Bridging the gap: Investigating the abuse of children with multiple disabilities

This is a summary of a series of practical papers written to help bridge the ‘gap’ between the fields of child protection and childhood disability, with a view to improving practice in child protection work with severely disabled children. Particular attention is paid to the needs of children using alternative communication systems. The theme of the paper is that disabled children are in most senses just like other children, but may have particular needs in relation to the investigation of abuse, as well as being particularly vulnerable to abuse. Issues around the assessment of suspicion, preparation for interviewing and the interview process are presented. The needs of the child, the accompanying adult and the child protection worker are considered. Guidelines and recommendations for practice at different stages of the investigation are given. The need to adapt the investigation to the particular needs of the child is emphasized throughout.     

Child abuse,child protection and disabled children: a review of recent research

This paper reports the results of a scoping study that reviewed research about child abuse, child protection and disabled children published in academic journals between 1996 and 2009. The review was conducted using a five stage method for scoping studies. Several studies have revealed a strong association between disability and child maltreatment, indicating that disabled children are significantly more likely to experience abuse than their non‐disabled peers. Those with particular impairments are at increased risk. There is evidence that the interaction of age, gender and/or socio‐cultural factors with impairment results in different patterns of abuse to those found among non‐disabled children although the reasons for this require further examination. It appears that therapeutic services and criminal justice systems often fail to take account of disabled children's needs and heightened vulnerability. In Britain, little is known about what happens to disabled children who have been abused and how well safeguarding services address their needs. Very few studies have sought disabled children's own accounts of abuse or safeguarding. Considerable development is required, at both policy and practice level, to ensure that disabled children's right to protection is upheld. The paper concludes by identifying a number of aspects of the topic requiring further investigation. Copyright © 2010 John Wiley & Sons, Ltd.     

Recognizing Abuse and Neglect in People with Severe Cognitive and/or Communication Impairments

ABSTRACT

It is widely acknowledged that physical abuse of persons with severe developmental disabilities is prevalent, usually perpetrated by a residential care provider and is rarely reported. However, no solid research on the topic has been reported. This article notes the lack of information about protective services directed to the developmentally disabled population and lack of coordination between agencies serving people with developmental disabilities and those providing protective services. The signs and symptoms of abuse in the developmentally disabled population, the alternative communication strategies required when interviewing, and the special skills needed for case assessment are presented. The author ends with a series of federal, state, and community level policy recommendations.     

Saying the ‘F word … in the nicest possible way’: augmentative communication and discourses of disability

This paper examines a case study of a severely physically disabled man, Ralph, in terms of his interaction with his carers. He communicates using various systems of augmentative and alternative communication (AAC, such as symbol boards and high-tech devices), the vocabulary for which has mostly been selected for him by others. The starting point of the paper is the assumption that disabled people have traditionally held a disempowered position in society (relative to non-disabled people), and the question asked is to what extent is Ralph further disempowered by the limited vocabulary available to him in his AAC systems, and in the way others interact with him. The paper draws on the work of Bourdieu, according to whom ‘Language is not only an instrument of communication or even of knowledge, but also an instrument of power’ (1977, 648). I consider the tensions between the drive towards the empowerment of disabled individuals, as exemplified by the provision of AAC, and opposition to allowing access to certain types of vocabulary (especially expletives such as ‘the F word’), unless it is expressed in ‘the nicest possible way’.     

Abuse and disabled children: hidden needs…?

In order to look at current practices in recording the abuse of disabled children, a questionnaire was sent out to the 121 Chairs of the Area Child Protection Committees in the United Kingdom. Of the 73 responders, over 50% claimed to identify the disability of an abused child but only 10% could given an actual figure. The lack of statistical evidence made it impossible to calculate anything except an approximation of the rate of abuse of disabled children. Schedules completed over a period of 1 year in two Social Services Departments for all disabled children who were conferenced for abuse showed that they were less likely to be put on the child protection register than a comparison group of non‐disabled children. Semi‐structured interviews with eight of the key workers for the disabled children revealed that they were concerned that there was a tendency ‘not to see’ the abuse of disabled children and they did not feel there was sufficient training regarding the interface between abuse and disabilities. Taking into account the responses to the study, a number of national and local recommendations were made. Copyright © 2002 John Wiley & Sons, Ltd.     

Safeguarding disabled children in residential settings: what we know and what we don't know

Research in America, Canada, Australia and Britain has revealed that disabled children are particularly vulnerable to abuse. Their likelihood of attending residential institutions, their dependency on others for personal care and the lack of opportunities for them to alert others to maltreatment or comprehend the nature of abusive acts all increase levels of risk. Over the last decade, there has been increasing public and professional concern about the abuse of children in residential establishments, resulting in a number of inquiries. However, the abuse of disabled children in residential settings has received little attention. Despite residential schools, care homes and respite care being widely used by disabled children, there is a paucity of knowledge regarding the standards of child protection in these establishments. This article explores the research literature revealing the vulnerability of disabled children to abuse when living away from home, what measures can be taken to help protect them and the limitations of available data as a basis for planning child protection measures. Copyright © 2002 John Wiley & Sons, Ltd.     

