This is a summary of the research review Evidence Review – Risk Factors and Prevention of Violence, Abuse, Neglect and Exploitation.
This information is also available in a downloadable format Evidence summary: Risk factors and prevention of violence, abuse, neglect and exploitation.
Why did we do the review?
The NDIS Quality and Safeguards Commissions’ (NDIS Commission) role is to improve the quality and safety of services, including preventing and responding to abuse and neglect. The Royal Commission into Violence, Abuse, Neglect, and Exploitation of People with Disability has highlighted the ongoing risk of violence, abuse, neglect, and exploitation, and the unacceptable levels of harm that people with disability face daily.
We did this review to:
- Understand what kinds of violence, abuse, neglect, and exploitation people with disability are more likely to experience.
- Understand the risk factors that increase the likelihood of a person with disability of experiencing violence, abuse, neglect, and exploitation.
- Understand what has been tested to help prevent or respond to violence, abuse, neglect, and exploitation.
How did we do the review?
Our researchers searched databases to find good quality studies and reports including by government about violence, abuse, neglect, and exploitation in people with disability and interventions used to prevent or respond to violence, abuse, neglect, and exploitation.
We included research of any age with any type of disability, and looked at studies done in residential group homes, disability services and schools.
Harm can be described as:
Violence
The intentional use of physical force or power, threatened or actual, against oneself, another person, or a group or community that either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment or deprivation.
Abuse
Physical, psychological or emotional, sexual abuse, neglect or financial exploitation. Abuse can manifest as mistreatment or the degradation of dignity in organisational settings.
Neglect
The failure, whether intentional or unintentional, to provide essential physical or psychological support, resources, or care, leading to harm or potential harm to an individual’s wellbeing.
Exploitation
When an individual unfairly manipulates another person or their resources, whether opportunistically or premeditatedly, for personal gain. Forms of exploitation include coerced criminal, sexual, financial, spiritual, or labour-related activities, and often rooted in relationships based on trust or loyalty.
Our findings
Finding 1: What kinds of violence, abuse, neglect, and exploitation people with disability are more likely to experience?
- People with disability face significantly higher rates of violence, abuse, neglect, and exploitation compared to the general population, with heightened risks for those with intellectual disability, from culturally diverse backgrounds, or in institutional settings.
- A systematic review of the type of violence, abuse, neglect, and exploitation experienced by
people with disability across their lives in Australia found having a disability increased the
risk of experiencing:- intimate partner violence (physical, sexual, emotional, and financial abuse)
- violent crime and victimisation (physical and sexual abuse, systemic abuse/neglect)
- child maltreatment (physical, sexual, and emotional abuse, neglect)
- bullying or peer victimisation (physical, emotional, social, and financial abuse)
- disability-related hate crimes (emotional, physical, social abuse)
- systemic abuse/neglect.
- The type of violence, abuse, neglect, and exploitation against people with disability can also be unique in the form of disability-related forms of violence:
Destruction or withholding of wheelchairs, communication devices, or other forms of assistive technology
Withholding essential support or assistance
Restricted access to social and other support services
Bodily autonomy violations such as forced or coerced sterilisation
Denied treatment, medication and/or specific aids
Violence, abuse, neglect, and exploitation is not always obvious or intentionally malicious and can therefore be hard to know about.9 This can still have growing negative effects on a person with disability.
Finding 2: What kinds of risk increase violence, abuse, neglect, and exploitation against people with disability?
- Risks that increase violence, abuse, neglect, and exploitation against people with disability
can be understood in three levels. These are:
Individual level - personal characteristics about the person with disability.
Service level - the way a service provider or service is run and managed.
Systemic level - external conditions in society that affect an individual’s experience, the way people behave or get help.
- It is important to remember that people with disability are not inherently vulnerable but become so when others exploit their situation. It is likely to be a consequence of unequal power relations between people with disability and people without disability.
The risk factors are summarised in the table below. Further detail about the risk factors can be found in the Evidence Review: Risk Factors and Prevention of Violence, Abuse, Neglect and Exploitation.
Level: Individual (personal characteristics)
Identified risk factors
Type and severity of disability, people with:
- psychosocial and intellectual disability, especially when severe
or profound - physical disability requiring personal assistance
- maladaptive or risky behaviours
- mental health conditions
- sensory impairments
- declining cognitive function.
Gender and cultural diversity:
- women from non-English-speaking backgrounds and Indigenous
backgrounds.
Level: Service (service provider characteristics)
Identified risk factors
Organisation and staff management with:
- stressful and poor working conditions
- ineffective management and staff supervision
- lack of clear policies addressing violence, abuse, neglect, and exploitation.
Service environments with:
- isolated work environments
- misuse of overuse of restrictive practices
- environments limiting choice and opportunity for people with disability.
Worker characteristics:
- male gender compared to a high female workforce
- lack of appropriate education, qualifications, training, and professional skills working with people with disability
- previous history of abuse towards people with disability, staff and family
- high burn out symptoms and personal stress
- work dissatisfaction.
Level: Systemic external conditions in society
Identified risk factors
Home environment:
- unstable living situations.
