Practice guidance to help safeguard children with disabilities
Legislation, research and guidance
Awareness
Prevalence of abuse
Indicators
Risk of discrimination against children with disabilities
Referral and assessment
Strategy discussion
Section 47 enquiries and core assessments
References
Practice guidance to help safeguard children with disabilities
Please note Local LSCB’s must refer to their own guidance in the first instance, the following is intended as additional helpful information.
Disabled children have exactly the same human rights to be safe from abuse and neglect, to be protected from harm and achieve the Every Child Matters outcomes as non-disabled children. This practice guidance aims to ensure that all agencies are assisted in their responsibilities to:
- safeguard disabled children and young people
- apply the LSCB Child Protection Procedures to disabled children as to nondisabled children
- understand particular issues which influence the safety and welfare of disabled children and young people
- communicate directly with disabled children and young people whose safety and welfare is the subject of enquiries.
It should be read in conjunction with the section of these procedures in respect of managing individual cases which is compliant with Working Together: A guide to Interagency Working to Safeguard Children (2010)
Disabled children require additional action because they experience greater and created vulnerability as a result of negative attitudes about disabled children and unequal access to services and resources, and because they may have additional needs relating to physical, sensory, cognitive and/ or communication impairments. A failure to acknowledge and promote disabled children’s human rights can lead to abusive practices being seen as acceptable.
An inclusive safeguarding system will meet the needs of disabled children and improve practice for all children.
The Disability Discrimination Act 2005 (DDA) defines a disabled person as someone who has “a physical or mental impairment which has a substantial and long-term adverse effect on his or her ability to carry out normal day-to-day activities.”
‘substantial’ means ‘more than minor or trivial’ and ‘long-term’ means that it ‘has lasted or is likely to last more than a year’.
Children with speech, language and communication needs include those who use non-verbal means of communication as well as a wider group of children who have difficulties in communicating with others.
Differences in the use of terminology may result in a loss of focus on the welfare of the child. The key issue is the impact of abuse or neglect on a child’s health and development, and consideration of how best to safeguard and promote the child’s welfare.
Everyone has the right to determine how they want to describe themselves.
Legislation, research and guidance
The Disability Discrimination Act 1995 made it unlawful for service providers to treat disabled people less favourably for reasons related to their disability and introduced the concept of reasonable adjustments. This legislation is the basis for all agencies having to ensure that their practice offers the same level of safeguarding to disabled as to non-disabled children.
The Disability Discrimination Act 2005 went further and required public bodies to promote disability equality.
In Spring 2008 the DCSF published new guidance to help schools tackle the bullying of disabled children and children with special educational needs.
The Treasury/DfES Policy Review of Children and Young People (2007) found that disabled children are likely to have poorer outcomes across a range of indicators compared to their non-disabled peers, including lower educational attainment, poorer access to health services, poorer health outcomes and more difficult transitions to adulthood. In addition the review noted that disabled children are more likely to suffer from family break up and are significantly over represented in the populations of looked after children and young offenders.
Research has shown that families with disabled children are more likely to experience poverty than those where there is no disabled child. In addition pupils with Special Educational Needs (SEN) are more likely to be excluded from school, and 70% of all permanent exclusions are of pupils with SEN, far in excess of their proportionate presence in schools
The Aiming High for Disabled Children Core Offer (2008) sets out the standards which families with disabled children can expect from local services, including: information and transparency, assessment, participation and feedback.
The potential risks to the safeguarding of disabled children, especially those with complex health care needs, where unqualified/untrained carers are employed in the home (using Direct Payments or Personal Budgets) must be taken seriously.
Awareness
Disabled children are more vulnerable to abuse than non-disabled children, and safeguarding disabled children’s welfare is everybody’s responsibility,
Reasons why disabled children are more vulnerable to abuse
- Children are dependant on others for intimate care, which is often carried out by a number of carers in different settings
- Mistaken attitudes and assumptions within society and amongst those working with children can lead to a view that abuse does not happen to disabled children
- Dependency on a wide network of carers and other adults
- Communication barriers mean that many disabled children including deaf children have difficulty reporting worries, concerns or abuse.
- Lack of participation and choice in decision-making
- Factors associated with impairments can lead to greater vulnerability to abuse.
- Isolation from other children and adults
- Double discrimination faces many disabled children from black and minority ethnic groups and refugee and asylum seeking children.
- Spending greater periods of time away from home, particularly in residential settings,
- Lack of understanding and training about safeguarding disabled children can result in professionals not recognising the signs of abuse or neglect.
- Limited personal safety programmes and personal, social and sex education for disabled young people
- Higher levels of bullying of disabled children Guidance on Bullying involving Children with Special Educational Needs and Disabilities notes that disabled children may be more at risk of bullying because of their impairment (for example, they may be less able to move away or they may have cognitive impairments which make anticipation and avoidance difficult.
Prevalence of abuse
A large scale American study in 2000 found that disabled children were 3 times more likely to be abused or neglected than non-disabled children.
Overall, it concluded that 31% of disabled children had been abused, compared to a prevalence rate of 9% among the nondisabled child population. A number of studies in the UK have indicated similar levels of abuse and neglect to that found in the US.
The Children in Need Census (2005) illustrates that disabled children are over represented among the looked after population, making up 10% of all children in care, and only around 5% of the overall population.
