youngpeople who reported the process taking longer than 20 weeks (five months) most commonly reported that it took between 21 and 24 weeks, or approximately 6 months (18%); a slightly smaller proportion stated that it took more than 10 months (14%). The survey results show a different perspective on timeframes to those provided by local authorities in the official data. This may reflect differences between when parents/youngpeople and local authorities started timing the process. For example, parents might have considered the 20-week period to have started when they made a request to a teacher, whereas local authorities may have considered it to have started when the request was brought to their attention later (as allowed in the SEND Code of Practice). It may also reflect some recall difficulties for survey respondents when estimating the duration of a process that ended between six and 18 months ago. Furthermore, parents and youngpeople were not asked whether exceptional circumstances had been applied to the timeframes of their plan (as this would have been difficult for them to comment on), and so the survey data does not reflect the proportion of plans that would have been exempt from the 20-week target.
This starting sample included records for some individuals who did not actually have EHC plans. This was because some education providers had misunderstood how pupils with SEN should be recorded in the school census following changes to support for them set out in the Children and Families Act 2014. New SEN data categories were introduced to the school census: ‘SEN Support’ and ‘EHC plan’. Children with SEN whose needs were being met without a SEN Statement (i.e. those receiving School Action and School Action Plus) were to be re-classified into the new ‘SEN Support’ category. Those pupils with SEN Statements were to be re-classified to the ‘EHC plan’ category, after they had transferred from a SEN Statement to an EHC plan (following an EHC needs
Interviews were transcribed in full and summarised into an analysis framework under headings related to the objectives: this allowed comparisons to be made between individual experiences and between the above and below average rated local authority areas. Demographic characteristics and other factors – including the reported length of the process, the age of the child/young person and the types of need that the EHC plan was perceived to cover, as noted above – were also used as factors in our analysis. Finally, when arranging and conducting each interview, the research team sought to obtain – with informed consent – a copy of the individual’s EHC plan. In total, 18 parents agreed to share their child’s EHC plan. These were anonymised and shared with
Youngpeople who have been trafﬁcked may have experienced signiﬁcant trauma and vio- lence but little is known about their health and healthcare needs. This UK study aimed to address that gap. It included a healthsurvey and qualitative interviews with 29 young peo- ple aged 16–21 trafﬁcked into the UK from other countries who were recruited through voluntary organisations and children’s social services. These data were supplemented by interviews with relevant professionals. Over half the youngpeople had been trafﬁcked for sex work but sexual violence had also been experienced by those trafﬁcked for domes- tic servitude and labour exploitation. Physical violence, threats, restrictions of liberty and deprivation were also widespread, as were experiences of physical and sexual violence prior to being trafﬁcked. Five young women had become pregnant whilst trafﬁcked; three were parents when interviewed. Two-thirds screened positive for high levels of psycho- logical distress, including PTSD. Twelve reported suicidal thinking. Whilst some were keen for opportunities to talk to health professionals conﬁdentially and wanted practitioners to treat their accounts as credible, others wanted to forget abusive experiences. Complex gatekeeping systems, language barriers and practitioners who failed to take them seriously limited access to healthcare. Support and advocacy were helpful in assisting these youngpeople to navigate healthcare systems. Health professionals need to recognise and respond appropriately to trafﬁcked young people’s often complex mental health needs and refer them to relevant services, as well as facilitating care at later times when they might need support or be more ready to receive help.
In both the focus groups and at the end of the online survey, youngpeople were asked for other suggestions to make health services more youth friendly. A number of ideas focused on ways to make the facility itself more comfortable for youngpeople. Suggestions included providing a more relaxed environment, hiring staff who have good rapport with youngpeople and who are genuinely interested in their issues, staff who can explain things clearly to youngpeople using accessible language and things to do in the waiting room, which might include beverages and snacks or free Wi-Fi. Other ideas focused on how best to promote youth-friendly health services. Suggestions included advertising where youngpeople go, such as on YouTube or using videos; another was to let youngpeople know how to get their own Medicare card. Youngpeople also suggested additional services that they believed are not currently available, such as online or telephone consultations, health services forging stronger links with educational institutions, youth-only facilities or youth areas within general health facilities, and more youth centres. The youngpeople who had accessed youth centres spoke enthusiastically about their ability to obtain support and information around health. Finally, a number of youngpeople expressed the desire to be able to access health services without their parents knowing or accompanying them.
