Making sense of secure childrens homes

This article is a model of speech and language therapy intervention with young offenders

Making Sense of Secure Children’s Homes

Author: Steven Boyd, Highly Specialist Speech & Language Therapist, 5 Boroughs Partnership NHS Trust

Setting the Scene

The Community Homes Health Team are a small dedicated Multi-Disciplinary Mental Health Team, which includes Speech & Language Therapy, working across 3 Secure Children’s Homes in the North West. There are 2 types of Secure Children’s Homes, Local Authority Secure Children’s Homes (LASCH) and Secure Children’s Homes run by the private sector. For the purposes of this article I will focus on the work with LASCH, mainly because in the Secure Children’s Home run privately the young people are secured on welfare grounds.

According to the Youth Justice Board’s website in 2007, LASCH are generally used to accommodate young offenders, aged 12 to 14, girls up to the age of 16, and 15 to 16-year-old boys who are assessed as vulnerable. The focus of the home being on attending to the physical, emotional and behavioural needs of the young people they accommodate. To achieve this they tend to be small facilities with a high staff to young people ratio. The young people are sent from court and are either convicted, they have been given a sentence that means they have to spend part of that in custody, or they are on Secure Remand, these young people are awaiting trial and have been sent to custody because the offence is particularly serious or they have offended frequently. There are a number of criminal orders young people can be sentenced with and a fuller explanation can be found on the Youth Justice Board’s website (www.yjb.gov.uk).

The Speech & Language Therapy needs of Young Offenders has been widely documented, Bryan et al in 2007, concluded that Speech & Language Therapy assessment, and interventions for those assessed necessary, should be available to Juvenile Offenders (Bryan et al, 2007). They further concluded that there is an implication for Speech & Language Therapy services for young people who are not engaging in Education provisions. Most of the research in this field focuses on Young Offenders Institutes (YOI), these are run in the main, by the Prison Service and accommodate 15 – 21 year olds. There is therefore a lack of information on the needs of the younger and more vulnerable young people who offend and are accommodated in LASCH. However, from observation and working in this environment I would suggest that the evidence from YOI’s could be mirrored, if not magnified, in Secure Children’s homes.

Observations from Clinical Work

Focussing on the clinical need of one LASCH in particular, this LASCH being different from the others because it has an Open Provision for Young People who display Sexually Inappropriate Behaviour, I would describe the Speech & Language Therapy input as wide and varied; in no way belittling the service, it was once described as “a busy Community Clinic behind a high fence”.

In the Open Provision, for example, I provide assessment, recommendations and a full range of interventions. I have more recently provided some group work on Social Communication, in this setting the young people in the group were all verbal and aged between 15 and 17 years old, all male and most were described as “adequate” communicators who needed their Social Skills “fine tuning”. However, as the group progressed it was evident that the young people had a range of surface skills that were built on very poor foundations. These young people had very poor preverbal skills, for example, we abandoned working on higher-level communications skills and returned to building on early skills such as Turn Taking, eye contact and Listening. The young people placed in this setting, come from a complex and often chaotic background, including maternal mental health needs, witness to domestic violence, are often victims, as well as perpetrators of, sexual abuse and it can only be surmised that this complex and often traumatic childhood can have had an impact on the young people’s speech, language and communication development. It was felt that with a block of therapy focussing on these skills the Care Staff’s perception of the young people’s communication improved. By working in a group the young people became more tolerant of each other’s needs and difficulties.

On the Secure Provision, I offer assessment, advice and recommendations; support and consultation to the staff groups; and less frequently, direct interventions. The intervention stage is less frequent in this setting as the young people tend to be placed on shorter Criminal Orders, with Detention and Training Order being the most likely sentence; these can range from 4 months up to 2 years with half of this being spent in a custodial setting. However, in this setting a model of Consultation and indirect working offers positive outcomes. For example, one young man who was placed on Secure Remand, presented as unsettled, verbally and sometimes physically aggressive as well as having Moderate to Severe Learning Difficulties; by advising the staff on appropriate ways to communicate and to make the environment more communicatively friendly he became much more settled and less aggressive.

Another example was a short group working on listening and turn taking skills with 6 young people. This was highly successful because the young people became better listeners, the staff better equipped at managing young people with poor listening and attention skills and the profile of Speech & Language Therapy working with Young People who Offend was raised. This was mainly because Lord Hunt, a peer with an interest in Speech & Language Therapy and Young People who offend, heard about us and came to join in our group to observe.

As well as working directly with the Care Staff, I provide advice to the Offence Focussed Programmes workers who seek advice on the Young People’s ability to access certain programmes designed to target offending behaviour. In this setting, the team are imaginative and dedicated and we work together to adapt programmes, as these are mostly verbal programmes that rely on good reasoning and verbal skills. Both skills that the research suggests the young people accommodated on site are not likely to have.

This paper has merely scratched the surface of the Speech & Language Therapy service of the Secure Children’s Homes I work in. Working in Secure Children’s Homes is challenging and complex but effective. We work with some very difficult young people who come with very difficult stories and histories. However, Speech & Language Therapy has a very valid and important role within this setting.

The difficulty often comes when the Speech, Language and Communication needs are identified in custody and the young person returns to the community. This population are known to not access services readily; both education and health, and therefore community referrals and follow up can be very difficult. The only statutory contact that almost all of the young people will have is with Youth Offending Services in the community and it could be argued that this is where the follow on support should take place.

References & Interesting Reading:

www.yjb.gov.uk

HMI of Prisons (2004) Juveniles in Custody: A unique insight into the perceptions of young people held in Prison Service

Bryan, K (2004) Preliminary study of the prevalence of speech & language difficulties in young offenders International Journal of Language and Communication Disorders Vol 39 No 3 391 – 400

Bryan, K; Freer, J; Furlong, C (2007) Language and Communication Difficulties in Juvenile Offenders International Journal of Language and Communication Disorders Vol 42 No 5 505 – 520