Disability is a part of everyday life for many people, with one in five people identifying as a person with disability. Despite this, people with disability are more likely to:
Children with disability are more likely to have contact with the Department of Communities (the Department) and are particularly vulnerable to all forms of abuse. When working with children with disability, take the time to understand the impact the disability has on their lives and understand how it may intersect with other forms of vulnerability and/or discrimination for them and their unique family dynamic. The
Royal Commission into violence, abuse, neglect and exploitation of young people with disability provides more information about these additional difficulties.
According to the UNICEF report
Take Us Seriously!
The Convention on the Rights of Persons with Disabilities, the voices and experiences of children with disability are often silenced in relation to major decisions about their life, including where and who they live with, medical treatment and their education. A child with disability has the same right to autonomy and decision-making as a child without disability. It is the responsibility of the child's family and support services around the family, including the Department, to ensure these rights are respected and facilitated.
The Department is committed to working with the National Disability Insurance Agency (NDIA), the National body that manages the National Disability Insurance Scheme (NDIS), its partners, other government agencies and service providers to improve the outcomes for children with disability and their families, across all areas of child protection. This includes ensuring access to reasonable adjustments and disability supports. Refer to Chapter 3.4 Working with the National Insurance Disability Scheme (NDIS) for further information.
When assessing the safety of a child with disability, you must also consider their siblings and other children living or staying in the home.
You must take additional measures to protect a child with disability who is vulnerable to abuse, including neglect.
You must ensure that specialist clinical advice, co-ordination and support is available where a child has high and complex disability support needs within the child protection system, or who is at risk of entering the child protection system.
Disability may include an illness, impairment or disorder that affects a person's thought processes or emotions, the loss of a body part or physical function, or difficulty learning and concentrating. It may be visible or hidden to others, it may be permanent or temporary, and may have a minimal or substantial impact on a person's life. Mental illness is among one of the greatest causes of disability, diminished quality of life and need for additional support.
Engagement with the Department is a difficult process for most families, but where a child has additional barriers due to disability, genuine participation can be even harder. A child and their family may struggle to participate in meetings, decision-making processes and other forms of communication without additional support, adaptions, advocacy and accommodations being provided. Planning is paramount to ensure effective participation. The website Together we rock provides more information about practical tips on managing inclusion accessibility.
A child may feel that their needs are not being met, that the worker is biased and patronising or that their views are being ignored due to their disability. To engage meaningfully with the child, consider the following:
Understand them as a person, not just the disability: Two people with the same diagnosis can have very different experiences and level of function. Work with the child and/or family to understand how they are affected and what they need to overcome barriers to participation. Explore training options and/or consult with someone with specialist disability knowledge if you do not feel confident in understanding the specific needs of a person with disability. Recognise that disability and trauma-related behaviours can look the same in presentation. Families who have contact with the Department often have backgrounds with trauma and it can be difficult to determine what behaviours related to disability, what is a trauma-response to a stressful situation and where trauma is exacerbating difficulties stemming from trauma. These behaviours don't always represent the feelings they look like, especially when a child has ASD, an intellectual disability or cerebral palsy. Ask the person what they are feeling if you are unsure and if there is anything you can do to help them communicate their feelings better.
Understand that a child with disability doesn't always have a diagnosis. Adapting your intervention and engagement strategies should be dependent on the safety risks and the needs of the child, not based on a formal diagnosis. A child's disability may not have been assessed or diagnosed due to borderline disability (not diagnosable till 16+) that is exacerbated by other factors, such as drug use or trauma, and/or having a dysfunctional family of origin. A diagnosis may take years and can be a difficult process to navigate. Your engagement strategies should change based on safety and need at any time.
Make a commitment to include the child with disability and communicate this commitment to the child and their family: this should include using simple, positively phrased language and processes, ensuring the information you provide is accessible and user-friendly, provide additional time for the child to engage in asking and answering questions. Regularly check-in to ensure the child has an adequate understanding of what is happening and why.
