Blog spot

Can Tik-Tok trends be educational or are they creating further barriers to inclusion?

26/03/2023

The popularity of TikTok (and other social media) amongst children and young people is hard to deny. Over the last few years we’ve seen teenagers creating inventive dances, jumping on trends and using social media to connect with other people. No doubt this was a saving grace to many young people’s mental health during the COVID-19 pandemic. Social media can be such a useful tool to remain connected to other people and it can also be quite enlightening and educational at times. There are many people out there raising awareness on social media platforms about living with conditions, disabilities, and mental health issues. It is great that we can use these platforms to raise awareness of conditions, promote inclusion, and diversity, and come more aware of other people’s unique experiences. But can there be a downside to these trends?

Recently a 16-year-old close to me said she has been watching Tik-Tok and learning a lot about Autism, this has then led her to consider if she could be autistic. She can struggle with anxiety at times and in social situations. If she does now want to pursue a diagnosis how helpful would this be? Would it help her to understand herself better or could it re-enforce her own self-perception that she is anxious, leading to more anxiety?

When I view my own TikTok ‘for you’ page, it is awash with people suggesting that they have ADHD because sometimes they can appear forgetful, hyper or disorganised. More than enough people close to me have commented over the years that I have ADHD. Again, do I need this label and would it help me to understand myself better or would it be unhelpful?

If we explore the diagnostic criteria of Attention Deficit Hyperactivity Disorder (ADHD) to meet the diagnostic criteria, a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development must be observed.

Let’s look at inattention, at least five of the following symptoms are required to be present to meet one part of the diagnosis:

  • failing to give close attention to detail
  • difficulty sustaining attention in tasks
  • often doesn’t list seem to listen when spoken to directly
  • often does not follow through on instructions
  • often has difficulty organising tasks and activities
  • often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort
  • often loses things necessary for tasks or activities
  • often easily distracted by extraneous stimuli
  • often forgetful in daily activities

Now anyone who knows me well would state that I do not listen well to others, I can’t follow through on instructions, because I failed to listen to the instruction in the first place. I cannot organise or plan. It’s now 4pm on Sunday and I still haven’t got around to booking my train for tomorrow. I’ll only engage in activities that require mental effort – if I am interested in the topic and am always loosing my glasses or bank cards. I get distracted by the spring lambs whilst driving down the country road and can’t even remember to take the washing out of the machine for days, meaning when I get round to it, it’s musty and requires washing again and again, before I remember to remove it! I think you get the point….

So let’s move on to hyperactivity and impulsivity

  • often fidgets with or taps hands or feet or squirms in seats
  • often leaves in situations where remaining seated is expected
  • after runs about or climbs in situations where it is inappropriate
  • often unable to play or engage in that leisure activities quietly
  • is often “on the go”
  • unable to be comfortable being still for an extended time
  • often talks excessively
  • often blurts out an answer before questions have been completed
  • cannot wait for turning conversation
  • often has difficulty waiting their turn
  • often interrupts or intrudes on others

I’m sure reading this set of criteria, you can find ways in which you would live up to this label. Let’s revisit me – my legs never stay still, I am always moving, and squirming and even in my sleep I am never actually still and restful. I am loud, chatty and according to my high school teachers; “Antonia is a most able pupil, but she would make work easier for herself and for others if she could resist the temptation to talk”. My targets were to “concentrate harder in order to avoid distracting other people”. Furthermore “she needs to spend some serious time really listening”. ADHD was relatively uncommon when I was at school and the rates of diagnosis began to gather speed throughout the late 1990s and 2000s, but I think my teachers could have been alluding to something here.

At the time of the publication of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Population surveys suggest that ADHD occurs in most cultures in about 5% of children and around 2.5% of adults. Now it seems everyone on social media has something to say about ADHD, most recently Prince Harry claiming in a news article to have the condition. But can this be doing more harm than good? Can there be a damaging aspect of trying to label everyone with some condition or other?

Now I am not taking away from the fact that having a diagnosis can be really beneficial to some people, it can help with access to support services, medication, therapy and understanding. There is no doubt that following the medical model of disability, can bring benefits to some people, they can get the support that they require to help them overcome difficulties.

But on the flip side, can this be damaging to equality, diversity and inclusion. At Team Teach, we suggest “looking beyond the behaviour”. So is it then right to see the child as a set of criteria to meet a diagnosis?

When we label a child, they can then become only seen by the label. We will look for reasons why the child may live up to that label. Worse then, the child will adopt the label themselves, experience a lose of control and re-enforce it further. This is known in psychology, as the self-fulfilling prophecy.

One teacher referred to me as “erratic”.

Again, I am not denying that supporting a child to get a diagnosis can be useful, but we also need to be really careful to ensure that they are not then seen as “the kid with ADHD”, or the “autistic child”. This could just be one small part of the whole person. Children with any diagnosis can still be warm, caring, compassionate, fun, creative and achieve. When we label someone, they can easily then become seen by only their flaws. I would argue that my “erratic” behaviour is actually quite positive, I’m spontaneous and live life to the full. My “chatty” nature serves me well as a Team Teach Tutor, otherwise, training would be boring if I wasn’t chatty.