on the effectiveness of these legislation documents in capturing the voices of children is still rather scarce. For example, in England, there is no systematic evidence on the quality of the methods by which the voices of children and youngpeople were captured in previous legal documents describing their needs—the Statements of SEN—although critiques on Statements do exist (Warnock and Norwich, 2010). The evidence concerning the effectiveness of the EHC plans in capturing the voices of children since the reformed system was introduced are even narrower. In 2017, the Department for Education published the findings of a commissioned study examining the views of parents and children on EHC plans (Adams et al., 2017). It was reported that two thirds of the children that took part in the survey were satisfied with the process followed for obtaining their EHC plan and that this would help to achieve the outcomes agreed on the actual plan for the child or the young person. Interestingly, it was reported that only 44% of the children and youngpeople were being directly asked if they wanted to take part and it was much less common for them to be given choices of how to take part (19%) in the Education, Health, Care assessment process. It was also noted that the chances of children/youngpeople being actively involved in the process seemed related to the child’s age and whether they previously had a Statement of SEND. Along the same lines, two other recent reports (National Autistic Society, 2016; Scott, 2016) described the level of satisfaction of parents and children since the introduction of the reformed system but neither provided evidence deriving directly from the children’s EHC plans documents.
Recent evidence has shown that, in addition to poor glycaemic control, there are alarming differences in diabetic ketoacidosis admissions throughout the country and the quality of care and education that children and youngpeople with T1DM receive is hugely variable. Compared with our European and global counterparts this care is below the highest European and global standards. 5 Furthermore, inconsistencies in quality of care is highlighted as a possible contributory factor towards poor outcomes. Poor quality diabetes care results in an increased risk of short‐ and long‐ term clinical complications, as well as compromised social and psychological wellbeing, leading to increased healthcare costs. 6 Therefore, it makes sense to ascertain current standards of care and identify gaps in service provision, before making recommendations in terms of how diabetes care needs to improve for the benefit of children and young people’s health outcomes.
The UK Government’s Autism Spectrum Disorders Good Practice Guidance (DfES, 2002a; 2002b) outlines findings from a 2-year working group examining what constitutes good practice for this population of children. This guidance is now over 10 years old, and as outlined by one author, “most of the principles and content … are based on what appears to make good sense, by those with long experience in the field, rather than on empirical evidence” (Jones, 2006, p. 547). Nevertheless, researchers stress that, “given the lack of robust, empirical evidence in many areas of practice and provision, the views of experts (including parents) remain a vital source of information and guidance” (Parsons et al., 2009a, p.4). This guidance continues to be provided by the NAS, and offers a helpful list of pointers to good practice in supporting students with ASD. Key principles highlighted include the importance of practitioner knowledge and understanding of ASD, the value of clear short-term and long-term goals, in particular to develop the social skills of children with ASD, as well as the continuing need to monitor, evaluate and research the effectiveness of provision. In reviewing the literature on what is currently known about good practice in the education of students with ASD, Jones (2006) recommended a dual focus – to help children with ASD to develop social skills to understand the world around them and communicate their needs, whilst at the same time making adaptations to the environment which support child with ASD to function and learn. In a report commissioned by the Autism Education Trust (AET), Jones and colleagues used a mixed methods approach, including a literature review, survey questionnaires and interviews with school staff, relevant professionals, parents/carers and children with ASD to describe the school experiences of children with ASD in England (Jones et al. 2008). They concluded that important factors are staff understanding of the particular needs and learning styles of students with ASD, effective relationships between staff and students, and a whole-school positive and optimistic ethos.
The participants in this study were twenty men and women who were expecting their first child. They were all Swedish speaking, literate and had completed parent education during a pregnancy at some time between August 2008 and January 2009. In August, midwives invited 56 potential participants from three different midwife clinics and only two responded with a written submission of the two question survey. Between October 2008 and January 2009 another 24 potential partici- pants were recruited by the authors of the study from the three clinics and of these 18 responded with written responses. Each of the three locations conducted from between five to eight sessions per parent group which lasted about 2 hours each. Each parent group was made up of four to ten couples. The content of the training was consistent at all of the clinics and included information about childbirth, pain management, breastfeeding, bonding and parenting. Staff members from the Child Healthcare Services, the family center, family
Half of all surveyparents and the majority of interview parents had attended parent and toddler groups however, many parents did not attend these groups due to health concerns (for them or their child), perceived lack of understanding from other parents about premature birth, the unsuitability of the groups for children born prematurely and/or multiple births or lack of access to such groups in the area. The judgement from other parents or group organisers about children’s development represented a particular barrier that could be addressed with training for organisers of groups. Non-attendance at these groups sometimes had the effect of isolating parents from the communities whose primary purpose is to support them. A small number of parents had found specialist groups near to them which they found useful. However, these specialist groups are not provided for all parents in all locations and early years settings could consider providing the space and time for parents of prematurely born children to meet and share experiences.
