A small number of young people will go on to commit much of this country’s most violent crimes. Natalie Valios finds out how practitioners can assess the risk factors before this extreme behaviour becomes persistent
Murder, rape and serious physical assault are crimes seldom associated with children. Nevertheless, every council area is thought to contain, on average, seven children whose dangerous behaviour results in them committing the most violent crimes.
The estimate comes from research for a book published last year on the main risk factors and the best types of intervention and care for these children.(1) Although the number might not seem that high – extrapolated to all local authorities in England and Wales it comes to about 1,000 children – this small group will be responsible in later life for a large part of the country’s most serious and persistent crimes.
The risk factors – neglect, emotional abuse, domestic violence, school failure, poor parenting, an antisocial and deprived lifestyle – may look little different from those affecting other young people who end up in the youth justice system. But it is the accumulation of risk factors that characterises this much smaller group’s persistent extreme violence.
Few specialist services
Because of scarce specialist provision at an early age, such as residential school placements, foster care, family placements, therapeutic input, assessments or forensic advice, the children have often reached adolescence before their behaviour is serious enough to force professionals to respond.
NCH-The Bridge director Renuka Jeyarajah-Dent, who co-edited the book, says: “The picture is of an ad hoc range of services because for each local authority to do something means investing a lot of money on a small group of children. Social services end up trying to sort the problem.”
Jenny Boyd, service manager for looked-after children at the London Borough of Tower Hamlets, recognises this. “Every local authority has access to child and adolescent mental health services (Camhs) at the very least so would look to them to provide assistance with diagnosis and treatment. But more usually you would have to refer to specialist resources. We need social workers with good assessment skills and knowledge of where to seek help and where and when to refer. It’s expensive, particularly if you need residential care.”
And this is the crux, says Boyd. “We know the risk factors but it can be difficult to distinguish which child will go on to be extremely dangerous. So it can be difficult to get funding [for specialist resources] on the basis that you are predicting something that hasn’t happened yet.”
But early intervention is the key, says Vivian Hill, a consultant educational psychologist at the Institute of Education, University of London. “Between one and two [of these children] are present in each age cohort, not just at adolescence. But there is an impoverished level of service with them early on so their needs escalate until they reach 15 and they have bounced through every service.”
One day a week Hill works for a local authority dealing with two schools, as well as supervising trainee educational psychologists all over London and the Home Counties. Within her practice Hill is aware of recent high-profile cases where young men have been involved in serious crime.
In the past couple of years she has worked with several primary school-aged children who have been engaged in serious and dangerous behaviour, placing both themselves and others at risk as a result of violent and aggressive behaviour, bringing used syringes into school and acting as sexual predators.
“It’s only when a child does something as extraordinary or dangerous as this that they get a response,” she says. “The inability to respond and prioritise some cases over others, early on, means we end up with these extreme behaviours.”
When working with such cases Hill activates a multi-professional network around the child with social services, Camhs, the school and family. The first thing to do is to try to understand the child’s history and patterns of attachments with their carers. “With very young children it might be working on behaviour, developing friendships and empathy, expressing emotions, thinking about the impact of their actions on others. If older children have the language skills I might try cognitive behavioural therapy where we are trying to change the way they think.”
In extreme cases a child may need to move to an in-patient setting, others might be placed in a special school with fewer pupils and more staff. But if they stay in a mainstream school Hill works closely with teachers to provide advice and guidance.
She says: “Aggression is fairly persistent and difficult to undo. The longer down the road of deviance and disaffection they are allowed to travel the harder it is to change the outcomes. By the time children are properly identified at a local authority level they have already been around for a period of time and are in trouble.”
The key issue is that young people who show the more persistent forms of this aggressive behaviour start early, says Friedrich Losel, director of the Institute of Criminology at the University of Cambridge. A clinical and forensic psychologist, Losel contributed to the book: “Conduct problems often start by the age of five and about 40 per cent go on to become more serious and persistent as the child gets older. This is why it’s important to develop and implement measures to stop it relatively early.”
There are three categories of programme that can be used, says Losel.
● Universal prevention where social services are in contact with all families. This could also be used as a “foot in the door” technique for more intensive services to interact with families.
● Selective prevention where social services focus on families at risk, such as young, single mothers.
● Indicated prevention, where social services make a clear assessment of the child’s development when they have already shown some aggressive behaviour, such as fighting, disobeying parents, or fire setting.
“If the child shows these behaviours in more than one social context, such as at school and at home, then this is an early indicator,” says Losel. “The problem is that these families often think this is normal which is why professionals have an important warning function because they are more neutral in recognising the problem.
“Research has given us a relatively sound knowledge of risk factors and there are a number of programmes but we need better evaluation about which ones are successful in the long-term and we need an integrated policy on this. We should avoid trial and error strategy. We need some indicators to show what kind of programme is needed for what kind of family at what time.”
But nothing will “magically work” unless the general problems are made right first, says Jeyarajah-Dent. “They need what every child needs – consistency of care and education – before you can give them anything more specialist.” Then programmes must be well structured with detailed individual casework, with staff trained and supervised to match the child’s needs. “There must be adequate endurance – this is not quick fix – and adequate intensity,” she adds.
The message she wants to emphasise is that there needs to be a centralising of specialist experience and a development of ways to use this to provide support and supervision at a local level to those doing the work on the ground. “Staff need access to people who have worked with this population before, you can’t just use the local Camhs.”
The longer it takes to intervene, the more intensive the problems become and the more it costs to deal with. Estimates from the US show that each child with dangerous and violent behaviour costs society about £1m from childhood up to early adulthood. These costs include special pre-school, school, intensive foster care, residential care, psychiatry, social services, health services, involvement with criminal justice and damages to others.
Professionals never like to think that there is a point at which it is too late to turn around a child’s life, but for these children Jeyarajah-Dent says: “As they reach adolescence the probability of changing the course of their life gets less and less.” CC
(1) A Hagell, R Jeyarajah-Dent (eds), Children Who Commit Acts of Serious Interpersonal Violence: Messages for Best Practice, Jessica Kingsley Publishers, 2006
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