Safeguarding and Disability:
The national picture
Anne Patmore
Why a separate day?
Relationship between child abuse and disability is complex:

Child abuse can cause or contribute to disability

Disability can increase a child's vulnerability

A disabled child may have:




A different method of communication
Differences in physical experiences
Different life experience
Differences in learning and knowledge
The Social Model of Disability
‘redefines disability as the disadvantage or
restriction of activity caused by society which
takes little or no account of people who have
impairments and thus excludes them from
mainstream activity’
A Jigsaw of Services DoH 2000
Why is the social model
important in protecting disabled
children?
 Emphasises
their right to be protected
from harm
 Ensures the child is not seen as the cause
of their own abuse
 Challenges the ‘feel sorry for factor’disability is not a tragedy
Medical
(individual)
model
Welfare
model
Social
Model
Rights
Model
“For children and young people who are both
black and disabled, the experience of
discrimination on the basis of their disability
is compounded by the effects of racism.
Despite this, many black and disabled
children find that only one aspect of their
experience is addressed at any one time.”
Framework for the Assessment of Children in Need and
Their Families – Practice Guidance (DoH, 2000)
DISABLED
CHILD
BLACK
CHILD
CHILD
CHILD
Kennedy & Wonnacott, 2000
DISABLING BARRIERS
Disabling barriers create barriers
… to a fulfilling and positive
life
Euthanasia / termination of pregnancy
life itself
Denial of sufficient resources leading to
poverty / hardship
health and development
Discriminatory and prejudicial practice
leading to oppression
self-esteem, confidence,
emotional and psychological wellbeing
Degrading and humiliating treatment
human rights
Lack of research on disabled children’s
experiences of abuse
safety and protection
Language of ‘care’ gives image of
‘burden’
empowerment / independence
Maltreatment of Disabled
Children
Likelihood of maltreatment of disabled children
compared to non-disabled children, by type of
maltreatment
Type of Maltreatment
Sullivan & Knutson
Maltreatment and Disabilities: A School-based
Epidemiological Study 1999
Neglect
3.8 times as likely
Sexual Abuse
3.1 times as likely
Physical Abuse
3.8 times as likely
Emotional Maltreatment
3.9 times as likely
THE DEPENDENCY – STRESS
MODEL OF ABUSE
Caregiver stress
Dependency
Abuse
Family
Stress
Reduction
Impairment
This model assumes that abuse occurs as an outlet
for increased family stress associated with the
abused individual’s disability and the family’s limited
resources
Sobsey, D Violence & Abuse in the Lives of People with
Disability – The End of Silent Acceptance? Paul Brookes
Publishing 1994
Poor /
inadequate
services and
support
Poor child care as
a result of
inadequate service
provision
Caregiver
Stress
Poor / negligent
care given to
disabled child
‘Good relationship
of care’
Abuse and Neglect as the Result of Adverse
Family Conditions Despite Adequate services
Adverse conditions
in families
• parental mental ill health
• substance misuse
• domestic violence
• problematic relationships
Adequate
Service
provision
Caregiver
Feels stress
The professional
network
Disabled child seen
as cause of stress
and scapegoated,
leading to abuse
and neglect
Do we understand the way in
which abuse for disabled
children may involve practices
which would not affect nondisabled children?
Practices which harm disabled
children:
 Parents who will not allow equipment the child
might need, rejection of household adaptations,
‘rejection of markers’
 Body integrity compromised
 Denial of treatments / alternative regimes
 Verbal abuse / degrading comments
 Threats of abandonment / exclusion
Is there a different
threshold for
intervention where
disabled children are
concerned?
The Integrated
Ecological Model of
Abuse
Culture
Environment
Relationship
Potential
Offender
Potential
Victim
Provides support and
rationale for power
inequities and abuse
Sobsey, D Violence & Abuse in the Lives of People with
Disability – The End of Silent Acceptance?
Paul Brookes Publishing 1994
Relationships:

Likely to be in contact with a larger number of
service providers and are likely to receive
intimate care from a larger number of people

More likely to be away from their families
Three times as many disabled children as non-disabled children
attend residential educational establishments (Utting 1997)
Disabled children are 8 times more likely to be living away from
their families (Utting 1997)

