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ADHD Science episode 4 with Abby Russell
151 Plays1 year ago
We talk to Abby Russell, Senior Lecturer in Child and Adolescent Mental Health at Exeter University, about Tools for Schools, a project finding practical strategies for schools to support pupils with ADHD.
She's great!! She's on Twitter @DrAbbyRussell! Go and say hi!
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Transcript
Introduction and Birthday Talk
00:00:07
Speaker
Hello! Hi! Episode 4 is here. We're sorry we're a bit late. Somebody had a very, very big essay to do and for once it wasn't... Oh dear. And for once it wasn't you. It wasn't me and it wasn't your mum. How are you Tess? I'm alright. You know how I am. I'm excited.
00:00:26
Speaker
go on. Why could I possibly be excited? It's almost my birthday. You're gonna be 17 on Monday. Yay! And you're gonna have lots of people that I'm not allowed to be anywhere near. No, I just said, don't come downstairs and scowl at everyone like you did last time. I don't scowl, I was just keeping an eye on people. I just have resting
00:00:49
Speaker
Whatever face. Okay. Can we say resting bitch face on the podcast? You just did. Yeah, true.
Guest Introduction: Abby Russell
00:00:55
Speaker
We're going to talk today to Abby Russell. Abby Russell. There was a really good chat, a really lively kind of engaged person who was researching essentially how we can help children with ADHD in schools, but not
00:01:15
Speaker
One of the points that Abby makes, which I think is really important, is that she's not trying to suggest things that schools can't afford. Yes. Because there's a lot of... Because people might have noticed schools have a lot of money at the moment and neither does anyone in the public sector in Britain. Yay! So Abby is working very much within those constraints and it's the practicality of her work that I really appreciate.
00:01:41
Speaker
Yes. Abby, I hope you enjoy the interview with Abby. Enough knitter-natter. Let's get on with it.
Abby's Research Focus on ADHD
00:01:48
Speaker
Thank you. All right, let's go. Enjoy.
00:02:00
Speaker
OK, so great. Hello. We are joined today by Abby Russell. Abby, if you could just introduce yourself and then we'll talk about what you've been thinking about and researching around the ADHD area. Brilliant. So, yeah, I'm Abby Russell. I am a senior lecturer at the University of Exeter in child and adolescent mental health. So that basically means that I do mostly research around young people's mental health, but I also do some teaching at the university.
00:02:29
Speaker
So I'm based in a medical school, but I teach kind of medicine related topics and psychology related topics. My background is psychology. So yeah, that's who I am.
Supporting ADHD in Schools
00:02:39
Speaker
Okay, amazing. And the particular thing, I think I picked up a poster that you've been involved with.
00:02:47
Speaker
about an intervention for children with ADHD in schools. And I have a big area of interest in mind. So should we dive straight into that? Let's jump right into it. So with your research, what question were you answering? Well, what I'm trying to achieve is to provide primary school staff with some better tools to support children that have either a diagnosis of ADHD, but also just some of those personality traits.
00:03:16
Speaker
So children who struggle with attention or are quite hyperactive or impulsive. And that's come from my PhD, which I did a few years ago now, where I interviewed some school staff about what they thought about ADHD, what they knew about the causes of it. And staff just kept saying to me, you know, we've got loads of these children with needs that we need to support in school. They have a terrible time in school, but we've got nothing that we can use at the moment in the UK.
00:03:42
Speaker
So I went off and I looked to see what there was out there for primary schools to use. And actually, there's a lot of trials. So we call them randomised control trials, which you normally see for like drug treatments, where you compare a group of children that get a treatment and a group of children that don't get a treatment. So there's loads of research doing that with school interventions for ADHD, but most of it's in America. And most of it involves loads of stuff like therapists delivering the intervention and
00:04:10
Speaker
I don't know if you know much about our schools here, but we don't have a lot of therapists kicking around. We do not. And they were super intensive as well. So you'd have like social skills training for a child, you'd have like a parent support group after school, you'd have stuff in the classroom, you'd have stuff with a counselor.
