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Joint Strategic Needs Assessment
(JSNA)
Topic Specific Report:
Children and Young People with
Special Educational Needs and
Disability (SEND) in Wolverhampton
2016
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Table of Contents 1.0 Introduction ..................................................................................................................................... 6
1.1 Context .......................................................................................................................................... 6
1.2 Scope of SEND JSNA ...................................................................................................................... 7
1.3 Methodology ................................................................................................................................. 7
1.4 Limitations ..................................................................................................................................... 7
1.5 Defining Special Educational Needs (SEN) and Disability (D) ........................................................ 7
1.6 Types of SEN .................................................................................................................................. 9
1.7 Educational Intervention for children identified with SEN(D) .................................................... 10
1.8 National SEND Policies ................................................................................................................ 11
1.9 Local SEND Structure .................................................................................................................. 11
1.10 Local SEND Policies and Strategies ........................................................................................... 12
2. National Picture ................................................................................................................................ 13
2.1 National Context - England Population ...................................................................................... 13
2.2 Prevalence of SEND ..................................................................................................................... 14
2.2.1 SEN by primary need ............................................................................................................ 14
2.2.2 SEN by age and gender ........................................................................................................ 16
2.2.3 SEN by Ethnicity ................................................................................................................... 16
2.2.4 Type of SEN .......................................................................................................................... 16
2.2.5 Downs Syndrome ................................................................................................................. 21
2.3 Health Needs ............................................................................................................................... 21
2.3.1 Mental Health ...................................................................................................................... 21
2.3.2 Community Care Nursing (CCN) ........................................................................................... 22
2.3.3 Palliative Care....................................................................................................................... 22
2.4 Wider Determinants ................................................................................................................... 22
2.4.1 Poverty ................................................................................................................................. 22
2.4.2 Disability Living Allowance ................................................................................................... 23
2.4.3 Social inclusion ..................................................................................................................... 24
2.4.4 Looked after children (LAC).................................................................................................. 24
2.4.5 Education ............................................................................................................................. 24
Table of Contents
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2.4.6 Not in Education, Employment or Training (NEET) .............................................................. 27
2.4.7 Further Education ................................................................................................................ 28
2.4.8 Transition ............................................................................................................................. 28
2.4.9 Housing ................................................................................................................................ 29
2.4.10 Equipment .......................................................................................................................... 29
2.4.11 Respite Care ....................................................................................................................... 29
2.4.12 Childcare ............................................................................................................................ 29
2.4.13 Transport ............................................................................................................................ 30
2.4.14 Lifestyle Factors ................................................................................................................. 30
3.0 Local Picture .................................................................................................................................... 32
3.1 Wolverhampton population ....................................................................................................... 32
3.2 Prevalence of SEN(D) .................................................................................................................. 33
3.2.1 Type of special educational need and disability in Wolverhampton ................................... 35
3.3 Risk Factors ................................................................................................................................. 38
3.3.1 Maternal Age ....................................................................................................................... 38
3.3.2 Smoking at time of delivery ................................................................................................. 38
3.3.3 Low Birth Weight ................................................................................................................. 39
3.3.4 Breastfeeding ....................................................................................................................... 39
3.3.5 Palliative Care....................................................................................................................... 39
3.4 Wider Determinants of Health .................................................................................................... 39
3.4.1 Poverty ................................................................................................................................. 39
3.4.2 Disability Living Allowance ................................................................................................... 40
3.4.3 Education ............................................................................................................................. 41
3.4.4 Not in Education, Employment or Training (NEET) .............................................................. 51
3.4.5 Social Care ............................................................................................................................ 52
4.0 What’s on Horizon: Future Needs ................................................................................................... 60
4.1 Population projections to 2030 .................................................................................................. 60
4.2 Projecting Adult Needs and Service Information System (PANSI) .............................................. 60
4.3 Projected estimates for children with SEN in schools in Wolverhampton ...................... 61
4.3.1 Projected estimates by type of Need ................................................................................... 62
4.3.2 Projected estimates in educational attainment .................................................................. 64
4.3.3 Projected estimates for children in employment, education and training .......................... 66
4.3.4 Looked after children ........................................................................................................... 66
5.0 Current Services .............................................................................................................................. 68
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5.1 NICE Guidelines ........................................................................................................................... 69
6. Stakeholder Views ............................................................................................................................. 71
6.1 Service Providers/ Commissioners including education sector .................................................. 71
6.1.1 Methodology ........................................................................................................................ 71
6.1.2 Results .................................................................................................................................. 71
6.2 Views of Parents/Carers of children and young people with SEND and young people with
SEND: Survey ..................................................................................................................................... 74
6.2.1 Methodology ........................................................................................................................ 74
6.2.2 Results .................................................................................................................................. 75
6.3 Views of Parents/ Carers of children and young people with SEND and young people with
SEND: Evidence ................................................................................................................................. 81
7. Evidence Review ............................................................................................................................... 86
7.1 Speech, Language and Communication ...................................................................................... 87
7.2 Children with Disabilities: Early Years and Key Stage 1 (age 0-8) ............................................... 88
7.3 Children and young people with disabilities: School age and beyond ....................................... 89
7.4 Personalisation ............................................................................................................................ 89
7.5 Educational partnerships with parents ....................................................................................... 89
7.6 Transition to adult care and support .......................................................................................... 90
7.7 Gaps in the evidence ................................................................................................................... 90
7.8 Summary ..................................................................................................................................... 90
8. Gaps in service provision .................................................................................................................. 91
9. Draft Recommendations ................................................................................................................... 93
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Author: Bindweep Kaur; Advanced Health Improvement Specialist: Needs Assessment, Public Health, City of Wolverhampton Council Contributors: Glenda Augustine, Seeta Wakefield, Karla Bailey, Jason Gwinnett, Sandra Squires, Margaret Liburd, City of Wolverhampton Council Acknowledgements: East Sussex County Council (2013) East Sussex Children and Young People with Special Educational Needs (SEN) or disabilities (D): Comprehensive Needs Assessment Janette Huntbatch, Vanita Patel, Public Health, City of Wolverhampton Council Jill Wellings, Sandy Lisle: SEN Team, City of Wolverhampton Council Kathy Roper, Mai Gibbons, Commissioning Team, Peoples Directorate, City of Wolverhampton Council Lynne Stodart: Education and enterprise team, City of Wolverhampton Council Sarah Rennison: Community, City of Wolverhampton Council Adrian Barlow, Business intelligence, City of Wolverhampton Council Lucy Harris: Information advice and support service Alison Baggs: Voice4Parents Jane Cox and others at Connexions School Leadership and Governance team; City of Wolverhampton Council Member of the JSNA Steering group Members of the SEND Partnership Board All those who completed the stakeholder engagement surveys All those who attended the stakeholder face to face event National Congenital Anomaly Register Wolverhampton CCG Include Me too ConnectEd Partnership
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1.1 Context The recent reform to the Government’s Children and Families Act (2014)1 and introduction of
the ‘Special educational needs and disability (SEND) code of practice: 0 to 25 years’ (2015)2
is transforming the way children and young people with SEND receive services across
education, health and social care. In Wolverhampton, SEND is a key priority for joint
commissioning between the local authority and clinical commissioning group (CCG).
Children with special educational needs and disabilities are a diverse group, where some
children require minimal support whereas others require multi-agency intervention across the
three sectors of education, health and social care. In order to ensure the best outcomes for
these children, young people and parents, it is vital to understand the needs of this
population.
This needs assessment aims to collate and analyse national and local information and data
to develop a comprehensive picture of education, health and social care needs of children
and young people with SEND in Wolverhampton. The SEND Code of practice emphasises
the role of the Joint Strategic Needs Assessment (JSNA) in identifying the needs of children
and young people with SEND and commissioning services that meet the needs of these
children identified in their education, health and care (EHC) Plans (Fig. 1).
Fig. 1: Role of JSNA in meeting the needs of children and young people with SEND
The objectives of this JSNA are to determine:
the number of children and young people requiring SEND services currently and project
future need.
the current education, health and social care needs of children and young people with
SEND
1 Secretary of State (2014) ‘Children and Families Act 2014’ Accessed at http://www.legislation.gov.uk/ukpga/2014/6/contents/enacted 2 Department of Health and Department for Education (2015) ‘Special educational needs and disability code of practice: 0 to 25 years: statutory guidance for organisations which work with and support children and young people who have special educational needs or disabilities’
1.0 Introduction
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the current service provision available for children and young people with SEND
any identified gaps in service provision and develop recommendations on how these
may be addressed.
1.2 Scope of SEND JSNA This JSNA focuses on children and young people aged 0 to 25 years in Wolverhampton. It
considers the education, health and social care needs of children and young people with:
Learning difficulties (specific learning difficulties, moderate learning difficulties,
severe learning difficulties and profound and multiple learning difficulties)
Special educational needs (Across the 4 areas of need described in SEN(D) code of
practice , that is, communication and interaction, cognition and learning, social,
emotional and mental health and sensory and/or physical needs). This would also
include hearing impairment, visual impairment and multi-sensory impairment (MSI)
Physical disability
Autistic spectrum disorder (ASD)
1.3 Methodology This needs assessment has been informed by the comprehensive needs assessment
produced by Public Health East Sussex3 in terms of the format as well as some of the
evidence utilised. The aim is to analyse the data available for children with special
educational needs and disability within City of Wolverhampton Council, combined with local
data across health, education and social care partners as well as nationally published
statistics. All attempts have been made to analyse the data and evidence base for children
and young people aged less than 25 years, in line with the Children and Families Act 2014
and SEN Code of Practice.
All relevant stakeholders have been included in the development of this needs assessment,
as members of the JSNA Steering Group and stakeholder engagement activities across,
health, social care, education and parents/carers of children with special educational needs.
A comprehensive evidence review has been undertaken to identify the current literature
around risk factors, prevalence and trends of special educational needs and disabilities as
well as interventions and services which seem to make a positive impact for these children.
1.4 Limitations The needs assessment does not include data/evidence on children and young people with
SEND in pre-school nurseries, those who are educated out of area or at home and those in
youth custody. Also, there are gaps in data obtained about the use of the health care
system, particularly secondary service. This is primarily due to information governance
restrictions, the format of data collection (at times) and the lack of electronic data collection
within secondary services.
1.5 Defining Special Educational Needs (SEN) and Disability (D) Special Educational Needs is a term often used to describe children or young people with
additional learning needs who require support from special educational provision. However,
this term includes a wide spectrum of children and young people, ranging from those
3 East Sussex County Council (2013) East Sussex Children and young people with special educational needs (SEN) or disabilities (D) : Comprehensive Needs Assessment
Page 8 of 110
requiring minimal or temporary interventions to those with complex needs requiring long term
multi-agency support. Within education, SEN are defined under the SEN code of practice
and the Education Act 2001 as follows:
Disability has been defined by a number of statutory organisations and no common definition has been agreed to be used across health and social care. The SEND Code of practice utilises the Equality Act 2010 definition which defines disability as follows: The Equality Act 2010
2
A person is disabled, if he or she has a physical or mental impairment that has a ‘substantial’ and
‘long-term’ negative effect on his or her ability to do normal daily activities:
‘substantial’ is more than minor or trivial - e.g. it takes much longer than it usually would to
complete a daily task like getting dressed
‘long-term’ means 12 months or more - e.g. a breathing condition that develops as a
result of a lung infection
In Health, disability is usually defined by the World Health Organisation (WHO) as follows:
Definition of Disability (WHO, 2013)
Disability is an umbrella term, covering impairments, activity limitations, and participation
restrictions:
An impairment is a problem in body function or structure;
An activity limitation is a difficulty encountered by an individual in executing a task or
action;
A participation restriction is a problem experienced by an individual in involvement in life
situations.
Disability has also been defined by the Disability Discrimination Act as follows:
Definition of SEN (SEN Code of Practice 2014)2
Children have SEN if they have a learning difficulty or disability which calls for special
educational provision to be made for them.
Children or young people have a learning difficulty or disability if they:
Have a significantly greater difficulty in learning than the majority of others of the same
age, or
Have a disability which prevents or hinders them from making use of facilities of a kind
generally provided for others of the same age in mainstream schools or mainstream post-
16 institutions
Are under the compulsory school age and fall within the definition of (i) or (ii)
Special educational provision means:
for children of two or over, educational provision which is additional to, or otherwise
different from, the educational provision made generally for children of their age in
schools maintained by the LEA, other than special schools, in the area
for children under two, educational provision of any kind.
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Definition of Children with Disabilities (Disability Discrimination Act 1995)4
A person has a disability for the purposes of this Act if he has a physical or mental impairment
which has a substantial and long-term adverse effect on his ability to carry out normal day-to day
activities.
Section 1(1), Disability Discrimination Act 1995
1.6 Types of SEN The SEN code of practice (2015) describes four broad areas of need which provide an
overview of the range of need amongst children and young people with SEN(D) requiring
additional support.
1.6.1 Communication and interaction
Children and young people with speech, language and communication needs
(SLCN) have difficulty in communicating with others. The profile for every child
with SLCN is different and their needs may change over time. They may have
difficulty with one, some or all of the different aspects of speech, language or
social communication at different times of their lives.
Children and young people with autistic spectrum disorder (ASD), including
Asperger’s Syndrome and autism, are likely to have particular difficulties with
social interaction. They may also experience difficulties with language,
communication and imagination, which can impact on how they relate to others.
1.6.2 Cognition and learning
Support for learning difficulties may be required when children and young people
learn at a slower pace than their peers, even with appropriate differentiation.
Learning difficulties cover a wide range of needs, including moderate learning
difficulties (MLD), severe learning difficulties (SLD - where children are likely to
need support in all areas of the curriculum and associated difficulties with mobility
and communication), through to profound and multiple learning difficulties (PMLD
- ,where children are likely to have severe and complex learning difficulties as
well as a physical disability or sensory impairment).
Specific learning difficulties (SpLD), affect one or more specific aspects of
learning. This encompasses a range of conditions such as dyslexia, dyscalculia
and dyspraxia.
1.6.3 Social, emotional and mental health difficulties
Children and young people may experience a wide range of social and emotional
difficulties which may include becoming withdrawn or isolated, as well as
displaying challenging, disruptive or disturbing behaviour. These behaviours may
reflect underlying mental health difficulties such as anxiety or depression, self-
harming, substance misuse, eating disorders or physical symptoms that are
medically unexplained. Other children and young people may have disorders
4 Secretary of State; ‘Disability Discrimination Act 1995 Accessed at http://www.legislation.gov.uk/ukpga/1995/50/contents
Page 10 of 110
such as attention deficit disorder, attention deficit hyperactive disorder or
attachment disorder.
1.6.4 Sensory and/or physical needs
Some children and young people require special educational provision because
they have a disability which prevents or hinders them from making use of the
educational facilities generally provided. Many children and young people with
vision impairment (VI), hearing impairment (HI) or a multi-sensory impairment
(MSI) will require specialist support and/or equipment to access their learning, or
habilitation support. Children and young people with MSI have a combination of
vision and hearing difficulties.
Some children and young people with a physical disability (PD) require additional
on-going support and equipment to access all the opportunities available to their
peers.
The SEN code for each type of SEN is shown in the table below5.
SEN Code SEN Type
ASD Autistic Spectrum Disorder
BESD Behavioural, Emotional and Social difficulties
HI Hearing Impairment
MSI Multi-Sensory Impairment
OTH Other difficulty or disability
PD Physical Disability
MLD Moderate Learning Difficulty
PMLD Profound and Multiple Learning Difficulty
SLCN Speech, Language and Communication Needs
SLD Severe Learning Difficulties
SpLD Specific Learning Difficulty
VI Visual Impairment Table 1: SEN codes (Source: School census Codes)
1.7 Educational Intervention for children identified with SEN(D) There are two levels of intervention for children identified with SEN(D) in school within the
SEN(D) Code of practice,:
SEN Support: Schools must provide SEN support to children identified as needing
additional learning support. This may include specialist input.
Education, Health and Care (EHC) Plan: to meet the needs of the child or young
person has not made expected progress despite the school having taken relevant
and purposeful action to identify, assess and meet the special educational need
An Education, Health and Care needs assessment can be requested by the
school or parents .
5 School Census Codes
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The current provision of SEN Support and EHC plans replaces the ‘School Action’,
‘School Action Plus’ and ‘Statement of SEN’. Currently, there are a number of children
going through the process of transferring from ‘Statement of SEN’ to ‘EHC plans’.
1.8 National SEND Policies Improving the health and wellbeing outcomes for children and young people with disabilities
is a government priority. This has been illustrated by a growing body of evidence and
government policies, such as the ‘National Service Framework for Children, Young People
and Maternity Services’ (DoH/DfE, 2004), ‘A Transition Guide for all Services’ (DCSF/DoH,
2007), Transition: Moving on Well (DoH, 2008) and the ‘Aiming High for Disabled Children
Transition Support Programme’ (HM Treasury and DfES, 2007).
The government set out a vision for a radically different system for children and young
people with SEND by setting out a range of proposals in the 2011 Green Paper ‘Support and
aspiration: A new approach to special educational needs and disability’ which aims to
address the existing issues and gaps within the system.
The Children and Families Act 2014 has reformed the system of SEN provision by making
the following changes:
1. Extending the SEN system from birth to 25 years and incorporating children and young
people with disabilities as well as children and young people with SEN.
2. Giving children, young people and parents more control and choice in decision making.
3. New joint arrangements for assessing, planning and commissioning services for SEN
across education, health and social care.
4. New local offer, which is an information portal providing clear and transparent information
on what services are available locally across education, health and social care.
5. Introduction of a ‘graduated approach’ to support children with SEN (to replace School
action and School Action Plus) and EHC plans for 0-25 years olds (to replace the
Statements and Learning Difficulty assessments). The EHC plans focus on helping to
improve the outcomes including future employment and independent living.
6. Personal budgets for those families who want to have them.
1.9 Local SEND Structure The Wolverhampton CCG and local authority are working together to meet the requirements
set out in the SEND code of practice2. There are clear strategic governance structures in
place in Wolverhampton to ensure the SEND agenda is a priority and taken forward jointly
(see Fig. 2).
Page 12 of 110
Fig. 2: Governance Structure for SEND in Wolverhampton (Source: City of Wolverhampton Council and CCG)
The City of Wolverhampton council has published a local offer on its website, which has
been developed in partnership with Wolverhampton CCG and parents. It provides a wide
range of information on the services available for children and young people with SEN(D)
across education, health and social care6.
1.10 Local SEND Policies and Strategies Local policies and strategies have been developed in Wolverhampton to support children
and young people with SEN(D) and their families. They consist of:
1. Wolverhampton’s Joint Strategy for Children and Young People with Special Educational
Needs and Disability (SEND) 2015 - 2020
2. Wolverhampton SEND Local Offer Annual Review 2015
3. Wolverhampton All Age disability Strategy 2013 - 2016
4. Wolverhampton Joint Autism Strategy 2016 – 2021
5. Home to School Travel Policy
6. Transport policy statement for learners aged 16-19 in further education
7. Post-16 transport guidance
6 Wolverhampton Local Offer for SEND Accessed at http://www.wolverhampton.gov.uk/send
Health & Wellbeing Board
Children's Trust Board
SEND Strategy Group
SEND Partnership Group
Education Health & Care Plan
Integrated Partnership
and Commissioning
Board
Page 13 of 110
2.1 National Context - England Population The World report on disability7 estimates that there are 93 million (5.1%) children with a
disability aged 0-14 years in the world, of which 13 million (0.7%) are ‘severely’ disabled.
The 2014 population estimates from the Office of National Statistics (ONS) suggest that
there are just over 54 million residents in England. Of these, 30.4% are children and young
people aged 0-25 years (Fig. 3). The population of children and young people aged 0-25
years has increased by 8% since 20018.
Fig. 3: Mid 2014 Population estimates for England (Source: ONS)
In England, the highest proportion of children and young people are in the age bands 20-24
years (22%) and 0-4 years (21%) (Fig. 4). Since 2001, the population of children aged 0-4
years and 20-24 years has increased by 17% and 21% respectively. A fall of 8% has been
observed in the population of children and young people aged 10-14 since 20018.
7 World Health Organisation (2011) World Report on Disability 8 Office of National Statistics (2014) ‘Mid 2014 Population estimates’ Accessed at https://www.ons.gov.uk/
1757740 1675149
1521497 1658765
1837360 1861199 1844311
1694773 1838430
1935219 1839842
1576145 1426088 1446590
1040581 820363
560580 438564
1673217 1597216
1451558 1572189
1769057 1857183 1862898
1701231 1868974 1983144
1877446 1610436
1487843 1528871
1146831 964595
753781 836952
0-45-9
10-1415-1920-2425-2930-3435-3940-4445-4950-5455-5960-6465-6970-7475-7980-84
85+
Population
Age
Mid 2014 Population estimates for England
females males
2. National Picture
Page 14 of 110
Fig. 4: Population of children and young people in England 2014 (Source: ONS)
2.2 Prevalence of SEND Current estimates suggest that there are 1.3 million pupils (15.4%) in schools in England
with special educational needs (SEN) including 236,165 (2.8%) with SEN statements and/or
EHC plans and just over 1 million pupils (12.6%) who need SEN support9. Since 2007, there
has been a fall in the total percentage of pupils with SEN (SEN support + SEN statements/
EHC Plans) which is primarily due to the fall in pupils with SEN support. Since 2007, the
percentage of pupils with SEN statement and/or EHC plans has been constant at 2.8% and
the percentage of pupils with SEN support has fallen from 16.5% in 2007 to 12.6% in 2015
(Fig. 5).
