Woman's Hour - Concussion in women, Age of criminal responsibility, Why women read fiction

Episode Date: January 7, 2020

The word ‘concussion’ might sound like a benign knock to the head but it can have lasting consequences. Women are particularly at risk. With all else being equal, women are two to three times more likely to experience a concussion, will have worse symptoms and take longer to recover. Dr Willie Stewart from Glasgow University has been trying to find out why – but has been hampered by the lack of female brains available to study. He’s now asking women to consider donating their brains in the name of science and understanding how sex differences affect the outcome and treatment of traumatic brain injury. Jane is also joined by Samantha Ainsworth, who talks about her experience of post-concussion syndrome. Back in October we spoke to the anti-abortion group who put up graphic posters of aborted foetuses in the constituency of the MP Stella Creasy. At the time she was heavily pregnant. The same group, called CBR UK, is now planning regular anti-abortion demonstrations at Cardiff University. They've had three of them already, just before Christmas. We speak to the student who encouraged an automatic pro-choice stance at Cardiff University, and a recent graduate who's part of a group which helps students who are against abortion to express their views. Also, Dr Pam Lowe from Aston University who has been researching attitudes to abortion at UK universities. Women are the main readers of fiction. They outnumber men in all categories of fiction bar fantasy, horror and science fiction. In her new book Why Women Read Fiction, Professor Helen Taylor draws on over 500 interviews with women readers to examine how and why women consume fiction and why reading fiction is so important to huge numbers of women. The government’s official advisers on youth justice are calling for a full review of the age of criminal responsibility. They would like it raised by at least two years to 12, as Scotland has done recently. So why do England and Wales continue to set theirs at ten despite it being the lowest in Europe? Should children as young as ten caught committing a crime receive welfare interventions rather than being dealt with by the justice system? Jane is joined by Dr Eileen Vizard, Consultant Child & Adolescent Psychiatrist at the Institute of Child Health in UCL and Louise King, Director of Policy and Campaigns, from the legal charity, Just for Kids Law.Presenter - Jane Garvey Producer - Anna Lacey Guest - Isadora Sinha Guest - Madeline Page Guest - Pam Lowe Guest - Samantha Ainsworth Guest - Willie Stewart Guest - Eileen Vizard Guest - Louise King Guest - Helen Taylor

This BBC podcast is supported by ads outside the UK. I'm Natalia Melman-Petrozzella, and from the BBC, this is Extreme Peak Danger. The most beautiful mountain in the world. If you die on the mountain, you stay on the mountain. This is the story of what happened when 11 climbers died on one of the world's deadliest mountains, K2, and of the risks we'll take to feel truly alive. If I tell all the details, you won't believe it anymore. Extreme, peak danger. Listen wherever you get your podcasts.

BBC Sounds. Music, radio, podcasts. This is the Woman's Hour podcast. Today we're discussing how concussion affects women. We'll discuss as well raising the age of criminal responsibility. You might know it is just 10 in England and Wales and as an example it is 16 in the Democratic Republic of Congo and much higher in other countries. Also, Helen Taylor, the emeritus professor of English, will talk about her new book about why women read fiction.

In many cases, I know our listeners positively devour it. So perhaps you can email the programme or contact us on social media about your favourite work of fiction and why it means so much to you. At BBC Women's Hour on Twitter and Instagram. Email us via our website. First this morning, is it true that anti-abortion groups are becoming more prominent and more influential on British university campuses? In October, we talked to the anti-abortion group CBR UK.

They had put up graphic posters of aborted fetuses in the constituency of the Labour MP Stella Creasy, and she was heavily pregnant at the time. The group also held demonstrations close to Cardiff University late last year, and more are apparently planned. So let's talk to Isadora Sinha, who lobbied for the student union in Cardiff to have an automatic pro-choice stance.

Madeleine Page is here, too. She did graduate from the University of Cardiff a couple of years ago. And she's from another organisation, the Alliance of Pro-Life Students. It says it helps students who are against abortion to express their views whichever way they see fit. Also joining us from our studio in Coventry, Pam Lowe, who's from the University of Aston. She's Dr Pam Lowe and she has been researching attitudes to abortion, including at British universities.

First of all then, to Isadora, why did you want to establish that automatic pro-choice stance at your student union, Isadora? I think a lot of people mistake pro-choice for pro-abortion, whereas pro-choice even supports the pro-choice stance at your student union, Isadora? I think a lot of people mistake pro-choice for pro-abortion, whereas pro-choice even supports the pro-life stance in the fact that if a woman does want to keep her pregnancy, I want the university and all the students to then support that decision.

I just wanted to make sure that it was inclusive for all students, no matter what choices they make. Not, though, inclusive to those students who feel very passionately that abortion is wrong. They are free to feel that and they are free to express that on their own body as well. No one would ever tell them that they should have an abortion or shouldn't. I think that's the point. Were you aware of the demonstrations by the organisation CBR UK?