When we try to medicalise everything and everyone, the medical model of disability says people are disabled by their impairments or differences. Surely we need to move away from medicalising and trying to look at what is ‘wrong’ with the person. It is seen to be damaging, as it can create low expectations of people. In comparison, let us embrace our differences, isn’t variety the spice of life after all? Let’s celebrate our uniqueness, our quirks, and our different perceptions.

I may or may not have ADHD, but what I refuse to be is defined by a label and a diagnosis. I will embrace and promote a way of viewing the world, that rather we are all individuals, with different experiences, feelings, thoughts and behaviours. We can choose our response, and I’ll choose not to live up to a label.

It’s a good job my ADHD didn’t allow me to listen to my teachers when they said I’m “erratic“ and “a most able pupil, but one who rarely gives her best at all times”, or I might not have achieved my Post-Graduate Qualification in Psychology.  😛 (I think it might also be time to delete the Tik-Tok)

The need for raising standards in care. 
23 Sept 2021

The serious case of institutional, physical, emotional and neglectful abuse at Winterbourne View was a scandal that rocked the nation in 2011. Exposed by BBC Panorama, the vulnerable people were let down by those people entrusted to care for them. The abuse exposed failings in safeguarding and found that the staff were undertrained. They were trained in little other than restrictive practises and employing physical restraint techniques, however as trainers, we know that no respectable intervention trainer would ever advocate the behaviour of the staff applying inappropriate and unnecessary force.  

These individuals should have been better protected – a review following the scandal stated: “As much as Winterbourne View fills us all with sorrow and anger, it should also fire us up to pursue real change and improvement in the future”. Lamb, (2012). 

Despite the health minister at the time advocating for change, how can we measure that change has occurred, when we continue to observe instances of abuse, neglect and failures in safeguarding?

In 2019, the BBC exposed staff intimidating, mocking and excessively restraining patients with learning disabilities and autism at Whorlton Hall, County Durham. The culture was deviant with evidence of “psychological torture” (Triggle, 2019). Therefore, there is evidence to suggest limited change. These serious cases of abuse, highlight the need for effective training across the care sector to prevent the misuse and abuse of restrictive practises.

Training is required to safeguard vulnerable individuals from harm, and even death. A recent BBC news report highlighted further failings in care, the vulnerable individuals in one setting were let down, the report found:

  • “Excessive” use of restraint and seclusion by unqualified staff
  • Concerns over “unsafe grouping” of patients
  • Overmedication of patients
  • High levels of inactivity and days of “abject boredom”
  • Relatives described “indifferent and harmful hospital practices” and said their questions and “distress” were ignored (BBC News, 2021)

These are all failings that require a safe level of staff training. Chairwoman of the Norfolk Safeguarding Adults Board, said: “This is not the first tragedy of its kind and, unless things change dramatically, it will not be the last” (Joan Maughan, cited in BBC News, 2021).

Residing at this setting, Joanna Bailey had a learning disability, autism, epilepsy and sleep apnoea. The coroner’s report gave her cause of death as sudden unexpected death in epilepsy (SUDEP), primary generalised epilepsy, obesity and obstructive sleep apnoea. Ms Bailey was not checked for two hours the night she died on 28 April 2018, despite 30-minute checks being in her care plan. This is in addition to Nicholas Briant who died of a brain injury following a cardiac arrest and obstruction of his airway after swallowing a piece of plastic cup. He had told staff: “I cannot breathe. I am dying”. The scene was captured on CCTV, and the coroner said staff “did not appear to be doing anything” (BBC News 2021).

These two deaths should and could have been prevented with effective care training, supervision, and knowledge of how to administer first aid and uphold safe, caring, person-centred support.  

Serious cases continue to make for regular headlines; Jessie McKinlay, died on April 21st 2019, as a result of the serious injuries she suffered during a violent assault from another resident. Questions have to be asked about why this happened when supervision should have been maintained, risks assessments in place to manage the behaviour and staff be equipped to manage behaviours that challenge. It was reported: “The court heard Mr Whiteside, who suffered from dementia, was known to be aggressive and had attacked both residents and staff before. He was nonetheless allowed to wander around the home unsupervised, and would frequently go into other residents’ rooms”. This should not have been allowed, if effective care planning and risk assessments were being adhered to. Furthermore, the management went unchallenged by staff. One staff member told the court that the care home’s manager at the time, told staff to “stop logging complaints about Mr Whiteside’s behaviour, and that if they wrote anything about him in their digital reports, those reports would be deleted” (Holmes, 2021). This goes against safeguarding procedures and staff should have the knowledge to challenge this poor practise. Again, another example of a preventable care home death.

What has been learnt then from the Winterbourne View scandal appears to be limited. These recently reported cases above are coming to light now, but happened before the Covid-19 pandemic, what has happened and is happening inside care settings now? What is the current impact of a further crisis in care, staff shortages, limited visitors for the vulnerable people to be additional eyes to safeguard them, absent training, or at best training delivered online, staff worries and stress? This could be considered as a toxic combination that puts those vulnerable individuals at further risks of care failings. If improvements needed to be made prior to covid, what now?!?!