Examination of Witnesses (Questions 176-207)
Virginia Beardshaw, John Dickinson-Lilley, Paula
Lavis, Jane Vaughan
27 October 2010
Q176 Chair:
Excellent. I am so glad that I didn't have to send the Serjeant
at Arms to go and fetch you, forcibly compelling you to appear.
[Laughter.] Thank you all very much for joining this session
of the Education Committee and our inquiry into behaviour and
discipline. You bring specialist expertise. Will you start off
by giving us an opening view about your thoughts on this misbehaviour
and discipline inquiry, as briefly as you can? I will start with
you, John, if I may.
John Dickinson-Lilley: Good morning.
My name is John Dickinson-Lilley and I am vice-chair of the Special
Educational Consortium. First, I just want to take this opportunity
to thank you for inviting me to give evidence today. I really
appreciate the opportunity to do that. The SEC is made up of 22
voluntary sector and professional organisations. We provide a
discussion and debate about special educational needs and disability
issues. We define our policies by identifying areas of consensus,
and I will be talking about those areas of consensus today. There
are three particular issues that I would like to pick up on: the
first is the link between behaviour and the ability of disabled
children and children with SEN to access their learning; the second
is the importance of making reasonable adjustments to behaviour
policies, and the third is exclusions. In terms of the first issue,
I think that the Steer review built on a lot of previous evidence
about behaviour in schools. SEC supports the conclusion of his
report that for all children behaviour in school is intrinsically
linked with good teaching and the ability of a child to access
their learning. It is common sense that a child who is engaged
with their education and making good progress is less likely to
be disruptive or challenging in class. That means that where a
child is disruptive, schools should not look at behaviour in isolation
and take the disciplinary route, but should look to identify the
underlying causes of that behaviour. Furthermore, where a child
has a disability or SEN, it means looking at the support that
they are receiving and determining whether that support is the
right type of support. We know that there is a lot of confusion
in some quarters about the crossover between children with SEN
and disability. We think that schools perhaps need to appreciate
slightly more the difference between SEN as a legal concept and
disability as a legal concept. The confusion means that schools
are not always clear about when they should provide a reasonable
adjustment and when they should make provision for a SEN. The
legal protections afforded disabled children, specifically in
schools, are about reasonable adjustments and actually those reasonable
adjustments are sometimes critical to ensuring that disabled children
can engage in a learning environment. In terms of exclusions,
we know that children who have been permanently excluded are less
likely to achieve five good GCSE results, they are less likely
to be employed in later life, and they are more likely to enter
custody. There is a broad consensus that exclusion from school
results in dramatically poorer outcomes for children and has a
significant long-term cost for society. We know that disabled
children and children with SEN continue to be eight times more
likely to be permanently excluded from school than the rest of
the school population. In fact, 24 children in every 10,000 excluded
have SEN compared with two in every 10,000 excluded without SEN.
We have argued for many years that when a disabled child or a
child with SEN is at risk of exclusion, a review of that child's
SEN should be undertaken before they are referred off-site. The
review should look at whether reasonable adjustments are required
for the disabled child or a child with SEN that, if they are made,
could avoid the need to remove the pupil from the school in the
first instance. We know that exclusion is only likely to compound
the considerable barriers that disabled children and children
with SEN face in achieving their full potential.
Q177 Chair: Thank you very much,
John. Virginia, what are your opening remarks? Could you be as
brief as you can, please, because we have limited time?
Virginia Beardshaw: I am Virginia
Beardhaw, chief executive of I CAN, the children's communication
charity. Our mission is to support all children's speech and language
development, and our special focus is on children who find speech
and language difficult. I CAN is a member of the Special Educational
Consortium, of which John is the vice-chair. I thank the Committee
for inviting me to give evidence today. I will start by giving
some killer facts. There is a clear and proven link in research
between a child's speech, language and communication needs and
their behaviour. Children with speech, language and communication
needs, SLCN, are at a higher risk of developing poor behaviour
and therefore are much more likely than average to be excluded
from school. Two thirds of seven to 14-year-olds with behavioural
problems actually have SLCN, so it is a very high incidence. Undetected
speech and language difficulties will often manifest themselves
as poor behaviour, both at school and within the home. It is just
common sense: members of the Committee will understand that if
you are not understanding something very well, and if you cannot
express yourself very well, school may be a frightening, humiliating
and absolutely confusing place to be. Those of us who know this
do not find it in any way surprising that children and young people
with SLCN act up or opt out. They are highly over-represented
in both the excluded and truanting populations, but from their
point of view it is entirely logical.
Q178 Chair: That is a very powerful
statement, Virginia. Paula?
Paula Lavis: My name is Paula
Lavis and I am from the children's mental health charity YoungMinds.
Our particular interest is in the links between behaviour and
mental health problems. As you probably know, one in 10 children
have a mental health problem, and many children with a mental
health problem are excluded from school for bad behaviour. I was
really interested in your conversations in the previous session
about CAMHS and early intervention.
