Graham Connelly

The work of health visitors and school nurses with children with psychological and behavioural problems

AIM This paper is a report of a study to describe the workload of health visitors and school nurses in relation to children and young people with psychological, emotional or behavioural problems, and to identify perceived challenges, obstacles and sources of satisfaction associated with this aspect of their work. BACKGROUND There is little published information on the work performed by non-specialist community nurses with children and young people who have psychological, emotional and behavioural problems. METHOD We analysed data from a survey conducted in 2002 - 2003 of 1049 Scottish professionals working with children and young people. Data included quantitative responses and free-text describing the cases seen by respondents. Responses from a sub-sample of 71 health visitors and 100 school nurses were analysed using a combination of descriptive statistics and analysis of themes emerging from the text. FINDINGS Although community-based nurses saw a relatively small number of children with psychological, emotional or behavioural problems each week, dealing with these problems took up a disproportionate amount of time. The commonest types of problem were self-harm, externalizing behaviours and family difficulties. Few respondents had received specific training in child and adolescent mental health but most expressed a wish to receive such training. CONCLUSION The work of health visitors and school nurses in caring for children with mental health problems is substantial and important. Development of their public health role should not be at the expense of this important contribution. There is a need for rigorous evaluation of nursing mental health interventions among children and young people.

The work of health visitors and school nurses with children with emotional, behavioural and psychological problems: findings from a Scottish Needs Assessment

AIM This paper is a report of a study to describe the workload of health visitors and school nurses in relation to children and young people with psychological, emotional or behavioural problems, and to identify perceived challenges, obstacles and sources of satisfaction associated with this aspect of their work. BACKGROUND There is little published information on the work performed by non-specialist community nurses with children and young people who have psychological, emotional and behavioural problems. METHOD We analysed data from a survey conducted in 2002 - 2003 of 1049 Scottish professionals working with children and young people. Data included quantitative responses and free-text describing the cases seen by respondents. Responses from a sub-sample of 71 health visitors and 100 school nurses were analysed using a combination of descriptive statistics and analysis of themes emerging from the text. FINDINGS Although community-based nurses saw a relatively small number of children with psychological, emotional or behavioural problems each week, dealing with these problems took up a disproportionate amount of time. The commonest types of problem were self-harm, externalizing behaviours and family difficulties. Few respondents had received specific training in child and adolescent mental health but most expressed a wish to receive such training. CONCLUSION The work of health visitors and school nurses in caring for children with mental health problems is substantial and important. Development of their public health role should not be at the expense of this important contribution. There is a need for rigorous evaluation of nursing mental health interventions among children and young people.

Assessing wellbeing at school entry using the Strengths and Difficulties Questionnaire: professional perspectives

Background Emotional and behavioural disorders in early childhood are related to poorer academic attainment and school engagement, and difficulties already evident at the point of starting school can affect a child’s later social and academic development. Successful transfer from pre-school settings to primary education is helped by communication between pre-school staff and primary school teachers. Typically, in Scotland, pre-school establishments prepare individual profiles of children before they start school around the age of five years, highlighting their strengths and development needs, for transfer to primary schools. There is, however, no consistent approach to the identification of potential social, emotional and behavioural problems. In 2010, in one local authority area in Scotland, the Strengths and Difficulties Questionnaire (SDQ) was introduced for children about to start school as a routine, structured, component of the transition process to help teachers plan support arrangements for classes and individual children. The SDQ assesses emotional, conduct, hyperactivity/ inattention and peer-relationship problems as well as pro-social behaviour. In order to be an effective means of communicating social and emotional functioning, the use of instruments such as the SDQ needs to be practicable. Finding out the views of pre-school education staff with experience of assessing children using the SDQ was, therefore, essential to establish its future utility. Aim The purpose of this study was to explore the views of pre-school education staff about assessing social and emotional wellbeing of children at school entry using the SDQ. The objectives were to examine the opinions of pre-school workers about completing the SDQ and to elicit their thoughts on the value of doing this and their perceptions of the usefulness of the information collected. Method Pre-school establishments were approached using a purposive sampling strategy in order to achieve a mix of local authority (n=14) and ‘partnership’ establishments (n=8) as well as different socio-economic areas. Semi-structured interviews (n=25) were conducted with pre-school head teachers (n=14) and child development officers (n=11) in order to explore the process of completing the SDQ along with perceptions of its value. The interviews were transcribed verbatim and analysed thematically. Results In general, staff in pre-school establishments viewed the use of the SDQ positively. It was seen as a chance to highlight the social and emotional development of children rather than just their academic or educational ability. Most felt that the SDQ had not identified anything they did not already know about a child. A minority, nevertheless, suggested that a previously unrecognised potential difficulty was brought to light, most commonly emotional problems. Completing the SDQ was felt to be relatively straightforward even though the staff felt under pressure from competing priorities. Concerns were, however, raised about the potential of labelling a child at an early stage of formal education. Conclusion The findings from this small scale study suggest that, from the point of view of pre-school education staff, it is feasible to assess children systematically for social and behavioural problems as part of the routine transition process at school entry.

