Contents

1. The Child
2. The Safeguards
3. Actions
4. Communication

1.  The Child

Disabled children 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.  Disabled children have the same rights to protection as any other child.  People caring for and working with disabled children need to be alert to the signs and symptoms of abuse.

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

Disabled children 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
• Some sex offenders may target disabled children in the belief that they are less likely to be detected
• Over-identification with the needs of parents/carers that can lead to a professional reluctance to make judgements about concerning aspects of parenting

In addition to the universal indicators of abuse/neglect listed in Definition and Recognition of Abuse and Neglect Procedure, the following abusive behaviours must be considered:

• Force feeding
• Unjustified or excessive physical restraint
• Rough handling
• Behaviour modification techniques which include the deprivation of liquid, medication, food or clothing
• Misuse of medication, sedation, heavy tranquillisation
• Invasive procedures against the child’s will where the child is competent
• Failure to attend medical appointments and/or follow medically recommended treatment programmes where the child suffers harm as a result
• Misapplication 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 disabled children 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. 

It is important to acknowledge the difficulties for parents/carers in caring for a child who is disabled and provide adequate support; however, it is essential to maintain a focus on the child need for adequate care and protection.

LSCB partner agencies should:

• Make it common practice to enable disabled children 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 disabled children
• Make sure that all disabled children 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 disabled children’s 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.  Actions

Concerns about the welfare of a disabled child should be acted upon at an early stage in the same way as any other child under the Common Assessment Framework process and, in appropriate cases, under the Referrals Procedure.

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 disabled children receive the same levels of protection from harm as other children.  A protocol is being developed in Shropshire in relation to the Initial Assessment Teams and Children with Disabilities Team working together on child protection cases.

4.  Communication

Please see Work in Child Protection with Deaf Children or Children who Communicate in other ways, and their Families Guidance

Throughout the Initial Assessment, Core Assessment and Section 47 Enquiry, all service providers must ensure that they communicate clearly with the disabled child and the family and with one another as there is likely to be a greater number of services and staff involved than for a non disabled child. All steps must be taken to avoid confusion so that the welfare and protection of the child remains the focus.

Where there are communication impairments or learning difficulties, particular attention should be paid to the communications needs of the child to ascertain the child’s perception of events and his or her wishes and feelings.  The practitioners should be aware of the additional vulnerability of disabled children during the enquiries that are being undertaken.  To facilitate communication with the child, consideration should be given to seeking advice from those professionals who work with the child and have an understanding of their communication needs.  Workers should be sensitive to the child’s embarrassment where those who know well or see on a regular basis are present when they are asked about intimate details of abuse.

Children and Young People’s Services 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 disabled child 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 court proceedings, whether criminal or otherwise, when this is in their interests as set out in Achieving Best Evidence which includes comprehensive guidance on planning and conducting interviews with children and a specific section about interviewing disabled children. 

Participation in all forms of meetings such as Child Protection Conferences and Core Groups must be encouraged and facilitated and take into account any issues about access.

The full range of service providers and carers must be represented at all meetings.

End