8. Reporting and investigating child protection concerns
Where a practitioner has concerns that a disabled child may be being abused or neglected, they should follow their own agency and local child protection committee policy and procedures for passing on a concern to statutory child protection services. Concerns should be shared at the first opportunity either with an appropriate manager or with the designated member of staff who has responsibility for child protection in the agency/service provider, so that a referral can be made promptly.
Under GIRFEC, we all have a responsibility to pass on concerns if we have reason to believe that any child is at risk of, or has suffered significant harm because of, abuse and/or neglect. Local authorities have a duty to make initial enquiries and investigate child protection referrals. The Childrens Hearings (Scotland) Act 2011(section 37-54) sets out the duties and powers of local authorities where there is an immediate level of concern for a child.
Specific aspects to consider in making a child protection referral, or raising a concern, in respect of a disabled child may include the following. However, this should not prohibit a timeous referral to the local child protection team or service.
The referrer should:
- In line with any referral of a child protection concern, state specifically what the concern is, include recent changes in behaviour, responses to individuals in additional to other indicators of concerns or descriptions of incidents.
- State the child's diagnosis (if known), the main difficulties affecting day to day functioning and avoid describing solely in broad terms such as learning disability.
- State the child's medical conditions, associated treatments and how they are managed.
- Describe how the child communicates (thoughts, behaviours, feelings and wishes) and what aids to support communication are used, e.g. symbols/picture communication symbols, Makaton.
- Describe how the child expresses distress.
- In the absence of direct substantiation of a concern (e.g. a disclosure), state a hypothesis based on professional judgement (the person raising concern is likely to be someone who knows the child/family more than others so his/her judgement is valid).
- Detail the other agencies/services that are involved and what their specific role/ service is (e.g. support, respite care), including those supporting adult carers.
- Detail child's network - family members, friends, neighbours. Specifically identify those who provide care and/or support.
- Not delay passing on a concern and/or making a referral because of lack of any of the above information.
- Accurately record concerns and actions taken.
As with non-disabled children, it is not always obvious from an initial referral that there is a child protection issue to be considered. Practitioners, the family, the child and others may emphasise other problems or difficulties and the need for protection from harm may not always be obvious. Thus, the practitioner receiving the referral should systematically seek information about the identified needs and circumstances that have prompted the referral.
Acting on the referral/concern
- Ask for information in relation to all the referral points above.
- Cross-reference to other family members including siblings/check with other agencies (e.g. the child/young person's main carer may have indicated to another service, e.g. family GP, that she/he isn't coping, or that there are other issues that might be affecting the safety of the child).
- Confirm whether the child and their parents/carers are aware that this referral has been made.
- Have initial discussions with line manager following the referral. This is particularly important given the complexities often around for disabled children/young people and extra resources may be necessary, especially where a child has speech, language and communication needs, in order to ensure that an appropriate assessment can be undertaken.
It is important that, where possible, as much accurate information is gathered, in order to fully understand the context and assess the likelihood of harm to the child. It may be necessary to obtain an accurate assessment of the child's understanding and language abilities from their parent, teacher, speech and language therapist or advocacy support and then take advice on communicating or working with the assistance of someone who knows the child well.
In addition, the following questions should be considered and asked when a referral is received concerning a disabled child:
- What is the nature of the child's disability? Ask for a description of the child's impairment rather than just using generic terms, 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 child's impairment affect the child on a day-to-day basis?
- How does the child communicate? If someone says the child can't communicate, simply ask the question: "How does the child indicate s/he wants something?"
- How does s/he show s/he is happy or unhappy?
- Has the impairment or condition been medically assessed and/or diagnosed?
- What type of assessment was carried out, when and has it been reviewed?
- Is there someone who can support the child's communication, e.g. a speech and language therapist or teacher?
Investigation of allegations of abuse involving disabled children
Local procedures and National Guidance must be followed where there is reasonable cause to believe that any child, is suffering, or is at risk of suffering, significant harm. The first responsibility, as with any investigation into allegations of abuse and/or neglect is to ensure that the child is safe including when the child is living away from home in foster, residential, secure or hospital care. Consideration also needs to be given to the wellbeing and protection needs of any siblings living in the family home. As with all enquiries, the need for accurate, detailed, contemporaneous recording of information is essential.
