Caroline Voaden

It is a pleasure to serve with you in the Chair today, Mr Betts, and I thank the hon. Member for Dagenham and Rainham (Margaret Mullane) for bringing this important topic to the House and for raising awareness of it in this place. As the hon. Member set out, pica is a condition most commonly associated with autism, learning disabilities and some mental health conditions, whereby a person compulsively eats non-food items such as soil, paper, hair, small objects or chemicals. This, of course, carries serious health risks, including choking, poisoning and internal injury, and in the most severe cases, it can be a cause of death. The specific causes of pica are not clear, but the bottom line is that people with pica, especially children, need support and management to help keep them safe. Pica is disproportionately prevalent among children and young people with autism and severe learning disabilities. Research estimates that between 20% and 23% of young autistic children engage in eating non-food items. We know that the more severe a child or adult’s learning disability is, the greater the chance they will display pica behaviour. School staff working in SEND settings, including mainstream schools with SEND pupils, special schools and early years settings, are therefore considerably more likely to encounter pica than the population at large. The Government’s SEND reforms, with their focus on inclusion, will undoubtedly be a cause of concern for parents of children with pica, who need to be reassured that their child will receive the support they need if they are going to be taught in mainstream education. When it comes to SEND, we can probably all agree that the status quo is not working. The SEND system is failing children every single day. After years of neglect under the Conservatives, it is failing to deliver the outcomes that children deserve and is driving local authorities to the brink, so we welcome the Government’s commitment to improve outcomes. Their reforms are an important step in the right direction, but many questions remain about funding, staffing and early intervention—all questions that parents of children with pica need to know the answers to. The Liberal Democrats will continue to press the Government to ensure that vulnerable children, including those with pica, get the support they need. One Liberal Democrat who has done just that is my hon. Friend the Member for Epsom and Ewell (Helen Maguire). Unfortunately, she is unable to attend the debate, but her work to support one of her constituents whose child has pica illustrates how the system is currently failing such children. Her constituent lives in constant fear that as soon as she leaves the room, her child will eat something dangerous, such as carpet underlay, which could have fatal consequences. The National Pica Advisory Service—which I believe is represented in the Public Gallery—has been a vital resource for my hon. Friend’s constituent, for which I offer thanks, but it should not have to be. I repeat: children in the UK have died and will continue to die as a direct result of pica, yet no one is taking my hon. Friend’s constituent or pica as a whole seriously. Many medical professionals do not understand the condition, there is a fundamental lack of awareness and it is regularly dismissed as autism, even though it is a separate diagnosis. Importantly, there is a lack of formal support pathways and an absence of national guidelines, which is unacceptable. Children and young people living with pica and their families deserve so much better. Effective management of pica could include staff recognising the behaviour, understanding its triggers and applying consistent, safe strategies, such as de-picaing the environment, teaching children to discriminate between edible and non-edible items, and offering safe sensory or textual substitutes. If we are to have an inclusive SEND system that works for all children, including those with pica, schools and teachers must be equipped with the training they need to support these children. That is one reason why the Liberal Democrats would improve teacher training and continuing professional development, with a focus on identifying and supporting children with SEND, including those with autism, dyslexia or other neurodiverse conditions, such as pica. Being aware of this condition is the first step to keeping children safe. We have also consistently campaigned for putting early identification at the heart of any SEND interventions and reducing diagnostic delays by streamlining NHS processes and increasing funding for assessments. Awareness of behaviours such as pica is an important part of keeping pupils safe. Teachers and support staff need to be able to recognise pica when they see it. As a result, advice on recognising pica should be included in the new SEND training offer for teachers and support staff at a general level. However, although there needs to be a greater emphasis on teachers and support staff being able to identify conditions such as pica and other general barriers to learning as part of the SEND reforms, it should not be their responsibility to diagnose or offer detailed support. Knowing how to safely manage and support a child who is showing pica behaviour is a specialist skill, and more detailed advice and support must be available to teachers who have a child with pica in their class. That is why it is so important that the health element of an education, health and care plan actually means something. Currently, there is no legal footing for ensuring children, including those who have conditions such as pica or avoidant/restrictive food intake disorder, can access the healthcare they need as part of their education, health and care plan. We Liberal Democrats were disappointed that earlier this week the Health and Social Care Committee’s amendment was not added to the Health Bill. It would have given statutory footing to the “H” in EHCP, and helped children with pica and ARFID get the health support they so desperately need. It is also why we need to ensure that teachers have the help they need in the classroom, with more specialist staff in schools to meet neurodiverse children’s needs. We welcome the Experts at Hand service, but we cannot create these people out of thin air. Given the lack of such specialists, the Liberal Democrats are calling on the Government to publish a credible workforce plan to recruit and train the staff needed and to encourage trained specialists back into the profession. Pushing the emphasis on to individual teachers to spot and manage learning needs without new specialist capacity is a cost-saving measure, rather than a genuine improvement in support for our children. Teachers cannot be expected to have every form of SEND training required to meet the specific needs of every child, while also having all the skills necessary to teach the class. We cannot shove the burden of SEND on overworked, burnt-out teachers and expect good results for all children with special educational needs, as well as all the other children in the class. It is important to note that inclusion-focused SEND reforms will be deliverable only if we reduce wider pressures, such as workload, on educators. I recently ran a survey of teachers and got just under 1,000 responses. Nearly half of those teachers said they were planning to quit the classroom in the next five years, citing high workload as a key reason. That is why the Liberal Democrats are calling for proper enforcement of teachers’ legally mandated working hours, the introduction of reasonable limits on overtime and for all schools to be required to introduce flexible working policies. Returning to the topic of the debate, the Liberal Democrats are clear that children with pica must be kept safe if they are to be taught in mainstream school, and their parents deserve that guarantee, which I hope the Minister can provide. Every child with autism, dyslexia or another neurodiverse condition, such as pica, deserves the chance to thrive in school and move confidently on with their life and into work. With earlier assessment, better training for teachers, inclusive education and more specialist support, we can unlock the talents of neurodivergent young people and help them to thrive in life.