Abuse of Disabled Children
As agreed by LSCB: June 2015
Update required: June 2016
Abuse of Disabled Children
Key Points
It should be remembered that disabled children are children first and foremost, and 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 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.
The increased vulnerability for disabled children arises from a number of factors, which
include the following:
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They tend to have fewer contacts with other people than other children
They receive intimate personal care often from 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
They have an impaired capacity to resist or avoid abuse
They may have communication difficulties and have greater dependency on adults
which make it difficult for them to tell others what is happening
They may be inhibited from complaining through a fear of losing services
They may be isolated from their families by virtue of respite care or residential
placement which may make disclosure of abuse more problematic
They may lack sex education or understanding which can increase vulnerability
They are especially vulnerable to bullying and intimidation
Lack of recognition
There is a lack of recognition by many professionals and carers that disabled children are
abused or that, if they have been abused, they are badly affected and may benefit from
therapy.
Signs or symptoms of abuse may be ‘explained away’ as part of their normal behaviour.
For example, bruising could be said to be caused by a child’s tendency to fall or sexualised
behaviour may be put down to impairment. It is important therefore to check out all these
explanations and not accept them at face value. It will be helpful to check out whether the
child’s behaviour is consistent with all carers.
Society may see disabled children as having less value and attribute to these children an
inability to make their own decisions, a lack of capacity to be affected by abuse or an inability
to fully comprehend their circumstances.
Consequences
Some children will have become disabled because of abuse perpetrated on them.
An abusive environment may reduce an individual’s ability to maximise their potential.
In addition, abuse may have a much more profound effect on a child whose self-esteem is
already low as a result of attitudes towards their disability.
Communication
Disabled children may have limited verbal skills. This can make a direct disclosure of abuse
less likely.
Disabled children are often not taught words, signs or symbols for intimate parts of their
bodies or for sexual behaviour.
Lack of specialist communication skills can hamper enquiries and specialised workers will
need to be engaged.
Some children may develop their own means of communication, the interpretation of which
requires specialist knowledge of the child and therefore, this limits those from whom the child
can seek assistance.
Assumptions must not be made about the inability of a child with disabilities to give credible
evidence or to withstand the rigours of the court process.
In planning an interview with a child with disabilities, workers need to take account of how a
child communicates. It will often be appropriate to involve other professionals with skills in
particular modes of communication. However, it should always be the social worker
conducting the interview who takes the lead in the interview process.
Over-reliance on the facilitator should be discouraged, as is communicating with the
facilitator about the child. All children communicate the onus is on the interviewer to
understand and use the child’s own method or system of communication
Relationships and sexuality
Disabled children are often seen as having no sexual identity and their sexual feelings are
often not acknowledged.
Sexualised and/or disturbed behaviour is frequently accepted as part of a child’s disability
without further thought or questioning.
They may not be taught about appropriate relationships, and therefore may be more easily
exploited.
Limitations of personal choice
Disabled children are accustomed to being directed. They are rarely offered choices or
provided with enough information to make a choice. This may mean they are less able to
recognise and withdraw from abusive situations.
Where a child with a disability requires intimate care, which may often be undertaken by a
number of different carers, it may be difficult for a child to distinguish between appropriate
and non-appropriate touching and their right of choice about who carries out such care.
This may also be true for children who have experienced a high level of medical
interventions and treatment.
Signs and symptoms
Disabled children will usually display the same signs and symptoms of abuse as other
children. However these may be incorrectly attributed to the child’s disability.
All people who work with disabled children will need to be alert to the possibility of abuse
and seek advice from appropriately trained professionals, e.g. community paediatricians;
social workers, nurses and teachers specialising in disability, if they are concerned that a
child may have been abused.
Safeguards for Disabled Children
All agencies should pay particular attention to promoting a high level of awareness of the
risks to disabled children and high standards of practice. For example, it should be common
practice to help disabled children to make their wishes and feelings known in respect of their
care and treatment and ensure they know how to raise concerns if they are worried or angry
about something.
There should be an explicit commitment to and understanding of all children’s safety and
welfare among providers of services used by disabled children.
Referrals concerning disabled children
Where there are concerns about significant harm to a disabled child, a referral hould be
made.
In addition to the details required for all referrals, further information must be provided on:
The nature and degree of disability and the effects on the child;
The level and degree of the child’s ability to communicate and methods used;
The level of the child’s comprehension and concentration span;
Any network of support provided to the family (including details of any respite care).
The Assessment must focus on the child rather than the impairment. There is a danger that
the needs of the parents take priority and a ‘Care package’ is the outcome rather than a
Child Protection Plan.
Workers must ensure that, whatever the difficulties, the child has an opportunity to be heard.
See ‘Communication’ above.