30881
Social Services Referrals and Child Protection Plans Involving Autistic Children and Children with Intellectual Disability in the United Kingdom
Autistic individuals are at increased risk of victimisation by peers throughout the lifespan. It is less clear whether autistic children are also at increased risk of maltreatment by adults as children. There is good evidence that intellectual disability increases the risk for maltreatment. Additionally, some studies have found that autism increases a child’s risk of ending up in the child protection system in some states in the USA, but this has not been investigated in the United Kingdom at a population level.
Objectives:
The current study aims to determine whether autism diagnosis and/or intellectual disability (ID) increase children’s risk of being referred to social services and/or becoming the subject of a child protection plan (which are put in place if there is evidence of maltreatment) in the UK using population data.
Methods:
Data from the National Pupil Database (NPD), which includes information about all children in the state funded school system in the UK, was obtained from the Department of Education for the 2015-16 school year (N= 7,973,400). Unique Pupil Identification numbers were used to link school records and social service records that contain information on whether a child has been referred to social services, and whether they have received a child protection plan. Information on demographic factors (age, gender, ethnicity, home language and socioeconomic status) were also extracted from the NPD. Special educational needs diagnosis information was used to identify whether or not each child had autism and/or and ID. Logistic regression was used to determine the odds of being referred to social services and receiving a child protection plan depending on autism diagnosis and ID.
Results:
After adjustment for demographic variables and ID, autism significantly increased the odds of being referred to social services (odds ratio =2.83, 95% CI 2.78-2.89). Having ID also independently increased the odds of referral to social services (odds ratio =2.54, 95% CI 2.51-2.56). After adjustment for demographic variables and ID, there was no evidence that autism increased the odds of receiving a child protection plan (odds ratio = .919, 95% CI .859-.983). Conversely, ID significantly increased the odds of receiving child protection plans (odds ratio = 1.75, 95% CI 1.71-1.80).
Conclusions:
After adjusting for the effect of ID, autism does not increase the risk of receiving a child protection plan in the UK, indicating autism does not independently increase the risk of maltreatment by adults. However, children with ID (including a significant proportion of autistic children) are at a significantly increased risk of maltreatment. A limitation of this study is that it only includes cases of maltreatment that are identified by social services. Further work is needed to identify the impact maltreatment on autistic and non-autistic children with ID.