Q179 Chair: Jane?
Jane Vaughan: I am the director
of education for the National Autistic Society. I have three key
areas that I feel run on quite well from the previous discussion.
First, the behaviour of children with autism is linked to teaching
and learning, and to appropriate support for teachers and learning.
Anxiety and stress have a great deal of impact on how you see
a child with autism behaving in the classroom. We are talking
throughout this session about behaviour, and I think that sometimes
we need to think about the individual child and, rather than how
we manage the behaviour, what we have to do to return the child
to learning. What should we put in to return the child to learning,
not necessarily just manage the behaviour? What should we be doing
to return to learning? Secondly, training: Pat's discussion about
training in secondary schools was very interesting. I liked that
bit. I feel very, very strongly that it is not just the teachers
and special educational needs co-ordinators that need training;
we have to get to the head teachers and the governors, because
they influence the whole school. That is very important to us.
It's not just the teaching assistants, supervisors and teachers.
Let's get those head teachers and governors involved. We need
to improve our assessment to identify additional needs and special
educational need, especially before exclusion. If you are going
to exclude a child, you should look at whether there is a special
educational need. Is there autism there? Could we do something
differently? Could we put something in now, before the exclusion?
Also, we talked about alternative provision: there again, assess
the child before alternative provision. Let's have a look at what
their need is. Is there something that we have not picked up,
especially around autism? We use lots of assessment for learning
in the classroom. It is a superb tool for teachers. They don't
need a different tool for children with autism, but they need
to know about and appreciate autism so that they can use exactly
the same tool in perhaps a slightly different way. So the areas
are training, assessment and returning to learning through appropriate
support.
Chair: Thank you very much.
Q180 Nic Dakin: I shall pick up
on the training theme. Thank you for coming today. You mentioned
in those opening remarks several areas—for example, speech
and language, mental health, autism and other issues. Do you think
that the training that is currently in schools for the staff—head
teachers, support staff, teaching staff—is adequate to allow
identification of those different needs, and to know the appropriate
interventions to get the best out of pupils? If it is not adequate—I
saw heads shaking—what needs to be done to make it adequate?
Virginia Beardshaw: We have advocated
for a long while, as have others, tools to help staff to identify
and assess SLCN in both special and mainstream settings in order
to help to identify areas for development. We would also like
to see a step change in the initial teacher training and continuous
professional development processes for teaching staff to help
them to link poor behaviour and speech and language difficulties—and
other special educational needs for that matter—to address
the cause rather than the effect. More specifically still, we
are advocating the introduction of a screening tool for children
at two and a half, linked to the healthy child programme, and
then subsequently at five, prior to the proposed reading test,
to pick up children's communication difficulties early and to
introduce a personal plan for the child. That would have general
benefits across special educational needs, because communication
difficulties are a part of so many different special educational
needs and disabilities—autism is a notable one, and 60%
of children with cerebral palsy and a very high proportion of
all deaf and hard of hearing children, for example, are affected.
John Dickinson-Lilley: The Institute
of Education and its teacher development agency have developed
new modules which specifically look at SEN and disability. New
teachers and initial teacher training should be getting more input
around those specific areas. There is also the inclusion development
programme which is basically bringing teachers up to the same
level through CPD. Overall we are probably starting to move in
the right direction at a very, very simplistic level, but we are
not even going to start to see the impact yet. I would like to
pick up on one of the points that Nic made, which is about support
staff. One of the problems we can see is that TAs are being used
at the moment just specifically to manage behaviour, rather than
to support attainment. It is clear that the more support assistant
time a child has, the further back they are in attainment. A good
example of that would be in a classroom environment and, say,
filling in a classroom survey. Quite often a TA would do that
for a child, so the child is not being integrated into the learning
that's going on with the rest of the class. Making sure that TAs
have the right kind of support to support a teacher and the child
in getting children to learning points is significant.
Q181 Pat Glass: We know that the
National Association of Head Teachers and many others, even I
in my time, have said that far too many children with special
needs are attending pupil referral units simply because there
isn't the appropriate provision in local authorities. As a Committee
we went last week to visit New Woodlands School in Lewisham where
they have powers—what is it?
Chair: Innovation powers.
Pat Glass: They have powers to innovate
to allow the school to run the pupil referral unit and for children
without statements to attend. It was clearly an outstanding school,
which was meeting the needs of all the children there. Do you
think that there needs to be separate provision for children with
SEN? Is it about the culture and ethos within the provision or
does there need to be separate provision? If there is a need for
separating provision for children with challenging behaviour with
SEN from children who have disaffected, delinquent, conduct-disordered
behaviour, within the SEN bits do we need to have separate provision
for autism, language and all the separate areas around the disabilities?