Fig. 5: Trend of pupils with SEN in England (Source: DoE 2015)
2.2.1 SEN by primary need
SEN by primary need by type of school
In primary schools, speech, language and communication (27.7%) is the most common
primary need followed by moderate learning difficulty (24.6%) in England in 2015. In
secondary schools moderate learning difficulty (24.9%) is the most common primary need
9 Department for Education (2015) ‘Statistical First Release: Special Educational Needs in England: January 2015’
3,430,957 3,272,365 2,973,055 3,230,954
3,606,417
0
1,000,000
2,000,000
3,000,000
4,000,000
0-4 5-9 10-14 15-19 20-24
Po
pu
lati
on
Age bands
Population of children and young people in England 2014
0%
5%
10%
15%
20%
25%
2007 2008 2009 2010 2011 2012 2013 2014 2015
% p
up
ils
Percentage of pupils with SEN in England 2007 - 2015
SEN Statement and/or EHC Plans SEN Support Total SEN
Page 15 of 110
followed by specific learning difficulty (20.9%) in England. However in special schools, multi-
sensory impairment (24.4%) is the most common type of primary need followed by autistic
spectrum disorder (24%)9 (Fig. 6).
Fig. 6: SEN by primary need in primary, secondary and special schools (Source: DoE 2015)
SEN by primary need by type of SEN intervention
In 2015, the most common type of primary need for children with SEN support in England
was moderate learning difficulty (26.6%) followed by speech, language and communication
needs (20.2%). The most common type of primary need for children with SEN statement/
EHC plans in England was autistic spectrum disorder (24.5%) followed by moderate learning
difficulty (14.1%).
In special schools, however, severe learning difficulty (22%) was the most common type of
primary need in 2015 followed by social, emotional and mental health (20.1%) for children
with SEN support and severe learning difficulty (24.5%) followed by autistic spectrum
disorder (24.2%) for children with SEN statements and/or EHC plans (Fig. 7).
Fig. 7: Percentage of pupils with SEN by primary type of need (Source: DoE 2015)
10.5 20.9
1.3
24.6
24.9
16.2
0.9
0.6
24.4 0.3
0.1 8.6 15.6
19.3 13.0
27.7 9.8
5.5
1.7 2.3
1.3
3.0 3.0
3.5
6.5 8.3 24.0
4.4 6.8 1.0
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Primary school Secondary school Special school
Other Difficulty/Disability
Autistic Spectrum Disorder
Physical Disability
Multi- Sensory Impairment
Visual Impairment
Hearing Impairment
Speech, Language andCommunications NeedsSocial, Emotional and MentalHealth (9)Profound & Multiple LearningDifficultySevere Learning Difficulty
Moderate Learning Difficulty
0%5%
10%15%20%25%30%
Percentage of pupils with SEN in primary,secondary and special schools by primary type of need in England 2015
SEN statement/ EHC SEN support
Page 16 of 110
2.2.2 SEN by age and gender
In 2015, nearly twice as many boys were identified with SEN compared to girls suggesting
SEN is more prevalent in boys. Also, SEN seems to be more prevalent in children aged 5-
10 years and shows a gradual decrease thereafter. Moreover, there seems to be a drastic
increase in the percentage of children receiving SEN statements/EHC plans at the age of
18-19 years and older 9, probably because the new guidance has increased the upper
threshold of EHC Plans to 25 years (Fig. 8).
Fig. 8: Percentage of pupils with SEN by age and gender (Source: DoE 2015)
2.2.3 SEN by Ethnicity
SEN is found to be most prevalent in children and young people of black ethnic origin
(18.5%) followed by children and young people of white ethnic background (16.7%)9 (Fig. 9).
Fig. 9: Percentage of pupils with SEN by ethnicity (Source: DoE 2015)
2.2.4 Type of SEN
2.2.4.1 Physical Disability
Physical disability can be associated with a number of medical conditions such as cerebral
palsy, spina bifida and muscular dystrophy which impact mobility or sensory impairments,
neurological problems and learning difficulties. Having a disability does not necessarily
suggest that the child will have SEN if they are able to access the curriculum and learn
0%
5%
10%
15%
20%
25%
2 andunder
3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19+
% p
up
ils
Age
Percentage of pupils with SEN in primary, secondary and special schools in England 2015
Boys SEN support Girls SEN support Boys SEN statement/ EHC Girls SEN statement/ EHC
0%
5%
10%
15%
20%
White Mixed Asian Black Chinese Any other ethnicgroup
% p
up
ils
Percentage of pupils with SEN by ethnic group in England 2015
SEN statement/ EHC plans SEN support
Page 17 of 110
effectively without additional educational provision10. The Thomas Coram Research Unit
(TCRU) estimates that the mean percentage of children with a disability in English local
authorities is between 3% and 5.4%11.
The Family Resources Survey 2013/14 suggests that across the whole spectrum of
disability, there are 198 children with a disability in UK and most of them experienced
difficulties in more than 1 aspect of daily living12 (Fig. 10).
Fig. 10: Number of disabled children in UK 2013/14 (Source: Family Resources Survey)
In January 2015 the Department of Education statistics reported that there were 30,790
(3%) children in England with physical disability as their primary need. Of these, 42% have
received a SEN Statement or EHC Plan. 52% (n=16,075) of these children are in maintained
primary schools, 36% (n=11,115) are in maintained secondary schools and 12% (n=3,600)
are in special schools9.
2.2.4.2 Autistic Spectrum disorder (ASD)
There is no register or exact count of the number of children with autistic spectrum disorder
in the UK. Therefore, all estimated prevalence of ASD is based on epidemiological studies.
The latest prevalence studies suggest that 1.1% of the UK population may have autism,
which means that over 695,000 people in UK may be suffering from autism (estimates based
on 2011 census data). Prevalence of childhood autism is estimated to be 38.9 per 10,000
and prevalence of ASD has been estimated to be 77.2 per 10,00013. The latest research also
suggests that there was a fivefold increase in the annual incidence rate of autism during
1990s in the UK and since then the incidence and prevalence rates in 8 year old children
has reached a plateau. It has remained steady through 2010 with annual prevalence rates of
approximately 3.8 per 1,000 boys and 0.8 per 1,000 girls and annual incidence rates of 1.2
per 1,000 boys and 0.2 per 1,000 girls14.
10 Department for Education and Skills (2005) ‘Data collection by Type of Special Education Need’ 11 Thomas Coram Research Unit (2008) ‘Disabled children: numbers, characteristics and local service provision 12 Department of Works and Pensions (2015) Family Resources Survey: financial year 2013/14 13 Baird, G, Simonoff, E, Pickles, A, Chandler, S, Loucas, T, Meldrum, D & Charman, T (2006), 'Prevalence of disorders of the autism spectrum in a population cohort of children in South Thames: the Special Needs and Autism Project (SNAP)' The Lancet, vol 368, no. 9531, pp. 210-215 14 Taylor, B. et al (Oct 2013) Prevalence and incidence rates of autism in the UK: time trend from 2004–2010 in children aged 8 years BMJ open Vol 3, Issue 10
0102030405060
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Number of disabled children in UK by impairment type 2013/14
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In 2014, the rate of children with autism known to schools in Wolverhampton was 10.8 per
1,000. The trend has increased from 7 per 1,000 in 2009/2010 to 9.1 per 1,000 in 2013/1415.
According to the Department of Education statistics, there were 90,775 (9%) children in
January 2015 in England with autistic spectrum disorder as their primary need. Of these,
60% have received a SEN Statement or EHC Plan. 39% (n=35,030) of these children are in
maintained primary schools, 34% (n=30,845) are in maintained secondary schools and 27%
(n=24,900) are in special schools9.
2.2.4.3 Visual Impairment
Visual impairment refers to a range of difficulties from partial sight through to blindness. For
educational purposes, a pupil is considered to be VI if they require adaptations to their
environment or specific differentiation of learning materials in order to access the
curriculum10. Epidemiological research on estimating the prevalence of visual impairment in
younger population in the UK is quite limited16.
Department of Education statistics indicate that in January 2015 there were 10,840 (1.1%)
children in England with visual impairment as their primary need. Of these, nearly 30% have
received a SEN Statement or EHC Plan. 48% (n=5,165) of these children are in maintained
primary schools, 46% (n=4,935) are in maintained secondary schools and 7% (n=740) are in
special schools9.
2.2.4.4 Hearing Impairment
Pupils with a hearing impairment range from those with a mild hearing loss to those who are
profoundly deaf. For educational purposes, pupils are regarded as having a hearing
impairment if they require hearing aids, adaptations to their environment and/or particular
teaching strategies in order to access the concepts and language of the curriculum10.
Department of Education statistics indicate that in January 2015 there were 19,350 (1.9%)
children in England with hearing impairment as their primary need. Of these, 31% have
received a SEN statement or EHC Plan. 48% (n=9,275) of these children are in maintained
primary schools, 45% (n=8,705) are in maintained secondary schools and 7% (n=1,370) are
in special schools9.
2.2.4.5 Multi-Sensory Impairment
Pupils with multi-sensory impairment have a combination of visual and hearing difficulties.
Pupils are recorded as MSI only if sensory impairment is identified as their greatest need10.
Department of Education statistics indicate that in January 2015 there were 1,845 (0.2%)
children in England with MSI as their primary need. Of these, 33% have received a SEN
statement or EHC Plan. 61% (n=1,120) of these children are in maintained primary schools,
27% (n=505) are in maintained secondary schools and 12% (n=220) are in special schools9.
2.2.4.6 Speech, Language and Communication Needs (SLCN)
Pupils with SLCN may have difficulty in understanding and/or making others understand
information conveyed through spoken language. Their acquisition of speech and their oral
language skills may be significantly behind their peers. Their speech may be poor or
15 Public Health England (2015) ‘Learning Disabilities Profile’ 16 Tate, et al, (2005) The prevalence of visual impairment in the UK, A review of the literature RNIB 2005
Page 19 of 110
unintelligible. Pupils with language impairments find it hard to understand and/or use words
in context. They may use words incorrectly with inappropriate grammatical patterns, have a
reduced vocabulary or find it hard to recall words and express ideas. They may also hear or
see a word but not be able to understand its meaning or have trouble getting others to
understand what they are trying to say10.
Department of Education statistics indicate that in January 2015 there were 190,475 (18.8%)
children in England with SLCN as their primary need. Of these, 16% have received a SEN
statement or EHC Plan. 78% (n=148,085) of these children are in maintained primary
schools, 19% (n=36,665) are in maintained secondary schools and 3% (n=5,725) are in
special schools. This suggests that most of the children with SLCN are being identified early
and being managed in maintained schools9.
The Royal College of Speech and Language Therapists (RCSLT) estimate that 50-90% of
the learning disabled population have communication difficulties and one third of all Speech
and Language therapy (SALT) services in the UK are directed at the learning disabled
population17.
2.2.4.7 Social, Emotional and Mental Health Difficulties (SEMHD)
The SEND Code of practice states that children with SEMHD may display challenging,
disruptive or disturbing behaviour or may be withdrawn or isolated. These behaviours may
reflect underlying mental health difficulties such as anxiety or depression, self-harming,
substance misuse, eating disorders or physical symptoms that are medically unexplained2.
Department of Education statistics indicate that in January 2015 there were 169,110 (16.7%)
children in January 2015 in England with SEMHD as their primary need. Of these, 17% have
received a SEN statement or EHC Plan. 49% (n=83,595) of these children are in maintained
primary schools, 43% (n=72,065) are in maintained secondary schools and 8% (n=13,450)
are in special schools9.
2.2.4.8 Learning Disability and Learning Difficulties
In 2014, there were 33.7 per 1000 children known to schools with learning disabilities in
England15.
There are four types of learning difficulties recognised by the SEN Code of Practice:
Specific Learning Difficulty (SpLD):
A specific learning difficulty is an umbrella term which indicates that pupils display
differences across their learning. Pupils with SpLD may have a particular difficulty in
learning to read, write, spell or manipulate numbers so that their performance in
these areas is below their performance in other areas. Pupils may also have
problems with short-term memory, with organisational skills and with co-ordination.
Specific learning difficulties include dyslexia, dyscalculia and dyspraxia10.
Department of Education statistics indicate that in January 2015 there were 135,505
(13.4%) children in England with SpLD as their primary need. Of these, 7% have
received a SEN statement or EHC Plan. 41% (n=56,190) of these children are in
17 Royal College of Speech and Language Therapy (2009) Resource Manual for commissioning and planning services for SLCN
Page 20 of 110
maintained primary schools, 58% (n=77,965) are in maintained secondary schools
and 7% (n=1,350) are in special schools9.
Moderate Learning Difficulty (MLD)
Pupils with moderate learning difficulties will have attainments well below expected
levels in all or most areas of the curriculum, despite appropriate interventions. Their
needs will not be met by normal differentiation and the flexibilities of the National
Curriculum. Pupils with MLD have much greater difficulty than their peers in acquiring
basic literacy and numeracy skills and in understanding concepts. They may also
have associated speech and language delay, low self-esteem, low levels of
concentration and under-developed social skills10.
Department of Education statistics indicate that in January 2015 there were 241,125
(23.8%) children in England with MLD as their primary need. Of these, 13% have
received a SEN statement or EHC Plan. 55% (n=131,530) of these children are in
maintained primary schools, 38% (n=92,770) are in maintained secondary schools
and 7% (n=16,825) are in special schools9.
Severe Learning Difficulty (SLD)
Pupils with severe learning difficulties have significant intellectual or cognitive
impairments. This has a major effect on their ability to participate in the school
curriculum without support. They may also have associated difficulties in mobility and
co-ordination, communication and perception and the acquisition of self-help skills.
Pupils with SLD will need support in all areas of the curriculum. They may also
require teaching of self-help, independence and social skills. Some pupils may use
sign and symbols but most will be able to hold simple conversations and gain some
literacy skills10.
Department of Education statistics indicate that in January 2015 there were 32,090
(3.2%) children in England with SLD as their primary need. Of these, 90% have
received a SEN statement or EHC Plan. 14% (n=4,650) of these children are in
maintained primary schools, 7% (n=2,145) are in maintained secondary schools and
79% (n=25,295) are in special schools9.
Profound and Multiple Learning Difficulty (PMLD)
Pupils with profound and multiple learning difficulties have severe and complex
learning needs, in addition they have other significant difficulties, such as physical
disabilities or a sensory impairment. Pupils require a high level of adult support, both
for their learning needs and also for personal care. They are likely to need sensory
stimulation and a curriculum broken down into very small steps. Some pupils
communicate by gesture, eye pointing or symbols, others by very simple language10.
Department of Education statistics indicate that in January 2015 there were 10,915
(1.1%) children in England with PMLD as their primary need. Of these, 92% have
received a SEN statement or EHC Plan. 15% (n=1,675) of these children are in
maintained primary schools, 3% (n=370) are in maintained secondary schools and
81% (n=8,865) are in special schools9.
Page 21 of 110
2.2.5 Downs Syndrome
Downs syndrome is a chromosomal disorder caused by the presence of an additional
chromosome and is the most frequent genetic cause of mild to moderate intellectual and
developmental disabilities, occurring in approximately one in every 800 live births. In 2012
there were 1,982 diagnoses of Downs syndrome, 64% of which were made prenatally, a rate
of 2.7 per 1,000 births in England and Wales. There were an estimated 775 babies born with
Downs syndrome, a live birth rate of 1.1 per 1,000 live births in England and Wales. There
were clear regional differences in screening for Downs syndrome in England and Wales in
2012. These differences may arise not only due to service factors, but also maternal factors
including age, social deprivation and cultural beliefs influencing the take up of screening and
diagnostic tests. It was estimated that the prevalence of Downs Syndrome in West Midlands
was 2.4 per 1,000 total births18.
2.3 Health Needs People with disabilities have greater unmet needs and seek more health care compared to
people without disabilities. These people are particularly more vulnerable to deficiencies in
health care services and may experience greater vulnerability to secondary conditions, (such
as diabetes), age related conditions (such as premature ageing in their 40s and 50s),
engaging more in health risk behaviours (such as smoking, poor diet and reduced physical
activity) and higher rates of premature death. Barriers to healthcare can include lack of
appropriate transportation and appropriate services, physical barriers such as inaccessible
medical equipment and inadequate bathroom facilities and inadequate skills and knowledge
of healthcare staff19. (WHO 2015)
2.3.1 Mental Health
Mental health issues are more prevalent in those with SEN than those without, and levels of
mental health problems increase with levels of educational support needed20. Children and
adolescents with learning disabilities are over six times more likely to have a diagnosable
psychiatric disorder than their peers who do not have learning disabilities. In total, over one
in three children and adolescents with a learning disability in Britain (36%) have a
diagnosable psychiatric disorder21. The increased risk of having a mental health problem
cuts across all types of psychiatric disorders. Children with learning disabilities are 33 times
more likely to have an autistic spectrum disorder than the general population, 8 times more
likely to have ADHD, 6 times more likely to have a conduct disorder, 4 times more likely to
have an emotional disorder, 3 times more likely to experience schizophrenia and 1.7 times
more likely to have a depressive disorder22. Despite research suggesting higher demand for
mental health services among children and young people with learning disabilities, the Prime
Ministers Strategy Unit found that mental health services for this group of children are under-
resourced within Child and Adolescent Mental Health Services (CAMHS)23.
18 Morris JK, Springett A. The National Down Syndrome Cytogenetic Register for England and Wales 2012 Annual Report. Queen Mary University of London, Barts and The London School of Medicine and Dentistry 2014. 19 World Health Organisation (2015) Factsheet No 352 ‘Disability and Health’ accessed at http://www.who.int/mediacentre/factsheets/fs352/en/ 20Meltzer H et al (2000) the mental health of children and adolescents in Great Britain 21 Emerson and Hatton (2007) The Mental Health of Children and Adolescents with Learning Disabilities in Britain. Institute for Health Research, Lancaster University. 22 Young Minds: Children and young people with learning disabilities – Understanding their mental health accessed at http://www.youngminds.org.uk/assets/0001/0610/children-and-young-people.pdf 2323 Carers UK (2007), Real change, not short change – time to deliver for carers, London: Carers UK
Page 22 of 110
2.3.2 Community Care Nursing (CCN)
Community care nursing provides care for children at home and aims to improve the quality
of life for families. Community care nurses care for children with acute and short term
conditions, children with long term conditions, children with disabilities and complex
conditions and children with life limiting and life threatening illness24. Research undertaken
for the Department of Health described the importance of reliable, accessible expert CCN
provision to families to enable them to care for their child at home25. The Department of
Health suggests that a “comprehensive” service should be the bedrock of wider out of
hospital services for ill and disabled children26.
2.3.3 Palliative Care
Children and young people with SEND have higher palliative care needs than the general
population. Currently, there are no registers to identify the number of children and young
people receiving palliative care in UK. However, the Palliative Care Statistics Study27
estimates the prevalence rate for children and young people aged 0-19 likely to require
palliative care services to be 16 per 10,000 population. The study also found that the most
commonly recorded cause of death category likely to require palliative care, for non-neonatal
deaths aged 0-19 years, were congenital malformations, deformations and chromosomal
abnormalities.
2.4 Wider Determinants
2.4.1 Poverty
Child poverty has been defined as the percentage of all dependent children under 20 in
relative poverty, that is, living in households where income is less than 60 per cent of median
household income before housing costs. In 2013, there were 18% children in England who
were deemed to be living in relative poverty which is a decrease from 20.8% in 2006.
Research demonstrates a strong relationship between disability, low income and social
exclusion and disability among families who have a disabled child28. The link between
poverty and SEND is also evident from the data from DfE in relation to free school meals
being accessed by children and young people with SEN. In 2015, free school meals were
claimed by 28.2% of pupils with SEN compared to 12.8% of pupils without SEND. This
suggests a clear link between disadvantaged children and SEN9.
A recent report on ‘special education needs and their link to poverty’ by Joseph Rowntree
Foundation29 suggests that
‘Children from low-income families are more likely than their peers to be born with inherited
SEND, are more likely to develop some forms of SEND in childhood, and are less likely to
move out of SEND categories while at school. At the same time, children with SEND are
more likely than their peers to be born into poverty, and are also more likely to experience
poverty as they grow up.’
24 Royal College of nursing (2014) The future for Community Children’s nursing: challenges and opportunities 25 Carter B, Coad J, Goodenough I et al. (2009) Community Children’s Nursing in England: An appreciative review of CCNs. Department of Health in collaboration with the University of Lancashire and the University of the West of England. 26 Department of Health (2011) NHS at home: children’s community nursing services 27 Hugh Cochrane et al (2007) Palliative Care Statistics for children and young adults 28 Institute for Public Policy Research (2007), Disability 2020: Opportunities for the full and equal citizenship of disabled people in Britain in 2020, London: IPPR 29 Joseph Rowntree Foundation (2016) Special educational needs and their links to poverty
Page 23 of 110
There is strong evidence that parental disability is a driver of poverty, as certain disabilities
lead to a ‘decline in income and employment rates’30. Moreover, low levels of maternal
education co-occurs with poverty and mothers without qualifications are 2.3 times more likely
to have children identified as SEND compared with children whose mothers have a degree31.