Consider the language you use and its level of appropriateness for the level of disability: The words you speak, write and communicate can have a profound impact on the feelings and self-esteem of a child with disability, who may already face numerous barriers and discrimination. If the strategies you are using do not appear to be helping with engagement, take direction from the family about what will help them. See Tips on Disability Etiquette.
Provide information that is relevant and accessible in an appropriate format according to their comprehension capacity and their specific needs. This might include providing an Auslan interpreter, having documents made into accessible formats or learning about Augmentative Alternative Communication (AAC) which could include using assisted technologies such as iPads or no tech options like picture cards.
Be aware that children with disabilities frequently agree to suggestions or plans especially when they do not fully comprehend their content.
Ensure they are provided with extra time to show they understand the content and meaning of any discussion and to communicate their views, wishes and feelings. It is important they do not feel rushed or put under stress to hurry up, or they may choose not to engage as it feels too hard.
Understand their specific strengths and weaknesses, so you know when they become emotionally or physically tired, or their attention span is stretched. A child with disability is likely to tire more easily than other children, as they will have to work harder to achieve the same outcomes. It is then that they will agree to suggestions to get the session over with rather than based understanding and decision-making.
Provide spaces that are accessible to their needs, particularly if the child needs to use a wheelchair or other mobility aides. If the child has a hearing impairment, sit facing them speaking somewhat slower so they can watch your expression and lips if they lipread. The space should also allow them to leave easily if they need a break or to use the bathroom facilities and this should be outlined in preliminary comments.
Support and encourage them as their views and wishes are important.
It is important to provide access to an interpreter where it is appropriate. Consider potential drawbacks such as difficulties in accessing interpreters who are able to work with children and in the context of child protection. The interpreter will need to feel comfortable engaging in difficult conversations such as neglect and sexual abuse.
If you are getting assistance to communicate from someone close to the person, such as a family member or a therapist, there is a risk of bias which should be considered. It may be helpful to locate a speech-language therapist who is trained in AAC and who is familiar using a variety of devices. Refer to Chapter 4.2 Language Services – booking and payment for more information.
Australian and international research shows parents with intellectual disability are subjected to unusually high rates of statutory intervention in relation to the care of their children. Children with parents with disability are overrepresented in out-of-home care, at rates suggesting this is unlikely to be related to parenting capacity alone. Parents with disability may be disadvantaged and struggle due to political, social and institutional factors, which make parenting more difficult.
Parents with disability may also face discrimination and prejudice when engaging in child protection proceedings, particularly where there they do not have an advocate and their communication, physical and/or other needs are not being met. Be mindful of these factors and the impact they have, both an individual's ability to parent and on any care proceeding outcomes.
When you are working with a family where one or more individuals has a disability, speak with extended members of the family to gather information about their relationships and living circumstances, their skills and strengths. This, along with any relevant reports can help you meet the individual needs of the person with disability to engage.
Where there is an expectation for long periods of engagement for example pre-birth planning or Signs of Safety meetings, it may be better to schedule additional shorter meetings, rather than long ones.
Aboriginal and Torres Strait Islander people face higher rates of disability than the non-Aboriginal population with 1 in 4 identified as living with disability. Due to transgenerational trauma and longstanding disadvantage related to colonialism, Aboriginal people also face additional barriers and more extreme disadvantage directly related to their disability. From geographical distance, lack of support services, to culturally unsafe responses in health care settings, Aboriginal people are less likely to engage in services such as the National Disability Insurance Scheme (NDIS). Refer to Chapter 3.4 Working with the National Disability Insurance Scheme (NDIS) for further information.
English being a second language and other issues can also make it difficult for Aboriginal people to complete the registration process with NDIS, leaving them with fewer or no supports in the community to manage their child's disability. If they do register, they may find the process of goal setting and disability planning difficult to manage without additional culturally safe support services. See the
NDIS website for further information.
