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This paper examines the participation of children and young people within government consultation processes. It considers the recent Department for Education consultation on its statutory guidance for schools for Relationships and Sex Education in England. The paper is based on a Freedom of Information request for the consultation responses categorised as from 'young people'. We identify two issues in our interrogation of the data. First, there is evidence that a substantial proportion of responses were not submitted by young people. Second, the consultation approach did not include all the features necessary for meaningful consultation. We consider the implications for the youth consultation on policy matters that affect them. [ABSTRACT FROM AUTHOR]

Purpose: Secure children's homes (SCHs) restrict the liberty of young people considered to be a danger to themselves or others. However, not all young people referred to SCHs find a placement, and little is known about the outcomes of the young person after an SCH or alternative placement. The purpose of this paper is to understand which characteristics most likely predict allocation to an SCH placement, and to explore the outcomes of the young people in the year after referral. Design/methodology/approach: A retrospective electronic cohort study was conducted using linked social care data sets in England. The study population was all young people from England referred to SCHs for welfare reasons between 1st October 2016 to 31st March 2018 (n = 527). Logistic regression tested for differences in characteristics of SCH placement allocation and outcomes in the year after referral. Findings: In total, 60% of young people referred to an SCH were allocated a place. Factors predicting successful or unsuccessful SCH allocation were previous placement in an SCH (OR = 2.12, p = 0.01); being female (OR = 2.26, p = 0.001); older age (OR = 0.75, p = 0.001); and a history of challenging behaviour (OR = 0.34, p = 0.01). In the year after referral, there were little differences in outcomes between young people placed in a SCH versus alternative accommodation. Originality/value: The study raised concerns about the capacity of current services to recognise and meet the needs of this complex and vulnerable group of young people and highlights the necessity to explore and evaluate alternatives to SCHs. [ABSTRACT FROM AUTHOR]

The rising prevalence of paediatric type 2 diabetes (T2D) is concerning, particularly with limited medical intervention despite evidence of accelerated disease progression. This study of a Barts Health NHS Trust cohort from 2008 to 2022 aims to elucidate the incidence, clinical outcomes, and complications associated with paediatric T2D. A retrospective analysis utilising electronic and paper records identified 40 patients with T2D. The incidence doubled from 2.6/year in 2008–2013 to 5.4/year in 2014–2018. Sixty-eight percent exhibited co-morbidities, notably learning disabilities. At diagnosis, the mean BMI was 32.4 ± 6.71 kg/m2, with no gender-based disparity and no significant change over a two-year follow-up. The initial HbA1c was 75.2 ± 21.0 mmol/mol, decreasing to 55.0 ± 17.4 mmol/mol after three months (p = 0.001) and then rising to 63.0 ± 25.5 mmol/mol at one year (p = 0.07). While 22/37 patients achieved HbA1c < 48 mmol/mol, only 9 maintained this for a year. Several metabolic and cardiovascular complications were observed at diagnosis and follow-up, with no significant change in frequency. In 2022, 15 patients transitioned to adult services. HbA1c at transition was 74.7 ± 27.6 mmol/mol, showing no change one year post-transition (71.9 ± 26.9 mmol/mol, p = 0.34). This study highlights substantial therapeutic failure, with current management falling short in achieving a sustained reduction in BMI or HbA1c. Novel treatment approaches are needed to improve clinical outcomes and address the high burden of co-morbidities and complications. [ABSTRACT FROM AUTHOR]

In this paper, we explore the benefits of new forms of in-school grouping for children moving from primary to secondary school during the COVID-19 pandemic in England. Our three-phase study with over 400 students and teachers found that protective measures to limit COVID-19 though year group 'bubbles' generated an environment more aligned to children's previous primary school experience. This natural experiment smoothed the process of transition by providing a better correspondence with students' developmental needs, especially for those on the cusp of adolescence. We recommend that physical, administrative and pedagogical school structures are reimagined for this age group to this end. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to evaluate pre- and post-formulation findings with multi-disciplinary staff within two secure children's homes (SCHs) in the North East of England. Design/methodology/approach: Multi-disciplinary staff teams involved in formulation across two SCHs were administered pre- and post-formulation questionnaires. The pre- and post-formulation questionnaires focused on five domains: knowledge; confidence; motivation; understanding; and satisfaction with treatment plan. Findings: A total of 338 pre- and post-formulation questionnaires were administered across 43 formulation meetings. The highest proportion of formulation attendees were: residential staff (44%); mental health staff (17%); case managers (12%); and education staff (9%). Paired samples t-tests showed significant post-formulation improvements across all domains including: knowledge [t(337) = 22.65, p < 0.001]; confidence [t(337) = 15.12, p < 0.001]; motivation [t(337) = 8.27, p < 0.001]; understanding [t(337) = 19.13, p < 0.001]; and satisfaction [t(337) = 18.81, p < 0.001]. Research limitations/implications: The SECURE STAIRS framework has supported formulation developments across the Children and Young People's Secure Estate. Preliminary findings within two SCHs suggest multi-disciplinary staff teams find psychologically informed formulation beneficial. Future directions are considered including future evaluation of young person involvement in formulation meetings. Originality/value: There is a notable lack of existing research within the child and young people secure estate evaluating the impact of SECURE STAIRS trauma-informed care developments including the impact of team formulation. This paper adds to the evidence base. [ABSTRACT FROM AUTHOR]

From sexual exploitation and serious youth violence, to recruitment into drugs trafficking lines, young people encounter a range of risks in their neighbourhoods. Safeguarding partnerships in England face a practical challenge in addressing these 'public' types of significant harm, when using a child protection framework designed to respond to risks within the 'private' space of families. In the absence of a safeguarding system equipped to reshape unsafe extra-familial contexts young people are moved away from them. Drawing upon cumulative evidence from 20 case reviews and audits of safeguarding practices in 14 local authorities this paper explores the extent to which such relocations have achieved physical, psychological and relational safety. In doing so it articulates how relocation following public-space risks can disrupt private-space safety and recommends the practice be reviewed to identify the conditions in which it is an appropriate safeguarding mechanism. [ABSTRACT FROM AUTHOR]