00:04:27
Speaker
So the things that were being trialed in research were just not matching up with like the reality of a primary school in the UK, which is that there's no time and there's no money. So people need stuff that's like available now that they can use today and then move on with if it works or drop if it doesn't. So that's where the project started from. Okay. And so just to kind of, can you develop a little bit what you, what you found, what were the frustrations that
00:04:55
Speaker
school staff had about ADHD. What was the problem? Can you kind of expand on that a little bit? Yeah, I think what the problem, there's kind of two main things that the problem comes down to. One is that in our mainstream school system, it's not really designed for students that struggle to sit still or struggle to pay attention. More and more, we're asking our kids to spend all their time sat very still
00:05:20
Speaker
They're told that they're not listening if they're not looking directly at the teacher and they're maybe not allowed to get up and move around. And that's like completely counterintuitive for someone who has ADHD and especially young children in primary school, they can't consciously control their behavior and they're maybe not even aware of that. So you've got the problem where kind of children were constantly getting into trouble at school and teachers were recognizing that it wasn't that the child was being naughty or deliberately being bad. It was that school wasn't set up for those kinds of children.
00:05:50
Speaker
And so that was one part of it. And then the other part of it was that teachers were saying to me, I know what ADHD is. I know it stands for Attention Deficit Hyperactivity Disorder, but I don't know anything more about it. Like I've heard it's got genetic causes, but I also think like maybe families can cause it in a child. Like we just don't know enough. So we don't know what to do. So it was that lack of knowledge combined with the fact that schools are a really difficult place for these children that made me really want to tackle it.
Trials and Challenges
00:06:20
Speaker
And the trials that you were looking into, what kind of stuff was that? What did that entail? I mean, there's a lot of them. There's more than 50 because I thought this was like a new and exciting idea. And then I went to look at the evidence and actually loads of people have done something similar with problems. So a lot of them are kind of non-pharmacological, so they don't involve medication. But if a child's already taking medication for their ADHD, they don't interfere with that.
00:06:51
Speaker
And what they tended to do is kind of target every possible difficulty that any child might have with ADHD, but all for all children. Whereas actually kids with ADHD really differ from one another. So one of them might really struggle with social skills. Yes, but another child might have no problems with social skills and actually just really struggle to focus. Um, so most of these existing trials have basically thrown everything at every child.
00:07:18
Speaker
And then they found that these programs are effective. They definitely improve things for children, but they don't know which parts improving what for who. And like I say, we just don't have the resources in our school system to do that kind of thing. So I was kind of looking at these trials and thinking some of this is really useful, but actually we can't get a therapist into a school for 24 weeks to work with parents after school every week. And I work with the child every lunchtime and yeah.
00:07:45
Speaker
what had been trialed is just not the kind of thing we could do here. Yeah, I mean, I suppose it's worth making the really obvious point that it's not that we're saying here or not that it matters, but that we shouldn't have enough money for have therapists in schools, that we accept that that's the best, you know, the situation where you quite
Toolkit Flex: Design and Purpose
00:08:06
Speaker
often have a police officer assigned to a school, but not a therapist is not something that I'm comfortable with. But your work
00:08:15
Speaker
which I think is striking. I think that's one of the things that really attracted me to it is it's obviously it's existing and it's trying to apply itself to the current situation, not some kind of idealised situation which may occur in another time and place, I suppose. Yeah, exactly. And I think the thing is we know we've got lots of good psychological evidence for things that do work.
00:08:41
Speaker
in a clinical setting, in mental health services and in these kind of idealistic school settings. But when you actually then go to people who are working in schools now or children who are at schools now or recently have left school, that's just not the reality of what they have to work with. So I really wanted to design something that could actually be used rather than something that theoretically works, but no one can actually access it. So that was a big driver.
00:09:08
Speaker
And so how did you go about designing the tools and choosing the tools that you were going to test? I suppose you would. Yeah, it's been a really long process actually. So I first had this idea in 2016 and we're now in 2023 and it took a few years just to get the hand thing. I've never done that since then. It's very uneventful.
00:09:32
Speaker
So, I mean, the first thing was, as I've said about those existing studies, we know that these programs overall are improving things for children. So it was about what bits of these might actually be useful for which children. So I've used a method, a research method called intervention mapping, which is all about designing your intervention, which in my case is a toolkit.
00:09:53
Speaker
to really fit the needs of the people that are going to use it. So to do that I have a group of about 25 people, I call them my planning group, and that's people with ADHD who are young adults now, families who have children with ADHD at school, parents kind of on their own without children who have a child who's not interested in the study.
00:10:16
Speaker
as well as kind of school stuff like CENCOs and educational psychologists and teachers and head teachers. So everything I do research wise, I take to my planning group and I get their input and thoughts on it. So they've been like, I would say they're probably like a key third of the project is their input. Then I've got the existing evidence, what we already know works. So I've drawn lots of kind of small bits of techniques from that. So that's another third.
