Safeguarding Disabled Children

Around 777,000 children in the UK are disabled, and evidence concerning disabled children suggests that they are at increased risk of abuse. Disabled children are:

• 3.4 times more likely to be abused;
• 3.8 times more likely to be neglected;
• 3.8 times more likely to be physically abused;
• 3.1 times more likely to be sexually abused;
• 3.9 times more likely to be emotionally abused.

Source: Charity for Disabled Children

A number of factors related to disability account for the fact that disabled children are at greater risk than other children, of all types of abuse from their direct caregivers or from professionals in institutions where care is provided (e.g. respite establishments or day care facilities):

• Child's need for practical assistance in daily living, including intimate personal care, from what may be a number of carers;
• Child has fewer outside contacts and increased likelihood of social isolation;
• Physical dependency with consequent reduction in ability to be able to resist abuse;
• Communication or learning difficulties preventing disclosure;
• Carers and staff lacking the ability to communicate adequately with the child;
• A lack of continuity in care leading to an increased risk that behavioural changes are unnoticed;
• Child/family compromised about making complaints for fear of losing services;
• Child is more vulnerable to bullying, intimidation abuse by peers;
• Child may not be believed when they report what has happened or may not be clear about what is/ not acceptable intervention by their carers.

Where there are any concerns about the safety and welfare of a disabled child these should be treated in the same way as any other child, with careful consideration of any additional needs.

Professionals must be watchful for institutional abuse. There have been enquiries into residential care offered to people with disabilities that identified well meaning but abusive behaviours for staff that have been institutionalised as a means of assisting staff in dealing with challenging and difficult behaviours.

Statutory and Voluntary providers of services must have:

• An explicit commitment to, understanding of disabled children's needs, safety and a culture of openness;
• Guidelines and training for staff on good practice in intimate care, working with children of the opposite sex, handling difficult behaviour, consent to treatment, anti-bullying strategies, sexuality and sexual behaviour among young people and the vulnerabilities of those living away from home;
• Have clear guidelines about the administration of drugs and medication;
• Providers and individual practitioners should always ensure that all disabled children are helped to:
• Make their wishes and feelings known in respect of their care and treatment;
• Receive appropriate personal, health and social education (including sex education);
• Know how to raise concerns, and give them access to range of adults with whom they can communicate;
• Promote safe practice in the transport of children and young people with disabilities.

A disabled child like any child is vulnerable to abuse. However, the research findings are that incidents of neglect, physical, sexual and emotional abuse are greater over the whole range of disability including physical disability, sensory impairment and learning disability. Hence when disabled children display behaviours that would cause concern in other children, it is important not to make assumptions about its connection with the disability.

Where a child is unable to tell someone of her/his abuse s/he may convey anxiety or distress in some other way, e.g. behaviour or symptoms. Carers and staff must be alert to this and be aware of the possibility that challenging behaviour may be caused by something more than disability.

The basic principles of communication are the same for any child. Communication can be direct, e.g. through speech, signing, writing, pointing or indirect through play, drawings, behaviour or expressions.

Where a disabled child has communication impairments or learning disabilities, special attention should be paid to communication needs, to ascertaining the child's perception of events, his or her wishes and feelings. Every effort should be taken to enable a child to communicate to their fullest ability including the need for an interpreter or someone skilled in using the child's preferred method of communication. Sometimes this will require someone who knows the child and their individual style of communication well.

Many disabled children will be known to specialist services, (e.g. health and education) and may already be receiving services not as a child in need. However, there will be children and families who have not previously accessed services but whose vulnerabilities and needs become more pressing as the child becomes older and/or their condition becomes more difficult to manage.

When plans are being made to undertake an assessment of a disabled child it is important to identify someone who can communicate with the specific child to ensure that their wishes and feelings are heard. For those who cannot communicate we need to ensure that key staff record any changes in behaviour or demeanour.

The Early Help Assessment may be used by any agency as a means of working with the child, family and other service providers to identify and meet needs which could enable the child t achieve a satisfactory level of health and/or development.

Some disabled children will have more complex needs. Children who are unlikely to reach or maintain satisfactory level of health or development are entitled to receive services as a child in need.

Children's Social Care will carry out a Child's Assessment to determine whether the child is in need, and the nature of any services required.

If at any point a practitioner becomes concerned that a disabled child is suffering or likely to suffer Significant Harm they should consult with their Designated Senior Manager and make a referral to Children's Social Care – for more information, see Referring Safeguarding Concerns about Children Procedure.

Expertise in both safeguarding children and promoting the welfare of the disabled children must be brought together to ensure that disabled children receive the same levels of protection from harm as any other children.

Possible indicators of abuse or significant harm may prove difficult to separate from the effects of child's impairment, therefore a multi-disciplinary approach involving all practitioners who work with the child is essential.

It is usual for a practitioner from the Children's Disability Team to take a lead in any Section 47 Enquiry involving a child already known to them. Where the child is not known to the disabled children's team, case management rests with the relevant locality team unless a decision is made to transfer the case to the Children's Disability Team.

Where the concern is about abuse or neglect within the child's home all other children in the household should also be subject to enquiry in the normal way. Sometimes the locality team social worker will undertake the enquiry about all of the children, though they will need to liaise closely with other practitioners involved with the family. Usually the needs of the family will be better met with the specialist worker and a locality team social worker, undertaking the enquiry together.

There may be an increased role for practitioners from the disabled children's service, health and education services because of their relationship with a child and/or family.

The nominated health practitioner may be able to provide useful information prior to any investigation and other key practitioners who are familiar with the child's disability and communications method may be able to assist, directly or indirectly, with the Section 47 Enquiry.

Where there are concerns that a disabled child may be or is likely to suffer significant harm the Team manager will convene a Strategy Discussion/Meeting in consultation with the Team Manager and other relevant practitioners.

In addition to considering the threshold for Section 47 Enquiries, a strategy discussion may also look at appropriate multi-agency interventions early in the process and seek to minimise risk.

The strategy discussion/meeting for disabled children in addition to points in the Referring Safeguarding Concerns about Children Procedure should give particular consideration to:

• Ensure that there is sufficient information about the impact and the context of the specific disability on the child;
• Enabling the child to communicate effectively, sometimes this will require someone who knows the child and their individual style of communication. They can advise whether the usual method of communication can be used;
• Whether specific specialist advice should be sought, who should undertake the investigation, where and how it will take place.

Agencies should not make assumptions about the ability of a disabled child to give credible evidence, or to withstand the rigours of the court process. Each child should be assessed carefully and be helped and supported to participate in the criminal justice process when this is in the child's best interest and the interests of justice.

In criminal proceedings witnesses aged under 17 are automatically eligible for assistance with giving their evidence. The special measures which may be provided include: screens around the witness box so they cannot see the defendant: DVD recorded 'evidence in chief', live DVD links so that they may not have to go into the courtroom at all, intermediaries and communication aids, to facilitate good communication. Achieving Best Evidence in Criminal Proceedings Guidance on interviewing victims and witnesses, and guidance on using special measures (Ministry of Justice) - includes comprehensive guidance on planning and conducting interviews with children and a specific section about interviewing disabled children.