When working with an Aboriginal or Torres Strait Islander family, consider what additional supports a child with disability may need to engage in important cultural activities.
Seek funding via the NDIS to facilitate cultural engagement, but where funding is not available and a child will otherwise miss out on meaningful cultural activities or engagement because of their disability, use case management costs to support the goals of the Cultural Support Plan.
See chapters 3.5 Case management costs and 3.4 Care planning for further information.
When considering the needs of an Aboriginal and/or Torres Strait Islander child in relation to their disability, consider what additional supports they may need to engage in culturally important activities. The NDIS will not pay for everyday expenses such as transport to visit family but may provide funds to buy a wheelchair to use in the desert for a return to Country trip.
Where they are available, consider using Aboriginal Community Controlled Organisations (ACCO's) for service provision. Where these are not available, meet with the service providers and the family and ask how they can help in creating culturally safe spaces for families.
The way we understand disability is culturally constructed and looks different in different cultural contexts. People with disability from culturally and linguistically diverse (CaLD) backgrounds may face additional barriers and more extreme disadvantage directly related to their disability. In some cultural groups, disability is associated with shame, fear and supernatural events. The latter may lead to parents ignoring or declining medical intervention or withholding treatment. In others, a person with disability is valued and they or their carers are provided with additional supports.
People from CaLD backgrounds who have resettled in Australia through the humanitarian program may already be suffering from disability arising from their refugee experience as result of significant trauma.
Language barriers, social isolation and limited access to transport may also present barriers for people to access support.
If you are unsure how disability is viewed within the broader cultural context for a family from a CaLD background, discuss this with them first. Even if the broader culture may consider disability to be shameful, each family is unique and may hold very different views. To improve your cultural competence, ask other members of the community, including community Elders or cultural groups for their views and support.
You must consult with an Aboriginal practice leader or other relevant senior Aboriginal worker when working with children and/or families who identify as Aboriginal or Torres Strait Islander.
Contact the Ethnic Disability Advocacy Centre and consult with the Principal Policy and Planning Officer – Cultural Diversity in the Specialist Child Protection Unit when working with children and/or families from a CaLD background.
Children who have been exposed to trauma and abuse are more likely to suffer from developmental delay, transient and/or permanent disability as a result of poor care. It is important to:
understand the links between disability, abuse and trauma for both parents and children
identify signs of possible delay and/or disability in babies and small children to ensure they have access to early intervention services, and
identify when a child is displaying signs of harm that could be attributed to abuse.
Due to the links between with child protection and disability, there are several disabilities you are likely to see more often than others.
Global Developmental Delay/Intellectual disability
Children reach developmental milestones at different times but failing to meet age-appropriate milestones can indicate a
Global Developmental Delay (GDD). Signs of GDD can include delayed fine and gross motor skills, such as learning how to crawl, sit up and walk, or later, how to hold a pencil. The child may have difficulties with speaking or may not develop speech at all. They may have difficulties with age-appropriate self-care tasks such as dressing themselves, feeding, toileting or following social norms that their peers are able to follow. A child with GDD may feel frustrated that they cannot do things they see their peers doing or feel confused by directions given to them and respond with challenging behaviours.
Where a GDD is picked up early and the child has access to early intervention, the child may be able to 'catch-up' with their peers, especially if the delay has been exacerbated by environmental factors such as neglect. But the child may continue to live with disability and receive a diagnosis of an Intellectual Disability. The resource
Developmental Milestones provides an overview of age-normative developmental milestones for the early years. Use this to help you recognise when a child may not be meeting these milestones.
Autism Spectrum Disorder
Autism Spectrum Disorder (ASD) is a cognitive and developmental disorder. The child may display symptoms similar to a child with GDD but may also show difficulties with social interactions such as communicating and making eye contact with others and understanding social cues such as body language and facial expressions. Like GDD, the impact on the child from ASD can be mild to profound.