00:10:43
Speaker
And then we've got the theory about how you change human behaviour. So my intervention or my toolkit is all about children with ADHD, but it's not really the child's behaviour that I'm trying to change. It's the behaviour of the people around the child in the school. Because I don't see ADHD as something you want to cure or you want to squish or really do anything differently with. It's more about how can we adapt. Exactly. You just bounce right back, right?
00:11:13
Speaker
So it's all about actually called the toolkit flex, because it's all about being flexible around the child and what they need with the hope that that would support them to develop some more kind of better self recognition of when they're going to be impulsive or when they need a break or a movement. So that kind of that information comes from theories of behavior change and how humans actually learn new behaviors. So that stuff most people know about Pavlov's dogs.
00:11:41
Speaker
and kind of, you know, if you ring a bell, then the dog salivates because it's learned to associate the bell with food. And some of those principles are very similar in terms of how humans learn new skills. So it's taking those kind of things that we know about how humans learn new behaviour, and using those techniques in the toolkit. So for example, one of those things is that people tend to
00:12:04
Speaker
believe something more likely to change their attitudes if they hear information from a trusted source or from someone that they respect. So in terms of schools that might be getting the senior staff at the school to talk to their teachers about something or in the toolkit we've actually got videos from parents
Pilot Testing Feedback
00:12:23
Speaker
and school staff talking about their experiences and how that relates to ADHD for our new teachers to watch.
00:12:29
Speaker
So it's combining those three things really. And what we've come up with is this toolkit, which has six different modules. So it's individualized to what the child needs. And then each module has a range of different strategies, which are fairly short things you can do in the classroom with the whole class, most of them that then are targeting whatever it is that that child with ADHD is struggling with at the time. So.
00:12:54
Speaker
It includes a lot of the things that we've seen in those big trials that do everything, but teachers are able to pick out, okay, well, I'm having this problem with the child at the moment. What could I do to support them with that? And they could just go to that part of the toolkit rather than having to do everything all at once. So is it a more tailored approach to each individual child?
00:13:15
Speaker
like taking the aspects of other methods that work and then applying them rather than just using one single method. Yeah, exactly that. So it starts with the teachers figuring out along with the family and the child, what are the two things we want to work on?
00:13:33
Speaker
And then based on what those are, the toolkit website directs you to, oh, look at the strategies in this module about feeling good if it's about self-esteem. And then the teacher gets to pick which of those they think they could do in their classroom and that would help. So. That's brilliant. Yeah. It's always the sort of thing that I try and communicate to teachers, but it's so good to have it kind of formalized in this way and kind of
00:14:02
Speaker
done proper. We have got a version of it in Lambda's but yours is more research driven and has been kind of validated. I think that's probably the next thing to talk about. What have you found in terms of
00:14:19
Speaker
testing this out. And assuming that this is the way that your research is going, is it testing the acceptability and effectiveness of this? Exactly. Yeah. So I spent two years developing the first prototype. So that was working with my planning group and actually a software guy, Ian, who's made the website for me and actually turning my ideas into something that works.
00:14:40
Speaker
We've got about 60 strategies and each of those have like PDF resources for the teachers. So there might be a lesson plan. There might be like a tracking template and stuff. So actually the job of creating all of that is quite, quite big. I maybe didn't understand how big that job was at the start. Yeah. So we had the first full prototype in December, last year, December, 2022. And now I'm doing what's called a feasibility study.
00:15:08
Speaker
So I've got eight primary schools who are testing it out over the next couple of years. And our first two schools actually have just finished testing it. They started using it in January. So I can tell you a bit about what they thought if you'd be interested. So we have about four children in each school who have traits of ADHD or a diagnosis and then their class teachers and maybe the teaching assistants.
00:15:34
Speaker
And what we've found is a really interesting mix. So there have been some teachers who haven't used it at all. And that's been mostly teachers where actually the student we've recruited is really struggling to be in school at all. So they might have attendance as low as 20%. So then the teacher is just really struggling because they don't know when the child's going to be there. And then it's not a priority for them to spend time looking at the toolkit, which is quite important to know, I think.
00:16:02
Speaker
Then at the start of the toolkit, we ask teachers, like I said, with families, to set what the goals are going to be for them to work towards. And I have quite a rigid process of how I think that should happen, which is based in psychology and really understanding what happens before a problem behaviour, what happens after it. So, for example, if a child is shouting out in class, do all the other students laugh? And is that then encouraging them to do it more?
00:16:26
Speaker
So in the talk at the moment, we suggest that the staff have two meetings. So they kind of think about ideas and then they go away and they do some investigation and observation and then they come back. But actually no one's been able to do that because there's just no time for them to have two meetings with one child's parents basically at the beginning of term. So we're going to have to change that in some way to make that easier for school staff.
