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6.13 Children with a Disability and Child Abuse

AMENDMENT

A minor addition to the text has been added in Section 4, Assessment and support and can be viewed in red text. March 2016.


Contents

  1. Introduction
  2. Essential Safeguards
  3. Communication
  4. Assessment and Support
  5. Employing a Personal Assistant


1. Introduction

Any child with a disability is by definition a 'child in need' under s17 of the Children Act 1989. The Disability Discrimination Act 1995 makes it unlawful to discriminate against a disabled person in relation to the provision of services. This includes making a service more difficult for a disabled person to access or providing them with a different standard of service.

UK evidence (cited in Working Together to Safeguard Children 2010 now archived) 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. Advice about vulnerability associated with living away from home provided the Children Living Away from Home Procedure is also relevant.

The disabled child may be especially vulnerable due to:

  • A need for practical assistance in daily living, including intimate care from what may be a number of carers;
  • Carers and staff lacking the ability to communicate adequately with her/him;
  • A lack of continuity in care leading to an increased risk that behavioural changes may go unnoticed;
  • Carers working with the child in isolation;
  • Physical dependency with consequent reduction in ability to be able to resist abuse;
  • An increased likelihood that the child is socially isolated;
  • Lack of access to 'keep safe' strategies available to others;
  • Communication or learning difficulties preventing disclosure;
  • Parents'/ carers' own needs and ways of coping may conflict with the needs of the child;
  • Bullying and intimidation;
  • Abuse by peers;
  • Fear of complaining in case services withdrawn;
  • Some sex offenders may target disabled children in the belief that they are less likely to be detected.

In addition to the universal indicators of abuse / neglect mentioned the following abusive behaviours must be considered:

  • Force feeding;
  • Unjustified or excessive physical restraint;
  • Rough handling;
  • Extreme behaviour modification including the deprivation of liquid, medication, food or clothing;
  • Misuse of medication, sedation, heavy tranquillisation;
  • Invasive procedures against the child's will;
  • Deliberate failure to follow medically recommended regimes;
  • Misapplication of programmes or regimes;
  • Ill fitting equipment e.g. callipers which may cause injury or pain, inappropriate splinting.


2. Essential Safeguards

Safeguards for disabled children are essentially the same as for non disabled children and should include enabling them to:

  • Make their wishes and feelings known;
  • Receive appropriate personal, health and social education, including sex education;
  • Raise concerns;
  • Have access to more than one adult with whom they can communicate.

Providers of services must have:

  • An explicit commitment to, understanding of disabled children's safety and a culture of openness;
  • 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, sexuality and sexual behaviour among young people, especially those living away from home.


3. Communication

Throughout the Assessment and Section 47 Enquiry, all service providers must ensure that they communicate clearly with the disabled child and the family and with one another as there is likely to be a greater number of services and staff involved than for a non disabled child. All steps must be taken to avoid confusion so that the welfare and protection of the child remains the focus.

Where there are communication impairments or learning difficulties, particular attention should be paid to the communications needs of the child to ascertain the child's perception of events and his or her wishes and feelings. The practitioners should be aware of the additional vulnerability of disabled children during the enquiries that are being undertaken. To facilitate communication with the child, consideration should be given to seeking advice from those professionals who work with the child and have an understanding of their communication needs. Workers should be sensitive to the child's embarrassment where those who know well or see on a regular basis are present when they are asked about intimate details of abuse.

Children's Services and the Police should be aware of non-verbal communication systems and should know how to contact suitable interpreters and facilitators.

Agencies must 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 supported where relevant to participate in court proceedings, whether criminal or otherwise, when this is in their interests as set out in Achieving Best Evidence which includes comprehensive guidance on planning and conducting interviews with children and a specific section about interviewing disabled children.

Participation in all forms of meetings such as Child Protection Conferences and Core Groups must be encouraged and facilitated and take into account any issues about access.

The full range of service providers and carers must be represented at all meetings.


4. Assessment and Support

Disabled children must receive the same level of protection from harm as other children and this procedure manual applies in full to them.

Disabled children and young people may have a number of plans including an Education, Health and Care (EHC) plan.

The reasons why disabled children are more vulnerable to abuse are explored in the 'Safeguarding Disabled Children Practice Guidance ' July 2009 and can be summarised as below:

  • Many disabled children are at an increased likelihood of being socially isolated with fewer outside contacts than non-disabled children;
  • Their dependency on parents and carers for practical assistance in daily living including intimate personal care increases their risk of exposure to abusive behaviour;
  • They 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 often do not have access to someone they can trust to disclose that they have been abused;
  • They are especially vulnerable to bullying and intimidation;
  • Looked after disabled children are not only vulnerable to the same factors that exist for all children living away from home but are particularly susceptible to possible abuse because of their additional dependency on residential and hospital staff for day to day physical needs.

Where there are safeguarding concerns about a disabled child, there is a need for greater awareness of the possible indicators of abuse and/or neglect as the situation is often more complex. It is crucial that the disability is not allowed to mask or deter the need for an appropriate investigation of child protection concerns.

If a disabled child has communication impairments or learning disabilities, special attention should be paid to those needs see Interpreters, Signers and Others with Special Communication Skills Procedure. When a child is unable to tell someone of her/his abuse (s)he may convey anxiety or distress in some other way, e.g. behaviour or symptoms and carers and staff must be alert to this.

Each child should be assessed carefully and supported where relevant to participate in the child protection and criminal justice system, when this is in her/his interests and the interests of justice.


5. Employing a Personal Assistant

Advice to parents / child

If those with parental responsibility wish to employ a personal assistant to help support a disabled child (or if a sixteen or seventeen year old disabled child wishes to employ an assistant), they should be urged to:

  • Obtain a Disclosure and Barring Service (DBS) check via Children's Services;
  • Work with an advocacy service in taking up references and interview processes;
  • Avoid employing an under sixteen year old as (s)he cannot be held legally responsible for harm befalling a child in her/his care;
  • Avoid employing anyone about whom they have doubts;
  • Consider recruiting someone else if they are unhappy with the person working for them.

DBS checks

The potential employee should submit her/his application for DBS checks to Children's Services. The potential employee should be advised that the results of this check will be shared with the child / parent.

Whilst the check is carried out, potential users of direct payments should continue to receive services commissioned by the local authority.

Local authorities must be satisfied that a direct payment used for this service will safeguard and promote the welfare of the child (see the Department of Education website). Once the check is received the responsible manager must decide whether the direct payment can be progressed.

If the person is deemed to be unsuitable, the direct payment should be declined, pending a more suitable candidate. The practitioner should discuss the circumstances with the parent or child (and if relevant, their advocate).

If parent / child decides not to pursue DBS checks

If the parent / young person decide not to pursue DBS checks, Children's Services has grounds for refusing direct payments only if it has good reason to believe a potential employee is unsuitable.

If Children's Services declines a direct payment on these grounds, the reasons should be sensitively shared with the child / parent and clearly recorded.

Where a child and/or parent decide not to pursue a DBS check, they (with assistance of an advocate if necessary) should be asked to sign a disclaimer form.

Contract with parent / carer

To cover the possibility that an employee leaves and Children's Services is not informed, it may be useful to ask the parent / carer to agree to a simple contract that requires notification of any new potential employee thus facilitating a DBS check (and potentially justifying removal of payment if such notice was not in fact provided).

End