4.15 Disabled Children

Contents

1. The Child
2. The Safeguards
3. Concerns
4. Communications

1. The Child

It should be remembered that children with disabilities are children first and foremost, and have the same rights to protection as any other child.  People caring for and working with children with disabilities need to be alert to the signs and symptoms of abuse.

Children with disabilities must be responded to as individuals with their own specific needs, feelings, thoughts and opinions. 

Children with disabilities are particularly vulnerable and at greater risk of all forms of abuse, including abuse whilst being cared for in institutions.  The presence of multiple disabilities increases the risk of both Abuse and Neglect. Yet they are under represented in the Child Protection System.

Children with disabilities may be especially vulnerable to abuse for a number of reasons:

• An increased likelihood that the child is socially isolated with fewer outside contacts than other children
• A need for practical assistance in daily living, including intimate care from what may be a number of carers, which may increase the risk of exposure to abusive behaviour and make it more difficult to set and maintain physical boundaries
• Physical dependency with consequent reduction in ability to be able to resist or avoid abuse
• Communication or learning difficulties preventing disclosure or making disclosure more difficult
• 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 may go unnoticed
• Lack of access to ‘keep safe’ strategies available to others
• Parents’/carers’ own needs and ways of coping may conflict with the needs of the child
• The child/carers being inhibited about complaining for fear of losing services
• The child being especially vulnerable to bullying, intimidation or abuse by their peers – see also Bullying Guidance
• Some sex offenders may target children with disabilities in the belief that they are less likely to be detected.

In addition to the universal indicators of abuse/Neglect listed in the Recognition of Significant Harm - Definitions and Signs of Abuse Guidance, the following abusive behaviours must be considered:

• Force feeding
• Unjustified or excessive physical restraint
• Rough handling
• Extreme behaviour modification including the deprivation of liquid, medication, food or clothing
• Misuse of medication, sedation, heavy tranquillisation
• Invasive procedures against the child’s will
• Deliberate failure to follow medically recommended regimes
• Mis-application of programmes or regimes
• Ill-fitting equipment e.g. callipers, sleep boards which may cause injury or pain, inappropriate splinting
• Misappropriation/misuse of a child’s finances

Where a child is unable to tell someone of the abuse, they may convey anxiety or distress in some other way, e.g. behaviour or symptoms and carers and staff must be alert to this.

2. The Safeguards

Safeguards for children with disabilities are essentially the same as all other children.  Particular attention should be paid to promoting a high level of awareness of the risks of harm and to high standards of practice, and strengthening the ability of children and families to help themselves.

Measures should:

• Make it common practice to enable children with disabilities to make their wishes and feelings known in respect of their care and treatment
• Ensure that appropriate personal, health and social education (including sex education) is provided to all children with disabilities
• Make sure that all children with disabilities know how to raise concerns and give them access to a range of adults with whom they can communicate
• Ensure that there is an explicit  commitment to and understanding of children with disabilities’ safety and welfare among all service providers
• Ensure close contact with families and a culture of openness on the part of services
• Provide 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; and sexuality and sexual behaviour among young people, especially those living away from home.

3. Concerns

Concerns about the welfare of a Disabled Child should be acted upon in the same way as any other child in accordance with Part 3 of the Manual.

Expertise and resources in both safeguarding and promoting the welfare of children and in working with disability have to be brought together to ensure that children with disabilities receive the same levels of protection from harm as other children.

4. Communications

Throughout the Initial Assessment, Core Assessment and Child Protection Assessment, all service providers must ensure that they communicate clearly with a child with disabilities, the family and with one another as there is likely to be a greater number of services and staff involved than for a child who has no disabilities. All steps must be taken to avoid confusion so that the welfare and protection of the child remains the focus. This takes time and may be difficult to fit into prescribed timescales.

Where there are communication impairments or learning difficulties, particular attention should be paid to the communication needs of the child to ascertain the child’s perception of events and his or her wishes and feelings.

Children, Young People and Families and the Police should be aware of non-verbal communication systems and should know how to contact suitable interpreters and facilitators.

Agencies must not make assumptions about the inability of a child with disabilities to give credible evidence, or to withstand the rigours of the court process.

Each child should be assessed carefully and supported where relevant to participate in the criminal justice system when this is in their interests as set out in the Achieving Best Evidence Guidance which includes comprehensive guidance on planning and conducting interviews with children and a specific section about interviewing children with disabilities.

End