Children with ASD can be challenging to care for. Especially as they get older, their behaviours can become aggressive as they feel frustrated with their limited capacity to communicate and to feel understood by others. A child with ASD may engage in repetitive behaviours such as rocking, flapping or banging their head, which can be distressing for both the child and the carer. They may also become highly distressed by stimuli such as light, noise and touch.
When a child and their family have not been provided with early intervention, the impact on the family may be considerable and family members and/or carers may feel unable to cope or feel they have reached a crisis point. At these times, the family or police may call the Department for assistance.
Neurodevelopmental disorders, including Foetal Alcohol Spectrum Disorder (FASD) are lifelong conditions where the brain fails to develop as expected. Children in the CEO's care have higher rates of neurological impairments than the general population, as their parents are likely to have their own history of trauma, dysfunction and difficulties.
A child with a neurological impairment may or may not have facial indicators indicative of FASD, but will almost certainly have difficulties with impulsivity, attention, language development, memory, learning and challenging behaviours. As the child gets older, these behaviours may place the child at risk of engagement with the police and/or the judicial system, as they are also unlikely to understand the consequences of their actions.
For more information on difficulties for a child with FASD, see the
Attention Deficit (Hyperactivity) Disorder (ADD/ADHD)
Most young children have limited capacity to remain focused or to keep their attention fixed, but a child with
Attention Deficit (Hyperactivity) Disorder (ADHD) has a disorder that can have a profound impact on the child and the capacity of the parents to cope if it is left undiagnosed and unsupported.
Attention Deficit (Hyperactivity) Disorder may be missed where parents, teachers, carers and other adults assume the child's inattention, refusal to follow instructions, avoidance of structured tasks and forgetfulness are examples of deliberate obstinate behaviours, rather than disability.
Where ADHD is missed, the child may become viewed as 'naughty' or labelled a 'bad' child and may suffer emotional or physical punishments. The child's parents may feel unable to cope with the constant challenging behaviours and may lash out, causing harm to the child, particularly when the parent or carer is struggling with other issues and/or has minimal supports.
In adolescence, a child with ADHD is likely to continue to do impulsive things, but at a higher risk to themselves and others. This could include drug use, early experimentation with sex and engaging in criminal activity such as stealing cars.
The signs of Post-Traumatic Stress Disorder (PTSD) can look a lot like ADHD. If you are working with a child who has experienced abuse and trauma, assume the child is engaging in trauma-based behaviours and respond accordingly, until the child has been assessed by a multi-disciplinary team and received a diagnosis that indicates the primary cause of the presenting behaviour.
Offer support and safety for a child or young person in the CEO's care, regardless of their use of challenging or concerning behaviours.
Explore what supports are available for the child through NDIS funding, such as a specialist positive behaviour plan run by an NDIS-registered specialist behaviour support provider.
Refer to Chapter 3.4. Working with the National Insurance Disability Scheme (NDIS) for further information.
Abuse and neglectA child with disability has particular and additional vulnerabilities, and are at an increased risk of abuse and neglect, compared to a child without disability. This is particularly true in relation to sexual abuse. Sexual abuse may be disguised as childcare where the child is reliant on a carer to provide for their personal care needs. This is often due to their increased dependence on caregivers for daily physical routines, their difficulties with communication and their increased level of social isolation which makes it more difficult for the child to report the abuse. Where children with disability do report abuse, the Courts and lawyers may not respond as thoroughly as they otherwise would and may assume the child will be unable to provide consistent, accurate and detailed evidence.
All children may fear retribution, fear of being separated from family and of being blamed. Children with disability may experience these fears more intensely given their physical dependence on family and carers.
Child abuse may cause severe and/or permanent impairment for some children leading to problematic and harmful behaviours.. With early understanding about the effects of trauma, intervention and support, the physical and developmental impact of abuse and trauma can be minimised in some instances. The resource
Effects of Abuse and Neglect on Child Development provides more information on the connection between abuse and disability.