Social, community and service isolation:
- limited informal support network
- limited to a single service provider
- carer burnout including limited access to respite and assistance.
Economic inequality:
- low financial decision-making capacity
- inability to afford basic necessities.
Lack of education and awareness:
- insufficient, appropriate safeguarding education
- knowledge gaps in workers and professionals.
Policy and system gaps:
- barriers to reporting violence, abuse, neglect, and exploitation
- limited knowledge of safeguarding systems
- negative social attitudes.
Finding 3: What helps prevent or respond to violence, abuse, neglect,
and exploitation against people with disability?
- Interventions to reduce or prevent violence, abuse, neglect, and exploitation are mostly focused at helping people with disability recognise and report violence, abuse, neglect, and exploitation with training to learn new skills.
- There are not many interventions to help service providers or society to reduce and prevent violence, abuse, neglect, and exploitation. More research is needed to find what service providers and society can do.
- The interventions we found can be used in different situations or target different people depending on their needs.
The interventions factors are summarised in the table below. Further detail about the interventions can be found in Evidence Review: Risk Factors and Prevention of Violence, Abuse, Neglect and Exploitation.
People with disability (individual level)
Intervention
Training on:
- sex education and sexual abuse prevention
- identifying and responding to inappropriate staff behaviour
- safety awareness and protective behaviour
- social relationships
- pattern recognition in high-risk situations.
Workers (service level)
Intervention
Training on:
- sexual abuse and risk factors specific to individuals with developmental disability
- general ongoing professional development.
Service provider (service level)
Intervention
Oversight:
- regular unannounced visits by supervisors
- regular clinical supervision.
Society (systemic level)
Intervention
Training for all on:
- school based physical violence.
Oversight:
- regular unannounced visits by inspectors.
What do the findings mean?
This evidence review has highlighted the significant and complex risks of violence, abuse, neglect, and exploitation faced by people with disability in Australia. It emphasises that violence, abuse, neglect, and exploitation does not just happen once or alone but occurs from a complex relationship between individual vulnerabilities, service level deficiencies, and systemic societal issues. Commitment is necessary at the service level to deliver safe and responsive services to individuals.
The following points are further considerations needed to support and boost the effectiveness of any interventions as well as remove barriers to reducing and preventing violence, abuse, neglect, and exploitation.
Accessible safeguarding resources
Providing people with disability with accessible, plain-language materials about violence, abuse, neglect, and exploitation, recognising it, reporting it and safeguarding referral processes is critical. Developing resources in various formats, such as visual aids or audio guides, ensures inclusion for all disability types.
Tailored training for children
Children with intellectual disability benefit from concrete, relatable examples applied to real situations rather than abstract ‘what if’ scenarios. Integrating prevention lessons into everyday activities and using tools like storytelling videos, comic strips and role-playing can build their understanding gradually.
Capturing diversity data
Collecting disaggregated data on disability types, cultural and linguistic backgrounds, gender, and age to understand specific vulnerabilities and needs.
Self-advocacy and societal perceptions
Self-advocacy and societal perceptions Empowering people with disability to self-advocate requires a shift in societal attitudes to view them as capable and autonomous individuals with decision-making capacity.11 Public campaigns and community education programs can help dismantle stereotypes and promote recognition of their rights and abilities. Access to independent advocates who can identify and raise concerns on behalf of those unable to advocate for themselves are essential to a robust safeguarding framework.
Regular audits and reviews
Implement routine data audits to ensure accuracy and identify trends using incident management systems data.
Program design for people with intellectual disability
Safeguarding programs should be designed to cater to diverse intellectual and developmental needs. Using immersive and in-situ-based learning methods can increase engagement and comprehension, enabling individuals to recognise and respond to risks effectively.
Specialised workforce training
Disability service providers require ongoing, targeted training to address the specific relational and contextual dynamics of violence, abuse, neglect and exploitation. Topics such as recognising subtle signs of harm, fostering supportive environments, and maintaining professional boundaries are essential for effective intervention.
Workplace culture reform
Shifting the culture within disability service providers to prioritise transparency, trust, and proactive reporting can strengthen natural safeguards. Acknowledging good practice, providing open communication and providing clear guidance on reporting mechanisms are key steps toward this goal.
Person-centred practice
Establishing practices that centre on the preferences, needs, and voices of people with disability can build better relationships to help detect risks and foster resilience. Encouraging active participation in decision-making processes ensures that safeguarding measures are both inclusive and effective.
Strengthening community connections
Enhancing relationships between people with disability, their families, service providers, and broader community networks can foster a sense of belonging and trust to build natural safeguarding mechanisms and support effectiveness of early intervention. Collaborative approaches with an educative function involving justice, health, education, and community sectors can amplify the impact of safeguarding efforts.
These additional considerations aim to fill gaps and strengthen the broader ecosystem supporting people with disability, ensuring interventions have success and are meaningful, accessible, and impactful.
This review highlights that effective safeguarding demands a holistic, multi-level and integrated approach to reshape the structures and cultures that can harm people with disability. This can be achieved through combining individual empowerment, service level improvements, and systemic reform with a focus on prevention, accountability, and empowerment at every level.