Introduction: Chronic Pain is increasingly affecting young people, their quality of life and wellbeing including education, social life and mental health. Current Western approaches to psychological support for Chronic Pain often focus on 'pain management' and learning skills and strategies from professionals, making use of Cognitive Behavioural Therapy (CBT), Acceptance and Commitment Therapy (ACT) and psychoeducation approaches in individual and group interventions. As a Paediatric Psychology service, we have trialled groups running over multiple weeks informed by these approaches and experienced low attendance rates. Method: This paper describes a feasibility study of an alternative group intervention; the 'Living with Pain group', which combines the 'Journey of Life' (Denborough, 2014) with collective narrative and liberation psychology approaches. Results: Thirty three young people and eight parents / carers attended the intervention. Attendance rates, quantitative and qualitative feedback from one face-to-face group for young people and parents and two online groups for young people showed increased access and acceptability of the group. Conclusion: The findings from this study have shown that a 1-day collective narrative group intervention is feasible, suitable and acceptable and has increased access to our group intervention. Future directions include co-creation with young people and families, community engagement to increase accessibility of our groups and developing partnerships to respond to young people's hopes to raise awareness. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to present an analysis of a "county lines" safeguarding partnership in a large city region of England. A critical analysis of current literature and practice responses to "county lines" is followed by the presentation of an analytical framework that draws on three contextual and social theories of (child) harm. This framework is applied to the partnership work to ask: are the interconnected conditions of criminal exploitation of children via "county lines" understood?; do interventions target the contexts of harm?; and is social and institutional harm acknowledged and addressed? Design/methodology/approach: The analytical framework is applied to a data set collected by the author throughout a two-year study of the "county lines" partnership. Qualitative data collected by the author and quantitative data published by the partnership are coded and thematically analysed in NVivo against the analytic framework. Findings: Critical tensions are surfaced in the praxis of multi-agency, child welfare responses to "county lines" affected young people. Generalising these findings to the child welfare sector at large, it is proposed that the contextual dynamics of child harm via "county lines" must be understood in a broader sense, including how multi-agency child welfare practices contribute to the harm experienced by young people. Originality/value: There are limited peer-reviewed analyses of child welfare responses to "county lines". This paper contributes to that limited scholarship, extending the analysis by adopting a critical analytic framework to a regional county lines partnership at the juncture of future national, child welfare responses to "county lines". [ABSTRACT FROM AUTHOR]

Social media applications are used daily by billions to communicate. Adolescents living in state care are no different, yet the potential implications of their social media use are. Despite the global use of social media and evidence highlighting their role in social capital cultivation, how adolescents living in state care make use of social media remains unknown, with discussions tending to focus exclusively on risk. Using data from a four-year Digital Life Story Work (DLSW) research programme, this paper explores adolescents' and social care professionals' (n =45) perspectives on the everyday use of social media by adolescents living in state care. Using an ethnographic multi-method approach, extracts of conversations from the four English residential homes engaged in the DLSW programme were thematically analysed. Three major themes emerged; contacts as currency, promoting and protecting the self and transitions. Analysis illustrates how adolescents living in state care use social media as active digital agents and the need to reframe this usage to enable benefits to be enacted. The paper concludes that urgent research is needed to enable practitioners and policy makers to show a deeper appreciation of the potentials of social media, enabling a more balanced approach to succeed in practice. [ABSTRACT FROM AUTHOR]

Background: Young people moving from adolescent secure hospitals to adult care present with multiple and complex needs which often remain unmet during transition periods. This paper delineates the process of developing and co‐producing the moving forward intervention (MFi), which aims to address the psychosocial needs of transitioning youth who have limited access to well‐researched and tailored service provisions. Method: An extensive search of the relevant literature was conducted to generate themes and guide the co‐production phase. Fourteen Advisory Group Meetings were held virtually during COVID‐19 to design the MFi module content with 17 keyworkers, 2 parents and 13 young people aged 17–18 years across six adolescent secure hospitals in England. Thematic analysis was used to reflect on the field notes discussed in the Advisory Groups. Results: Co‐produced themes from the literature and the Advisory Groups informed the development of the proposed intervention. Three overarching themes pertinent to expectations in adult services, improving communication gaps between services and facilitating the letting go period emerged from the co‐production phase. It was suggested the MFi is co‐delivered by a peer with lived experience to build trust and create hopefulness among young people. The importance of promoting graded transitions through standardised procedures was highlighted. Conclusions: The current findings promote evidence‐based initiatives and build robust practice frameworks that inform treatment and policy guidelines. The young people, parents and keyworkers found the MFi supportive and valued the co‐production experience. As such, co‐production has been a vital tool in promoting patient engagement and empowerment, and reducing service inequalities, especially in adolescent secure hospitals. [ABSTRACT FROM AUTHOR]

Purpose This paper provides an overview of transitions across forensic child and adolescent mental health services in England and Wales. The purpose of this paper is to delineate the national secure services system for young people in contact with the youth justice system.Design/methodology/approach This paper reviews findings from the existing literature of transitions across forensic child and adolescent mental health services, drawing attention to present facilitators and barriers to optimal transition. The authors examine the infrastructure of current services and highlight gaps between child and adult service continuity and evaluate the impact of poor transitions on young offenders’ mental health and wellbeing.Findings Young offenders experience a broad range of difficulties, from the multiple interfaces with the legal system, untreated mental health problems, and poor transition to adult services. Barriers such as long waiting lists, lack of coordination between services and lack of transition preparation impede significantly smooth transitions.Research limitations/implications The authors need to develop, test and evaluate models of transitional care that improve mental health and wellbeing of this group.Practical implications Mapping young offenders’ care pathway will help to understand their needs and also to impact current policy and practice. Key workers in forensic services should facilitate the transition process by developing sustainable relationships with the young person and creating a safe clinical environment.Originality/value Transition of care from forensic child and adolescent mental health services is a neglected area. This paper attempts to highlight the nature and magnitude of the problems at the transition interface in a forensic context. [ABSTRACT FROM AUTHOR]

