Disabled Children

Children with a disability are children first and foremost, and deserving of the same rights and protection as other children. By definition, any child with a disability should also be considered as a child in need. A child can be considered to be disabled if he or she has significant problems with learning, communication, comprehension, vision, hearing or physical functioning including a learning difficulty or developmental delay. The child may also have a diagnosis from a medical professional.

Many factors can made a disabled child more vulnerable to abuse than a non-disabled child of the same age. Safeguarding disabled children demands a greater awareness of their vulnerability, individuality and particular needs. It is also important to see the child in the context of the whole family and community supports that are present.

Disabled children may be especially vulnerable to abuse for a number of reasons. Some disabled children may:

• Be isolated and have limited contact with others;
• Receive intimate care possible 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;
• Have an impaired capacity to resist or avoid abuse;
• Have communication difficulties that may make it difficult to tell others what is happening and no support around their Speech and Language difficulties;
• Be inhibited about complaining for fear of losing services; and/or not aware services are abusive;
• Be especially vulnerable to bullying and intimidationnd more willing to accept bullying due to lack of recognition of those issues;
• Be more vulnerable than other children to abuse by their peers.
• Attitudes and discrimination can mean that only their disability is seen rather than the full picture.

Additional factors may be:

• The child's dependence on carers could result in the child having a problem in recognising what is abuse. The child may have little privacy, a poor body image or low self-esteem;
• Carers and staff may lack the ability to communicate adequately with the child and may not be trained appropriately to meet the needs of the child;
• A lack of continuity in care or multidisciplinary working which leads leading to an increased risk that behavioural changes may go unnoticed;
• Lack of access to 'keep safe' strategies available to others, and overprotective nurse of carers/services so the child or young person cannot identify what abuse is;
• Disabled children living away from home and community are not seen daily by others outside of the organisation they live in. Iin poorly managed settings they are particularly vulnerable to over-medication, poor feeding regimes and toileting arrangements, issues around control of challenging behaviour, lack of stimulations and emotional support;
• Parents'/carers' own needs and ways of coping may conflict with the needs of the child;
• Pressure on family carers with limited support can be a risk factor for the disabled child;
• Some adult abusers may target disabled children in the belief that they are less likely to be detected, evidence indicates a disabled child or young person is less likely to be seen as a reliable witness when they do disclose;
• Signs and indicators can be inappropriately attributed to disability such as normalisation or over use of restraint. Issues around abuse and mental health issues may be ignored or not seen due to the focus on disability;
• Services do not have the expertise to support a child with disabilities with other needs such as trauma, neglect etc.
• Disabled children are less likely to be consulted in matters affecting them and as a result may feel they have no choice about whether to accept or reject sexual advances.

The UK Social Work Practice in Safeguarding Disabled Children and Young People report details some of the reasons why disabled children and young people are at greater risk and the reasons why, including where gaps in provision exist.

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

• Force feeding;
• Unjustified or excessive physical restraint;
• Rough handling;
• Extreme behaviour modification including the deprivation of food medication, or clothing;
• Misuse of medication, sedation, heavy tranquillisation;
• Invasive procedures against the child's will;
• Neglect of personal care needs;
• Failure to accept child's disability. Deliberate failure to follow medically recommended regimes;
• Non- compliance with programmes or regimes;
• Failure to address ill-fitting equipment e.g. callipers, sleep boards which may cause injury or pain, inappropriate splinting;
• Misappropriation/misuse of a child's finances;
• Over protective parenting; limiting social activities.

Safeguards for disabled children are essentially the same as all other children:

• Make it common practice to enable disabled children to make their wishes and feelings known in respect of their care and treatment;
• Ensure that disabled children receive appropriate personal, health and social education (including sex education);
• Make sure that all disabled children know how to raise concerns and give them access to a range of adults with whom they can communicate. This could mean using interpreters and speech and language support using the child's preferred method of communication, this may mean visiting a number of times;
• Recognise and utilise key sources of support including staff in schools, friends and family members where appropriate;
• Develop the safe support services that families want, and a culture of openness and joint working with parents and carers on the part of services;
• Ensure that guidance on good practice is in place and being followed in relation to: intimate care; working with children of the opposite sex; managing behaviour that challenges families and services; issues around consent to treatment; anti-bullying and inclusion strategies; sexuality and safe sexual behaviour among young people; monitoring and challenging placement arrangements for young people living away from home.

Carers are relied upon (whether family or paid carers) as a source of information about disabled children and to interpret and explain behaviour or symptoms. Professional staff can potentially feel out of their depth in terms of knowledge of a disabled child's impairment, where the familiar developmental milestones may not apply.

Disabled children should not be left in situations where there is a high level of neglect or other forms of abuse, because a professional feels the parent, carer or service is 'doing their best'.

Carers will need to be challenged in the same way as carers of non-disabled children.

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 Children's Social Care Services and the Police should be aware of non-verbal communication systems and should 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 the criminal justice system 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.

Intermediary support can be provided if a disabled child need support with communication at court or in a tribunal hearing.

Please see GOV.UK around how to access an intermediary service - HMCTS intermediary services

Disabled children come into contact with a wide range of carers, it is important that all staff are clear about the process that they should follow if they become aware of an allegation or concern which relates to an individual who works with children.

Where such concerns come to light they should be discussed with the Local Authority Designated Officer (LADO). The LADO contact details are as follows:

Nottinghamshire

• Any concerns relating to staff or volunteers in schools should be discussed with the Safeguarding Children in Education Officer, who can be contacted on 01623 433433;
• Concerns relating to staff/volunteers in all other settings should be discussed with the Safeguarding Children Manager for Nottinghamshire County Council, who can be contacted on 01159 773921.

Nottingham City

• Any concerns relating to staff or volunteers in schools should be discussed with the LADO, who can be contacted on 0115 8764744;
• Concerns relating to staff/volunteers in all other settings should be discussed with the for, who can be contacted on 0115 8764148.

The type of concerns which should be discussed with the LADO are those concerns that indicate an individual may have:

• Behaved in a way that has harmed a child, or may have harmed a child;
• Possibly committed a criminal offence against or related to a child;
• Behaved in a way that indicates s/he may not be suitable to work with children.

It should be noted that the final bullet point includes types of behaviour that although not directed towards a child may give rise to concerns about an individual's suitability to work with children, e.g. a sexual offence against an adult.

The Children Act 1989 s17(1) creates a general duty on children's services authorities to safeguard and promote the welfare of children within their area who are 'in need'. So far as is consistent with this duty, children's services authorities must promote the upbringing of such children by their families.

The definition of 'children in need' is to be found at CA 1989 s17(10), which provides that a child is to be taken as 'in need' if:….

(c) he is disabled.

At subsection (11) the definition of 'disabled' for the purposes of CA 1989 Part III is given as follows:

'For the purposes of this Part, a child is disabled if he is blind, deaf or dumb or suffers from mental disorder of any kind or is substantially and permanently handicapped by illness, injury or congenital deformity or such other disability as may be prescribed'.

Mental health and behaviour in schools (November 2018) - How schools can support pupils whose mental health problems manifest themselves in behaviour.

Safeguarding Disabled Children: Practice Guidance

Ofsted Thematic Inspection: Protecting Disabled Children

Cyberbullying and SEN/disability: Advice provided by the Anti-Bullying Alliance on developing effective anti-bullying practice.

Locally, support can be sought from the following organisations:

• National Parent Partnership Network;
• Rainbow Parents Carers Forum;
• Ask Iris;
• Scope;
• Carers Federation.