Some additional considerations in relation to disability are outlined below.
- Any enquiries planned or undertaken should be carried out with sensitivity and an informed understanding of a disabled child's needs and impairment. This includes taking into consideration matters such as the venue for the interview/s; the care needs of the disabled child; whether additional equipment or facilities are required; who should conduct the interview; who should be present at the interview and whether someone with specialist skills in the child's preferred method of communication needs to be involved.
- Throughout the process, all service providers must ensure that they take time to communicate clearly and objectively the relevant information, with the disabled child and family, and with one another, as there is likely to be a greater number of practitioners involved with a disabled child than with a non-disabled child. This should be co-ordinated through the lead professional as consideration should be given to impact of information sharing on any criminal investigations.
- The disabled child's preferred communication method for understanding and expressing themselves needs to be given the utmost priority, and where a child has speech, language and communication needs, including those with non-verbal means of communication and deaf children, arrangements will need to be made to ensure that the child can communicate about any abuse or neglect she/he is experiencing and their views and feelings can be made obtained.
- When assessing/considering the child's needs, the focus should always be: "what are their abilities?" Even if the child cannot communicate through the usual communication media, this should not prevent investigative agencies from attempting to obtain their account.
- Some disabled children may not be able to state dates/times when particular events (such as an abusive experience) occurred but may be able to describe an event as before or after some other event e.g. at mealtime.
- The collation of medical information concerning the health needs of the child is important as it may be have a bearing on the outcome of any enquiry/investigation.
Consider and identify who may have the best knowledge about the child's medical condition, for example, paediatrician; school doctor or school nurse. Where there is a need for a medical examination, consideration needs to be given to the most appropriate medical professional who should undertake the examination, the venue, timing and the child's ability to understand the purpose of the medical procedure.
- The number of carers involved with the child should be established as well as where the care is provided and when. A disabled child's network of carers could include short break foster carers, befrienders, sitters, personal assistants, community support workers, residential care staff, independent visitors and learning support assistants.
- Do not underestimate the important information that others can provide (including, for example, transport drivers/escorts).
- Where there is to be a police investigation into allegations of abuse or neglect of a disabled child, those undertaking such investigations should not make presumptions about the ability of the child to give credible evidence. All such investigations should be undertaken in accordance with Guidance on Joint Investigative Interviewing of Child Witnesses in Scotland (Scottish Government, 2011) and the use of special measures for vulnerable witnesses with special support needs in the guidance pack on the Vulnerable Witnesses (Scotland) Act 2004 (Scottish Executive, 2006).
- Where there are allegations of abuse and a disabled child is the alleged abuser, investigations need to be handled with sensitivity and a duty of care shown to both the victim and the alleged abuser.
- Where the parents of a disabled child are disabled themselves, arrangements also need to be put in place to accommodate their needs throughout the investigation/assessment process.
- Following any child protection referral and investigation, the need for the disabled child and their family to be provided with on-going support, should be recognised. This is especially important where disabled children have disclosed that they have been abused as the need for therapeutic services for disabled children, following such experiences is not always recognised.
- A very useful question to ask when assessing a disabled child is "Would I consider that option if the child were not disabled?" Clear reasons are necessary if the answer is No. (Assessing Children in Need and their Families: Practice Guidance, Department of Health, 2000 p.80)
- Consider the use of an Independent Advocacy service to support the child or young person to express their views and wishes.
- Ensure ongoing support is put in place throughout the investigation process and beyond to avoid the child/young person not being aware of what is happening and becoming confused/disempowered.
Transition to adult services
The importance of ensuring appropriate planning to support disabled children in the transition from child to adult services is vital. A child may be biologically of an adult age but developmentally much younger. Therefore, local authorities should ensure that there are appropriate operations links between adult and children's services to ensure a careful and planned transfer. The Protection of Vulnerable Groups (Scotland) Act 2007 is of particular relevance here.
Email: Sandra Aitken