Child sexual exploitation (CSE) is a category of child abuse that was historically created to recognize the victimhood of children and young people, illuminating the ways that their evolving capacity to consent to sex is manipulated and undermined. Using evidence from the evaluation of specialist foster care provision and a CSE training course for foster carers, this paper considers how training might be used to widen the pool of potential foster carers for children affected by CSE and identifies qualities displayed by effective carers. It argues that improving the recruitment of foster carers can create safer home environments for teenagers at risk of or experiencing sexual exploitation and reduce the risk of further harm and that informed and effective foster care provision is crucial to prevent both the sexual exploitation of looked‐after teenagers and placement breakdowns that can ultimately increase risk. [ABSTRACT FROM AUTHOR]

Purpose: Teachers are often the first contact for students with mental health difficulties. They are in an ideal position to identify students who are struggling and frequently support them using different approaches and techniques. The purpose of this paper is to investigate secondary school teachers' experiences of supporting the mental health of their students. Design/methodology/approach: Seven secondary school teachers from state-funded schools in the UK participated in face-to-face semi-structured interviews. Interpretative phenomenological analysis was used to understand and structure the data into themes. Findings: Five superordinate themes emerged from the data analysis: perceived role of teacher, nature of relationship, barriers to helping the child, amount of training and resource, and helplessness and satisfaction. Participants described the lack of training, resource and clarity about their role to be causes of frustration. Internal and environmental factors often influenced participants' feelings of helplessness. Research limitations/implications: The findings from this study cannot be readily generalised to the wider population due to the nature of qualitative interviews. Practical implications: This study has led to a greater understanding of the experiences of teachers within a school setting. It is crucial that mental health training for teachers directly meets their needs and abilities. Originality/value: This paper finds value in recognising the lived experience and difficulties faced by teachers supporting students' mental health problems. A theoretical model is presented based on this analysis that can help inform best practice for schools. [ABSTRACT FROM AUTHOR]

The paper describes three stories of children and adolescents with atypical gender identity development followed in psychotherapy. These cases have already been published, but are revisited here to show how these experiences contributed to the creation of the therapeutic intervention model of the Gender Identity Development Service originally established in 1989 at St George's Hospital, London. The service transferred to the Tavistock Centre in 1996. The first case shows the gradual recognition of dealing with the development of an atypical gender identity rather than a psychiatric condition. Reflection on this case led to the definition of possible therapeutic goals. The second case illustrates the difference between solid and fluid identities, an important distinction in the decision to consider the possibility of physical intervention. The third case shows the network management model and addresses issues concerning autonomy. [ABSTRACT FROM AUTHOR]

During adolescence, risk to young people's safety shifts from familial to community contexts. Contextual safeguarding has emerged in response to this dynamic; by providing a conceptual framework through which to incorporate extra-familial contexts (and those who manage them) into traditionally family focused child protection systems. This paper uses Geographic Information System mapping techniques to explore the extent to which bus boarding data could be used to: target protective interventions in public spaces; evidence routes where young people may be vulnerable; and build local area problem profiles. In doing so it provides foundational evidence for including transport providers in contextual safeguarding systems. [ABSTRACT FROM AUTHOR]

Long-term unemployed young people are a ‘social concern’ in many countries. The focus for research is usually cities, but may also include rural areas. The qualitative study described in this paper focuses instead on four young people living in coastal towns in South East England. The study suggests that their experiences in education and employment markets are shaped, negatively, by their particular location and the ongoing opportunity structures. The paper outlines their views and discusses the three main themes that emerged from the analysis: opportunity structures, supported resilience and the impact of living in a coastal town. Implications for targeted youth guidance are considered, alongside a consideration of the reflexive role of the researcher in such work. [ABSTRACT FROM PUBLISHER]

ABSTRACT This paper presents findings from qualitative interviews with 24 young people (11-17 years) who have been referred to Children's Social Care Services in England. The paper explores young people's experiences of help seeking and their experiences of receiving help for maltreatment through statutory agencies. A central finding is the importance of relationships for young people when seeking and receiving help. It is through trusting relationships with professionals that young people are most likely to disclose maltreatment and/or engage with services. The paper concludes that young people's expectations and needs are not always met by the current safeguarding system and that the system needs to become more child-centred if it is to address the concerns maltreated young people have consistently voiced through research. [ABSTRACT FROM AUTHOR]

Trauma‐informed practice has been developing for decades, though much remains unknown regarding how it is understood and practised. Drawing upon focus group data from an evaluation of a trauma‐informed approach (TIA) implemented by an organisation in Southeast England, this paper provides a unique perspective of 31 staff members and 18 young people. Results indicate how choice and control, key elements of a TIA, align with the Capability Approach (CA). The CA is then used as a novel analytic framework to examine the data. A 'Trauma‐Informed Capabilities Approach' is introduced as a holistic, person‐centred way of conceptualising young trauma survivors' well‐being. [ABSTRACT FROM AUTHOR]

This paper describes the construction of the Athwal-Francis Scale of Attitude toward Sikhism, working in the tradition of the Francis Scale of Attitude toward Christianity, the Sahin-Francis Scale of Attitude toward Islam, the Katz-Francis Scale of Attitude toward Judaism, and the Santosh-Francis Scale of Attitude toward Hinduism. Drawing on data provided by 90 self-assigned 13- to 15-year-old Sikh students attending year-nine and year-ten classes in a state-maintained school in England with a Sikh foundation, the 24 items selected from a larger pool of items to comprise the Athwal-Francis Scale of Attitude toward Sikhism displayed good properties of internal consistency reliability and construct validity. No significant difference in mean scale scores was found between male students and female students, or between year-nine students and year-ten students. The instrument is commended for further use. [ABSTRACT FROM AUTHOR]

Food insecurity in the UK is a pressing concern that is associated with poor health outcomes. Research to date has focused on the challenges for adults in providing food for families. However, there is little evidence showing how children and young people experience food insecurity, particularly outside of the home and school. This paper, drawing on 14 months of ethnography in a youth club in the North of England, explores how young people manage food insecurity. In this youth club, the circulation of takeaway food is part of an informal network where boys purchase, share and receive food. This practice allows the boys to participate meaningfully within their peer groups whilst also providing stable access to food. This peer practice, however, was not available to everyone. This was a gendered practice that for the girls held little benefit due to their concerns about eating and pressure to provide for others. Instead, some girls depend on romantic relationships for food provision that is equated with affection and care. The findings will be discussed through a 'materialities of care' perspective to explore the complex ways in which food as a practice of care is part of everyday routines embedded within local places. [ABSTRACT FROM AUTHOR]