I was not fully aware until they actually came to Cardiff and then that's when I started to look into them more. And what did you make of them? I think they are quite radical to be honest because I spoke to one of the CBR UK men themselves there and they told me to my face that they would force their daughter to carry a pregnancy even if it was a result of rape so I think they're quite radical. How big were their demonstrations as far as you're aware? And we need to say they weren't actually on Cardiff University grounds, were they? They were just very close to the university. The first time it was on Cardiff University grounds. Okay, was it? Right, go on. Yes. And after that, they actually targeted one of our chaplaincies to punish them

for the motion going through. So I thought that was quite below the belt, to be honest. Madeline Page, you're with me in London, and you are not from this organisation. You are from a separate one. This is the Alliance of Pro Life Students. But do you support the actions of CBR UK? Yeah, we support all pro-life action. Anyone that's trying to educate people on abortion will support that. And I think what's really important to note is that about Isadora's pro-choice motion is she's saying that it's fine for pro-lifers to still have their point of view, but that's simply not what's happening. The harassment of pro-lifers has been horrendous. And there's nowhere in the motion that actually supports people who wish

to parent at university. What evidence do you have that the harassment of pro-lifers has been horrendous and there's nowhere in the motion that actually supports people who wish to parent at university. What evidence do you have that the harassment of pro-lifers has been horrendous? We have pro-life students who have spoken to us and have told us the the abuse that they've received on campus but they're too scared to make a formal accusation to the Students' Union because they don't believe that they'll be supported. Isadora, do you recognise that? I haven't heard anything but I would encourage them to come forward because no students should be targeted for whatever views they have. That should not be tolerated. However, I will say that the pro-choice camp has had lots of harassment as well. I've had death threats and I've been told by the SU themselves not to go out by myself.

So I think this has been quite contentious and it's not just one side that's suffering. Well, let's bring in somebody with an overview, Dr Pam Lowe. Pam, what do you know about the attitudes to abortion on British university campuses now? Well, there is really no difference in terms of younger people. You know, the overwhelming majority of the population support abortion, in at least some circumstances, about 93%, and that holds through for most social groups.

Where does your figure of 93% come from? That comes from the British Social Attitude Survey, which is obviously a very credible source. It's a survey that's been carried out by national statistics for decades. We know that it's over 65s that are much less supportive of abortion than other age groups. And I think that we also know that the anti-abortion movement themselves have recognised that they have an ageing population. And we have seen attempts through different organisations to try and get

more young people to come across to their views. But there is no evidence that any of those attempts are successful in changing the views of the population at the minute. Madeleine, what do you make of that assessment? Yeah, I mean, I completely disagree that we're in the minority. There's comrades polls that show otherwise. But even if we are in the minority, that doesn't make it a reason to censor us just because there's less of us. And in terms of the pro-life activism on campus being unsuccessful, I mean, obviously you have an agenda here, Pam, because you are a prominent member of abortion rights,

so it's not like you're a neutral campaigner. Well, hang on, don't make that assertion without involving Pam. So, Pam, you can answer that. Yeah, like the majority of the population, I am pro-choice. And I think what we need to understand here, that it's not about holding views. What happens with student societies, that they are, a constituted student society is able to claim resources from the student union so what is happening when groups

are setting up pro-life societies what they're actually and when they threaten legal action which is what the alliance of pro-life students have been supporting groups to do that what they're actually doing is making the students who don't agree with their views actually support the the views and resource the views of a minority of students and i think that that raises questions in a multi-faith society clearly everyone has the opportunity to hold their own beliefs but how to what extent should you actually provide resources if you don't believe with that position to a small group, which is not generally supported in the rest of society? OK, well, let's put it effectively, a financial point. What do you say to that, Madeleine?

Yeah, the Students' Union is there to support all students. So if they are genuinely neutral on the subject, then they'll be able to put resources toward pro-life students and towards pro-choice students. But that's just not what's happening, and that's a free speech issue. We did mention earlier the activities of the organisation CBR UK, and I should say there is a statement here from them. They say, The students complaining about us because the photos of aborted unborn children destroy the myth that abortion is healthcare. We see these displays as part of the process of bringing abortion to an end

and defending expressive rights. I think you would say something rather different, Isadora. Well, they use very emotive arguments, but when you look into the science of it, they really do display quite shoddy science. They use things like it has a certain stage fingerprint, so it's unique, whereas that's not an argument for why a woman or a person should be forced into giving up their basic human right to bodily autonomy. And on that note, CBR UK hasn't been giving arguments or debating with us

more like bullying and intimidation. They're unhappy with something we've done democratically and they wish to interfere with it when they simply have no place in it. Can I just ask you, Pam, whether you honestly think that Britain's university campuses are changing, that there's been a sea change in attitudes towards freedom of speech over the last five years or so? To be honest, I don't think there is a sea change. I mean, there is, I think as well, we need to separate out student unions from universities because they're actually legally two separate bodies. And universities have a duty for free speech, that the rules for student unions are slightly different and i don't think that that

this there is evidence on you know there are isolated incidents of course but again i don't think this is what is actually happening it's not about a free speech issue it's about whether a minority of students with a very particular religious belief can claim resources from the majority of students who feel that their belief is discrimination against others. What we're actually seeing here is an issue between different parts of the Equality Act and whether or not religious, you know, the protection of religious belief means that actually you can claim resources from people who feel that abortion is actually gender discrimination and I think that is what's going on in this debate and that's what's important to focus on well because you're

on the other side of that debate Madeleine the last word to you very briefly how do you respond to that yeah I don't really see how how the resources thing becomes an issue I think all students should be entitled to the resources that that their students union wishes to give them everyone should get the same and you know science shows us that life starts at conception, and that is the real issue here. And as your very profound belief, I know, but it isn't a view that's shared by everybody, clearly. Medical textbooks will say otherwise.

