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Contents

Introduction

Purpose of Guidance

What does this mean for Practice?

Vulnerability of Disabled Children and Young People

Possible Indicators of Abuse

Deprivation of Liberty Practises

Listening to and Communicating with Disabled Children and Young People

Procedures

Responding to Concerns about Sexual Abuse

Allegation of Abuse Carried out by Employee, Agency Worker, Volunteer Against a Disabled Child

Managing Transitions to Adult Services where Child Protection /Safeguarding Concerns Persist

Introduction

This practice guidance has been based on guidance published by Nottingham City and Nottinghamshire LSCB and Tadworth Children's Trust.

Safeguarding the welfare of disabled children and young people is everybody's responsibility. Attitudes in society and amongst the children's workforce can lead to a view that the abuse of disabled children does not happen or that disabled children are somehow less harmed by abuse, this in turn undermines the safeguarding of disabled children at all levels.

This practice guidance starts from the premise that disabled children have exactly the same human rights to be safe from abuse and neglect and to be protected from harm as non-disabled children. Research demonstrates that disabled children are more vulnerable to being abused than their non-disabled peers and that agencies need to be more vigilant to the need to safeguard disabled children.

All children and young people should have the opportunity to achieve optimal development according to their circumstances and age. Disabled children and young people have a right to services which support and safeguard them and maximise their independence.

The term "disabled children and young people" in this context is intended as a broad and inclusive term which may include any child or young person who has a physical, sensory or learning impairment or a significant health condition.

The Disability Discrimination Act 2005 (DDA) defines a disabled person as someone who has "a physical or mental impairment which has a substantial and long-term adverse effect on his or her ability to carry out normal day-to-day activities." According to the DDA 'substantial' means 'more than minor or trivial' and 'long-term' means that it 'has lasted or is likely to last more than a year'.

The key issue in safeguarding disabled children is not the definition of disability used but the impact of abuse or neglect on a child's health and development, and consideration of how best to safeguard and promote the child's welfare.

Purpose of Guidance

The purpose of this guidance is to ensure all agencies are assisted in their responsibilities to:

• Ensure the focus is maintained on the child/young person;
• Safeguard from harm and promote the welfare of disabled children and young people;
• Understand the particular issues which influence the safety and welfare of disabled children and ensure these are acted upon;
• Ensure that the need for expertise in both safeguarding and promoting the welfare of the child, and in relation to disability is recognised and brought together in order that disabled children receive the same levels of protection from harm as non-disabled children;
• Make clear the critical importance of communication with disabled children, including recognising that almost all children can communicate preferences if they are asked in the right way, by people who understand their needs and have the skills to listen to them;
• Reinforce the right of disabled children and their families to a thorough assessment of their needs and to services, which safeguard and promote the welfare of children;
• Ensure all agencies recognise that safeguarding and promoting the welfare of disabled children depends on effective information sharing, collaboration, shared expertise and understanding between agencies and professionals.

Children and young people from black and minority ethnic, particularly those of Asian origin, are over-represented and frequently are even more isolated. Many experience additional difficulties and challenges in accessing and receiving appropriate services, and discrimination

Additional guidance and procedures that should also be considered are

• Children who live away from home;
• The use of witchcraft;
• Forced marriage.

Some young people with learning disabilities may be at risk of forced marriage. Research figures demonstrate that although people of all nationalities can be forced into marriage, the practice most commonly occurs in families of South Asian origin and that it happens to children with learning disabilities for a range of reasons with potentially a number of abusive consequences.

See also guidance on how to respond to concerns regarding Children and Forced Marriage Procedure and Child Abuse Linked to a Belief in Spirit Possession (including Witchcraft) Procedure.

What does this mean for Practice?

