Aims In 2009 the Department for Children, Schools and Families published ‘Safeguarding Disabled Children: Practice Guidance’. This states that disabled children are more likely to be abused than non disabled children. Evidence for this comes from North American studies which suggest that disabled children are 3.4 times more likely to be abused in general and 3.8 times and 3.1 times more likely to be physically abused and sexually abused respectively. We therefore undertook a local clinical audit of all medical examinations of children for suspected non-accidental injury or sexual abuse to see if doctors are identifying those children who are disabled and how the rates of disability in this population compare with the published data.
Methods Locally, the paediatric team serves a population of 120 000 children. When a child is referred for a medical examination as part of an investigation of suspected physical or sexual abuse the paediatrician completes a locally devised proforma which records whether the child has a disability as well as the medical findings. Data were collected from all proformas completed between 1 October 2008 and 1 October 2010.
Results 546 proformas had been completed. 50 of 350 children examined for signs of physical abuse had a disability (14%). 28 of 196 children examined for signs of sexual abuse had a disability (14%). There were some differences in who first initiated the concerns of possible abuse. 27% of disabled children were referred by an educational professional while only 18% of non disabled children were. Yet rates for parents and social workers initiating the concerns were similar between both groups.
Conclusion Knowing that the local paediatric team serves a population of 120 000 children of which 10% will have a disability, our data indicates that local disabled children are 1.5 times more likely to be examined for physical or sexual abuse than non disabled children. This is less than would be expected from the Practice Guidance. Questions now need to be addressed: are we missing the abuse of disabled children locally or is the American data describing a different population? More detailed analysis of local data is being undertaken.