Neurodiversity in youth justice – supporting children to achieve their goals

Helen Arnold-Richardson, Managing Director of Do-IT Solutions Ltd.

Many of the children who enter the Youth Justice System will have complex lives and have faced adversity that some of us could only imagine. Many have faced traumatic events and had struggles with family interactions, peers, substance misuse, mental health, homelessness and school¹.

Children may not know they have difficulties or mask the challenges they have. They may present this through their negative behaviour and actions as their only means of communicating their needs. Without appropriate, timely and accurate identification, it can be hard to know how to deliver targeted support. One thing is certain- each child has strengths that need to be harnessed to support them in engaging with interventions. Subsequently reducing the likelihood of reoffending.

There is increasing evidence that many children have additional learning challenges. We are moving to use a term neurodiversity to embrace these differences.

What is neurodiversity?

Neurodiversity is a term which has come from a sociological background and has been increasingly used over the last few years. It moves away from the traditional deficit and more medical model and terms such as Specific Learning Difficulties and Learning Difficulties and Disabilities which have a more negative connotation. These umbrella terms were variably used to encompass such conditions as Dyslexia, Dyscalculia, Attention Deficit Hyperactivity Disorder (ADHD), Autistic Spectrum Disorder (ASD) and Development Coordination Disorder (DCD)/Dyspraxia.

Neurodiversity embraces the diversity of our brains and how they work. It allows us to consider ways we can harness the child’s strengths. Emphasising that different thinking is good, whilst promoting inclusion to support challenges they may have internally and in the context of their lives.

Missed and Misdiagnosed

Many children in the Youth Justice System will not come with a formal diagnosis as their pathway may have been a ‘messy’ one.

Children are often missed or misdiagnosed, therefore not having their needs recognised or supported.

• Looked After Child or Young Person (LACYP). The child may have moved from school to school making a referral and follow-up harder to do despite evidence of high levels of learning difficulties.
• The child, carers or parents do not know there are barriers. This is especially significant with underrepresented groups such as BAME groups or females, where there is less knowledge about their presentation.
  They could be or have been excluded from school. There is a high level of undiagnosed children in this group with ADHD and Developmental Language Disorder and Autism Spectrum Disorder for example, but there remains no mandatory screening at present.
• Left school early or not attended school regularly and not been in a ‘system’ at all.
• Not recognised as needing to be diagnosed. They may have come from social settings where their parents had similar patterns of difficulties but were never diagnosed. As a result, the parents don’t see that the challenges in their child as anything to be concerned about.
• Come from another country where neurodiversity is less well recognised. Or they don’t have English as first language and so people assume challenges are related to this.
• Homeless and not have a regular G.P to make a referral.
• Other reasons for symptoms may not have considered. There is increasing interest in the association between Traumatic Brain Injury (TBI) and ADHD. It can be difficult (especially if the question isn’t asked) to know whether attention problems are due to ADHD or to a head injury or potentially a combination of the two. In Williams’ report ‘Repairing Shattered Lives’, he cites that there is evidence from England that up to 60% of young people in custody have reported having experienced a traumatic brain injury.

The negative impact of not identifying

It is so important that children in the Youth Justice System are able to understand what is happening to them, what is required of them² and have a means of communication they can use to articulate their needs and wants.

If they are neurodivergent, they may have difficulties with:

• Identifying their strengths
• Understanding the requirements of a statutory order and any conditions associated with it
• Comprehending the words used within the Youth Justice System
• Understanding that they may be required to take part in programmes to reflect on their offending behaviour
• Attending appointments on time and on the right day
• Stating aloud to others that they have difficulties

There is also the safeguarding concern in that children with communication difficulties can be at greater risk of abuse than other children (Snow, 2009³ ; Stalker & McArthur, 2010⁴). Young people with speech, language and communication needs are extremely vulnerable as their difficulties may stop them from informing someone what has happened to them⁵.

The need for the ‘whole child approach; to screening and guidance for Youth Justice Practitioners- What are the barriers currently?

The systems in place may preclude appropriate screening or assessments being made:

• Paper- based systems may not be accessible for those who cannot read the questions, e.g. with low levels of literacy. Or for the 10% of people where English as a second language⁶ (but there may not be a means of assessing their needs in their home language resulting in limited or little information about their prior educational experiences).
• Questions relating to the ‘other’ factors may not be asked concurrently so conclusions may be biased by the data collected.
• A lack of confidence and training by the non-specialist staff to have a conversation with the child if identified as being neurodivergent. There can also be a lack of knowledge to know what to do and how to provide support for the child or make reasonable, practical adjustments.
• A lack of tools in place to assist may prevent the process of screening happening. Or the tools may take too much time or be too confusing to administer. Therefore, missing key information on the rehabilitation barriers the child may have. A scoring system can be categorical and so one point below means nothing received. Meaning children then miss out on gaining personalised support according to need and not to label.
• Lack of pathways for onward referral or waiting lists for assessment – there may not be a system in place to know what to do if a child is identified with ADHD or Dyspraxia traits or how to make reasonable adjustments.
• Labelling – making subjective judgements on the child based on prior experiences for example diagnostic overshadowing – seeing the child has having attachment challenges rather than recognising they have receptive language difficulties.

