Slide outline: Children with disability: Inclusive practices and child-safe organisations

Return to CFCA webinar - 12 October 2017

1. Children with disability: Inclusive practices and child-safe organisations

CFCA Webinar 12th October 2017

  • Professor Gwynnyth Llewellyn

2. Defining themes

  • Children with disability evoke particular images – these are usually inaccurate
  • Not all children with impairment, health condition or chronic illness are disabled
  • Being disabled results from interactions between the child and their environment
  • Children with disability are children first
    • Disability does not define their lives
    • They are children and young people going about their everyday lives
    • They have the right to be protected

3. However …

  • The everyday lives of children with disability do not mirror the everyday lives of other children in the community
  • Children with disability spend more time than other children with adults in institutional contexts
  • Children with disability spend a great deal of time with non-familial adults away from the public eye or in the community accompanied by an adult
  • Children with disability may be segregated into disability specialist settings or ‘included’ in mainstream settings – with different organisational cultures

4. Children with disability continue to be over-represented in unsafe environments

  • Over-represented beyond their numbers in the population
    • mainstream closed environments – juvenile justice, detention centres –
    • foster care and residential out-of-home care environments
    • reportable conduct matters
  • The systems put in place to cater for the ‘special needs’ of children with disability can and do isolate them from other children
    • They miss out on:
      • formal education about protective behaviours
      • the incidental learning about staying safe that children and young people share with each other
    • Specialist disability and mainstream inclusive services may harbour:
      • Out-of-date attitudes toward children with disability

5. Disability and child sexual abuse in institutional contexts

  • Professor Gwynnyth Llewellyn, Professor of Family and Disability Studies
  • Dr Sarah Wayland, Post-doctoral Research Associate
  • Ms Gabrielle Hindmarsh, Senior Project Officer
  • Centre for Disability Research and Policy February 2016 – August 2016
  • www.childabuseroyalcommission.gov.au/getattachment/495f6adf-cc06-4498-9d7d-da1b03f5d90a/Disability-and-child-sexual-abuse-in-institutional

6. We set out to answer three questions…

  • How are children with disability regarded in Australia today?
  • How likely are children with disability to be sexually abused?
  • How can we prevent sexual abuse of children with disability today and into the future?

7. Current discourses about disability in Australia

  • The institutional practices of the past
  • The relatively recent focus on individual rights, person-centred supports and community presence and participation for people with disability

Continue to influence thinking about children with disability as a ‘special group’ which results in …

  • Focusing on differences rather than similarities with other children
  • Requiring ‘special’ treatment rather than community responsibility
  • Resulting in segregated and adult-dominated settings rather than inclusive child-centred settings

8. Institutional factors today…

  • Physically or ideologically separated specialist services
  • Strong power differential between staff and children with disability
  • Institutional cultures of ‘caring for’ rather than respecting the rights of children with disability
  • Staffing challenges - unacceptable behaviours may be overlooked
  • Staff poorly trained in understanding sexual abuse
  • Parents reluctant to complain
  • Disability organisations disability focused rather than child focused
  • Between children sexual abuse - acting out or ‘play’ behaviours

9. Prevalence and risk of sexual abuse

  • There is no national data on prevalence or risk of abuse against children with disability although children with disability make up about 6% of the Australian population
  • Jones et al. (2012) published a meta-analysis in the Lancet of 17 international studies on violence against children with disability
  • Findings on prevalence, that is rate of frequency of sexual violence against children with disability:
    • Pooled prevalence estimate of sexual violence 13.7 % (<1% - 40%)
    • Fixed prevalence estimate 8.9%
    • Together this means … that between 9-14 children in every 100 children with disability are likely to experience sexual abuse
  • Findings on risk, that is the population risk of children with disability being sexually abused:
    • Risk ratio for sexual violence of 2.88
    • This means …. that relative to non-disabled children, children with disability are nearly 3 times more likely to experience sexual abuse
  • Strongest finding is in relation to mental and intellectual impairment with relative risk 4.6 times higher than children without disability

10. Turning TO THE SCALE OF THE ISSUE

  • Children with disability and abuse is NOT A TRIVIAL PROBLEM in Australia
    • 2000: Review of NSW Care and Protection Records found 24% of all care matters about children with disability or medical condition
    • 2016: NSW Ombudsman found overall 29% of reportable conduct matters involved children with disability
      • 36% of closed notifications in care and protection involve children with disability –when children with disability only12% of this population
      • 21% of notifications from education involve children with disability – when children with disability are only12% of this population
    • 2017: WA 26% of maltreatment allegations and 29% of substantiated allegations were about children with disability

11. New Australian study 2017

  • Linked administrative data from Western Australia by Telethon Institute published in Pediatrics on line March 6 (Maclean et al. 2017)
    • Focused on maltreatment allegations and substantiated allegations
    • All children born in WA between 1990 and 2010
  • Children with disability comprise:
    • 25.9% of maltreatment allegations
    • 29% of substantiated allegations
  • Threefold increased risk of substantiated allegations for children with intellectual disability, mental/behavioural problems and conduct disorders
  • This increased risk remains after adjusting for child, family and neighbourhood risk factors
  • Severity of disability with 2.73 higher likelihood of maltreatment allegation for children with borderline intellectual disability (Maclean et al. 2017)

12. Turning to the grey literature and case studies

  • Child characteristics
    • Severity of disability particularly intellectual disability and physical disability together and multiple disability
    • Children requiring frequent intimate personal care
    • Children who cannot communicate verbally or easily
    • Children who may not develop awareness of personal boundaries
    • Children who may be less aware of difference between right and wrong
    • Children who spend a lot of time in settings that expect compliance
  • Environmental contexts
    • Segregated settings with limited external visibility or direct supervision
    • Being alone with an adult – personal intimate care, school transport
    • Organisational culture and attitudes towards children with disability
    • Poor or absent leadership and governance mechanisms
    • Closed institutional settings

