ObjectivePara athletes reap significant health benefits from sport but are vulnerable to non-accidental harms. Little is known about the types and impacts of non-accidental harms Para athletes face. In this literature review, we summarise current knowledge and suggest priorities for future research related to non-accidental harms in Para athletes.DesignSix electronic databases were searched between August and September 2017. 2245 articles were identified in the initial title/abstract review, and 202 records were selected for full-text review following preliminary screening. Two independent examiners evaluated each full text, and eight citations were selected based on inclusion/exclusion criteria.Data sourcesMEDLINE, Embase, PsycInfo, Cumulative Index to Nursing and Allied Health Literature, Scopus and Academic Search Premier.Eligibility criteria for selecting studiesInclusion criteria: (A) human participants; (B) written in English; (C) descriptive, cohort and case series, case–control, qualitative, mixed methods studies and all clinical trials; and (D) data pertain to harassment/abuse of youth, recreational, collegiate, national-level and/or elite-level athletes with a physical and/or intellectual impairment.ResultsMost studies focused on young, visually impaired athletes and approximately half of all studies described high rates of bullying and its social implications. One study confirmed remarkably high rates of psychological, physical and sexual harms in Para athletes, compared with able-bodied peers.ConclusionsBullying in young, visually impaired athletes is described most commonly in the available literature. Due to the limited amount of data, the prevalence of non-accidental harms in Para athletes remains unclear and information on trends over time is similarly unavailable.

Sport is a context within which human and children’s rights should be respected, promoted, and protected. Yet, research and high-profile cases demonstrate that this is not always the case. To understand the existence (or not) of reporting mechanisms for child protection violations in sport, as well as how existing reporting and response systems operate, the authors, with the support of the Centre for Sport and Human Rights, conducted research on current abuse disclosure and reporting pathways in sport. The purpose was two-fold: to describe global child protection systems and reporting mechanisms, and to identify major areas of stakeholder concern, in terms of effective case resolution, healing, and children’s experiences along reporting pathways in sport. Two sources of evidence were tapped. First, a rapid evidence assessment consisting of a literature review and an exploratory survey with 112 global stakeholders was conducted. Second, focus group interviews informed by the evidence assessment were held with nine athletes with lived experiences of abuse in youth sport and 13 global human and children’s rights experts primarily working outside of sport. Through this emergent research, a ‘pathway’ or ‘journey’ to incident reporting in sport was developed, summarized as 5 ‘Rs’: Readiness, Recognition, disclosure and Reporting, Response, and Remedy, which are similar but not identical to existing trauma frameworks. Each stage of the reporting journey appears to be influenced by a range of contextual, organizational, relational, and individual factors. All told, the disclosure of child protection violations in sport is a complex and dynamic process where myriad factors interact to influence outcomes, including healing. Key recommendations include: (a) establishing a global Safety Net Environment in sport practice with varying applications from region to region, (b) building bridges with specific partner organizations to enhance child protection and safeguarding work in sport and (c) bringing safeguarding to unregulated sporting environments.

Members of the athlete medical/sport science support team must be confident that athletes are benefitting from treatment, and that they are not victims of medical mismanagement. Athletes must not be treated differently to any other patient in society. This chapter discusses why protection of the child athlete is necessary, and how child athletes can be subjected to psychological abuse, which may form the gateway to other types of abuse. These can include physical abuse, sexual abuse, and neglect, all of which are prevalent in all sports and at all levels. It also covers particularly vulnerable groups of child athletes, including the elite, the disabled, and the LGB (lesbian, gay, bisexual) athlete populations. It covers the many sport organizations working in the field of child athlete protection, as well as the existing statutes governing the rights and freedoms of children in sport.