I: As I said you are a child you’re going puberty , hormones, all these life changing things you are experiencing and then you just throw another thing into the mix and outside of the school structure, this person approaches you and is trying to talk with you about your issues and it’s like wait a second I don’t know you from Adam you know, your parents tell you never talk to strangers, but it’s like you are introduced to this person and your expected to spill the beans about life and how you are feeling, and it’s like wait a second this is too much too soon, you haven’t sat in a classroom you haven’t tried to teach me anything, you haven’t form that type of loco parentis relationship with me , yet you want to have a more intense. Do you know what I am trying to say, it’s really hard to put the button on the right words, but you know what I mean , but yeah you see the person for the allocated time, and they’re gone , they come back and their gone. I feel that it’s very difficult to forge a genuine relationship with these people, so maybe they should think about where the child is coming from there situation and try to slowly bridge the gap and find some understanding and necessarily look at the child’s overall health and wellbeing rather than look at it as avenue to improve the child’s educational career. R: So maybe the idea of it feeling more holistic and genuine?
provided in the Appendix). This reduced sample is pooled from surveys completed by youngpeople (n=897, 19%) and by parents/carers (n=3755, 81%). For the dataset the item non-response rate is 1.5% based upon the variables of interest and a useable total of 13,643 respondents. The percentage of respondents answering all questions is 28.6%. The largest proportion of cases with at least one missing variable did not respond to only one (26%) key variable. The average sum of missing variables is 1.81 (1.89 standard deviation) variables per respondent. Chi square tests were conducted in order to determine whether there were significant differences between age groups, gender, ethnicity and primary SEN and whether a respondent was included in the model. There were significant differences between age groups, ethnicity and primary SEN and whether a respondent was included in the analysis. 7 The exclusion of these respondents was
Service structure was also identified as problematic for these parents. There was agreement that there are too many necessary points of contact and that parents felt stretched between health, social services, education and voluntary agencies, with respect to geography, time and the subsequent financial effects. Parents were clear that a single point of contact would significantly ease their burden with respect to accessing help. This is in line with current service policy, which aims to make closer integration between social and health services and better “work in partnership” a reality over the next few years (Department of Health, 2001a). The consequences of closer service integration would clearly be very positive for these parents, whose children’s particularly complex combination of problems necessitates multi service input. Equally, closer integration, information sharing, and work in partnership between all services (including those in the voluntary sector) would not only improve coherence for parents and service providers alike (see Scior & Grierson, awaiting publication) but also enhance awareness of issues specifically relating to youngpeople with learning disabilities and mental health problems for service providers in all agencies. This idea also fits with a recommendation made by the Mental Health Foundation (2002) regarding promotion of young learning-disabled people’s mental health in school and colleges, thus facilitating improved monitoring of the young person’s behaviour and mood and therefore early recognition and response to mental health problems.
Community-based mental health services for children and youngpeople (CYP) can offer alternatives to inpatient settings and treat CYP in less restrictive environments. However, there has been limited implementation of such alternative models, and their efficacy is still inconclusive. Notably, little is known of the experiences of CYP and their parents with these alterna- tive models and their level of satisfaction with the care provided. Therefore, the main aim of this review was to understand those experiences of the accessibility of alternative models to inpatient care, as well as overall CYP/parental satisfaction. A searching strategy of peer-reviewed articles was conducted from January 1990 to December 2018, with updated searches conducted in June 2019. The initial search resulted in 495 articles, of which 19 were included in this review. A narrative synthesis grouped the studies according to emerging themes: alternative models, tele-psychiatry and interventions applied to crisis, and experiences and satisfaction with crisis provision. The identified articles highlighted increased satisfaction in CYP with alternative models in comparison with care as usual. However, the parental experiential data identified high levels of parental burden and a range of complex emotional reactions associated with engagement with crisis services. Furthermore, we identified a number of interventions, telepsychiatric and mobile solutions that may be effective when applied to urgent and emergency care for CYP experiencing a mental health crisis. Lastly, both parental and CYP experiences highlighted a number of perceived barriers associated with help-seeking from crisis services.