13. Child safe organisations in disability context – current policy context

  • National Disability Service Standards 2013 do not address child safe organisations, support services or independent providers
  • NDIS Quality and Safeguarding Framework 2017 does not specify child safe organisations
  • The National Child Protection framework and implementation plans locates risk in the child with disability
  • The Child Protection Minimum Data Set (AIHW 2017) findings do not include disability.
  • The nationally agreed disability identifier has not been implemented in jurisdictions around Australia
  • Australia lacks an evidence base on prevalence and risk of sexual abuse of children with disability in institutional and other contexts

14. Factors in prevention strategies from the literature

  • No Australian data on prevention strategies
    • Recent heightened focus on safeguards for adults is not complemented by similar focus for children
  • Primarily a literature of discussion and recommendations NOT EVIDENCE
    • Children: developing programs to teach children to be safe
    • Families: fact sheets and guides to assist families
    • Organisational mechanisms: such as Working with Children Check and internal reporting processes
    • Culture: creating child safe organisations
    • Wider community: children with disability are everyone’s responsibility

15. WHERE TO FROM HERE?

A child-centred framework, that identifies ways to be ‘child-safe’ means that children with disability are active agents in their own lives. This framework provides space for effective population approaches and targeted interventions that place the child at the centre of conversations – identifying ways to assist all involved – children, families, staff, organisations and the community – and to implement prevention strategies to minimise risk

16. MOVING FORWARD – NEW DIRECTIONS – CHILD SAFE ORGANISATIONS

  • Children with disability need to be considered as children first and as agents in their own right
  • Population health approaches require primary, secondary and tertiary prevention for all children including children with disability
  • Children with disability at heightened risk of sexual abuse so targeted strategies needed alongside the child safe organisation approach
    • Children with disability have rights and a voice
    • Our responsibility is to listen to their voices and to implement their rights
    • United Nations Convention on the Rights of the Child, and the United Nations Convention on the Rights of Persons with Disabilities

17. MOVING FORWARD – NEW DIRECTIONS ….

  • Child safe organisations must be safe for all children which means children with disability too

Due diligence in understanding and responding to the particularities relevant to children with disability

  • For children
    • Protective behaviours taught in appropriate ways using materials in accessible, culturally appropriate and diverse formats including Easy English, community languages, Auslan, Braille, audio, video, large print and screen reader
    • Opportunities for informal learning, peer to peer about staying safe
    • Opportunities for their non-disabled peers to learn about the heightened risk of abuse for children with disability
    • All adults in the organisation trained to recognise signs of abuse in children with disability – changes in behaviour, excessive fear with particular adults, injuries to private areas

18. Responding to the particularities of children with disability

  • For families
    • Targeted information about increased risk of maltreatment, grooming in relation to specific vulnerabilities of children with disability, and identifying signs of sexual abuse including behavioural change
    • Targeted information about their rights to speak out about concerns and who they can turn to if staff are dismissive or if they fear reprisal
    • Targeted information about how staff in mainstream and disability specific organisations may continue to view children with disability through a ‘disabled lens’
    • Targeted training opportunities for talking to their children about protective behaviours and particularly when their child receives intimate personal care from non-familial adults
    • Targeted information about what to find out before agreeing to organisational or individual support for their child with disability

19. MOVING FORWARD – NEW DIRECTIONS ….

  • For staff and managers
    • Changing staff attitudes to understand and respect children with disability as children first, disability second
    • At every level, staff trained in and monitored for listening to children with disability acknowledging that their voices come in many forms
    • Educating all personnel on increased risk of maltreatment for children with disability and the situations in which this is likely to occur
    • Educating all personnel on identifying and responding to signs of behavioural or emotional distress that may indicate sexual abuse
    • Educating all personnel on the expanded power differential that exists between adults and children with disability and how they can monitor their own behaviours and that of their colleagues
    • At every level, staff and volunteers rewarded for child safe practices

20. MOVING FORWARD – NEW DIRECTIONS…

  • For organisations
    • Changing organisational cultures to acknowledge children with disability as children first, disability second and respect the rights of children with disability
    • Meeting best practice standards for child safe organisations including particularities relevant to children with disability
    • Monitoring, oversight and regulation requirements that address the specific situation of children with disability incorporated in all policies and procedures
    • Ensuring a culture in which at every level:
      • initial and ongoing training of all staff and volunteers is mandatory
      • staff and volunteer training is competency and behaviourally based in knowledge, skills and attitudes
    • Disability specialist organisations and providers developing communities of practice to share knowledge and experience and develop best practices on the ground

21. When children with disability are regarded as equal…

  • Children with disability will be heard no matter what form their voice takes
  • Families of children with disability will feel confident to speak up and have choices about which people and what organisations spend time with their children
  • Children with disability will be supported to learn protective behaviours with their non-disabled peers and with extra support if needed
  • And, …
  • There is now good evidence of the nearly three times increased risk of maltreatment for children with disability
  • When children with disability are regarded as equal this would no longer be the case

22. References and resources

  • A resource sheet will be on the AIFS website with links to relevant resources and websites as well as the references from today’s presentation.
  • Feel free to contact us if you have more questions.
  • The research team can be contacted via
  • Centre for Disability Research and Policy

www.sydney.edu.au/health_sciences/cdrp/

Email: disabilitypolicy.centre@sydney.edu.au

Phone: +61 2 9351 9553 

23. Questions?

  • Join the conversation & access key resources
  • Continue the conversation started here today and access related resources on the CFCA website:
  • www.aifs.gov.au/cfca/news-discussion

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