Disabled children more like to be victims of violence

Children with disabilities are three to four times more likely to be victims of violence than children who are not disabled, with an estimated one in four experiencing violence during their lifetime, according to a systematic review and meta-analysis published Online First in The Lancet.

About 5% of children worldwide (around 93 million children) have a moderate or severe disability. Although children with disabilities are thought to be at greater risk of violence, this is the first study to quantify the prevalence and magnitude of that risk.

After searching systematically for studies over the past twenty years containing data on the prevalence of violence against disabled children, Mark Bellis from Liverpool John Moores University, Liverpool, UK and colleagues identified 17 studies including over 18 000 children (mostly aged 2–18 years) from the USA, UK, Sweden, Finland, Spain, and Israel.

They found that more than a quarter (26·7%) of children with disabilities have been exposed to some type of violence (physical, sexual, emotional abuse, or neglect) during their lifetime. Lifetime levels of physical (20·4%) and sexual violence (13·7%) were also high in these children.

Although individual studies varied, overall they estimated that disabled children are at nearly four times greater risk of experiencing violence than those without a disability, at least three times more likely to be exposed to physical violence, and have nearly three times the risk of sexual violence.

What is more, children with mental or intellectual disability appear to have a higher risk of sexual violence (odds ratio 4.62) than both children with other types of disability and those without a disability. Risk estimates for other types of disability could not be calculated because of insufficient data.

According to Bellis, “The impact of a child's disability on their quality of life is very much dependent on the way other individuals treat them. This research establishes that the risk of violence to children with disabilities is routinely three to four times higher than that of non-disabled children. It is the duty of government and civil society to ensure that such victimisation is exposed and prevented."

He adds, “Estimates are missing for most regions of the world, particularly low-income and middle-income countries. This is a fundamental gap that needs to be addressed because these countries generally have higher population rates of disability, higher levels of violence, and fewer support services than do high-income countries.”

Commenting on the paper, Dr Etienne Krug, Director of WHO’s Department of Violence and Injury Prevention and Disability, which contributed to the study, says, "The results of this review prove that children with disabilities are disproportionately vulnerable to violence, and their needs have been neglected for far too long. We know that specific strategies exist to prevent violence and mitigate its consequences. We now need to determine if these also work for children with disabilities. An agenda needs to be set for action.”

In a linked Comment, Emily Lund and Jessica Vaughn-Jensen from Texas A&M University in the USA say, “Researchers need to target under-represented disability groups…[to] provide a clear picture of the interactions between the type of disability and risk for violence and maltreatment. Future research should seek to strengthen our knowledge through rigorous studies with diverse populations, both in terms of nationality and type of disability.”