00:16:54
Speaker
Things that are going really well. A lot of the teachers have incorporated more movement into their school days and they're finding that really helpful, not just for the child in the research study, but for their whole class. Yeah. So loads of movement breaks. Yeah.
00:17:11
Speaker
I think when I was in primary school that would have been very helpful. A bit more movement. Yeah, just a bit. Yeah, they had to get me this special little pillow to put on my chair so I could fit it without annoying. I had to carry it around with me like a little book bag. Yeah, because they had a little handle, didn't they? Quite cute.
Evaluating Toolkit Impact
00:17:28
Speaker
Nice. So yeah, movement breaks have been something a lot of our teachers have picked up on. And we have a strategy in there about creating a menu of all the different movement things you could do with the class and letting them choose. Some of them are doing that. Some of them are just going, well, I can find five minutes and I just put on a dance video because that's what the kids in my class like at the moment. That's lovely.
00:17:52
Speaker
I mean, primary school classrooms are incredibly cute, aren't they? I don't know how much you get. Do you get to observe in them? Yeah. So we go and observe the children twice a term and it is fantastic. It's so much fun. I actually started out my career as a teaching assistant, so I love being in schools. So it's a real bonus. I actually get to go as part of my research job to go and basically play.
00:18:21
Speaker
But yeah, absolutely lovely. So you spoke about what this means for teachers and parents, but what does this mean for other people looking after ADHD people like clinicians? And I mean, maybe a bit more detail on parents or anything. Yeah, so when I started up the project, I went virtually because it was the middle of the pandemic to lots of clinical team meetings, so with child and adolescent mental health services or pediatricians.
00:18:48
Speaker
to tell them about what I was planning to do and to get their thoughts on it. And I just had an overwhelmingly positive response because a lot of clinicians seem to perceive that they diagnose families or they diagnose a child with ADHD. And if that family doesn't want medication for the child, there's essentially nothing more that they provide. So they know that families want more support and they know that school is a real problem, but there's nothing currently that they do kind of routinely, I guess, for schools.
00:19:18
Speaker
So in Devon at the moment, a couple of our kind of clinical areas, so Torbay and the main Devon area are looking at kind of an early response when children are referred to clinical services. And a few of them have approached me about, could this toolkit be part of their early response where they kind of refer to schools and say, or sign up to use the Flex toolkit, because that will support this child in school, whether or not they get a diagnosis. Yeah. And you can do that.
00:19:46
Speaker
you don't have to wait, do you? You can just do that. In fact, the schools could do that. Could the schools do that without even reference to a clinical? Yeah, so we're in a bit of a... What's the word? We're still in an early
00:20:00
Speaker
period. So we've just tested this with the first two schools. And one of the things that we need to make sure is that this doesn't have any negative impacts on the children. So one thing that's come up is making children feel singled out and actually making them feel more isolated or more different because we're using the toolkit. So we're being very careful early on just to ask explicitly, ask teachers, ask parents, ask the child, is there anything negative that's happening that you think is because you're using the toolkit or because your teacher's doing something differently?
00:20:30
Speaker
And so far, everyone has said no, other than teachers struggling to find the time to complete my questionnaires. That's okay. And so I think once I've had two more schools, and I'm very satisfied that it's not going to cause any problems, then I would be happy for more schools to know about it and use it. So I'm just at that difficult balancing point at the moment where I don't want to really widely say everyone go to this website and look at this because I
00:20:57
Speaker
You know, I base my work on evidence and what I'm doing is creating new evidence and I want to make sure even if it should be beneficial that I'm sure that it won't be detrimental. I think that's really important. So I kind of mentioned briefly earlier, most of the stuff in the toolkit is designed so you don't do it with the individual child. You can do it with a small group or with your whole classroom.
00:21:17
Speaker
So most of the children aren't even aware that anything different is happening for them because it's all done at a group level. But we'll have to see if that bears out for the next two schools as well. I think that's so important, asking the child themselves. Because a lot of people, when they use tools for children in the classrooms, they kind of assume that, oh, they're kids, they won't understand, that you can't actually talk to the child about their own issues. And I mean, they are the person who this is happening to. They're the one who knows the most.
00:21:47
Speaker
And the fact that some people will go around trying to help these kids without even having the time to actually ask them how it's going for them is just wild to me. You're doing this for the child, but you're not speaking to the child. But it's so common. And it is difficult because, as you said, Abby, the thing you're actually trying to change is other people, not the child themselves. And so it is tempting not to really ask the child anything because you're not asking anything differently from them.
