SCN0132

Written evidence submitted by Roehampton University

Introduction

1. Dr Susana Castro and Dr Olympia Palikara are Chartered Psychologists and Senior Lecturers in the School of Education at the University of Roehampton. From 2015, they coordinated a number of funded projects which involved the evaluation of the support provided to children and young people with Special Educational Needs and Disabilities (SEND), as well as the study of new models with potential to improve provision. Their funders included The British Academy and Leverhulme Trust, the European Commission and the Froebel Trust.

2. They are submitting a response to the House of Commons inquiry into the support for children and young people with SEND, based on the evidence that resulted from their studies and aiming to address the following points raised in this enquiry: 

• The transition from statements of special educational needs and Learning Disability Assessments to Education, Health and Care Plans;

• The roles of and co-operation between education, health and social care sectors;

Executive Summary

1. In this response, we present remarks that refer to scientific evidence independently gathered by our research team over the last three years on a number of issues surrounding SEND support.

2. Our remarks can be summarised in three main points that will be elucidated in detail in our response:

1. There is evidence of a clear disconnect between the principles conveyed in the current Children and Families Act 2014 / SEND Code of Practice 2014 and the way in which these principles have been implemented;

2. There is solid quantitative and large-scale evidence that the quality of the Education Health and Care plans developed since 2015 is questionable and jeopardises an effective and high-quality provision of multi-agency services for children and young people with SEND.

3. There is an international classification system which is recognised world-wide as the gold-standard for disability documentation across disciplines and contexts - The International Classification of Functioning Disability and Health (ICF; WHO, 2001); this has been adopted in a number of countries; our team has tested and has gathered evidence that the ICF would be helpful for the Education Health and Care planning process in England.

1. Evidence from a large-scale survey conducted with professionals involved in SEND provision

1.1. With funding from the Froebel Trust, a large-scale survey on the views of professionals concerning the implementation of the Children and Families Act 2014 and respective SEND Code of practice was conducted. The survey was completed by 349 professionals, including educational psychologists, special educational needs co-ordinators, speech and language therapists, head teachers and other school staff. 50% of the participants are from London and 50% are relatively evenly distributed across other regions (the South East, East of England, East Midlands, West Midlands, the South West, Yorkshire and the Humber, the North East and the North West).

1.2. The results revealed that although many professionals agreed in principle with some of the key changes introduced as well as with some key ideas underpinning the new policy, several concerns were reported regarding its practical implementation; these included: tight timelines, budget cuts, challenges regarding the collaboration between education, health and social care, suggesting a rather fragmented implementation of the new policy, instead of the promised holistic approach.

1.3. No significant differences were found between groups of professionals for most questions, with the exception of the item regarding the extension of the provision age range to 25 years; here, educational psychologists differed significantly from SENCOs, and thought that their professional requirements have changed substantially, as they are not trained to work with over 18s.

1.4. The most striking aspect of this study (now published and available here) is the clear evidence of the disconnect between a policy that professionals agree with ideologically, and its fragmented implementation, facts that had been highlighted and discussed in previous work by the team (Castro & Palikara, 2016 – available here).

2. Evidence from a systematic content analysis and quality evaluation study of a large sample of Education Health and Care plans

2.1.         A series of studies were conducted looking specifically at the quality of the content included in the newly developed Education Health and Care plans, from 2015 to 2017, across age ranges and school provision, including mainstream and special school settings.

2.2.         Study 1 - Analysis of section A, the voice of the child and the family, where 184 plans were included (Palikara, Castro, Gaona & Eirinaki, 2018 – available here)

1. The plans included in the analysis belong to 92 children attending mainstream settings and 92 children attending special settings from 9 local authorities of greater London, which differ considerably in terms of their deprivation indexes.

2. Use of the first person and accessing the child’s voice: Although 63.6% of the plans gathered use the first person in section A, as if the child had described her experience first-hand, 83.2% of them do not describe the method used to access the child’s perspective, and there is evidence that the child might not have been consulted, thus raising serious ethical concerns. Even when it is explicit that the parent is representing the child’s voice, very often there is no mention of how the parent communicates with the child, which would be useful for intervention purposes.

3. Focus on abilities, disabilities or both: Even though the great majority of plans include the child’s perspective on both abilities and disabilities (91.3%), the majority of statements included in section A relate to disability issues or specific needs (51.9%). There is very little information about what the child thinks he/she is good at (only in 36.4% of the plans). The remaining statements refer to environmental aspects (11.7%). Within the disability/needs-related statements, 67% were regarded as non-definable, as they were too vague to be coded, not illustrating a specialist approach to SEND provision.

4. Differences in provision: The findings revealed high levels of variability in the way the voices of children were captured, including the methods used to ascertain their views, with statistically significant differences between Local Authorities; some Local Authorities use the first person significantly more often than others, some describe the method for obtaining the child’s voice in much more detail than others and some are adopting consistently better practices than others, showing that there are no standard procedures or evidence-based practices being adopted in the development of Education, Health and Care plans, which in turn highlights the absence of a clear evidence-based system to support the EHC process.

2.3.         Study 2: Results from the analysis of section E (Castro, Grande & Palikara, submitted): The SEND code of practice clearly states that the outcomes included in the EHC plans should be SMART (Specific, Measurable, Achievable, Realistic, Time-framed).