2.4.2 Disability Living Allowance
Disability Living Allowance (DLA) is a benefit that helps with the extra cost a person may
face if they are disabled, that is, if they need help looking after themselves and/or have
difficulty walking32. Research suggests that fewer than half of the families with a disabled
child receive health-related or disability benefits33. A survey by Carers UK found that half of
all carers reported subsidising the costs of the disability of the person they care for because
of inadequate disability benefits34. (Carers UK 2007)
In Nov 2015, the number of DLA claimants for learning difficulties in children was 231,440 of
which 66% were aged 16 and under. Since May 2011, there has been a 28% increase in the
number of claimants for DLA for learning difficulties for children aged under 16; however the
number of DLA claimants for learning difficulties for children aged 16-17 has decreased by
15% in the same period. Moreover, since May 2011, there has also been a 26% increase in
the number of DLA claimants for learning difficulties for young people aged 18-2435. (Fig. 11)
Fig. 11: Number of DLA claimants in England (Source: Nomisweb)
In England, 2.8 times more boys are claiming DLA for learning difficulties compared to girls.
The trend is increasing for both boys and girls, with 26% more boys and 17% more girls
claiming DLA for learning difficulties in November 2015 compared to May 2011. There has
30 Department for Work and Pensions (2014) An evidence review of the drivers of child poverty for families in poverty noe and for poor children growing up to be poor adults. London: DWP 31 Anders, Y., Sammons,P., Taggart,B., Sylva,K. Melhuish,E. and Siraj-Blatchford,I. (2011) The influence of child, family home factors and pre-school education on the identification of special educational needs at age 10’. British Educational Research Journal, Vol. 37, No. 3, pp. 421-41 32 UK Government (2015) ‘Disability living allowance (DLA) for adults’ accessed at https://www.gov.uk/dla-disability-living-allowance-benefit/overview 33 Department for Work and Pensions (July 2013) Fulfilling Potential: Building a deeper understanding of disability in the UK today 34 Carers UK (2007), Real change, not short change – time to deliver for carers, London: Carers UK 35 Official Labour Market Statistics (2015) accessed at https://www.nomisweb.co.uk/
010,00020,00030,00040,00050,00060,00070,00080,000
Nu
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of
clai
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Number of claimants for DLA in England for learning difficulties in children and young people aged under 25 years May 2011-Aug 2015
Aged under 5 Aged 5 to under 11 Aged 11 to under 16 Aged 16-17 Aged 18-24
Page 24 of 110
been a decrease in the number of DLA claimants for learning difficulties for boys (-14%) and
girls aged 16-17 years (-19%) in November 2015 compared to May 2011.
2.4.3 Social inclusion
National evidence shows families with disabled children feel excluded from social and
recreational opportunities that other families enjoy, due both to physical accessibility and to
other people’s attitudes36. Children with learning disabilities, in particular, find it hard to
socialise at school because they have difficulty understanding how to interact with their
peers, and so they risk becoming isolated37. Children with disabilities are likely to be living
fairly solitary lives and to be largely dependent on families and parents for emotional
support, yet a key identified need for children with disabilities is the desire for contact with
others who have similar experiences. Such relationships can be a key information source for
children with disabilities38.
2.4.4 Looked after children (LAC)
The looked after children are those children who are ‘looked after continuously for at least
twelve months’.
Children with SEND may be placed in residential care if their families believe that they are
unable to provide the care needed at home. Research suggests that a ‘typical’ child in
residential care tends to be a teenage boy with a persistent development disorder such as
autism and at least one other disability39. Disabled children in residential care are more likely
to be vulnerable to abuse, feel isolated and be vulnerable to a lifetime of care, compared to
those living at home40. Moreover, NICE suggests that there are particular specialist dental
needs of looked after children and young people with a disability41.
The Department of Education statistics suggest that 60% of all looked after children, that is,
children looked after continuously for at least twelve months as at 31 March 2015, excluding
those children in respite care, are identified with SEN. Moreover, 46% of all looked after
children with SEN have a statement of SEN or EHC Plan42.
The Department of Education statistics also suggest that in 2015, nearly 50% of all children
in need are identified with SEN, of which 43% have a statement of SEN or EHC Plan.
2.4.5 Education
In England, during 2015, 14.4% of primary school pupils and 14.3% of secondary care pupils
were identified with SEN. Of the pupils identified with SEN, 1.4% primary school pupils and
1.8% secondary school pupils were in receipt of SEN statement/ EHC Plan.
Since 2010 in England, the percentage of total pupils with SEN has decreased from 19.9%
to 14.4% in 2015 in primary schools and from 21.6% to 14.3% in secondary schools. The
36Bennett, E. (2009) What makes my family stronger: A report into what makes families with disabled children stronger – socially, emotionally and practically. Contact a Family May 2009 37 Department of Health (2012) Research and development work relating to assistive technology 2011-12 38 Beresford, B. & Sloper, P. (2007) Information Needs of Disabled Young People Research Findings published from Beresford, B. & Sloper, P. (2007) The Information Needs of Chronically Ill or Physically Disabled Children and Adolescents Social Policy Research Unit, The University of York, York. 39 McGill et al, 2006, cited by Lombard, D. (2009) Meeting the Specific Needs of Children with Disabilities. CommunityCare.co.uk 40 Lombard, D. (2009) Meeting the Specific Needs of Children with Disabilities. CommunityCare.co.uk. 41 NICE Public Health Guidance 28 (2013) Looked-after children and young people 42 Department of Education (2014) ‘Children with special educational needs: an analysis 2014’
Page 25 of 110
percentage of pupils with SEN Statements/EHC plans has remained constant at 1.4% in
primary schools and has slightly decreased from 2% in 2010 to 1.8% in 2015 in secondary
schools in England. There is a downward trend for the percentage of pupils receiving SEN
support in both primary and secondary schools in England43,44,45,46,47,48 (Fig.12, 13).
Fig. 12, 13: Percentage of pupils with SEN in primary and
secondary schools in England: Time trend (Source: DoE)
The distribution of children with SEN by the national curriculum year in England increases
from Year 2 to Year 6 and then shows a gradual decrease thereafter. A similar pattern is
present for children with SEN support. There is a gradual increase in the percentage of
children with SEN statement/ EHC plan from Reception to Year 12 and above9 (Fig. 14).
Fig. 14: Percentage of pupils with SEN by national curriculum year (Source: DoE)
43Department of Education (2015) ‘Special educational needs in England: January 2015’ 44 Department of Education (2010) ‘Special educational needs in England: January 2010’ 45 Department of Education (2011) ‘Special educational needs in England: January 2011’ 46 Department of Education (2012) ‘Special educational needs in England: January 2012’ 47 Department of Education (2013) ‘Special educational needs in England: January 2013’ 48 Department of Education (2014) ‘Special educational needs in England: January 2014’
0%
5%
10%
15%
20%
25%
2010 2011 2012 2013 2014 2015
% c
hild
ren
Percentage of pupils with SEN in Secondary schools in England: 2010-
2015
Pupils with statement Pupils with SEN Support
Total SEN Pupils
0%
5%
10%
15%
20%
% c
hild
ren
Percentage of pupils with SEN in primary, secondary and special schools by national curriculum year group 2015
SEN statement/ EHC plans SEN support
0%
5%
10%
15%
20%
25%
2010 2011 2012 2013 2014 2015
% c
hild
ren
Percentage of pupils with SEN in Primary schools in England: 2010-
2015
Pupils with statement Pupils with SEN Support
Total SEN Pupils
Page 26 of 110
The Department for Education 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. These include
poverty, dissatisfaction with life, gaps in support at key transition points, isolation, high levels
of unmet needs and lack of support from social services49.
2.4.5.1 Educational Attainment
Education is key to enabling an individual to fulfil their future potential, yet disabled young
people face multiple barriers to achieving the outcomes their peers can expect50. Children
with SEN are only a third likely to achieve national expectations as those without SEN51.
The Department of Health statistics indicate that pupils with SEN are less likely to perform
well compared to pupils without SEN at all stages of education52,53,54,55,56 (Table 2).
% Pupils with SEN attaining
expected goals
% Pupils without SEN
attaining expected goals
EYFS (2014) 17% 63%
Y1 Phonics (2015) 39% 83%
Y2 Phonics 62% 96%
KS2 Reading, writing and
mathematics (2015)
39% 90%
GCSE 5+ A*-C (2013/2014) 28% 75%
Year 11 (Age 19) Level 2 66% 92%
Year 11 (Age 19) Level 3 29% 66%
Table 2: Educational achievement of pupils with and without SEN (Source: DoE)
Across all ages, levels of SEN provision, and subjects, pupils eligible for free school meals
(FSM) are less likely to achieve expected levels of development than those not eligible.
2.4.5.2 School Absences
Persistent absentees are defined as having an overall absence rate of around 15 per cent or
more. This equates to 56 or more sessions of absence (authorised and unauthorised) during
the year for pupils aged between 5 and 14 and 46 or more sessions of absence (authorised
and unauthorised) during the year for pupils aged 1542.
49 CHiMAT: Disability Needs assessment; selection Wolverhampton; Geographies Top level local authority 50 Department for Children, Schools and Families (2009) Healthy Lives, Brighter Futures: The strategy for children and young people’s health. Department of Health. A Commitment from the Children’s Plan 51 Department for Children, Schools and Families (2010) Breaking the link between special educational needs and low attainment Everyone’s business 52Department of Education (2014) ‘EYFPS attainment by pupil characteristics 2013-2014’ 53 Department of Education (2015) ‘Phonics Screening checks and Key Stage 1 assessments: England 2015’ 54 Department of Education (2015) ‘National Curriculum assessments: Key stage 2 2015 (revised)’ 55 Department of Education (2015) ‘GCSE and equivalent attainment by pupil characteristics 2014’ 56 Department of Education (2016) ‘Level 2 and 3 attainment by young people aged 19 in 2015’
Page 27 of 110
Children with SEN are more likely to be persistent absentees compared to children with no
SEN. In England during 2014/15, 9.5% of pupil enrolments with SEN were classified as
persistent absentees compared to 2.8% of non-SEN pupils. The percentage of pupils
classified as persistent absentees has increased since 2009, by 2.3% for pupils with SEN,
and by 1% for pupils without SEN. Pupils with SEN statements are more likely to be
persistent absentees compared to pupils with SEN support. In 2014/15, 11.6% of pupils with
SEN statements were classified as persistent absentees compared to 7.3% of pupils with
SEN support. The difference between the percentage of pupils with SEN classified as
persistent absentees and the percentage of pupils without SEN classified as persistent
absentees has increased from 0.6% in 2009/10 to 2.2% in 2014/1557,58. In England, girls are
more likely to be classified as persistent absentees compared to boys. In 2013/14, 9.7% of
girls with SEN were persistently absent compared to 8.7% of boys59.
Pupils with Profound and Multiple learning difficulties (28.5%) are most likely to be classified
as persistent absentees followed by those with physical disability (16.1%). Overall absence
and authorised absence is also most common in pupils with Profound and Multiple learning
difficulties; however unauthorised absence is most common in pupils with social, emotional
and mental health needs58. The most common reason cited for absence of pupils with SEN
was Illness (51.3%) followed by other unauthorised circumstances (17.6%). The other
reasons cited were medical/dental appointments, agreed family holidays and other
authorised circumstances42.
2.4.5.3 School Exclusions
School exclusions have been higher for pupils with SEN, particularly pupils with SEN support
compared to pupils without SEN. In 2013/14, 65.5% of the permanent exclusions were for
pupils with SEN, which is a decrease from 74.2% in 2009/10. In 2013/14, 60% of the fixed
period exclusions were for pupils with SEN60.
School exclusions are higher in boys (5.11%) compared to girl (1.8%). Pupils with behaviour,
emotional and social needs received the most number of fixed term and permanent
exclusions followed by those with moderate learning difficulties. The most common reason
for exclusions is persistent disruptive behaviour. The most common reason for fixed period
exclusions for pupils with a SEN statement is physical assault against an adult (19.6%) and
for pupils with SEN support, it is verbal abuse/ threatening behaviour against an adult
(19.2%). The most common reason for permanent exclusions of pupils with SEN statement
is physical assault against an adult (26.1%) and for pupils with SEN support, it is physical
assault against a pupil (13.5%)59.
2.4.6 Not in Education, Employment or Training (NEET)
‘NEET’ stands for young people aged 16-24 who are not in education, employment or
training. A person identified as NEET is either unemployed or economically inactive and is
either looking for work or is inactive for reasons other than being a student or a carer at
home61.
57 Department of Education (2011) Pupil absence in schools in England: 2009 to 2010 58 Department of Education (2016) Pupil absence in schools in England: 2014 to 2015 59 Department of Education (2016) SEN absences and exclusions: additional analysis 60 Department of Education (2015) Permanent and fixed period exclusions in England: 2013 to 2014 61 House of Commons (2016) ‘Young people not in education, employment or training: Briefing Paper’
Page 28 of 110
In England, 4.3% of all 16-18 year olds were classified as NEET in 201597; whilst 14% of all
16-17 year olds with a learning difficulty/ learning disability are not recorded as being in
education, employment or training62.
In 2015, 87.3% of the 16-17 year olds with SEND were in education, employment or training
compared to 91.3% of the 16-17 year olds without SEND. The gap between children with
and without SEND has reduced from 4.1% in 2013 to 4% in 201563.
In 2013/14, 90% of the children with SEN statements in KS4 cohort and 85% of the children
with SEN support in the KS4 cohort, remained in education, employment or training
compared to 94% of the non-SEN KS4 cohort in England. The percentage of children with
SEN statements and those receiving SEN support in KS4 cohort remaining in education,
employment or training has increased from 84% in 2010/11 to 90% in 2013/14 and from 80%
in 2010/11 to 85% in 2013/14 respectively64.
In 2013/14, 76% of the children with SEN in the KS5 cohort went to an education or
employment destination in England compared to 79% of the non-SEN children in the KS5
cohort. 49% of children with SEN in the KS5 cohort went to UK higher education institution
compared to 59% of the non-SEN children in the KS5 cohort64.
2.4.7 Further Education
Evidence shows that entrants to full-time first degrees in 2010-11 who are known to be
disabled were less likely to remain in higher education (8.2%) at the end of year one when
compared to those not known to be disabled (7.4%). There are also disparities in student
success between those who receive Disabled Students’ Allowance (DSA), those who
declare a disability but do not receive DSA, and those not known to be disabled. The
students who received DSA performed above the sector-adjusted average, whereas
disabled students not receiving DSA performed below it65.
2.4.8 Transition
Children are surviving longer with conditions they would previously have died from in
childhood and so support with the transition from children to adult services is becoming a
more prevalent issue66. Health-related quality of life for young people with complex health
needs and disabilities can be improved by a good transition, and a well-planned transition
improves health, education and social outcomes for young people. A poor transition out of
children’s services without continuity of care can lead to disengagement with services and
can have serious outcomes for young people67. The SEND Code of Practice2 provides a
greater focus on support that enables those with SEN to succeed in their education and
make a successful transition to adulthood. It also lays more emphasis on personalised
transition plans at all transition points such as between early years, school and college,
between children’s and adult social care services, or between paediatric and adult health
services and involving young people, parents and families in their development.
62 Department of Education (2013) ‘Special Educational needs in England January 2014’ 63 Department of Education (2016) ‘Participation in education and training: local authority Fig.ures’ 64 Department of Education (2016) ‘Participation in education and training: local authority Fig.ures’ 65 Department for Business, Innovation and Skills (2014) National strategy for access and student success in higher education 66 Department for Children, Schools and Families (2008) Transition: moving on well. A good practice guide for health professionals and their partners on transition planning for young people with complex health needs or a disability 67 Department for Children, Schools and Families (2008) Transition: moving on well. A good practice guide for health professionals and their partners on transition planning for young people with complex health needs or a disability
Page 29 of 110
2.4.9 Housing Children living in poor housing conditions are more likely to: have mental health problems;
contract meningitis; have respiratory problems; experience long-term ill health and disability;
experience slow physical growth and have delayed cognitive development68. Families with a
disabled child are more likely to rent their homes compared to families with non-disabled
children. Families with a disabled child are less likely to be living in a decent home compared
to families with a non-disabled child. Those with a disabled child are 50% more likely than
other families to live in overcrowded accommodation, to rate their home as being in a poor
state of repair, and to report problems with wiring, draughts and damp in the child's
bedroom. Compared to other groups of disabled people, disabled children requiring
specifically adapted homes are the least likely to be living in suitable accommodation. The
most frequently reported housing problems include lack of family space, and a lack of space
for storing and using therapeutic equipment. Other common problems are difficulties with
location and unsuitable or inaccessible kitchens, toilets and bathrooms. Improvements in
families' housing situation can lead to increased independence, more confidence and
greater self-reliance among disabled children69.
2.4.10 Equipment
There are up to 6,000 children in Great Britain living at home who are dependent on
assistive technology and one third of parents with a severely disabled child under the age of
two uses in excess of three pieces of equipment daily to provide basic care70. Over the last
decade the number of technologically dependent children being cared for at home has
increased significantly, reflecting both improving technology, and increasing clinical
expertise. However this increase will need to be supported through the transition into adult
services in the near future and research suggests that few specific services currently exist to
do this71.
2.4.11 Respite Care
Respite care offers opportunities to a disabled child that would not otherwise be available, in
terms of a therapeutic opportunity which promotes independence and quality time which is
beneficial for both the young person and their family72. However, a review of children’s
services suggests current level of demand for a short break service is high and there is
difficulty meeting this demand73.
2.4.12 Childcare
Appropriate childcare for disabled children is scarce and expensive and varies according to
the disability of the child. National research acknowledges that parents and carers of
children who have a disability or special needs are poorly served by the current system of
childcare74. In England in 2008, children with special educational needs were less likely to
68 Harker L (2006) Chance of a lifetime: The impact of housing on children’s lives. London: Shelter 69 Joseph Rowntree Foundation (2008) Housing and disabled children 70 Department for Education and Skills (2004) National Service Framework for Children: Young People and Maternity Services: Disabled Children and Young People and those with Complex Health Needs 71 Wallis et al (2010) Children on long-term ventilatory support: 10 years of progress 72 Littlewood, B., Fearns, D., Nash, A., Smith, R. (2009) Respite Care and Short Break Services for Children and Young People with Disabilities in Luton Borough: an Independent Review. The School of Social, Community and Health Studies. Centre for Community Research. University of Hertfordshire 73 Prabhakar, M., Thom, G., Hurstfield, J., Parashar, U. (2008) Individual Budgets for Families with Disabled Children: Scoping Study. SQW Consulting 74Family and Parenting Institute (2013) Childcare Costs Survey 2013
Page 30 of 110
receive formal childcare (37%) than those without special educational needs (45%)75. A
2012/13 childcare cost survey reported that only 14% of local authorities felt they had
sufficient childcare for disabled children76. Frequently cited difficulties include refusal of
group childcare providers to accept their child unless 1-1 support was in place; prohibitive
cost of 1-1 support in group childcare settings; lack of availability and additional costs of
private child-minders; Difficulties in finding child-minders who would accept their children for
reasons relating to either the child’s impairment, behaviour or support needs77.
2.4.13 Transport
Transport is a key issue in terms of accessing services including educational and health care
services. Transport is frequently identified as the largest barrier to accessing extended
provision, with research showing that 10% of disabled young people believe transport to be
the main barrier to participation in sports events78.
2.4.14 Lifestyle Factors
2.4.14.1 Substance Misuse
National evidence suggests that pupils with learning difficulties (14%) are more likely to take
an illicit substance including alcohol compared to pupils without learning difficulties (11%)79.
2.4.14.2 Obesity
Children who have a limiting illness are more likely to be obese or overweight, particularly if
they also have a learning disability. 40% of children aged less than 8 years old with a limiting
illness and learning disability are obese or overweight compared to 22.4% of children who
have neither condition. The percentage of children classified as overweight or obese in the 8
to 13 years old age category with a limiting illness and a learning disability increased to
almost 45%. Boys with a limiting illness are more likely to be obese or overweight than girls,
particularly where the child also has a learning disability80.
2.4.14.3 Sport and Leisure
Research suggests that play and leisure are a priority for disabled children as opportunities
to express choices, develop independence, learn new skills and develop social
relationships81. However, young people with a disability are more likely to be inactive (60%)
than those who do not have a disability (47%)82. Evidence suggests that disabled children
are as likely as other children to visit a library or museum at least once a year, but less likely
to take part in sport83. The 2015 annual active people survey for people aged 16 and over
suggests that a disabled person is still half as likely to play sport as a non-disabled person. It
also suggests that the percentage of disabled people playing sport regularly has increased
to 17% compared to 15.3% in 2005/0684.
75Speight, S., Smith, R., La Valle, I., Schneider. V. and Perry. J., with Coshall. C. and Tipping.S. (2009) Childcare and Early Years Survey of Parents 2008, London: DSCF/NatCen 76Daycare Trust (2010 a) Childcare costs survey 2010, London: Daycare Trust 77 Department for Education (2011) Disabled Children’s Access to Childcare (DCATCH): a qualitative evaluation 78 Department for Children, Schools and Families (2009) Healthy Lives, Brighter Futures: The strategy for children and young people’s health. Department of Health; A Commitment from the Children’s Plan 79 Department for Children, Schools and Families (October 2009) Children with special educational needs 2009: an analysis 80 Chimat (2011) Disability and obesity: the prevalence of obesity in disabled children 81 Littlewood, B., Curran, B., Dixon, N., Byers, C., Fearns, D. (2007) A Needs Analysis for Children and Young People with Learning Difficulties and/or Physical Disabilities in Hertfordshire; The Centre for Community Research; University of Hertfordshire 82 Fraser and Ziff (2009) Children and Young People’s Participation in Organised Sport Omnibus Survey. Research report DSF 83 Department for Culture Media and Sport (2012) ‘Taking Part: The National Survey of Culture, Leisure and Sport Adult and Child Report 2011/12: Statistical Release’. 84 Sport England (2016) Annual Active people survey
Page 31 of 110
1. Population 30% of England’s population is aged 0 – 25 years and has
increased by 8% since 2001
Highest proportion of children and young people are in the age
groups 20-24 (22%) and 0-4 (21%)
2. Prevalence 15.4% pupils in England have SEN. Of these 2.8% have SEN
statements and 12.6% receive SEN support.