This paper provides an overview of research about adolescent neglect funded by the Department of Children, Schools and Families (now the Department for Education) and the Department of Health. The paper examines what is known from literature about the causes of adolescent neglect, together with its potential consequences for well-being. Drawing on qualitative data, the concept of neglect is explored from the perspectives of young people themselves and the professionals who work with them. Consideration is given to examples of interventions and preventative models geared towards addressing adolescent neglect. Key findings indicate that there is a need for both a re-examination of current definitions of neglect in the light of age-related distinctions and perspectives, and a fuller understanding of the particular needs of adolescents who are experiencing neglect. Additionally, the research highlights that there is a lack of research knowledge about neglectful parenting and the behaviour of young people, as well as limited understanding of interventions with neglected adolescents. Key themes from the research are discussed in terms of their implications for future practice, policy and research in relation to working to improve the welfare of neglected young people. [ABSTRACT FROM AUTHOR]

There is a prevalent view in England that family-based care is the preferred placement option for children placed in out-of-home care. Nonetheless, it is acknowledged that for some young people residential group care can offer the best chance of positive outcomes, transition, and in some cases a route to permanence. With an emphasis on innovation, there has been a recent governmental focus on the role and purpose of these placements. This conceptual paper explores how the political and legislative context has influenced the current opinion and use of residential care, as well as examining the importance of factors such as attachment and relationships, parenting/intervention, the notion of home, a sense of belonging, and adolescent development. Evidence exploring associated risk and resilience factors is also discussed. We question whether adopting a child development perspective and moving the discourse away from placement type to placement purpose would better support children and young people to fulfill their life chances. Residential care undoubtedly offers a different experience to that of family-based care, although, further research assessing a wider range of attributable outcomes is necessary to understand how policy and practice can intervene to best support development and opportunity for children placed in out-of-home care. [ABSTRACT FROM AUTHOR]

This paper presents findings from a comparative study of peer- and teacher-led Sex and Relationship Education (SRE). One lesson delivered by a peer educator, and one lesson delivered by a teacher was observed with the aim of exploring the communicative process between educators and students within SRE. It is claimed that open communication between students and peer educators promotes the adoption of positive attitudes to sexual health, making it a potential alternative to teacher-led provision. Yet to our knowledge, no studies have investigated the communicative process within peer-led adolescent health interventions to examine factors underpinning its potential efficacy. The development of a coding scheme to measure the extent to which educators and students are communicating openly within SRE is used to describe the communicative process between sex educators and students, characterise differences in communication within peer- and teacher-led conditions and discuss how these differences affect student participation in SRE. Results suggest interaction of students in the peer-led condition was different to that of students receiving teacher-led SRE; and provide valuable insight into educator-student communication in the context of classroom-based SRE. [ABSTRACT FROM AUTHOR]

Caregiving is recognised as a source of stress with potential for negative health impacts as well as positive outcomes and development of resilience. For young carers, children, and adolescents providing care for close family members, adaptation through resilience is crucial, yet work using a resilience approach is limited. This study explored protective factors and pathways to resilience in a sample of young carers, through application of the socioecological model in caring relationships. An in-depth qualitative approach was used, with in-person interviews facilitated by auto-driven photo elicitation. Deductive thematic analysis was applied, framed by three levels (individual, community, and society) of the socioecological model of resilience. Twelve participants (nine girls and three boys) aged 5–18 years, each providing care to a family member, were recruited using opportunity and volunteer sampling via carers' centres in the southwest of England. Ten key themes were identified, four at the individual level: pre-empting challenges and planning, cognitive strategies, emotional strategies, and seeking solitude; three at the community level: family support, friendships, and pets and inanimate objects; and three at the society level: professional support, access to caregiver activities and community, and being outdoors. The location of themes at each level indicated relevance of the socioecological model to identification of protective factors in a young carer population. These findings have important applications for guidance to charities and organisations supporting young carers. Identification of factors that promote resilience offers support for the development of well-informed interventions, which harness these protective factors to develop resilience and improve health for young carers. [ABSTRACT FROM AUTHOR]

Satisfaction with service-related choices has not received much research attention, especially beyond medical/health-related decisions. This paper reports findings from an analysis of parents' accounts of making service-related choices with, or on behalf of, a disabled son or daughter with a degenerative condition. It focuses particularly on factors and processes, which contribute to parents' satisfaction. This is particularly interesting given that sub-optimal outcomes or negative consequences are often experienced following a service-related choice being implemented. The data reported here were collected as part of a larger, longitudinal study (the Choice and Change project) of service users' experiences of choice-making, including the outcomes and consequences of those choices. Parents of disabled young people with degenerative conditions formed part of this sample. The accounts of 14 of these parents, collected over three interviews during a two and a half-year period, all of whom expressed satisfaction with the medium- to long-term outcomes of a service-related choice, were selected for specific analyses to understand what underlies satisfaction with service-related choices. Clarity of the desired outcome for the young person supported effective decision-making and led parents to feel confident that the best possible choice was being made. Evidence of desired outcomes being attained were used by parents to 'trade off' the negative consequences of a choice. These included the considerable demands placed on parents' personal, financial and practical resources to operationalise a choice, and the emotional impact incurred by significant changes such as the loss of the carer role. The passage of time was important in allowing evidence of positive outcomes to emerge, psychological or emotional adjustments to be made, and for parents to develop trust in new service providers. The findings suggest that practitioners can have an important role in both practical and emotional support for parents' choice-making for, or with, their disabled son/daughter. [ABSTRACT FROM AUTHOR]

