G80(P) Are children with disability more at risk of abuse? A single centre retrospective case notes review

Background A report commissioned by NSPCC in 2014, ‘We have the right to be safe: Protecting disabled children from abuse’ stated disabled children are 3 times more likely to be abused than non-disabled children. The report identified certain high risk groups among disabled children including males, conduct disorders and learning disabilities. Aims A retrospective case notes review of a single centre, to compare the occurrence of suspected and confirmed abuse among children with and without disability. An estimated risk of abuse was calculated from local authority population data. Methods We identified all children referred for suspected abuse at a single Tertiary Safeguarding Unit, covering a population of over 2 70 000 children, in a 3 month period. Data on Demographics, type of injuries and disability was collected and analysed. Occurrence of abuse in those with disabilities was compared with those without disability. Results Data was analysed for all 109 children referred with safeguarding concerns between January to March 2016. Disability was recorded for 106 children and 31% had a disability. The rates of disability in our population is estimated at 20% by the local authority. Our figures suggest a 1.55 fold increased risk of abuse in disabled children compared with non-disabled. Children presented with a range of and sometimes multiple disabilities to include communication problems(42%), pre-school developmental delay(21%), Learning difficulties(27%) and ADHD(27%). 61% of disabled children seen were male. Following referral there were more outcomes of abuse in disabled(n=33) versus non-disabled(n=73), demonstrated in Table 1 (shaded=disabled). The commonest injuries seen in disabled children were physical assault(27%), poor handling(15%) and ear bruising(15%). Conclusions Of children referred with safeguarding concerns nearly one third had a disability(31%). Our estimated 1.55 times increased risk is half that quoted by NSPCC raising concerns that abuse in these vulnerable children may be underreported. Greater awareness among professionals caring for these families and increased vigilance in identifying abuse in disabled children is needed.