The most common primary need of children with SEN support is
moderate learning difficulty and of children with SEN Statement/
EHC Plans is Autistic Spectrum disorder.
SEN is more prevalent in boys, among 5-10 year old pupils and in
children from black ethnic background.
3. Health Needs People with SEN have greater health needs and utilise healthcare
more
Mental health issues are more prevalent in those with SEN than
those without, and levels of mental health problems increase with
levels of educational support needed
Children and young people with SEND have higher palliative care
needs than general population.
4. Wider Determinants Research demonstrates a strong relationship between disability, low
income and social exclusion and disability among families who have
a disabled child
There is strong evidence that parental disability is a driver of poverty
60% of all looked after children as at 31 March 2015, excluding
those children in respite care, are identified with SEN.
5. Education 14.4% of primary school pupils and 14.3% of secondary care pupils
were identified with SEN in England
Pupils with SEN are less likely to perform well compared to pupils
without SEN at all stages of education
Children with SEN are more likely to be persistent absentees
compared to children with no SEN.
School exclusions have been higher for pupils with SEN, particularly
pupils with SEN support compared to pupils without SEN
In 2015, 87.3% of the 16-17 year olds with SEND were in education,
employment or training compared to 91.3% of the 16-17 year olds
without SEND.
6. Housing Those with a disabled child are 50 per cent more likely than other
families to live in overcrowded accommodation, to rate their home
as being in a poor state of repair, and to report problems with wiring,
draughts and damp in the child's bedroom
7. Lifestyle factors National evidence suggests that pupils with learning difficulties
(14%) are more likely to take an illicit substance including alcohol
compared to pupils without learning difficulties (11%).
Children who have a limiting illness are more likely to be obese or
overweight, particularly if they also have a learning disability.
Summary of Key findings (National picture)
Page 32 of 110
Young people with a disability are more likely to be inactive (60%)
than those who do not have a disability (47%).
3.1 Wolverhampton population The latest Office for National Statistics (ONS) population estimates that there are 252,987
residents in Wolverhampton. Of these, 32% (n=81,428) are children and young people under
25 years of age. This is a higher percentage compared to England’s average, where 30.4%
of the population are children and young people under 25 years8 (Fig. 15).
Fig. 15: Mid 2014 Population estimates for Wolverhampton (Source: ONS)
In Wolverhampton, the highest proportion of children and young people are in the age bands
0-4 years (22%) and 20-24 years (22%). This is similar to the national picture where 21%
and 22% of children and young people are in the age bands 0-4 and 20-24 respectively8
(Fig. 16).
Fig. 16: Population of children and young people by age bands (Source: ONS)
8692 7901 6927 7551 8667 9225 8701 7604 8746 8843 8333 6940 6393 5905 5256 4576 3706 3918
9259 8208 7192 8118 8913 9163 8663 7791 8909 8721 8047 6808 6299 5711 4655 3767 2752 2127
12000 10000 8000 6000 4000 2000 0 2000 4000 6000 8000 10000 12000
0-45-9
10-1415-1920-2425-2930-3435-3940-4445-4950-5455-5960-6465-6970-7475-7980-84
85+
Age
Mid 2014 Population estimates for Wolverhampton
males females
17,951 16,109
14,119 15,669
17,580
0
5,000
10,000
15,000
20,000
0-4 5-9 10-14 15-19 20-24
Nu
mb
ers
Age band
Population of children and young people aged 0-24 years in Wolverhampton (2014)
3.0 Local Picture
Page 33 of 110
3.2 Prevalence of SEN(D) The 2015/2016 School Census indicates that there were 6,935 (16.5%) pupils receiving SEN
provision in Wolverhampton, of which 5,782 (83%) received SEN support, 972 (14%)
received a SEN statement and 181 (2.6%) received an EHC plan. In 2015, Wolverhampton
has a higher proportion of children receiving SEN provision (17.4%) compared to England
(15.4%).
This needs assessment also utilised data held on the social care data system, CareFirst,
and the GP health data system, Graphnet. The CareFirst system is populated by social
workers and only includes data for children and young people with SEN who access social
care services. The Graphnet system, extracted from the clinical commissioning group
(CCG), is populated with GP practice data which is better suited to providing services for
adults with learning disabilities and ADHD due to the QOF register for learning disabilities.
Therefore the data presented below will be an underestimate; however it is a good starting
point to identify the number of children and young people with SEN accessing social care
and primary healthcare services.
According to the data on CareFirst, 851 children with SEN or EHC Plans have accessed
social care services as at April 2015. The maximum number of children aged 25 and below
are accessing social care services for acquired disability (n=1561) followed by learning
disability (n=1018). This is very different to the CCG’s Graphnet data which shows that the
maximum number of children aged 25 and below are accessing primary healthcare system
for ADHD (n=700) (Fig. 17).
Fig. 17: Children with SEN(D) recorded in LA and CCG by gender (Source: CareFirst, Graphnet)
Boys with SEN(D) are more likely to access social care and healthcare services compared to
girls. There is a marked difference in the number of children and young people with a
learning disability and ADHD on CareFirst compared with Graphnet. This suggests that there
is a need for linking the social care and health care data capturing systems to obtain a more
comprehensive picture.
1010
674 532
312 253 66 28
567
254 288
551
344
319
125 54
14 17
133
131 57
0
200
400
600
800
1000
1200
1400
1600
Aquireddisability
Learningdisability
SEN orEHCP
MentalHealthNeeds
Autism ADHD Diagnosedcongenitalcondition
ADHD Learningdisability
Autism
Local Authority CCG
Fre
qu
en
cy
Number of 0-25 year olds in Wolverhampton LA/CCG recorded as SEN(D) by gender: April 2015
Female Male
Page 34 of 110
Among children and young people accessing social care services for SEN or EHC Plans,
55% are aged 10-19 years. Among children and young people accessing social care
services and healthcare services for ADHD, nearly 50% and 38% respectively are aged 15-
19 years. Among children with autism accessing social care services, 63% are aged 10-19
years. This is quite similar to the children with autism accessing primary healthcare services
where 58% are aged 10-19 years. The proportion of children with learning disability aged 20-
24 years show a marked difference in accessing social care services and primary healthcare
services with only 16% accessing social care services and 41% accessing primary
healthcare services (Fig. 18).
Fig. 18: Children with SEN recorded on social care and primary healthcare system in Wolverhampton (Source:
CareFirst, Graphnet)
In Wolverhampton, SEN is most common in people of white ethnic origin (66.4%), followed
by children of Asian ethnic origin (14.4%). This is true for learning disability, acquired
disability, autism and congenital conditions. The exceptions are ADHD and Mental health
needs where children of Black and minority ethnic origin access the social care services
more, compared to children of Asian origin (Fig. 19). As this data is drawn from Graphnet, it
is not possible to compare it with England.
Fig. 19: Children with SEN(D) by ethnicity and type of condition (Source: CareFirst, Graphnet)
24.6 13.9 20.1 21.5 23.8 15.6 3.7 6.9
27 7.5
27.7 23.2
31.2 24.8 27.1 33.3
24.7 24.6
31.6
21.8
27.7 37.1
32.2 26.4 27.6 37.8 49.4 37.6
26.4
28.6
10.6 23.9 15.3 21.4 15.8 11.1 22.2 30.9 10.4
41.3
020406080
100
SEN orEHCP
MentalHealthNeeds
Autism Acquireddisability
Learningdisability
Diagnosedcongenitalcondition
ADHD ADHD Autism Learningdisability
Local Authority Clinical Commissioning Group
Pro
po
rtio
n (
%)
Percentage of SEN children by age group and type of condition in Wolverhampton as at April 2015
Aged 0 - 4 Aged 5 - 9 Aged 10 - 14 Aged 15 - 19 Aged 20 - 24
88.5 72 67.7 67.2 66.4 64.8
55.8
85 73.8
64.4
2.6
7.5 12.6 15.3 14.4 15.4 20.9
3.3 10.4 21.2
0
10
20
30
40
50
60
70
80
90
100
ADHD Mental HealthNeeds
Autism Aquireddisability
SEN or EHCP Learningdisability
Diagnosedcongenitalcondition
ADHD Autism Learningdisability
Local Authority Clinical Commissioning Group
% c
hild
ren
Percentage of children and young people with SEN(D) by ethnicity and type of condition in Wolverhampton as at April 2015
White Asian Black Mixed Other
Page 35 of 110
In Wolverhampton, 68.6% of the children and young people with SEN tend to come from the
most deprived background. This is similar to the children and young people with autism,
learning disability, acquired disability and mental health needs but particularly for ADHD,
where nearly three-quarters of the children are from the most deprived group (Fig. 20).
Fig. 20: Children with SEN(D) by IMD category of deprivation (Source: CareFirst, Graphnet)
3.2.1 Type of special educational need and disability in Wolverhampton
3.2.1.1 Congenital Anomalies in Wolverhampton
During 2013 the national congenital anomaly and rare disease registration service recorded
83 live births with all congenital anomalies in Wolverhampton, which is lower compared to
124 in 2011. The local child development centre (CDC) has a caseload of 21 children with
Down’s syndrome and 20 children with chromosomal abnormalities aged 0-5 years as at
January 2016.
3.2.1.2 Autistic Spectrum Disorder in Wolverhampton
In Wolverhampton, children and adults with autism are recorded on Graphnet, as well as
CareFirst. In April 2015, there were 314 children and young people aged 25 and below
recorded with autism by CareFirst and 345 by Graphnet. More boys were recorded with
autism compared to Females (Table 3) and it was found to be more prevalent in children
aged 10-14 and 15-19 (Table 4). Autism was found to be more prevalent in children and
young people of white ethnic origin followed by Asian origin as recorded by both CareFirst
and Graphnet. There was also a higher prevalence of Autisim in the most deprived quartile
of Wolverhampton recorded by both CareFirst (61.9%) and Graphnet (56.3%).
Male Female Total
CareFirst 253 54 314
Graphnet 288 57 345 Table 3: Number of patients with autism by gender recorded on CareFirst and Graphnet, April 2015
Age
0 - 4
Age
5 - 9
Age
10 - 14
Age
15 - 19
Age
20 - 24
CareFirst 1.3% 20.1% 31.2% 32.2% 15.3%
GP practices 4.6% 27% 31.6% 26.4% 10.4%
0102030405060708090
100
SEN or EHCP MentalHealthNeeds
Autism Aquireddisability
Learningdisability
Diagnosedcongenitalcondition
ADHD ADHD Autism Learningdisability
Population %
Local Authority Clinical Commissioning Group .
Pro
po
rtio
n (
%)
Percentage of children and young people with SEN(D) by IMD category of deprivation in Wolverhampton as at April 2015
0-19.9 (Most deprived) 20.0-39.9 40.0-59.9 60.0-79.9 80.0-100 (Least deprived)
Page 36 of 110
Table 4: Percentage of patients with autism by age recorded on CareFirst and Graphnet, April 2015
The schools also record the rate of children with autism. In 2014, the rate of children with
autism known to schools in Wolverhampton was 4.6 per 1,000. The trend has increased
from 2.6 per 1,000 in 2009/2010 to 4.1 per 1,000 in 2013/14 which is similar to the rising
trend in England15 (Fig. 21).
Fig. 21: Children with autism known to schools in Wolverhampton (Source: Learning disability profiles)
3.2.1.3 Learning Difficulties in Wolverhampton
In 2014, Wolverhampton had a significantly higher prevalence of moderate (59.2 per 1,000)
and severe (5.34 per 1,000) learning difficulties compared to England where the prevalence
is 28.6 per 1,000 and 3.8 per 1,000 respectively15.
The prevalence of severe learning difficulties has decreased in Wolverhampton since
2010/11 by 0.43 per 1,000 which is in contrast to England, where it has increased by 0.13
per 1,000 since 2010/11. The prevalence of moderate learning difficulties has decreased in
Wolverhampton by 0.2 per 1,000 since 2010/11 which is similar to England where it has
decreased more drastically by 4.2 per 1,000 since 2010/11. (Fig. 22). This suggests that
Wolverhampton has a significantly higher proportion of children with moderate and severe
learning difficulties compared to England.
Fig. 22: Prevalence of moderate and severe learning difficulties in Wolverhampton (Source: Learning disability
profiles)
0
5
10
2009/10 2010/11 2011/12 2012/13 2013/14pro
po
rtin
o p
er
10
00
Children (per 1,000) with Autism known to schools in Wolverhampton 2009/10 to 2013/14
Wolverhampton England
0
10
20
30
40
2010/11 2011/12 2012/13 2013/14
pro
po
rtio
n p
er
1,0
00
Children (per 1,000) with moderate and severe learning difficulties in Wolverhampton 2010/11 to 2013/14
Severe learning difficulties Wolv Severe learning difficulties Eng
Moderate learning difficulties Wolv Moderate learning difficulties Eng
Page 37 of 110
3.2.1.4 Learning Disability in Wolverhampton
There were 1,030 children and young people in Wolverhampton recorded on CareFirst with
learning disabilities in April 2015 of which 65% (n=674) were boys. 27.6% of these children
and young people were aged 15-19 years followed closely by 27.1% aged 10-14 years.
CareFirst figures were higher compared to the data held on Graphnet, however, the
proportions by gender and age were quite similar.
In total, 385 children and young people were identified with learning disabilities on Graphnet
in April 2015 of which 66% were boys. 28.6% of these children and young people were aged
15-19 years and 21.8% aged 10-14 years. This suggests that more children and young
people are accessing social care services compared to health care services or that the
health services do not collect SEND specific data for children and young people.
The data also illustrated that the prevalence of learning disabilities is highest in children and
young people of white ethnic origin followed by children and young people of Asian origin.
Moreover, prevalence of learning disabilities was found to be higher in most deprived
quartiles of Wolverhampton compared to less deprived quartiles (Table 5).
Ethnicity (% of those with a stated ethnicity)
White Asian Black Mixed Other
CareFirst 64.8 15.4 8 7.1 4.8
Graphnet 64.4 21.2 5.8 6.1 2.6
IMD category (% of total)
0-19.9 20.0-39.9 40.0-59.9 60.0-79.9 80.0-100
CareFirst 68.1 15.9 9.6 5.5 0.8
Graphnet 70.5 15.3 7.6 5.8 0.8 Table 5: Percentage of children with learning disabilities in Wolverhampton by ethnicity and deprivation as in April
2015 (Source: CareFirst, Graphnet)
The rate of children with learning disabilities known to schools in Wolverhampton (65.9 per
1,000) in 2014 is significantly higher compared to the England average (33.7 per 1,000) and
the West Midlands (48.5 per 1,000). Also, Wolverhampton has the 2nd highest rate of
children with learning disabilities known to schools compared to the 15 CIPFA neighbours
(Fig. 23).
Fig. 23: Children with learning disabilities known to schools in Wolverhampton (Source: Public Health England
Learning Disability tool)
0
20
40
60
80
Rat
e p
er
1,0
00
Children with learning disabilities known to schools in Wolverhampton compared to CIPFA neighbours: 2014
Page 38 of 110
3.3 Risk Factors There are a range of risk factors which can impact on a child having special educational
needs and/or disabilities. The sections below highlight the most important contributory
factors.
3.3.1 Maternal Age
Maternal age has been associated with pre-term birth and low birth weight, with those at the
extreme ends of spectrum being more susceptible to either or both birth outcomes. Pre-term
birth and low birth weight are known risk factors for a range of disorders and malfunctions
which can ultimately lead to a child/ young person having special educational needs.
The total fertility rate (TFR) is the average number of live children that a group of women
would each have if they experienced the age-specific fertility rates of the calendar year in
question throughout their childbearing lives85. In 2013 the total period fertility rate for women
in Wolverhampton was 1.99 children per woman, compared to 1.85 children per woman in
England. In Wolverhampton women have a higher fertility rate at ages of 15-19 (22.5 per
1,000 women) and 20-24 (89.7 per 1,000 women) compared to the national average (14.4
per 1,000 and 63.3 per 1,000 respectively). This suggests that there is a higher risk of poorer
birth outcomes due to lower maternal age in Wolverhampton compared to England (Fig. 24).
Fig. 24: Total fertility rate by maternal age in Wolverhampton 2013 (Source: Wolverhampton PH Intelligence, WCC)
3.3.2 Smoking at time of delivery
Smoking during pregnancy can cause serious pregnancy-related health problems. These
include complications during labour and an increased risk of miscarriage, premature birth,
still birth and low birth-weight which can lead to disabilities in children and sudden
unexpected death in infancy86. Babies born to women who smoke are on an average 200
grams (8 oz) lighter compared to babies born to non-smoking women87. In 2015/16, 16.3%
85 Office of national statistics (2014) Statistical Bulletin: Birth Summary Tables, England and Wales: 2014 Accessed at https://www.ons.gov.uk/ 86 Larsen, L.G. et al. Stereologic examination of placentas from mothers who smoke during pregnancy. Am J Obstet & Gynecol. 2002; 186: 531-537 87 Quitting smoking in pregnancy and following childbirth: Guidance. National Institute for Health and Clinical Excellence, 2010 http://www.nice.org.uk/guidance/ph26
22.5
89.7
113.2 107.9
53.8
11.1
1.99
14.4
63.3
101.2 109.9
63.5
14.7
1.83
0
20
40
60
80
100
120
Nu
mb
er
of
live
bir
ths
pe
r 1
,00
0 w
om
en
Total fertility rate, by maternal age, in Wolverhampton in 2013
Wolverhampton England
Page 39 of 110
babies were born to women who smoked at the time of delivery in Wolverhampton which is
higher compared to 12.8% in West Midlands and 10.6% in England88.
3.3.3 Low Birth Weight
Low birth weight is defined by the World Health Organisation as weight at birth of less than
2500 grams. Low birth weight is associated with poor outcomes in babies, including infant
mortality, and it is more prevalent in lower socio-economic groups. The main risk factors for
low birth weight have been identified as poor maternal nutrition, smoking during pregnancy,
substance misuse, low uptake of prenatal care and psycho-social factors such as stress and
depression89.
In Wolverhampton, during 2014/15, 3.2% babies were born with a low birth weight, which is
similar to the England average (2.9%) and significantly lower than the average for the West
Midlands (3.4%). The trend for low birth weight babies in Wolverhampton has improved from
4.3% in 2005 to 3.2% in 201490. In 2014, 1.6% babies were born with a very low birth weight
of less than 1500 grams in Wolverhampton an increase from 1.1% recorded in 201391. This
suggests that the percentage of highly vulnerable babies born with very low birth weight
appears to be increasing in Wolverhampton.
3.3.4 Breastfeeding
In 2014/15, 64.4% of mothers in Wolverhampton initiated breastfeeding, which is lower than
74.3% in England and 66.8% in the West Midlands88. The trend of mothers initiating
breastfeeding in Wolverhampton has decreased slightly from 65.2% in 2010/1188. In
2014/15, breastfeeding prevalence at 6-8 weeks after birth was lower in Wolverhampton
(33.8%) compared to England (43.8%) and West Midlands (40.9%)9191.
3.3.5 Palliative Care
Palliative Care Statistics Study estimates the prevalence rate for children and young people
aged 0-19 who are likely to require palliative care services to be 16 per 10,000 population27.
Applying these statistics to the Wolverhampton population suggests that there are 405
children and young people, aged 0-19 years who are likely to require palliative care
services8.
3.4 Wider Determinants of Health A range of wider determinants of health have a major role in lives of children and young
people with SEN(D), of which education and social care are most prominent.
3.4.1 Poverty
Income Deprivation Affecting Children Index (IDACI) is defined as the percentage of children
aged 0-15 living in income deprived families, that is, families which receive income support,
income based job-seekers allowance and/or child tax credit with an equalised income below
88 Health and Social Care Information Centre (2016) Satistics on Women’s Smoking Status at Tine of Delivery: England accessed at http://content.digital.nhs.uk/catalogue/PUB20899 89 Bull, J et al (2003) Prevention of low birth weight: assessing the effectiveness of smoking cessation and nutritional interventions. Evidence Briefing July 2003 Health Development Agency 90 Public Health Outcomes Framework (2016) accessed at nttp://www.phoutcomes.info/ 91 Public Health Intelligence, City of Wolverhampton Council
Page 40 of 110
60% of the national median before housing costs. In 2015, Wolverhampton had an IDACI
score of 31.3 which is 12th most deprived in England92.
Child poverty within Wolverhampton varies between wards from 42.3% children living in
poverty in Bushbury South and Low Hill to 9.3% children living in poverty in Penn in 2012
(Fig. 25).
Fig. 25: Child poverty (2012) within Wolverhampton (Source: Public Health Intelligence, WCC)
3.4.2 Disability Living Allowance
Disability Living Allowance (DLA) is a benefit which helps with the extra cost a person may
face if they are disabled, that is, if they need help looking after themselves and/or have
difficulty walking93. In Wolverhampton, the number of DLA claimants for learning difficulties
in children aged 16 and below has risen from 630 in May 2011 to 690 in August 2015, which
is a rise of 10%. This is very similar to the national picture where the number of DLA
claimants has increased by 27%. The number of DLA claimants for learning difficulties in
children aged 16 to 24 increased from 410 in May 2011 to 480 in August 2014 and shows a
decrease since that time to 330 in August 2015 (Fig. 26). The national picture shows a
similar trend of increase by 27% untill August 2014 and a decrease thereafter.
