Abuse and ‘neglect’ – how is this identified? And what support is offered?

 

I am grateful to this post from one of CPR’s readers, who is parent to an autistic child. She writes about her difficulties in getting help and support for her son and the problems families experience in a system which does not seem set up to identify difficulties and offer support. What happens when children with difficulties arising out of their undiagnosed disabilities are mis-identified as children suffering from parental neglect or abuse?

As she comments:
As it stands, the Child Protection system is a blunt and sometimes cruel instrument often used without much prospect of bringing about positive change because it can only ever work as one part of a system of support for families, and this system of support is largely absent.

Not having met a social worker in our local authority until the day my son with an Asperger Syndrome diagnosis entered Care under section 20 of the Children’s Act 1989, I began to read anything I could find about children with his profile who enter Care. That was the day I accepted that having tried everything else, Care was the only option available to get an integrated package of support for him, something we and he had needed by any measure for some time. He was not going to be someone ‘who didn’t fit within our services’ remit’ nor just another statistic of a disabled young person living rough with poor mental health or worse, something that seemed almost inevitable at that time, without trying everything including Care.

As part of my coping mechanism for the immense grief and desolation I was experiencing, I read report after report to learn about the Care system. Eventually, to cut down on my reading, I’d open reports and papers in pdf format and search within the document with the search facility using terms like ‘disabled, disability, autism, neuro-developmental, ASD, ASC’ and might get one ‘hit’. What I did notice was that if I carried out the same search using ‘neglect’ as a search term I’d get scores of ‘hits’ within the same document. I concluded that for social workers ‘neglect’ was ‘sexy’ and disability anything but. Children like mine, with an autism diagnosis but without an obvious learning disability were a bit of a side show while all the action in Child Protection was around ‘abuse and neglect’ and that didn’t seem to be up for discussion. There were a few reports like the excellent ‘Unprotected, Overprotected’  that made links between disability and core child protection issues but generally these reports were few and far between.

If one looked a little wider to the family unit with an autistic or learning disabled family member there seemed to be almost nothing in terms of research into how to support families with complex difficulties around neuro-disability including poor mental health, different ways of thinking and processing information, mental inflexibility and the need for extreme control to manage anxiety as just some examples.

I came to loathe the word ‘neglect’, surely the reasons why children enter care are multi-faceted yet this word is so un-nuanced and brings with it a mountain of stigma, shame and blame for parents.

One of the things that also became apparent to me, was that there seemed to be a lot of children with extreme difficulties within Care. When I asked why our son hadn’t a social worker from The Children with Disabilities Team I was told they only took on cases of children with multiple and complex disabilities and they had a very full caseload. Similarly when I asked why his case did not have clinical oversight, (something that eventually did come) I was told ‘’All our children have the same kinds of difficulties’. My response was ‘’well, are they being given autism assessments?’’ The answer to that question ( yet more reading..) was that ‘no, children who enter Care are not assessed or even screened for autism – all their difficulties (they are most commonly described as having developmental delay not disability and/or traumatised with poor mental health) unquestionably stem from ‘’neglect and/or abuse by parents prior to entering Care’’. Well that is not my experience so..?

I eventually came to the conclusion that assessments and healthcare for children in Care are not remotely up to the task of meeting the needs of a sizable number of children who are in Care, many with undiagnosed hidden disabilities. There is almost no data collected on children in Care with disabilities and we do not know how many are diagnosed as being autistic before they enter Care or within Care although we know from 2017 Freedom of Information requests there is considerable local variation in their numbers from 0% (Calderdale) -to 12.7% (Walsall). Surely this is Corporate Neglect and why were Child Protection professionals / CQC / Ofsted not making that point? Obviously some types of neglect are more ’sexy’ for professionals working in Child Protection than others.

There are some other troublesome issues around ‘neglect’

I’ve recently being made aware of this project. Identifying and Understanding Inequalities in Child Welfare Intervention Rates. It is worth watching the You tube video associated with the link as it identifies that in a poor neighbourhood within a wealthy borough there are a lot more children on child protection plans than in a poor neighbourhood in a poor borough. Surely ‘abuse is abuse’ and ‘neglect is neglect’ so how to explain this? Assuming ‘abuse’ is an absolute, maybe the concept of ‘neglect’ is a relative one, so one person’s/team’s idea of neglect is not another’s? I’ve a working lifetime of experience where I’ve learned to never ask anyone in a local authority whether they would like to be involved in decision making unless it falls within their strictly defined statutory remit and I check that myself first rather than asking. This is because I have found that many are tempted to try and control things they have no statutory remit for and ‘it is best not to invite trouble’. This is certainly not unique to people who work in Local Authorities just that when asked for our opinions, most of us have difficulties not telling people what they should be doing based on our own likes/dislikes/perspectives. When it comes to Child Protection, where there is a huge power imbalance and a very diffuse remit, I think this can enter some really dangerous territory.

