Children with disabilities and special needs
Disabled children are more likely to have poor outcomes compared with their peers including lower educational attainment, poorer access to health services resulting in poorer health outcomes, more difficult transitions to adulthood and poorer employment opportunities. Families with a disabled child are more likely to have one or both parents out of work, and to suffer family break up. Siblings of disabled children may also be more likely to suffer from emotional and behavioural problems.
Children with long-term disability are a diverse group, some will have complex needs needing multiagency support with some will be technological dependent. The precise number of children with disabilities in South Gloucestershire is unknown, but estimates have been made based on national data sources. An estimated 3.0 – 5.4% of children have disabilities, when applied to South Gloucestershire this equates to between 1,607 and 2,893 children with some level of disability. An estimated 36 to 68 children have visual impairment. On average one child per year will be diagnosed with severe impairment or blindness. Nationally numbers of disabled children have risen.
Routine data is collected by the local authority on Special Education Needs (SEN) although this does not reflect the spectrum of disability and is only a proxy for severity. The proportion of children in South Gloucestershire with a SEN in 2014 was 3.0%, an increase from previous years of 2.9% in 2014 and 2.00% in 2013. Of the 1123 pupils with a statement of SEN, 47.5% are in a mainstream school, 29.5% are in special schools and 10.2% are in resource bases attached to a mainstream school. A further 4,600 pupils have a special educational need but not a statement.
Over the last 5 years there has been an increase in the number of children with Autistic Spectrum Disorders. The most common type of Special Educational Need is communication and interaction followed by moderate learning difficulty. In 2012, the rate of profound and severe learning difficulties in primary schools in South Gloucestershire was 0.2 per 1000, half the England average. In secondary school the rate was 0.4 per 1000 compared to an England average of 0.7 per 1000. Rates for other disabilities were in generally lower than the England average. In 2013/14, GCSE educational results were lower for those with a special educational need than for the general population but similar to the England average.
The 0-25 Special Educational Needs and Disabilities service was formed in September 2014. This service supports a range of children and young people including around 1400 young people with an Education, Health and Care Plan or Statement; around 330 children with severe and moderate learning difficulties or physical disabilities; and around 130 adult social care young adults.
Recommendations for consideration
|Improve data on children with disabilities in order to identify gaps; improve support for children with autism both educationally and in the community; develop service provision including development of an autism pathway, employment strategy, fulfilling the Disabled Children’s Charter, 16+ education provision and short course, and a single pathway within the 0-25 service; review short break providers in co-production with parents’ forum; and further develop early intervention and help for disabled young people.|
Author: Mark Nesden, Service Manager 0 -5 Disability Service, South Gloucestershire Council
Who is at risk and why?
Disabled children are more likely to have poor outcomes compared with their peers including lower educational attainment, poorer access to health services resulting in poorer health services resulting in poorer health outcomes, more difficult transitions to adulthood and poorer employment opportunities. Families with a disabled child are more likely to have one or both parents out of work, and to suffer family break up. Siblings of disabled children may also be more likely to suffer from emotional and behavioural problems.
The Department for Education (DfE) has stated that:
- Disabled children and young people currently face multiple barriers which make it more difficult for them to achieve their potential, to achieve the outcomes their peers expect and to succeed in education.
- 29% of disabled children nationally live in poverty.
- The educational attainment of disabled children is unacceptably lower than that of non-disabled children and fewer than 50% of schools have accessibility plans.
- Disabled young people aged 16-24 are less satisfied with their lives than their peers and there is a tendency for support to fall away at key transition points as young people move from child to adult services.
- Families with disabled children report particularly high levels of unmet needs, isolation and stress.
- Only 4% of disabled children are supported by social services.
- A report by the Audit Commission in 2003 found that there was a lottery of provision, inadequate strategic planning, confusing eligibility criteria, and that families were subject to long waits and had to jump through hoops to get support.
- The prevalence of severe disability is increasing.
The level of need in the population
National statistics show that the number of families with a disabled child rose from 700,000 in 2004 to 950,000 in 2010. One of the reasons for this increase is because 80% of children born prematurely now survive and 50% of those children have severe and complex disabilities.
Arriving at an accurate figure for the number of children and young people with a disability in South Gloucestershire is problematic. A major challenge is that there is no one method to identify disabled children; each agency or service works to a different definition. Work needs to be undertaken on a needs analysis that will provide a comprehensive understanding of children with disabilities, which will take into account the different definitions of disability.