This guidance has been produced to ensure practitioners across all agencies understand the wide ranging issues impacting on adequate and appropriate safeguarding of disabled children from harm. It is expected that:

• Professionals from all agencies need to be aware that the belief that disabled children are not abused, or beliefs that minimise the impact of abuse, can lead to denial of or failure to report abuse or neglect;
• Disabled children at risk of abuse/who have experienced abuse should be treated with the same degree of professional concern given to non-disabled children;
• Additional time and resources may be needed if an investigation of abuse is to be meaningful. This is a basic premise and should not be ignored at any stage of the safeguarding process;
• The reporting of safeguarding concerns needs to be encouraged at all levels of professional involvement, prompt and detailed information sharing is vital;
• The impairment with which a child presents should not detract from early multi-agency assessments of need that consider any underlying causes for concern;
• Where a criminal offence is alleged, investigation by the police needs to be handled sensitively and in accordance with the national guidance covering this, Achieving Best Evidence;
• Parents and carers need to be made aware of the vulnerability of their children to abuse or neglect.

Vulnerability of Disabled Children and Young People

Research indicates that disabled children face an increased risk of abuse or neglect yet they are under-represented in safeguarding systems and less likely to be protected from harm (Ann Craft Trust, 2000). Research by Sullivan and Knutson (2000) indicates that disabled children are between 3 and 4 times more likely to be abused than their non-disabled peers.

Organisations must ensure that their staff are aware that disabled children and young people are more vulnerable to being abused than their non-disabled peers for a range of reasons. The reasons for additional vulnerability include:

• They are more likely to be socially isolated with fewer outside contacts than non-disabled children;
• Their dependency on parents and (multiple) carers for practical assistance in daily living, including intimate care, increases their risk of exposure to abuse;
• They have impaired capacity to resist or avoid abuse;
• There may be speech, language and communication needs which may make it difficult to tell others verbally what is happening. There may only be a small number of people with the skills to communicate with the child;
• They often don't have personal or confidential access to someone they can trust to disclose that they have been abused, as they are unlikely to have the opportunity to speak to an adult on a one-to-one basis;
• They are especially vulnerable to bullying and intimidation;
• They have an increased need for physical handling, for example in hoisting, lifting and feeding;
• There may be a lack of support/training for parents and carers in dealing with behaviour that challenges them;
• The child/young person may be perceived as being of lower status;
• Parents may accept inadequate standards of substitute care as a result of their own need for support;
• Some children may behave in ways which are self-harming, and this can lead to potentially abusive injuries being missed;
• There may be an assumption that challenging behaviour is an integral part of the child's condition, rather than a response to abusive treatment or a negative reaction to medication. Examples of this would include smearing faeces, children who soil themselves and children on the autistic spectrum who display behaviours that are challenging;
  
  All of these are forms of behaviour which could be indicators that a child is upset or distressed and staff should ensure that assessments are objective and consider all possible reasons for such behaviour are explored;
  
  If there are concerns that a child's behaviour is an indicator that they are experiencing harm then this must be discussed with children's social care;

Organisations must ensure that arrangements are in place to minimise the likely impact of these vulnerabilities on disabled children and young people by:

• Ensuring that necessary policies and procedures are in place for;
  • Responding to disclosures of abuse;
  • Intimate care and administering medication;
  • Dealing with challenging behaviour;
• Ensuring that all staff coming into contact with disabled children are trained appropriately, recognise vulnerability to abuse and understand their roles and responsibilities in relation to safeguarding. This must include all ancillary staff;
• Where a child/young person is cared for away from home ensuring they have access to an independent advocate;
• Promoting children and young people's rights and right to safeguarding and ensuring they have access to accessible information about their rights in a format they can understand;
• Ensuring that children and young people's basic right to communication is always met.
• Ensure that children and young people have access to information about strategies for keeping safe that is usually available to other children and young people;
• Ensure that commissioning arrangements and contracts explicitly include obligation to comply with safeguarding standards and adherence to interagency procedures of the Children and Adults Safeguarding Boards.

Negative assumptions and attitudes can lead to institutional discrimination; this in turn can lead to disabled children not being afforded the same levels of protection from harm as their non-disabled peers. Possible reasons for this include:

• Concerns not being recognised as safeguarding issues;
• Over identifying with the parent/carer;
• A reluctance to challenge parents or carers;
• A willingness to believe abuse has not occurred as it is difficult to obtain evidence;
• Lacking the skills to communicate with the child.

