'Good Intentions, Good Enough? 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 and typically cater for those with the highest needs, including those with autism, communication difficulties, severe learning difficulties and challenging behaviour, those with social, emotional and mental health needs, and those with profound and multiple learning difficulties. They also cater for some children and young people with a special educational need or disability but moderate or no learning difficulties, some of whom may have mental health conditions
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.
It may be understandable that some schools and colleges struggle with such behaviour, but much of this seems to be driven by a misunderstanding of what causes it, and a lack of knowledge about the steps they can take proactively to prevent it. For those with autism and those with SEMH, the causes of the challenging behaviour can be quite different.
Autism, communication difficulties, severe learning difficulties and challenging behaviour. 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.
quotes from an interviewwith Dame Christine Lenehan talking about the report:- "I have been looking at care for children in in-patient mental health units and I saw that some of these children were bouncing back and forth between in-patient care and residential special schools.".. "Furthermore, I saw that these are some of the most vulnerable children in the country, they are caught in the middle of a complicated system and sometimes schools and local authorities don’t do enough to make it simpler for children and families to navigate through the interlocking services responsible for them.".. "I was also struck by the fact that many of the children and young people we spoke to felt it was they themselves who had failed in some way, but my Review shows it was all too often the system that failed them.".. "One professional I spoke to said ‘local authorities don’t commission residential schools, they shop for them’. This is not good enough and shows how these children can be undervalued. So one of the things I’m really pleased about is that the Government has agreed to set up an implementation board to ensure the recommendations I have made are acted on quickly."
Quotes from Department for Education Response Justine Greening, 6th November 2017
"I have instructed my officials to look at them in greater depth, with a view to responding to them more fully next year. However, to demonstrate our commitment to the findings of the review, I am today announcing some actions we will take forward immediately.
These are: • as recommended in the review, we will establish a national leadership board for children and young people with high needs, reporting to the minister for children and families. I would like to invite you both to sit on this board to continue your involvement in taking this agenda forward;
• as recommended in the review, we are today publishing updated guidance for local authorities, making clear their statutory responsibility to visit children and young people with SEND or health conditions in long-term residential settings ;"...
• "to improve how schools and colleges support children and young people with SEND, we are today announcing the publication of a new resource,developed by ASK Research and Coventry University, setting out evidence on effective approaches for these children and young people, and examples of current practice in good and outstanding schools and colleges."