Estimate of prevalence
The National Child and Maternal Health Intelligence Network published disability profiles for each local authority area. The information in this section is taken directly from this report.
The number of disabled children in England is estimated to be between 288,000 and 513,000 with the mean percentage of disabled children in each local authority estimated to be between 3.0% and 5.4%. The table below show the estimated number of disabled children locally.
Table 1: Age specific estimates (population age 0-19) living with a long standing illness or disability in South Gloucestershire
|Age group||Living with long standing illness or disability estimate ONS (2011)||Severe disabled estimate|
The incidence of mild disability in children and adolescents was found to be higher in semi-skilled manual and unskilled manual backgrounds. The prevalence of children with mild disabilities from professional family backgrounds were lower in comparison to the other socio-economic groups. The rate of severe disability was found to be greatest among children from semi-skilled manual family backgrounds while the lowest rates were for children from professional and managerial family backgrounds.
A literature review of by the RNIB concluded “There are no agreed definitions of visual impairment among children. Terms such as visual impairment and visual disability have been used to mean different things in different studies and contexts”. Using a broad and pragmatic definition of visual loss of sufficient severity as to mean a child is identified as being in need of special educational or social services, the existing data suggest a prevalence of visual impairment in the region of 10-20 per 10,000 children. Around half the children receiving support for visual disabilities will have additional disabilities, and this proportion may be higher for those with severe visual loss.
Visual impairment estimates for South Gloucestershire for 5-15 year olds range from
- 36 (lower estimate of 10.5 per 10,000)
- 68 (upper estimate of 20 per 10,000)
- 1 newly diagnosed with severe visual impairment
The report contains further details of research on visual impairment and children with disabilities in schools. It can be accessed in here and needs to be read in conjunction with the local information presented below. Prevalence rates in both primary and secondary school for special educational needs were lower than the national average in 2012.
SEN Incidence and School Placement
The local authority provides information to the Department for Education (DfE) as part of the January SEN Census each year. Children with SEN are identified by schools at School Action, School Action Plus or with a SEN statement/EHCP.
Of the 1123 pupils with a statement of SEN, 47.5% are placed in mainstream schools, 29.5% in special schools and 10.2% in resource bases attached to mainstream schools. The remaining pupils are placed in other local authority special schools (4.5%), independent specialist school placements Independent Specialist Education Placement ISEP (5.8%), South Gloucestershire Education Other Than at School, SG EOTAS (2.6%). This represents an incidence of 2.9% of the total school age population and compares to a national rate of 2.8%.
Table 2 – Children with statements of SEN on roll in South Gloucestershire by Type of Provision Attended. Based on January 2013 Census
|Type of Provision||Primary||Secondary||All|
|Out of area Special School||16||34||50||(4.5%)|
|Education other than at school||11||18||29||(2.6%)|
A further group of pupils with SEN are identified by schools in the School Action and School Action Plus categories but do not have a statement for SEN. This is estimated at circa 4600 (circa 1350 and 3250 respectively). Added to the pupils with statements this represents 14.6% of the school age population which is slightly lower than the national level of 16.2% and lower than all of the statistical neighbours. Based on this data South Gloucestershire schools are identifying fewer pupils with SEN than their statistical neighbours. It is predicted that other local authorities will lower their identification level and become closer to the South Gloucestershire level in the next three years. The new Code of Practice no longer requires identification at School Action/Plus levels.
Breakdown of South Gloucestershire pupils by SEN Type
The local data illustrates that the most common type of SEN need is communication and interaction covering speech, language and communication needs and autistic spectrum disorder (36%), followed by moderate learning difficulty (MLD). It is anticipated that the numbers identified in the MLD category of need will reduce as the majority of this group will have been identified some time ago as younger children and are now in the top year groups in schools. Pupils are now unlikely to be allocated a statement for this category of need unless they have other associated complex learning difficulties. In future, the majority of this cohort of MLD pupils are likely to remain in mainstream schools and will no longer require a statement or Education, Health Care Plan. Communication and interaction has increased at a national level and is one of the reason for a significant number of statements for primary and secondary schools.
In 2013/14 there were 533 young people in South Gloucestershire’s maintained schools with special educational needs.
Over the last five years the greatest increase was in the number of children with Autistic Spectrum Disorders.
Levels of special educational needs are highest amongst males, the difference between genders increases with the severity of special educational need. In terms of ethnicity, prevalence of special educational needs are highest amongst children and young people of Black or Black British heritage. Although locally this is smaller than the national trends.