Direct Payments/Self Directed Support

Direct Payments / Self Directed Support is the scheme whereby, following an assessment by children's social care parents are provided with a budget to purchase support services to meet the assessed need of their child.

Whilst the use of personal budgets and direct payments supports empowerment and choice for parents/carers and disabled young people it can also contribute to vulnerability of abuse if safer recruitment practices are not adopted, e.g. checks are not made to ensure that the person providing the service is suitable to do so. If minimum requirements in respect of checks and references are not followed unsuitable people may be employed. The local authority cannot insist that parents/carers undertake such checks but strongly encourage them to do so.

The Local Authority will exercise discretion in the making of payments and can decline to do so if they consider a child may be placed in a situation where they may be at risk of harm. The Local Authority has a duty to ensure that Direct Payments are used in a way that ensures the child / young person's welfare is safeguarded.

Possible Indicators of Abuse

Disabled children can, of course, be abused and neglected in the same way as non-disabled children; however, they can also be abused in ways that other children cannot. The early indicators suggestive of abuse or neglect can be more complicated for practitioners to recognise and understand. Professionals in all agencies who come into contact with disabled children and young people are in a position to identify indicators that the child may be suffering or may be at risk of Significant Harm.

Guidance regarding how to respond to such situations is provided in the Inter-agency Child Protection Procedures which apply equally to disabled children and young people. A child/young person's disability should always be considered when considering whether Significant Harm might be indicated.

Disabled children and young people may also be at risk of being abused in other ways including:

• Force feeding or inappropriate feeding, which would include withholding food or not using prescribed food;
• Their personal care needs may not be met adequately, e.g. a child who smears or soils is left in unhygienic conditions;
• Physical restraint being carried out unnecessarily or not in accordance with agreed guidelines;
• Rough handling, this would include for example disproportionate use of force when dressing or undressing a child;
• Extreme behaviour modification including the deprivation of clothing, medication or food, limiting movement, restricting freedoms, being locked in or confined in small spaces (see section on restrictive practices below);
• Actions taken by a carer for the sake of their own convenience and without regard for the consequences to the child or young person, the impact of which is potential or actual humiliation or risk to the health and well being of the child. e.g shaving of pubic hair to ease the carer's responsibility in meeting personal hygiene needs;
• Misuse of medication, sedation, heavy tranquillisation or withholding medication against medical advice;
• Being denied access to medical treatment;
• Deliberate misapplication of programmes or regimes which contravene expert advice, for example,  implementation of Occupational Therapist or Physiotherapist guidance which may result in the child experiencing complications in the future, e.g. physiotherapy in cystic fibrosis;
• Deliberate use of ill-fitting equipment e.g. callipers, sleep board which may cause injury or pain, inappropriate splinting;
• They may be more vulnerable to abuse through the use of Information and Communication Technology (ICT), i.e. inappropriate exposure via social networking media or online bullying;
• Inappropriate restriction (i.e. long periods in wheelchair/bed when this against professional advice);
• 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;
• As with other children disabled children are potentially vulnerable to abuse from Fabricated or Induced Illness, which is where parents/carers seek unnecessary medical attention for the child. If this is suspected then staff should refer to the specific guidance regarding this in the Fabricated or Induced Illness Procedure.

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

• 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;
• A failure to recognise that behaviour, including sexually harmful behaviour or self-injury, may be indicative of abuse;
• Some health/medical complications may influence the way symptoms present or are interpreted. 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.

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 or a teacher. It is essential therefore that relevant and pertinent information is incorporated into any assessment and recorded clearly on a child/young person's file.

Deprivation of Liberty Practises

Deprivation of liberty refers to any practices where one person or more restricts the movement of another. These can be physical barriers which involve a child being prevented from freedom of movement or being confined inappropriately (including for long periods of time). Examples of restrictive practices are:

• Spending long periods of time in a wheelchair within the home environment against professional advice;
• Leaving immobile children in bed for prolonged periods against professional advice;
• Locking children in a room, sometimes referred to as seclusion;
• Using "reins" for older children whilst out in the community.

