Education Bill

Debate between Lord Ramsbotham and Lord Quirk

Thursday 30th June 2011 Grand Committee

[Lord Quirk]

My Lords, I support Amendments 34 and 35. I do so having in mind particularly children who are speech defective and suffer from various communication needs where the continual and continuous support by speech therapists and others is vital. There is only a small window of opportunity, to coin a phrase, in which you can address speech pathological problems. All exclusions are a tragedy, but they are an especial tragedy for someone for whom a continuous supply of special education is required as, for example, in speech pathology.

The amendment of the noble Lord, Lord Rix, which was introduced by the noble Baroness, Lady Walmsley, talks about behavioural needs. I hope that it is understood that this goes very much further to the conditions underlying the behavioural needs in question.

[Lord Ramsbotham]

My Lords, I entirely endorse what my noble friend Lord Quirk just said about those with communication difficulties. Like a number of other failings in health and education, I have been alerted to a particular problem by the numbers suffering from it in custody, such as those with the communication difficulties that we have just been hearing about. Some 48 per cent of young offenders suffer from attention deficit hyperactivity disorder, commonly known as ADHD.

I have spoken already about the concentration in this Bill on who should be assessed and the lack of detail on what should be assessed. In the opening amendment, my noble friend Lord Northbourne talked about a child's healthy, social, emotional and cognitive readiness to enter school. The noble Baroness, Lady Perry, questioned the responsibility for preparation being passed to local government. I agreed with that in one particular respect—the word “consistency”. If you delegate responsibilities, they will inevitably be given different priorities, which leads to what are known as postcode lotteries. There must be no postcode lottery in ensuring that our children—all our children—are as ready as possible to enter school, which means that possible preventable problems have been identified and amelioration plans made.

I spoke to Amendment 1 to suggest that every child’s communication skills should be assessed, not just to identify learning disabilities and special educational needs, but also difficulties that do not qualify for either definition. The problem with ADHD is that it is another one that does not qualify for definition either as a learning disability, a disability or a special educational need. It is not mentioned in any of the other amendments in this group although it is hinted at in Amendment 42 about which the noble Lord, Lord Touhig, has just spoken.

ADHD is a common behavioural disorder affecting school-age children. But it is also a clinically distinct neurobiological condition that is caused by an imbalance of chemicals affecting specific parts of the brain responsible for behaviour. If you look at the figures, 3.62 per cent of all boys and 0.85 per cent of all girls aged between five and 15 suffer from ADHD, 90 per cent of whom will underachieve academically at school. Children with ADHD are more than 100 times at greater risk of being excluded than other children and up to two thirds of those who are diagnosed with ADHD will continue to experience symptoms into adulthood.

It is not always generally understood what these symptoms might be, and in looking for them the clearest I could find was in A Parent’s Guide to ADHD in Children published in 1997, which said that:

“Children with ADHD often act without thinking, can be hyperactive, and may have trouble focusing. ADHD can affect all aspects of a person's life, extending far beyond poor behaviour or problems at school. The symptoms can have a significant impact on family life, relationships with friends, school discipline and society as a whole.

In other words, it is not something to be taken lightly or wantonly.

Although the youth crime action plan in 2008 identified ADHD as one of the main risk factors in criminal offending during childhood, ADHD struggles for recognition within the current educational system. The term is not listed in the Special Educational Needs and Disability Act. It is not listed in the Disability Discrimination Act, the SEN Code of Practice, or the Disability Discrimination Act 1995 Code of Practice. It is not mentioned in the 2005 report on improving behaviour by the Practitioners’ Group on School Behaviour and Discipline led by Sir Alan Steer. It is mentioned only in the section entitled removal of pupils on medical grounds in the 2008 government guidance on exclusion, Improving Behaviour and Attendance: Guidance on Exclusion from Schools and Pupil Referral Units. The only mention under that is pretty bare. It does not include any direction regarding the next steps for school staff to adhere to in order to make correct, informed decisions on exclusion.

ADHD is not mentioned in Support and Aspiration: A New Approach to Special Educational Needs and Disability published in March this year, so does not qualify for education and health and care plans from birth to 25.

A specialist consultant using standard criteria and rating scales can diagnose ADHD in school-age children, but the majority of adolescent psychiatrists and paediatricians believe that it is currently underdiagnosed in the United Kingdom. Sadly, once it is diagnosed there is no quick fix. The condition is manageable with a combination of regimes that include behaviour management, cognitive therapies and medication.

According to NICE, ADHD is associated with significant financial and emotional cost to the healthcare system, education services, families, carers and society as a whole, quite apart from the basic financial cost of £4,000 a year to teach a child in mainstream and £15,000 a year in a pupil referral unit. Carrying on with this problem, two thirds of parents of children with ADHD who had been in contact with teachers found that the perceived competence by teachers in the management of ADHD was at best variable. A very large number of specialists feel that teachers are not aware of ADHD and do not therefore realise what the symptoms are or that people showing those symptoms should be referred to someone as quickly as possible. We come down to the fact that, at present, ADHD is usually identified only after the second exclusion for bad behaviour. The youngest excludee whom I came across in prison was a boy who had been excluded from his playgroup at the age of four and never allowed to attend any form of education thereafter. It was small wonder that I found him Young Offender Institution Dover—and that was down to ADHD.

What should we do? We have already brought out the fact that a large number of ministries are involved in taking action to ensure that every child is ready for school. I have already quoted a number of Ministers who are involved in different aspects of ADHD. I ask the Minister to agree to undertake not only to consider my amendment, which has a specific recommendation about action following a second exclusion and is what is happening now and should be enshrined—but to start thinking seriously about those who are at risk of exclusion as a result of ADHD by raising its profile on the political and healthcare agendas to ensure better futures for children with this condition.

If we were to go on to debate the subject, I would talk about the effects of nutrition, because it has such a huge effect on the brain and is such a powerful contributor to the condition and its treatment. However, this is not the time or the place for that. However, confident in the hope that the Minister will accept my plea and its logic, I am sure that all that can come out in the consideration that will, I hope, follow.