Chronic malnutrition can result in growth and/or neurodevelopmental delays or permanent damage.
Head injuries caused by shaking or other trauma, can cause brain stem compression, leading to blindness, deafness, and death. If the child does not die, there is an ongoing risk of acute brain injury, epilepsy, cerebral palsy, paralysis, and coma. A head injury that causes damage to the hypothalamus and pituitary glands can result in growth impairment, inadequate sexual development, and other chronic hormonal issues.
Injuries to the ear and inner ear can result from less serious head trauma and may go unnoticed but can lead to partial or complete hearing loss. If minor head trauma is repeated/chronic, it can lead to the same injuries as noted above for major head trauma.
Trauma to the body can cause internal injuries leading to permanent disability or death.
Refer to Chapter
2.2 Physical abuse for further information.
Medical neglect occurs when a caregiver withholds medical treatment, for whatever reason, for an ill and/or injured child. Treatable conditions can become much more serious, leading to lifelong disability e.g. an ear infection can lead to permanent hearing loss if not addressed.
Physical neglect in babies and toddlers includes a child being left alone for extended periods of time, without physical stimulation. If the child is left for extended periods in a cot or pram, the child may fail to develop muscle tone and have poor motor control. In these situations, a child is unlikely to reach age-appropriate milestones such as learning to hold their head upright, to crawl or walk. If the loss of muscle tone and co-ordination are not actively supported to develop, the child may fail to develop co-ordination and basic motor skills, causing disability.
Cognitive neglect in babies and toddlers refers to an absence of contact and stimulation. Examples include children being left alone with no stimulation, exposure to language, touch or access to an attachment figure for long periods of time. Significant lack of stimulation can lead to cognitive, speech and social delay, with the possibility of permanent intellectual disability.
A child who is chronically under-stimulated can become uninterested when presented with speech or play and may not respond as a healthy baby or toddler would. They may not show interest in toys and the child may lack curiosity to explore their environment which limits their ability to learn.
Refer to Chapter
2.2 Neglect for further information.
Attachment disorders can develop due to different forms of emotional and physical abuse, neglect and/or trauma, such as exposure to FDV. Diagnosed by a psychologist, an attachment disorder can look like a lack of attachment with a caregiver. A child with an attachment disorder learns that they cannot rely on a consistent comforting or safe response from their primary attachment figure when they are distressed.
Passivity and apathy can be seen in babies and toddlers who have been in an environment where they do not feel safe. They may lay listless, placid and immobile, but remain intently observant. During their early years, a young child's neural pathways develop. For a child in an unsafe environment, they will learn strategies to stay safe from danger instead of learning from their environment. This can lead to GDD in some children and interfere with healthy personality development and the ability to self-soothe. Early safety strategies can lead to profound mental health issues throughout the child's life, causing significant disability.
Chapter 2.3 Assessing emotional abuse – family and domestic violence for further information.
Sexual abuse can cause profound disability for many children, particularly in relation to mental health outcomes, including suicide.
Children who have been sexually abused at a very young age may develop many of the same disorders and disabilities mentioned above. This may include self-harm which can be overlooked as a sign of distress related to abuse for a child with disability.
Sexual abuse often occurs in conjunction with other forms of violence, such as physical abuse and where a child is neglected.
A child with an existing disability, or a disability exacerbated by other forms of abuse and neglect, is significantly more likely to be re-victimised throughout their lives.
Refer to Chapter
2.2 Sexual abuse for further information.
People with disability are at increased risk of experiencing FDV. Children with disability who are NDIS participants and are at risk of or are being exposed to FDV, will have a budget and flexibility in their existing NDIS Plan that can be used when immediate disability supports are required (over and above reasonable adjustments).
Consult immediately with the child's Local Area Coordinator (LAC) or Support Coordinator to collaborate and safety plan to create an increased level of safety for the child and non-offending parent, including engaging additional supports where required. Advise the LAC or Support Coordinator to contact the Department immediately if they learn FDV is present and there are safety concerns.