No, scientists don't say that. Right, OK, well, here we are. I mean, this is the nub of the argument, and I don't think for one minute that any of you are going to change your views on abortion at the moment. I certainly can't change anybody's opinion on a subject that I know means so much to so many people. Madeleine, thank you very much for taking part. Thank you to Isadora and to Dr. Pam Lowe as well from Aston University.

Now, concussion, it actually sounds relatively benign when you say it, but it really can have lasting consequences. We talk about it a lot. We hear about it a lot at the moment, particularly in terms of retired footballers and the appalling impact it appears to have on them. Men who have headed the old leather footballs and end up with dementia in some cases. But women are at risk, too. And in fact, they seem to experience concussion differently with worse symptoms and a longer recovery time. Willie Stewart, Dr. Willie Stewart from Glasgow University, has been trying to find out why, but he says he's been hampered by the lack of female brains available to study.

We're also joined in the studio by Samantha Ainsworth, who's a lawyer who has post-concussion syndrome after a skiing accident two years ago. Samantha, I'll talk to you in detail in a moment or two, but thank you very much for coming in. We appreciate it. Let's talk to Willie Stewart then. In simple terms, Willie, what is concussion? Good morning. Well, I'm glad that you mentioned that concussion sounds like a very benign and simple injury. And of course, what we're learning over the recent years is it's anything but.

Reality is we don't really understand fully what happens inside the brain but we know it's a form of traumatic brain injury and in the terms of what we understand at the moment what we think is happening in many cases is that the very fine fibers that run from the brain cells and connect up the different centers in the brain and pass messages out to the body, they become stretched and twisted when the brain rotates at the point of impact. And that causes the symptoms, the very complex symptoms that people present with and can lead to some of the long-term problems as well. Now, just in October of last year, I had a fascinating conversation with Professor Gina Rippon. She'd written a book called The Gendered Brain.

And at the centre of her book was the belief that female brains and male brains are not fundamentally different. You seem to be suggesting otherwise. Well, that's a very important point. Because we've known for some time that there's this difference between men and women, as you mentioned, that women seem to be more susceptible to concussion and seem to get symptoms that last longer in many cases.

But we haven't really understood why. And recently there's been some science to try and figure out why that might be. And one of the things that's turned up is those very fine fibres that we were mentioning, these fibres that might be responsible for some of the concussion symptoms. In women, they're very much more slender and very much more fragile than they are in men. And that may be why they're more at risk. Can you just take us through what happened to you, Samantha? Because I know that your accident happened on a skiing holiday.

And you were standing still, I think, at the time of impact. Is that right? Yes, that's right. So I was wearing a helmet. That's, I think, quite important to stress. So I stood at the side of a slope waiting to cross. So it was at a crossroads of two pistes and there were skiers coming downhill so waiting for this group to go past when one of them didn't, came down the side of the slope and hit me

took me off my feet and as I fell I landed heavily, hitting my head twice really knocking it hard and that was it, that was the impact or double impact. And in the short time, how did you feel? Terrible. I was winded. I'd hurt my neck and back. And I thought that was the main injury initially. But it quickly became apparent that I had a really bad headache that came on quickly. The rescuers arrived very soon after and sort of got me sorted out.

They sort of thought I had a neck injury. So they sort of immobilised me, put a head block on and got me onto a rescue sled. I think they called it a blood wagon. Lovely term. Yeah. And then you were in hospital in France, wasn't it? Yes, I mean, they got me down the slope.

So immobilised, they sort of inflate the bag on the sleigh, whizz you down the slopes, going head first, pointing downhill, feeling very sick. Not the greatest trip I've ever had. Not the great way to see the Alps. Didn't leave a review on TripAdvisor. No, I bet. I mean, what was explained to you about what lay ahead for

you in terms of recovery? At the hospital in France, nothing. They just released me. They kept me in overnight after scans and basically said, they gave me a neck brace and said I had a contusion. I can speak French, so I understood that to be a bruise. It gave me a sheet of information and said, return if you have any bleeding from nose, ears, and pretty much stay off screens, rest, come back if you're sick. And that was it, but nothing about sort of longer terms. No. Okay. You lay in a darkened room and you got a bit better, clearly, but you were explaining to me earlier that months later, I think it was months later, you were doing things like, well, frankly, forgetting to collect your children from school.

Yeah, I think the so initially, even back in the UK, I was seen at a local hospital and the advice there was pretty much rest. They mentioned second impact syndrome, which was something that I'd never heard of and it was very concerning it was sort of be very careful not to bump your head again because with the initial brain swelling a second impact could be fatal and that was really worrying so you know that that was the advice was be really careful, rest up. And the symptoms seemed to change from that sort of initial shock to loads of different things like confusion, tinnitus, ringing in the ears, hypersensitivity to light, major forgetfulness, clumsiness. I had stuttering as well. Now, you're a lawyer. I know you are trying. You tried once to ease yourself back into work and it just was too much for you.