Virginia Beardshaw: At I CAN,
because speech, language and communication needs are of very high
prevalence—SLCN is the largest category of reasons for statementing
in primary school and applies to more than a quarter of all statemented
children—we advocate the classic, public-health-based, waves
model. The critical thing—John mentioned this too—is
that mainstream settings need to have very good teaching and learning
for all children. Quality first teaching and learning, when it
works, is a good way of addressing the needs of many, many children
with speech, language and communication needs. For others with
greater needs, a targeted approach will be required. What is really
needed is for the whole school work force to have the skills to
be able to bring special resources to bear to support the child
well and make reasonable adjustments. Then there is a group of
children who might need specialist help. That can often be done
in mainstream settings, but sometimes it is best for the individual
child if that is done outside. For example, I CAN run specialist
special schools for children with severe and complex speech, language
and communication needs, many of whom have failed in mainstream
schools. Sadly, poor behaviour will be a significant component
of that failure. I do not believe that there is a right or wrong
approach, but it needs to be based on the needs of the child.
Q182 Chair: When you have provision
for children who have been excluded from school, which has to
be provided structurally, should that be provided collectively
so that the children with serious behavioural issues that are
not related to SEN—bad behaviour—are put together
with children with SEN? Is that the right way, or should we be
trying to have separate channels of provision?
Virginia Beardshaw: No; I think
wherever possible the needs should be met in the mainstream school.
Moving children out should be the exception.
Q183 Pat Glass: Do you think it
would be helpful if the Committee made a recommendation that no
child with a statement of SEN should attend a PRU?
Jane Vaughan: No; I do not think
that that would be helpful at all. I think that for some children
with autism, going into a PRU can be very challenging, very stressful
and, for some of them, the worst thing that possibly could happen.
They will find that their needs are not being met at all, and
that goes back to the point we made earlier: before deciding on
the provision that the child will be placed in, you have to ensure
that you know what that child's need is. As Virginia said, we
all accept that children with SEN are individual. Children with
autism are individual, as it affects everyone in a different way.
There is a core diagnostic issue for autism, the triad of impairments
and difficulties, but every child is different. Autism affects
children differently, as do speech and language difficulties.
With person-centred planning, we should be able to support those
youngsters in mainstream schools, if that is suitable for them.
There needs to be a range of provision. Some children can be supported
well in mainstream schools. If we can get them assessed well and
meet their needs, if there is good teaching and learning, and
if the support services are there, are accessible and are coming
into schools to support teachers, then we can do it. However,
there are some children who do need specialist provision. It is
the same as going into PRUs; for some children with autism, that
is not the right place for them, in which case specialist provision
is preferable and will give them the best opportunities in life.
Going to a PRU could well destroy their future. However, there
are some PRUs that are good at assessing need, and I know some
very good PRUs where children with autism are assessed as soon
as they come in and put in the right structures, and you see them
fly.
Q184 Pat Glass: Given that unfortunately,
whichever way we look at it, there are an awful lot of children
who have very serious speech and language difficulties, whether
or not they have a statement or have been diagnosed, and are perhaps
on the semantic-pragmatic spectrum of autism, what one thing could
we do to improve alternative provision, such as short-stay schools
or PRUs? Do you want to answer that, John? If you had a wish list,
what is the one thing you would do? I know what I would do.
John Dickinson-Lilley: To be honest,
this is where SEC is quite an interesting organisation; because
we're a consensus organisation, I could give you 22 different
answers to that question. I am inclined to write to you after
speaking to our members, because they would all want the opportunity
to put their little No. 1 in, if that's possible.
Q185 Pat Glass: Paula?
Paula Lavis: I would say that,
obviously, looking at it from the mental health perspective, what
I hear from colleagues who work in PRUs is that better links with
CAMHS for particular young people are important. I gather, and
this is similar to conversations that we had earlier, that there
is a lot of stigma around mental health problems. I gather from
children and parents in PRUs that a lot of people would like CAMHS
to come into PRUs to work with them, rather then expecting children
to go to the service, but I guess there would be some who wouldn't
want that, so it's about being more flexible in how you work with
others or how they work with other services.
Q186 Pat Glass: So better, more
flexible CAMHS?
Paula Lavis: Yes.
Jane Vaughan: For me, it would
be about training and autism awareness, and exactly as you've
been saying. Looking at training, there should be a tiered approach,
so you should have a certain level of training if you are a TA,
a certain level if you are a teacher, and there should be a level
of training if you are a head teacher or governor—you can
tell it's my thing. If you are working in a PRU, there should
be a level of training in awareness of autism and other special
educational needs so that you can put in the individual package
to get that child accessing learning, whether that is outreach
in their homes to support them or whether it is coming into the
PRU.
Virginia Beardshaw: I don't know
whether this is the one right answer, but for me, given the high
prevalence of speech, language and communication needs, I would
say that all children should be screened for SLCN, ideally before
they're excluded; then those needs can be met in the PRU. It is
such a pan-SEN and pan-disability issue.
