Positive support for learning disability

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We need new attitudes and a new approach to the care and education of children with complex needs, writes Ben Higgins

A child as young as six years old is left covered in bruises after being physically restrained by adults. A child is locked in an empty room, isolated, alone and terrified because their behaviour is considered “out of hand”. A child is tied to a chair and left sitting in their own urine just because they didn’t understand that they had to get off a bike. These stories are all true and all happened recently in a UK school. 

These cases are not rare. Too many children with learning disabilities or autism are being denied their basic rights as we fail to meet our obligations under the UN Convention on the Rights of the Child

The four core principles of the Convention are non-discrimination, the best interests of the child, the right to life, and respect for the views of the child. But how does the culture we promote in our schools support these principles? Are we meeting the needs of society’s most vulnerable children?

Excluded and left behind

Ofsted recently highlighted the “deep injustice” of the rising number of children with SEN being excluded from school. The education watchdog found that pupils with SEN are five times more likely to be permanently excluded than other pupils overall. Shocking reports like this led the Department for Education (DfE) to commission a review of school exclusions (currently expected to report by Easter 2019), led by former Children’s Minister Edward Timpson.

What is behind these high exclusion figures for children with SEN? Recently there has been a growth in schools adopting a “zero tolerance” approach to behaviour. This involves a focus on reactive disciplinary approaches such as “naughty” children being removed from the classroom, put in detention or excluded from school. The zero tolerance approach puts the blame on the child, when often the reality is that their needs have not been met. We are punishing children because we have failed to meet their needs. This approach is unethical, not at all in the best interests of the children and is often detrimental to their mental health.

So how have we ended up with such a draconian education system – a system that focuses on academic results and relies on a punitive culture? And what happened to the inclusion agenda?

The Education Policy Institute has highlighted the severe shortage of teachers. The Secretary of State for Education has said recruitment of teachers is the top priority for his department. The assumption is that teachers do not want to teach due to difficult behaviour so tackling behaviour issues in schools is a political priority. 

Discipline and force

Last year, the Government strengthened teachers’ power to discipline pupils for misbehaviour, impose same-day detentions and search pupils. But where is the evidence base that this approach works? The DfE has also reinforced the message that teachers’ powers to discipline pupils include the power to use reasonable force, yet teachers are not required to attend training in order to use reasonable force safely. In fact, a school could commission training in the use of physical force from someone with a background in martial arts or as a nightclub doorman rather than in education, health and social care. I find it shocking that we live in such a regulated world, yet training in using physical force on vulnerable children in our schools is completely unregulated. As a result, too often such training does not include prevention, de-escalation or recovery but focuses on technical skills, restraint and the use of force. Such training is high-risk in terms of safeguarding and can result in unnecessary trauma, increased risk of physical harm and the development of a toxic culture. Whilst measures are being put in place to ensure training in health and adult social care is accredited by the United Kingdom Accreditation Service (UKAS) and complies with the Restraint Reduction Network Training Standards, this remains voluntary in schools. 

Far too many schools are over-reliant on restrictive practices and this has been reinforced by recent research by the Challenging Behaviour Foundation. In 2017, BBC 5 Live Investigates revealed that hundreds of children in special schools across the UK have been injured while being physically restrained. The Government needs to take action to address this scandal. While the Education Secretary recently announced new funding to support children with SEN, putting the right provision in place depends on more than just money; it also requires policy and cultural change in schools and services. 

So clearly there is a problem. But what is the solution?

The roots of behaviour

We know there is always an underlying reason for any behaviour. A child may be disruptive simply because they are feeling unwell or haven’t had any breakfast. Equally, a child may be traumatised as a result of abuse they may have experienced the week before. We don’t always know what the reason is. Our job is not to send the problem out of the classroom, it’s to find out what that problem is. 

In Connection Parenting, parent educator Pam Leo says: “You can’t teach children to behave better by making them feel worse. When children feel better they behave better”. We need a shift in values in our schools, to move away from a system based on compliance, judgement and disciplining pupils. 

It’s not the children that need to change; it’s the adults. We as professionals and services have to take responsibility for supporting every child and recognising what we can do differently in order to meet needs. We must change the ethos within our schools to one that develops and nurtures the mental health and wellbeing of the next generation. Our school system should promote inclusion, not exclusion, and teach compassion and understanding.

We have to introduce training on evidence-based approaches to preventing behaviour of concern and move away from a focus on reactive approaches like sanctions or restraint. Whilst this is happening in health and adult social care, it is less developed in schools in the UK. It is staggering that different government departments can use such different approaches. 

Positive behaviour support

Respected school systems, such as those in Scandinavia and North America, have increasingly adopted positive behaviour support to better understand and meet children’s needs, as it has a strong evidence base in preventing behaviour occurring in the first place and in promoting sympathy and inclusion. The overall aim of this approach is to improve the quality of life for an individual and those around them. Support is personalised and engages an individual in activities that are meaningful for them. Based on an understanding of how an individual learns and what behaviours of concern mean for them, it includes proactive strategies to prevent or reduce the triggers and events that provoke or maintain these behaviours. Interventions are designed to support personal development and the learning and maintaining of new skills. 

Some UK schools have adopted positive behaviour support and also sourced physical intervention training from a provider that has been through external scrutiny to ensure best practice. These schools have demonstrated a significant reduction in reliance on restrictive approaches. One such school is Calthorpe Academy in Birmingham. As a result of changing to accredited training and introducing positive behaviour support, Calthorpe has reduced restrictive practices by 85 per cent over an 18-month period. A recent Ofsted report said that “the use of physical interventions has reduced enormously over the last year and is now infrequent… Staff use their skills and knowledge of communication and behaviour to support pupils in a thoughtful way, helping pupils to express their needs and feelings in a more acceptable way”.

Our school system is cautious about promoting particular approaches or frameworks. After-all, we know every child is different and different children will respond better to different approaches. But we also know we have a problem of excess exclusion and restraint in our schools. Whilst positive behaviour support is not a silver bullet, it can be important in promoting a culture of wellbeing and inclusion within schools. 

The need for action

The DfE is responsible for supporting professional development and helping disadvantaged children. NHS England’s Transforming Care Programme and the Lenehan review (of residential special schools) recognise the benefits of positive behaviour support. I hope that Edward Timpson’s review will also encourage the DfE to facilitate the system-wide roll out of evidence-based preventative approaches to bring about a culture more akin to that of adult health and social care.

We also need to publish improved guidance to reduce reliance on restrictive practices and better protect children’s fundamental human rights. The US Department of Education has recently announced a programme to address the inappropriate use of restraint and seclusion with people with disabilities. Surely, we in the UK can do the same. 

Education is a fundamental right for children. We need inclusive schools that foster compassion and wellbeing and that adequately cater for all pupils. The failure to create such an ethos in our schools is an unintended consequence of current misinformed policy, such as zero tolerance to behaviour in schools. The Government and service commissioners must take action to fulfil their responsibilities to better protect the human rights of all children and to stop the physical and emotional harm experienced by too many children with learning disabilities or autism in UK schools. 

About the author

Ben Higgins is Chief Executive of the charity BILD, the British Institute of Learning Disabilities: bild.org.uk

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Kathryn Bennett
Author: Kathryn Bennett

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