• 219 outcomes randomly extracted from EHC plans were independently rated on how SMART they are. Results show that:

1. 94.1% of the outcomes were not specific enough to mention a form of participation that is meaningful for the child’s routine

2. 93.6% of the outcomes do not mention a meaningful acquisition criterion (how do we know the child has achieved that outcome?), 96.3% of the outcomes do not include a generalisation criterion (how do we know the child is able to demonstrate that behaviour in other situations?) and 58% are not observable or manageable, thus not clearly measurable or attainable.

3. The majority of outcomes focus on skills that are relevant for the child’s daily participation (57.5%), but a large number of outcomes do not (42.5%)

4. The great majority of outcomes are time-framed (98.6%), although this happens because most plans include a time-frame of 12 months for the review. There is no specific mention to a time-frame for each outcome.

5. Again, we found statistically significant differences between local authorities with some local authorities adopting consistently better practices in developing SMART outcomes, than others.

6. This analysis was extended to more than 3000 outcomes with similar results (paper can be provided upon publication).

2.4.         Study 3: Results from the analysis of sections B, C and D – The Education, Health and Social care needs of the child, respectively:

1. The recommended structure of the EHC plan includes one dedicated section per domain (education, health and social care needs respectively); however, it is found that in the great majority of plans the education section includes information on all three domains, leaving the health and social care sections empty. This shows that the actual planned structure of the plan, diving it into three separate sections for education, health and social needs, might be hindering the development of truly holistic narratives about the child’s needs. This is a dangerous situation as it can easily lead to misinterpretations about the child’s functioning – e.g. assuming the child has no health needs because the respective section is empty, when in fact these have been included in the education needs.

2. When describing the needs of children in sections B, C and D of the EHC plans, it was observed that in the great majority of statements there was no specific mention to the magnitude of the problem / functional issue observed.

3. The team is currently analysing these sections across 226 plans, with the identifying clusters or patterns of needs across plans, so that the main need of the child can be easily identifiable based on patterns of participation, not on diagnostic labels (often children with the same diagnosis have very different functioning profiles). These participation-based clusters are identifiable and may provide a better indication of the necessary provision, than diagnostic-based needs descriptions, and are more in-line with the principles of the Children and Families Act – focus on participation and holistic understanding of the child.

3. Evidence from a training session on the International Classification of Functioning Disability and Health (ICF; WHO, 2001) with professionals working in SEND provision (Castro, Palikara, Gaona & Eirinaki, in press)

3.1.         A whole-day ‘taster’ session introducing the ICF as a tool to support the EHC planning process[1]. The training involved 25 participants (5 Educational Psychologists, 9 Special Educational Needs Coordinators (SENCos), 7 SEN specialists from the Local Authorities, 3 SEN teachers and 2 speech therapists).

3.2.         Amongst the 25 participants in the training session, 23 had never heard about the ICF. Following the ‘taster-session’, 20 participants agreed that the ICF model has clear conceptual links to the current policy for SEND provision in England. Additionally, participants were asked to highlight the areas where they think the ICF can be most useful: The majority (21) of participants agreed that the ICF model and system can be helpful to support multi-agency working, since it provides a common language to describe functioning; they also think it can help to develop more individualised descriptions of functioning and simultaneously, more holistic EHC plans. Additionally, participants mentioned its usefulness to support the evidence-based descriptions of needs, for monitoring the child’s progress over time and to help develop plans with fewer technical terms, which are more user-friendly.

3.3.         Outcomes that were written by the participants before the ICF training session were compared to outcomes written by the participants after the session. These outcomes were then rated by experts on SEND based on their level of ‘SMARTness’; We found that the majority of outcomes saw statistically significant improvements following the training in terms of the extent to which they were rated as SMART by SEND experts, in all criteria (Specific, Measurable, Attainable, Relevant) but in relation to the ‘time-frame’ criterion (paper can be provided upon publication).

4. Evidence-based suggestions for improving the EHC planning process

4.1.         The body of research conducted by this team over the last 3 years has extensively demonstrated that there are a number of challenges with the current Education health and Care planning process, which ultimately lead to poor quality standards of provision and poor quality outcomes for children.

4.2.         Based on the evidence provided we strongly recommend:

1. That a panel of experts is set to discuss the implications of including the ICF in the current policy for SEND provision as a means of improving multi-agency working and higher quality Education Health and Care plans;

2. That this panel is comprised of experts in SEND provision, experts in education policy, experts in the ICF with experience of usage and training, and parents.

3. That this panel conducts a consultation and review process on how the ICF has been successfully adopted in other countries.

4. That this panel supports a pilot implementation of the ICF for cost-benefit analysis of its introduction in the system.

5. A Nation-wide standardised training curriculum for professionals on how to write outcomes, how to report the children’s perspective and how to describe the children’s needs holistically, based on expertise from academic and scientific research.

By Dr Susana Castro and Dr Olympia Palikara

List of published references

Castro, S., & Palikara, O. (2016, November). Mind the gap: the new special educational needs and disability legislation in England. In Frontiers in Education (Vol. 1, p. 4). Frontiers.

Palikara, O., Castro, S., Gaona, C., & Eirinaki, V. (2018). Professionals’ views on the new policy for special educational needs in England: ideology versus implementation. European Journal of Special Needs Education, 1-15.

Palikara, O., Castro, S., Gaona, C., & Eirinaki, V. (2018). Capturing the voices of children in the Education Health and Care plans: are we there yet?. In Frontiers in Education (Vol. 3, p. 24). Frontiers.

World Health Organization. (2001). International Classification of Functioning, Disability and Health: ICF. World Health Organization.

June 2018