Paula Lavis: May I just add something
about training in mental health? In school or a PRU, if teachers
or school staff have some ability to identify mental health problems
and possibly improve the referrals—so they only refer people
to CAMHS who need to be referred—you might not get the bottleneck
that you get at the moment in CAMHS.
Q187 Nic Dakin: One of the things
that's come through in what we've heard in other witness sessions
is reading, which, I suppose, is one of the representations of
language at its core. As young people who can't read are more
likely to have behavioural issues, notwithstanding the other situations
that they might be in, do you think that it is a key issue? We
heard from Charlie earlier about a clear strategy for addressing
that in his area. Is it important or is it a distraction?
John Dickinson-Lilley: In my day
job, working for RNIB, we know that only 100 titles are available
in an accessible format to visually impaired kids in schools.
With only 100 textbooks on the curriculum available to visually
impaired children, it goes without saying that those children
will not perform as well. In a sense, it is connected to reading,
but more widely it illuminates the need for training of staff
who can identify needs. The same theory might apply, for example,
to a child with a hearing impairment, where how they are taught,
in terms of acoustics, is more important. Therefore, it is also
about linking into the comments I made earlier about reasonable
adjustments, lesson planning and the tools you use as a teacher,
but using different tools in different ways to ensure that everyone
is achieving the right learning points.
Virginia Beardshaw: I think the
reading is an important one, but both literacy and numeracy rest
on a language base. The single most accurate predictor of a child's
attainment at age five is their vocabulary and their ability to
use language. Therefore, there is an inextricable sequence of
language skills knocking into and forming literacy and numeracy
skills, and, therefore, having a huge impact on attainment and
a child's ability to thrive in school.
Jane Vaughan: With autism, we
sometimes have a different angle to cope with, in that a lot of
children with autism are very good readers and will read quite
fluently. Where the teacher then has to be skilled is to dig deeper
and be able to assess the comprehension, because they often have
over-expectations. That young person may have learnt and be reading
by rote and their comprehensive language may be very low indeed.
So, there is a different issue there again, but teachers need
to be trained to understand that for a child with autism, that
issue might be something that presents.
Paula Lavis: I guess, from a child
development and mental health perspective, these building blocks
of education are important to get into place early on so you have
a better sense of self-esteem, and so you don't start off your
education or early life thinking that you're an educational failure.
You are building resilience so you are much better able to cope
with difficulties of life, which would hopefully reflect in your
behaviour.
Q188 Nic Dakin: Can you give an
example of how inappropriate teaching and learning can impact
on a pupil with special educational needs?
Jane Vaughan: I will give you
one anecdote of something that happened to me. I gave a child
a worksheet and on it, you had to put a cat beside the table and
a lamp on the table. This was many years ago. It said, "Draw
a line under the table" and, when I turned around, the little
boy had actually gone under the table. When I dug deeper, it was
not bad behaviour—you could have seen that as him just messing
about. It was before I was very knowledgeable about autism and
I thought, "What is going on here?" and I realised he
had read that totally literally. That could be interpreted as
a behaviour issue, because he did a lot of things like that, but
really, it was literal understanding.
Q189 Chair: Does anyone else want
to come in on that? Quality of teaching for children with SEN,
as for other children, is the single most important thing in terms
of shaping behaviour in the classroom.
Jane Vaughan: Could you repeat
that, Graham?
Chair: We are very keen to explore the
quality of teaching because it is so important—that's what
Alan Steer said, and that's what you have said to us. As Alan
Steer put it, "You'd always ask in these matters, 'What does
it look like?'" That's what we are trying to find out. What
does good teaching for children with SEN look like and what does
bad teaching look like? What does it look like to disadvantage
a child with SEN in the classroom, because if we can't understand
what it looks like, it's hard.
Q190 Nic Dakin: I suppose the
other thing is, are we making improvements? You are working in
this arena—do you feel we are moving in the right or wrong
direction?
Jane Vaughan: I think in the last
five or 10 years, we have moved on hugely—I am especially
talking about autism. You see huge improvements in primary schools.
Five years ago, some primary schools had never heard of autism
but that rarely happens now. You go in and they have heard of
it. I am not saying that they are all doing wonderful things,
but it is very rare now to go into a primary school where they
are not doing something or they are not aware of it. Secondary
schools are another, completely different issue.
Paula Lavis: May I say something
about projects such the targeted mental health in schools programme?
I think that has made huge differences in some areas, possibly
to those who were in the first pathfinder. They have been going
for nearly three years now. Those huge differences are not just
in terms of the school, but how the school sits within the system
of services that supports children and young people—obviously,
I'm thinking about children and young people with mental health
problems. YoungMinds has been involved in some of the training
for some of the TaMHS projects, to train teachers in basic things
connected to mental health, so they can be reflective on their
practice and think how they can best help young people.
Q191 Nic Dakin: So, you feel that
awareness is raised on those issues with staff in schools and
that the interventions for those sort of students are better than
they were 10 years ago, so the outcomes should be better?