It is recognised that there are a number of disabled children who may have types of behaviour which severely challenges those who care for them. This would include, for example, those who self-harm, those who target/physically harm other children in the household and those who are at risk of running away or exposing themselves to other forms of harm if they are not under constant supervision.

It is often these types of behaviour that may lead parents and carers to engage in restrictive practices. Those involved with the child should not assume that the behaviours described are directly associated with the child's disability but may be due to emotional distress / anxiety as would be the case if the child exhibiting these behaviours were not disabled. Workers should always work from the premise that children / young people who exhibit these behaviours do so for a reason.

When workers become aware that parents/carers are using restrictive practice then they should recognise that this requires further assessment and that parents/carers are supported to find an alternative approach to managing the child/young persons behaviour. In most cases, and in all cases that involve locking children in, a referral must be made to children's social care.

It is important that parents/carers are fully involved in the completion of this assessment. It must be identified from their point of view what they see as the behaviour issues that present with risk and which has led them to apply restrictive care to their child. This needs to include other individuals within the family (e.g. siblings) who parents/carers deem to be at risk from these behaviours including the child subject to this assessment.

All such assessments must be multi-agency and involves other key agencies appropriate to the specific child. It is crucial to involve parents/carers in implementing measures which keep their child safe within their home and that parents and professionals work together to seek the best resolution.

Listening to and Communicating with Disabled Children and Young People

"Ascertaining how and what a child communicates is key to safeguarding them whatever their level of impairment" (Marchant and Page, NSPCC, 2003 p62).  Workers must not rely on parents/carers to speak for the child or use someone who may be abusing the child to assist with communication.

Many disabled children and young people have a communication impairment which creates barriers in reporting difficulties, worries or abuse. Children who use alternative means of communication are particularly vulnerable due to the limited number of people they can tell; in addition to this, many children are not taught or given the words they need to disclose abuse.

Additional and augmentative means of communication include objects, pictures, symbols and signs, electronic communication device, British Sign Language, Makaton and finger spelling etc. Professionals such as speech and language therapists, occupational therapists and physiotherapists, doctors and school nurses can provide advice and support for disabled children/young people and may be able to advise on a range of communication issues.

As some disabled children and young people use means of communication that are very personal to them, it is important to involve professionals who know the child well, e.g. teachers, residential social workers. If the assessment is related to an allegation or concern about an individual who works with the child then it would not be appropriate to involve that individual and careful thought must be given as to whether it is appropriate to use another person from the same establishment team. Any such decision would need to be made in the strategy discussion.

All reports that are written about a disabled child or young person should include their views, wishes and feelings, and how they have been ascertained. Any particular communication needs that they have must be met. When acting under Section 47 (Local Authority's duty to investigate) the 2004 Children Act amends the 1989 Children Act to strengthen the Local Authority's responsibility to "ascertain the child's wishes and feelings regarding the action to be taken with respect to him" (Children Act 2004 section 53).

The best practice for disabled children is for a worker with appropriate communication skills to be allocated, where this is not possible the worker who best understands the child should be included throughout the assessment.

Workers should identify any barriers to accessing information and must provide information taking account of the child/young person's impairment and preferred communication methods and make it available within agreed time frames.

Procedures

Making a Referral

Further guidance regarding the making and receiving of referrals is available in the Referrals Procedure.

In making a referral about possible abuse of a disabled child it is particularly important to give as much relevant information about the child's context as possible, including:

• A description of the disability, special needs or impairment that affects the child;
• Whether any disability or condition has been medically diagnosed or assessed;
• How the disability or impairment affects the child on a day to day basis;
• The child's level of understanding, language ability and means of communication; and
• How the child shows that he/she is happy or unhappy.

Where a professional has concerns that a disabled child may be being abused or neglected, they should follow their own agency policy and procedures for making a referral to the Children's Social Care. Of the utmost importance however, is to share such concerns at the first opportunity either with an appropriate manager or with the designated member of staff who has responsibility for safeguarding in the agency/service provider, so that a referral can be made promptly.