Child Sexual Abuse and the Black Disabled Child

This paper seeks to document a previously neglected area of study, namely the effects of sexual abuse on black disabled children. With a particular focus on black children with learning disabilities, it examines how the interlocking dimensions of race, gender and disability compound the problems that they are faced with in the aftermath of sexual abuse. This paper presents case studies drawn from data generated from a broader research project of sexual abuse and black families to illustrate the specific ways the negatively valued position of black disabled children shape responses to them. It is argued that the way in which black disabled children and their families interpret their experiences is likely to differ from other groups of disabled children, as multiple marginalised identities shape their lived realities. The paper concludes with some reflections on the implications for making risk assessment for black disabled children.     

A study of disabled children and child protection in Scotland — A hidden group?

This paper is based on analysis of data collected for a study, commissioned by the Scottish Government, which examined child protection work with disabled children. At a conceptual level, the paper draws on Goffman's frame analysis and on different models of disability. Focus groups were conducted with five Child Protection Committees (40 individuals) and semi-structured interviews with a further 21 practitioners from social work, education, health services, third sector organisations and the police. The findings show that, for various reasons, abuse of disabled children may go undetected. Where it is suspected, effective action does not always follow, for example, where practitioners over-empathise with parents. When child protection work is undertaken, disabled children may remain relatively invisible in terms of participation and professional focus. It is suggested that the ways in which practitioners and managers “frame” disabled children has implications for how abuse is responded to and how well these children are protected. Participants also “framed” disability in different ways, and it is suggested that a social relational model seems particularly applicable. In conclusion, in many respects disabled children experiencing abuse may remain absent from or to some extent hidden within child protection services in Scotland. While some creative work is taking place, considerable changes are required to make child protection services accessible to all disabled children, sensitive to their needs and respectful of their rights.     

Doing research with children and young people who do not use speech for communication

Despite emphasis in policy on participation of disabled children,¹ we still know relatively little about how to obtain the views of disabled children with significant communication impairment and their views are often overlooked in planning and service provision. This article describes how the views of children who do not use speech were accessed in research aiming to identify disabled children and young people's priorities regarding outcomes of social care and support services. The main challenge was to develop a method that was reliable, non‐threatening, enjoyable and relevant to individual children, as well as enabling children to think beyond their everyday life and express what they aspire to.     

Disabled children,child protection systems and the Children Act 1989

It is now widely recognized that disabled children are particularly vulnerable to abuse but that a number of factors get in the way of protecting them. This article discusses research on the implementation of the Children Act as it applies to disabled children and the findings from in‐depth interviews with young disabled people. The research concluded that: current child protection systems are not addressing the particular needs of disabled children; the Children Act regulations on short‐term and long‐term placements are often not complied with; and disabled children and young people have little say in decisions which affect them and few opportunities to communicate their experiences. Copyright © 1999 John Wiley & Sons, Ltd.     

Consulting the Children: Interviews with Children Using Residential Respite Care Services

The Children Act, 1989, requires that services for children are provided in partnership with parents and that the wishes and feelings of the child and his/her parents are ascertained and given due consideration (sect. 22). As part of a research project assessing the quality of services to children with disabilities under the Children Act, the authors carried out evaluations of six residential respite care services. The services were used mainly by children with learning difficulties, some of whom had little or no speech. Staff at the schools attended by the children were asked to interview them, so that their views could be included in the evaluation reports. Interview schedules and aids to communication were devised to try and enable all the children to express their views. This article describes the initial schedules and the changes made in the light of experience during the research. The authors then summarise the children's responses and consider how the process of consultation could be improved in future.     

Asking the Question: Childhood Sexual Abuse in Adults with Mental Illness

Enquiry about childhood sexual abuse (CSA) is not routine practice for mental health practitioners undertaking client assessment. This study audited 100 patient charts to determine rates of enquiry and response by mental practitioners around CSA. Fifty-seven mental health staff also completed a subsequent questionnaire exploring factors that influence practice in regard to sexual abuse. Staff lacked confidence in how to ask and effectively respond to sexual abuse disclosure. Mandatory training focusing on trauma informed care could improve staff confidence and capacity to identify and effectively address not only sexual abuse, but childhood trauma and abuse more generally.     

Preventing child sexual abuse: parents' perceptions and practices in urban Nigeria

This study examined parents' perceptions of child sexual abuse as well as prevention practices in an urban community in southwest Nigeria. Questionnaires were collected from 387 parents and caregivers of children younger than 15 years of age. Results showed that many parents felt CSA was a common problem in the community, and most parents disagreed with common child sexual abuse myths. In addition, almost all parents ( >90%) reported communicating with their child(ren) about stranger danger. However, about 47% felt their children could not be abused, and over a quarter (27.1%) often left their children alone and unsupervised. There were no significant variations in the perceptions of child sexual abuse and communication practices. The implications of findings for child sexual abuse prevention are discussed.     

