Focus: Violence against children with disabilities
By Lisa Jones, Mark A. Bellis, Sara Wood, Karen Hughes, Ellie McCoy, Lindsay Eckley, Geoff Bates
Centre for Public Health, Liverpool John Moores University
Department of Violence and Injury Prevention and Disability, World Health Organization
Children with disabilities are three to four times more likely to be victims of violence.
Children and adults with disabilities often face a wide range of physical, social and environmental barriers to full participation in society, including reduced access to health care, education and other support services. They are also thought to be at significantly greater risk of violence than their peers without disabilities. Understanding the extent of violence against children with disabilities is an essential first step in developing effective programmes to prevent them from becoming victims of violence and to improve their health and the quality of their lives. To this end, research teams at Liverpool John Moores University and the World Health Organization conducted the first systematic review, including meta-analysis, of existing studies on violence against children with disabilities (aged 18 years and under).
Seventeen studies, all from high-income countries, met the criteria for inclusion in the review. Prevalence estimates of violence against children with disabilities ranged from 26.7 per cent for combined measures of violence to 20.4 per cent for physical violence and 13.7 per cent for sexual violence. Estimates of risk indicated that children with disabilities were at a significantly greater risk of experiencing violence than peers without disabilities: 3.7 times more likely for combined measures of violence, 3.6 times more likely for physical violence and 2.9 times more likely for sexual violence. The type of disability appeared to affect the prevalence and risk of violence, although the evidence on this point was not conclusive. For instance, children with mental or intellectual disabilities were 4.6 times more likely to be victims of sexual violence than their non-disabled peers.
This review demonstrated that violence is a major problem for children with disabilities. It also highlighted the absence of high-quality studies on the topic from low- and middle-income countries, which generally have higher population rates of disability, higher levels of violence and fewer support services for those living with a disability. This gap in the research urgently needs to be filled.
A number of explanations have been put forward to account for why children with disabilities are at much greater risk of violence than children without disabilities. Having to care for a child with a disability can put extra strain on parents or households and increase the risk of abuse. Significant numbers of children with disabilities continue to be placed into residential care, which is a major risk factor for sexual and physical abuse. Children with disabilities that affect communication may be particularly vulnerable to abuse, since communication barriers can hamper their ability to disclose abusive experiences.
The Convention on the Rights of Persons with Disabilities aims to protect the rights of individuals with disabilities and guarantee their full and equal participation in society. In the case of children with disabilities, this includes ensuring a safe and stable progression through childhood and into adulthood. As with all children, a safe and secure childhood provides the best chance of achieving a healthy, well- adjusted adulthood. Adverse childhood experiences, including violence, are known to be related to a wide range of negative health and social out- comes in later life. The extra demands placed on children with disabilities – who must cope with their disabilities and overcome societal barriers that increase their risk of poorer outcomes in later life – mean that a safe and secure childhood is particularly important.
Children placed away from home need increased care and protection, and institutional cultures, regimes and structures that exacerbate the risk of violence and abuse should be addressed as a matter of urgency. Whether they live in institutions or with their families or other caregivers, all children with disabilities should be viewed as a high-risk group in which it is critical to identify violence. They may benefit from interventions such as home visiting and parenting programmes, which have been demonstrated to be effective for preventing violence and mitigating its consequences in children without disabilities. The effectiveness of such interventions for children with disabilities should be evaluated as a matter of priority.