Take this situation where there are concerns about abuse and neglect by parents of their autistic children :-
‘’ Some families may feel that they accept their child for who they are and allow them to withdraw from the world. Is that neglect? Many people with autism need to have structure and routine in their lives to cope with an unpredictable world. Some parents may allow this to take over and dictate the lives of the whole family, others may rally against it, believing it’s in the child’s best interest for them not to give way to the structure. Is this abuse?

There are many different therapies and interventions available which claim to cure autism. Some of these practices can in themselves ‘appear’ abusive. Some parents pursue these out of desperation and when the claims for some of these therapies and interventions are far from clear, it can be difficult for parents to know what to believe’’

http://www.autismeurope.org/activities/projects/speak-up-publications/guide-for-the-protection-of-children-and-young-people-with-autism-from-violence-and-abuse.html

If social workers working with children have little training about autism, are they really able to make decisions about what constitutes ‘neglect’ when it comes to this group? What if an autistic child doesn’t t have a diagnosis because clinicians do not have resources to carry out specialist assessments? If they do not have very good multi-disciplinary working arrangements that can quickly identify the reasons for a child’s difficulties and help build the child’s capacity, ,not just focus on questions about the parent’s fitness to parent, are they likely to get this right?
Where is the discussion about this in Child Protection circles and if decision-making is wrong why is that not abuse? It is absolutely foreseeable and mostly preventable with good training and good multi-disciplinary working arrangements around diagnosis.

Which brings me to ‘Edge of Care’ support for autistic children.

Autism is a spectrum condition and a child’s difficulties can present in many ways. One of the most difficult to explain is that a child who is very bright and no trouble in school can have extreme difficulties in processing what is happening around them and may develop very poor mental health particularly around anxiety. See this National Autism Society video  explaining how autistic children who have acute difficulties such as these, may end up in secure or forensic settings.

The tone is very much ” Their parents never taught them and because of this..” My response to that would be ”Give parents the tools to help their autistic children and most will.” Autistic children need an autism diagnosis (my son got his at 16 in the most horrendous circumstances) and parents need support (we got none). I also believe billions of pounds of cuts are purposefully being made to Children’s Services, legal aid and the NHS with an unspoken acceptance that naive carers/parents in desperate circumstances will find it almost impossible to access support for themselves and their children. Many pathways to support exist in name only, are supposed to be provided by the market via brokerage or self-funding or unfunded charities, are initiatives or time limited programmes that quietly disappear, unlike the fanfare around their introduction. Services where they exist are understaffed and complaints/appeals processes so difficult to negotiate that only the most committed, resourceful and able persist. All, including professionals who have to somehow work in this environment whilst retaining their own humanity, understand this, so is this the ‘neglect and abuse’ that Child Protection Professionals are concerned about? Maybe.

I could go on and on..

As you will have gathered my own ‘special interest’ is around children who are autistic. See this piece http://www.bbc.co.uk/news/health-41345647
”About 20,000 children have been harmed by valproate medicines in the UK since the 1970s. The medicines regulator said the drug had been kept under constant review. Babies exposed to the drug in the womb have a 40% risk of developing autism, low IQ and learning disabilities.” —Almost 70% of women surveyed about a powerful epilepsy drug have not received new safety warnings about the dangers of taking it during pregnancy.”

Anyone interested in the law may already know that a number of years ago, legal aid was withdrawn to families trying to take a case against the drug’s manufacturer and it could not proceed. Since then children continued to be born with abnormalities and some died, as a result of their mothers taking this drug without being aware of the risks, causing unimaginable and completely preventable suffering to children. Is that ‘neglect’ by the State? Can it get any more serious if so?

Or is this the kind of ‘neglect and abuse’ that the United Nations has called for action on, United Nations criticises treatment of disabled children in the UK  that concerns Child Protection professionals?

These are rhetorical questions in the main because although Child Protection professionals refer to preventing ‘abuse’ and ‘neglect’ of children what they really mean is intervening in families that are experiencing difficulties with the mind-set that children’s difficulties stem from neglectful or abusive parenting. The reality is that it isn’t possible for parents or professionals to nurture children particularly children with high needs, without the State taking an active role in supporting and protecting families.