It was. But one of the main things was I didn't have, and maybe other people have this, is no clear plan. I think if you break your arm, you come back, you see a doctor, you get your arm set, you know you're going to go back to hospital, etc. And you may have physiotherapy afterwards. I found that I was just getting signed off every couple of weeks because my symptoms weren't getting better. There was no plan of treatment to sort out the dizziness, photosensitivity, all of these things. And I was looking for help. Can we just bring Willie Stewart back in again then? I mean is that for your from your point of view Willie a typical female recovery or journey

after concussion? Well I mean I think for most people with a mild brain injury or a concussion recovery is fairly rapid so we can expect for somewhere between 80-85%, 90% of people to get better within a couple of weeks. But there are this really important and complex group of patients who 10-15% or slightly more who will get persistent symptoms and develop a post-concussion symptoms. And that can be really challenging. And these kind of symptoms have been described the dizziness, the forgetfulness, and just difficulty getting back into life is the kind of things that people experience. Rehabilitation services, as Samantha has outlined, are really dreadful at the moment for people with mild brain injury. And your struggle, Willie, to find female brains to study, why is that a problem for you? Well, there's a focus, there's a great attention on, as you've mentioned earlier as well, on the

late effects of brain injury at the moment, particularly people who played football and rugby at a high level. And they tend to be male-dominated sports. And so attention just naturally seems to drift towards talking about former male footballers, former male rugby players, former male boxers. But actually, you know, these sports are played by women in large numbers and have been for some time. But we haven't been having that conversation about the need to be looking at the differences in the female brain. Well, I know lots of our listeners, not all of them, lots of our parents,

their children will be active and playing sport. Indeed, we are encouraged to do exactly that. Are you saying, Willie, that we should be watchful, that perhaps women shouldn't take part in contact sports like boxing? Oh, no, far from it. We know that physical activity is a fantastic thing for the prevention of all sorts of diseases, including dementia. But what I've been saying for some years now and reinforced by our study on footballers and the work we're doing on women is that actually what we need to be mindful of is reducing unnecessary head impact. So, you know, we're cutting back on things like heading and training, cutting back on sparring perhaps and boxing, but also where brain injuries occur, where concussions may have occurred, managing them better, sort of recognising them better. So my advice to parents is get your kids out participating in sport, but ask the coach, ask the teachers looking after them. What's their policy on head injury? What do they do with their kid they think might have a concussion?

And should Samantha have been, should she have been told after her concussion that your recovery is going to be long, there will be setbacks, you will suffer all sorts of symptoms you might not have heard of, and it will be different because you are a woman um i i think we know that there's different because you're a woman because we know that that the more recent research has suggested that recovery times can be longer and symptoms i'm just going to ask samantha what did anybody say that to you that i wasn't told anything in fact they it was very much self-help at a time when i was totally confused and having to stay off screen so my husband did a lot of research and we found Headway was enormously

helpful. That's the charity isn't it? It is yes the brain injury charity they have fantastic information on their websites and they have helplines booklets they certainly you know offer a great service to people that very clear information about concussion. And that's what helped us through a lot of the understanding what the pathway was. We had an email, Willie, from a listener called Heather who says she had a head injury a couple of weeks ago whilst playing netball at a local leisure centre. She hurt her temple. She went to A&E. She had five stitches. But five weeks later, she says, I'm still feeling the effects of the concussion. It's wearing off gradually, but it's been very traumatic.

So there's somebody who was doing a sport you wouldn't think of netball as a contact sport. And of course, lots of women simply fall over, particularly in older age. So this is a concern if female recovery is just slower than male, isn't it? It is. And actually, another one that's been in the news recently is Alex Danson, the GB hockey captain, is just getting back to playing now after 18 months. And you'd think that was a hockey injury, but actually it wasn't. She was on holiday and banged her head

in a concrete stair or step. So, unfortunately, brain injuries happen everywhere. We focus on sport, but actually they're just part of life. You're standing in a queue at the bottom of a ski slope is a risk. Skiing is a risk. But, you know, it's about recognising these risks and managing them better. And a quick mention, because it is significant, the menstrual cycle and the possible protective impact of progesterone.

Can you explain that? Well, now that's a very complex story. Ah, can you be really pithy and brief? I'm going to be really pithy and brief. What really smart colleagues of mine in America have looked at ladies who are presenting with, young women who are presenting with concussion and realised the symptoms can be worse if they get their concussion in the second half of their menstrual cycle, which is where progesterone levels are typically higher and i think that what's happening there is that actually the protective effect of progesterone is suddenly lost because the the the control system

for your menstrual cycle gets interrupted and that progesterone level drops suddenly and produces much worse symptoms in these ladies and so depending where you are your menstrual cycle can produce perhaps worse symptoms for ladies. Right. Well, that is so interesting because, of course, that is an under-researched area, isn't it? The impact of the menstrual cycle on everything. Really fascinating.

Willie Stewart, thank you very much indeed for your time. And Samantha Ainsworth, good luck with your return to work. I know you're having another go. I hope it goes better for you this time. Thank you. Thank you very much. That's Samantha Ainsworth.