Paula Lavis: For some schools.
I'm sure that some schools are still struggling.
John Dickinson-Lilley: I kind
of build in the point I made earlier. My specialism is in visual
impairment. If you think about how you are taught in a classroom,
there is a huge dependency on the written word and on being able
to interact with a blackboard. For example, I can't really see
any of you particularly clearly, so for me to read on a blackboard
would be tremendously difficult. This leads back to the point
about training, and why we are all so keen on really high quality
training of teachers and teaching assistants. If you aren't able
to physically think about how to make an on-the-hoof adjustment
in the classroom—something very simple that includes children—you
start to build the potential for a behaviour problem right there.
We need to see the impact of improved teacher training, and then
work out whether what teachers are being taught now in terms of
their initial teacher training and what existing staff are already
doing in terms of classroom practice is the right approach, or
whether they need more upskilling.
Q192 Chair: What would it look
like? We heard from Alan Steer that primary schools are rather
better at classroom management and planning where children sit.
Secondary schools tend to do that less well. Is it about where
you position children, or are we talking about teachers changing
how they present the curriculum, or the curriculum itself, to
better suit the children? What does it look like? When we have
done the training, what will the teachers do that they were not
doing before?
Jane Vaughan: I think again that
it is looking at the individual, and knowing what to look for
and how their SEN may impact on their learning. I can give a simple
example. A teacher in a mainstream secondary school was having
a lot of difficulty in getting a young child with autism even
to come into the classroom. We went to look at it, and after just
a little digging we discovered that the child found it very hard
to come into the classroom past two particular boys who were themselves
quite challenging. There was obviously a slight issue between
him and them. He also found it difficult because of his sensory
needs to look at the whole classroom and know where to sit. His
anxiety levels went straight up as soon as he was in her classroom.
All we did was to try to work out, by talking to him, how we could
get over that. We cut a circle out of black paper and whenever
that class was coming in, the teacher put that circle under a
chair so that when the boy got to the door he could look for the
circle and make straight for the chair. That took that problem
out completely. The issue is about making adjustments, and knowing
your children and what to look for, especially when children with
autism are in mainstream education. If you don't know autism,
you don't know that they may have sensory needs. You may not know
that they are anxious about walking into bright lights, or that
they have difficulties anticipating when lessons will end. There
are so many things that if you know about them, you realise that
something that you think is behavioural could just be their autistic
need.
Virginia Beardshaw: I agree with
that personalised approach that Jane is advocating. One very practical
suggestion for the Committee to consider is building on the general
continuous professional development in the inclusion development
programme with which I CAN was a collaborator. We wrote the speech,
language and communication needs bit of it. I think the inclusion
development programme was a good start, but there needs to be
renewal, and building on that. It is only if you have that basic
level of understanding in the whole school population that you
will be able to build the personalised approaches that Jane has
told us about so eloquently.
Jane Vaughan: The inclusion development
programme has one for autism as well. Last year, every school
got that. When I go to meetings or do training, I say, "Hands
up who's seen the IDP in their school." Perhaps 50% or 25%
do so, and I am thrilled. Again, what is happening to that training?
I know that I am being repetitive, but I am making my point. Head
teachers should be saying, "I want all my staff trained in
this."
Q193 Pat Glass:
May I ask something quickly? I think the IDP was absolutely superb,
and I think it got better as it moved on. At the beginning there
were issues, but as it moved on it was superb. It is about every
teacher. It is not targeted at specialist teachers; it is targeted
at every teacher. What can we do that would help that to move
on?
Virginia Beardshaw: I think you
should recommend a refresher, if I may be so bold. We learned
as we went along, so that learning should be applied to move it
up a level. I think we fell down a bit in the dissemination plan
and programme for it, so I recommend that the Committee looks
at that.
Q194 Pat Glass: So what about
saying that Ofsted will look at it?
Jane Vaughan: I was thrilled that
Ofsted now has to look at SEN, because local authorities do not
really have much power in schools. Again, it is back to the head
teacher and governors. It would have been great to see some accountability,
which is why I talk about this tiered approach. Norfolk, for instance,
has developed in its schools a tier of training so that if you
are a TA you have so many modules, or if you are a head teacher
so many modules. Everybody is expected in their schools to have
so much training in SEN. If we had linked the IDP with that, with
some sort of sign-off that you had actually completed looking
at it on your PC, that would have had much more impact if there
was some accountability somewhere.
Q195 Craig Whittaker: As a trainer
in my other job, before I came to this place, I know that you
have to be very careful that meeting training needs is not just
a tick-box exercise, which quite often happens. I think that we
have established that training need with teachers is key. We have
also learned over the last few weeks that assessors probably over-assess,
and because of the training needs quite badly sometimes. The
key for me is provision. I want particularly to talk about CAMHS,
because Paula has already said that one in 10 young people have
mental disorders in school. Going back to the head teachers as
well, Sir Alan Steer's report clearly says that head teachers
complain very strongly about accessing CAMHS. CAMHS is not just
about one thing; it is about a range of services that do not always
come from a primary care trust, but from a whole range of providers.