As it stands, the Child Protection system is a blunt and sometimes cruel instrument often used without much prospect of bringing about positive change because it can only ever work as one part of a system of support for families, and this system of support is largely absent. I think families are a huge resource – painting us as incompetent, neglectful, not to be trusted, ignorant etc. is just so damaging for our children. My son didn’t need rescuing. We needed to be listened to and we needed help. That our son had to enter Care to get it is my idea of what constitutes ‘neglect’.

 

Further Reading

NHS (2017) Developing Support and Services for Children and Young People with a learning disability, autism or both  ”The Department for Education supports the development of the work undertaken in the Transforming Care Partnership Boards and encourages local authorities to pay regard to this guidance”

Tizard, Challenging Behaviour Foundation (2017) Developing Better Commissioning for Individuals with behaviour that challenges services – A scoping exercise.
The Children Act 1989 – deeply flawed legislation?

37 thoughts on “Abuse and ‘neglect’ – how is this identified? And what support is offered?

  1. Angelo Granda

    Thanks for this post which is very interesting. As the writer suggests, it is true that the professionals refer to ‘neglect and abuse ‘ wrongly without investigating correctly or getting expert opinion.
    However, I assert that they are doing so due to strict directives from LA’s which act with ulterior motives . They need to satisfy criteria for neglect before they can get a care-order. Thus, we should be studying threshold criteria documents to establish how they do so. Alas, these are never published . If they were ,I suggest the LA’s would be laid open to libel charges. To present guesswork and speculation as facts to satisfy threshold is unlawful because it misleads the Court.
    So researchers should examine a cross-section of these documents. A hint – Severe learning difficulties may be cited as a fact to satisfy criteria. Yet autistic children don’t have S.L.D. Even if they did, it does not mean a child has been neglected and abused. Yet a Judge will find it does. This is because they usually have to accept the opinions of SW’s and Guardians .

    Reply
    1. Sarah Phillimore Post author

      The threshold document itself may not be published – but many court judgments are which refer directly and in some detail to the threshold document when it is disputed.

      Reply
    1. looked_after_child

      Not sure if this off or on point but has anyone seen this http://www.op.nysed.gov/prof/sw/swbroch.htm
      Clinical social worker..wonder what that would mean here? I guess this a response to need in a country with almost no free healthcare. Could we head down this road here too. What would it mean if so – DfE would need to change their remit and that would be very challenging for them…really strange to think of SWs doing diagnostic work.

      Reply
        1. looked_after_child

          See https://www.nice.org.uk/guidance/GID-SCWAVE0770/documents/short-version-of-draft-guideline
          This could be a blueprint for Children’s Services if only DfE cared enough to even become a sponser department ( and is probably trying to frustrate things in the background as it would involve an erosion of their power base?)

          ”Local authorities and clinical commissioning groups should jointly designate a single lead commissioner who is responsible for commissioning health, social care and education services for children, young people and adults with a learning disability, including for those whose behaviour is described as challenging. This commissioner should have in-depth knowledge and experience of working with people with a learning disability and behaviour that challenges.
          Local authorities and clinical commissioning groups, acting through the single lead commissioner, should consider jointly commissioning the most specialised behaviour support services across areas for people with particularly complex needs”

          Reply
          1. looked_after_child

            When you’ve dehumanised people who need services to the extent this is happening in children’s social care is it possible to do this?-
            ”Commissioners should establish a multi-agency group, including experts by experience and providers, to monitor the quality of services and the outcomes achieved. Commissioners should use these as part of their performance management of services”

          2. looked_after_child

            This guidance with no statutory force ( so a govt. promoted ‘wish list’ from the Department of Health, would make anyone who has experience of the issues weep.
            Imagine what this would mean if Children’s Services could do this for families (although some are getting around to it for paid carers out of necessity)?

            Support for families and carers
            Local authorities should ensure that parents and carers of children, young people and adults with a learning disability and behaviour that challenges have support to care for that person from the following specialist services:
             psychology  speech and language therapy  occupational therapy  behaviour analysis and positive behaviour support, including training on
            restrictive interventions and how to reduce their use.
            Specialist staff should provide information and training to families and foster carers of children and young people in line with recommendations 1.7.1 and 1.7.2 in NICE’s guideline on challenging behaviour and learning disabilities: prevention and interventions.
            Local authorities should provide information, guidance and support for families and carers of people with a learning disability and behaviour that challenges which addresses different aspects of their life. This support could include:
             peer support  parent and carer groups  email support  individual phone and in-person support  family networks  managed email networks (a shared discussion forum).

