Disabled children have an increased risk of experiencing abuse, however this often goes unnoticed. There is also not the support in place to better protect them or help with recovery after experiencing abuse. This systematic review aims to synthesise existing qualitative UK evidence to support evidence informed planning and development of more appropriate, targeted, and cost-effective interventions for disabled children and their families. It also aims to produce a better understanding of the complexity of safeguarding concerns and improved understanding of how and why key issues disproportionately affect disabled children.
The findings of this review suggest that disabled children and young people are at greater risk of harm as a result of often being invisible to services and a lack of service provisions, as well as disablist and discriminatory attitudes towards children and young people. Multiple policy and practice recommendations were developed from the evidence review to improve the safeguarding of disabled children and young people.
The review looked at existing studies and academic articles and reports to answer key questions:
- Why are disabled children and young people at greater risk of harm?
- What tailor-made responses and interventions are made available to disabled children and young people?
The review also wanted to assess the outcomes for disabled children and young people who have experienced abuse and associated trauma from the perspective of the young people, their parents/cares and practitioners Finally, it wanted to look at the training and skill development needs of the workforce to effectively support disabled children.
How we went about it
Academic searches across seven databases were made to identify UK studies published from January 2000 onwards. The systematic review included 14 qualitative articles/reports from across 10 unique studies.
197 qualitative findings were found across the studies, which in turn formed 12 synthesised findings to answer the four research questions.
Risk of harm
The findings of this review indicate that disabled children and young people are at greater risk of harm as a result of disablist and discriminatory attitudes towards them, rendering these young people invisible. Another finding was that lack of services for disabled children and thresholds for services create increased risk for this group of young people. Isolation, a lack of voice and agency, and overprotection were seen to create vulnerability in disabled children and young people.
Tailor-made responses and interventions
Sharing information across multi-agencies is important for a holistic and child-centred practice to be taken by practitioners. Multi-agency coordination and cooperation at all levels is crucial to improving service responses and the availability of appropriate interventions for disabled children/young people who have been or are at risk of abuse. A lack of services, and appropriate accessible provision, as well as resources and time for practitioners, impact on quality responses and interventions to risk and abuse for disabled children.
Outcomes for disabled children who have experienced abuse and associated trauma
Outcomes for disabled children were dependent on having opportunities for telling and/or recognition of abuse by others, and the subsequent responses from services. Disabled children and young people were often perceived as unreliable witnesses therefore access to justice via thorough police investigations and criminal proceedings was rarely an outcome.
Specific training and skills development needs for the workforce
The variation of skills and access to training across all agencies contributed to a lack of robust multi-agency and practitioner responses to suspected abuse of disabled children. Findings indicate a need for increased training for practitioners in awareness and confidence and communicating with disabled children as well as increased opportunities for multi-agency working.
The review exposed the scarcity of research evidence on the abuse and protection of disabled children and young people within the UK across all forms of harm. The review reported that there were gaps in understanding on how to prevent abuse, identify harms and reduce risks. As well as there being little knowledge on the outcomes of child protection responses. The synthesised evidence highlighted major learning for practice and policymakers at local and national levels were recommended. This included that attitudes towards disabled children and a lack of services and/or high thresholds for services creates increased risk for this group of young people.
Multiple policy and practice recommendations were made based on the evidence from the review and an urgent need to address significant research gaps to develop a more robust and encompassing evidence base. These recommendations include:
- Developing updated national Multi-Agency Safeguarding Deaf and Disabled Children and Young People Practice Guidance
- Local Authorities and Local Safeguarding Partnerships having arrangements in place to address Individual and collective responsibilities for ensuring equal safeguarding and protection of the young people.
- Effective data gathering by all organisations and Local Safeguarding Partnerships
- Multi-agencies ensuring there is an effective range of provisions in terms of advocacy, speech and language therapy
- Recognition at all levels that more time and support for practitioners is required for working with disabled children and their families.