SCN0292
Introduction
1. Afasic is the UK-wide charity representing children and young people with speech and language disorders. Afasic welcomes the opportunity to make a submission to this inquiry.
2. Afasic primarily represents children with specific speech and language disorders, that is to say their difficulties have no known cause.
3. Speech and language may be affected in any or all of the following ways:
4. Speech and language disorders may be associated with other cognitive impairments, including:
5. As a result, children with speech and language disorders often function and perform at quite low levels and have real difficulty with many aspects of daily life and learning, including acquiring literacy and numeracy skills.
6. Speech and language disorders affect 7% of school-aged children. The majority of these will be at the lower end of the age range, as most children’s speech and language skills improve as they get older, especially if they are given appropriate support by speech and language therapists and teaching staff. However, even where a clinical diagnosis of speech and language disorder is no longer appropriate, children and young people may still have any or all of the cognitive difficulties described above which will affect their learning and performance at school. It should also be noted that 1 in 500 children has a persistent, life-long speech and language disorder, which will affect them throughout their time at school and beyond.
Executive Summary
Assessment of and support for children and young people with SEND
7. The factors that have always stood in the way of an effective and inclusive SEND system are attitudes, expertise and funding. Of these, funding will be discussed below. Unfortunately, instead of addressing these fundamental issues, successive governments have simply tinkered with the system, in the vain hope that this would make a difference.
8. Attitudes: The problem is that while there are lots of nice words about meeting the needs of children with SEND, the reality is that the education system is geared towards children meeting certain targets at certain ages, and children with SEND, who often will not match this profile, tend to be an afterthought. A truly inclusive system would start where the children are, and would also go beyond the focus on academic attainment to encompass preparation for life in its widest sense including social skills, organisational skills etc.
9. Expertise: There is insufficient expertise in the system at all levels. Standard teacher training courses do not adequately prepare teachers for SEND and even if this were changed now, it would take decades to work through the entire workforce. Regrettably, those rare specialists within the system who do have a high level of expertise are slowly disappearing due to budget cuts.
10. Assessment: To be effective, assessments need to be carried out by people with the appropriate expertise. For various reasons, this does not always happen. Frontline staff may not know enough to recognise what they don’t know and, even if they do, there can be long waiting lists to see specialists. It is also the case that if professionals identify a need, they have to address it, and the costs involved can be a strong incentive not to do so. These are examples of recent worrying trends:
11. Support often continues to be over-reliant on poorly trained and managed teaching assistants rather than the high level of expertise that might make a real difference. A truly effective SEND system would include better trained teachers, together with speech and language therapists (SLTs), occupational therapists (OTs) and educational psychologists in all schools.
The transition from statements of special educational needs and Learning Disability Assessments to Education, Health and Care Plans
12. This has proved highly problematic, with many delays, and some children and young people still without an EHC Plan. In too many cases the transfer was rushed and breached the Government guidelines by not involving a full assessment. In some cases, schools were, quite inappropriately, asked to use annual reviews to draft an EHC Plan based on an existing Statement.
13. The introduction of EHC Plans has not been a positive move. The documents are too long and unwieldy and very difficult for everyone, including parents, to navigate. They contain a lot of extraneous detail which does not add anything useful and have lost their primary focus, which should be on the child’s needs and the additional support required to meet those needs. In other words, we would recommend going back to something more like the old Statement.
The level and distribution of funding for SEND provision
14. Funding for SEND provision appears to be very tight and probably inadequate. The new funding system has not helped. Most funding is devolved to schools, but, as it is not ring-fenced, there is no real clarity over how much money schools should be spending on SEND. Senior management teams may not know how much of their funding is intended for SEND; the budget given to SENCOs may bear no relation to the actual allocation given to the school; and parents may be given the impression that the school has no extra funding for SEND at all.