How would you model a provision that was actually going to provide
for all children who need a CAMHS specialist, from low-level support
to more complex support?
Paula Lavis: I guess it is also,
as you say, thinking about what CAMHS actually is. It is not just
about specialist NHS services, which I think often people think
of it as being. It goes back to what I was saying earlier about
the idea of this being a whole-system approach to mental health.
You do not just have the schools, but you have the NHS, and they
all work together in partnership to produce a strategy for how
they can commission and deliver these services together at their
local level. That also needs to be based on the local need, which
I think is quite important, because there is obviously no point
in putting in place services that you do not need in your service.
The other important thing is listening to young people, because
they have a lot to tell us, and we can learn a lot if we listen
to them about what sort of service they would find acceptable.
Jane Vaughan: We have an issue
reported to us by a lot of young people with autism, adults with
autism and parents, in that a lot of children with autism have
real difficulty accessing CAMHS, because they will say that this
behaviour is their autism, when in fact it is actually a mental
health problem.
Q196 Tessa Munt: Sorry; this behaviour
is—?
Jane Vaughan: Sometimes CAMHS
will say that a child cannot be referred because they are autistic,
and therefore the behaviour that we are seeing is part of their
autism rather than a mental health issue. We know, however, that
autism does not mean that you have a mental health issue, and
you can have autism and a mental health issue. Because of the
lack of recognition of the anxiety and stress around autism, it
often deteriorates into a mental health issue, and such individuals
are having great difficulty accessing CAMHS.
Q197 Craig Whittaker: So how do
we model that provision, to give that provision where needed?
That is the key question, really.
Paula Lavis: I suppose we have
to see the whole person, not just split-off bits. Our mental health
is integral to our physical health as well, so you can't just
split them all off.
Q198 Chair: We are talking about
the structure of that provision. What does good provision look
like? How is it modelled? Who does what? Who has what responsibility?
Who has the lead? Where should the budget go?
Paula Lavis: Maybe it should be
a pooled budget. That has always been a bit of an issue, with
different agencies contributing to the main pot. It does not take
a lot before a bit of that money is pulled off. Often you get
lots of project money, so you might get a little pot of money
for the short term, which is then taken away because it has not
been mainstreamed. It would probably be helpful to have a centralised
fund within a local area.
Jane Vaughan: Again, going back
to CAMHS, we assume people have been trained in autism, but lots
of the CAMHS teams have not. We go back once again to having that
training.
John Dickinson-Lilley: I think
that, as people have already pointed out, it is really difficult
to disentangle mental health disability and behavioural difficulties.
There is a real issue in schools about who is responsible for
a child's mental health; we need a bit more clarity about that.
One of the key challenges for schools now, certainly with the
changes to the structure of the system, is how to develop those
partnerships. Not only are the quality and types of services available
variable—within counties sometimes—but the relationships
may need to be built with the local mental health trust, the NHS
and social services to create a bigger picture. There are all
kinds of reasons for mental health issues that may be related
to disability or to something else. I think that a fundamental
role for schools would be to build those partnerships in the first
instance, which then links to making sure that children are being
assessed at school. That assessment is critical, because we know
that children with an SEN or disability are more likely to have
a mental health problem than their peers. Getting that identification
in place should lead a school to question the need to look at
the kinds of interventions that need to be made either now or
in the future. It is not only about looking at a child's SEN or
disability in isolation, but at its tangential effects.
Q199 Craig Whittaker: The initial
question was about what sort of structure you would put in place,
but I am not quite getting it.
John Dickinson-Lilley: I could
give you a direct answer to that. It is very hard for us to talk
about structure, because of the changes to the education system
as it is now. One of our concerns at the SEC is that we are seeing
significant defragmentation already in the traditional central
support services provided by local authorities—such as educational
psychologists and so on—because of the new academies programme.
There is potential for further defragmentation with free schools,
where schools will be required to commission services. If the
money has already been taken away from local authorities, those
services will be lost, and if they are lost, how will provision
be made? It is an absolutely critical question, but it is one
that we are going to find very hard to answer until the Government
can give us an answer about how they are going to ensure that
this provision will continue to be made while education is being
changed in the way that it is being changed.
Q200 Craig Whittaker: That leads
nicely to my next question. As a previous Lead Member, one of
the key things that I have been banging on about for many years
in the local authority is that, with things such as CAMHS and
disabled children, we often see money going from vast amounts
of pots through different directorates, children and young people's
services, primary care trusts and sometimes justice services,
and we often also see a huge amount of duplication of service
and huge gaps in the service. The thing that I have been banging
on about for years is: why don't we get one pool of money, tear
down those structures and have one overhead cost? And, guess what,
all of a sudden we wouldn't just have service, but a provision
right across the board. Surely, in the light of the savings that
are needed, that would be the best way forward.
