Implementing the United Kingdom's ten-year teenage pregnancy strategy for England (1999-2010): how was this done and what did it achieve?

In 1999, the UK Labour Government launched a 10-year Teenage Pregnancy Strategy for England to address the country's historically high rates and reduce social exclusion. The goal was to halve the under-18 conception rate. This study explores how the strategy was designed and implemented, and the features that contributed to its success. This study was informed by examination of the detailed documentation of the strategy, published throughout its 10-year implementation. The strategy involved a comprehensive programme of action across four themes: joined up action at national and local level; better prevention through improved sex and relationships education and access to effective contraception; a communications campaign to reach young people and parents; and coordinated support for young parents (The support programme for young parents was an important contribution to the strategy. In the short term by helping young parents prevent further unplanned pregnancies and, in the long term, by breaking intergenerational cycles of disadvantage and lowering the risk of teenage pregnancy.). It was implemented through national, regional and local structures with dedicated funding for the 10-year duration. The under-18 conception rate reduced steadily over the strategy's lifespan. The 2014 under-18 conception rate was 51% lower than the 1998 baseline and there have been significant reductions in areas of high deprivation. One leading social commentator described the strategy as 'The success story of our time' (Toynbee, The drop in teenage pregnancies is the success story of our time, 2013). As rates of teenage pregnancy are influenced by a web of inter-connected factors, the strategy was necessarily multi-faceted in its approach. As such, it is not possible to identify causative pathways or estimate the relative contributions of each constituent part. However, we conclude that six key features contributed to the success: creating an opportunity for action; developing an evidence based strategy; effective implementation; regularly reviewing progress; embedding the strategy in wider government programmes; and providing leadership throughout the programme. The learning remains relevant for the UK as England's teenage birth rate remains higher than in other Western European countries. It also provides important lessons for governments and policy makers in other countries seeking to reduce teenage pregnancy rates. BACKGROUND METHODS RESULTS CONCLUSION

How inclusion became exclusion: Policy, teachers and inclusive education

It is almost two decades since a concept of inclusion as selective segregation was proposed as an alternative to the concept of full inclusion and inclusive education was reconfigured as providing children with varied educational settings in order to meet their needs. A version of this model of inclusive education subsequently gained political traction in England where the issue of segregated or mainstream provision is now constructed as a matter of parental choice and child voice. Meanwhile, the implications of this latest model of inclusive education for teachers and schools in a rapidly changing wider educational landscape have largely been ignored or reduced to a question of training. This paper explores how the inclusive education landscape has changed in England in recent years, charting recent key developments in areas such as policy, statutory guidance and teacher training, with particular reference to teacher workload and the positioning of teachers within political and polemical educational discourse

'Zero tolerance' and drug education in Australian Schools

For a decade in Australia, drug education in schools has been shaped by the approach of harm minimization adopted by state and national governments alike. Harm minimization has been accepted broadly by drug educators, and has encouraged schools to deepen their commitment to drug education, allowed them to communicate honestly with students, and to respond to instances of drug use in a less confrontational and more caring manner. Despite those advances, the notion of 'zero tolerance' within schools has been promoted recently by protagonists in the formulation of drug policy and it is mentioned in the recently published national school drug education policy. This article suggests that the adoption of a zero tolerance policy will end the consensus among drug educators, reduce the efficacy of drug education, lead to more punitive treatment of youthful drug experimenters, while doing nothing to reduce drug use. It concludes the existing policy of harm minimization offers schools more scope to address drug issues in a constructive manner than does zero tolerance, which in practice may inflate the harmful effects on young people of drug use

Work to be done? A survey of educational psychologists exploring their contribution to special schools for profound and multiple learning difficulties

This article explores the perspectives of educational psychologists across England with regard to their professional involvement, role and contribution to special schools for children and young people with profound and multiple learning difficulties (PMLD). An online survey was distributed to all educational psychology services in England and to private educational psychology practices. Data collected from 207 respondents were analysed using descriptive statistics and quantitative and qualitative content analysis. The findings suggest a complex national picture, including great variation in the frequency of educational psychology visits and indirect contact with the special schools. While the work carried out by educational psychologists in these special schools is primarily individual, statutory-led casework, systemic work is considered to be the ‘ideal’ contribution. Educational psychologists’ views on their role in PMLD settings seem to feature limited ideas. The authors suggest that improving educational psychologists’ skills and knowledge of PMLD, building relationships with special schools and finding a niche in supporting, among other things, the emotional well-being of the school’s community, might be ways forward for working in PMLD schools. The article concludes by emphasising the continued need for the profession to understand and market the specific role it can play in PMLD settings

Assessing parental capacity when there are concerns about an unborn child: pre-birth assessment guidance and practice in England

Assessment where there are concerns that an unborn child is likely to suffer significant harm is one of the most difficult tasks that social workers undertake; the legal and ethical context makes the process of assessment and intervention during this period complex. This paper explores pre-birth assessment guidance and practice in England. Local safeguarding guidance in 147 English localities was accessed and analysed, and interviews were conducted with 22 practitioners involved in pre-birth assessments. The findings showed that while most local safeguarding guidance was more detailed and explicit than the national guidance, legal and ethical issues were rarely addressed. Interview data showed that, in general, guidance to support social work assessments during the pre-birth period was insufficient, and that few practitioners used standardised tools to aid assessment. Some practitioners regarded pre-birth assessments as less urgent than cases involving infants/older children, thereby increasing delays in decision-making. It is concluded that existing guidance and practice with regard to pre-birth assessment are inadequate

The role of special schools for children with profound and multiple learning difficulties: is segregation always best?

