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We need a new approach to assessing special educational needs – here’s why

The Conversation | Jonathan Rix | February 24, 2016

There is a huge variation in the way that children are allocated into categories of special educational needs. It is a lottery which people have known about for years, and it is not going away despite changes to legislation. To add to this unfairness, the categories themselves are of little help to teachers.

A couple of years ago, I looked at how local authorities in England used these categories. I noted that even those categories which might seem really obvious (such as visual, physical or hearing difficulties) were used in widely different ways. For example, in 2013, the category “autistic spectrum disorder” was used to diagnose 3.47% of children with special needs in one local authority, and 22.37% of children in another.

I wondered if the 2015 figures would be different – particularly after the 2014 Children and Families Act introduced a new Special Educational Needs and Disability Code of Practice. The categories of assessment were merely mentioned in passing in the new code, which introduced four new “broad areas of need”: communication and interaction, cognition and learning, social, emotional and mental health difficulties, and sensory and/or physical needs.

How this impacts upon the education of the children concerned is not clear at all. The kind of education we receive always depends upon so many variables. Education provision varies both between schools and within them, regardless of the label we receive. But you can be certain that different labels produce different local responses, resources and funding.

Professionals influence diagnoses

The second challenge is the inconsistent way in which people are allocated to categories. A 2012 study reviewed the diagnoses of 984 children of military personnel in the US who had been assessed by both clinicians and researchers, for conditions such as Attention Deficit Hyperactivity Disorder, Oppositional Defiant Disorder and Dysthymia. The researchers found that if the child had one condition, the diagnosis was only slightly less likely to have been made than if any diagnosis had been picked at random. But if the child had two conditions, each diagnosis could have been made with a flip of a coin.

The key determining factor was the professional background of the person undertaking the assessment. A diagnosis was most likely to be the one that would increase the diagnosing clinician’s chance of receiving funding and the likelihood of the child being placed where they worked.

Others have made similar arguments. Psychiatrist Allen Frances and psychologist Thomas Widiger – two of the authors of the fourth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders – concluded that the fifth edition, which came out in 2013, relied too much on the work and interests of those who had written it. As a result, it had the potential to cause: “false epidemics of misidentified pseudopatients”. And this manual influences assessment all around the world.