Special Educational Needs Provision Research Articles

Early educational attainment in children with major congenital anomaly in the UK

ObjectiveTo describe early educational attainment and special educational needs (SEN) provision in children with major congenital anomaly (CA) compared with peers.DesignAnalysis of educational data linked to the ongoing Born in...

Impact of special educational needs provision on hospital utilisation, school attainment and absences for children in English primary schools stratified by gestational age at birth: A target trial emulation study protocol

Introduction One third of children in English primary schools have additional learning support called special educational needs (SEN) provision, but children born preterm are more likely to have SEN than those born at term. We aim to assess the impact of SEN provision on health and education outcomes in children grouped by gestational age at birth. Methods We will analyse linked administrative data for England using the Education and Child Health Insights from Linked Data (ECHILD) database. A target trial emulation approach will be used to specify data extraction from ECHILD, comparisons of interest and our analysis plan. Our target population is all children enrolled in year one of state-funded primary school in England who were born in an NHS hospital in England between 2003 and 2008, grouped by gestational age at birth (extremely preterm (24-<28 weeks), very preterm (28-<32 weeks), moderately preterm (32-<34 weeks), late preterm (34-<37 weeks) and full term (37-<42 weeks). The intervention of interest will comprise categories of SEN provision (including none) during year one (age five/six). The outcomes of interest are rates of unplanned hospital utilisation, educational attainment, and absences by the end of primary school education (year six, age 11). We will triangulate results from complementary estimation methods including the naïve estimator, multivariable regression, g-formula, inverse probability weighting, inverse probability weighting with regression adjustment and instrumental variables, along with a variety for a variety of causal contrasts (average treatment effect, overall, and on the treated/not treated). Ethics and dissemination We have existing research ethics approval for analyses of the ECHILD database described in this protocol. We will disseminate our findings to diverse audiences (academics, relevant government departments, service users and providers) through seminars, peer-reviewed publications, short briefing reports and infographics for non-academics (published on the study website).

Evaluation of variation in special educational needs provision and its impact on health and education using administrative records for England: umbrella protocol for a mixed-methods research programme

IntroductionOne-third of children in England have special educational needs (SEN) provision recorded during their school career. The proportion of children with SEN provision varies between schools and demographic groups, which...

Early special educational needs provision and its impact on unplanned hospital utilisation and school absences in children with isolated cleft lip and/or palate: a demonstration target trial emulation study protocol using ECHILD

Background Special educational needs (SEN) provision is designed to help pupils with additional educational, behavioural or health needs; for example, pupils with cleft lip and/or palate may be offered SEN provision to improve their speech and language skills. Our aim is to contribute to the literature and assess the impact of SEN provision on health and educational outcomes for a well-defined population. Methods We will use the ECHILD database, which links educational and health records across England. Our target population consists of children identified within ECHILD to have a specific congenital anomaly: isolated cleft lip and/or palate. We will apply a trial emulation framework to reduce biases in design and analysis of observational data to investigate the causal impact of SEN provision (including none) by the start of compulsory education (Year One – age five year on entry) on the number of unplanned hospital utilisation and school absences by the end of primary education (Year Six – age ten/eleven). We will use propensity score-based estimators (inverse probability weighting (IPW) and IPW regression adjustment IPW) to compare categories of SEN provision in terms of these outcomes and to triangulate results obtained using complementary estimation methods (Naïve estimator, multivariable regression, parametric g-formula, and if possible, instrumental variables), targeting a variety of causal contrasts (average treatment effect/in the treated/in the not treated) of SEN provision. Conclusions This study will evaluate the impact of reasonable adjustments at the start of compulsory education on health and educational outcomes in the isolated cleft lip and palate population by triangulating complementary methods under a target-trial framework.

Local authority variation in primary school-recorded special educational needs provision among children with major congenital anomalies: A research protocol