00:22:15
Speaker
necessarily, you're asking the things of the parents, you're asking things of the teachers, you're not actually asking the child to change themselves, which is right. But you're also right to say, yeah, we should, I mean, clearly we should, whenever we put one of these interventions, we should be asking children what they think themselves, as far as they're telling. Yeah, it's quite a difficult balance and different children and different families have different views on it as well. So what we do, we have a children's kind of information sheet,
00:22:44
Speaker
because to do a study ethically, you give everyone information and then you get their consent. So we have an information sheet for children, which is like, what is a study? And it very, very basically explains what research is and the fact that we want them to be part of a study. And they get to meet one of our researchers when we get the parents consent and we have a form that the child can sign themselves if they want to take part or if they don't want to take part, then, you know, they don't take part. And they really seem to like
00:23:13
Speaker
doing that I think they feel very important, especially the very young ones, it feels very important to be asked to sign some paperwork and to say that you are happy to do this thing. And then when we work with the children in schools, when we're observing them in the classroom, they don't know that we're just observing the one child that we're kind of presented as like someone who's just in watching the teacher.
00:23:33
Speaker
But when we do the questionnaires, the questionnaires are about how happy you are at school and it talks about the different areas of school and then they circle smiley faces or sad faces to indicate how they're feeling. So we're not going, you have ADHD, how bad is it for you? How are things going generally and how do you feel? It's just the most important question anyway, whatever else you do.
00:23:57
Speaker
So I think that leads us on quite nicely to our next question, which we've done quite a lot of questions already. I've got some other stuff I want to cover. I'm not going to say this is the second question because it's the fourth. This leads us onto our lovely fourth question. What does this mean for ADHD people themselves? I mean, hopefully it will mean that children who have ADHD will have a better experience of primary school, particularly if they're in a mainstream primary school.
00:24:26
Speaker
with staff who understand more about ADHD. So we've got videos in there about ADHD and neurodiversity and neurodivergence and sensory processing. So hopefully people will know more and that will make it easier for children to feel like they're a normal part of the school environment and their communities. And I think one of the real problems that young people have growing up with ADHD is those kind of constant negative impacts on your self-esteem. So that by the time you become a teenager with ADHD,
00:24:56
Speaker
you can feel really bad about yourself because you're constantly told you're doing things wrong, even though you've got no control over it. So I'm hoping that, you know, children will will grow up feeling better about themselves, essentially.
Implementing Flexible Policies
00:25:08
Speaker
I'm not so fussed, like I said, about doing anything about their actual symptoms or traits of ADHD. I don't think anyone needs to be less hyperactive. I think it's more about how you manage that hyperactivity and let it out in constructive ways. So I'm hoping that would change. Yeah.
00:25:25
Speaker
Yeah. And if you're an adult with ADHD and you're thinking about having kids, it's a good chance your kids will have traits. And so knowing that schools are changing their, you know, changing their approach or could change their approach potentially in the future is, is, is relatively encouraging. Um, although it's obviously a long process and you're not going to be without its difficulties, I think. Yeah. I mean, I do my talks like I do with the clinicians. I've been around to groups of school staff and kind of Senco networks and things.
00:25:55
Speaker
And anytime I talk about the project, school staff are so engaged with it because they, they're so aware that they want more knowledge. They just don't know how to access actual scientific knowledge. So it's not that people are deliberately trying to do things wrong at the moment. It's just that people don't know how to do things better. So that's what, what we're trying to do with this project is really bridge that gap. This is something that I was wondering about because you talked about giving people tools.
00:26:22
Speaker
To what extent are you giving people tools and to what extent are you giving people knowledge and informing them about the condition and how are you balancing that out? So it is a balance of the two and using that intervention mapping method that I mentioned what you actually do is you make a list of all the behaviours that you want to change for all the people that might use this toolkit down to like a really basic level like
00:26:47
Speaker
a teacher should believe that ADHD has genetic components to the cause of it. And then you think about, okay, well, what do we use? What kind of method can we use to change someone's beliefs? And then you design the bit of the toolkit using that method. So we've got quite a lot of knowledge building stuff in there. Probably
00:27:09
Speaker
maybe 20% of the toolkit involves new knowledge and we've got things like quizzes and kind of test your own knowledge and then talk to a colleague, lots of reflection with your colleagues about what you've learned and what you thought before. The other thing that we're trying to address is like the power dynamic between school staff and parents because parents have said, oh, you know, my child's had a diagnosis. I've been on a parent training course, but the school won't listen to anything that I've learned because they don't believe that I've got the knowledge.
