Maltreatment of Children With Disabilities

Abstract

Over the past decade, there have been widespread efforts to raise awareness about maltreatment of children. Pediatric providers have received education about factors that make a child more vulnerable to being abused and neglected. The purpose of this clinical report is to ensure that children with disabilities are recognized as a population at increased risk for maltreatment. This report updates the 2007 American Academy of Pediatrics clinical report "Maltreatment of Children With Disabilities." Since 2007, new information has expanded our understanding of the incidence of abuse in this vulnerable population. There is now information about which children with disabilities are at greatest risk for maltreatment because not all disabling conditions confer the same risks of abuse or neglect. This updated report will serve as a resource for pediatricians and others who care for children with disabilities and offers guidance on risks for subpopulations of children with disabilities who are at particularly high risk of abuse and neglect. The report will also discuss ways in which the medical home can aid in early identification and intervene when abuse and neglect are suspected. It will also describe community resources and preventive strategies that may reduce the risk of abuse and neglect.

Child Maltreatment and the Child Welfare System as Environmental Factors in the International Classification of Functioning

“…It was found that child welfare-involved youth with borderline-to-mild intellectual disabilities reported significantly greater dating violence victimisation and perpetration, compared to youth with average IQs ( 78 ). Children with disabilities are at greater risk of experiencing child maltreatment, with three times the higher prevalence of maltreatment than the typically developing population ( 95 ). When considering the whole child welfare system, ~50% of children investigated by CPS had a developmental disability(ies) ( 95 ).…”

“…Children with disabilities are at greater risk of experiencing child maltreatment, with three times the higher prevalence of maltreatment than the typically developing population ( 95 ). When considering the whole child welfare system, ~50% of children investigated by CPS had a developmental disability(ies) ( 95 ). More concerning is the understanding that maltreatment rates are likely higher than reported, as those with disabilities may experience communication difficulties that hinder disclosure or self-report to caseworkers or practitioners.…”

Characterizing physical trauma in children and youth with special health care needs

“…[24][25][26] Contributors to this increased risk include the added financial and emotional stress that caring for CYSHCN places on caregivers. 25 The Western Trauma Association and the Pediatric Trauma Society recognize the increased risk of abuse in CYSHCN and therefore list chronic medical conditions as a red flag when evaluating a child for abuse. 27 In older children, while abuse can still occur, bullying and crime victimization also likely play a role.…”

“…Within the trauma system, CYSHCN are at greater relative risk of assault, and this finding holds across all age groups. Maltreatment of children with disabilities has been documented in the literature for CYSHCN generally, as well as for specific diagnoses such as autism spectrum disorder 24–26 . Contributors to this increased risk include the added financial and emotional stress that caring for CYSHCN places on caregivers 25 .…”

“…Maltreatment of children with disabilities has been documented in the literature for CYSHCN generally, as well as for specific diagnoses such as autism spectrum disorder 24–26 . Contributors to this increased risk include the added financial and emotional stress that caring for CYSHCN places on caregivers 25 . The Western Trauma Association and the Pediatric Trauma Society recognize the increased risk of abuse in CYSHCN and therefore list chronic medical conditions as a red flag when evaluating a child for abuse 27 .…”