A study for the DCSF estimated that 13,300 disabled children in England are in long term residential placements in education, social care and health settings and an additional group of about 900 disabled children living in foster care.
Indicators
All professionals who work with disabled children should be alert to the indicators of abuse or neglect, for example:
- A bruise in a site that might not be of concern on an ambulant child, such as the shin, might be of concern on a non-mobile child
- Not getting enough help with feeding leading to malnourishment
- Poor toileting arrangements
- Lack of stimulation
- Unjustified and/or excessive use of restraint
- Rough handling, extreme behaviour modification e.g. deprivation of liquid, medication, food or clothing
- Unwillingness to try to learn a child’s means of communication
- Ill-fitting equipment e.g. calipers, sleep boards, inappropriate splinting
- Misappropriation of a child’s finances (for example disability living allowance)
- Invasive procedures which are unnecessary, or are, carried out against the child’s will
- Changes in the pattern of the child’s behaviour
Risk of discrimination against children with disabilities
Disabled children experience greater and created vulnerability as a result of negative attitudes and unequal access to services and resources and because they may have additional needs relating to physical, sensory, cognitive and/ or communication impairments.
Professionals should be aware of the following potential risks in assessing indicators of abuse or neglect:
- Over identifying with the child’s parents/carers and being reluctant to accept that abuse or neglect is taking or has taken place, or seeing it as being attributable to the stress and difficulties of caring for a disabled child
- A lack of knowledge about the impact of disability on the child
- A lack of knowledge about the child, e.g. not knowing the child’s usual behaviour
- Not being able to understand the child’s method of communication
- Confusing behaviours that may indicate the child is being abused with those associated with the child’s disability
- Denial of the child’s sexuality
- Behaviour, including sexually harmful behaviour or self-injury, may be indicative of abuse
- Being aware that certain health/medical complications may influence the way symptoms present or are interpreted. For example some particular conditions cause spontaneous bruising or fragile bones, causing fractures to be more frequent.
Referral and assessment
Where a professional has concerns that a disabled child may be being abused or neglected, they should follow internal and LSCB policy and procedures for making a safeguarding referral to children’s social care or the police.
Extra resources may be necessary, especially where a child has speech, language and communication needs, in order to ensure that an appropriate assessment can be undertaken.
Additional input may be required from those professionals who have knowledge and expertise of working with disabled children as well as child protection.
Independent advocates provide independent and confidential information, advice, representation and support and can play a vital role in ensuring children have appropriate information and support to communicate their wishes and feelings in a range of settings including child protection conferences.
It will be important to collate medical information and also to gain an accurate assessment of a child’s understanding and language abilities from their parent, teacher and speech and language therapist and then take advice on communicating or working with the assistance of someone who knows the child well.
- What is the disability, special need or impairment that affects the child? Ask for a description of the disability or impairment: for example, ‘learning disability’ could mean many things and does not tell you much about the child or their needs
- If you do not know how to spell a word that describes an impairment or condition ask how it is spelt. This will be important if further enquiries are required about how the condition might be expected to affect the child
- How does the disability or impairment affect the child on a day-to-day basis?
- How does the child communicate? If someone says the child can’t communicate, simply ask the question:“How does the child indicate s/he wants something?”
- How does s/he show s/he is happy or unhappy?
- Has the disability or condition been medically assessed/diagnosed?
A very useful question to ask when assessing a disabled child is:
“Would I consider that option if the child were not disabled? Clear reasons are necessary if the answer is No.” (Assessing Children in Need and their Families: Practice Guidance, Department of Health, 2000 p.80)
Strategy discussion
Consideration should be given to appointing a support social worker to cover any complex issues relating to a disability (e.g. communication aids/ interpreter for interview). Several strategy meetings may be required to plan the appropriate way of interviewing the child. Expertise from professionals, family members or friends who know the child well may be necessary, or outside experts may be required. The child may require a chosen advocate to support them through the investigation. If a facilitator or interpreter is required, s/he should be involved from the outset when planning an investigation.
Section 47 enquiries and core assessments
The disabled child’s preferred communication method for understanding and expressing themselves needs to be given the utmost priority, and where a child has speech, language and communication needs, including those with non verbal means of communication and deaf children, arrangements will need to be made to ensure that the child can communicate about any abuse or neglect she/he is experiencing and their views and feelings can be made obtained.
Where the parents of a disabled child have a disability themselves, arrangements also need to be put in place to accommodate their needs throughout the investigation/assessment process.
The number of carers involved with the child should be established as well as where the care is provided and when. A disabled child’s network of carers could include short break foster carers, volunteer befrienders, sitters, personal assistants, community support workers, residential care staff, independent visitors and learning support assistants.
The most appropriate medical professional for any examination, the venue, timing and the child’s ability to understand the medical procedure must be carefully considered.
Any police investigation should be undertaken in accordance with Achieving Best Evidence in Criminal Proceedings: Guidance on interviewing victims and witnesses and using special measures (Home Office 2007) available at http://www.cps.gov.uk/publications/docs/achieving_best_evidence_final.pdf
Following enquiries, the need for therapeutic services should be carefully considered.
References
More detailed guidance on safeguarding disabled children and young people including research and statistical evidence, legislation and guidance, and specialist resources and training can be found in Safeguarding Disabled children (DCSF June 2009). Click here to view.
