In 2016, Professor Jim McKenna of Leeds Beckett University described how Evolve Health Mentors provided vital support that enabled “unintentionally disruptive” pupils to access learning within their mainstream school classrooms. Evolve’s own research and development over the 8 years since has shown how this life-affecting label can be reliably removed using a combination of carefully designed mentoring programmes and supporting digital tools.
On Wednesday 17 July, the Centre for Human Brain Health at the University of Birmingham published a study that describes how the behaviour of children and young people is affected by compromised brain development. In particular, how a lack of white and grey matter can lead to a condition called Conduct Disorder. In other words, the children and young people affected are unintentionally disruptive.
Over the past decade there has been a significant shift in how children who are suffering from early adversity in life are treated by public services such as schools and youth offending services. Trauma informed practice is the heading for this way of working, which is less concerned about punishment and more focussed on rehabilitation.
Evidence suggests that people who have challenging upbringings in the form of adverse childhood experiences (ACEs) such as emotional abuse, living with someone who abused alcohol, exposure to domestic violence, and/or losing a parent through divorce, death or abandonment are more likely to suffer from chronic health problems. What’s more, they can also expect a reduced life expectancy of up to 20 years.
During childhood, brains adapt to help people adjust to the environment they are in and to deal with challenges they may face. In this example, people often become hypervigilant; less able to regulate their emotions; and difficulties in forward planning and understanding the consequences of their actions.
This recent study about Conduct Disorder provides further support for why a trauma informed approach is more appropriate than a response that dwells on punishment and blame. However, there is a real risk that devising names like ACEs, Conduct Disorder and Unintentionally Disruptive wrongly and lazily attributes blame to these labels rather than the society that caused them.
And societies that have the knowledge, technology, finance and resources to remove them.
A pioneer of human brain health who is regarded by the scientific community as the founding father of neuroplasticity is a gentleman called Dr Michael Merzenich. Rather than spend time looking at the causes of compromised brain development, Merzenich has devoted his career to finding ways of improving brain health. He has shown how over 50 aspects of brain health can be easily, cheaply and reliably enhanced regardless of age or pre-existing neurological status.
Put simply, trauma informed practice is no longer good enough.
As a society, we have the knowledge and tools to remove these labels by reversing the very same processes that are responsible for creating them. This is especially true in childhood and adolescence where young brains are at their most malleable.
Headteachers in schools, both UK and internationally, are showing real leadership and bravery by embracing Dr Merzenich’s teachings. Rather than wait for government departments or system leaders to introduce new ways of working, they have critically analysed scientific literature and research studies in order to deploy evidence-based solutions to the increasing challenges they face, which may or may not be formally attached to labels such as ACEs and Conduct Disorder. These include unacceptable behaviour, rising levels of suspensions and exclusions, SEND and inclusion, and mental ill health.
Similar to headteachers, prison governors do not have the luxury of conducting longitudinal and double blind randomised control trials before they invest in solutions that are needed to relieve the chronic and systemic pressures of today. As such, the first neurocognitive development programme using Dr Merzenich’s software is starting in a prison setting in September and this follows the first implementation in a youth offending service earlier this year.
I am certain that, should such a study be commissioned, the brains of most prisoners and those of young people known to youth justice services will be lacking in grey and white matter. Many will also suffer from mental ill health and have an ADHD diagnosis. Most will also be found at the top of the league table for ACEs. With prisons already at bursting point, and youth offenders acutely aware of this, governors don’t have the luxury of naval gazing to dissect the various reasons why we have ended up here.
Like other frontline public servants such as headteachers and youth justice leads, prison governors have no time for labels. They need solutions.
Unfortunately, solutions cost money and money follows labels. For example, if the issue is hyperactivity and a lack of focus and attention, an ADHD diagnosis will lead to a defined treatment path that is an approved use of public funds, often involving pharmaceutical drugs.
However, if the issue is executive dysfunction, which shares many of the same symptoms as ADHD, and the best course of treatment is a longer term lifestyle adjustment that involves targeted improvements in sleep, diet, and exercise, this treatment path may not justify use of public funding, despite it being a safer and more sustainable solution that is detached from future dependency.
I welcome this latest research from the university that I graduated from some 25 years ago. However, I remain concerned about how thoughtful research findings like this are often used in less thoughtful ways. Distilling complex science to labels is unintentionally disruptive to both logic and critical thinking. Conversely, I remain in utmost admiration of Dr Merzenich and fellow researchers who focus on finding robust scientific solutions, especially in the absence of finance and resources to support their efforts and devotion.