Referral should include as much information as possible including any significant events and chronologies and written confirmation of the referral sent to children's social care within 24 hours of making a referral by phone.

If the concerns raised are not thought to require a referral to Children Social Care, this decision and the reason for it should be recorded in the child's records. Workers should consider whether it may be appropriate to undertake an assessment using the Common Assessment Framework (CAF). There should be liaison with any other agencies to ensure appropriate support services are in place.

What to do if your referral is not responded to but you remain concerned

Professional disagreements must not be a barrier to children receiving the support that they need. If difficulties are encountered in making a referral this must be reported to the line manager responsible for the service. Such concerns should be put in writing and escalated in a timely fashion where resolution cannot be agreed.

Professional disagreements must be escalated where resolution cannot be achieved and the Resolution of Professional Disagreements in Work Relating to the Safety of Children Procedure sets out how to deal with interagency disagreements. This highlights the importance of:

• Consulting with line manager or practitioner lead as appropriate;
• Ensuring disagreements do not put the children at risk and obscure the focus on the child;
• Identifying and clarifying issues using procedures and promote resolution;
• Managers should discuss cases where there has been escalation of concerns;
• Confirmation by letter to determine any outstanding issues;
• Once resolved the Coventry Safeguarding Children Board (CSCB) subcommittee may need to review cases as a learning opportunity;
• Individuals may need to debrief to promote good working relationships.

Referrals to Children's Social Care

Children's social care will record information from the referrer in relation to all referrals made.

For disabled children additional information will be required and more questions will need to be asked, for example:

• Who is the most appropriate person to respond to this referral?
  
  It is essential that an assessment of a disabled child is undertaken by staff who have the knowledge and the awareness to assess the risk of harm to a disabled child and know how to work best together to provide a high quality service to the child.
  
  Concerns about children with severe and lifelong disabilities will be investigated by a social worker from the Disabled Children's Team. These staff have both knowledge and experience in safeguarding disabled children
• Are extra resources required?
  
  For example, where there are communication difficulties, is there a need for specialist advice so that assessments can be properly undertaken.
• What is the best way to gather the information? Is one visit enough?
  
  A first contact visit may not be enough to identify child protection concerns. There needs to be discussion with the professionals, the family and the child about the circumstances of why the referral was made.

When making a referral it is important that the information given is full, accurate and identifies the impact of disability as this is vital in evaluating the likelihood of significant harm. In addition the following questions should be asked when a referral is received concerning a disabled child:

• What is the disability, special need or impairment that affects the child? Ask for a description of the disability, e.g. learning disability doesn't describe how it impacts on the child or his or her needs.
• How is the impairment/condition spelt?
• How does the disability or impairment affect the child on a day to day basis?
• How does the child communicate or express their wants and needs?
• Has the disability been diagnosed or medically assessed?

Investigation and Assessment

Disabled children are subject to the same procedures for investigating abuse as non-disabled children.

Where there is reasonable cause to believe that a child or young person is at risk of Significant Harm they should be referred to Children's Social Care in order that relevant enquiries can be carried out and the child effectively safeguarded in accordance with the Referrals Procedure. The first responsibility is to ensure that the child is safe while further investigations are carried out.

It is crucial that in relation to a disabled child or young person the investigation is planned and carried out in a way which is informed by an understanding of their impairment.

The safeguarding needs of any siblings living in the family home also need to be considered. Where the parents of a disabled child have a disability themselves, arrangements need to be put in place to respond appropriately to their needs throughout the investigation / assessment process and there should be liaison with Adults Social Care Services.

There will be situations where there are significant concerns about a child or young person, and it will be necessary clarify their risk of Significant Harm. In these circumstances the objective of the Police and Children's Social Care involvement is to determine whether action is required to safeguard and promote the welfare of the child or children who are subjects of the enquiries.

A Core Assessment is the means by which a Section 47 Enquiry is carried out. LA Children's Social Care has the lead responsibility for the Core Assessment under Section 47 of the Children Act, 1989. The assessment is undertaken in accordance with the Framework for Assessment of Children in Need and Their Families. It should be led by a qualified and experienced social worker.