Virginia Beardshaw: I wasn't expecting
to make this point today, but this fragmentation is a real worry.
It has been a consistent feature of the system for umpteen years,
not just affecting CAMHS. Children with speech, language and communication
needs fall through the cracks between local authority-provided
services and NHS-provided services arguably more than any other
group. As a result, I CAN, the Council for Disabled Children,
the National Children's Bureau and the Communication Trust have
made a submission to the Department of Health, in response to
the new White Paper, suggesting that the child health commissioning
budget, which is the money that pays for CAMHS among many other
things, should migrate with the public health budget to local
authorities, so that local authorities would be able to take an
integrated view of commissioning. That is quite a radical suggestion.
It has always been rejected in the past, because of issues around
health professionals' terms and conditions. Those would not apply,
because, under the proposals on splitting provision and commissioning,
it is only the commissioning budget that need move to local authorities.
Health professionals' terms and conditions could remain the same.
I wasn't expecting to do this today, but I highly recommend that
radical suggestion to this Committee, which is of course known
for its independence, and I will make available the letter from
I CAN, CDC, the National Children's Bureau and The Communication
Trust, so that you can consider it.[1]
Jane Vaughan: Craig, I would like
to think about this a bit more. Can I think about it and write
back to you?
Craig Whittaker: Certainly.
Q201 Chair: John, do you want
to give an instant response to Virginia's radical proposal?
Virginia Beardshaw: It's CDC,
so—
John Dickinson-Lilley: It's slightly
more complex for me to give a radical answer—no matter how
radical I would like to be on occasion.
Chair: If you have to get consensus of
22, we're lucky that you say anything at all.
John Dickinson-Lilley: You're
right; it takes a lot of preparation. On provision, one of the
difficulties is that, if you look at children with sensory impairment,
including children who are deaf, for example, there is a very
low incidence; the same goes for children who are blind and partially
sighted. As a result, service provision by someone central is
actually fairly essential. We're not necessarily saying that local
authorities are brilliant, but we're not saying that they are
terrible either. We're not even saying who should provide it.
What we are saying is that the market is not viable, because you
are talking about such a small number of children. The question
about how that provision is made is really important and it is
something that the Committee might want to reflect on a little
bit more. Charities such as the RNIB or the National Autistic
Society provide such services and can do a little bit of work
in providing some of those services, but we don't have the capacity
or the ability to provide specialist support services. There is
a real question there about the viability of those services going
forward.
Chair: Thank you, John.
Jane Vaughan: May I just add one
more thing?
Chair: No, I'm afraid not, Jane.
Q202 Ian Mearns: There's a strong
correlation between children who have emotional and behavioural
difficulties and SLCN. In particular to you, Virginia, can you
tell us about the correlation between children's emotional and
behavioural difficulties and their speech, language and communication
needs?
Virginia Beardshaw: That is what
I was starting to do at the beginning. It always amazes me that,
in this field, we always tend to make things too technical. That
is why, when I'm talking about behaviour and SLCN, I always say
that it is commonsensical that, if you can't really understand,
because comprehension is a big part of language, what is going
on in a setting, particularly a setting as formal and as demanding
as a school, and if you can't really express yourself very well—in
technical terms, this means receptive language and expressive
language—is it any wonder that you either act up, misbehave
or absent yourself? Hence the exclusion figures of 60% to 70%—actually,
those are the figures for youth offending—and truanting
is equally high. I could go off into technical detail, but I would
invite members of the Committee to make an imaginative leap. All
those same elements apply in the youth offending and criminal
justice system. These kids cope very badly. If we could get into
the whole teaching work force, the whole school work force and
the young offending work force a realisation of just how many
children are not getting it and are not able to express themselves
properly, then, I think, we would bring about a sea change that
would have a beneficial effect across the whole range of special
educational needs, including key areas such as autism, dyslexia,
deaf and hard of hearing children and a range of others.
Jane Vaughan: I will just give
you an example that I think demonstrates a lot of what Virginia
says, with which I agree totally. It was given to me by the SENCO
of a secondary school in Surrey. A young boy who has Asberger's
syndrome accidently dropped his sandwiches as he walked into the
dining room. He didn't realise and went to the other side of the
hall. The head teacher came in, saw the sandwiches, realised that
they were his and shouted, "Boy, pick up these sandwiches."
The young man stood up and said, "Man, you pick them up."
Absolutely horrified, the SENCO rushed over to the head teacher,
as he was exploding, to say "Let me explain. Let me explain."
She got the young man to sit down and explain how he saw the situation
according to his understanding of language and his own expression.
The person he'd seen had called him "Boy", so he responded
with "Man". In his logic, the sandwiches were next to
the man, so why would he walk right the way across the hall to
pick them up when they were next to the man? I thought that that
was a great example of how speech and language communication difficulties
can result in a behaviour difficulty.