            Our children are not important. We are not important. Policymakers have made that evalution/choice because all know what good practice is but that is as far as it goes…the realms of fantasy only.

      1. looked_after_child

        Quote:-
        What are we doing about it?

        We are very aware of the increasing numbers of parents who find themselves subjected to child protection procedures as a result of asking for support, challenging professionals or having a child with a condition that someone working with them does not understand.

        Tania and I have already spoken openly to ministers, journalists, child protection experts, medical experts and parents about our concerns surrounding the anti-parent language used in publications and guidance around child protection and the lack of adequate monitoring and accountability for safeguarding personnel.

        We have also raised concerns about the lack of evidence supporting much of the guidance published by the government, as well as numerous journal articles listing ‘risk characteristics’, such as a parent asking for a second opinion or disagreeing with a doctor.

        Also concerning is the focus of safeguarding training encouraging practitioners to rely on lists of risk indicators that have had no rigorous independent scrutiny or any fact-based evidence to support them. Given the heavy price that parents and children have to pay when practitioners follow these guidelines and get it wrong, we simply cannot understand why no one is demanding the same rigorous scrutiny and quality control as we expect of the scientific community.

        Reply
        1. looked_after_child

          quote:-

          ”This guideline on handling and responding to abuse and neglect caused us serious concern that it was directly discriminating against disabled children and their families, and would lead to specific developmental disorders being targeted. We believed that the evidence gathered, including the testimonies of expert witnesses, was not representative of all the people on whom these guidelines will impact. For example, it fails to properly explore the likelihood that these guidelines will be applied in error and what the unwarranted consequences of this might be to children and their families.

          The evidence search also failed to properly explore the consequences and possible harm that could be caused by incorrectly accusing parents of abuse and the expert witnesses and committee members did not include any experience of childhood disability and its presentation and did not invite input from experts dealing with false allegations of abuse.”

          Reply
          1. looked_after_child

            quote: ”Isn’t it time we stopped being so scared of having an open and honest conversation about child protection? Isn’t it time we stopped demonising all parents, and stopped putting child protection ‘experts’ on untouchable pedestals?”

          2. looked_after_child

            ”It is the most terrible thing to be accused of as a parent, and the weight of the accusation should not be lost because we hide behind the pretence that we are acting in the best interests of the child, because we are not.

            When you accuse a parent, you are taking away their ability to advocate for their child. You are removing and discrediting the best source of information you have about how to help the child. You are taking away the expertise of the person that knows them the best. This is not in the best interests of anyone.
            quote
            ”So let’s stop repeating the same mistakes and learn from best practice rather than guidance that tells us to ignore our instincts and use an assessment tool that is no more accurate than rolling a dice. Let’s approach child protection from a position of kindness, compassion, and communication, then all the money we save by not overwhelming social services with pointless assessment referrals, could be ploughed back into supporting families and helping give children positive outcomes rather than dragging families through the dirt and then blaming them for being too broken to cope”

          3. looked_after_child

            Just looked at the NICE guidance (https://www.nice.org.uk/guidance/ng76/chapter/Recommendations#recognising-child-abuse-and-neglect)

            includes this statement – As highlighted in the recommendations below, alerting features for child abuse and neglect can be similar to behaviours arising from other causes, such as other stressful life experiences or neurodevelopmental disorders such as autism. However, practitioners should continue to consider the possibility of child abuse or neglect as a cause for behavioural and emotional alerting features, even if they are seemingly explained by another cause.

            Thinking aloud, It might be more cost effective to have parents and their autistic children to report to the authorities at 6 month intervals for an ‘abuse and neglect’ check. Might suggest it to NICE….

          4. looked_after_child

            ..:: or better still professionals could come en-masse to houses where there are autistic children for randomised ”abuse and neglect” spot-checks and them families could get a clean ‘abuse and neglect’ bill of health – that sounds sensible, I think..

          5. looked_after_child

            I realise it is going to be difficult to get the ”abuse and neglect checkers’ trained up at short notice but there must be some out of work trainee sock puppet ‘therapists’ who’d be up for it – again a lot cheaper than clinical expertise, so very positive really.

          6. looked_after_child

            It is a good thing everyone’s intentions are for the best..such nice people really ..no idea why people feel fear at the thought of social services/care getting involved with their family.