Introduction: Special educational needs (SEN) provision has been called a “postcode lottery” in England, but the extent to which this represents underlying inequities has not been sufficiently investigated. This study will focus on children with similar underlying health characteristics to explore sources of systematic variation in SEN provision by local authority (LA) in England. Methods and analysis: We will use linked individual-level state-funded hospital and school records from the Education and Health Insights from Linked Data (ECHILD) database, alongside open-source school-level data. Our cohort will be defined as singleton children with major congenital anomalies born in England between 1 September 2003 and 31 August 2012. We will identify major congenital anomalies from diagnoses in hospital records in the first year of life using European Surveillance of Congenital Anomalies (EUROCAT) guidelines. LA (152 in total) will be defined by child’s residential address reported in education records at entry into year one of school (aged five years old). SEN provision will be defined by a recording of an educational health and care plan or SEN support in any census in Reception, year one or two of primary school (ages four/five to six/seven). To quantify variation in SEN provision we will fit multilevel logistic regression models to the individual records, with a-priori selected individual-, school- and LA-level characteristics. We will report the estimated intraclass correlation coefficient at each stage of the model, signifying the percentage of remaining variation in the odds of recorded SEN provision that is due to differences between LAs. Ethics and dissemination: We have existing research ethics approval for analyses of the ECHILD database described in this protocol. We will disseminate our findings to diverse audiences (academics, relevant government departments, service users and providers) through seminars, peer-reviewed publications, short briefing reports and infographics for non-academics (published on the study website).

Primary-school recorded special educational needs in children born with major congenital anomalies in England: A population-based study using the Education and Child Health Insights from Linked Data database

ObjectivesWe provide a national overview of survival to primary school and recorded special educational needs (SEN) provision among children with hospital identified major congenital anomalies (MCAs) born in England. We also report changes before and after government reform of SEN in 2014.
 MethodsWe created a cohort of 6,180,400 singleton children born in England between 1 September 2003 and 31 August 2013 using linked administrative health and education records (from the ‘ECHILD’ database). MCAs were identified using hospital admission and mortality records during infancy. We used at least one record of SEN in state-school records as a proxy for SEN provision. We quantified: survival to age 5 using Kaplan-Meier survival analysis; the prevalence of recorded SEN during primary school Years 1 to 6; and the difference in proportion of children with recorded SEN in Year 1 before and after the 2014 government SEN reforms.
 ResultsChildren with any MCA had 5-year survival rates of 95.1% (95% confidence interval, CI, 95.0, 95.2), compared with 99.7% (95% CI 99.7, 99.7) among children without a MCA. 41.5% (75,202/181,328) of children with an MCA attending state-school between Year 1 and 6 had any recorded SEN compared with 25.6% (1,282,979/5,008,624) of children without a MCA. Of the 12 system-specific MCA subgroups, children with chromosomal, nervous system and eye anomalies had the largest prevalence of recorded SEN. The prevalence of recorded SEN decreased by 4.9% (95% CI -5.3, -4.4) for children with any MCA compared with a reduction of 4.3% (95% CI -4.4, -4.2) for children without a MCA, when comparing pupils in Year 1 before and after 2014.
 ConclusionRecorded SEN among children with hospital identified MCAs was markedly higher than for those without MCAs, however more than half had no recorded SEN. Our findings suggest government reform in 2014 reduced SEN provision for children with MCAs.

Risk of school exclusion among adolescents receiving social care or special educational needs services: A whole-population administrative data cohort study

BackgroundExclusion from school is associated with health, well-being and social detriments and disproportionately affects vulnerable children. No study in England has examined the total cumulative risk of exclusion across secondary school among children with a history of children's social care (CSC) or special educational needs (SEN). ObjectiveTo assess the risk of any secondary school exclusion among adolescents receiving CSC or SEN services compared with their peers. MethodsAn administrative data cohort study comparing children in English state schools (n = 1,031,500) with no history of CSC or SEN provision with children who had received different levels of CSC and SEN in combination. Outcomes were proportions of students with any fixed-term or permanent exclusion in years 7 to 9 (age 11 to 14) and years 10 to 11 (age 14 to 16). ResultsOverall, 13 % of children were excluded at least once across years 7 to 11. CSC exposure was associated with exclusion risk: 32 % of children in need (or formerly in need) and 40 % of current or former children looked after and those subject to child protection plans were excluded at least once across years 7 to 11, compared to 12 % of the non-exposed group. After adjusting for confounders, children with SEN history were more at risk of exclusion, regardless of CSC exposure category (except for exclusions among children looked after during years 10 to 11). Rates of exclusion varied significantly between local authorities. ConclusionsLarge inequalities in school exclusion rates between CSC-exposed and unexposed children were observed, with even higher rates observed for children with SEN history. These inequalities undermine the right to education of these vulnerable groups of children.