This is the pre-peer reviewed version of the following article 'The role of special schools for children with profound and multiple learning difficulties: is segregation always best?' British Journal of Special Education 34(1) pp.19-24, which has been published in final form at http://www3.interscience.wiley.com/cgi-bin/fulltext/117989211/PDFSTART.The education of young people with profound and multiple learning difficulties continues to raise challenges and controversies. In this article, Ben Simmons, an ESRC funded PhD student and research assistant, and Phil Bayliss, programme director for the masters degree in special education and disability, both based in the School of Education and Lifelong Learning at the University of Exeter, describe their research into provision for pupils with profound and multiple learning difficulties in a special school in the south west of England. Their work, based in an interpretivist, qualitative approach, set out to illuminate issues relating to the inclusion of pupils with profound and multiple learning difficulties. The findings presented here suggest that the school, in spite of its strong reputation, struggled significantly to provide appropriate learning experiences for pupils with profound and multiple learning difficulties. Ben Simmons and Phil Bayliss discuss the need for improved staff development opportunities focused on enhancing current levels of knowledge and skills. They conclude by calling for a reappraisal of the established view that special schools necessarily provide the best learning environment for pupils with profound and multiple learning difficulties

Fatal child maltreatment in England, 2005-9

Objective: This paper presents comprehensive and up-to-date data covering four years of Serious Case Reviews into fatal child maltreatment in England. Methods: Information on all notified cases of fatal maltreatment between April 2005 and March 2009 was examined to obtain case characteristics related to a systemic classification of five broad groups of maltreatment deaths (severe physical assaults; covert homicide/infanticide; overt homicide; extreme neglect/deprivational abuse; deaths related to but not directly caused by maltreatment). Results: A total of 276 cases was recorded giving an incidence of 0.63 cases per 100,000 children (0-17) per year. 246 cases could be classified based on the data available. Of these the commonest specific group was those children who died as a result of severe physical assaults. Apparently deliberate overt and covert homicide was less common, whilst deaths as a direct consequence of neglect were rare. In contrast, some evidence of neglect was found in at least 40% of all cases, though not the direct cause of death. Conclusions: Class characteristics differ between the different categories of death and may suggest the need for different strategies for prevention

Do early life cognitive ability and self-regulation skills explain socio-economic inequalities in academic achievement? An effect decomposition analysis in UK and Australian cohorts

SSocio-economic inequalities in academic achievement emerge early in life and are observed across the globe. Cognitive ability and “non-cognitive” attributes (such as self-regulation) are the focus of many early years’ interventions. Despite this, little research has compared the contributions of early cognitive and self-regulation abilities as separate pathways to inequalities in academic achievement. We examined this in two nationally representative cohorts in the UK (Millennium Cohort Study, n = 11,168; 61% original cohort) and Australia (LSAC, n = 3028; 59% original cohort). An effect decomposition method was used to examine the pathways from socio-economic disadvantage (in infancy) to two academic outcomes: ‘low’ maths and literacy scores (based on bottom quintile) at age 7–9 years. Risk ratios (RRs, and bootstrap 95% confidence intervals) were estimated with binary regression for each pathway of interest: the ‘direct effect’ of socio-economic disadvantage on academic achievement (not acting through self-regulation and cognitive ability in early childhood), and the ‘indirect effects’ of socio-economic disadvantage acting via self-regulation and cognitive ability (separately). Analyses were adjusted for baseline and intermediate confounding. Children from less advantaged families were up to twice as likely to be in the lowest quintile of maths and literacy scores. Around two-thirds of this elevated risk was ‘direct’ and the majority of the remainder was mediated by early cognitive ability and not self-regulation. For example in LSAC: the RR for the direct pathway from socio-economic disadvantage to poor maths scores was 1.46 (95% CI: 1.17–1.79). The indirect effect of socio-economic disadvantage through cognitive ability (RR = 1.13 [1.06–1.22]) was larger than the indirect effect through self-regulation (1.05 [1.01–1.11]). Similar patterns were observed for both outcomes and in both cohorts. Policies to alleviate social inequality (e.g. child poverty reduction) remain important for closing the academic achievement gap. Early interventions to improve cognitive ability (rather than self-regulation) also hold potential for reducing inequalities in children's academic outcomes.Anna Pearce, Alyssa C.P. Sawyer, Catherine R. Chittleborough Murthy N. Mittinty Catherine Law, John W. Lync

School-level variation in health outcomes in adolescence: analysis of three longitudinal studies in England

School factors are associated with many health outcomes in adolescence. However, previous studies report inconsistent findings regarding the degree of school-level variation for health outcomes, particularly for risk behaviours. This study uses data from three large longitudinal studies in England to investigate school-level variation in a range of health indicators. Participants were drawn from the Longitudinal Study of Young People in England, the Me and My School Study and the Research with East London Adolescent Community Health Survey. Outcome variables included risk behaviours (smoking, alcohol/cannabis use, sexual behaviour), behavioural difficulties and victimisation, obesity and physical activity, mental and emotional health, and educational attainment. Multi-level models were used to calculate the proportion of variance in outcomes explained at school level, expressed as intraclass correlations (ICCs) adjusted for gender, ethnicity and socio-economic status of the participants. ICCs for health outcomes ranged from nearly nil to .28 and were almost uniformly lower than for attainment (.17-.23). Most adjusted ICCs were smaller than unadjusted values, suggesting that school-level variation partly reflects differences in pupil demographics. School-level variation was highest for risk behaviours. ICCs were largely comparable across datasets, as well as across years within datasets, suggesting that school-level variation in health remains fairly constant across adolescence. School-level variation in health outcomes remains significant after adjustment for individual demographic differences between schools, confirming likely effects for school environment. Variance is highest for risk behaviours, supporting the utility of school environment interventions for these outcomes