00:27:37
Speaker
And so we ask school staff and families to do the exact same training within the toolkit and watch the same videos so that they're on the same page. So we're hoping that will help. So, yeah, there's a lot of knowledge stuff. And then there are a lot more. Yeah. The bulk of the toolkit is more pragmatic strategies. And a lot of it, as the teachers have said to me themselves, is kind of good practice in teaching, like making sure that you're praising your students.
00:28:05
Speaker
And it's just kind of tweaked for ADHD in that it's like, make sure you do this immediately and make sure you're really specific about what it is you're praising. And to do that, we have like a classroom game called Pick Up the Positives, where the teacher introduces to the whole class, we're going to catch each other out being good. And we're going to be really specific about what it is that other people are doing well.
00:28:26
Speaker
And so then it becomes hopefully kind of integrated in part of the normal classroom culture. And yeah, so teachers are saying to me, oh, you know, I saw that and I thought, oh, yeah, I know I should be doing that, but I just forget. So there's a lot of kind of basic teaching stuff just kind of tweaked for ADHD and hopefully implementable in a fun way to get them to engage with it. And have you had any resistance because there is
00:28:51
Speaker
At least in theory, and people worry about this. I'm not sure that this actually happens in practice. There is in theory, a tension between behavioral policies and SCN intervention for ADHD.
Broadening Research Scope
00:29:04
Speaker
And people worry, well, if you pick him out and you let him off for doing this behavior, then shouldn't you let all of the kids off? And did you have any pushback about that kind of thing? Because people talk about it a lot. Although I think it, I'm not convinced actually. I'm not convinced actually.
00:29:19
Speaker
That's a really difficult one. We have, there's an optional strategy in the toolkit, which is a senior leadership team inclusion challenge. And that's to encourage the senior leadership to think about their current policies and what they could change to make it more flexible for some students. And nobody's used that yet. So what I'm seeing is that head teachers and Senkos are very, very keen to take part in the study and for their teachers to use the toolkit, but in terms of actually
00:29:49
Speaker
buying into shifting their larger policies and school culture, it might be a slower process. I think there can be a tension between the two. So I know some schools, for example, don't allow students to come into the building slightly earlier or slightly later if they're students that really struggle with the busyness of everyone arriving at the same time. So most schools can be really flexible on that, but I have come across schools that are adamant that everybody arrives at the same time.
00:30:19
Speaker
think the reality is that those schools either don't volunteer to take part in research like this or students who have traits of ADHD don't get on well at those schools and then they leave and move to other schools. So I'm not seeing them in my study but you know you have to volunteer to take part so you get quite a specific group of schools that might be willing to do that. I mean that always worries me hugely because ultimately
00:30:47
Speaker
what happens is that the children who have needs congregate in particular schools whose results, therefore, people with ADHD, autism, other special needs don't necessarily perform as well as other children of equal intelligence and ability in academic terms. So the schools who are inclusive will lose out in terms of their academic records. And so it's a sort of incentive for schools to
00:31:16
Speaker
gently push these children out. Yeah, I mean, it's really challenging, isn't it? Yeah, some of the fun times elsewhere. Yeah, because you also have things like where children might be on the register for a school, but actually encouraged never to come to the school and to learn at home and things like that. It's called off rolling, I think. But yeah, I mean,
00:31:41
Speaker
We could do a whole other podcast on the fundamental problems with our school system. I think, you know, the focus, schools are ranked on attainment and they get a lot of pressure to have students who academically attain. But we do have that in Devon. We have some schools that are known for being brilliant for children with special educational needs. So lots of parents who have children with special educational needs send their child there and then those schools become overwhelmed because they have the same staffing as every other mainstream school.
00:32:12
Speaker
And it can be the case, I know, anecdotally of a case where there was a school that had a huge number of children with special educational needs because the Senco had a fantastic reputation. They moved school and a huge number of the children left the school they were at as well. So I think at the moment there's too much individual variation and it really depends on the individual staff members at a school and the pressures they're under. And I don't think that's how it should be.
00:32:41
Speaker
Can you use just to sort of be a little bit less gloomy because I mean I get very gloomy about these things but but I think that there's a ray of light in that it's if you actually look at some of the actual the effects of the interventions they are helpful for all children. Yeah.