Where you learn FDV is present you must request the NDIS Plan is reviewed to reflect the current disability support and safety needs of the parent and her children.
This includes updating who can share information. This is very important as the perpetrator may have been previously involved in the plan with access to information.
The NDIA recognises that sustaining the informal support of family or carers is very important to meet the needs of children with disability and maintaining close supportive relationships.
Currently there is no item listed under NDIS specifically as 'respite'. The following provisions are noted in relation to providing families with short break care.
1. Short-term accommodation and short-term living assistance are available for up to 28 days. Assistance with informal short-term living arrangements (e.g. with host family/alternative family) can be supported.
2. Higher levels of respite may be provided where there are:
Where a child is in the CEO's care and the carer requires a break from caring, see chapter 3.1 Short break care for further information. Ensure that short break carers are identified and assessed early to prevent planning for a short break in a crisis.
Young people with complex care needs (YPECN) is an inter-agency state government initiative to provide young people with the highest level of care needs with a comprehensive and co-ordinated response from services through interagency coordination, information sharing. This service is for young people who have experienced gaps in regular service provision.
Many of these young people are extremely vulnerable and many are in the CEO's care but being in the CEO's care is not a pre-requisite for this intensive service. As a state-based initiative, YPECN is not associated with the NDIA, but service providers are responsible for advocating and supporting young people through the process of receiving appropriate support through the NDIS. This occurs in collaboration with the child's child protection worker where they are in the CEO's care.
Young people with disability, are more likely to have engagement with the police and judicial system, particularly when their disability;
The Disability Justice Service (DJS) is a state government funded service delivered by the Department to support eligible people with disability that are engaged with the justice system. The DJS provides support to young people and adults and may assist if you are working with parents with disability, where the parent is engaged in the justice system.
The DJS provide the following supports:
In-reach services to Banksia Hill Detention Centre and adult prisons.
Multi-disciplinary offender diversion services with a multi-disciplinary team.
Information and referral provision to relevant legal services when a person with disability has contact with the Western Australia Police.
Fast-track diagnostic assessment pathways and assessment reports for people with disability who are facing Court, and
a Disability Justice Centre (residential facility) for people with disability who are deemed Mentally Impaired Accused, i.e. are unfit to stand trial.
See the Disability Justice Service Brochure for more information on services and referral information.
Identify any potential disability as soon as possible during a young person's care journey. If they are suspected of having disability, maximise the amount of support they will receive within the community after they leave the CEO's care. This should include engaging the NDIS as soon as possible.
If a young person already has an NDIS Plan, update it with specific Leaving Care goals prior to the young person turning 17 years. As a minimum, this should include housing support arrangements to help the young person live independently.
Where a disability is suspected and a young person does not have an NDIS Plan, ensure the NDIS Coordinator has all necessary assessments required to identify disability and demonstrate NDIS eligibility.
When liaising with the NDIS and advocating for a young person transitioning to independent living, consider the Supported Independent Living (SIL) program. The Department is responsible for managing the majority of support and provisions a young person will require after leaving the CEO's care, but the NDIS may be able to assist with specific adjustments and/or amendments to assist with independent living in the community. The SIL program is designed to provide this kind of support.
Where you are working with a high-risk young person with extreme impairment or very high support needs, and where they are unlikely to be able to live independently, consider the Specialist Disability Accommodation program provided by the NDIS.
Be aware that this program has strict eligibility criteria.
If the future housing arrangement will be managed by a non-disability mainstream provider (i.e. public housing or private rental agreements), work with the LACs or support coordinator to identify appropriate disability supports for the young person as they transition to adult accommodation. The LAC or support coordinator should be involved and/or advised of care planning meeting outcomes, particularly as the young person prepares to leave the CEO's care.
Disability Gateway provides comprehensive information about supports available for a person with disability across different areas of their life.