Reflections on Recognising and Responding to Maltreatment Experienced by Disabled Children- Glasgow 28th September 2018

There is significant evidence that disabled children are at greater risk of abuse than their non-disabled peers (Taylor, Stalker & Stewart, 2015) and so it is essential that we continue to develop our understanding of the experiences of disabled children and our ability to recognise and respond to maltreatment or abuse. The BASPCAN event in September was a great opportunity to hear about the latest research from experts in the field but also to join in a wider conversation that is taking place across Scotland, the rest of the UK and ultimately, at a global level.

Several practitioners, including those from education, social work, health and the third sector, attended the day and participants had travelled from across Scotland and the UK to attend: the range of voices in the room contributed to a level of rich discussion that enhanced our learning throughout the day. Professor Julie Taylor and Dr Christine Jones, who are both leading researchers in the field, led the event and together they walked us through data, activities and discussion focusing on the risks, experiences and consequences of abuse and models of disclosure.
The learning began by exploring the concepts, theories and evidence surrounding the maltreat of disabled children (the word maltreatment encompasses the wide range of types of abuse or neglect that children with disabilities experience) and this session provided an important opportunity to discuss the dominant discourse related to disability and to consider whether the binary thinking encapsulated in the push for social or medical models is at all helpful. Together, we discussed the Human Rights model of disability as a more effective way of understanding and responding to need and considered key ways in which the model differs from the social model of disability. Central to this thinking is the need for diversity to be valued and the importance of social justice. The model prompted discussion about the broader contextual issues relating to civil, political, economic and cultural rights and the very real challenges that children with disabilities are facing both in the UK and beyond. The group reflected on how able current systems are to respond to such complex adversities and how the voice of disabled children can get lost in the melee.
Later in the day, we discussed the interactions between impairment and risk and the barriers disabled children face in having their experiences heard. As a speech and language therapist, I have a particular interest in understanding how and when communication breaks down and I was keen to understand what stops children from being heard. Through the session, I learnt that there are many challenges in understanding and identifying barriers, as research often focuses on non-disabled children and so data is less readily available. The absence of data relating to disabled children also arose in discussions around the Child’s Plan, rooted in Getting It Right for Every Child (GIRFEC) and the England equivalents and Serious/Significant Case Reviews. What we do know, is that disclosure often takes place many years after the onset of abuse and there are many factors that create barriers, including developmental factors, the relationship of the child and caregivers to the abuser; broader cultural issues and negative attitudes and assumptions made about disability which impact upon the way the information is heard. A number of themes were highlighted throughout these discussions including the challenges practitioners face in striking the balance between the needs of the parents and being child-centred in their approach to support. We also discussed national frameworks for understanding and anticipating the needs of disabled children.
In the afternoon, Julie and Christine led us through theories relating to disclosure, including typologies of disclosure and prompted delegates to consider the range of ways in which distress may be communicated. Two key frameworks were particularly helpful, including the Five Rs of Disclosure and A virtuous cycle of relational disclosure: protecting disabled children. The Five Rs provide a way of understanding the purpose of the disclosure of abuse by children (and adults), including: rehearsal, recovery, rescue, redress and rehabilitation and we were prompted to consider both the child’s perception of the purpose as well as those hearing the disclosure.
The discussion around A virtuous cycle of relational disclosure: protecting disabled children, supported delegates to understand the relational, dynamic process through which a teller discloses information to a listener. Key features of the model include the need to create conditions that enable children to disclose their experience and asks us to consider the values and belief system in which the conversation takes place. The model calls for listeners to be responsive to the needs of children who may have an alternative means of communicating and who may be non-verbal and asks that listeners actively facilitate communication. The model also prompts listeners to be reflexive and consider how their own experiences will affect the way in which they receive information. Finally, listeners are required to act with integrity and respond in a way that is right and moral.
The discussions in the afternoon were of great interest to me and it was heartening to hear recommendations that prioritise a shift away from the emphasis being placed on the child to disclose, towards a model that recognises the role that we, as adults play in enabling information to be shared. We recognise that children with disabilities are less likely to verbally communicate a disclosure of maltreatment and so it is our collective responsibility to be aware of and respond to, signs of maltreatment or sudden changes of behaviour. With this shift in thinking comes a recognition that the needs of practitioners also need to be addressed, so that we can ensure they feel competent and confident in their roles as aware and responsive communicators. Opportunities for peer support or more structured supervision were identified as central to building confidence and for ensuring that practitioners had capacity to both listen and act with integrity.

Contributed by Emma Mairi Hanley
Child Protection Health Consultant, CELCIS

Please see below a link to the book containing the chapter on 5Rs and Model of Disclosure.