15. The nominal £6000 that schools are expected to provide from their own resources has had a severely detrimental effect on EHC Plans. Many local authorities are now insisting on schools demonstrating that they are already spending £6000 or more on the child concerned before they consider an EHC Needs Assessment – something which is not a requirement of the law. Draft EHC Plans are full of clauses specifying that the school will use existing resources to implement various strategies so that little or no additional funding is provided. This seems a colossal waste of time and resources. Essentially, the EHC Plan ends up asking the school only to deliver what an inclusive school would be expected to deliver anyway and the child is denied the additional, specialist support he or she needs. This is the complete opposite of the main purpose of an EHC Plan, which is to deliver the resources and expertise the child needs, and is one of the factors driving parents to lose trust in the system and, in some cases, opting out completely in favour of home education in combination perhaps with private support.
The roles of and co-operation between education, health and social care sectors
16. This was a problem with the old system and continues to be an issue now. Essentially, this is because the SEN system is basically an educational process, with the occasional input from health and social care here and there.
17. For the children Afasic supports, speech and language therapy is a key service, but access remains problematical. The system seems to expect education and health to work together to provide therapy but this is not really happening successfully at all. Both sectors continue to feel it is the other’s responsibility and the financially strained environment means that it keeps being batted between them. In part, this is due to funding arrangements, historical background and different conceptualisations of the role of speech and language therapy. The NHS has a particular responsibility for under fives, and tends to focus on enabling children to develop basic communication skills, which again primarily means younger children. Even then the level of service they provide can only be described as ‘anaemic’, typically consisting largely of advice for parents, and often no more than one course of therapy. Health would argue, with perhaps some justification, that speech and language therapy for older children largely involves supporting them to access the language elements of the curriculum, and so should be an educational responsibility – something education would reject, on the grounds that speech and language therapists are a health-related profession. The people who miss out of course are the children in the middle.
18. Case law does make clear that in the case of children with EHC Plans, speech and language therapy should ultimately be education’s responsibility – and actually for many of the children Afasic supports, securing an EHC Plan is often the only way to access the therapy they need. This is often far from straightforward, though. Parents often have to go to Tribunal, or threaten to do so, to get the local authority to carry out an assessment and then find that, in order to avoid having to pay for therapy, education and health appear to collude to specify inadequate levels of therapy – usually just a ‘programme’ for the school.
19. A parent contacted us with her story: Her son was not getting his allocated SLT sessions even though these were included in his EHC Plan. His SLT moved away last summer and he was not allocated a new one until January. Now the 6 sessions he is supposed to have over a year will all be scheduled over 6 weeks and there will be no time for monitoring or setting new targets for the rest of the school year.
20. The situation for occupational therapy is similar to speech and language therapy but, if anything, even worse.
21. As under the previous system, social care rarely gets involved with children with speech and language difficulties, or indeed many children with SEND at all. This can be a relief to parents who tend to associate social care with child protection, but there is no doubt that some families who might benefit from support are not receiving it.
22. Social care has a particular role to play in supporting older children and young people to develop independence skills, but this is only routinely offered to a small proportion – often just those attending certain special needs schools.
Provision for 19-25-year olds including support for independent living; transition to adult services; and access to education, apprenticeships and work
23. For various reasons, children with speech and language difficulties tend to lose their SEND classification, and hence EHC Plans (if they had one), as they get older. This may be because they no longer need, or at any rate receive, speech and language therapy.
24. EHC Plans are also often withdrawn if young people move onto FE College on the basis that they are doing a course targeted at their level, and so do not need extra support.
25. The transition process is still very poorly handled. In the case of children in mainstream schools, there is often no multidisciplinary planning at all, and parents may be quite unaware that a transition plan should be drawn up. Families are often given few options for their next move at 16 or 19. Not infrequently, schools will simply tell young people and parents about a course at a local college that their SEND pupils tend to do.
26. To give a concrete example, a parent contacted us to say that her 19 year old son with complex needs and behaviours is about to leave school, with no agreed plan for what he will do next. The parents managed to secure a capital grant from the Government to set up a supported living unit for their son and other young people with SEND, but the local authority blocked it, claiming that it is not needed. Several of the other young adults were assessed repeatedly until found NOT to be eligible for social care funding.
June 2018