The benefits of screening children – using technology to help

The reality is that even though there are many neurodiverse children there remains a need to understand all their barriers and strengths to support each young person’s rehabilitation and move towards developing their skills and achieving their outcomes.

This requires a bio-psychosocial approach. Therefore screening across areas, when a child enters the Youth Justice System, is important so as not to miss key information about the child that is needed to prepare reports, to plan their intervention and in cases understand why they are not adhering to, for example, statutory orders.

One tool that is currently used in Youth Justice both in custody and in the community is the Do-IT Profiler. It is a child-centred tool, which is web based and screens for neurodiverse strengths and challenges to empower the young person and the youth justice practitioner working with them. It also gathers information about the child’s context as well.

Oakhill Secure Training Centre managed by G4S have been using the Profiler to support a whole child approach to supporting children in their care. David Brown, Resettlement Practice Manager says:

‘After an initial roll out period we began using DO IT just over 12 months ago starting first with our complex children and then rolling it across the centre. As an establishment we deal with complex children many of whom have unidentified learning needs and/or diagnosed mental health needs. The DO IT allows us to get an understanding of the needs of the child when they arrive, then as we get to know an individual and refer to their past history, we are able to have a bigger picture of what their needs are.

We can use DO IT’s intervention screener to apply the interventions based on their responses and it allows us to create plans for behaviour management with the child, that is bespoke to them and makes them feel like they are part of the process of planning their future, which is fundamental if we are to achieve success with a child.’

St Helen’s Youth Justice Service have been leading the way in the community. St Helens have used the Profiler for over 2 years with their children and young people to identify the strengths and challenges and target individual support and referrals where challenges have been identified.

Lee Matthews, Operational Manager at St Helens Youth Justice Service says:

‘Do-IT profiler’ has been an invaluable in assisting Youth Justice Service practitioners to identify the neurodiverse strengths and challenges of the children that we work with. Using this tool, practitioners have been able to tailor plans and interventions specifically with each child in mind. In addition, practitioners have been able to share findings with other key agencies to ensure a each child’s needs are supported appropriately across the partnership. Regular data analysis from the team has also helped us to gain a greater understanding of the neurodiversity of children known to our service.’

Simona Kiliotaityte, Intervention Development Officer & Participation Lead at St Helens Youth Justice Service says:

‘Do-IT profiler is a very useful, easy to use online assessment tool. It helps Youth Justice Service practitioners to put the child at the centre of the intervention planning, and focus on his/her strengths as well as supporting them in the areas where challenges were reported.’

For more information on the Profiler contact INFO@DOITPROFILER.COM for more information for your organisation.

We also have more information on our youth justice packages, which can be found HERE.

References

₁British Medical Association (2014) Young Lives Behind Bars The health and human rights of young people detained in the criminal justice system British Medical Association report available from HTTPS://WWW.BMA.ORG.UK/MEDIA/1861/BMA-YOUNG-LIVES-BEHIND-BARS-2014.PDF (accessed 9 November 2020)

₂Coles, H; Gillet, K; Murray, G; Turner, K (2017) Royal College of Speech and Language Therapists Justice Evidence Base Consolidation available from HTTPS://WWW.RCSLT.ORG/-/MEDIA/PROJECT/RCSLT/JUSTICE-EVIDENCE-BASE2017-1.PDF (accessed 9 November 2020)

₃Snow, P. (2009) Child maltreatment, mental health and oral language competence: inviting speech-language pathology to the prevention table, International Journal of Speech Language Pathology, 11(2).

₄ Stalker, K. and McArthur, K. (2010) Child abuse, child protection and disabled children: a review of recent research, Child Abuse Review.

₅Coles, H; Gillet, K; Murray, G; Turner, K (2017) Royal College of Speech and Language Therapists Justice Evidence Base Consolidation available from HTTPS://WWW.RCSLT.ORG/-/MEDIA/PROJECT/RCSLT/JUSTICE-EVIDENCE-BASE2017-1.PDF

₆13% Prison Population HMP data (2006)