92 Department for Communities and local government (2015) ‘English Indices of deprivation 2015’
93 UK Government (2015) ‘Disability living allowance (DLA) for adults’ accessed at https://www.gov.uk/dla-disability-living-allowance-benefit/overview
Page 41 of 110
Fig. 26: Number of DLA claimants in Wolverhampton (Source: Nomisweb)
In Wolverhampton, 2.4 times more boys are claiming DLA for learning difficulties compared
to girls. The trend is increasing in boys and decreasing in girls. Since May 2011, the number
of boys with learning difficulties aged under 16 claiming DLA has increased by 14%;
however, the number of boys with learning difficulties aged 16-24 claiming DLA has
decreased by 17%. The number of girls with learning difficulties aged under 16 years old
claiming DLA has remained fairly constant, whereas the number of girls aged 16-24 years
claiming DLA has decreased by 25%.
3.4.3 Education
3.4.3.1 SEN provision in schools in Wolverhampton
In 2015/16, there were 6,935 children registered in Wolverhampton schools as having
special educational needs of whom 83% (n=5,782) needed SEN support, 14% (n=972) were
on SEN Statements and 2.6% (n=181) had received Educational, Health and Care (EHC)
plans94. The proportion of pupils receiving SEN support in Wolverhampton has decreased
from 15.8% in 2009 to 14.5% in 2015 which is similar to the national trend. The proportion of
pupils receiving SEN statements/ EHC plans have reduced in Wolverhampton from 3.3% in
2009 to 3.0% in 2015; however it has remained fairly constant at 2.8% in England43 (Fig. 27).
Fig. 27: Proportion of pupils receiving SEN Support and EHC Plans (Source: SFR25 / 2015: Special Educational Needs
in England, Jan 2015)
94 School Census 2015/16, City of Wolverhampton Council
0
200
400
600
800
Nu
mb
er
of
clai
man
ts
Number of claimants for disability living allowance in Wolverhampton for Learning difficulties in children and young people aged under 25 May 2011 to August 2015
Aged under 16 Aged 16-24
0%
10%
20%
2009 2010 2011 2012 2013 2014 2015
Pro
po
rtio
n o
f p
up
ils
Proportion of pupils receiving SEN Support and/or EHC Plan/ Statement
England EHC plans/Statements England SEN SupportWolverhampton EHC plans/ Statements Wolverhampton SEN Support
Page 42 of 110
Overall, 1% of pupils in Wolverhampton’s primary schools and 1.9% in Wolverhampton’s
secondary schools received SEN Statements/ EHC plans in Jan 2015. This is lower than
England’s average of 1.4% for primary schools and higher than 1.8% for secondary schools.
14.4% of primary school pupils and 15.6% of secondary school pupils receive SEN support
in Wolverhampton compared to 13% and 12.4% for primary school and secondary school
pupils, respectively, in England43 (Fig. 28).
Fig. 28: Children with SEN in primary and secondary schools Source: SFR25 / 2015: Special Educational Needs in
England, Jan 2015
Over the last five years in Wolverhampton, the percentage of pupils with SEN in primary
schools has decreased from 18.9% in 2010 to 15.3% in 2015 and from 20.9% to 17.4% in
secondary schools.
The percentage of pupils with SEN Statements/ EHC plans had increased from 2010 to 2014
in both primary and secondary schools; however, a slight fall has been observed in 2015 in
both primary and secondary schools. There is a downward trend for the percentage of pupils
receiving SEN support in both primary and secondary schools in Wolverhampton43-48 (Fig.
29, 30).
Fig. 29, 30: Pupils with SEN in primary and secondary schools in Wolverhampton (Source: DoE)
1.4 1.8 1 1.9
13 12.4 14.4 15.6
0
5
10
15
20
Primary Secondary Primary Secondary
ENGLAND Wolverhampton
% c
hild
ren
Proportion (%) of all Primary and Secondary school pupils with a SEN statement or EHC plan, or receiving SEN support, Jan 2015
Pupils with SEN statements/EHC plans Pupils with SEN support
0%
10%
20%
2010 2011 2012 2013 2014 2015
%ch
ildre
n
Percentage of pupils with SEN in Primary schools in Wolverhampton:
2010-2015
Pupils with statement Pupils with SEN Support
Total SEN Pupils
0%
5%
10%
15%
20%
25%
2010 2011 2012 2013 2014 2015
%ch
ildre
n
Percentage of pupils with SEN in secondary schools in Wolverhampton:
2010-2015
Pupils with statement Pupils with SEN Support
Total SEN Pupils
Page 43 of 110
The Wolverhampton school census 2015/16 indicates that 53% of SEN pupils were in
primary schools, 35% were in secondary schools and 11% were in special schools. Of these
55.7% children with SEN were of white ethnic origin followed by 9.2% children with SEN of
Asian ethnic origin94.
In January 2015, 45% of Wolverhampton’s pupils identified with SEN attended community
(mainstream) schools, whilst 27% attended academies and 10% attended a special school43.
(Fig. 31)
Fig. 31: Children with SEN by educational establishment in Wolverhampton (Source: DfE, SFR 25)
Data from the 2015/16 School Census shows that a very low number of primary school
children who receive SEN support and no primary school children with SEN statement/EHC
plans attended a SEN unit. This is in contrast to national data where 0.5% of pupils
receiving SEN support, and 6.7% of those with SEN statement/EHC plans attended a SEN
unit. Very few, if any, primary school children from Wolverhampton with SEN are placed in
resource units43.
A much higher proportion of Wolverhampton secondary school pupils attend a SEN unit:
4.2% of those who receive SEN support and 9.1% of those who have SEN statements/EHC
plans. This is in contrast to national data where attending a SEN unit is lower, with 1.7% of
pupils receiving SEN support and 5.7% of those with SEN statement/EHC plans attending a
SEN unit in England. Secondary school pupils in Wolverhampton who have SEN are also
much less likely to be placed in resource provision compared to the regional and national
average: 0.9% of pupils who receive SEN support, and 3.5% of those with a SEN
statement/EHC plan43.
The distribution of children with SEN in Wolverhampton by the national curriculum year
represents a fairly similar distribution across year 2 to year 6 and year 7 to year 11 and then
drastically reduces after year 11 94 (Fig. 32).
3335
1070 915 750 680 355 260
45 15 0
CommunitySchool
AcademySponsor Led
AcademyConverter
CommunitySpecial School
Voluntary AidedSchool
VoluntaryControlled
School
OtherIndependent
School
LA NurserySchool
Pupil ReferralUnit
Free Schools
Tota
l nu
mb
er
Type of educational establishment
Total number of pupils with SEN statements/EHC plans or receiving SEN support, by type of educational establishment, Wolverhampton,
January 2015
Page 44 of 110
Fig. 32: Children with SEN by national curriculum year (Source: School Census; City of Wolverhampton Council)
In 2015/16, the provision for SEN support increases with age until 10 years and then
reduces and remains similar for pupils across the 11-15 years age group. There is a
considerable reduction from age 16 onwards. The provision for SEN statements increases
with age and is highest for children aged 12 years to 15 years and then falls. The provision
of EHC plans is highest for children aged 11 and those aged between 4 years and 7 years
and then drops drastically94. The EHC plans have been recently introduced and all efforts
are being made to transfer the children who currently have SEN statements to EHC plans
(Fig. 33).
Fig. 33: Children with SEN by age and SEN Provision in Wolverhampton (Source: School Census 15/16, City of
Wolverhampton Council)
In 2015, within Wolverhampton, the largest proportion of children with SEN reside in
Bushbury South & Low Hill (11%) followed by 7.7% in Bilston East and the lowest proportion
of children with SEN reside in Tettenhall Wightwick (2.3%)94 (Fig. 34).
0
100
200
300
400
500
600
700
N1 N2 R Year1
Year2
Year3
Year4
Year5
Year6
Year7
Year8
Year9
Year10
Year11
Year12
Year13
Year14
Nu
mb
er
of
child
ren
Number of children with SEN in Wolverhampton by national
curriculum year 2015/16
0
100
200
300
400
500
600
2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Nu
mb
er
of
child
ren
Number of children with SEN by age and SEN provision in Wolverhampton 2015/16
SEN Support Statement EHC Plan
Page 45 of 110
Fig. 34: Number of children with SEN provision in Wolverhampton in 2015 (Source: School Census 2015/16)
Also, more children with SEN reside in most deprived areas compared to least deprived
areas within Wolverhampton. In 2015, 70.1% of children with SEN support and 65.2% of
children with SEN statements/ EHC plans in Wolverhampton resided in most deprived
quintile of the city compared to 0.8% and 1.1% respectively in the least deprived quintile94
(Fig. 35).
Fig. 35: Children with SEN by quartiles of deprivation (Source: School Census 2015/16; City of Wolverhampton
Council)
Speech, Language and Communication needs are the most prevalent type of SEN in
younger children aged between 3 and 7 years old, with the prevalence declining with age.
Autistic Spectrum Disorder is most prevalent amongst those aged between 11 and 18 years
of age. It appears that specific learning difficulties and severe learning difficulties increase
with age. Moderate learning difficulty seems to be most prevalent in children aged between 5
years and 10 years and forms a high proportion of type of SEN need across this age group.
It decreases for children aged 11 years and over (Fig. 36).
0%
20%
40%
60%
80%
0-19.9 20.0-39.9 40.0-59.9 60.0-79.9 80.0-100
% c
hild
ren
Deprivation quintile (0-19.9=most deprived; 80-100=least deprived)
Percentage of school children with SEN by quintiles of deprivation in Wolverhampton 2015/16
Children with SEN support Children with SEN statement/ EHC plan
Page 46 of 110
Fig. 36: Children with SEN by age and type of SEN need (Source: School Census 15/16, City of Wolverhampton
Council)
Moderate LD is the most common type of primary SEN need in primary schools (48.7%) as
well as secondary schools (41.1%) followed by Speech , Language and Communication
Needs (SLCN) (17.7%) for primary schools and Social, Emotional and Mental health (19.4%)
for secondary schools. In Special schools in Wolverhampton, severe LD is the most common
type of primary SEN need (27.1%) followed by Moderate LD (24.9%) and ASD (14%)94.
There is a similar picture in England with SLCN (27.7%) and Moderate LD (24.6%) being the
top 2 types of primary SEN need in primary schools. Moderate LD (24.9%) is the main
primary SEN need for secondary schools and severe LD (27.1%) is the main SEN for special
schools43 (Fig. 37).
Fig. 37: Children with SEN by primary care of need and school type (Source: SFR25 / 2015: Special Educational Needs
in England, Jan 2015)
3.4.3.2. Educational Attainment
Early Years Foundation Stage: In 2014, 13% of pupils with SEN support in Wolverhampton
achieved the expected standard in all early learning goals. The data for pupils with SEN
Statements/ EHC plans was compressed due to low numbers52.
Year 1: In 2015, 40% of pupils with SEN support met the expected standard of phonic
decoding in Wolverhampton which is an increase of 21% since 2012. In the same year, 16%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Age
SPLD
SLD
SLCN
SEMH
PD
MLD
ASD
0%
10%
20%
30%
40%
50%
60%
Specific LD Moderate LD Severe LD SEMH SLCN PhysicalDisability
ASD
% c
hid
lre
n
Percentage of pupils with SEN by their primary care of need by school type in Wolverhampton, Jan 2015
Primary
Secondary
Special
Page 47 of 110
of pupils with SEN statements/ EHC plans met the expected standard of phonic decoding in
Wolverhampton which is an increase of 10% since 201253.
Key Stage 1: Percentage of children with SEN support receiving level 2 or above in KS1 is
improving. Writing is the most underperforming subject for children with SEN support and
SEN statements.
In 2015, 65%, 51%, 67% and 58% pupils with SEN support achieved level 2 or above in KS1
in reading, writing, mathematics and science respectively in Wolverhampton. The proportion
of children with SEN support achieving level 2 or above in KS1 in reading, writing and
mathematics has improved since 2010 by 14%, 13% and 8% respectively; however the
percentage of children with SEN support achieving level 2 or above in KS1 for science has
declined by 2%. This is line with the national increase in achievement except for science
where percentage of pupils with SEN achieving level 2 or above in KS1 has improved in
England54 (Fig. 38).
In 2015, pupils with SEN statements/ EHC Plans achieved level 2 or above in KS1 in reading
(16%), writing (13%), mathematics (14%) and science (13%) in Wolverhampton. The
proportion of children with SEN statements achieving level 2 or above in KS1 has improved
by 7% in reading, 6% in writing, 3% in mathematics and 2% in science in Wolverhampton
since 2010. This is in line with the national increase in achievement53 (Fig. 39).
The gap between England and Wolverhampton for the proportion of children achieving level
2 or above in KS1 for all four subjects is decreaseing53.
Fig. 38, 39: Children with SEN receiving Level 2 or above in KS1 in Wolverhampton (Source: DfE, SFR 32/2015)
Key Stage 2: In Wolverhampton, the percentage of pupils with SEN support achieving level 4
or above in reading, writing and maths has improved from 32% in 2012 to 45% in 2015.
Similarly, the percentage of pupils with a SEN statement or EHC plans achieving level 4 or
above in reading, writing and maths has improved from 5% in 2012 to 11% in 201554.
0
5
10
15
20
25
30
2010 2011 2012 2013 2014 2015
%ch
ildre
n
Percentage of children with SEN (with statements) achieving Level 2 or above in
KS1 in Wolverhampton 2010-2015
Reading Writing
Mathematics Science
0%
20%
40%
60%
80%
2010 2011 2012 2013 2014 2015
% c
hild
ren
Percentage of children with SEN (without statement) achieving Level 2 or
above in KS1 in Wolverhampton 2010-2015
Reading Writing
Mathematics Science
Page 48 of 110
Fig. 40: Gap in achievement of Level 4 for KS2 Gap (Source: SFR47/2015)
The gap in achieving level 4 in KS2 for all four subjects between children with SEN and
those without SEN has fallen from 2012 to 2015 across Wolverhampton, West Midlands, and
England. The decrease in the gap has been much sharper in Wolverhampton during this
time period, falling from a difference of 60% to 51% (Fig. 40). This suggests that the
education provisions for children with SEN are improving and SEN is becoming less of a
barrier to achieving good levels in education.
GCSE: In 2015, 23.5% of pupils with SEN support and 8.8% of pupils with SEN statements
achieved 5+ GCSE A*-C in England; however, Wolverhampton data was suppressed due to
low numbers55. The trend data is available from 2010; however, there were significant
changes to the way data is collected for GCSE in 2014, and therefore the data from previous
years is not comparable.
Attainment by age 19: The total number of 19 year old children in year 11 in schools with
SEN has increased by 57% in Wolverhampton since 2006 compared to 35% in England
within the same period56.
Since 2006, the percentage of children with SEN achieving level 2 in year 11 in
Wolverhampton has improved dramatically by 43.3% for children with SEN without
statement and by 19.5% for children with statement of SEN. The improvement in
Wolverhampton is higher compared to a 35.7% and 15.1% improvement in England for
children with SEN without statement and children with SEN statement respectively56 (Fig.
40).
The percentage of children with SEN achieving level 3 in year 11 in Wolverhampton has
improved by 13% for children with SEN without statement and by 5.2% for children with
statement of SEN since 2006. The improvement in Wolverhampton is lower compared to
18.1% and 6.1% improvement in England for children with SEN without statement and
children with SEN statement respectively56 (Fig. 41).
45
50
55
60
65
2012 2013 2014 2015
Gap
(%
) Gap in Achievement of level 4 (KS2) for Reading, Writing, and Mathematics
between pupils with SEN and without SEN 2012 to 2015
England West Midlands Wolverhampton
Page 49 of 110
Fig. 41: Attainment by Age 19 in Wolverhampton (Source: DfE Statistics: 16-19 attainment)
3.4.3.3 Absences
Persistent absentees are defined as having an overall absence rate of around 15% or more.
This equates to 56 or more sessions of absence (authorised and unauthorised) during the
year for pupils aged between 5 and 14 years and 46 or more sessions of absence
(authorised and unauthorised) during the year for pupils aged 1542.
In 2014, the percentage of children with SEN defined as persistent absentees was higher in
Wolverhampton compared to England. 9.5% children with SEN support and 14.6% with SEN
statements were defined as persistent absentees in Wolverhampton compared to 8.7% and
12.4% respectively in England42. Moreover, in 2014, the percentage of children with SEN
defined as persistent absentees (12.1%) is higher compared to percentage of children with
no identified SEN defined as persistent absentees (4.2%) in Wolverhampton.
3.4.3.4 Exclusions
Wolverhampton has a very low permanent exclusion rate and the number and percentages
are not available as the data was suppressed due to low numbers. During 2013/14, in
Wolverhampton, 3.22% of children were excluded from state-funded primary, secondary or
special schools compared to 3.54% in England95.
In 2014/15, there were 1747 exclusions in Wolverhampton, out of which 1704 were fixed
period exclusions and 43 were permanent exclusions. Of the fixed period exclusions, 43% of
exclusions were received by children with SEN support and 24% exclusions were received
by children with SEN statements/ EHC Plans. Of the permanent exclusions, 49% of
exclusions were received by children with SEN support and 14% of exclusions were
received by children with SEN statements/ EHC Plans96.
In Wolverhampton since 2011/12, the number of fixed period exclusions has increased
dramatically by 101% for children with SEN support and by 273% for children with SEN
Statements/ EHC Plans (Fig. 42). Similarly, the number of permanent exclusions has
95 Department of Education (2015) ‘Permanent and fixed term exclusions in England 2013-2014’ 96 City of Wolverhampton Council (2015) Exclusions data
0%
20%
40%
60%
80%
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
% c
hild
ren
Percentage of children with SEN qualified to Level 2 and Level 3 in Year
11 in Wolverhampton 2006-2015
Level2 SEN without statement Wolv Level2 Sen with statement WolvLevel3 SEN without statement Wolv Lvel3 SEN with statement Wolv
Page 50 of 110
increased from 1 in 2011/12 to 21 in 2014/15 for children with SEN support and from 0 in
2011/12 to 6 in 2014/15 for children with SEN statement/ EHC Plans96.
Fig. 42: Fixed Period exclusions for children with SEN in Wolverhampton (Source: City of Wolverhampton Council)
The number of fixed exclusions in children with SEN support has increased dramatically in
PRUs from 22 in 2011/12 to 337 in 2014/15 and in special schools from 2 in 2011/12 to 12 in
2014/15 in Wolverhampton. Also, there has been an increase in the number of fixed
exclusions for this group of children in primary schools by 76%, but a fall in secondary
schools by 6%96 (Fig. 43).
The number of fixed exclusions in children with SEN statements/ EHC Plans has increased
dramatically in PRUs from 8 in 2011/12 to 147 in 2014/15, in secondary schools from 10 in
2011/2012 to 41 in 2014/15 and in special schools from 45 in 2011/12 to 175 in 2014/15.
Also, there has been a slight increase in the number of fixed exclusions in children with SEN
statements/ EHC Plans in primary schools by 11%96.(Fig. 43).
Fig. 43: Fixed term exclusions for children with SEN by type of school (Source: City of Wolverhampton Council)
The number of fixed period exclusions seem to increase with the national curriculum
reaching a peak at year 8 (n=222) for children with SEN statements/ EHC Plans and a peak
at year 9 (n=469) for children with SEN support in Wolverhampton across 2011/12 –
0
200
400
600
800
2011/12 2012/13 2013/14 2014/15
nu
mb
er
of
chid
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n
Number of fixed period exclusions for children with SEN in Wolverhampton 2011/12 - 2014/15
SEN Support EHCP No SEN
0
50
100
150
200
250
300
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400
PRIMARY ACADEMY SPECIAL PRU SECONDARY PRIMARY ACADEMY SPECIAL PRU SECONDARY
EHCP SEN Support
Nu
mb
er
of
child
ren
Number of fixed term exclusions for children with SEN in Wolverhampton by type of school 2011/12 - 2014/15
2011/12 2012/13 2013/14 2014/15
Page 51 of 110
2014/15. A dramatic fall is seen from year 10 onwards for children with SEN support as well
as children with SEN Statements/ EHC Plans96.
In 2014/15, the percentage of fixed exclusions received by children with SEN statements/
EHC Plans increased by national curriculum year, reaching a peak of 58% in year 4 and
thereafter decreasing gradually. There is a sharp decline in the percentage of fixed period
exclusions received by children with SEN statements/ EHC plans from year 9 onwards.
However, the percentage of fixed period exclusions received by children with SEN support
was highest in year 1 (63%) which reduced gradually until year 5 and started rising again
with peaks at year 7 (52%) and year 9 (53%) (Fig. 44).
The numbers of permanent exclusions are variable across the national curriculum years.
The highest number of permanent exclusions for children with SEN support was seen in year
9 (n=8) and for children with SEN Statement/ EHC Plans in year 3 (n=<5) in Wolverhampton
across 2011/12 to 2014/1596.
Fig. 44: Percentage of fixed term exclusions received by children with SEN by national curriculum year (Source: City
of Wolverhampton Council)
The most common reasons for fixed term exclusions in children with SEN support were
physical assault against pupil (21%), verbal abuse/threatening an adult (20%) and being
persistently disruptive (18%). The fixed term exclusions in children with SEN Statements/
EHC Plans were also given for similar reasons with physical assault against an adult (26%)
being the most common reason followed by physical assault against pupil (19%), verbal
abuse/threatening an adult (17%) and being persistently disruptive (15%)96.
The most common reason for permanent exclusion in children with SEN support was being
persistently disruptive (35%) and physical assault against an adult (40%) for children with
SEN statement/ EHC Plans96.