Interviews were carried out one to two weeks following the out of hours consultation and took place between September 2005 and December 2005. These were taped and transcribed verbatim. Participants were invited to view and comment on their transcripts, though all but one felt this to be unnecessarily time consuming. Interviews were analysed by each researcher identifying key con- cepts and categories, then compared between researchers in order to develop a coding framework based on the original topic guide and issues arising from the participants’ experiences. These were then charted to enable comparison between the experi- ences of older people and parents with young children in different settings. Framework analysis is explicitly geared towards generating policy and practice orientated findings and has been widely used in health related research, as it enables ana- lysis of specific issues that the stakeholders may
This research has crucial significance both for social policy and for parents and their children. Griffin, strikes a note of alarm at 'medical science's increased ability to save premature babies, which should be balanced against the costs and problems it causes'24. It is reported that it is now possible to save the life of a baby weighing as little as lib (500grams), with consequent lengthy and costly hospital stays, special education needs to be considered and an increasing number of severely handicapped babies to be supported by relatives, friends, health professionals and the community. The issues of euthanasia and abortion are the inescapable consequences of this cost to society approach to disability. This was not a main focus for the interviews but was raised by John's mother who had consented to abdominal surgery for him at the age of five. John had severe spastic quadriplegia, probably caused by placenta interruptus at birth.
participation therefore are essential during transition ’ (Department of Health and others, 2007, p50). The language of participation implies some degree of choice for parents, and indicates that transition planning is a joint activity between services and families. However, the evidence from this study shows this was not the case for many parents in the sample, who took on this care coordination role because of a lack of service input for their child’s move into adulthood. In turn, they experienced the emotional demands that came with this role. Other studies have also shown that transition planning can be poor, with a lack of information, support and options (Morris 2002; Heslop 2002; Bhaumik and others, 2011; Martin 2011), and with parents having to coordinate planning themselves (Ward and others, 2003).
experience difficulties beyond that of their accompanied peers, with a negative impact on psychological well-being. Bean et al. (2007) found that separated children scored significantly higher on measures of internalising problems, traumatic stress reactions and stressful life events, putting them at greater risk of developing significant psychological distress. Weise and Burhorst (2007), in the Netherlands, identified that separated children had higher frequencies of trauma symptoms and psychiatric diagnosis than those accompanied by family. Similarly, Ramel, Täljemark, Lindgren and Johansson (2015) found that in their review of admissions to a Child and Adolescent Psychiatry Emergency Unit, separated children and youngpeople were over represented compared to their accompanied peers. They identified higher rates of self-harm and suicidal behaviour and reported that 86% of those admitted were admitted due to symptoms related to stress as a consequence of the asylum system. Chase et al. (2008) also identified the difficulties experienced by some separated children and youngpeople in navigating and understanding the different cultural context of their host country; for example coming from a culture where people are more tactile with each other and being castigated in the UK for being overly physical. Jakobsen, Meyer DeMott, Wentzel-Larsen, Trond and Heir (2017) reported the significant negative impact of the asylum system on the psychological well- being of the children and youngpeople accessing it. In keeping with past
as frequent (often/sometimes) versus infrequent (rarely/never) to examine variations in parents’ use of discipline according to se- lected child, parent, and demographic characteristics. These in- cluded child age (4 –9 months; 10 –18 months, 19 –35 months), child developmental risk (any vs none), child health status (excel- lent/very good vs good/fair/poor), frustration with parenting (frequent [always or sometimes] vs infrequent [rarely or never]), parent’s race/ethnicity (white non-Hispanic, black non-Hispanic, Hispanic English speaking [Hispanic parent who completed the interview in English], Hispanic Spanish speaking [Hispanic parent who completed the interview in Spanish]), annual household in- come ( ⱕ $17 500, $17 501–$35 000, $35 001–$60 000, ⬎ $60 000), maternal education (⬍high school vs ⱖhigh school), and maternal marital status (married vs not married). Logistic multivariate re- gression was used to examine the association between the use of each discipline practice (frequent vs infrequent) and child, parent, and demographic factors. Findings from bivariate analyses guided the development of the multivariate models. Confidence intervals (CIs) for variables with ⬎1 degree of freedom (having ⬎2 catego- ries) were adjusted for multiple comparisons using the Bonferroni correction method.
Despite the link to employment and sectors offered by many vocational qualifications, only 23 per cent of youngpeople on vocational routes chose courses to help get them a job, and 31 per cent because they needed a particular qualification – these proportions are not significantly different from youngpeople on general qualifications routes. The main reason for vocational students taking a qualification was that it was something they were interested in (73 per cent) or good at (54 per cent). This reflects the conclusion, drawn by the exploratory study, that youngpeople often did not choose vocational courses with a concrete next step in mind. The older groups were most likely to choose qualifications that would help them make the next step: 38 per cent of 17-18 year olds chose qualifications that they needed for what they wanted to do (compared with 29 per cent of 15–16 year olds) and 31 per cent of this age group chose subjects that would help them get into university.