Children and young people with special educational needs are more likely to be at risk of poor outcomes than their peers. They are more likely to be excluded from school and less likely to do well in education. Outside of education they are more likely to have contact with the youth offending system and less likely to be in education, employment or training between the ages of 16-18.
However, there is also evidence to suggest children, young people and young adults with special educational needs are increasingly achieving great things, and building better lives. The proportion of young people with SEN achieving 5+ GCSE A*-C including English and Maths is improving, and employment rates for people with learning difficulties is increasing. The GCSE results for 2013/14 are presented in table 3 below.
Table 3: England and South Gloucestershire GCSE attainment in 2013/14 by SEN, school action plus and special needs.
|Pupils with no identified SEN||Pupils at school action5||Pupils at school action plus5||Pupils with special education needs but without a statement5||Pupils with a statement of special educational needs|
|Number of eligible pupils1||% achieving 5+ A*-C grades||Number of eligible pupils1||% achieving 5+ A*-C grades||Number of eligible pupils1||% achieving 5+ A*-C grades||Number of eligible pupils1||% achieving 5+ A*-C grades||Number of eligible pupils1||% achieving 5+ A*-C grades|
Source: National Pupil Database
Current services and assets in relation to need
The 0-25 SEN and Disabilities services were formed in September 2014. The service was formed on the voice of parents and young people’s views that they wanted a single pathway and service. SEN, Social Care for Children and Adults and Early Years services were brought together to form the 0-25 SEN and Disabilities Services. The vision of the service is for ‘every child and young person with a special education need or a disability to be given the best chance to succeed in life by enabling them to maximise their potential at school and college, and to move successfully into adulthood.
The following Threshold criteria applies to access these services. These are the amount young people accessing these services.
- SEN – A young person with an Education, Health and Care Plan or Statement (about 1400)
- Social Care Children – A child with complex needs and has an Education, Health and Care Plan.
- Children with Serve and moderate learning difficulties or physical disabilities. (About 330 Cases)
- Adult Social Care (18-25) Young Adults who meet the Care Act Criteria for services. (about 130)
- Occupational Therapy (0-18) Children and Young People who require services in the community.
- Early Years and Portage – (0-5) Support services to children who meet the criteria for an Education, Health and Care Plan.
- SEN Transport – Children with an SEN need who is entitled to School Transport
To oversee the monitoring of these service, a 0-25 partnership board has been established and this reports to the Children Trust Board.
Projected service use and outcomes in first 5 years and 5-10 years
The 0-25 service currently has about 1400 service users from birth to 25 years old. It is predicted that the local population will raise over the next 10 years of which statistically about 4% of the school age population will have additional need or disability. Since the launch of the service in September 2014 there has been a significant rise in referrals for Early Years.
The information presented within this chapter provides evidence of needs in respect of diverse groups. Consideration of these needs has resulted in the identification of priority issues to be addressed within South Gloucestershire as follows:-
- Improve the evidence and the ability to access how fair society is for young people with learning difficulties
- Raise standards and close attainment gaps in education for disabled young people
- Develop employment and different pathway opportunities for young people with learning difficulties.
- Develop the EHC process to support young people with disabilities in meeting their full potential.
- Support improved living conditions in cohesive communities
Unmet needs and service gaps
Arriving at an accurate figure for the number of children and young people with a disability in South Gloucestershire is problematic. A major challenge is that there is no one method to identify disabled children; each agency or service works to a different definition.
Work needs to be undertaken on a needs analysis that will provide a comprehensive understanding of children with disabilities, which will take into account the different definitions of disability.
We need to also take into account the growing population in South Gloucestershire and developing systems in identifying children from early year’s agencies to plan and predict trends.
Short Breaks services need to be reviewed for children and young adults with an SEN or Disability.
The Health and Well Being Board have agreed to the council working towards the standards of the Disabled Children Charter. The local authority will require assistance from all stakeholders in meeting this.
Support to families who has a child diagnosed with a behavioural problem – Support parents in the community. This to include reviewing Early Birds and Cygnet training.
Further integration with Health in developing a single pathway for individuals who are part of the 0-25 services.
Health pathway to be developed from 0-25
Young Person Participation needs further development.