Special educational needs in bilingual primary schools in the Republic of Ireland

While the Irish language (Gaeilge) is the traditional language of Ireland, it is spoken on a daily basis by a decreasing minority of people. There is an increasing trend for parents to send children, whose first language is English, to Irish-medium schools, where the language of instruction is Irish. Little research has been undertaken regarding special educational needs (SEN) provision in Irish-medium schools. This paper reports on a study that involved a national survey of two types of Irish-medium schools in Ireland. It examined SEN provision and teaching practices in these schools. It investigated the prevalence of various types of SEN amongst Irish bilingual learners, and the benefits of, and the challenges arising from, bilingual education for these learners. It explored the experiences of teachers in meeting the needs of bilingual learners with SEN and the training needs of these teachers. The study reports on standards of good practice in relation to SEN provision that are in keeping with national guidelines. It also identified advantages and challenges for particular learners with SEN in Irish-medium schools that are likely to be equally applicable to bilingual learners within Ireland and in other jurisdictions.

Educational outcomes of children in Wales with cerebral palsy

Background with rationaleIt is recognized that children with disability have special educational needs (SEN). They are likely to have poor school attendance and do not achieve well academically. Many children with a cerebral palsy (CP) have SEN but little is known about their educational provision or outcomes.
 Main AimTo investigate the educational experience of children in Wales with CP and describe the type of SEN and SEN provision; school attendance; achievement—teacher assessments at the end of the Foundation Phase and Key Stages 2 and 3 of the National Curriculum (NC)—and in General Certificate of Secondary Education (GCSE) examinations.
 Methods/ApproachData from the Pupil Level Annual School Census (PLASC), NC and GCSE results from 2009 to 2016 were linked with routine e-health records of primary and secondary health care data held in SAIL. The health care records were used to identify pupils who, potentially, had a cerebral palsy.
 ResultsThe linked data set included around 360,000 pupils per school census of whom 1200–1400 per school census were identified as having a CP, representing a crude prevalence of 0.4%. Adjusted for age, year and sex, there was no significant variation in prevalence by area deprivation. Around 60% of children with a CP have a statement of SEN; over a quarter of CP children are educated in special schools; CP children in mainstream (primary, middle and secondary) schools tended to miss more school sessions (~50% more) than other children and lower percentages achieved the expected levels at Key Stages 2 and 3 and the Level 2 GCSE threshold.
 Conclusion/Implications This work demonstrates the utility of record-linkage between health and education data to map, monitor and provide information to parents, carers and policymakers about education outcomes for this group of children to inform planning and service provision.

Educational outcomes of children with cerebral palsy

IntroductionChildren with special educational needs (SEN) are more likely to have disadvantaged backgrounds than their peers, attend school less and do not achieve as well academically. Many children with a cerebral palsy (CP) have SEN but little is known about their educational outcomes.
 Objectives and ApproachTo investigate the background of children in Wales with CP and describe their educational experience including: type of SEN and SEN provision; school attendance; achievement—teacher assessments at the end of the Foundation Phase and Key Stages 2 and 3 of the National Curriculum (NC)— and in General Certificate of Secondary Education (GCSE) examinations.
 Data from the Pupil Level Annual School Census (PLASC), NC and GCSE results were linked with routine e-health records of primary and secondary health care data held in SAIL. Using health care records for everyone aged between 0-25 in 2004–14, cases of CP were flagged.
 ResultsThe linked data set included some 1500–2000 children per school census classified as having a CP, representing a prevalence of some 0.3%. Provisionally, results show: prevalence of CP is higher amongst children living in relatively deprived areas; around 60% of CP children have a statement of SEN; the SEN type most commonly recorded for CP children with SEN is ‘Physical and medical difficulties’ and relatively high proportions have profound, multiple or severe learning difficulties; around 30% of CP children are educated in special schools; CP children in main stream (primary, middle and secondary) schools tended to miss more school sessions (~50% more) than other children and lower percentages achieved the expected levels at key stages 2 and 3 and the Level 2 GCSE threshold.
 Conclusion/ImplicationsThis work demonstrates the utility of record-linkage for providing information to parents, carers and policymakers about education outcomes for this group of children to inform planning and service provision.

‘Forget the Health and Care and just call them Education Plans’: SENCOs' perspectives on Education, Health and Care plans

In England, Education, Health and Care (EHC) plans are used to identify children's educational, health and social needs, and describe the additional support required to meet those needs. Replacing statements of special educational needs (SEN), the intent was to improve the process of accessing SEN provision through the greater participation of families in decision‐making processes, and increased collaboration between education, health and care sectors. Special educational needs co‐ordinators (SENCOs) play a pivotal role in the implementation of education reforms, and are often responsible for the application of EHC plans. As such, gaining insight into their experiences of initiating applications and transferring statements of SEN into EHC plans can help identify whether these documents are meeting their objectives as person‐led, wraparound care plans. This qualitative study used semi‐structured interviews to explore 16 SENCOs’ perspectives on the effectiveness of the process of applying for and transferring EHC plans. Thematic analysis of responses elicited three key themes: the perceived role of the SENCO in the EHC plan process; procedural challenges and changes – an evolving process; and difficulties in accessing an EHC plan for children with social, emotional and mental health needs.

