Children with disability are at increased risk of all types of abuse, according to large American database study and NSPCC 2014 report, with 3.8 times more likely to be physically abused and neglected. The risk of abuse are accentuated by additional needs, lack of ability to communicate as well as the ability of the carers to address their needs.
Aim To raise the awareness of risk of children with disability to abuse
To compare the outcome of children with disability subject of abuse
To improve our services for children with disability
Method List of children with concern of NAI, discussed at our weekly peer review meetings, referrals from Social care for NAI medicals and NAI medical reports completed, by paediatrician, over a year period from (1 January – 31 December 2014), the audit carried out (1 /01/2015–1/09/2015).
Result 212 cases identified, with 79 (37%) Female, 81 (38%) were referred because of bruises, 20 (9%) with burn,12 (6%) red mark, 10 (5%) fractures, 4 (2%) with head injury & 42 (20%) sibling examination. 34 (16%) children identified with disabilities, of those, 36% of disabled group presented with behavioural problems & 26% had ADHD, 23% with speech and communication difficulties, 20% with learning difficulties and 20% with physical disability.
The outcome assessment of 27% of disabled children confirmed to have NAI vs 14% of nondisabled children, with relative risk of 1.88 and P value 0.07. while 29% of disabled group found their injuries to be accidental vs 49% of nondisabled with relative risk 0.51 and P value 0.06. 32% of disabled children assessment was in conclusive vs 10%, with relative risk of 3.1 and P value 0.001.
Conclusion Although of sample size was small, it is evident that children with disabilities are more likely to be have NAI with higher prevalence of 16%. The relative risk (3.3) of NAI in disabled children is higher compared to other child population. The rate of inclusive outcome is much higher with significant relative risk of (3.1). This mean the clinicians are likely to miss the NAI in children with disability. The clinicians and safeguarding team need to raise awareness of such risk and be vigilant for holistic assessment including the assessment of need, and to train the work force about such risks.
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