Better commissioning of 16+ Education and local courses for young people with additional needs
Communication and accessing reports for EHCP needs assessments has been fraught with difficulties for both the 0-25 Team and Health practitioners, including advice reports not being received within the time limits, no response regarding attendance at Team Around the Child (TAC) meetings, requests for advice reports being sent through the incorrect route (not through the central route), Health not receiving requests for advice in time, not being notified of TAC dates and not being able to attend more complex TACs due to the dates which have been allocated. 0-25 Senior Practitioner and Panel Administrator met with Health Admin to tighten up procedures for sharing of information and communication, the results of which were:
- A flowchart for Health was created which included the input required by the 0-25 Team.
- A secure email is in place which 0-25 staff use and which goes to one central point.
- All communication is now being done electronically which has cut down on workload.
- 0-25 Panel Administrator provides a ‘head’s up’ to Health following Panel decision to start an EHCP needs assessment in advance of the official request for advice reports. In addition to this the allocated Lead Worker is also named. This is to allow Health the opportunity to ask for specific dates for TAC meetings for complex cases at which their attendance is required.
- Health would provide the 0-25 Team with details of secretaries contact details and dates of clinics to support with the organisation of TAC meetings.
This process continues to be a source of frustration and needs further tightening up. Further meetings are planned and some case studies considered to help to highlight where improvements can be made.
Health have begun to copy the 0-25 Team into reports of children with complex needs, with the consent of parents. Children’s files are being created where they aren’t already known and reports saved for future information. In addition to this, this is also a further source of information for the 0-25 Team’s pipeline data. Further work is required on this to ensure a more effective transfer of data.
Portage workers have continued to be based primarily at Patchway Hub, alongside many of our Health colleagues, which facilitates effective partnership working for this part of the 0-25 Service.
Portage and 0-25 Early Years Lead Workers are running courses which Health professionals will be asked to support from time to time.
In order to improve things further the following could be considered:
Health work in localities – is there a way of coordinating these localities alongside the allocation of schools to Assessment Coordinators as this could produce more effective partnership working.
It has been suggested that a representative from the 0-25 Team might attend TACs for complex children as these children are those who will eventually be referred into the team. This would require further capacity but is worth considering. Currently if a request is made, every attempt is made for someone to attend.
It was recently suggested that an Early Years Strategic Group might be reinstated in order to:
- consider what is currently in place
- determine how best to work together to facilitate co-production of groups
- put together a clear pathway for early years which can be shared with parents
The 0-25 Partnership Board have agreed on the following priority areas for development :-
- Threshold/ Eligibility for 0 – 25 Service
- Clarity of roles in the 0 – 25 Service
- Safeguarding for children and young adults between 0 – 25
- Early Intervention / Help
- Joint Commissioning
- Local Offer
- Young People Participation
- Short Breaks
- Post 16
- Personalised Budget
- Quality Assurance Framework
- Inclusion within Schools/
Recommendations for consideration by commissioners
Once we developed systems in gathering data, we will be able to identify gaps in services more clearly. However, with the increase in the number of children diagnosed with autism, there is a clear need for more services to support this client group, both educationally and in the community.
- Reviewing of all Short Breaks Providers in co-production with parents’ forum
- Early Intervention and help for Disabled young people
- Development of Employment Strategy
- Development of an Autism Pathway
- Development of services for 0-25
- Development of fulfilling the Disabled Children Charter
- Development of 16+ Education provision and short courses
- Development of a Single Pathway within the 0-25 service
We will look to identify the areas of gaps to address through commissioning by communicating the benefits of working in partnership. Ensuring that the consultation and decision-making processes are open to the active involvement of relevant VCS organisations and networks is also important. Identifying future needs and talking to organisations about whether services could be provided more effectively by working in partnership or by being provided by another organisation would be a priority.
Encouraging and marketing ‘meet the buyer’ events, provider forums and other opportunities for the VCS to engage with commissioners is a big part of this process as is making sure that the issues of risk are allocated.
We will ensure that bidding opportunities are widely publicised and check that the procurement timetable is long enough to encourage bids from smaller providers, partnerships or consortia.
The tender documentation needs to be clear, concise and jargon-free and there may be a need to offer training to potential providers to enable them to improve their tender submissions.
Also of high importance is the need to check that the evaluation and monitoring process has been explained to tenderers early with outcomes and social value are being reflected in the evaluation criteria.
We will focus on proper notice periods and clear communication about transition arrangements when decommissioning or redesign of services is necessary with the necessary impact assessment/service reviews procedures in place.
Recommendations for needs assessment work
Further work is required to understand in more detail the number, trends and needs of children with a disability locally.