: A Scoping Study. Abridged report. University of Strathclyde.
- Sullivan, PM and Knutson JF (2000) Maltreatment and disabilities: a population based epidemiological study. Child Abuse and Neglect 24, 10, 1257–1273
- Taylor, J, Stalker, K, Fry, D and Stewart, ABR (2014) An Investigation into the Relationship between Professional Practice, Child Protection and Disability.
- The Scottish Government (2014) National Guidance for Child Protection in Scotland - Additional Notes for Practitioners: Protecting Disabled Children from Abuse and Neglect.
- Jones, L, Bellis, MA, Wood, S, Hughes, K, et al. (2012) Prevalence and risk of violence against children with disabilities: a systematic review and meta-analysis of observational studies. The Lancet July 2012.
- Sullivan PM and Knutson JF (2000) Maltreatment and disabilities: a population based epidemiological study. Child Abuse and Neglect 24, 10, 1257–1273.