This week’s Blog is written by Professor Julie Taylor and Dr Chris Jones from the University of Edinburgh/NSPCC Child Protection Research Centre.

We will be hosting this week’s ENB twitter chat on Wednesday the 5th of November between 8-9pm (GMT) focusing on recent research on disabled children and the child protection system. Participating in the twitter chat requires a Twitter account; if you do not already have one you can create an account at www.twitter.com. Once you have an account contributing is straightforward – follow the discussion by searching links to #ebnjc @EBNursingBMJ, or better still, create a tweet (tweets are text messages limited to 140 characters) to @EBNursingBMJ and add #ebnjc (the EBN chat hash tag) at the end of your tweet, this allows everyone taking part to view your tweets.

There is a significant body of international research to show that disabled children are more likely to be abused than their non-disabled peers. Despite this heightened risk, there is evidence that the abuse of disabled children goes undetected and under-reported. Children with particular forms of impairment are more at risk than others. Although findings vary, a literature review (Stalker & McArthur 2010) found that those with communication impairments, behavioural disorders, learning disabilities and sensory impairments are likely to experience higher levels of violence and neglect. Not enough is known about the direction of causality, however, and the extent to which some of these impairments may have been caused by abuse.

Despite this heightened risk, there is evidence from a number of countries that the abuse of disabled children often goes undetected and, even when suspected, may be under-reported. This is given further credence by the low numbers of children on child protection registers recorded as having an impairment.

A range of factors has been cited to explain disabled children’s increased vulnerability to abuse. Children may be viewed by potential perpetrators as less aware and/or knowledgeable than a non-disabled child; communication impairments may make it hard to report abuse; mobility difficulties can make it difficult to remove themselves from the abuser; and personal care needs open up opportunities for abuse. Family related factors may centre on the stress of caring for a disabled child without adequate support (although it should be noted that the vast majority of parents provide loving and safe homes for their disabled children), as well as ambivalence about having a disabled child and disciplinary approaches. Increased risk may arise in services if staff are not aware of disabled children’s heightened vulnerability or may even think that no-one would abuse a disabled child. Maltreatment may also be administered under the guise of treatment, such as medication or electro-convulsive therapy and in some countries, disabled girls may be forcibly sterilised (UNICEF 2013). Staff within residential settings (where disabled children are disproportionately represented), may not know how to communicate effectively with children who have communication impairments, and signs of distress and abuse may go undetected, or be attributed to the impairment.

Our study for the Scottish Government earlier this year confirmed that disabled children were often marginalised or made invisible. Thresholds were higher than for other children, as professionals often ‘felt sorry’ for parents. Our ongoing study for the NSPCC is talking to disabled children about their experiences of the child protection system.

Questions for consideration:

• Are health professionals aware of the particular vulnerabilities of deaf and disabled children?
• Do we sometimes sympathise with parents and carers to the extent that we may have lower expectations about the care parameters?
• What are the signs and symptoms of abuse that disabled children and young people may display?
• What particular forms of impairment are likely to put children most at risk of abuse?
• What are the protective factors against abuse for deaf and disabled children and young people?
• Have you ever thought ‘no-one would hurt a disabled child’?

Sources of information

Literature review (Stalker)

http://strathprints.strath.ac.uk/27452

Research report

http://www.scotland.gov.uk/Publications/2014/04/4363/0

The Child Protection and Disability Tool Kit

http://withscotland.org/resources/child-protection-and-disability-toolkit

Protecting Disabled Children from Abuse

http://www.nspcc.org.uk/preventing-abuse/research-and-resources/right-to-be-safe

Professor Julie Taylor and Dr Christine Jones, Child protection Research Centre, University of Edinburgh. @ChildProtectRes

Join in the twitter chat #ebnjc @EBNursingBMJ