The more complex or severe the impairment,
the more likely the child is to be cared for
outside the family home
…
Relationships:

Low self worth may lead to a desire to please
Disabled children often do not have access to
someone they can trust to disclose that they
have been abused
 There is a common failure to consult with and
listen to disabled children about their
experiences – children may not tell about
abuse if they are not used to being listened to

Service provision:

Poor service provision may lead to social
isolation, disabled children have fewer outside
contacts than non-disabled children

When the organisation of service systems fails
to take account of the additional needs of
disabled children
e.g.



lack of independent visitors/advocates for disabled children
environments that lack stimulation or access to the ‘real’ world
long waiting lists for essential equipment ..
Service provision:
 Focus
on disability masking child
protection issues e.g.
- services
to address disability needs but not
assessing wider needs of the child and family and
missing child protection concerns
- workers not sufficiently experienced and
knowledgeable about child protection issues
- failure to recognise the increased vulnerability of
disabled children, for example to child sexual abuse
Culture:

Offenders will think it is safer to victimise a
disabled child

Society gives permission to abuse
May be overt, e.g. difference in law with regard to
termination of pregnancy
Or covert, e.g. limitation of services, including those which
impact on quality and length of life

Failure to acknowledge and promote disabled
children’s human rights means that abusive
practices are seen as acceptable
Bullying:

82% of children and young people with a learning
disability have experienced bullying

They are twice as likely to be bullied as other
children
8 out of 10 children and young people with a learning
disability who have been bullied had experienced bullying
at school
5 out of 10 children with a learning disability had been bullied
in more than one place
Children with a learning disability already face barriers
in accessing education and leisure opportunities –
bullying compounds this, preventing them from
living full and happy lives.
Don’t Stick It, Stop It -- Bullying Wrecks Lives, Mencap
Targeted violence and hostility has wide-ranging
impacts on the lives of disabled people
It can:
lead to a deterioration of disabled people’s physical
and mental well-being

cause disabled victims to restructure the way their
lives are lived on a day-to-day basis so as to minimise
the risk of repeated experiences

These impacts infringe on disabled people’s ability to
exert full control over their lives and minimise the lifestyle
choices available to them.
‘I tend to stick to myself – I’m worried about people taking advantage
of me. People used to talk past me and try to hit me and call me an
idiot at school and outside of school – it’s hard to trust people.’
Disabled people’s experiences of targeted violence and hostility (2009)
Equality and Human Rights Commission. Research Report 21
Housing:

Families with a disabled child have a different tenure
profile to families with non-disabled children:




More likely to be renting their home than families with nondisabled children
Less likely to be living in a decent home compared to families
with non-disabled children, on all measures of house
condition, they emerge as more disadvantaged than families
with non-disabled children
50% more likely to live in overcrowded accommodation
Disabled children appear to be disadvantaged
compared to other groups of disabled people. Among
those needing specially adapted housing, they are
least likely to be living in suitable housing compared to
all other age groups of disabled people
Disabled children experience a multiplicity of
difficulties within their home, with a key and universal
difficulty of lack of space

The research evidence is that living in unsuitable
housing has an adverse impact on the physical and
emotional well-being on all family members

“Within 24 hours of being in this house, it was like
WOW! She was a different child. Her confidence
increased overnight. I can’t describe to you the
difference in Debbie.”
Complex inter-relationship between
poverty and disability:
23% going without heating
73% going without leisure and
days out
14% going without food
34% have fallen behind with
repayments, mostly for credit
cards or loans
51% have borrowed from family or
friends to keep financially afloat
or pay for essentials
42% have applied for a charity
grant
Almost 90% said that financial
worries had a detrimental
impact on their family life.
“I do not know how to describe
the hell that is imposed on us as
a family due to financial worries.
It impacts on every single aspect
of our lives.”
“When the children have gone to
bed, I turn off all the lights to
save electric.”
“Our debt frightens me, it is a
constant source of stress and
anxiety, it makes me feel ill, and
of course the creditors are not
willing to listen, they just want
money, whether you can afford
the repayments or not”.
Contact a Family Counting the Cost 2010
National Service Framework for children,
young people and Maternity services Standard 8:

