4. Why disabled children and young people may be at greater risk
Disabled children are at greater risk of harm partly from the effects of their disability and their environment; partly because of the response of practitioners.
The list below details some of the risks from the effects of their disability and environment - it is by no means exhaustive and is supported by additional reading and resources identified in Appendix 2.
- Many disabled children are at increased likelihood of being socially isolated with fewer outside contacts than non-disabled children. They may particularly lack the support of peers in whom they can confide.
- They may not know they are being abused or neglected because they lack the life experience to make that judgement.
- Their dependency on parents, carers and service providers for practical assistance in daily living, including intimate personal care, increases their risk of exposure to abusive behaviour.
- They may be reluctant to share worries or concerns, for fear of getting familiar adults into trouble, or may not have access to someone they can trust to disclose that they have been abused.
- There may be established practices within the family which minimise or hide risk factors or actual abuse.
- They may have an impaired capacity to resist or avoid abuse.
- They may have speech, language and communication needs which may make it difficult to tell others what is happening.
- They are especially vulnerable to bullying and intimidation.
- Looked after disabled children are also vulnerable to the same issues that exist for all children living away from home e.g foster/kinship care. They are particularly susceptible to abuse due to their additional dependency on residential and hospital staff for their day to day physical and other care and support needs as they may not have the vigilance of family members to be alert to such abuse.
- They may lack self-worth and feel that the abuse is their fault, even be desensitised to abuse.
- They are less likely to know about/understand their rights.
- There is an even greater power imbalance between disabled children and other non-disabled children and adults.
- They are less likely to have had sex education.
- They may not have the communication aids which allow them to describe body parts and abuse.
- They may have less choice, be used to obeying/complying to survive, lack belief they can control things in their lives.
The response of practitioners can also contribute to the vulnerability of disabled children in respect of the risk of abuse and harm. Practitioners from all agencies/disciplines must be aware of the values, attitudes and beliefs that lead to denial or minimisation of the impact of abuse and neglect in relation to a disabled child, as this can lead to a failure to respond and/or report abuse or neglect.
Practitioners may find it more difficult to attribute indicators of abuse or neglect, or may be reluctant to act on concerns in relation to disabled children due to a number of factors which they may not be consciously aware of.
These could include:
- The belief that disabled children are not abused; or are not at risk of certain types of abuse and harm i.e. child sexual exploitation; cyberbullying; forced marriage.
- Assuming that an investigation cannot take place without a disclosure of abuse.
- Beliefs that minimise the impact of abuse on disabled children, e.g. that due to their impairment they are less likely to remember or be adversely affected by an abusive incident.
- Workers feeling overwhelmed by the child's disability.
- A lack of knowledge about the child, e.g. not knowing the child's usual behaviour or the impact of disability on the child.
- Not being able to understand the child's method of communication, therefore not seeking their views.
- Assumptions being made about the impairment rather than the needs of and risks to the child i.e. accepting a parent or carers explanation that an injury or behaviour is the result of the impairment rather than considering other possible causes.
- Being uncomfortable with or in denial of the child's stages of sexual development and sexuality.
- Lack of understanding of a disabled child's health care needs. Medication being delayed by one hour can cause significant risk of life threatening seizures which is not the case with typically developing children.
- Not considering behaviour, including harmful sexual behaviour or self-injury, which may be indicative of abuse.
- Not being aware of how certain health/medical complications may influence the way symptoms present or are interpreted i.e. some conditions cause spontaneous bruising or fragile bones potentially resulting in more frequent fractures.
- Assessments which focus on needs relating to impairment rather than general wellbeing.
- A lack of time for thorough assessment which considers family history, chronologies, concerns about or actual harm to other children within the family group.
- Making assumptions that disabled children who can communicate will disclose abuse - an assumption not made for other children.
- Not being alert to the possibility of abuse by professionals caring for disabled children
Email: Sandra Aitken