Learning disabilities among extremely preterm children without neurosensory impairment: Comorbidity, neuropsychological profiles and scholastic outcomes

BackgroundChildren born extremely preterm are at high risk for intellectual disability, learning disabilities, executive dysfunction and special educational needs, but little is understood about the comorbidity of intellectual and learning disabilities in this population. AimsThis study explored comorbidity in intellectual disability (ID) and learning disabilities (LD) in children born extremely preterm (EP; <26+0weeks' gestation). Subjects and study designA UK national cohort of 161 EP children and 153 term-born controls without neurosensory impairments was assessed at 11years of age (the EPICure Study). Outcome measuresIQ, mathematics and reading attainment, executive function, visuospatial processing and sensorimotor skills were assessed using standardised tests, and curriculum-based attainment and special educational needs (SEN) using teacher reports. ResultsOverall, 75 (47%) EP children and 7 (4.6%) controls had ID or LD (RR 10.12; 95% CI 4.81, 21.27). Comorbidity in ID/LD was more common among EP children than controls (24% vs. 0%). EP children with comorbid ID/LD had significantly poorer neuropsychological abilities and curriculum-based attainment than EP children with an isolated disability or no disabilities. LD were associated with a 3 times increased risk for SEN. However, EP children with ID alone had poorer neuropsychological abilities and curriculum-based attainment than children with no disabilities, yet there was no increase in SEN provision among this group. ConclusionsEP children are at high risk for comorbid intellectual and learning disabilities. Education professionals should be aware of the complex nature of EP children's difficulties and the need for multi-domain assessments to guide intervention.

Consultation, negotiation and compromise: the relationship between SENCos, parents and pupils with SEN

One outcome of the UK Government's commitment to inclusive educational policies was an increase in the number of pupils with special educational needs (SEN) being taught in mainstream schools. From the perspective of SENCos, this article analyses whether parents and pupils are able and willing to influence the development of SEN provision and distribution of SEN resources, both of which aim to ensure that pupils have more meaningful experiences of mainstream education. The findings of the study cast light on the power and influence of parents when it comes to SEN provision and resources, the importance of consulting parents and the ways in which parents empower SENCos to make decisions on behalf of themselves and their children. The importance of negotiating and attempting to seek a compromise with pupils was another key issue identified in the article. Ultimately, however, the power to decide where resources go and what is done with them appears to reside with SENCos.

Key Drivers of Optimal Special Education Needs Provision: An English Study

AbstractThe aim of this paper is to argue that there are a number of key drivers for Special Educational Needs (SEN) provision that have to be met by Special Educational Needs Coordinators (SENCOs) and teaching professionals so as to ensure optimal provision and inclusion for children with SEN in mainstream primary schools. Although the research has been carried out in England, there is a significant European Dimension to the issue, as a similar role to that of SENCOs in respect of SEN management already exists in countries such as Finland and Ireland, and is being considered in Italy.This paper focuses on the data gathered for the purpose of the author’s doctoral research in England, through questionnaires and interviews with SENCOs, head teachers and teachers. Thematic analysis was used to explore key drivers of SEN provision by practitioners who support children with SEN.Data illustrate that the key drivers of SEN provision include time; teacher openness to change; target setting; evidence of tried interventions; empowerment; decision-making and approachability. The implementation of such drivers depend largely on practitioner skills and competencies.The main conclusion within this paper is to develop points of reference for planning and practice, with illustrations of optimal provision by all practitioners who work with children with SEN.

Narrowing the Gap between ‘Intention and Reality’

In England, the governing body of each school has duties in relations to special educational needs (SEN), and these have recently been extended. It is common practice for responsibility for this area to be delegated to an individual governor or subgroup of governors. Clearly, such arrangements are dependent upon an effective relationship between the governing body, and the staff of the school, in particular the special educational needs coordinator (SENCO) who is responsible for coordinating SEN provision. There is a lack of recent relevant research and the perspectives of the SENCOs are under-represented. This research examines those relationships using data gathered via an electronic questionnaire completed by a national sample of SENCOs ( n =191). While examples of good practice exist, the intentions of the national policy are only partly realized in many schools, with a gap existing between policy and reality.