‘Children and young people who are
disabled or who have complex health needs
receive coordinated, high-quality and
family-centred services which are based on
assessed needs, which promote social
inclusion, and, where possible, which
enable them and their families to live
ordinary lives’
Access to information and
services:
 Parents experiences of having to take a proactive role and in some cases ‘fight’ to
access services were felt to be timeconsuming and ‘stressful’ for parents, which
in certain cases was said to have led to
health problems.
 This was particularly emphasised during the
early stages of the process when parents
were often struggling to come to terms with
their child’s disability. ..
Parental experiences of services for disabled children (2009) DCSF
Information was often criticised for being too general
and confusing in terms of the complexity of the
language used and the format in which it was
presented

Professionals were not always as forthcoming as
they could be

parents’ experiences
of ‘gaps in information’ and uncertainty
in relation to specific issues such as the range of services and
support available, expectations for service delivery, and the
allocation of services
Parental involvement in decision-making about
treatment, care and support varies considerably across
the different sectors

 Awareness
of specific complaints procedures was
generally limited across all service areas
Parental experiences of services for disabled children (2009) DCSF
“They can’t offer you what you need, and they know that, so they offer you
something you don’t want and in the end you take it because they’re
desperate to help you. You take it even though it’s not what you need. You
feel you’ve been awkward if you don’t take it. You’re frightened they’ll put
down that you’ve been offered such and such and turned it down.”
“I can remember being mortified that I’d become the sort of person who
needed a social worker. I felt abandoned.”
“That I must be a bad mother to need a social worker.”
“One half term when I had no support for the week, I felt I had to force the
issue by ‘doing a bunk’ while my son was out with care workers. I rang the
social workers to say I would not be at home when they returned him. The
messages left for me were threatening, horrible – you must come back. It
was awful. My son went to a children’s home some distance away. No one
came to see me while my son was away to talk about why I had taken such
action.”
(All parents of a disabled child)
Family perspectives on safeguarding and on relationships with children’s services
The Children’s Commissioner for England. June 2010
Safeguards for disabled children are essentially the same as for nondisabled children
Particular attention should be paid to promoting a high level of
awareness of the risks of harm and high standards of practice, and
strengthening the capacity of children and families to help themselves.
Measures should include:
making it common practice to help disabled children make their
wishes and feelings known in respect of their care and treatment;

ensuring that disabled children receive appropriate personal, health,
and social education (including sex education);

making sure that all disabled children know how to raise concerns,
and giving them access to a range of adults with whom they can
communicate. Those disabled children with communication
impairments should have available to them at all times a means of
being heard …

an explicit commitment to, and understanding of disabled
children’s safety and welfare among providers of services used
by disabled children;

close contact with families, and a culture of openness on the
part of services;

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

guidelines and training for staff working with disabled children
aged 16 and over to ensure that decisions about disabled
children who lack capacity will be governed by the Mental Health
Capacity Act once they reach the age of 16.

Working Together to Safeguard Children (2010), para 6.45
Promoting resilience:




Secure base and a sense of belonging
Promoting self esteem and self efficacy
Positive school experience
Importance of spare time activities
…. for disabled children this means …
Secure base and a sense
of belonging:




Avoiding excessive respite care/hospital admissions
Increasing family-based care and placement
Addressing family dynamics rather than removing the
disabled child
Promoting disability awareness and a positive self
identity
Promoting self esteem and
self efficacy:



Being disabled is not a
negative concept
Positive expectation about
what the disabled child can
achieve - focus on what child
can do rather than what they
can’t do
Promoting independence,
choice and decision making
in all areas of the disabled
child’s life
Positive school experience:

Sensitivity to individual
disabled children’s
education needs

Tackling bullying of
disabled children within
school ..

Accessible school
facilities

Participation encouraged
in all activities, with
support to facilitate
participation if required
Importance of spare time
activities:

Offering the means to
enable disabled
children to associate
freely with their disabled
and non-disabled peers
e.g. accessible transport

Facilitating the inclusion
of disabled children in
clubs and leisure
activities that children
enjoy
Empowering disabled children:

Give choice wherever possible gives children the message they
have rights

Encourage them to ‘speak’ for
themselves and make decisions
about their care

Learn to interpret their clues and
gestures and messages they may
give through play

Give lots of praise and
encouragement - praise effort,
not just achievement
Would this be
acceptable
for a nondisabled
child?