The prevalence and nature of abuse and neglect in children under four: a national survey

This paper reports the results from a Danish national survey of child abuse and neglect. Data were obtained by a written questionnaire sent to all home health visitors. All newborn Danish children receive visits by a home health visitor several times during their first year of life. For children in need of special care for social reasons the visits may continue until school age (at 6 or 7 years). The questionnaire included four checklists of signs of abuse and neglect. The home health visitors were asked to record what they had actually observed visiting the children in their homes. Eighty‐three per cent (covering about 80% of all newborns) answered the questionnaire. The objective was to establish a scientific based framework that could be used to guide preventive efforts. Ten per cent of all children under 1 year of age may be characterized as children in need of special care for social reasons, the most frequent single reason being reliance on social assistance, alcohol abuse or violence against the mother. A minimum of 4% of infants are subjected to broadly defined abuse or neglect from one or more of the four categories: physical abuse, physical neglect, emotional abuse and emotional neglect, physical and emotional neglect being the most frequent and physical maltreatment the most rare. Copyright © 1999 John Wiley & Sons, Ltd.     

Abuse of disabled children in Ghana

Even though disabled children are targets of various forms of abuse, such issues remain mostly undocumented open secrets in many countries including Ghana. The article is based on a qualitative data provided by three key informants. Six stories emerged from the data and are discussed in terms of four main forms of abuse. Labelling theories are employed to strengthen the discussions. The article is aimed at increasing awareness on the various forms of abuse experienced by disabled children in Ghana. The study is also meant to capture the attentions of stakeholders that have the responsibility to end abusive practices against disabled children in Ghana.     

Every Child Matters outcomes: What Do They Mean for Disabled Children and Young People?

To date, little attention has been paid to the appropriateness of the Every Child Matters (ECM) outcomes framework to disabled children. ¹ 1 For brevity, the term children is used to apply to children and young people up to 19.
This article reports findings from a research project which sought the views of disabled children and their parents about their desired outcomes. Twenty‐nine children and 90 parents were interviewed. The findings indicate that ECM outcomes are appropriate to disabled children but can have different meanings. In addition, the need to recognise the importance of maintaining outcomes, as well as progress, is highlighted.     

Sociometric methods and difference: a force for good – or yet more harm

This paper offers a critique of sociometrics as a ubiquitous method of measuring social relationships among children in social groups such as school classes. This is important in relation to disability politics and research as the apparently scientific measures are frequently used in the process of labelling children or predisposing the children involved, or others involved with them, to view disabled and other children in particular ways. We open a debate about judgements concerning whether the use of sociometric techniques needs to be better informed by questions about the underpinning normalising frameworks on which they depend, about the connotations of blame associated with particular sociometric statuses, and about the way that research constructs difficulties and reflects an adult agenda, marginalising the voices of (disabled) children. We argue for the value of the transactional turn in understanding the implications of this approach and for highlighting alternative perspectives.     

Effects of nonverbal-oriented social awareness training program on social interaction ability of learning disabled children

Educator-researchers have proposed that the learning disabled child's lower peer sociometric ratings could be influenced by the learning disabled child's reduced sensitivity to the nonverbal components of communication. The present study used a posttest-only control group design to test the relationship between a nonverbal-oriented social acceptance training method and social ratings. Thirty-three elementary learning disabled children were randomly assigned to experimental or control groups. Before the treatment began, all subjects were tested on their nonverbal decoding ability. Results indicated that the subjects receiving the nonverbal-oriented social affect training were rated significantly higher on both the peer acceptance scale and the social interaction rating scale. There was no significance interaction between treatment condition and pre-experimental nonverbal sensitivity aptitude.     

Growing Up at Centrepoint: Retrospective Accounts of Childhood Spent at an Intentional Community

A qualitative analysis of the accounts of 29 adults who grew up in a controversial New Zealand community identified positive and negative experiences and their psychological implications. In addition to highly publicized child sexual abuse that occurred at Centrepoint, children also experienced parental neglect, psychological manipulation, illegal drug use and stigma from the broader society. These factors created an adverse matrix that facilitated sexual abuse. Positive experiences included support for vulnerable families and children, recreational activities, and the opportunity to develop communication skills. While there may be positive experiences for children living in intentional communities such as this one, it is important to be aware of the potential for psychological harm to children in communities with powerful, shared systems of belief, skepticism about the broader society, and strong dynamics of dependence. These findings may have implications for other similar communities operating elsewhere in the world.     

Growing up at centrepoint: retrospective accounts of childhood spent at an intentional community

A qualitative analysis of the accounts of 29 adults who grew up in a controversial New Zealand community identified positive and negative experiences and their psychological implications. In addition to highly publicized child sexual abuse that occurred at Centrepoint, children also experienced parental neglect, psychological manipulation, illegal drug use and stigma from the broader society. These factors created an adverse matrix that facilitated sexual abuse. Positive experiences included support for vulnerable families and children, recreational activities, and the opportunity to develop communication skills. While there may be positive experiences for children living in intentional communities such as this one, it is important to be aware of the potential for psychological harm to children in communities with powerful, shared systems of belief, skepticism about the broader society, and strong dynamics of dependence. These findings may have implications for other similar communities operating elsewhere in the world.