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by Professor Nathan Hughes

Among the many profound impacts of the Covid-19 pandemic has been the transformation of family homes into classrooms, parents into teachers, and teachers into digital pen pals. Social media reflects the two coexisting realities of this new normal: the comfort of being able to keep loved ones close, spending some extra, precious moments with the kids; and the unwelcome juggling act of having to be parents, teachers (and frequently employees) in the same eight hour period of the day. 

The demands of this new situation are extremely challenging for parents of children on a straightforward path through school. But what of those families with a child normally schooled in a Pupil Referral Unit (PRU) as a result of a permanent exclusion from school? Those children judged to need acute additional support are now facing that same distance from their teachers and support workers. 

Alongside Louise Wilkinson of the Brain Injury Trust, our team of academics carried out research into the prevalence of Traumatic Brain Injury (TBI) in young people in PRUs. As part of the 2018-19 Crook Public Service Fellowship Cohort on Disadvantage and Disability, this work sought to highlight a key gap in our understanding of school exclusions and how best to improve the outcomes of those young people whose behaviour cannot be accommodated in mainstream schooling. 

Although we were fortunate to build upon work done by , it’s a historically under-researched area with potentially significant consequences. Whilst there is a strong body of evidence to suggest that TBI is highly prevalent among those in prisons, and that educational disengagement plays an influential role in this trajectory, to date there has been no research into the experiences of TBI among those excluded from school. The aim of this study was to understand the needs and difficulties of a group of young people who report a TBI, and who, having been permanently excluded from school, were subject to alternative educational provision, and, in doing so, to understand the potential for improved support.

The consequences of even a mild TBI can be significant in a classroom. Identified effects include:

• Limb weakness and poor mobility
• Fatigue
• Reduced concentration and attention
• Irritability or impulsive behaviour
• Impaired memory
• Difficulties processing information
• Difficulties understanding and using language
• Difficulties with organisation and planning
• Social difficulties, including a lack of empathy and awareness about their own or other people’s emotional situations

Education outcomes for those excluded from school are poor, and the disruption of the pandemic-enforced school closures piles further uncertainty and instability onto these young people and their families. As the Government and local authorities weigh the complexities of the decision of when to reopen schools, teachers and education leaders will no doubt turn their attention to how best to ease the transition back into the routine of school life for all pupils. There will naturally be concerns about the learning time missed and the variation of the lockdown experience from child to child. Again, a challenge for teachers and students in mainstream settings; a potentially substantial setback for those already on a precarious education path.

As part of our work, we developed a series of recommendations that we believe will make a positive impact upon the education outcomes of these young people:

1. Teachers should be aware of the potential signs of a brain injury, including changes in behaviour, the ability to engage in a classroom, or difficulties with learning. This should include compulsory training for all Special Education Needs Coordinators, and the availability resources produced by the Child Brain Injury Trust and other organisations to support all teachers to respond to identified needs.
2. When aware that a brain injury has potentially occurred, the progress and needs of the young person should be regularly reviewed by schools, through the particular lens of potential TBI, including at any point at which behaviour changes or the student is perceived to be struggling.
3. All young people with significant symptoms following a brain injury should be provided with an Education, Health and Care plan and the relevant support.
4. The Department for Education should update its statutory guidance so as to ensure no child can be excluded from school without a full assessment for brain injury and its impact on functioning. Where such needs are identified, appropriate support should be provided to maintain the student in school.
5. Alternative education providers – including those for children excluded from mainstream schools – should screen all young people for symptoms resulting from brain injury, and make appropriate referral to specialist services, and provide suitable education strategies to overcome specific learning difficulties.
6. Information regarding young people who experience a brain injury must be shared between health and education services. This includes data sharing to better support young people, as well as to better understand population level trends in the influence of brain injury on trajectories towards school exclusion.

They have taken on an additional urgency in the context of the pandemic to ensure that for this cohort, being locked down doesn’t mean being locked out.