These enquiries should take additional guidance regarding disabled account of any information gathered through the Common Assessment Framework (CAF) or Initial Assessments.

Strategy Discussion/Meeting

Where an investigation is being planned as a result of concerns about Significant Harm to a disabled child or young person, an early Strategy Discussion should be held involving key professionals who know them.

Specific considerations for the Strategy Discussion or meeting include:

• The child/young person's preferred communication method for understanding and expressing themselves;
• Timeliness of how and when the child / young person will be interviewed. The child / young person may have difficulty in recalling events or may have poor time concept;
• Who should interview the child/young person;
• Whether someone with a specialism in the child/young person's preferred communication method should be involved;
• Whether the interview will have to be significantly adapted to support the child/young person's understanding and their involvement;
• The venue of the interview;
• Whether additional facilities or equipment is necessary.

Planning for Section 47 Enquiries must include an informed consideration of the child's needs. This will include issues such as the choice of venue for interviews, the need for additional equipment or facilities, and the involvement of someone with specialist skills in the child's preferred method of communication.

If the parents of the disabled child also have a disability, the Strategy Discussion must consider how to accommodate their needs during Section 47 Enquiries. The social worker will consider whether Community Services should be involved in the Strategy Discussion, or notified of its outcome.

Where there is a need for a medical examination, the Strategy Discussion will give particular consideration to the selection of a medical professional to undertake the examination, the venue and timing of the examination, and the child's ability to understand the purpose of the procedure. Where there are medical uncertainties, clear time scales need to be set for these to be addressed.

When a disabled child is the alleged perpetrator of abuse, enquiries must be handled with particular sensitivity. The needs of the victim and the needs of the alleged aggressor will be considered separately as set out in Children who Display Sexually Abusive Behaviour Procedure.

Agencies must not make decisions about the enquiries based on assumptions about the ability of a disabled child or young person to give credible evidence, or to withstand the rigours of the Achieving Best Evidence Practice Guidance.

Where there is to be a police investigation into allegations of abuse or neglect of a disabled child, those undertaking such investigations should not make presumptions about the ability of the child to give credible evidence.

Interviewing children with disabilities

There is rarely any reason in principle why children with disabilities should not take part in a video-recorded interview, provided the interview is within the Achieving Best Evidence in Criminal Proceedings Guidance. All such investigations should be undertaken in accordance with the practice guidance Achieving Best Evidence in Criminal Proceedings: Guidance on vulnerable or intimidated witnesses including children (Home Office, 2011), which includes specific guidance in relation to disabled children. Measures made available through the Youth Justice and Criminal Evidence Act (1999), with the introduction of intermediaries, are specifically designed to address the barriers and enable disabled children to give evidence.

The phrase 'children with disabilities' encompasses a wide range of abilities and disabilities.  Interviewers need to be aware of differences between potential interviewees in their social, emotional and cognitive development, and in their communication skills, the degree of their understanding and in their particular needs. It will nearly always be necessary to seek specialist advice on what special procedures are appropriate and to consider if the services of an intermediary or an interpreter are required.

Particular attention will need to be taken to ensure that a safe and accessible environment is created for the child and that the interview suite is adapted to the child's particular needs. Children with disabilities are likely to have already come to the attention of professionals, as a result of which, information is likely to be available from existing assessments and from workers who know the child well. Such information should enable the interviewing team to make an assessment of the likely impact, if any, of a disability on communication.

Where children have specific communication difficulties, aids such as drawings or photographs may need to be prepared to facilitate questioning. All such aids should be preserved for possible production at court. It is important to find out what impact the child's disability is likely to have on the communication process, and to adopt a positive approach that focuses on the child's abilities when trying to find out how they can be helped to communicate. The impact of any medication being taken by the child on the interview, including the most appropriate timing for it, should be taken into account.

For some children, a number of shorter sessions may be preferable to a single interview. For example, children with learning disabilities often have shorter attention spans, giving rise to a need for regular and frequent breaks. In addition to this, some children with physical or learning disabilities might find communicating to be quite demanding and this is also likely to heighten the need for breaks and a slow pace, thus lengthening the duration of the interview(s).