Improving the educational experience of children and young people in public care : a Scottish perspective

The context for this paper relates to the policy and practice implications of efforts to achieve social justice for Scotland’s 12,000 children and young people in the care of local government authorities. The paper is located within a growing evidence base of the educational experience of young people in care and leaving care. The data on attainment and exclusion from school in particular are reviewed and confirm that looked‐after children in Scotland, as elsewhere in the UK, typically leave education with significantly fewer school leaving qualifications than is now the common expectation for young people in their age group and are significantly more likely to lose time in school due to exclusion. However, the review also shows the devastating impact of being in care on young children’s attainment in reading, writing and mathematics. The implications of the data reviewed are discussed in relation to the concepts of social justice, resilience and the educationally rich environment.

Reasons for Choosing a Further Education: the views of 700 new entrants

Abstract This article explores some reasons for choosing a further education given by 700 new entrants to 10 Scottish further education colleges. It tries to distinguish between instrumental reasons, such as those concerned with the quest for employment and what students perceive as most intrinsically worthwhile about a further education. It also tries to identify some of the methods of communication that are most effective in attracting students to further education. It seems that leaflets and mail shots are by far the most effective methods of communication before students enter college. The local reputation of the college as a place where good social relationships are fostered including those fostered in the classroom seems more important than the resources devoted to teaching. Even though many new entrants cite instrumental reasons as being very important, detail in the curriculum seems to be much less important to them. We speculate that this is because students are prepared to trust such detail to teachers they perceive to be good. Colleges therefore have an opportunity, if not a responsibility, to take students beyond instrumentalism. 191

Access courses and students from minority ethnic backgrounds

Abstract This article describes a study of the uptake of places on ‘access’ to higher education courses in Scottish further education (FE) colleges by students from minority ethnic backgrounds. Colleges surveyed recruited access students from minority ethnic backgrounds in close approximation to the proportions attracted to FE in general, despite the commitment to prioritise under‐represented groups, including students from minority ethnic communities. The study found a general acceptance of the principle of positive action by colleges, but little evidence of strategies likely to prove effective. It is suggested that the governments agenda for widening participation in education can only be accomplished when the FE sector recognises ethnicity as an important issue.

Can Scotland Achieve More for Looked after Children

The Learning with Care report (HMI and SWSI, 2001) made seven criticisms in relation to the provision of education for looked after children in Scotland. The most recent report, Looked After Children and Young People: We can and must do better (Scottish Executive, 2007), contains 19 actions for improvement. Graham Connelly and Mono Chakrabarti examine whether the distinctiveness of the Scottish political landscape has the potential to lead to improvements in tackling the deficits in the educational experience and attainment of looked after children and young people clearly acknowledged by the authors of both reports. Their article considers the recent history of political concern and asks whether things are getting better, concluding that while there is only limited improvement, the climate is more supportive and more emphatic in its expectations of the young people and the professionals who support them.

HNC (Social Care) as an entry qualification for the Diploma in Social Work in Scottish Higher Education Institutions

This paper describes a study of the first cohort of students who progressed from HNC (Social Care) to DipSW. Though these students had performed well in HNC, they were experiencing more difficulties than expected in both academic and practice components of DipSW. The paper describes the views of the students, and their teachers, and discusses the findings within a broader context of the articulation of further and higher education courses.

Inequalities in the dental health needs and access to dental services among looked after children in Scotland: a population data linkage study

Background There is limited evidence on the health needs and service access among children and young people who are looked after by the state. The aim of this study was to compare dental treatment needs and access to dental services (as an exemplar of wider health and well-being concerns) among children and young people who are looked after with the general child population. Methods Population data linkage study utilising national datasets of social work referrals for ‘looked after’ placements, the Scottish census of children in local authority schools, and national health service’s dental health and service datasets. Results 633 204 children in publicly funded schools in Scotland during the academic year 2011/2012, of whom 10 927 (1.7%) were known to be looked after during that or a previous year (from 2007–2008). The children in the looked after children (LAC) group were more likely to have urgent dental treatment need at 5 years of age: 23%vs10% (n=209/16533), adjusted (for age, sex and area socioeconomic deprivation) OR 2.65 (95% CI 2.30 to 3.05); were less likely to attend a dentist regularly: 51%vs63% (n=5519/388934), 0.55 (0.53 to 0.58) and more likely to have teeth extracted under general anaesthesia: 9%vs5% (n=967/30253), 1.91 (1.78 to 2.04). Conclusions LAC are more likely to have dental treatment needs and less likely to access dental services even when accounting for sociodemographic factors. Greater efforts are required to integrate child social and healthcare for LAC and to develop preventive care pathways on entering and throughout their time in the care system.

Towards the Right Care for Children: Orientations for Reforming Alternative Care Systems - Africa, Asia, Latin America

In order to increase its knowledge on the possible issue of de-institutionalisation in developing countries and how it could be addressed, the European Commission Directorate- General for International Cooperation and Development (DG DEVCO) commissioned SOS Children’s Villages International to conduct the present study. Its general objective was to “conduct a research on the possible issue of institutionalisation in six South and Central American, Asian and African countries in order to strengthen the knowledge of the European Commission on the nature, the extent and scope of institutionalisation and feasibility of de-institutionalisation (alternative care for children). On the basis of its results, the research would give recommendations for future possible initiatives (pilot programmes, social protection system reforms, for example) to be supported by the EU in developing countries.” The present synthesis report, Towards the Right Care for Children, presents the findings of the study as well as recommendations for EU external action.