The medicalisation of disabled children and young people in child sexual abuse: Impacts on prevention, identification, response and recovery in the United Kingdom

Abstract

Understandings of disability are situated within social, political and economic circumstances. Internationally, medical conceptualisations of disability prevail, influencing policy and practice, creating a discourse which encourages categorisation, diagnosis and prescribed ways of understanding behaviour. This body of knowledge has a profound influence, providing powerful explanatory models of disability. Such discourse excludes other ways of knowing, with little attention paid to competences and the construction of worlds especially from the perspectives of disabled children themselves. This article draws upon a small number of UK qualitative studies which have examined disabled child abuse and included the experiences of disabled children. These studies have highlighted how medicalised notions of disability have led to both medicalised and psychiatrised responses to abuse, which have ill-served disabled children. It could be argued that medicalisation has led to disabled children being labelled as either ‘too disabled’ to be abused or ‘not disabled enough’ to receive an appropriate response which meets their needs; they are also sometimes regarded as showing signs of mental ill health when such signs are more likely to be an understandable manifestation of the trauma of abuse. Evidence collected indicate that much can be learnt from understanding the construction of disabled childhoods and how our current limited exploration of this affects how society prevents, identifies and responds to disabled child abuse and associated trauma. Drawing upon disabled children’s recommendations to ‘see me, hear me and understand me’, this article will argue that in order to protect disabled children and support them to recover from abuse, we need to move away from a tick-box culture of medicalising, categorising, psychiatrising and ‘othering’ to a greater understanding of disabled children’s worlds, and to a rights-based model of disabled child protection whereby we challenge the increased barriers to support faced by disabled children who have experienced abuse.