The child needs to be given an opportunity to explain their world, especially where this might be unusual and relevant for the interview (e.g. if the child stays away from their family, if there are different adults involved with their care at home or elsewhere, if the child needs intimate care or other 'unusual' help in day-to-day life). If, for example, a child with disabilities has a number of adults involved in their care, it will be important to demonstrate their ability to distinguish reliably between these different people. Alternatively, if a child needs very invasive care procedures (e.g. intermittent catheterization), it will be helpful to establish the child's comprehension of this as a process before any discussion of possible sexual abuse ensues.

The experience of some children with disabilities might make them more compliant and eager to please or to see themselves as devalued. Some children with learning disabilities could have problems understanding the concept of truth, and interpreted communication may lead to additional confusion. Some children may need explicit permission to refute adult suggestions. Even with this permission, some children may find this impossible to do. It can help if everyone in the room makes a commitment to tell the truth.

It is important that efforts to meet these requirements do not unduly slow down the enquiry as the child or young person's safety should remain the paramount consideration at all times.

Responding to Concerns about Sexual Abuse

Disabled young people should be supported in the development of their sexuality. This may be harder for them than their non-disabled peers as they may not have access to opportunities for this to develop appropriately. However, there may be occasions where concerns are raised that sexual behaviour between two young people is abusive, exploitative or coercive.

In this event it will be essential to seek information from other professionals and the young people themselves in order to clarify the nature of their relationship, what was understood about consent and details about the incident. Investigations need to be handled with particular sensitivity with a duty of care being shown to both the victim and the alleged perpetrator.

Where significant harm is indicated as a result of concerns about abuse, Children's Social Care should be notified in order that an assessment can be carried out to ensure that the young people are safeguarded. Any assessment of a concern such as this should follow the guidance set out in the Interagency Safeguarding Children Procedures.

Allegation of Abuse Carried out by Employee, Agency Worker, Volunteer Against a Disabled Child

Disabled children come into contact with a wide range of carers, it is important that all staff are clear about the process that they should follow if they become aware of an allegation or concern which relates to an individual who works with children.

Where such concerns come to light they should be discussed with the Local Authority Designated Officer (LADO).

The type of concerns which should be discussed with the LADO. For further guidance, please see Allegations of Abuse made against a person who works with or is in contact with Children Procedure.

Managing Transitions to Adult Services where Child Protection /Safeguarding Concerns Persist

Where safeguarding concerns continue to exist for children and young people, it is critical that transitions to adult services are effectively managed from the age of 16.

This requires professionals to ensure that relevant professionals are alerted and included in the care planning processes and meetings at the earliest opportunity to ensure that as the young person moves into adulthood s/he continues to be safeguarded.

Where a young person is currently being supported and safeguarded under the Inter-agency Child Protection Procedures or Care Planning Regulations (Looked After Children) the Lead Social Worker, their manager and where appropriate the Independent Reviewing Officer (children looked after or subject to child protection plans) must ensure that

• Where there is a Child Protection Conference or Case Review meeting for young person aged 16 +, the relevant manager of the receiving adult's team is invited. Adults Services should ensure that they are represented at the relevant meetings.
• Full information on all relevant, actual or potential risks to be shared with the receiving adults' team.
• The transition arrangements and planning clearly identify and address how the risks for the young person will be managed, including any legal action.
• If there are safeguarding concerns or risks that are likely to persist as the young person reaches adulthood, an Adults Safeguarding Meeting will be convened by the relevant Adults Team Manager. A representative from children's services must attend a receiving-in Adults Safeguarding Meeting.

Further guidance for Safeguarding Adults can be found on:

On line Adult Safeguarding Procedures

Or by contacting
Safeguarding Adults Coordinator
Safeguarding Adults
Room 17, Faseman House,
Faseman Avenue,
Coventry,
CV4 9RB

E-mail: safeguarding.adults.team@coventry.gov.uk
Tel: 024 7678 6760
Fax: 024 7642 2583

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