00:32:58
Speaker
And that's what we're hearing from teachers already who have been using the toolkit. They say, oh, I know that this child is in a research study, but actually I want to use it with my whole class because I've got six other children that could really benefit from this. So there's lots of stuff in there about peer relationships and teacher relationships, which are important for all children. There's lots of stuff about self-esteem and generally kind of learning to be able to do things in chunks of time and kind of
00:33:26
Speaker
move on from one thing to another. So fairly basic kind of fundamental academic skills are quite well supported as well as that kind of flexibility in terms of if a child really hates to do handwriting and therefore they never fill in more than one sentence or they never write more than one sentence, do they really need to be using handwriting? Could they be typing it? Could a teacher provide them with sentence starters? So hopefully kind of
00:33:50
Speaker
giving people tools so that actually children can achieve their potential rather than being held back by what they can't do. Yeah. I mean, and that's, you can call that a kind of idealized version, but that is what you're going for. That's the reality of at least the aim of what you're going for here. What do you think Tess? Shall we do the final question? Sure. Yeah. What's your next question?
00:34:20
Speaker
What are you moving on to next? So I have two more years of funding for this project, which means that now is the time to start applying for funding for the next project. So at the end of this two years, we'll know if the toolkit looks like it's helpful. And because we're doing it with different schools each term, we can make changes as we go. So by the end, we should have a toolkit that primary school staff can pick up and use without, you know, me coming and telling them how to use it, which is the main aim.
00:34:49
Speaker
So then we would go on to do a trial of that with a much larger number of schools. So hopefully over 100 schools and a lot more children so that we can prove whether or not it's actually improving things for the children. So that's one thing that I want to do next is actually do it on a large scale so that we can get some really good evidence. And then the other thing is actually expanding. So the overall project is called Tools for Schools.
00:35:15
Speaker
And I want to expand that into other common problems that school staff are having in terms of managing young people's mental health. So at the moment, we focus on primary schools in ADHD, and I'm hoping to expand into secondary schools and thinking about other neurodevelopmental traits, but also things like the tricky behaviours that get children kicked out of school, basically, which we call externalising behaviour, which
00:35:40
Speaker
Quite often are the reason that a child might be referred to clinical services, but then they don't get seen because there's no real kind of underlying psychopathology, potentially, or no useful treatment. So the things that get children excluded and expelled are what I want to work on next, basically. And then I'm hearing more and more from teachers that they're having difficulty with children who have autistic traits, but particularly those who have pathological demand avoidance.
00:36:11
Speaker
which is children. Yeah, I know. It doesn't make any sense, does it? It's basically being very resistant to anything that appears like someone's demanding something of you. So the kind of child where if you say to them, go and put your book in that box, it causes a major explosion because they feel like they have no choice and they don't want to do that, but they don't know how to express it.
00:36:40
Speaker
And that's the kind of trait that's being more and more recognised with autism and autistic people. So, and that's something schools are finding really difficult because every time they ask a child to do something, the child just has a meltdown and it's not very constructive for anyone. So, yeah. And I think it's important that it's not necessarily things that they didn't want to do or some things that are unpleasant or difficult. It's something about being put on the spot almost like the anxiety of that.
00:37:06
Speaker
it's the perception that something has been demanded of you, I think, rather than having a choice. But yeah, schools are finding it tricky. It's not something I've done a huge amount of research into yet, but I can see it happening. Yeah. And the reason I mentioned the can of worms is that PDA, I think the position that I take and the position we take in our clinical service is that it's an identifiable set of behaviours within the autistic spectrum and works as a set of behaviours.
00:37:36
Speaker
rather than as a diagnostic label which is how it's been sort of widely adopted by some enthusiastic researchers and parents as a separate diagnostic label alongside autism. Absolutely and I'm not a huge fan of labels other than for being able to kind of explain that there's a group of people that might have similar traits. I think the way that you use a label can vary hugely but I agree I don't think it's you know a diagnostic
00:38:05
Speaker
entity on its own, it's more exactly as you described.
Understanding Labels and Behaviors
00:38:10
Speaker
Yeah. And one of the problems is I'm not completely sure that we know how to manage this, what is best practice for managing these behaviours. But I mean, maybe you I'll let you know in a few years time. Yeah, exactly. We need to know, but we don't know. So and it's kind of a bit circular.
00:38:28
Speaker
You can see it's a bit circular because we don't, we're not going to use it as a separate diagnostic label because we don't know that it guides intervention, but we do, we need to, we need to use it as a research label so that we know if it is then useful clinically. It kind of hard to get people to get their head round, but that is essentially in a way how we have to be at the moment. Yeah. I mean, I also do research in self-harm and suicide and young people, and it's kind of a similar area. Self-harm is not a diagnosis.
00:38:59
Speaker
in itself. It's a behaviour and there's many, many reasons for that behaviour. But there is something useful around, for scientific purposes, putting together a group of people who do that and looking at what they have in common or what an intervention does to improve that.
