Barriers Facing Social Workers Undertaking Direct Work With Children and Young People With a Learning Disability Who Communicate Using Non-Verbal Methods

Authors Katherine Anne Prynallt-Jones, Malcolm Carey and Pauline Doherty

Published by British Journal of Social Work, Volume 48 (2018)

Direct work entails entering a child's world in order to empathise with them, to support them to understand significant events, but also to actively understand their experiences, wishes and feelings (Horwarth, 2010).

The Children Acts of 1989 and 2004 require social workers to involve, consult and provide information to all children in care. Working Together 2018 outlines that assessments must take account of children's views and feelings. Policy and legislation emphasises the necessity of direct work and participation and yet legal requirements are not always met, in part, because meaningful relationships between social workers and children are not being developed (Munro, 2011).

In addition to structural discrimination, children who communicate non-verbally can be underestimated and excluded by professionals due to:

• Persistent attitudes towards disability as a deficit.
• An over-focus on a disability as defining the child's identity (i.e. they are their disability) and limited skills and confidence in eliciting children's wishes and feelings (Singh and Ghai, 2009).
• "Psycho-emotional disablism" which is where the assumptions of others impede children's ability to express and develop their individual identity, relationships and psychological wellbeing (Thomas, 1999).

The study

The authors outline a number of requisites for good social work practice with children with disabilities. For example, professionals need to have specific skills and knowledge as non-verbal communication is difficult to translate and speaking adults hold the power to shape and possibly misinterpret what is expressed (Clarke and Wilkinson, 2009).

This study analysed interviews with seven social workers who worked in a statutory Children with Disabilities Team and ethnographic accounts on the basis of the researchers working alongside the team for six months.

Key findings

Most of these seven social workers described feeling skilled in using a variety of non-verbal communication.

They identified the skills and knowledge they used to enable good communication and direct work:

• Creativity, improvisation and playfulness were cited as valuable skills.
• Non-verbal communication methods including observation of expressive noises and body language and use of symbols, pictures, emotions cards, sign language and facial expressions.
• Communication technologies such as Picture Exchange Communication System (PECS) and Makaton.

Requirements for positive contexts to enable direct work were identified:

• Familiar and safe environments so that children felt relaxed.
• Conducting visits in various contexts to build trust and to ensure holistic assessment and support.
• Working with wider family and other agencies to learn effective communication techniques as well as utilising advocates and interpreters.
• Peer learning including co-working and team discussions to reflect on new ideas for direct work.

Obstacles to effective communication/direct work were:

• Short assessment timescales do not take account of the additional time needed to elicit the views of a non-vocal child, and led to an over-reliance on parent/carers' views which was particularly problematic in child protection cases or where there are safeguarding concerns.
• Having to rely on non-verbal communication remained a challenge even for practitioners with extensive experience and this was attributed to children's diverse communication needs and difficulty interpreting children's communication when level of communication fluctuated.
• Trying to elicit information about allegations of abuse when social workers felt children may not understand or be able to communicate harm or injuries inflicted on them.
• Professionals' varying motivation, for example two of the social workers didn't know of any resources to help elicit children's wishes and feelings.
• While parents/carers were appreciated as a rich source of information, they could restrict social workers' engagement with children, including by not seeing the value of gaining the child's views.

Organisational barriers were:

• Being unprepared for practice as social work degree programmes lacked training on disabilities.
• Limited training and opportunities to develop non-verbal communication skills while in-post which meant that some practitioners lacked the knowledge and confidence to conduct direct work.
• Limited and outdated communication technology (for example, iPads and PECS).
• High caseloads negatively impacted quantity and quality of direct work.
• Bureaucracy reduced time spent with children.

Implications for practice

Inadequate direct work and communication with non-verbal children with learning disabilities can mean that they are not safeguarded and supported. Therefore:

• Social workers should receive regular formal and informal training and supervision on how to work with children who have disabilities and their families, and on specialist communication techniques.
• Social care services need to address the structural and organisational barriers (above) in order that legal requirements for inclusion are met.

FURTHER READING

Related resources

• Education, Health and Care Plans: Qualitative Investigation, 2018
• Special Educational Needs: Support in England, 2018
• ‘Realistic Positivity': Understanding the Additional Needs of Young Children Placed for Adoption, 2018
• Education, Health and Care Plans: our first 100 investigations, 2017
• Education, Health and Care Plans: Parents and Young People Survey, 2017

Related resources by Research in Practice

• Fetal Alcohol Spectrum Disorders (FASD) - identifying and responding in practice with families: Frontline Briefing, 2017
• Communicating with children and young people with speech, language and communication needs and/or developmental delay: Frontline Briefing, 2016
• NICE guideline "Transition from children's to adults' services", including links to SEND policy and practice: Webinar, 2016
• Lifespan personalisation: Strategic Briefing, 2015
• Supporting personalised approaches for children and young people with SEN and disabilities, and their families: Leaders' Briefing, 2013

The research section for this special report is based on a selection of academic studies which have been explored and summarised by Research in Practice, part of the Dartington Hall Trust.

This article is part of CYP Now's special report on special educational needs and disabilities. Click here for more