            Just so you know one of the first autistic people I met was a lovely man in his 60’s. When we got chatting I asked him what it was like growing up autistic in the 1950’s. He explained that both his parents were autistic as was his brother. They knew they were different and the family lived in fear of being ‘discovered’ by social workers because they knew they would be split up and the two boys placed in institutions, if so. Their mother taught them how to fit it – to be quiet and to watch others and copy what their peers were doing, sometimes with not so good outcomes. School was hell.
            He has done remarkably wonderful things in his life and has two autistic children. If they have children would it be any different for his grandchildren despite how much we now know about autism and pat ourselves on the back about how much better things are? I’m really not sure – this kind of really simplistic risk-averse guidance will only make things worse.

  2. Planet Autism

    “Assuming ‘abuse’ is an absolute” – which *is* done, even though clearly it isn’t. Considering the ethereal and frequently subjective definitions of ’emotional harm’ being misused against some parents and in all too many instances fabricated harm based on a social workers’ ignorant opinions, we can say hand on heart that abuse is not an absolute. Emotional harm and FII are being widely misused against parents and especially those witith autistic children and who are themselves autistic parents. The highest numbers of children termed as being abused or at risk of abuse are in the emotional harm category (https://www.theguardian.com/society/2017/jan/18/children-parents-foster-social-care-families-adoption).

    It happens all the time with autistic children that the state uses a tick-box ‘ideal’ that if they don’t match it there is something wrong and the parents are blamed as you describe. It is also far from accidental, parents are more and more frequently falsely accused of abuse by LAs in retribution for parents seeking SEN support or going to SEN tribunals against the LA.

    Parents are also being abused by their autistic children and the the parents are blamed for that too. Yvonne Newbold has received emails from many parents in this position. There is a nasty, punitive, negative and blaming attitude in social services across the UK. It seems to be about justifying their actions and nothing else. CAMHS doesn’t want to diagnose autistic children because it gives them access to expensive support. The Government has known (via Parliament) about this problem for 26 years and has done nothing. How can so many social workers get away with this behaviour? Because they can. Because judges don’t find them guilty of perjury, police don’t investigate reports of perjury, abuse of procedures happens on a daily basis without any action against guilty parties and procedures are written without sufficient safeguards built in. What a lovely job for vindictive people with an axe to grind, or those who have a personality disorder, become a social worker and get away with anything you want pretty much. If it leaks out, you will simply be moved to another area to continue your dirty deeds. You might have to dodge a bullet once in a while as the HCPC will now and again make an example of someone for the sake of show. But how lovely eh, all that power to abuse without any consequences to you.

    And as always, it’s the most vulnerablewho are targeted. So autism families and those with other invisible disabilities like Ehlers Danlos syndrome which causes easy bruising and bone issues, or chronic fatigue syndrome, where parents are accused of FII and enabling the child’s mental ill-health (because of course it’s all in their head) are the ones who suffer.

    You covered a lot in your post and I’m glad you pointed out the UN’s findings against the UK. What’s going on in this country is disgusting and evil.

    Reply
  3. Angelo Granda

    Sarah, Was I correct in law to say that IF threshold criteria documents were distributed openly and/or published it would render LA’s open to a legal action for libel ( just as a newspaper would be when it issues false reports )?

    Clearly the secret documents and lack of publicity, transparency etc. is not to protect any children; it is to protect LA’s, in my opinion and allows the Authorities to libel and slander citizen’s without any comeback!

    Reply
    1. Sarah Phillimore Post author

      No. It is unlawful to publish threshold documents because they reveal considerable details about the private lives of families and the particular abuse and trauma it is alleged that children have suffered. If they were to be published far and wide there would need to be strong safeguards against identifying children who have a right to grow into adulthood without all their family’s dirty laundary being hung out to dry for many years to come.

      Reply
      1. Angelo Granda

        Yes, Sarah, but please answer my question which I asked in the spirit of constructive discussion. We we already know the rationale behind the Court’s rules but is one of the side-effects ( planned or unplanned) that Local Authorities can make false allegations of neglect, abuse and trauma in these Court documents without any come-back? Thus it cannot really be said that such rules protect children but the opposite. To my mind when LA’s issue false documents and assessments of any kind under oath to be distributed amongst other professionals they should be open to the same level of public censure as the press etc. Thus Public Law threshold documents should be published in the children’s best interests. It is mere speculation that families will be harmed by having alleged dirty laundry made public. It is a fact that there must be strong safeguards against false allegations and misrepresentations because they cause immense harm and degradation. We should really get our priorities right and cease pandering to the Authorities,in my opinion.
        All comments welcome.