Team Collaboration
00:39:14
Speaker
Irrespective of their underlying mental health diagnosis or depression or anything like that. Wow, okay. And how do you feel about going into secondary school? Because I think that'd be so challenging.
00:39:27
Speaker
So my self harm work has centred around secondary schools. So it's not as terrifying as it could be. I think the reason I'm motivated to do it is because a real problem point is the transition between primary and secondary school. And a lot of families of children with ADHD say, and you know, kind of teenagers reflecting back to me, I was all fine in primary school, nobody knew there was anything different about me.
00:39:53
Speaker
But then I went to secondary school and I had to go to a different classroom for every lesson and I had a different teacher for everything and my whole world just fell apart. So it's a very different challenge, I think, but I think some of the same principles can be applied if you get the kind of the staff buy in because you need to involve a lot more staff, I think, at the secondary school level because they see so many students each for shorter amounts of time.
00:40:18
Speaker
Yeah. And it's a lot harder to like in primary school, a teacher can really get to know a child and know what that child needs. But when you get secondary school, when you have like 10, 12 teachers, it's very difficult for them all to know what to do with you. And so some kids can end up like dreading certain subjects because that teacher just does not know what to do with them. Doesn't get them. Yeah. Or because they have so many students keep track. They don't even notice that there's anything going on.
00:40:46
Speaker
So that can be quiet. Particularly the quieter kids. I mean they've mainly got the whole thing which we've talked about in previous episodes of girls with ADHD who don't come to light until well much later and perhaps when they're self-harming in fact. Okay well gosh.
00:41:02
Speaker
You've got your whole, you know, you're going to go on to retirement with all the questions. Yeah, I have a lot of side hustles going on as well. I'm a busy bee, but I have a fantastic team who work with me here. I guess Max, you probably met my researcher Susie in Edinburgh. So I have no shortage of people to help, that's for sure.
Accessing the Toolkit
00:41:22
Speaker
Yeah, amazing. And where can people find out more about it? Because I'm sure that a lot, I know you've been cautious in saying, well, don't, you know, we don't want everyone to start using this immediately because we don't know, but people will want to at least have a look at it. Yeah. So you can explore the toolkit. It is at www.toolsforschools.info. Okay. We'll put it in the show notes slash YouTube description. Yeah. So you won't be able to create a login and actually
00:41:52
Speaker
have the interactive use of the toolkit, but you can see all the strategies and resources. And you can also link to our kind of project blog where we talk more about the stages of the research process. So yeah, you can see the information there. You can look at the resources. If they look useful, then you can use them. And we do have the caveats on there about, you know, at the moment, it's not evaluated, but we are in the process of doing that.
Episode Conclusion
00:42:16
Speaker
So yeah.
00:42:18
Speaker
Fantastic. Well, thank you so much for joining us today. I think we've exhausted our questions and ourselves. Also exhausted me. Yeah, exactly. And do come back when we can come back and have that that podcast on the failings of the UK schools. We have a few people on we're gonna have a big round table on that, you know, four or five different guests all coming on and
00:42:43
Speaker
I can source you a lot of people. I'm sure you can. You're still very much in the moors of the UK school system. Very much. Sick form test is better. Yes, it is better. I can tell you that it is better. Thank you so much for lovely speaking to you. Bye bye. Right, there we were.
00:43:04
Speaker
You may detect that this is our second attempt at this part of the podcast. We didn't realise we were recording the first time. Because of the way you are. The way I am. Right, that was great. Obviously, we all agree with that. We hope to get Abby back because it's just really fun to talk to her. Please do continue to give us feedback. We've had some feedback and a request to talk about the overlap between autism and ADHD, which we will plan to do, but it has to be pegged
00:43:31
Speaker
to a paper but an interesting bit of research yeah um at least for the first couple of seasons and we might branch out to to kind of a more discursive chat but we'll have a look we'll have a check we'll have a look around i'll keep i'll keep an eye if you have any other topics that you particularly want to talk about um you know i don't know food food sport i don't know anything to do with ADHD ADHD is is is you know
00:44:00
Speaker
everywhere and everything, if you have it. So anything at all you want to talk about, we can try and weave in. So you can go to the ADHD UK website and fill out the feedback form there. You can tweet ADHD UK charity or me at maxdavey.
00:44:20
Speaker
or you can just shout into the void because that seems to be what social media basically is at the moment. That's so deep. Slightly falling apart. That's so deep. Right, anyway, thank you very much. Please let us know. Thank you. And we'll see you later this week because we are behind with our schedule.