Any thoughts on that? You can, of course, contact the programme. Any experiences of your own you'd like to tell us about, we would love to hear from you. Thank you very much. That's Samantha Ainsworth. Any thoughts on that? You can, of course, contact the programme. Any experiences of your own you'd like to tell us about, we would love to hear from you. If you've been watching on BBC One the trial of Christine Keeler, you'll be interested to hear that the programme Women's Hour tomorrow will be discussing how different her story looks today. And you can also hear something from the Women's Hour archive,

Christine Keeler on Women's Hour, 20 years ago. So we'll play some of that archive out on the programme tomorrow. Now, the government's official advisers on youth justice want to review the age of criminal responsibility. It's currently 10 in England and Wales, and that's the lowest in Europe. They would like it to be raised by at least two years to 12. It's currently 12 in Scotland, the last children to get a custodial sentence in England and Wales were two brothers sentenced in 2010 for an appalling violent attack on two other young boys. Let's get the view of Dr Eileen Vizard, who's a consultant child and adolescent psychiatrist

at the Institute of Child Health at University College London. Welcome to the programme. And with us as well from our studio in Brighton, Louise King, Director of Policy and Campaigns from the youth and legal charity Just for Kids Law. Eileen Vizard, what do you think of the fact that we still have this age of criminal responsibility at 10 and what does it mean actually? Well, it's not a good thing because at age 10, children are not sufficiently mature to understand the process into which they're about to enter, let alone participate

effectively as they are expected to in their own trial. It's also not a good thing because what we're doing is we're criminalising very young children. And this worries me a lot. They're adopting an identity, which is that they are a young criminal. And regardless of the outcome of the trial, but particularly if they are found guilty, that's an identity which they carry with them for the rest of their growing up period. And it's something which adds to the risk that they pose to other people in terms of violent behaviour or other types of offending. So in many ways it's a really bad thing. It's also extremely inhumane because these children

really don't understand what's going on around them. It would seem that England and Wales are a peculiar outlier when you look at the age of criminal responsibility elsewhere in the world. I mentioned the Democratic Republic of Congo at 16. Argentina isn't the only country to have 18. Norway, 15. China, 14. Why has this been 10 for so long in England and Wales?

Well, I think the government really are to blame. Sequential governments have dithered and dathered about this. They're fearful of upsetting victims groups. And of course, the voice of the victims who suffer at the hands of these young perpetrators, the voice of the victims must be heard. But there is already space for that within the criminal justice system. And I think we've got to look to recent research into brain development and brain functioning, which underlines strongly the fact that at age 10, the brain is a work in progress. There's a lot going on that's very positive. Children will continue to develop. But we know that on important aspects such as moral development, the development of empathy,

being able to see it from the other person's point of view, and being able to take the longer-term view of the consequences of your own violent behaviour, for instance. These are abilities which children of 10 do not have to any great extent. Louise King, what do you think the age of criminal responsibility should be? Well, similar to what Aileen was saying, we believe that it should be significantly raised. I mean, we do think that 10 years is far too young.

For example, I'm a mother of a boy. My oldest son is 10 years. And, you know, over the Christmas holidays, he had a nightmare and got into my bed because he was scared. And yet at that age, we still think that children are able to be capable of understanding the consequences of their actions and also be able to participate in a very formal and harmful process where we know from our work that they're simply not able to understand what's happening or be able to participate effectively. And also, the UK government have received numerous recommendations from the UN

Committee on the Rights of the Child and the Human Rights Council saying to the UK that we simply need to increase it. And indeed, the UN Committee issued new guidance last year saying that the age of criminal responsibility at a very minimum should be 14. So we're certainly slipping behind progress elsewhere. Can I just read a statement from the Ministry of Justice who's told us there are no plans to raise the age of criminal responsibility. Setting it at 10 provides flexibility in addressing criminal behaviour by children and allows for early intervention to help prevent further offending. Now, everybody listening to this item, certainly if they're my age, slightly younger and a lot older, will be thinking of one crime and one crime above all others, which was the hideous murder of James Bulger by two boys of 10.

And Dr Eileen Vizard has already mentioned the victims groups who, of course, we all understand why they feel so passionately about this. What do you say to them, Louise? Well, I think when we're talking about how we treat children who have got into trouble with the law, we're certainly not undermining the feelings of victims or, you know, how they felt. But I think it's important to recognise that actually the current approach just simply doesn't work. There's been numerous research that actually shows when children come into contact with a harmful and formal criminal justice process, it actually makes them more likely to be swept into a current of crime where they cannot escape, they're unable to actually fulfil their potential and go on to actually make a positive contribution to society. So actually,

the current approach is counterproductive. So as well as being harmful for children, and we know in our work, in all the children that we represent, that it really does have quite a traumatising effect on them. It actually isn't effective in terms of addressing the root causes of why children might be actually coming into contact with the law. Well, Eileen, she's the person, consultant child and adolescent psychiatrist. Eileen, why does a child carry out appalling acts of brutality at around the ages of nine or ten? Why might any child do that? Well, all the longitudinal research which has followed up children who do commit these crimes into adult life has confirmed that they have similar groupings of risk factors in their early childhood. Now, many other young offenders who commit less serious offences also have risk factors, such as poor parenting, parenting with mental illness, drug addiction, parenting with histories