3.4.4 Not in Education, Employment or Training (NEET)
The term ‘NEET’ is used to describe young people aged 16-24 Not in Education,
Employment or Training. A person identified as NEET is either unemployed or economically
inactive and is either looking for work or is inactive for reasons other than being a student or
0%
20%
40%
60%
80%
100%
% c
hild
ren
National Curriculum year
Percentage of fixed exclusions received by children with SEN in Wolverhampton 2014/15
EHCP
SEN support
Page 52 of 110
a carer at home61. In Wolverhampton, 3.5% of 16-18 year olds were classified as NEET in
2015 compared to 4.1% in 201497.
In 2015, 87% of 16-17 year olds with SEND were in education and training compared to
88.7% 16-17 year olds without SEND. The gap between children with and without SEND has
reduced from 9.4% in 2013 to 1.7% in 201563.
In 2013/14, 94% of children with SEN statements and 79% of children with SEN support in
KS4 cohort, remained in education/employment or training compared to 93% of Non-SEN
KS4 cohort in Wolverhampton. The percentage of children with SEN statements and SEN
support in KS4 cohort remaining in education/ employment or training has increased from
86% in 2010/11 to 94% in 2013/14 and 72% in 2010/11 to 79% in 2013/14 respectively64.
In 2013/14, 75% children with SEN in KS5 cohort went to an education or employment
destination in Wolverhampton compared to 83% of Non-SEN children in KS5 cohort. 49% of
children with SEN in KS5 cohort went to UK higher education institution compared to 66% of
non-SEN children in KS5 cohort64.
In Wolverhampton, a slightly higher proportion of 16-17 year olds without any learning
difficulties or disabilities are in education and training compared to the national average
(93.1% compared to 91%). However, of those 16 – 17 year olds with a learning difficulty or
disability, Wolverhampton has a slightly lower proportion in education and training compared
to the national average (83.8% compared to 86%)62 (Fig. 45).
Fig. 45: 16-17 year olds with Learning difficulties in education/ training Source: School Census: SFR/31 - Local
authority tables
3.4.5 Social Care
The adult social care services provide support to young people with SEN aged 18 to 24
years. In April 2015, there were 181 young people with SEN known to adult social care
services of which 36% (n=66) received social care services (Fig. 46).
97 Department for Education (2016) NEET data by local authority
91
86
93.1
83.8
75
80
85
90
95
16 - 17 year olds in education and training WITHOUT LDD 16 - 17 year olds in education and training WITH LDD
Pe
rce
nta
ge
Proportion of 16-17 year olds recorded in education and training by Learning Difficulties and/or Disabilities status, 2014
England Wolverhampton
Page 53 of 110
Fig. 46: Young people with SEN receiving social care services in Wolverhampton (Source: CareFirst)
As at the end of March 2016, there were 1,494 children and young people aged 0-25 years
with SEN on the CareFirst database. Of these, 170 (5%) received SEN Support, 1,045
(70%) received SEN Statements and 207 (14%) received EHC Plans. The remaining 10%
were classified as other or no special provision.
Children and young people with SEN statement/ EHC plans are most likely to access social
care services at the age of 11-16 years and then the demand falls drastically as age
increases. However, for those with SEN support, social care services are accessed when
the children are younger, at the age of 4-5 years. The demand for social care services for
children with SEN support decreases thereafter with an increase at age 10 (Fig. 47).
Boys (72%, n=1077) are more likely to access social care services compared to girls (28%,
n=417). Of those with SEN statement or EHC plans, boys (n=903) are nearly three times the
number of girls (n=337) accessing social care services, which is expected given the
disproportionately higher number of boys with SEN compared to girls. Boys and girls with
SEN statement/ EHC plans are most likely to have moderate learning difficulty (21% and
27% respectively) followed by behavioural, emotional and social difficulties (18%) in boys
and severe learning difficulty (21%) in girls. Information related to primary type of need for
children with SEN support was incomplete and therefore, has not been reported. Most of the
children and young people with SEN accessing social care services are of White British
origin (58%) followed by those of Asian origin (10%).
0
100
200
300
400
500
600
SEN or EHCP MentalHealth Needs
Autism Aquireddisability
Learningdisability
Diagnosedcongenitalcondition
ADHDnu
mb
er
of
you
ng
pe
op
le
Number of young people aged 18-24 receiving any council adult social care services in Wolverhampton as at April 2015
Numbers 18-24 Receiving services
Page 54 of 110
Fig. 47: Demand for social care services by age and SEN provision (Source; CareFirst)
Moderate learning difficulty (19%) is the most common type of primary need for all children
and young people with SEN (receiving SEN support and SEN statements) followed by
children and young people with severe learning difficulty (15%). Moderate learning difficulty
(25%) is the most common type of primary need for children and young people with SEN
statement accessing social care services, followed by behavioural, emotional and social
difficulties (16%) and severe learning difficulty (15%) (Table 6).
Primary Need
Percentage of all children with SEN identified with the
primary need as on 31/03/2016
Percentage of children with SEN
statement identified with the primary need
as on 31/03/2016
Moderate Learning Difficulty 19% 25%
Severe Learning Difficulty 15% 16%
Behaviour, Emotional and Social Difficulties 14% 15%
Autistic Spectrum Disorder 12% 14%
Speech, Language or Communication Difficulties 8% 9%
Complex Learning Difficulties 8% 8%
Physical Disability 5% 5%
Hearing Impairment 2% 2%
Profound & Multiple Learning Difficulties 1% 2%
Visual Impairment 1% 2%
Special Learning Difficulties (Dyslexia) 1% 1%
Physical and Medical Difficulties 1% 1%
Primary care need missing 12% 0% Table 6: Primary need of all children identified with SEN accessing social care services
The distribution of children with SEN across Wolverhampton who access social care
services can be seen in Fig. 48.
0
50
100
150
3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23Nu
mb
er
of
child
ren
Age
Number of children and young people (aged 0-25 years) known to Social care services in Wolverhampton as on 31/03/16 by age and SEN provision
EHC/ Statement SEN support
Page 55 of 110
Fig. 48: Distribution of children with SEN accessing social care services (Source: CareFirst)
The CareFirst database indicates that 65% of children and young people with SEN
accessing social care services live in the most deprived quintile of Wolverhampton
compared to 51% of overall city population (Fig. 49). This is consistent with research studies
that SEN is related to poverty, deprivation and low income.
Fig. 49: Percentage of children with SEN by deprivation quintiles (Source: CareFirst)
3.4.5.1 Vulnerable Children
On 31st March 2016 there were 132 children and young people categorised as ‘vulnerable
children’ from all the children and young people known to have SEN. Of these, 71% are
0%
10%
20%
30%
40%
50%
60%
70%
0-19.9 20.0-39.9 40.0-59.9 60.0-79.9 80.0-100
Pe
rce
nta
ge
Deprivation Quintile (0-19.9=most deprived; 80-100=least deprived)
Percentage of children with SEN accessing social care services by deprivation quintiles
% of total SEN population % in overall city population
Page 56 of 110
looked after children and 20% are children in Need. Among children on SEN statement/ EHC
Plan 68% are looked after children and among those on SEN support 78% are looked after
children (Table 7).
Children in Need Child Protection Looked After Children
SEN Statement/ EHC
Plan 21 9 65
SEN Support <5* <5* 29 Table 7: Number of vulnerable children with SEN
*Numbers lower than or equal to 5 have been collated into 1-5 due to confidentiality
Severe learning difficulty (39%) is the most common type of need identified among children
in need. BESD is the most common type of need identified amongst children on child
protection (31%) and looked after children (32%) (Table 8).
Primary type of Need
Children in
Need Child Protection Looked after children
Autistic Spectrum Disorder 6 <5* 6
Behavioural, Emotional and
Social Difficulty <5* <5* 30
Moderate Learning Difficulty <5* 0 22
Severe Learning Difficulty 11 <5* 6
Speech, Language or
Communication needs <5* <5* <5*
Complex Learning
Difficulties 0 0 12
Missing <5* <5* 12 Table 8: Number of vulnerable children by type of primary need
*Numbers lower than or equal to 5 have been collated into 1-5 due to confidentiality
3.4.5.2 Looked after children
Evidence suggests that children with SEN are more likely to be looked after. Separate
statistics are available for looked after children with SEN and therefore, these have been a
separate more detailed review of this data.
In 2015, there were 435 children in Wolverhampton schools who have been looked after
continuously for at least 12 months. Of these 55.8% (n=240) were children with SEN. Of the
240 children with SEN, 33% (n=80) were children with SEN statements/ EHC plans and 66%
(n=160) were children receiving SEN support98.
The proportion of children with SEN who are looked after for at least twelve months in
Wolverhampton have decreased from 60.8% in 2012 to 55.8% in 2015. The decrease has
been seen in children receiving SEN support as well as with SEN statements/ EHC plans98
(Fig. 50).
98 Department of Education (2016) ‘Outcomes for looked after children’
Page 57 of 110
Fig. 50: Percentage of looked after children with SEN (Source: CareFirst)
0%
20%
40%
60%
80%
2012 2013 2014 2015
% c
hild
ren
Percentage of children with SEN who have been looked after continously for twelve
months in Wolverhampton 2012-2015
No SEN SEN support SEN statement All SEN
Page 58 of 110
1. Population Wolverhampton has a higher proportion of children and young people
(32%) compared to England (30.4%)
2. Prevalence There are 6,935 pupils receiving SEN provision in Wolverhampton, of
which 5,782 (83%) received SEN support, 972 (14%) received a SEN
statement and 181 (2.6%) received an EHC plan in 2015/16
851 children with SEN or EHC Plans have accessed social care services
as in April 2015
In 2014, Wolverhampton had significantly higher prevalence of moderate
(59.2 per 1,000) and severe (5.34 per 1,000) learning difficulties
compared to England where the prevalence is 28.6 per 1,000 and 3.8 per
1,000 respectively
There were 1,030 children and young people in Wolverhampton recorded
on CareFirst with learning disabilities in April 2015
The rate of children with learning disabilities known to schools in
Wolverhampton (65.9 per 1,000) in 2014 is significantly higher compared
to England (33.7 per 1,000) and West Midlands (48.5 per 1,000). Also,
Wolverhampton has the 2nd
highest rate of children with learning
disabilities known to schools compared to the 15 CIPFA neighbours.
In April 2015, there were 314 children and young people aged 25 and
below recorded with autism by CareFirst and 345 by Graphnet. In 2014,
the rate of children with autism known to schools in Wolverhampton was
4.6 per 1,000.
3. Education The trend in the proportion of pupils receiving SEN support and SEN
statements/ EHC plans in Wolverhampton is decreasing.
Moderate LD is the most common type of primary SEN need in primary
schools (48.7%) as well as secondary schools (41.1%) followed by
Speech , Language and Communication Needs (SLCN) (17.7%) for
primary schools and Social, Emotional and Mental health (19.4%) for
secondary schools. In Special schools in Wolverhampton, severe LD is
the most common type of primary SEN need (27.1%) followed by
Moderate LD (24.9%) and ASD (14%).17
4. Educational
Attainment
KS1: Gap between England and Wolverhampton for the percentage of
children achieving level 2 or above in KS1 for all four subjects has
decreased25
KS2: The gap in achieving level 4 in KS2 for all four subjects between
children with SEN and those without SEN has fallen from 2012 to 2015
across Wolverhampton
Attainment by 19 years: Since 2006, percentage of children with SEN
achieving level 2 in year 11 in Wolverhampton has improved dramatically
by 43.3% for children with SEN without statement and by 19.5% for
children with statement of SEN.
Attainment by 19 years: Since 2006, percentage of children with SEN
achieving level 3 in year 11 in Wolverhampton has improved by 13% for
children with SEN without statement and by 5.2% for children with
statement of SEN
Summary of Key Findings (Local picture)
Page 59 of 110
5. Wider
determinants
In 2015, Wolverhampton has an IDACI score of 31.3 which is 12th most
deprived in England7
Claimants for Disability Living Allowance (DLA) aged 0-24 years are
increasing in Wolverhampton, particularly for boys.
The total fertility rate for women is higher in Wolverhampton compared to
England, particularly for women aged 15-19 years and 20-24 years. Smoking at the time of delivery (18.8%) in Wolverhampton in 2014/15 is
higher compared to 14.2% in West Midlands and 11.4% in England14
.
Page 60 of 110
4.1 Population projections to 2030 The ONS population projections suggest that by 2030, the population of Wolverhampton is
estimated to increase by 9%, from 252,987 in 2014 to 275,900 in 2030, with an increase of
7% in males and 11% in females. The population of 0-24 year olds is estimated to increase
by 9.7% in Wolverhampton by 2030, equating to 8.7% increase in males and 11.7% increase
in females (Fig. 51).
The highest increase is estimated to be in the age group 10-14 years; an increase of 24% in
males and 26% in females. There is an decrease of 0.1% for population of males in 20-24
years age band; however an increase of 3% for females in the same age band. It is
estimated that there will be a very slightly increase, 0.4%, in boys aged 0 to 4 years,
however, girls within the same age group are estimated to increase by 4%99.
Fig.: 51: Mid 2014 population based projections (Source: ONS)
4.2 Projecting Adult Needs and Service Information System (PANSI100) The Department of Health PANSI looks at how demography and certain conditions can
impact on population projections for adults aged between 18 and 64 years. Currently there is
no complementary system for children aged below 18 years. However, exploring the PANSI
population projections for 18 to 24 year olds in Wolverhampton will give an indication of the
level of need for this group of people when they are younger and utilising children’s services.
Data from PANSI suggests that the population of 18-24 year olds will decrease till 2025;
however it is estimated to increase thereafter till 2030. The table below provides the detailed
breakdown.
99 Office of national statistics 100 PANSI accessed at www.pansi.org.uk
10.0% 5.0% 0.0% 5.0% 10.0%
0-4
10-14
20-24
30-34
40-44
50-54
60-64
70-74
80-84
Percentage (%) of total population
Age
Mid 2014 population based projections to 2030: Wolverhampton
males females Males 2030 Females 2030
4.0 What’s on Horizon: Future Needs
Page 61 of 110
Estimated number of 18-24 year olds with learning disability
2017 2018 2020 2025 2030
Learning disability:
baseline estimates 635 622 597 579 637
Learning disability:
Moderate or severe 147 144 138 136 151
Learning disability:
severe 48 47 46 45 50
Downs Syndrome 15 14 14 13 15
Autistic Spectrum
Disorder 234 230 218 213 235
Moderate physical
disability 963 943 906 881 972
Serious physical
disability 188 184 177 172 190
Visual Impairment 16 16 14 14 15
Hearing
Impairment 37 36 35 33 36 Table 9: Estimated number of 18-24 year olds with learning disability (Source:PANSI)
4.3 Projected estimates for children with SEN in schools in Wolverhampton101
The future needs of children and young people with SEND have been identified by using the
Holts method of forecasting which extends simple exponential smoothing to allow
forecasting of data with trends. However, this data must be used with caution, as it only
provides an indication of the future trends. A number of assumptions have been utilised
while developing the forecasts, which may or may not hold in the future. Moreover, the
forecast is only based on the trend data and does not take into account changes in service
delivery and management.
The percentage of pupils receiving SEN support in Wolverhampton has decreased since
2009 and currently (in 2015) 15% of the pupils in schools of Wolverhampton receive SEN
support. According to the forecast estimates, this is likely to decrease further to 11% till
2020.
The percentage of pupils receiving SEN statements/ EHC plans in Wolverhampton has
remained fairly constant at 3% since 2009. This is likely to remain constant till 2020 (Fig. 52).
101 City of Wolverhampton Council, Public Health team
Page 62 of 110
Fig. 52: Proportion of pupils receiving SEN support/ SEN statement or EHC plans (Public Health, City of
Wolverhampton Council)
Since 2010, the percentage of pupils with SEN support in primary schools has decreased to
the current level of 14%. Forecast estimates predict that this is likely to decrease further to
10% until 2020. A similar picture is seen across secondary schools, where the percentage
of pupils receiving SEN support is likely to decrease to 13% until 2020 (Fig. 53).
The percentage of pupils receiving SEN Statements/EHC plans is likely to remain constant
at 1% in primary schools; however forecast estimates predict that the percentage of pupils
receiving SEN statements/EHC plans in secondary schools is likely to decrease from 2% in
2015 to 1% in 2020 (Fig. 54).
Fig. 53, 54: Projected percentage of children with SEN in primary and secondary schools in Wolverhampton (Source:
Public Health, City of Wolverhampton Council)
4.3.1 Projected estimates by type of Need
1. Specific Learning Difficulty: Forecast estimates predict that the proportion of pupils with
specific learning difficulty is estimated to decrease from 9.6% in 2015 to 8.2% in 2020 in
primary schools. However, the proportion of pupils with specific learning disability in
secondary schools has risen from 2010 (12%) to 2015 (16%) and there is estimated to be a
further increase from 16% in 2015 to 23.1% in 2020 (Fig. 55 & 56).
0%
5%
10%
15%
20%
2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
% c
hild
ren
Percentage of pupils receiving SEN support/ SEN statements or EHC Plans in
Wolverhampton: Forecast till 2020
EHC Plans SEN Support
0%
5%
10%
15%
20%
20
10
20
11
20
12
20
13
20
14
20
15
20
16
20
17
20
18
20
19
20
20
% c
hild
ren
Percentage of children with SEN in primary schools in Wolverhampton: forecast till 2020
SEN Statement SEN Support
0%
5%
10%
15%
20%
20
10
20
11
20
12
20
13
20
14
20
15
20
16
20
17
20
18
20
19
% c
hild
ren
Percentage of children with SEN in secondary schools in Wolverhampton: forecast till 2020
SEN Statement SEN Support
Page 63 of 110
2. Moderate learning difficulty: Forecast estimates predict that the proportion of pupils with
moderate learning difficulty are estimated to decrease from 48.7% in 2015 to 43.3% in 2020
in primary schools and from 41% in 2015 to 32.4% in 2020 in secondary schools (Fig. 55 &
56).
3. Severe learning difficulty: Forecast estimates predict that the proportion of pupils with
severe learning difficulties are estimated to remain constant at 0.7% in 2020 in primary
schools and decrease from 0.2% in 2015 to 0.02% in 2020 in secondary schools (Fig. 55 &
56).
4. Profound and multiple learning difficulties: Forecast estimates predict that the proportion
of pupils with profound and multiple learning difficulties are estimated to remain constant at
0.1% in primary schools (Fig. 55 & 56).
Fig. 55: Projected children by type of SEN need in primary schools (Source: Public Health, City of Wolverhampton
Council)
5. Social, emotional and mental health: Forecast estimates predict that the proportion of
pupils with social, emotional and mental health needs are likely to decrease from 11.5% in
2015 to 5.1% in 2020 in primary schools and decrease from 19% in 2015 to 2% in 2020 in
secondary schools (Fig. 55 & 56).
6. Speech, language and communication needs: Forecast estimates predict that the
proportion of pupils with speech, language and communication needs are likely to decrease
from 17.7% in 2015 to 8.1% in 2020 in primary schools. However, there is estimated to be
an increase in the percentage of pupils with social, emotional and mental health needs from
5% in 2015 to 6.8% in 2020 in secondary schools (Fig. 55 & 56).
7. Hearing Impairment: Forecast estimates predict that the proportion of pupils with hearing
impairment are likely to decrease from 1.8% in 2015 to 0.6% in 2020 in primary schools and
from 2% to 0.3% in secondary schools (Fig. 55 & 56).
0%
10%
20%
30%
40%
50%
60%
2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
% c
hild
ren
Percentage of children by type of SEN need in primary schools in Wolverhampton: forecast till 2020
Specific learning difficulty
Moderate learning difficulty
Severe learning difficulty
Social emotional and mentalhealth
Speech, language andcommunications need
Hearing impairment
Visual impairment
Physical disability
Autistic Spectrum disorder
Profound and multiple learningdifficulty
Page 64 of 110
8. Visual Impairment: Forecast estimates predict that the proportion of pupils with visual
impairment are likely to decrease from 0.9% in 2015 to 0.1% in 2020 in primary schools .
However, there is estimated to be an increase in the percentage of pupils with visual
impairment from 1% in 2015 to 1.5% in 2020 in secondary schools (Fig. 55 & 56).
9. Physical disability: Forecast estimates predict that the proportion of pupils with physical
disability are likely to remain constant at 2% in primary schools and decrease from 1% in
2015 to 0.5% in 2020 in secondary schools (Fig. 55 & 56).
10. Autistic spectrum disorder: Forecast estimates predict that the proportion of pupils with
ASD are likely to decrease from 1% in 2015 to 0.2% in 2020 in primary schools and from
2.7% in 2015 to 1% in 2020 in secondary schools. Although the proportion of children with
ASD are likely to decrease, the forecast estimates predict that the rate of children with
autism in Wolverhampton is likely to increase from 4.1 per 1,000 children in 2013/14 to 6.4
per 1,000 children in 2019/2020 (Fig. 55 & 56).
Fig. 56: Projected children by type of SEN need in secondary schools in Wolverhampton (Source: Public Health, City
of Wolverhampton Council)
4.3.2 Projected estimates in educational attainment
The percentage of pupils with SEN statements and SEN support achieving level 2 reading,
writing, mathematics and science in KS1 are likely to increase from 2015 to 2020. Forecast
estimates predict that there is likely to be a 16% and 13% increase in the percentage of
pupils with SEN support achieving level 2 in reading and writing respectively (Fig. 57).
However, for pupils with SEN statements or EHC plans, there is likely to be a 52% increase
in the percentage of pupils achieving level 2 in mathematics and 39% increase in the
percentage of pupils achieving level 2 in science.