Background: It is recognized that children from areas associated with socioeconomic disadvantage are at an increased risk of delayed language development. However, so far research has focused mainly on young children and there has been little investigation into language development in adolescence. Aims: To investigate the language abilities of adolescents from two different socioeconomic areas. The paper aims to determine if a higher proportion of adolescents from an area of socioeconomic disadvantage have low language scores when compared with adolescents from a relatively advantaged area. Methods & Procedures: Six standardized language assessments were used to measure expressive and receptive language skills across vocabulary, syntax and narrative in two cohorts of 13 and 14 year olds: one cohort attending a school in an area of socioeconomic disadvantage (103 participants) and the other cohort attending a school in an area of relative socioeconomic advantage (48 participants). Outcomes & Results: The cohort from the area of disadvantage performed significantly lower than the assessments' normative mean on all measures of language ability. There were significant differences between the two cohorts on four of the six language measures. More adolescents from the school in the area of socioeconomic disadvantage had standardized assessment scores that suggest hitherto undetected language difficulties. Conclusions & Implications: Results suggest that socioeconomic background is associated with language ability in adolescence as measured by standardized tests. In particular, adolescents from an area of socioeconomic disadvantage were at risk of low vocabulary scores. The advantages and disadvantages of using standardized language assessments are discussed and the implications for clinical and educational practice and for school level policies are highlighted. [ABSTRACT FROM AUTHOR]

This paper presents findings from a Department of Health-funded study into the emotional well-being of young people seeking asylum on their own in the UK. It discusses how young people accounted for only partly disclosing information about the circumstances surrounding their quest for asylum and subsequent aspects of their lives since arriving in the UK. Foucault's panoptic mechanism and its focus on the effects of power as dispersed through scrutiny are applied as a theoretical framework to contextualise these experiences. The paper shows that young people's decisions about how much of their current or past lives they share with others are more complex than indicated by earlier research. The paper argues that, for many young people, the predominant impetus for selective disclosure was a desire to retain a degree of agency as they navigated their way through immigration, asylum, social care, health and education systems and simultaneously sought to establish themselves in the social world. These findings have implications for how social care (and other) professionals engage and work with young people seeking asylum alone. [ABSTRACT FROM PUBLISHER]

Objectives Young people in the public care system ('looked-after' young people) have high levels of self-harm. Design This paper reports the first detailed study of factors leading to self-harm over time in looked-after young people in England, using sequence analyses of the Card Sort Task for Self-harm (Ca TS). Methods Young people in care (looked-after group: n = 24; 14-21 years) and young people who had never been in care (contrast group: n = 21; 13-21 years) completed the Ca TS, describing sequences of factors leading to their first and most recent episodes of self-harm. Lag sequential analysis determined patterns of significant transitions between factors (thoughts, feelings, behaviours, events) leading to self-harm across 6 months. Results Young people in care reported feeling better immediately following their first episode of self-harm. However, fearlessness of death, impulsivity, and access to means were reported most proximal to recent self-harm. Although difficult negative emotions were salient to self-harm sequences in both groups, young people with no experience of being in care reported a greater range of negative emotions and transitions between them. For the contrast group, feelings of depression and sadness were a significant starting point of the self-harm sequence 6 months prior to most recent self-harm. Conclusions Sequences of factors leading to self-harm can change and evolve over time, so regular monitoring and assessment of each self-harm episode are needed. Support around easing and dealing with emotional distress is required. Restricting access to means to carry out potentially fatal self-harm attempts, particularly for the young persons with experience of being in care, is recommended. Practitioner points Self-harm (and factors associated with self-harm) can change and evolve over time; assessments need to reflect this., Looked-after young people reported feeling better after first self-harm; fearlessness of death, access to means, and impulsivity were reported as key in recent self-harm., Underlying emotional distress, particularly depression and self-hatred were important in both first and most recent self-harm., Looked-after young people should undergo regular monitoring and assessment of each self-harm episode and access to potentially fatal means should be restricted., The CaTS would have clinical utility as an assessment tool, Recruiting participants can be a significant challenge in studies with looked-after children and young people., Future research with larger clinical samples would be valuable. [ABSTRACT FROM AUTHOR]

Background: Not being in employment, education, or training (NEET) is associated with poor health (physical and mental) and social exclusion. We investigated whether England's statutory school readiness measure conducted at 4–5 years provides a risk signal for NEET in late adolescence. Methods: We identified 8,118 individuals with school readiness measures at 4–5 years and NEET records at 16–17 years using Connected Bradford, a bank of linked routinely collected datasets. Children were categorised as 'school ready' if they reached a 'Good Level of Development' on the Early Years Foundation Stage Profile. We used probit regression and structural equation modelling to investigate the relationship between school readiness and NEET status and whether it primarily relates to academic attainment. Results: School readiness was significantly associated with NEET status. A larger proportion of young people who were not school ready were later NEET (11%) compared to those who were school ready (4%). Most of this effect was attributable to shared relationships with academic attainment, but there was also a direct effect. Measures of deprivation and Special Educational Needs were also strong predictors of NEET status. Conclusions: NEET risk factors occur early in life. School readiness measures could be used as early indicators of risk, with interventions targeted to prevent the long-term physical and mental health problems associated with NEET, especially in disadvantaged areas. Primary schools are therefore well placed to be public health partners in early intervention strategies. [ABSTRACT FROM AUTHOR]

Migration scholars have long regarded the trajectory of the third generation as a critical test of assimilation; however, scholarship to date has been limited and largely focused on socioeconomic attainment. In this article, we rely on a large dataset of adolescent respondents in England, Germany, and the Netherlands to compare the second and third generations in terms of their social networks and cultural identities. The third generation shows stronger ties to the native fourth-plus generation alongside weaker ties to coethnics. We document comparable, albeit more moderate, dynamics of assimilation over generations in regard to national and ethnic identification, along with substantial variation by country of destination and ethnic origin group. Our results point to a dominant trend of assimilation at the third generation and suggest future challenges to provide a more durable assessment of postwar migration waves two generations after settlement. [ABSTRACT FROM AUTHOR]

