Addressing maltreatment in children with disabilities

Maltreatment of children is a serious public health issue that can result in suboptimal outcomes for children and even lead to death. For children with disabilities, maltreatment can be an even greater cause for concern as child abuse or neglect can go unreported because some children may have difficulty communicating the problem or directly report problems to adults. A report in Pediatrics offers guidance for providing a medical home that can identify and intervene when maltreatment is suspected.¹

The report covered studies that concluded children with disabilities were 3.79 times more likely to be physically abused than children without disabilities. The highest rates of physical abuse were seen in children with no motor disability and mild cognitive disabilities, while children with the less severe disabilities were more likely to be physically abused than children with severe disabilities. Similarly, children with disabilities were 3 times more at risk of sexual abuse than typically developing peers. Children who had a psychiatric diagnosis were at a higher risk of emotional abuse.

The guidance for pediatricians to recognize and prevent maltreatment in children with disabilities included:

• Be able to recognize the signs and symptoms of child maltreatment.
• Understand the mandatory, state-specific reporting requirements for child and adult protective services.
• See every medical visit as a chance to assess a family’s well-being.
• Refer children with disabilities and families to community resources and agencies that can provided needed services.
• Have appropriate discussions about discipline within well-child visits, as some parents of children with disabilities may be uncertain of how to discipline their child.
• Consider sending families to specialists who are experts in parenting skills for children with disabilities.
• Have an active role in the development of educational and medical treatment plans created for children with disabilities.
• Be an advocate on the local and state level for systemic changes that can support at-risk children and those with disabilities and their families.

Reference

1. Legano L, Desch L, Messner S, Idzerda S, Flaherty E, Council on child abuse and neglect, Council on children with disabilities. Maltreatment of children with disabilities. Pediatrics. April 19, 2021. Epub ahead of print. doi:10.1542/peds.2021-050920