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
% c
hild
ren
Percentage of children by type of SEN need in secondary schools in Wolverhampton: forecast till 2020
Specific learning difficulty
Moderate learning difficulty
Severe learning difficulty
Social emotional and mentalhealth
Speech, language andcommunications need
Hearing impairment
Visual impairment
Physical disability
Autistic Spectrum disorder
Page 65 of 110
Fig. 57: Projected percentage of pupils with SEN support achieving level 2 in KS1 (Source: Public Health, City of
Wolverhampton Council)
The percentage of pupils with SEN support achieving level 4 in KS2 are likely to increase
from 45% in 2015 to 50% in 2020. There is estimated to be a marked increase in the
percentage of pupils with SEN statements achieving level 4 in KS2; from 10% in 2015 to
nearly 30% in 2020. The gap in achievement between children with and without SEN in KS2
is likely to reduce from 51% in 2015 to 46% in 2020 (Fig. 58).
Fig. 58: Projected percentage of pupils with SEN achieving level 4 in KS2 (Source: Public Health, City of
Wolverhampton Council)
The percentage of pupils with SEN achieving level 2 in year 11 are likely to increase from
62% in 2015 to 81% in 2020 and those achieving level 3 in year 11 are likely to decrease
from 19% in 2015 to 16% in 2020 (Fig. 59).
0%
20%
40%
60%
80%
100%
2012 2013 2014 2015 2016 2017 2018 2019 2020
% c
hild
ren
Percentage of Pupils with SEN support achieving level 2 in KS1 in Wolverhampton:
forecast till 2020
Reading Writing Mathematics Science
0%
10%
20%
30%
40%
50%
60%
2012 2013 2014 2015 2016 2017 2018 2019 2020
% c
hild
ren
Percentage of pupils with SEN achieving level 4 in reading, writing and maths in KS2 in Wolverhampton: Forecast till 2020
SEN support SEN statement
Page 66 of 110
Fig. 59: Projected percentage of pupils with SEN achieving level 2 and 3 in year 11 (Source: Public Health, City of
Wolverhampton Council)
4.3.3 Projected estimates for children in employment, education and training
The percentage of pupils with SEN support in KS4 who are likely to remain in education,
employment and training are estimated to increase from 83% in 2015 to 91% in 2020.
Similarly, percentages of pupils with SEN statements in KS4 who are likely to remain in
education, employment or training are estimated to increase from 98% in 2015 to 100% in
2020 (Fig. 60).
Fig. 60: Projected percentage of pupils with SEN remaining in education, employment and training (Source: Public
Health, City of Wolverhampton Council)
4.3.4 Looked after children
Forecast estimates predict that there is likely to be a 16% and 13% increase in the
percentage of pupils with SEN support achieving level 2 in reading and writing respectively
(Fig. 57). However, for pupils with SEN statements or EHC plans, there is likely to be a 52%
increase in the percentage of pupils achieving level 2 in mathematics and 39% increase in
the percentage of pupils achieving level 2 in science.
0%
20%
40%
60%
80%
100%
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
%p
up
ils
Percentage of pupils with SEN achieving level 2 and 3 in year 11 in Wolverhampton: Forecast till 2020
Level 2 Level 3
0%
20%
40%
60%
80%
100%
2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
%p
up
ils
Percentage of pupils with SEN in KS4 remaining in education, employment or tranining in Wolverhampton: Forecast till 2020
SEN Support SEN Statement/ EHC
Page 67 of 110
The percentage of children with SEN who are looked after for at least twelve months are
predicted to increase from 56% in 2015 to 59% in 2020. This is in contrast to the percentage
of children with no SEN who are looked after for at least twelve months who are predicted to
fall from 44% in 2015 to 41% in 2020.
Fig. 61: Projected percentage of children with SEN who are looked after children (Source: Public Health, City of
Wolverhampton Council)
Summary
In summary, forecasting estimates predict the following changes that may impact on the
provision of future needs for children and young people with SEND:
• Estimated increase in 0-24 population, particularly 10-24 year olds
• Predicted increase in:
• Specific Learning Difficulty and Visual Impairment
• Speech, Language and Communication needs in secondary schools
• Rate of Autism
• Increasing complexity of need
0%
10%
20%
30%
40%
50%
60%
70%
2012 2013 2014 2015 2016 2017 2018 2019 2020
% c
hild
ren
Percentage of children with SEN who are looked after for at least twelve months in Wolverhampton: Forecast till 2020
No.SEN SEN.support SEN.statement All.SEN
Page 68 of 110
Wolverhampton provides a range of services for children and young people with SEND.
These include universal services which are available to all children, including children and
young people with SEND and services specifically available for children and young people
with SEND (Table 10). A description of these services is provided in the appendix 1 with Key
assets illustrated in Fig. 62.
Services specifically available for children and young people with SEND
Universal services for all children (including children and young people
with SEND)
1. Child Development Centre 1. Child and Adolescent Mental Health Services (CAMHS)
2. Special Needs Early Years’ Service (SNEYS)’ City of Wolverhampton Council
2. Children’s Continuing Care and Adults Continuing Healthcare (18+); Wolverhampton CCG
3. Special Educational Needs Statutory Assessment and Review Team
3. Children’s Community Nursing Service; Royal Wolverhampton NHS Trust
4. Inspire (CAMHS) 4. Community Paediatrics
5. Children’s Hearing Services; Royal Wolverhampton NHS Trust
5. Children’s therapy services including Occupational therapy, Physiotherapy service and Speech and Language Service
6. Sensory Inclusion Service: Hearing Impairment; City of Wolverhampton Council
6. Health Visiting Service
7. Sensory Inclusion Service: Vision Team; City of Wolverhampton Council
7. Family Nurse Partnership
8. Equipment Service for children and young people with complex needs
8. Palliative Care Services
9. Transition service 9. Wheelchair service
10. Educational Psychology 10. Home to school transport
11. University of Wolverhampton Student enabling Centre
12. Personal Health Budget and Direct Payments
13. Short Breaks
14. Connexions
15. Supported Employment; City of Wolverhampton Council
16. Local Offer; City of Wolverhampton Council
17. Information, advice and support service
18. Wolverhampton Buddy service (partnership between Action for children and Wolverhampton short term breaks)
Table 10: Services available for children with SEND
5.0 Current Services
Page 69 of 110
Fig. 62: Wolverhampton Key Assets in the current provision of services for children and young people with SEND
5.1 NICE Guidelines NICE has produced four guidelines relevant for children and young people with SEND listed
below:
NICE Guideline CG128: Autism Spectrum disorder in under 19s: recognition, referral
and diagnosis (2011)
NICE Guideline CG170: Autistic Spectrum Disorder in under 19s: Support and
management (2013)
NICE Guideline NG11: Challenging behaviour and learning disabilities: prevention
and interventions for people with learning disabilities whose behaviour challenges
(2015)
NICE Guideline NG43: Transition from children’s to adult’s services for young people
using health and social care services (2016)
Further work will be undertaken with the current services being provided in Wolverhampton
to assess compliance with the NICE guidelines and how service provision can be improved
further. However, NICE has highlighted opportunities for decommissioning services for
children and young people with ASD and challenging behaviour and learning disabilities
based on evidence of poor effectiveness.
Key Assets
Child Development
Centre
Special Needs Early Years Service
Team Around the Child
Key Working
Sensory Inclusion Services
Local Offer
Short Breaks
Partnership Working among CCG, Council and
Parent/carer forums
SEND Partnership Board
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Opportunities to decommission services based on NICE CG170
1. Do not use neurofeedback to manage speech and language problems in children and
young people with autism.
2. Do not use auditory integration training to manage speech and language problems in
children and young people with autism.
3. Do not use omega-3 fatty acids to manage sleep problems in children and young people
with autism.
4. Do not use the following interventions to manage autism in any context in children and
young people: Secretin, chelation, hyperbaric oxygen therapy.
5. Do not use the following interventions for the management of core features of autism in
children and young people: antipsychotics, antidepressants, anticonvulsants, exclusion diets
(such as gluten- or casein-free diets).
6. Do not use a pharmacological intervention to aid sleep unless:
sleep problems persist despite following the sleep plan
sleep problems are having a negative impact on the child or young person and their
family or carers.
7. Do not routinely perform any medical investigations as part of an autism diagnostic
assessment, but consider the following in individual circumstances and based on physical
examination, clinical judgment and the child or young person's profile:
genetic tests, as recommended by your regional genetics centre, if there are specific
dysmorphic features, congenital anomalies and/or evidence of intellectual disability
electroencephalography if there is suspicion of epilepsy[4].
Opportunities to decommission services based on NICE NG11
1. Do not offer sensory interventions (for example, Snoezelen rooms) before carrying out a
functional assessment to establish the person's sensory profile. Bear in mind that the
sensory profile may change.
2. Do not offer medication to aid sleep unless the sleep problem persists after a behavioural
intervention, and then only:
after consultation with a psychiatrist (or a specialist paediatrician for a child or young
person) with expertise in its use in people with a learning disability
together with non-pharmacological interventions and regular reviews (to evaluate
continuing need and ensure that the benefits continue to outweigh the risks).
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6.1 Service Providers/ Commissioners including education sector Surveys were conducted to obtain the views of service providers and commissioners who
provide and/or commission services for children and young people with SEND. Two
separate surveys were conducted, one for health and social care service providers and
commissioners and the other for the education sector.
The results of these surveys are the views and opinions of the people/organisations/ teams
who responded to the survey. These results should be interpreted with caution as they do
not reflect the views of all the service providers/ commissioners or education sector in
Wolverhampton. A summary of the stakeholder engagement processes is presented below
and a detailed stakeholder engagement report is available on request.
6.1.1 Methodology
6.1.1.1 Survey for the Health and social care service providers and commissioners
The survey questionnaire was developed in consultation with colleagues from social care
commissioning and the JSNA Steering Group members, which includes membership from
the Wolverhampton CCG, Royal Wolverhampton Trust, Black Country Partnership
Foundation Trust, and Healthwatch. An implementation plan was agreed to ensure timely
administration.
The questionnaire was sent to the stakeholders via a survey monkey link along with an email
detailing the importance of the SEND JSNA and how stakeholders could help to shape the
services. The JSNA Steering Group supported dissemination to key stakeholders and there
was additional direct distribution to known networks.
6.1.1.2 Survey for the education sector
This survey was co-produced with the Education and Enterprise team at the City of
Wolverhampton Council. The focus of this survey was to understand the perceived gaps,
current needs and future anticipated needs from the perspective of the education sector in
Wolverhampton.
The questionnaire was sent to the stakeholders via a survey monkey link along with an email
detailing the importance of the SEND JSNA and how educational settings could help to
shape the services. Dissemination was via the City of Wolverhampton Council’s ‘Head-
teachers Weekly Bulletin’ and through ‘ConnectEd Partnership’, a local organisation of head-
teachers.
6.1.2 Results
Responses were received from a range of services including healthcare, social care,
voluntary and education.
6.1.2.1 Identifying Needs: Healthcare and Social care
The results highlighted the complexity in needs, particularly in providing for older children
and young people with SEND and capacity issues which are impacting on services’ ability to
meet those needs. Primary reasons were increasing caseloads, staffing issues or pressures
of work bought about because of new SEND legislative and policy requirements.
6. Stakeholder Views
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Services were more likely to identify that their service only partially/partly met the needs of
children and young people with SEND (n=8/17). The reasons for this were reported as
burden of work, lack of staff, lack of specialist staff and expertise, lack of specialist
equipment or training; lack of resources; pressure on workloads; and new SEND
policy/procedural requirements. Similarly, a lack of engagement from social services was
identified as a consequence of their increasing caseloads and reduced staffing by the
Children’s Community Nursing Service.
Commissioners identified needs including a lack of transport, personal assistants, non-take
up of direct payments/personal budgets and a lack of respite care and day activities for
young adults.
Service providers identified being unable to meet the needs of young people (19-25 year
olds) and those with complex needs (voluntary sector organisation), an inability to provide
intensive support, lack of knowledge about their service and exposure to the world of work.
In addition, service delivery needs were highlighted which included resource and capacity
issues, decreasing visits because of a high case loads and capacity problems brought about
by attendance at multi-agency meetings; inability to access services within statutory
timescales; and a lack of funding to buy specialist equipment.
The service providers/ commissioners were also asked about their views on future needs
and trends for children and young people with SEND. There was a consensus among the
respondents that increasing complexity and co-morbidity of multiple complex needs /medical
conditions will have an impact in the future. Emotional/behavioural and mental health
problems including Autism/ASD were identified as a factor impacting the future needs. There
was also a concern for older children and young people with SEND, and issues identified
included access to employment, an increase in challenging behaviour in 14-17 year olds,
social isolation and disengagement. Overall there was a worry that as children and young
people got older, services either would not be available or that they would be inaccessible.
The area of ‘transition’ was highlighted as an area of need by the service providers and
commissioners. It was felt that there was a need for support for GPs to manage the
transition, in terms of capacity and time, specialist training for GPs or provision of a specialist
team to support GPS. Moreover, it was felt that the Children’s Community Nursing Service
(CCNS) and District Nurses worked very differently and so families were vulnerable to losing
contact with a health professional for advice that knew and understood their child and their
medical condition. In addition, there was a need for multi-agency working, within existing
services, where all parties involved with young people should be involved in discussions
about appropriate provision in order that all the needs of the young person are understood
and can be met.
The need for data to identify the number of young people due to enter the transition phase
every year was acknowledged. Currently, the commissioners find it difficult to quantify this
information and therefore planning services for future is challenging.
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6.1.2.2 Identifying Needs: Education
The schools response to the survey highlighted that the majority of primary school children
(71.8%) and secondary school children (48.8%) had a cognitive and learning special
educational need (Table 11).
Area of need Percentage of primary
school children
Percentage of secondary
school children
Cognition and Learning 71.8% 48.8%
Communication and
Interaction
15.5% 27.7%
Social, emotional and mental
health
6.5% 16.5%
Sensory/ Physical 6.1% 7.7%
Table 11: Percentage of children by area of need
None of the schools felt that they did not meet the needs for children with cognition and
learning need. However, 23% felt they were not able to best meet the communication and
interaction needs, 67% felt that they were not best able to meet the social, emotional and
mental health needs and 39% felt they were not best able to meet the sensory and/or
physical needs of children and young people with SEND (Fig. 63-66).
Fig. 63-66: Percentage of schools meeting the 4 areas of need (Source: Stakeholder survey)
Social, emotional and mental health needs were identified as the area of concern and
provisions to support children with these needs were identified as an area of need by most of
67%
33%
Cognition and Learning
1 (Least)
2
3
4 (Most)
15%
8%
54%
23%
Communication and Interaction
1 (Least)
2
3
4 (Most)
17%
50%
25%
8%
Social, Emotional and Mental Health needs
1 (Least)
2
3
4 (Most)
8%
31%
46%
15%
Sensory and/or Physical needs
1 (Least)
2
3
4 (Most)
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the respondents. The respondents also identified more resources, especially to look at
mental health but also social and behavioural aspects of SEN as an emerging need in the
future.
The need for staff training was identified for a better understanding of the current legislative
changes to the SEND agenda, to provide support to pupils with speech and language
difficulties, to better support pupils with mental health needs and specific needs such as
ASD. Simplified referral routes to external healthcare services such as GEM centre and
CAMHS was identified by a number of respondents.
6.1.2.3 Identifying Gaps
The service providers/ commissioners questionnaire asked about further groups of children
and young people with SEND who would benefit from their service. Gaps in service provision
were identified for children with Autism/ ASD, children with complex needs, children with
multi-sensory impairment and support during transition to adulthood. Gaps in service
provision are detailed in section 7.
The education sector identified gaps in service provision in early years , that is, Early Years
Foundation Stage (EYFS) and Key Stage 1. A number of respondents identified gaps in
access to educational psychology service and referral routes to CAMHS and GEM centre.
Gaps in service provision are detailed in section 7.
6.2 Views of Parents/Carers of children and young people with SEND and
young people with SEND: Survey
The view of parents/carers of children and young people with SEND were obtained via a
survey questionnaire and during a workshop with Voice4Parents. The views of young people
were identified via Connexions in the form of informal interviews.
A summary of the stakeholder engagement processes is presented below. A detailed
stakeholder engagement report is available on request.
6.2.1 Methodology
The survey was co-produced with Voice4Parents who also suggested that the best way to
obtain view of the parents and young people was via a survey questionnaire rather than a
focus group where people might not be able to express their ‘real’ views.
The questionnaire was sent to parents and young people via a survey monkey link by a
number of routes. A letter was sent to all schools in Wolverhampton using the ‘Head-
teachers Weekly Bulletin’ including a link to the questionnaire. The questionnaire was also
disseminated via Voice4Parents and ‘Include Me Too’ who distribute the questionnaire to
parents of children with SEND attending a pre-arranged workshop by the organisation.
An additional survey, co-produced with the SEND Partnership Board was disseminated via
key partners and youth organisations to increase the response from parents and capture the
views of children and young people with SEND. This survey was advertised on the City of
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Wolverhampton Council Facebook and there was specific involvement of young people via
Connexions.
6.2.2 Results
A total of 50 responses were received from parents/carers of children and young people with
SEND via survey 1 and survey 2. In addition, 6 college groups of young people with SEND
(including approximately 60 young people aged 16-24 years) responded to the survey via
Connexions.
A total of 32 responses were received from survey 1; 31 (97%) reported they were the
parent, with 1 (3%) non-response. The respondents had a total of 37 children as some
parents had more than 1 child with SEND. Of the 32 respondents, 27 (84.4%) were resident
in Wolverhampton, whilst 2 (6.3%) were from Birmingham, and 1 (3.1%) each from Walsall,
Dudley, and Sandwell. The majority of the children (n= 22; 69%) of the children whose were
aged between 5 -15 years (Fig. 67).
Fig. 67: Age of children whose parents/ carers responded to the survey (Source: Stakeholder survey)
14 (43.2%) children were in receipt of SEN support, a further 7 (21.6%) have a statement of
SEN and 6 (18.9%) have an EHC plan. The most common type of SEND need experienced
by the children of respondents were behavioural/emotional/social difficulties, moderate
learning difficulties, autistic spectrum disorder, and speech and language therapy (Fig. 67).
The most commonly attended educational establishments were: Mainstream secondary
schools (n= 12; 37.8%), special schools (n= 9; 27%), and mainstream primary schools (n= 5;
13.5%).
2.6%
33.3% 35.9%
12.8%
2.6%
12.8%
Age Group
Age of children whose parents/ carers responded to the survey
Page 76 of 110
Fig. 67: Number of children by SEND need (Source: Stakeholder survey)
6.2.2.1 Service Use: Health
The main Health services used by the children of the respondents were: Child and
Adolescent Mental Health Services (CAMHS), Physiotherapy, and Speech and Language
Therapy.
Positive feedback was received for the GEM centre, physiotherapy, CCNS, community
paediatrics, school nursing service, transition, sensory inclusion service and
wheelchair service.
The school-centred therapy received positive feedback
“School-centred therapy is good because they liaise with staff directly.”
One of the key issues highlighted by the respondents was the length of time taken to receive
a referral for CAMHS service; however, the speed and thoroughness of the assessment was
appreciated. A few parents expressed their concern that getting support and diagnosis for
undiagnosed developmental difficulties has been difficult.
15 14 13 9
7 6 5 5 5 2 1
0
5
10
15
20
Tota
l
SEND need
Number of children by SEND need
They are fairly central, either New Cross Hospital or the
GEM Centre. My son is referred without any hesitation
and receives the support offered.
Cannot praise them highly enough ..what a hospital
should be but rarely seen! staff services care ..they
have it all!
GEM centre staff are kind
The GP I go to is good as they have touch screens
Page 77 of 110
Improved communication within healthcare professionals as well as between health care and
other professionals was a common theme across parents.
6.2.2.2 Service Use: Education
A range of comments were received regarding the education services provided by primary,
secondary and special schools. There were general comments regarding the EHC Plans
being very paper based and confusing. A number of positive comments were received for
providing individual support needed by children with SEND.
‘The school is very accommodating and my son receives individual support when he needs it’ ‘My child receives extra help by being taught in small groups’ ‘Absolutely fantastic school always having the interests of my daughter first’ ‘Very supportive and have made arrangements to support son throughout the
school day ‘ ‘School have been good in getting all of the equipment my child needs to make his life more easier’ ‘SaLT was helpful in school’
“Whilst the current GP service is good,
the children suffer with a genetic
condition which my husband has and
which was undiagnosed despite very
obvious markers and their difficulties
are linked to this condition. We are
currently taking civil legal action for
negligence in this regard.”
Not enough information about the
disorder that my child has. Feel I am
isolated, sometimes when I need
advice, I don't know whom to ask or
where to turn.
I also think a meeting with his
Paediatric Consultant more than
annually would be more reassuring,
it used to be twice a year but was
then reduced to annually.
“Improved communication is a common thread across
services, between services and families and between all the
services involved in looking after the young person. Often
patient notes don't seem to be shared or accessible to all
parties involved, appointment times could be better
managed to minimise the impact of missed time from school
and some staff lack empathy and understanding, seemingly
not sensitive to the needs of young people with additional
needs.”
‘My son receives extra support in
school and has access to a laptop as he
finds writing difficult. He also has a lot
of support from staff in school’
‘Education good in special schools.
Parents/carer support good’
‘Support teachers in college are good’
More
communicatio
n needed
across all
services
Parents don’t know
what’s available
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Parents who responded to the survey specifically praised the Great Park School,
Tettenhall School and Penn Hall School for their commitment, caring staff and out of
school activities provided to children with SEND. Team around the child and
keyworker service also received positive feedback.