Background.Depression and anxiety persist within and across diagnostic boundaries. The manner in which common v. disorder-specific genetic and environmental influences operate across development to maintain internalizing disorders and their co-morbidity is unclear. This paper investigates the stability and change of etiological influences on depression, panic, generalized, separation and social anxiety symptoms, and their co-occurrence, across adolescence and young adulthood.Method.A total of 2619 twins/siblings prospectively reported symptoms of depression and anxiety at mean ages 15, 17 and 20 years.Results.Each symptom scale showed a similar pattern of moderate continuity across development, largely underpinned by genetic stability. New genetic influences contributing to change in the developmental course of the symptoms emerged at each time point. All symptom scales correlated moderately with one another over time. Genetic influences, both stable and time-specific, overlapped considerably between the scales. Non-shared environmental influences were largely time- and symptom-specific, but some contributed moderately to the stability of depression and anxiety symptom scales. These stable, longitudinal environmental influences were highly correlated between the symptoms.Conclusions.The results highlight both stable and dynamic etiology of depression and anxiety symptom scales. They provide preliminary evidence that stable as well as newly emerging genes contribute to the co-morbidity between depression and anxiety across adolescence and young adulthood. Conversely, environmental influences are largely time-specific and contribute to change in symptoms over time. The results inform molecular genetics research and transdiagnostic treatment and prevention approaches. [ABSTRACT FROM PUBLISHER]

This paper reports on a study of experiences of young people aged 14 to 18 years who were nursed on acute adult hospital wards in NHS hospitals in England. In spite of British government guidelines, young people from 14 years of age continue to be admitted to adult wards in the UK. Although much has been written about the transition of the young person to adult services, there is little research about the experiences of young people who are nursed on adult wards. Hermeneutic phenomenology was used to explore the lived experiences of eight young people who had been nursed on adult wards between 2004 and 2010. Data were collected in 2010. In-depth interviews were recorded, transcribed and analysed using Colaizzi’s framework (Colaizzi, 1978). Themes explored included expectations of what the experience may be like, young people’s first impressions of the ward environment, the feelings of the young person while in hospital, the attitudes of people towards them including, both staff and other patients, and future admissions and how they would cope with readmissions. Better provision needs to be made for young people including appropriately trained staff, adolescent-friendly environments and areas in adult wards that are dedicated to adolescents. [ABSTRACT FROM AUTHOR]

Background Adolescent mental health (AMH) needs in England have increased dramatically and needs exceed treatment availability. This study undertook a comparative assessment of the health and economic return on investment (ROI) of interventions to prevent and treat mental disorders among adolescents (10–19 years) and examined intervention affordability and readiness. Methods Interventions were identified following a review of published and grey literature. A Markov model followed a simulated adolescent cohort to estimate implementation costs and health, education, and economic benefits. Intervention affordability was assessed, comparing annual cost per adolescent with NHS England per capita spending, and an expert panel assessed intervention readiness using a validated framework. Results Over 10- and 80-year horizons, interventions to treat mild anxiety and mild depression were most cost-effective, with the highest individual lifetime ROI (GBP 5822 GBP 1 and GBP 257: GBP 1). Preventing anxiety and depression was most affordable and 'implementation ready' and offered the highest health and economic benefits. A priority package (anxiety and depression prevention; mild anxiety and mild depression treatment) would avert 5 million disability-adjusted life-years (DALYS) and achieve an ROI of GBP 15: GBP 1 over 10 years or 11.5 million DALYs (ROI of GBP 55: GBP 1) over 80 years. Conclusion The economic benefits from preventing and treating common adolescent mental disorders equivalent to 25% of NHS England's annual spending in 2021 over 10 years and 91% over 80 years. Preventing and early treatment for anxiety and depression had the highest ROIs and strong implementation readiness. [ABSTRACT FROM AUTHOR]

Across Europe and North America, few young people meet the recommended levels of physical activity (PA) of 1 hour of moderate to vigorous PA per day. However, the lives of young people cannot simply be polarised as either completely sedentary or active. Drawing on findings from the World Health Organization Health Behaviour in School-aged Children cross sectional international study, this paper examines the domains of adolescent life associated with young people's participation in overall PA, including health behaviours, social relationships and family activities. Consideration is also given to gender differences. Information in England was collected from 4404 students aged 11, 13 and 15 years, using anonymised self-completed questionnaires. Physical aspects of lifestyle were determined using internationally validated items for measuring PA that met international guidelines for activity and the frequency and duration of vigorous exercise undertaken during leisure activities. Separate analyses were conducted for boys and girls. Levels of PA and vigorous exercise were compared using the chi-squared test for trend. The findings draw attention to the value for the health and well-being of young people participating in some form of PA, even if they do not meet the recommended levels. Medium levels of PA appear to be associated with high levels of life satisfaction, self-rated health and an improved sense of body image. Significant health gains are likely to be made for adolescents in encouraging sedentary young people to undertake some form of PA. [ABSTRACT FROM PUBLISHER]

Child protection social work's current concern remains largely with offline harm and injury and separate from the focus on child protection in relation to risks online and children's use of computer-mediated communication and the internet. This paper draws on original research reporting children's methods for assessing who they are talking to online, as part of a wider study designed to develop software tools for improved online child safety. It finds that children use similar methods to detect identity online as they do offline, reinforcing the interconnections between mediated and unmediated communication and an ontology of childhood in a digital world that is neither online nor offline, but both. Drawing on the concept of cyborg youth and understanding contemporary child protection in this context allows a re-visioning of the social work role that demands attention to computer-mediated literacy in the assessment of all vulnerable children and in the support of their parents and carers. [ABSTRACT FROM PUBLISHER]

This paper analyses data from a focus group conducted with a group of female pupils aged 13–14 to re-examine the assumption that pupils' negative assessments of sex and relationship education (SRE) should be understood only as a reflection of inadequate teaching. Focusing on the emotional aspects of their accounts, and the inconsistencies in their efforts to present a collective story of SRE, findings suggest that there are other ways in which such accounts can be read. Drawing on insights from psychoanalytic theory concerning the emotional aspects of learning and the teacher–pupil relationship, it is suggested that these accounts can also be understood as a result of transference. Using psychoanalytic understandings of the role of sexual learning in adolescence, findings reveal that pupils' relationships to SRE are complex and need to be understood as being tied up with internal struggles and anxieties about their own sexual development. This reading is presented as an additional perspective for teachers and is one that would benefit from further exploration. [ABSTRACT FROM PUBLISHER]