of convictions of violence, parenting with other problems. But what makes the child who seriously offends at age 10 stand out is that there are multiple risk factors that link together. Often they have suffered what is now called multiple ACEs, Adverse Childhood Experiences. Yes, we discussed those on the programme. Yes, serious offence, serious risk factors. They've often suffered multiple types of child abuse,

which intermingle with their effects. And finally, the more serious offenders may be those with a genetic predisposition towards psychopathic traits. And the research I did myself on our own sample of 280 young offenders who were both sexually and physically violent showed that there was a very tiny minority of children who could be identified at a much younger age, below 10, as being on, if you like, a bad trajectory, a red line towards later offending. Now, there's lots of research that confirms this.

Governments know this. They know that if they intervene early, pinch it in the bud, if you like, nip it in the bud at age 10, by moving these children to a welfare-based system where they could have special targeted treatment for the perpetrating offending behaviour. It's quite important to say that although they've all also been victims, just giving them treatment for PTSD when they are an offender is not, in my view, sufficient. There are available treatments, CBT-manualised treatments, for dangerous young offenders which could be used.

We need to get this all in perspective. It was interesting looking, Louise, at the table that showed the range of crimes committed by 10-year-olds. A variety, I should say, burglary, acts of violence, arson. But there has been a drop in the number of offences since 2010, 903 incidents down to 122. So that would suggest that actually judges are not criminalising young children, Louise. Well, I think when having this conversation, it is really important to have perspective in terms of actually the huge kind of majority of children that are kind of coming into contact with the criminal justice system are actually only committing very minor offences. And it is only a very, very tiny number of children that commit very serious crimes. But in terms of kind of decreasing numbers, there has been some positive approaches in more recent times to actually divert children away from the criminal justice system. So, for example, one of the police targets, which kind of focused

on ensuring offences were brought to justice, that was changed to focus on the most serious offences, which are more likely to be committed by adults. So that meant there was kind of a drop in children coming into contact with the police. And also there's been a change in kind of police policy nationally. So the National Police Chiefs Council have issued guidance, which kind of focuses on taking a child centred approach and recognising children's rights. So there has been a kind of a move towards seeing children as children first and foremost and kind of making use of sort of informal disposal so they don't come into the kind of the formal system. is still many, many children that we come across in our work that are really traumatised in terms of the way they are treated by the police, the formal police process and through the courts. Louise, sorry to interrupt, but we've got a busy programme. Thank you so much for your

contribution this morning. Briefly, Eileen, the truth of it is most of us are unsophisticated creatures. We're amateurs in this area. And we just find it incredibly difficult to process the notion of evil from a 10-year-old. And it's somehow easier just to think of them as born that way. Do you understand what I'm trying to say? Well, it's a question that's often put to me, but I think we must not think that way. Babies are not born evil. These children have a demonstrable trajectory towards committing, if you like, evil or very bad acts. But that can be interrupted. And can I just say really briefly, these children are often subjects of parallel proceedings, both in the family courts and in

criminal courts. And our legal system being such as it is, there is no talk between the two systems. So two sets of judges, lawyers, representatives for the same child who may be a subject of care proceedings as well as criminal. This is a ridiculous situation. And if we could at least raise the age of criminal responsibility to, say, 14, we could move towards integrating the systems and having a welfare approach, which also provided public protection. Thank you very much indeed for talking to us. The expert view of Dr. Eileen Vizard, who's a consultant child and adolescent psychiatrist at the Institute of Child Health. Thank you very much for your contribution. We also heard from Louise King, Director of Policy and Campaigns from the youth and legal legal charity Just for Kids Law. Your thoughts on that, welcome, of course, at BBC Women's Hour on Twitter and Instagram.

Email the programme via our website. I know there have been some emails already. People feel very passionately about this, as you might expect. Now, something else our listeners love is a blooming good book. And we are now in the company of Emeritus Professor Helen Taylor, who's written Why Women Read Fiction. Helen, welcome to the programme. Thank you, Jane.

Now, this is such an important topic for me. I've read all my life. I hope to be able to continue reading until my dying day, if at all possible. Why was it considered rather subversive for women to read fiction or read at all? Well, women, of course, have not been educated until this century, really. Women suffered from very poor education. They were expected to have a domestic role. They're expected to be carers and nurturers. And so reading has always been something that women have had to do secretly, or they've been very privileged elite women who've been encouraged to read by their fathers and have had access to libraries. But on the whole, women have been kept out of libraries,

perhaps nuns. Nuns have been the biggest readers because they had their own libraries. So it's really only in recent centuries when women started to read the novel and the novels were written for women and women started to read, to write fiction that women were able to read. And we've taken to it like ducks to water. Yes, we really do quite like it. We do. And it's interesting that a lot of women in the book express guilt at seeking out time in their lives to read. And I think somebody, one contributor, compares it to men who apparently don't feel guilty about, say, fishing or football.

