Abuse of Disabled Children
SCOPE OF THIS CHAPTERFor additional guidance, please see Safeguarding Disabled Children: Practice Guidance (issued by the Government in July 2009)
The available UK evidence with regards to abuse among disabled children suggests that disabled children are at increased risk of abuse, and that the presence of multiple disabilities appears to increase the risk of both abuse and neglect. Disabled children may be especially vulnerable to abuse for a number of reasons. Some disabled children may:
- They are likely to be in contact with a larger number of service providers than non-disabled children and are likely to receive intimate care from a larger number of people;
- They are more likely to spend time away from their families than non-disabled children, in short-break services, residential schools and so on;
- Disabled children and their families may experience inadequate and poorly co-ordinated support services. This can lead to isolation which is widely recognised as a risk factor for abuse;
- Abusive practices can sometimes go unrecognised. This happens in two ways: firstly, sometimes a practice is applied to a disabled child which if applied to a non-disabled child would be recognised as abusive (such as tying a child up or locking a child in a room in order to control his behaviour); secondly, for some disabled children a failure to provide a certain level of care can result in significant damage to their development, health and well-being, yet this is not always recognised;
- Some disabled children may have an impaired capacity to resist or avoid abuse.
- Communication difficulties may make it difficult to tell others what is happening.
- They may be especially vulnerable to bullying and intimidation, and /or be more vulnerable than other children to abuse by their peers.
- Underpinning all the many other factors which create a vulnerability to abuse are negative social attitudes towards disabled children - their lives and their experiences are commonly devalued;
- Failure to acknowledge and promote disabled children's human rights means that abusive practices are seen as acceptable.
Research evidence, and the experience of safeguarding disabled children, indicates that a number of features are key if systems and processes are to effectively protect disabled children from harm. The following features identify the systems which LSCP expect to be in place across member agencies:
- Clarity of responsibility within children's social care for safeguarding and disabled children with regard to S 47 enquires
- Good communication and effective working relationships between and within agencies working with disabled children in particular effective information sharing protocols
- Those receiving initial contact queries concerning disabled children are aware of safeguarding issues for disabled children
- Practitioners receive basic and advanced training on safeguarding and disabled children
- Practitioners have an awareness of factors likely to be relevant in any situation where concerns have been raised about the welfare or safety of a disabled child
- Practitioners have access to specialist advice and support which can be called on when an assessment involves a disabled child. Resources (in the form of budgets, information and services) are available to meet the communication needs of disabled children
- There is a strong culture of consulting with and listening to disabled children amongst all services with whom they come into contact. All services make it easy for children to complain
- Parents are supported to provide the best care possible for their child
- There are good working and strategic relationships between children's and adults' services
- Services for disabled children have guidelines, and provide staff training, on safeguarding issues for disabled children. There are also clear guidelines on, and awareness of, safeguarding procedures
- Emergency placement are able to meet the needs of disabled children
- Adaptations to section 47 enquiries and police investigation procedures have been made in order to accommodate the specific needs and circumstances of disabled children
- Therapeutic services are available for disabled children and young people who have been abused
- There are clear procedures for specific circumstances where disabled children may be particularly vulnerable e.g. children in residential care
- There is consistent recording of disabled children and their needs at each stage of the safeguarding process
- Case audits are used to monitor whether procedures are working well and also to share skills and solve problems
- A strategic approach is taken to the provision of sex education and safeguarding work with disabled children and young people
Safeguards for disabled children are essentially the same as for non-disabled children. Those agencies and professionals providing services to disabled children should pay particular attention to promoting a high level of awareness of the risks and high standards of practice, and to strengthening the capacity of children and families to help themselves as highlighted above.
Where there are concerns about the welfare of a disabled child, they should be acted upon in accordance with the guidance in Being Alert Procedure in the same way as with any other child. The same thresholds for action apply. It is unacceptable for poor standards of care to be tolerated for disabled children which would not be tolerated for non-disabled children. At the point of referral, the professionals and agencies with knowledge of the child and family because of her or his disability should be sought.
The following points are important for those receiving initial queries and referrals concerning a disabled child:
- When, in children's social care, a query relates to a disabled child, do not assume that it should automatically be passed to the disabled children's team;
- As with non-disabled children it is not always obvious from the initial contact with children's social care that there is a safeguarding matter. Professionals, the family, the child or others may emphasise another type of need and the need for protection from harm may not always be obvious. The person receiving the query should seek information about what needs and circumstances have prompted the contact;
- When an initial contact is passed on or a referral is made to children's social care it will be important that those receiving it have clear information in order to understand the context of any concern. In addition to establishing all the usual information, the following questions should be asked when the contact or referral concerns a disabled child:
- What is the disability, special need or impairment that affects this 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, try asking "How does the child indicate s/he wants something?