Abstract: Excessive alcohol consumption among young people in England regularly features in national media and has been a focus of recent academic research and government policy. Though the majority of young people do not regularly drink excessively, heavy sessional drinking – ‘binge’ drinking – is associated with negative health and social consequences for those who do. Alcohol-related health problems in young people are not spread consistently across England, however, and while there are significant intra-regional differences, northern regions fare worse overall than those in the south. This paper draws on an 18-month project which explored differences in the physical, social and regulatory environments (highlighted by previous research as influential) in two locations with contrasting alcohol harm profiles. The paper focuses on the lives of 15–16 year olds and examines potential differences that influence behaviour at this crucial age; and in particular issues that might presage risky and/or harmful drinking in young adulthood. The study examines evidence from young people themselves (activity diaries and interviews); stakeholder interviews; and observation analysis. The study finds social practices in the two areas to be largely similar; moreover, the collectivised and social nature of alcohol consumption suggests sources of influence from a wider context, beyond immediate family and friendship groups. However these social practices were acted out in locations with very different physical characteristics, in particular these related to the availability of non-alcohol focused leisure activities and the spatial arrangement/visibility of adult drinking culture. [Copyright &y& Elsevier]

The aim of the current paper was to examine externalizing and internalizing behaviors in adolescents with gender dysphoria. One hundred forty-one young people (84 natal females and 57 natal males, M age = 15.13, SD = 1.70) attending the Gender Identity Development Service in London completed the Youth Self Report form at the end of the assessment period (4 to 6 sessions). The main findings indicated that, overall, the adolescents showed significantly more internalizing than externalizing behaviors. Using cutoff points provided by Achenbach and Rescorla (2001), the mean internalizing score fell within the clinical range and the mean externalizing score within the normal range. There was also a significant positive relationship between these two behaviors both in the natal females and the natal males. The natal males presented with significantly more internalizing behaviors than the natal females; however, no significant difference was observed between the genders in terms of the number of externalizing behaviors and total problems. We discuss the implications of these findings with regard to clinical work. [ABSTRACT FROM AUTHOR]

Purpose – Research to date has identified young people's perspectives on a number of health-related topics such as smoking, alcohol, sexual health, physical activity and healthy eating. Whilst this body of research draws important attention towards young people's views on topical health concerns, it arguably remains located within a pre-defined agenda; thereby marginalising young people's own, and potentially different, frames of reference when discussing health. In light of this omission, the aim of this paper is to examine young people's own understandings of health in line with their own frames of reference. Design/methodology/approach – Data were collected from 55 young people aged 15-16 years through group discussions, individual interviews and observational data in a school and surrounding community settings. Key themes were analysed for their implications for "emic" conceptualisations of health. Young people's perspectives were further compared with accounts given by professionals. Findings – Two key themes emerged from young people's accounts: being happy and having fun. Young people's meanings of being happy highlighted the relational components of developing a positive self-belief, pointing to a number of socially located prerequisites for promoting their health. Discussions of having fun were understood as potentially liberating, resistive and subversive, but which exist in some tension with adults' discourses of risk and risk-taking. Originality/value – Examining young people's accounts points to the possibility of a more positive discourse on health – opening up new opportunities and insights for health promotion informed by concepts of empowerment. [ABSTRACT FROM AUTHOR]

Factors that contribute to sexual decision-making among young people are varied, and several determinants have been identified as contributing to the process. However, the influential role of music preference has been sidelined both in the literature and by sex and relationships educators. The research outlined in this paper explores the normative impact of music preference, and highlights the importance of influences drawn from teen culture. A preliminary study had indicated that representations of sex and relationships within lyrics were found to be genre specific. The main study comprised six single-sex focus group discussions on music and sex with young people aged between 14 and 19 years. Thematic analysis revealed that preferred genre and artists were found to be associated with all aspects of participants' lives and culture generally, with music functioning specifically as an educational tool for adult relationships. The findings from these studies indicate that the norms portrayed by young people's preferred genres reinforce (oftentimes inappropriate) beliefs about sex and adult relationships. [ABSTRACT FROM AUTHOR]

This paper describes brief work with pregnant teenagers, adolescent mothers, their infants and their wider families, a group who would not ordinarily seek treatment in child and adolescent mental health services. The work takes place in a community context in London and includes a home visiting service for young people unable to attend appointments in an advanced stage of pregnancy or in the early weeks of new motherhood. Accounts of emotional deprivation, disrupted care and separation in early childhood are often a feature of the history of many of these adolescents. Two case examples are considered in some detail. It is argued that for some young people, embarking on parenthood in adolescence is accompanied by the displaced attempt at repairing their own early relationships, as an alternative to the painful work of mourning. [ABSTRACT FROM AUTHOR]

This paper reports on the observation of a teenage mother of black British identity and her baby, living with her parents in a cosmopolitan city in England. It focuses on the way in which this young mother managed the developmental tasks of adolescence, alongside the infantile developmental tasks of her baby. The issue of facing the more depressive aspects of her situation were particularly significant. [ABSTRACT FROM AUTHOR]

This paper is based on my experience of working in an outpatient centre for adolescents at risk in a North London borough. The paper focuses on the pressures encountered when adolescent patients want to stop treatment prematurely, and on the risks of re-enactment in the transference. Clinical material is presented from the treatment of an adolescent girl who resorted to cutting herself when she had to face new developmental stages. Her unresolved Oedipal anxieties as well as possible meanings of the nature of her self-destructive behaviour are explored. Finally I attempt to explore how my struggles with letting her go contributed to her psychic development, which has continued since the end of the therapy. [ABSTRACT FROM AUTHOR]

Background: Post-COVID services have been set up in England to treat children with ongoing symptoms of Long COVID. To date, the characteristics of children seeking treatment from these services has not been described. Purpose: (1) to describe the characteristics of children aged 11–17 referred to the Pan-London Post-COVID service and (2) to compare characteristics of these children with those taking part in the United Kingdom's largest research study of Long COVID in children (CLoCk). Design: Data from 95 children seeking treatment from the Post-COVID service between May 2021 and August 2022 were included in the study. Their demographic characteristics, symptom burden and the impact of infection are described and compared to children from CLoCk. Results: A high proportion of children from the Post-COVID service and CLoCk reported experiencing health problems prior to the pandemic. Almost all Post-COVID service children met the research Delphi definition of Long COVID (94.6%), having multiple symptoms that impacted their lives. Symptoms were notably more severe than the participants in CLoCk. Conclusions: This study describes the characteristics of children seeking treatment for Long COVID compared to those identified in the largest longitudinal observational study to date. Post-COVID service children have more symptoms and are more severely affected by their symptoms following infection with COVID-19 than children in the CLoCk study. Research to understand predisposing factors for severity and prognostic indicators is essential to prevent this debilitating condition. Evaluation of short- and long-term outcomes of interventions by clinical services can help direct future therapy for this group. [ABSTRACT FROM AUTHOR]