Well, women feel guilty about doing things for themselves, let's face it. You know, we are supposed to be doing things for others. We're taking care of others, we're providing for others. And, of course, we do provide for others by giving them reading. I mean, women read to their daughters in bed, grandmothers read to their grandchildren. Women have made sure that they have shared reading because they see it as something which gives women a little space for their own intellectual and emotional development and how important that is for us all. Can I just ask then, why fiction?

Why do women read fiction in far greater numbers than men? Well, women are, you know, one hates to generalise, but women really do enjoy the whole thing about thinking about what the world means. We are in a patriarchal society, and women feel that women often don't have access through work and family responsibilities to imaginative spaces outside fiction. And fiction really gives women time and space to think about their own relationships, to think about themselves, to think about what the world means to them. And I think that that's one of the things that comes through again and again, women saying that they travel to different worlds in their minds. I don't doubt it. The fact to bear out what you're saying, there's crude statistics of who buys books and by whom, bear all that out. But why don't men need that same opportunity? Well, I've asked various women

this and some women tell me that they think men are not very interested in how people think. I don't think that's true. It's a bit hard on men. It is a bit hard on men. And I can't answer that question. I've written a book about what I wanted to do was to celebrate the fact that women buy sort of 80% of fiction, that they read every conceivable genre. And they celebrate fiction by joining book clubs, which are mainly women only. And they go to literary festivals because they're fascinated by writers know, they go on literary heritage visits. They go to visit, you know, Howarth Parsonage and Chawton to see Jane Austen's home. And so I wanted to celebrate that and say, you know,

fiction is kept going by women. And Ian McEwan said that, that when women stop reading, fiction will be dead. And it is true that we should be remembered as the ones who are keeping that fiction alive. Yes, I'm more than happy to do so. But the oldest of all literary chestnuts is the notion that women read men and women and men only read men. They do. That's true. Still true?

It is true. It is true that there are different studies which say that, you know, most men and women tend to read novels by their own gender. But actually, it is true that women largely read, even though a woman's name, which is why writers like J.K. Rowling, you know, MC Beaton, gave themselves initials because then they sound ungendered. Do you have a view on that, by the way? I think it's fascinating and I don't have a view on it. All I can say is that it's a phenomenon and that a lot of writers have resorted to pseudonymity by giving themselves, you know, George Eliot, George Sand,

all those women writers in the 19th century and 20th century women and 21st century women have given themselves initials and pseudonyms to try to attract male readers as well. Now, we have in the last couple of years talked on this programme about fan fiction, about erotica, and there is no doubt that e-books, audio books are, I was going to say allowing, allowing women, I'll say it anyway, to read the sort of stuff that they may not have sought out a decade or so ago.

Well, the number of women who told me that they could read Fifty Shades of Grey on their Kindle or their iPad and nobody knew what they were reading is Legion. And it's certainly true that erotica has become a very large body of work that women have taken to. And, of course, people are very shocked that Fifty Shades has been such a success. They shouldn't be that shocked, could they? Because women have always read erotica. Indeed they have, yes.

And right from Radcliffe Hall through to Sarah Waters. Radcliffe Hall is the well of loneliness. Well of loneliness. Which was about lesbianism. Yes, it was. Was it banned or was it simply something? Yes, it was banned, it was. But a lot of women discovered it

and then of course it was reprinted, I think, by Virago and Virago Press has discovered all these novels by women that women never knew about. And they've been a huge success as a result. I'm going to ask you an impossible but obvious question, which is your favourite book? I never answer that, Jane. I'm sorry. I thought I was onto something. No, I don't have a favourite book because, you know, often my favourite book is the one I've just been reading. OK, what have you just been reading?

What have I just been reading? Well, let me say that Bernadine Evaristo's... I'm glad you mentioned that. Winner of the Booker Prize. Winner of the Booker Prize and how wonderful that novel is. And that brought so many new... I need the title. I know I've got to hear it. So many new... Girl, Woman, Other. Yeah.

She brought so many new voices into fiction, voices I'd never heard before. And it's funny and it's clever and it's complex. And it's so delightful to see a BAME woman getting all the attention that she's getting. Well, not before time. Not before time. But Camilla Shamsi, Monica Ali. I mean, there are other BAME women who've really changed the way in which we think about women's writing. They're not just all white middle-class women that we're reading now.

That is Helen Taylor, who is a passionate advocate of women's reading and women's writing as well, of course. And loads of you wanted to tell us about why you love books and the books you love and why you love them. Just going to read a few now. This is Sarah. My love of fiction started relatively late in childhood. I struggled to read and I think my parents despaired. My dad was a vicar at the time and he used to go to conferences at Windsor Castle once a year. Every time he came back from a trip,

he had paper bags for all of us and inside was a book. This was the most exciting treat we could think of. The best one was a family visit to Ely Cathedral in 1970 and I remember going to the cathedral bookshop and he bought me my first copy of Jane Eyre, which I still have to this day. It's a bit brown around the edges and very well thumbed. Inside is the name, my name, address and the words,

approximately 13 years. I love this book. It still smells of cathedrals and reminds me of my adored late father. I love reading and still nothing quite beats that feeling in a bookshop or library when you find just the thing you were looking for. Oh Sarah, I totally get that and what a lovely memory of your favourite much cherished copy of Jane Eyre. From Genevieve, my favourite fictional book is one my daughter-in-law read and gave me to read and then my granddaughter's read it

