SEFTON LSCB Safeguarding Policies and Procedures Online Manual

    6.6 Assessing Children with Disabilities for Significant Harm

    Last updated 12/11/2018

    6.6  Assessing Children with Disabilities for Significant Harm

    6.6.1     Professionals in all agencies who come into contact with children and young people with disabilities are in a position to identify indicators that the child may be suffering or may be at risk of significant harm. These are included in the SSCB Child Protection Procedures and apply equally to disabled children and young people. There may be differences, and a child/young person’s disability should always be considered when considering whether significant harm might be indicated. For example a bruise in a site that might not be of concern on an ambulant child/young person, such as the shin, might be of concern on a non-mobile child/young person.

    6.6.2     Because of the particular needs of disabled children and young people they may also be at risk of being abused in other ways including:

    • force feeding or inappropriate feeding
    • Their personal care needs may not be met adequately
    • Physical restraint being carried out unnecessarily or not in accordance with available guidelines
    • Rough handling
    • Extreme behaviour modification including the deprivation of clothing, medication or food, limiting movement, restricting freedoms, locking doors etc.
    • Misuse of medication, sedation, heavy tranquillisation
    • Invasive procedures which are unnecessary or are carried out against\ the child/young person’s will
    • Being denied access to required medical treatment
    • Misapplication of programmes or regimes
    • Ill-fitting equipment e.g. callipers, sleep boards which may cause injury, inappropriate splinting
    • They may be more susceptible to bullying
    • They may be more vulnerable to abuse using Information Communication Technology

    6.6.3     Professionals may find it more difficult to attribute indicators of abuse or be reluctant to action concerns in relation to disabled children and young people because of a number of factors which may include:

    • Professionals over identifying with the child/young person’s parents/carers and being reluctant to accept that abuse could have taken place, or seeing abuse as being attributable to the stress and difficulties of caring for a disabled child/young person
    • A lack of knowledge about the impairment and its impact on the child/young person
    • A lack of knowledge about the child/young person, e.g. not knowing the child/young person’s usual behaviour or demeanour
    • Not being able to understand the child/young person’s communication
    • Confusing behaviours that may indicate the child/young person is being abused with those associated with the child/young person’s impairment
    • Denial of the child/young person’s sexuality
    • The child/young person having a number of carers.

    6.6.4     Behaviour, including sexually harmful behaviour or self -injury, may be indicative of abuse.

    • Carers may have unrealistic expectations of the child
    • Failure to follow treatment plans

    6.6.5     Certain health/medical complications may influence the way symptoms present or are interpreted. Certain indicators may be present that are attributable to the child/young person’s condition or medical treatment. For example, some anti-convulsants may lead to spontaneous bruising and some particular conditions can cause fragile bones increasing the likelihood of fractures during normal day to-day activities.

    6.6.6     Because of this it is essential that relevant and pertinent information is recorded clearly on a child/young person’s file. This may include communication methods used by the child/young person to understand and express themselves, severity of disability, numbers of care givers, and level of care required etc.

    6.6.7     The requirement to consult with the parents of any child or young person if there are concerns about their well-being, applies to disabled just as to non-disabled children and young people.

    6.6.8     Where there are concerns about a child/young person it is essential that workers with the required knowledge and skills, and who know that child, are involved promptly.

    6.6.9     Where a worker is not clear if a child/young person’s particular injury or behaviour is indicative of abuse, or is associated with their disability, they should seek advice from a professional who knows the child and the implications of their disability well, for example, a community paediatrician, a school nurse, a teacher, etc.