        Reply
  4. looked_after_child

    I’m not sure if people have seen the Victoria Derbyshire programme on Monday morning about lack of support for families with children who have autism and learning disabilities? It is worth watching. You can access via a blog by Helen Bonnick here
    https://holesinthewall.co.uk/

    Helen works a lot with adoptive parents and she and I are not always on the same page particularly the causes for really controlling behaviours in children without a learning disability. ( Do they choose to behave as they do or is this a maladapted coping strategy because they do not understand what is happening around them because of autism like experience of the world ? )

    Her blog is very good and well worth a read.

    Reply
    1. Angelo Granda

      Looked after child, Thanks for the link. I believe that one of the main faults of the autistic ( due of course to the condition) is selfishness ,self-absorbtion and the disability to empathise with the needs and requirements of others such as parents and schoolfriends.
      In some cases they will be violent etc. However , they can be corrected and the earlier corrective training commences the better .The earlier diagnosis is made the better etc. I think as with ordinary children ,the use of a naughty step can be beneficial plus the withdrawal of privileges and luxuries can work when older children and adults are involved. Logically,therefore, as the autistic are usually of average if not exceptional intelligence then they may also respond to the criminal reform system when they reach maturity. They should not necessarily be put in a mental hospital for unacceptable violence because they aren’t mental, they are autistic. If dealt with harshly ,such as by fines, probation training, community work or other such measures considered appropriate, the staff will naturally need to be autism-aware.
      On no account, in my view, should autistic children be smacked even though it may be acceptable to smack ordinary children and physical restraint in care homes should be outlawed.

      Reply
  5. looked_after_child

    I’m not sure I agree with much of that Angelo
    See http://network.autism.org.uk/knowledge/insight-opinion/tools-supporting-autistic-people?utm_source=AutismInsight02Nov2017&utm_medium=newsletter%2Femail&utm_campaign=AutismInsight02Nov2017&utm_content=Story1A&dm_i=YA3,59DUJ,L1P9W2,K9SSO,1

    That would be more my take on things.

    Boundaries – yes. Discipline -No
    Diagnosis – always and as early as possible because it brings understanding from others. or at least it should, and for many people such as Chris Packham self-awareness. (See http://www.communitycare.co.uk/2017/10/18/honest-inspiring-challenging-chris-packham-aspergers/)

    Reply
  6. Angelo Granda

    Whilst I respect the link and its writer, I am afraid I disagree with most of the sentiment and jargon about ‘wrong toolboxes’ etc.
    Discipline is effective and at an early age , as I wrote, a naughty step-type discipline does work in practice. When my child used to melt-down and leave the class group or disrupt it ,she would be taken from the room and placed in the ‘safe’ sensory room for a while . Teachers found she responded and her behaviour in class improved to the point where the measure became less and less necessary. They also found that when she tried to run away or misbehave ,a very stern “No” had the required effect Likewise, a stern call of “Come back, NOW” when she ran into danger was much more effective than chasing after her. These children are not mental and usually they understand every word said to them. They have physiological defects around sensory and communication issues only, as we all know but they can learn not to cross boundaries as we all can.
    Of course , I am only surmising but if an older autistic boy became unacceptably violent towards other family members or to outsiders , normal disciplinary measures on a scale from fines, ASBO’s , community work, probation etc. with the ultimate sanction of prison for the really serious offenders can be just as effective as they are with normal boys.

    Reply
  7. looked_after_child

    My son was never naughty as a child but he recognises NO restrictions of any kind and never really did. That is sometimes very good and sometimes very bad.
    If I raised my voice to him he would become very anxious so I never did.
    That is not a criticism Angelo of your approach just not what I’d be comfortable with.

    Reply
  8. looked_after_child

    Behaviour that Challenges

    “Behaviour can be described as challenging when it is of such an intensity, frequency or duration as to threaten the quality of life and / or the physical safety of the individual or others and is likely to lead to responses that are restrictive, aversive or result in exclusion”

    ‘Behaviour that challenges’ is not a diagnosis and does not in itself imply any understanding as to the causes of the behaviour. The behaviour may be a way for someone to let people know what they want or how they feel, or to try and control what is going on around them, or be a response to physical or mental distress.

    ….this is really my position Angelo – look beyond the behaviour and work with what you find….