Because of the additional issues involved in such cases, the strategy discussion (see Managing Individual Cases where there are concerns about a Child's safety and welfare: Introduction) should normally take the form of a meeting. As well as those who will be involved in carrying out further enquiries, it may be helpful to involve in the meeting, professionals who have a detailed knowledge of the child and/or expertise in the disability concerned and forms of communication, such as teachers or care staff.
In planning how enquiries should be handled, the strategy discussion should pay particular attention to the child's communication needs, arising from learning difficulties or other communication difficulties. Children's Social Care and the police will need to ascertain what kind of communication systems the child uses if non-verbal, and should access suitable interpreters or facilitators. Appropriate sources of help will include members of the Children's Children with Disabilities Team ( particularly if the child has an identified Lead Professional), staff in special schools, residential staff and members of child development teams. It is important not to underestimate the child's ability to communicate, or make assumptions that they will be unable to do so.
Information should be sought from a variety of sources, including looking back over case files held by different organisations.
Some sources of information can be underestimated within section 47 enquiries. They include:
- information from family/friends/carers;
- routine documentation from different agencies (school records, residential records, day logs, social work files, health records) which may assist in giving an understanding of effects upon the child and may record injuries or concerns not reported previously;
- previous allegations/complaints made by the child and/or about the alleged perpetrator should be accessed. These may be stored in different systems and not necessarily recorded as safeguarding concerns.
These sources may inform the strategy discussion and child protection conference but may also be seen as possible sources of evidence.
An investigative interview with a disabled child may not be appropriate in all circumstances but it should never be automatically ruled out. In interviewing children, every effort should be made to establish the child's view of events, and his or her wishes and feelings. Staff should be prepared to give more time than usual for the interview and where it is in the child's best interests, to carry this over more than one meeting.
Agencies should 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 helped and supported to participate in the criminal justice process when it is in the child's best interests and the interests of justice.
Clarity within the planning process should always ensure that consideration be given when conducting an interview, and that decisions are made in light of Achieving Best Evidence (ABE) Guidance. Records and strategy plans should detail these discussions and document clearly any decision taken. These records can then be reviewed if necessary, throughout the investigation process.
Methods of communication for an investigative interview should be considered where there are communication difficulties. The compatibility of methods with evidential rules should be established at the start of the investigation. Even if a formal interview within ABE guidelines is not possible, there is a value in communicating with the child in as evidentially safe a way as can be achieved.
If a formal investigative interview at one of the video suites is to be carried out (see Section 47 Enquiries and Social Work Assessments Procedure: Section 8: Seeing and Interviewing the Child) consideration will need to be given to access if the child has mobility problems. If the use of an interpreter or facilitator is being considered, this will need to be carefully planned and roles clarified. It may be appropriate to seek the advice of the CPS in these circumstances.
The outcome of a Section 47 enquiry can sometimes be absolute and clear that there is not a distinct protection issue. It may become apparent that injuries were 'accidental', signs and indicators were misinterpreted etc. However there are several other questions to answer following concerns being raised about a disabled child:
- Was the outcome due to insufficient evidence to reach the thresholds for action?
- What is it about the child's life and experiences that led to the concerns being raised?
- Can safeguards be developed to maximize the safety of the child?
- Is there an issue of poor supervision or neglect of the child through inadequate care which needs addressing, even though it does not reach the threshold of 'suffering significant harm'?
- Do workers and carers need closer supervision in how they provide care? Is training required?
- Do parents need more support to enable them to care for their child?
- Is there a need for greater communication and cooperation between different agencies involved with the child?
- Consideration for a multi-agency meeting under the TAC process should always be undertaken in partnership with the family.
Following S.47 enquiries, the disabled child, as with any other child, should have access to therapeutic services if these are assessed as being needed. The main agencies providing such therapeutic help in Lincolnshire are:
- CAMHS (Child and Adolescent Mental Health Services)
Good safeguarding training for disabled children's teams and service providers, and good disability equality and deaf awareness training for children and families teams will be key to effective safeguarding of disabled children. All those who come into contact with disabled children should have access to training on safeguarding children.
Additional guidance is available in Safeguarding Disabled Children: A Resource for Local Safeguarding Children Partnerships which is available on the Learing Exchange website.