Diagnosis and disengagement: exploring the disjuncture between SEN policy and practice

Special Educational Needs (SEN) policy and practice in England and Wales currently relies on an authoritative and accurate diagnosis of need by professionals working in partnership with parents and children. Our analysis suggests there is a ‘continuum of disengagement’ for children and young people with SEN. This will be used as a central theme to illustrate the disjuncture between SEN policy and practice. The continuum becomes apparent under the scrutiny of issues that arise during the diagnostic process. Identification of problems such as attention deficit hyperactivity disorder, dyslexia and dyspraxia lead to methods of intervention that can be identified as either preventative, counteractive or punitive. The ambiguity of the diagnostic process lies in the overlapping characteristics of these conditions. Referring to our research in the field of SEN provision in North Wales, this article explores the link between hidden disabilities, increasing disengagement and youth offending.

What does ‘inclusion’ mean for pupils on the autistic spectrum in mainstream secondary schools?

The last decade has seen a groundswell of developments in educational policy in the UK relating to inclusive education for students with special educational needs (SEN). However, whether government policy has been fully implemented in schools remains a concern. The experience of students with autistic spectrum disorders (ASDs) provides an excellent case in point. An increasing number of such students are now educated in mainstream schools, but the limited research in this area has indicated that their experience of school is often marked by bullying, social isolation and anxiety. In light of this, the aim of the current study was to examine the extent to which inclusive educational policy was actually reflected in the practices of four mainstream secondary schools. An exploratory case study approach was adopted, utilising interviews with pupils, teachers, other school staff (e.g., senior managers, learning support assistants) and parents, observations of lessons and other contexts (e.g., lunch time), and document analysis. Our findings highlighted a number of school practices which acted as facilitators or barriers to students’ learning and participation, some of which were generic to SEN provision, and some of which appeared to be specific to those on the autistic spectrum. A discussion of these is presented to enable further understanding of, and inform practice relating to, the inclusion process for students with ASDs.

Parental concerns on inclusion: The Northern Ireland perspective

The relationship between home and school is an integral feature of how pupils learn and parents have a central role to play in their child’s education. Philosophical and practical discourse around inclusion has informed and directed inclusive policy in recent years. In Northern Ireland, it has latterly been conducted under the auspices of emerging and revised legislation that is intended to promote the rights of children with special educational needs (SEN) and their families. This paper will examine provision for SEN within the evolving continuum of education in Northern Ireland. The paper will explore findings from the qualitative phase of recent research (O’Connor et al, 2003) on parental perceptions of SEN provision and contextualize these within the recent changes in educational policy and legislation. It will examine the research findings and their implications within the context of school practice, institutional and professional development.

The provision of communication aids to children in England: an analysis of applications to the Communication Aids Project

Children who experience difficulties in face-to-face interaction, understanding language and developing literacy can benefit from the provision of communication aids such as speech synthesizers and specialist software applications that support their social participation and learning. The Communication Aids Project (CAP) was a national initiative by the Department for Education and Skills in England, aimed at supporting and developing the provision of communication aids to children. This paper presents an analysis of the number and type of applications to CAP. In so doing, the paper begins to explore how the need for communication aids might be understood in England. The analysis was carried out on a database of 3060 anonymized records, representing applications to CAP between January 2002 and January 2004. Applications to CAP were made on behalf of children with a broader range of disabilities than might be assumed, including a relatively high proportion of children with autistic spectrum disorder. Rates of application to CAP varied in line with Local Education Authority population size [e.g. total pupils, total pupils with special educational needs (SEN)], rather than indicators of regional variation in SEN provision (e.g. proportion of population identified as having SEN). Within a context of changing services to children in England and increasing emphasis on the plurality and contestability of services, the relevance of these findings for service providers and service commissioners is discussed.

Awkward Customers? Parents and Provision for Special Educational Needs

This article selectively reports on a small-scale qualitative exploration of the experiences of families who had undergone recent conflict with special educational needs (SEN) professionals. The data were collected over the spring and summer terms of 2001 from 10 families in two local education authorities (LEAs) in the English midlands. The research aimed to examine the parents' perspectives on points of conflict or dissatisfaction between themselves and education professionals. It was concerned with the parents' points of view regarding their pursuit of desired outcomes for their children and the factors that helped or hindered their endeavours. The project found that the parents' negotiation of the SEN system was held by them to be exceptionally difficult and stressful compared to other troubling issues in their lives. The research suggests that dissatisfactions with SEN provision have important implications for the management of LEA Parent partnership Schemes (PPS) in ameliorating the differences between parental aspirations and governmental ambition.