    Reply
  9. Angelo Granda

    Thanks for your opinion.I am no professional,of course, so my opinions aren’t perfect. We are both for the cause of autistic youngsters and i don’t really disagree with anything you write after all we all look from our own perspectives, we all have different experiences and different levels of expertise etc. I try to bé constructive so in that spirit ,I would have to stress to readers again how beneficial it is for the autistic when diagnoses are made early and the children are sent as early as possible to the correct educational setting( usually one for children with the same developmen problems).
    I should also emphasise and i hope you include it in your discussions with other researchers that these children learn and communicate best with their own natural parents rather than with strangers no matter how well-meaning . As i have said before my daughter was being watched very carefully from a very early age due to her extreme prematurity which is why we were able to have her autism diagnosed at about three.With the help and support of the CDT and the Portage team etc. she made good, solid progress.
    I don’t think your boy was diagnosed until much later on which i guess explains why you had so many more problems.He was probably sent to the wrong nursery and school settings.
    My daughter was much more fortunate.She went to assessment centre and judged as moderate GDD and soon after as ASD or ASC as they call it now. As a result, she was statemented at 3/4 and we got her enrolled at a marvellous school for children with moderate learning difficulties and many of the children there were also ASC. She made progress for 4 years. By comparison, since going into care all that came to an end and she began to deteriorate steadily .She was removed from the school and sent to one out of area for children with severe learning difficulties etc. She became emotionally disturbed and developed serious behavioural difficulties, self- harming and so on.I had no further input.
    There is little point in going on in any more detail but the lesson is that as normal as possible a home-life these children have including input from natural parents the better.It is harmful to liquidate normal families but separating ASC children from their natural parents is even more catastrophic.
    Has this been recognised? Please note ,the schools for children with MLD are very few and far between.I only know of one in the Nort-West. It might bé better not sending children to school at all than to the wrong setting.
    Hope this helps.

    Reply
  10. looked_after_child

    Hello Angelo
    I know what you describe happens.
    See this report
    Good intentions, Good Enough?

    https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/657418/Good_intentions_good_enough_-_a_review_of_residential_special_schools_and_colleges.pdf

    A small number (of children), around 6,000, are educated in 334 residential special schools and colleges, in the state, non-maintained and independent sectors. These placements cost an estimated £500m per annum

    Who are the children and young people in residential special schools and colleges?

    The children and young people in residential special schools and colleges can be broken into four broad groups:-

    1. Those with autism, communication difficulties, severe learning difficulties and challenging behaviour. These children and young people will, in combination with their autism, have little to no verbal communication. When they find themselves becoming anxious, often linked to their autism, this can be difficult to communicate. The frustration and mounting anxiety that results from this can then lead to challenging behaviour.

    2. Those with social, emotional and mental health needs (SEMH) and challenging behaviour. These will be children and young people who experience a wide range of social and emotional difficulties. Many of these children and young people will either be in or on the edge of care, will have endured significant adverse childhood experiences such as neglect or abuse, and suffer from attachment disorder. Their behaviour can be impulsive, confrontational and sexualised, and involve verbal and physical aggression. These behaviours may reflect underlying mental health difficulties such as anxiety or depression, self-harming or substance misuse. Many will have no learning difficulties, but their placements in mainstream or day special schools fail due to challenging behaviour.

    3. Those with profound and multiple learning difficulties (PMLD) and health needs that require intensive specialist support. Children and young people with PMLD are likely to have severe or profound learning difficulties as well as a physical disability or sensory impairment, and almost all will have significant difficulty communicating. With 80% attending special schools, they are, alongside those with severe learning difficulties, the least likely to attend a mainstream school, indicating the high level of support their needs can require. Some, particularly in residential schools and colleges, will have life-limiting health conditions and require specialised health support to help to manage these conditions.

    4. Those with a special educational need or disability but moderate or no learning difficulties
    Children and young people in this group tend to be those with a hearing or visual impairment, those with Asperger’s syndrome, or those with a physical disability. They often have no or moderate learning difficulties, but seek residential placements following negative experiences in mainstream schools, and some may have developed mental health conditions.

    The needs of the first three groups cross the boundaries of education, health and care, and they generally require the most intensive support of any children or young people in the system.
    In schools, the first two groups are the largest, making up an estimated 70% of all children and young people in residential special schools.