so it's been a real family favourite it's called The Language of Flowers and it's a real treasure I still have it and would love to pass it on to someone who would love it too. I used to really look forward to climbing into bed at the end of the day to read it and I was so sad when I'd finished it. It's all about the Victorian

language of flowers used to express emotions and of course was entwined into a touching story with loss and regret, second chances and happy outcomes. I loved it. That sounds interesting as well doesn't it? I've got to be honest and say this is slightly going against the Woman's Hour motto but I am reading a book by a man at the moment i know don't tell anyone uh anyway it's called it's called scrublands and if you're looking for a thriller to guide you into the new year um i can heartily recommend it's by a man called chris hammer um obviously i'll go back to reading books by women exclusively in a moment or two when i finished um scrublands but for the moment that is absolutely absorbing me. Here's another recommendation from Sheila. I can

wholeheartedly recommend The Enchanted by René Denfeld. It is beautiful and lyrically written. The topic is quite dark. It's set in a death row prison, but it is surprisingly uplifting. The passages of magical realism and the part positive storyline lift the book to a higher Thank you to everybody who contributed. And we'll have Helen back on Radio 4 with her book of the week on the network starting on Monday, 9.45. So just before Woman's Hour next week. Now, so many of you talking about concussion and your own experiences. So let me just plough through some of the emails. My daughter was traveling in Australia a couple of years ago, says Marcella, and she got a job as a drove helping gather cattle in the outback. She was

thrown off her horse and left unconscious on the ground for a while. She was airlifted to the closest hospital with concussion, spent a week. She was airlifted to the closest hospital with concussion, spent a week in hospital and then went back to work as if nothing had happened. She was 19 at the time. Well, she's now 25 and has constant panic attacks and is mentally very fragile at times. The consequences of these things are quite long lasting. Thank you for highlighting such a serious condition. Thank you. Here's another one.

This is James. I'm a 25-year-old man working in London. I had a concussion injury playing rugby in my last year of university, and it took me 28 months to recover fully. I can relate entirely to what Samantha was saying, read the lack of guidance and support, and it's had a big impact on my life. I'm currently writing up an extensive recount Good luck with that, James.

From Roz, I'm listening to your programme this morning about head injuries and concussion in women. I feel it is really time that more research was done specifically with women in mind. As we know, the menstrual cycle has an impact on how things affect women, especially drugs. And it was interesting listening to your guest explaining that recovery from concussion in women can be worse depending on where they are in their cycles. So it made me wonder if recovery from concussion in women can be worse depending on where they are in their cycles. So it made me wonder if recovery from concussion is worse when you get through the menopause. Can't we do more research on this? I really think we should.

Roz is the name of that contributor. Hopefully more research will be done on this. Let me read one more from a listener called Catherine. I've recently retired from amateur women's rugby, where concussion is a common risk, unfortunately, and many of my teammates, including myself, have had to deal with this type of injury. Some of us recovered quickly, others didn't, having to take long-term breaks from work or study to help symptoms resolve. This was made all the more necessary by the fact that so much of modern life is screen based, which means that early recovery can be isolating and scary. You cannot message your friends, watch TV or Google concussion guidance without a symptom flare up. I mean, that is a really good and I should say an obvious point that I hadn't thought of. But thank you for drawing our attention to it. However, Catherine goes on,

the support of my teammates when I had concussion and the vigilance of the coaching staff in identifying the first symptoms and ensuring that I didn't return to the sport too early was key. The rugby community, which is an amazing place, is doing excellent work in promoting awareness and management of concussion at all levels of the game, such as the return to play rules, which anybody can find on the England RFU website. Well, Catherine, best of luck to you. And

thank you very much for that. And Willie Stewart, who is our concussion expert, and he is the man, Willie Stewart, the person, I should say, on this subject was very keen to say that actually the positive impact of sport impacts do outweigh any negatives. So he is not suggesting that women or men should give up playing sport. That absolutely isn't his point. And I was really touched by the fact that so many of you wanted to know how you could donate your brains in the future to help Willie Stewart's research. If you would like to do so, you can just go to the Glasgow Brain Injury Research Group website. Glasgow Brain Injury Research Group.

They've got a website and you won't be surprised to hear there is quite a bit of relevant paperwork. You can't just donate your brain. You need to fill in a few details. I mean, I don't know whether they'd want mine, but I suppose I should give it a go. Thanks to everybody who took part today. Jenny is here tomorrow.

And amongst other things, she's going to be talking about the notion of snowplow parenting. These are the parents who do their damnedest to ensure that no obstacle lies between Tallulah and Jasper and lifetime success. But is such a thing a good idea? Right. Thank you very much for listening. Jenny's here tomorrow. I'm Sarah Treleaven. And for over a year, I've been working on one of the most complex stories I've ever covered.

There was somebody out there who was faking pregnancies. I started like warning everybody. Every doula that I know. It was fake. No pregnancy. And the deeper I dig, the more questions I unearth. How long has she been doing this? What does she have to gain from this? From CBC and the BBC World Service, The Con, Caitlin's Baby. It's a long story, settle in. Available now.