The Strengths and Difficulties Questionnaire (SDQ) has been widely used to study children's psychosocial development longitudinally; however, such analyses assume longitudinal measurement invariance, that is, they presuppose that symptom manifestations are measured comparably across different ages. Violations of this assumption could bias longitudinal analyses and should therefore be empirically tested. This study tested longitudinal measurement invariance within a confirmatory factor analysis framework in the U.K.-based Avon Longitudinal Study of Parents and Children (N = 13,988). Results indicated that SDQ scores showed configural, metric, scalar, and residual invariance across ages 7, 8, 9, 11, 13, and 16, supporting its use for comparing variances, covariances, and means over time within a latent variable model as well as using observed scores. At age 4, configural invariance was not supported, indicating that mental health symptoms as measured by the SDQ manifest differently at this age, thus necessitating caution when comparing symptoms as measured by SDQ scores at this age to later ages. [ABSTRACT FROM AUTHOR]

Background: Early Intervention in Psychosis (EIP) services have been implemented with the dual aims of preventing harmful outcomes associated with early‐onset psychosis and improving prognosis. However, concerns have been raised regarding the ethical implications of involving young people in EIP services. One way to ensure high ethical standards and promote good practice in EIP delivery is through governance of clinical practice. This study aimed to investigate the normative dimensions of good practice in EIP through examination of clinical guideline documents published in England over the past 15 years. Methods: A total of 14 clinical guidelines and relevant policy documents for EIP were retrieved and analysed using a mixed inductive and deductive thematic approach. Themes were derived from the data itself, whereas the development of broader categories was performed through a constant comparison with the scientific literature describing ethical issues in EIP. Results: Ethical touchpoints of good practice in EIP included both procedural and substantive factors, which were seen to be interdependent and mutually constitutive. These ethical touchpoints were largely implicit in the documents analysed. Procedural requirements of EIP service delivery consisted of norms and rules pertaining to EIP service structure, adherence to codes of ethics, inclusivity, patient and family centredness and appropriate treatment provision. Substantive factors consisted of moral attributes that should be cultivated by healthcare professionals working in EIP: competency, empathy, sensitivity and trustworthiness. Conclusions: We argue that, to ensure good practice in EIP, procedural and substantive ethical expectations embedded in EIP guideline documents should be made explicit in EIP service and care delivery. We suggest that the procedural and substantive factors highlighted in this paper contribute useful dimensions for the eventual evaluation of good practice in EIP services across England. [ABSTRACT FROM AUTHOR]

The SECURE STAIRS framework promotes trauma informed understanding and training across the workforce to inform work with children and young people. A component of the framework is the 'Trauma Informed Practice with Children and Young People in Secure Settings' (TIPSS) training programme for multidisciplinary staff. Between November 2020 and May 2021, a total of 123 members of multidisciplinary staff from a Secure Children's Home (SCH) in the North East of England attended five-day TIPSS training. A pre-post repeated measures design was adopted. Paired samples t-tests were used to analyse pre- and post- questionnaires regarding self-reported levels of (i) knowledge, (ii) understanding and (iii) confidence across Attachment and Developmental Trauma, Understanding Complex Behaviour and Trauma Informed Care training modules. Staff reported significant (p ≤.001) post-training improvements in knowledge, understanding, and confidence across all three training modules. Implications of findings are discussed, and further developments outlined. [ABSTRACT FROM AUTHOR]

There is an absence of evidence supporting the use of 'out-of-area placements' to address risks adolescents face beyond the home. Approximately one in ten adolescents in England and Wales are 'relocated' from their hometowns by children's social care teams due to these risks. Initial findings from the Independent Review of Children's Social Care in England situate these relocations as a 'failure' to safeguard teenagers. Using participatory approaches to research design and data collection, this article asks what do we learn about the impact of relocations when we ask about safety? Activity-based, qualitative interviews were conducted with young people (n  = 5), parents (n  = 3) and professionals (n  = 15) based in England and Scotland between 2020 and 2021, asking what worked and what didn't when a relocation was chosen, and what was the perceived impact on safety. Interview data were thematically analysed in collaboration with young people and a Research Advisory Group of professionals, all with expertise in the area. Data indicated a tension between what professionals, and then parents and young people, thought was significant when planning relocations and an ambivalence about the impact of relocations. Considerations for safety planning are suggested to support young people's holistic safety needs. [ABSTRACT FROM AUTHOR]

Background The protective effect of community water fluoridation (CWF) against dental caries may be modified by secular changes in health behaviour. We aimed to determine the contemporary association between fluoride in public water supplies (PWS) and dental caries indicators and inequalities in England. Methods We estimated exposure to CWF and PWS fluoride concentrations from national monitoring data, using Geographic Information Systems and water supply boundaries, categorizing mean period exposure into <0.1, 0.1–<0.2, 0.2–<0.4, 0.4–<0.7 and ≥0.7 mg/l. We used area-level health outcome and confounder data in multivariable regression models to determine the association between fluoride and caries outcomes and calculated preventive fractions using these coefficients. Results The odds of caries and of severe caries in 5-year-olds fell with increasing fluoride concentration in all SES quintiles (P  < 0.001 to P  = 0.003). There was a negative trend between increasing fluoride concentration and dental extractions (P  < 0.001). Compared to PWS with <0.2 mg/l, CWF prevented 17% (95% confidence interval (CI): 5–27%) to 28% (95% CI: 24–32%) of caries (high-low SES) and 56% (95% CI: 25–74%) of dental extractions. The association between fluoride concentration and caries prevalence/severity varied by socioeconomic status (SES) (P  < 0.001). Conclusions Exposure to fluoride in PWS appears highly protective against dental caries and reduces oral health inequalities. [ABSTRACT FROM AUTHOR]