    Children and young people with autism can experience intense anxiety due to difficulties understanding communication, sensory over- and/or under-stimulation or unexpected changes in routines. This anxiety, when combined with communication difficulties, can cause a desperation that leads to them communicating this through challenging behaviour. Failing to manage the anxiety that often triggers this behaviour can mean it continues and often worsens. These children and young people have a large overlap with those covered by the NHS Transforming Care programme, and one LA officer noted that:
    There can be a vicious circle occurring within the ASD cohort. A poor provider triggers challenging behaviour or physical meltdowns (or fails to prevent such events), often exacerbating this with their reactions e.g. restraint, punishment or confinement. Good providers in whose care this behaviour may not have occurred will now not accept the child due to their history and pattern of risk.
    Therefore, the child is placed in a more restrictive or secure setting which can result in a worsening situation. Eventually, the child reaches a secure NHS setting which often is wholly inappropriate for their ASD needs. In different circumstances, a good specialist day placement could have worked for this child.

    Everyone knows it, who knows anything about it. There may finally be some change now Angelo because the whole inclusion agenda has collapsed – there are an awful lot of parents having to stay at home with their child who will not go to school. You can finally hear the penny dropping if you listen carefully and the costs of failure are very high but no more so than for children.

    Reply
    1. Angelo Granda

      Looked after child, Thank you again for all the research you do and all the links. I am concerned about something in your comment which says that some develop mental health conditions caused by the secure DOL placements.
      According to the Mental Health Act 1983 , a DOL order can only be issued under that Act for 16-18 year olds and above. So if they put in DOL placements before they have mental health problems I think that would be unlawful. Perhaps Sarah could clarify this point for us as she occasionally gets Cof P cases.

      Plus I believe a child under between 16 and 18 cannot be placed in such an institution without the consent of those with parental responsibility even when the child his or herself apparently consents. These laws aren’t kept too , as we all know.

      Readers , especially those having problems with their LA , it is important that you get access to ALL clinic letters and medical information from your child’s doctor. This is not easy because they will not always communicate due to LA dictats. Neither will the Education Authority. At the head of each clinic letter will be a short summary of medical and other problems. Perhaps, autism or ASD, Asperger’s or whatever, SLD,MLD perhaps behavioural difficulties. I suggest if there is no mental illness listed such as depression or psychosis etc. then the criteria under the Mental Health Act will not be met. Sarah?
      Mind you a diagnosis of MH problems can soon be arranged for by the LA with illegitimate aims. their ‘frindso

      Reply
  11. looked_after_child

    This is a good initiative
    https://www.vodg.org.uk/campaigns/learning-disability-providers-challenged-to-tackle-health-inequalities/

    Heard a NHS clinician explain the the greatest pressures for ‘secure learning disability/autism beds’ in his area ( land values relatively low) is coming from learning disability provider homes (not the local community). These homes are often privately owned, promise the earth, take children and adults from ‘out of area’, form no links with local NHS and then when there is a crisis ( often because they cannot deliver what they promised as in much was ‘commercial spin’) the person ends up in a local NHS secure bed.
    It is a real problem to address and not just in clinical terms but because of the fragmentation around budgets that is a massive barrier to getting things right.It is impossible to make provision without having diversion pathways, secure beds and then step down pathways.

    Local area budgets are meant to be addressing local need. All social care footprints are relatively small. NHS footprints are different but also meant to be addressing local need but actually his area is providing a regional service and the NHS underwriting failure by private providers. All have different budgets.

    Fragmentation around budgets and providers adds a layer of complexity that is making a difficult problem almost impossible to address and is also very wasteful of money.

    People just get lost in this system and it costs so much.

    We only have policymakers in thrall to competition to thank for this state of affairs.

    Reply
    1. Angelo Granda

      In relation to your point about cheap land values. All the homes I have visited have been stable blocks or coach-houses at farms or country halls, deep in the country well away from the children’s roots. Some of the bedrooms have no windows low enough for children to see through ; they are actually converted horse-stables. There are stone-walls, usually stone floors and farm-style kitchens. Please note many homes are off-shore in places like the Isle of Man and the Channel Islands; whether that gives these companies further financial advantage I don’t know. A child shipped off-shore will most likely very rarely get the chance to see family.
      As pointed out by McFarlane , I think it was, the Judiciary are unable to track what happens to thousands of children in care and thus has no idea what the outcomes are! As LAC Review procedures are flouted systematically too ,God only knows what becomes of these poor wretches in care. They could be anywhere ,perhaps in Outer Mongolia or the Cayman Isles wherever property is cheap and there are tax advantages. We really don’t know .
      Has anyone else heard the rumour that ex-Family Court Judges have a favourite retirement place which is in Saudi Arabia?

      Reply

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