Q203 Ian Mearns: If I can come
back to Virginia, I am delighted that you have raised the issue
of non-attendance and truancy, which often goes with youngsters.
It seems to me that it is one of the items that we have lost a
little bit. We did agree to look at that at the start of our proceedings
on behaviour and discipline, but we seem to have lost it somewhere.
Can I take you back to something you said that perturbed me a
little bit? You said that if youngsters were screened for speech
and language communication needs prior to exclusion, then they
could be dealt with in the PRU; but why would you exclude them
in the first place? It seems to me that if we identify such needs
through a screening process prior to exclusion, what we have actually
done is identify a failure in the institution rather the child.
Virginia Beardshaw: Thank you
for giving me an opportunity to clarify that for the Committee.
Of course, I would always prefer the child's needs to be met in
a school setting. If, prior to exclusion, there is screening for
SLCN, then that is exactly what I think could, should and in many
cases must happen, rather than the child going to a PRU. But sometimes
they will go to a PRU, and there, they will need to have their
needs addressed. I am also glad that you are pleased that I brought
up truancy. It is something that we see a lot in our I CAN schools.
We've had children who have been school refusers for two or three
years, and we bring them back. One of the things that I am proudest
of is how they can then achieve good GCSE results and go on to
college.
Q204 Ian Mearns: Is there one
magic bullet for detecting youngsters who have these needs that
have previously gone undetected through the systems and through
primary and secondary education?
Virginia Beardshaw: For SLCN,
which has wider applications across special education needs, we
are advocating screening at two and two and a half, linked to
the child health programme, and then screening at five on entry
to school. We are passionate—we think that would turn things
around if, and only if, this isn't just an assessment and it is
followed up by support. We spend far too much in this country
and waste a lot of our valuable, most skilled staff's time just
doing assessments and then doing nothing whatsoever about them.
Jane Vaughan: There is the danger
therein as well. If teachers are waiting for a child to be assessed
and diagnosed, they won't meet the need—"Oh no, we
don't need to do anything. They haven't got anything." We
need to look at the child and say, "This is your need."
Q205 Tessa Munt: We heard evidence
earlier about links with crime for the group of young people who
have SEN. There is a phrase from the YJB, which says, "Significant
numbers of young people with special educational needs can end
up in alternative provision and in turn involved in the criminal
justice system, when their needs have either not been identified
properly, or they have not been met appropriately in mainstream
provision." What kind of interventions are required where
a child with special educational needs or a mental health problem
is also identified as being at risk of committing a crime?
John Dickinson-Lilley: Again,
that links back to the assessment, because although a child might
already be diagnosed with a special education need, the fact that
there are behavioural issues might mean that there is another
underlying special educational need or disability. You quite often
find that disabilities, special educational needs and behaviour
get overlaid in different ways, so things get missed. One of the
most important things is that identification. One of the things
that we've found is that if a child has, for example, a behavioural
problem, quite often schools progress them through the disciplinary
route and forget about looking at curriculum and assessing need.
They just look at the child's bad behaviour and progress them
through the disciplinary route with fixed-term exclusions and
permanent exclusions. As a result, by the age of 19, 27% of young
disabled people are NEET, because, ultimately, they get excluded
from the system so many times that the system inherently fails
them. We then move on to the causes of crime, with which we are
all familiar and on which I don't really need to comment, including
social exclusion and all of the other factors. We need to get
it right at school and keep on getting it right. If you look at
the key stages, 42% of children in key stage 1 have a speech,
language and communication need. If you look at the same group
of children at key stage 3, only 5% have that need, but DCSF research
shows that, between the ages of 12 and 17, 38% of that group have
a behavioural, emotional or social difficulty. So what you are
seeing is a bizarre translation from key stage 2, in which 42%
of children with a speech, language and communication need becomes
38% of children with behavioural, emotional and social difficulties.
I allude to the point that was made earlier about secondary education
by saying that there is a distinct difference in how secondary
schools treat children with special education needs.
Virginia Beardshaw: I saw some
slightly bewildered faces among the Committee members, but I have
a nifty little chart that shows that miraculous conversion over
the summer holidays. High levels of speech, language and communication
needs are identified in primary school, but we believe that a
massive relabelling takes place by the time they get to secondary
school and those very same children are relabelled as having behavioural
difficulty. I have that chart here, and I will make it available
to the Committee. I just wanted to back you up, John.
Q206 Chair: I'm afraid that our
time is up, although there's much more that we'd like to explore.
There is just time for a final word from Paula.
Paula Lavis: There are strong
links between youth crime and mental health. Huge numbers of young
people with mental health problems end up in the youth justice
system. I guess that a lot of those cases may well have been avoided
if we had really good early intervention services to pick them
up. You can identify those at risk at a really young age.
Q207 Chair: So if you prioritise
them at the age of two and a half or five, they won't end up in
jail?
Paula Lavis: Yes.
Chair: On that positive note, I thank
you very much indeed for coming to give evidence to us today.
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