There was a general concern ‘about lack of support for those without statements and
plans’. Parents expressed dissatisfaction with communication between parents and
staff and the quality of education provided to their child via temporary staff.
Comments were received regarding lack of activities available during the school
holidays specifically for children and young people with SEND and stated that no
specialist college available for young people with SEND.
Parents also commented that lack of funding was the reason for delays or not being
able to provide particular services.
Moreover, the respondents commented on the process of SEN assessments, in particular
the length of time it takes to conduct and the lack of communication regarding the findings.
‘Not the best start in secondary schools, needs and disabilities not taking into account’
‘Constant use of agency staff, no consistency or continuity in staffing and the needs of a child with
disabilities’
‘I have found communication with school very poor as it is very hard to see staff face to face’
‘School has minimised all parental concerns and has been flippant in their responses which forced us to
obtain a private assessment which has helped and SENSTART has recognised the issues’
‘School SenCo need to support child and parent more, problems should be spotted earlier at school and to
ignore budget but put children first’
‘She needs a proper SEN assessment and an educational psychologist assessment as she has poor cognitive
skills and struggles with the same work as her age group and her memory. She has been waiting for the SEN
coordination in the school to arrange things for a long time and so far I have heard nothing apart from being
told indirectly about lack of funding’
‘Disturbingly laborious, slow process, which has caused distress and upset to my child on numerous occasions’
‘Please make the SEN process much more quicker my daughter has been waiting so long and he additional
support in place at an earlier time would make her school life much more enjoyable’
‘Feedback not being given to parents of assessments taking place’
Having keyworker and TAC team has
been good
Responsive to child's holistic needs; a good balance of
academic and pastoral input. Extracurricular social
integration with peers is actively encouraged.
Communication with parents by text message is
excellent.
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A number of respondents commented on the transition to secondary school services and the
need for improvement. Parents were also concerned about the “post 16 education and lack
of provision in the city for those with complex needs (both day and residential)”
6.2.2.3 Service Use: Social Care
The main Social Care service used by the children of the respondents was Short Breaks.
There were mixed comments from parents of children and young people with SEND and
young people themselves about short breaks and direct payments. Some shortcomings of
short breaks were identified, primarily around provision of short breaks services for children
and young people with challenging behaviour and very complex needs. Parents also felt that
they were not clear about what the short breaks service offered and for which group of
SEND children.
However, a number of concerns were raised which included lack of social care
workers and respite services.
6.2.2.4 Service Use: Other Services
Leisure, transport and input from the parent partnership service and other voluntary
organisations were the main ‘other’ services used by the respondents. The respondents
were happy with the leisure services as well as parent partnership service.
Transport services received mixed comments; negative in terms of the time taken to process
their applications but received good feedback in terms of the guide and the driver being very
pleasant and developing good relationships with children. Young people wanted more
independent travel training and someone to take them out.
‘Very poor education provision for young people post school age 19+. Need specialised provision purpose
built separate building to provide for students with severe and complex learning difficulties’
‘My son has just transitioned to secondary school and is feeling lost so more help is need to help him settle’
‘My carer is fabulous. Having direct payments
helps us both. Give us a break group has been
fab in providing activities as none in city’
‘Direct payments are good as they mean I can
play games with someone’
‘The social worker is a good helper’
‘Good respite services’
‘There is a lack of social workers in this service. My son had one that left 2 years ago not had replacement
and he is currently going through transition’
‘Constant helpful social worker needed who knows the family’
‘Longer with the youth worker would be beneficial’
‘I think they should give me more direct payments to be able to go to more social activities’
‘A taxi to bring me to school was good’
‘Transport available to all. Both parents work full time and although we may have a higher income, the fact
that we work makes it difficult to get our child to and from school. The model in use at Orchard should be
disseminated to all schools as a benchmark of excellence’
‘Travel training- help to feel confident to travel independently’
‘So many issues with short breaks: parents
don’t know what’s available and it feels that
what is available is for those with the most
complex needs. Short breaks are for all
disabled children’
‘Should not just be left once given direct
payments ‘
‘Feels like it’s available only in crisis’
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A number of leisure activities received positive comments. The young people identified that
they would want more football clubs, more places like the WAY, more opportunities at
performing arts centre, exercise clubs and more safe places to go to. They also felt that
more police presence would help them to feel safe in the community. They said that “they
would like to go out and about independently but stay home due to feeling unsafe in the
community”. Parents felt there was a lack of facilities for swimming for children with SEN.
Parents also felt that there was a need for a ‘fully comprehensive sensory centre’ as well as
‘more activities to do during holidays’.
In addition to the above, young people want more opportunities for jobs. There was a
general feeling that there was a lack of job opportunities for young people with SEND.
Parents of children and young people provided positive comments about the Information,
advice and support service (IASS) in Wolverhampton. The Parent’s Forum was praised,
particularly for coproduction activities with professionals.
Parents also commented strongly on the need for more support groups for families including
siblings.
The Information, Advice and Support Service has been invaluable support. I have used the service for over 10
years. All staff are helpful,informative, understanding and friendly. I would have found it extremely difficult and
stressful to navigate though the minefield of SEND without the IASS. I also find the workshops, information
days and weekly E-Bulletin that the IASS provide to be incredibly helpful.
The IASS seem stretched. I think this needs to be an area to look at for more staffing resource as the SEND
agenda has widened since the Children and Families Act
IASS very helpful- only info that is available
More whole family and sibling network
support is needed
More sibling support is needed
Goodyears disco is very good as it means we can go out and see friends
Climbing at The Way is good
The gym is available whenever I want to go
Lots of activities at the youth club
More activities in the city, sensory centres and playgrounds swimming etc
Please keep our adventure playgrounds running. We need a sensory centre to use and a hydropool in the city
available to all to access
Young people in the group were interested in The Way but not confident to use it. They would like youth club
activities in the community and felt this was missing.
‘Less job opportunities in Wolverhampton now as
more shops have closed, so it is harder for people
leaving college to get retail jobs’
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The responses received commented that there was a lack of awareness of the services
available and there needs to be more information provided in terms of their availability and
accessibility. Very few parents and only 1 of all young people were aware of the local offer.
Of those who were aware of the local offer, found it very clumsy, out of date, not user
friendly and difficult to navigate.
6.3 Views of Parents/ Carers of children and young people with SEND and
young people with SEND: Evidence The National Service Framework for children, young people and maternity services,
standard 8 outlines the main issues reported by children and young people with disabilities
and complex health needs. According to the national service framework, children and young
people say they want to102:
Be listened to when decisions are made about their lives;
Have friends of the same age or who share similar experiences;
Do the same things as other children and young people of their age – shopping,
going to a cinema, clubbing, going to youth and sport clubs, playing football etc;
Have the opportunity to be involved in out-of-school activities;
Be safe from harassment and bullying;
Have control of spending money, and have enough money to enjoy life, and
Live in a society where they don’t face prejudice
Accessibility and participation
Access to positive and inclusive activities improves disabled children’s health and wellbeing.
Disabled children and their families reported improvements in participation of equal
importance as improving access and stressed the importance of their involvement in
decision making about services offered103. Parents of disabled children report their children
face barriers not only to education but also to talking part in leisure and play104.
102 Department for Education and Skills (2004c) National Service Framework for Children. Young People and Maternity Services: Disabled Children and Young People and those with Complex Health Needs. Department of Health. Change for Children – Every Child Matters. 103 C4EO (2009) Disability Directors’ summary 2: Sept 2009 Centre for Excellence and Outcomes in Children and Young People’s Services 104
City of Wolverhampton Council (2013) All age disability Strategy 2013 – 2016
Only heard about it through Voice4Parents.
Yes it's out of date and difficult to use. Eg search for swimming lessons for disabled it brings
nothing up. Links need to be relevant and useful to parents. Parent partnership bulletin is more
useful
I have heard about it. I think it is clumsy, difficult to navigate and not very inviting to explore. It
would be nice for it to seem more 'alive'. e.g rolling news feeds of what activities are on, a
calendar of events and most importantly - the ability to be able to search the entire LO by
entering in key words that will assist with narrowing down your search for relevant information.
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Adults, with impairment, over 16 years of age (which includes young people aged 16-25
years) report a health condition, illness or impairment was a barrier to participation in the life
areas of leisure and social contact. Adults with impairment were more likely to report having
little or no choice over how they spend their free time and having a health condition, illness
or impairment was the top barrier to playing sport for adults with impairment105.
Disabled children and young people have stated that they like to do the same things that
children without disabilities like to do and they might just need extra help or more time to do
them104.
Autistic Spectrum Disorder (ASD) Assessment and Diagnosis
A review of parents’/carers’ views of the ASD assessment and diagnosis indicated that
families wanted:
improved communication, although the keyworker was valued in aiding
communication across services;
knowledge of the support available;
a more efficient process with choice of appointments and all parties accessing
relevant reports and documents before meetings;
speedier confirmation of diagnosis to enable application for necessary benefits;
communication skills to be incorporated into practitioner training106.
The Wolverhampton Joint Autism Strategy 2016-2021 acknowledges that challenges exist
where a young person is not in receipt of an EHC Plan but is in need of effective careers
education information advice and guidance. Equally there are issues where there is a need
for wrap around support, particularly in mainstream settings, to enable them to learn and
progress and maximize their potential. The strategy also emphasizes the need for young
105
Life Opportunities survey (2015) Wave 3, Final Report 106 Parent and Carers views of Autistic Spectrum Disorder (ASD) assessment and diagnosis report (2011) Julie Morehead
“I Like ……..
to play on the xbox360 computer, use xbox live”
watching the same bits from films and tv at the same time
and over again”
listening to Coldplay and play with my (brothers and
sisters) and my pet rabbit”
“I would like to be able to meet up
with friends, go to cinema, out for
something to eat, go to ‘gigs’ and
concerts, meet up with other geeks
for conventions”
“to do things in small groups, with
my friends”
“I like to………
do activities all on my own
do activities with other people
go to youth club in a big group with my friends”
Sometimes I like to do activities with staff; sometimes not”.
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people to be exposed to the demands of an employment setting to successfully navigate
their employment pathway.
Research also suggests that children with autism are more likely than others to experience
exclusions from school (both formal/legal exclusions and illegal exclusions)107 and more
likely to experience bullying108.
Early Years Intervention
National research suggests that in early years interventions, parents most value: key-
workers; web based information; high quality pre-school centres, particularly for most
disadvantaged children to improve cognitive development and reduce need for SEN at
primary school; support at time of diagnosis; Evidence of achievements and developmental
milestones; opportunities to develop parent skills; joined up and coordinated services;
enabling of parents to enter or return to work; assessments considering whole family needs.
Childcare Provision
National research indicates that parents feel there are numerous gaps and barriers to
childcare for disabled children. Specialised childcare tailored to a child’s specific needs was
a significant issue for parents, as well as: inclusive care for both disabled and non-disabled
siblings; emotional and practical support for parent carers; accessibility of care for children of
asylum seekers; childcare workers who are also parents of disabled children; appropriate
services for children as they get older and transition care from child to adult services.
Three of the most frequently cited challenges relating to childcare for children with
disabilities are: poverty and childcare costs; lack of appropriate places and service, and
inadequate information109,110.
Transition
It has been frequently stated that transition is a tough period for young people and their
families104. The majority of children with SEN leave school and move into local college
provision. The pathway out of education for these young people (who will mostly not be
eligible for social care services) is not clear, and leaves them vulnerable.
107 National Autistic Society (2003) Autism and Education: the on-going battle. London: NAS 108 Humphrey and Symes (2010). Perceptions of social support and experience of bullying among pupils with autistic spectrum disorders in
mainstream secondary schools. European Journal of Special Needs Education
109 London Development Agency (2007) Listening to Parents of Children with Disabilities and Special Educational Needs. Mayor of London 110 Campbell-Barr, V and Garnham, A (2011) Childcare: A review of what parents want. Equality and Human Rights Commission Research Report 66
“There is a lack of effective educational pathways for 16-25 year olds”
“There is nowhere for young people to go once they have finished school”
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Parents of disabled children often report feeling like they are ‘falling off the edge of a cliff’ as
their child moves from children to adult services. This is not just because of the change of
services and professionals, but also because of the change of the ethos between children
and adult services. In the broadest terms, the main difference between the services is the
focus with children services promoting nurturing and supporting children to grow, learn and
develop whilst in adult services the emphasis is on choice, control and empowerment.
Children and young people need support to learn, develop and thrive through a positive
childhood and equally achieve individual independence through a structured transition into
adulthood 104.
Short breaks
Parents and carers value short breaks provision and recognise it has benefits for all family
members. Short breaks for disabled children and young people allow them to develop
independence, new skills and interests, enjoy time away from home, have opportunities to
socialise, make friends and have fun. The breaks provide an opportunity for parents and
carers the to ‘recharge their batteries’, catch up on everyday activities and to have time to
spend with other family members and children.
Transport
A recent consultation with families of children and young people with disabilities identified
that the lack of accessible affordable transport in the city is a key barrier to them using all of
the sports leisure and recreational activities available as a family and is a barrier to them
being active citizens in the city104.
Basic facilities
A further barrier for disabled people of all ages accessing the city centre is the lack fully
accessible toilet and changing facilities.
Information and Communication
Parents of children with SEND feel that having information about the available services is
really important to support day to day life and planning for the future104.
“There is a lack of information sharing between agencies and sectors”
“Information needs to be available in different formats”
“Families often get information about services from other families who have had good
experiences.”
“There needs to be one place for families to get information from “
“I want to have the right support so I can achieve the best that I can out of my future” - young person with a learning disability.
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Summary
The main findings for the stakeholder views from parents/carers and young people indicate a
need for:
• Improved
• communication with parents and among services
• transition pathways
• transport services and travel training
• Timely
• referrals and diagnosis
• SEN assessments
• Increased awareness of services and the Local Offer
The main findings for the stakeholder views from service providers/commissioners indicate
the need for:
Improved
o transition from children to adult services
o Data collection
Support for children with ASD and mental and behavioural problems
Specialist training for staff
Increasing independence and employment opportunities
Bespoke services for older children and young peope with SEND (age 14 – 24 years)
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The Special educational needs and disability code of practice: 0 to 25 years111 was co-
produced by the Department for Education and Department of Health and published in
January 2015. The code outlines statutory guidance on duties, policies and procedures
relating to Part 3 of the Children and Families Act 2014 and clearly articulates the need for
all aspects of service provision, from commissioning arrangements to service delivery, to be
based on the best available evidence of effectiveness.
This evidence and best practice review has been informed by the comprehensive needs
assessment produced by Public Health East Sussex, which detailed recognised national
policy, guidance and expert opinion112, updated with latest evidence published since 2013. It
will only highlight interventions that are deemed effective in meeting the needs of children
with SEND and is not an overview of policy, framework and guideline recommendations.
Key Findings
There is comprehensive, evidence-based best practice available to support transition
to adulthood, including improving transition to health services, social care and
employment
There is a comprehensive database of evidence-based, effective interventions for
speech, language and communication needs which is free and easily accessible
Although the evidence base supporting early intervention with disabled children is
relatively strong, there is uncertainty regarding the long-term sustainability of the
outcomes
Individual Budgets may increase choice and control over the support available for
children with SEND, as well as support transition to adulthood, but there is
insufficient details provided on interventions purchased to achieve these outcomes
There is weak evidence available indicating interventions to improve educational
partnerships with parents to improve child outcomes
111 DFE (2015) Special educational needs and disability code of practice: 0 to 25 years. Statutory guidance for organisations which work and support children and young people who have special educational needs and disabilities. HMSO: London 112 Scamber M (2014) Appendix A: Evidence of effectiveness and best practice. Public Health: East Sussex County Council
7. Evidence Review
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7.1 Speech, Language and Communication A comprehensive virtual library of effective interventions, called What Works, was produced
in collaboration with The Communications Trust (TCT), in 2013, to provide a comprehensive
database to support speech, language and communication needs of children with special
educational needs and disability (SEND)113. It is currently maintained and updated by the
Royal College of Speech and Language Therapists and TCT through a robust process of
evidence review. The interventions in the database are arranged by target group, age
range, focus of the intervention, mode of delivery and format, as shown in Fig. 68.
Fig. 68: What works interventions database categorisation
The evidence for each intervention is rated as ‘strong’, ‘moderate’ or ‘indicative’ as
determined by an academic panel of experts (see Table 12 for definitions). It should be
noted that The Communication Trust clearly outlines that the strength of evidence does not
necessarily equate to the strength of outcome, placing an emphasis on the practitioner
selecting the most appropriate intervention to meet the needs of the child.
Rating Definition
Strong includes at least one positive systematic review plus subsequent trials as
available
Moderate includes single randomised controlled studies or quasi-experimental studies
Indicative means good face validity114
but limited research evidence , that is, case studies
or 'before and after' studies
Table 12: Evidence rating definitions
It is not possible within this evidence review to list every intervention contained within the
What Works database, but a summary of the number and rating of interventions by target
group is outlined in Table 13. There was a small number of interventions that were
applicable across two or three target groups (n=9).
113 The Communications Trust (2014) What works and the SEND reforms. Updated July 2014 http://www.thecommunicationtrust.org.uk/media/253982/what_works_and_the_send_reforms_final.pdf [accessed 20th June 2016] 114 Appears to superficially measure or achieve aims and objectives
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Target Group Strength of evidence
Strong Moderate Indicative
Speech (n=23) 2 15 6
Language (n=33) 2 24 7
Communication (n=11) - 9 2
Complex needs (n=6) - 3 3
Table 13: Strength of evidence of What Works interventions
In summary it appears that there is a robust database of effective evidence based
interventions to support the speech, language, communication and complex needs of
children and young people with SEND. Whilst there is only strong evidence to support 4
interventions covering speech and language needs, the rigorous nature of intervention
evaluation, indicates benefit could be derived from implementation of the moderate and
possibly intermediate interventions.
7.2 Children with Disabilities: Early Years and Key Stage 1 (age 0-8) There is a large body of evidence published on improving the outcomes and wellbeing of
disabled children aged 0 – 8 years through early intervention115
. The evidence suggests
that the most effective interventions should aim to:
achieve a balance between technique, teaching style, and sensitivity to the child’s
environment, and are delivered in an appropriate location
use electronic communication media to deliver teaching packages and information in
format- and audience-specific modes
include family-centred interventions that accommodate the reality of the child’s
environment and can be delivered with a minimal level of demands on parents
utilise key worker services, which are associated with better family relationships with
services, quicker access to benefits and reduced parental stress
moderate the risk of social exclusion by helping children communicate with their
peers
However, a significant caveat is that the majority of positive findings are derived from model
programmes which may be well resourced financially, with staffing and equipment, so the
challenge would be replicating the actual intervention and yielding similar results in
mainstream services.
Whilst the evidence base supporting early intervention with disabled children is relatively
strong, there remains uncertainty about the duration of intervention impact, whether the
impact is actually related to, or is a consequence of, the intervention and the optimum age to
commence an intervention. There is no clear evidence linking actual outcomes to a specific
intervention or population group of children. It should also be noted that the primary focus of
115 Newman, T. Mcewen, J. Mackin, H et al (2010) Improving the wellbeing of disabled children (up to age 8) and their families through increasing the quality and ranged of early years interventions. London: Centre for Excellence and Outcomes in Children and Young People’s Services
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the evidence base was pre-school children, aged birth to three years, with sparse studies
indicating effective intervention for children between 4 and 8 years.
It has proved challenging to demonstrate sustained effective outcomes following early
intervention in children who were born prematurely, between 26 and 33 week gestation.
Long-term follow-up following randomised control trials indicated no significant improvement
in cognitive, behavioural and motor function at age 5116,117.
7.3 Children and young people with disabilities: School age and beyond There is a large volume of information published on the needs and experiences of children
and young people with SEND within a school setting and beyond. This has resulted in the
production of a number of recommendations for commissioning services, educational
provision and service delivery, alongside qualitative reviews of child, parent and teacher
perspectives. However, there is no explicit detail of effective interventions that improve
outcomes for these children and young people.
7.4 Personalisation There is evidence to suggest that the use of individual budgets (IB) can improve outcomes
and the quality of experience available for children and young people by providing choice
and innovative options for interventions118. No details were provided on the actual
interventions listed so that an assessment of effectiveness could be derived. IB has also
been shown to support the process of transition for childhood to adulthood as it instils
personal control over the support provided for the future. However, this outcome would be
dependent on the young person controlling the decision-making119.
7.5 Educational partnerships with parents The involvement of parents in their child’s education can be enhanced through an
‘educational partnership’ between parents and the school. However, the level of parental
involvement has previously been variable across school settings, with lack of communication
cited as a major contributor to parental negative perceptions, with a subsequent decline in
engagement as children progress through the education system120,121. The evidence
reviewed primarily focuses on barriers to parent involvement and strategies for promoting
involvement, rather than on the links between parent involvement and student outcomes or
the effectiveness of interventions.
However, there is some weak evidence that suggests that structured conversations between
schools and parents122, teacher preparation programmes123, and a communication
116 Symington, A.J. and Pinelli, J. (2006) ‘Developmental care for promoting development and preventing morbidity in preterm infants’, Cochrane database of systematic reviews, issue 2. 117 University of Bristol (2010) Avon longitudinal study of parents and children. www.bristol.ac.uk/alspac/sci-com/research-partners/dcsf/ [accessed 21 June] 118 Department of Health (2012), Personal health budgets pilot - final evaluation report – source Personal health budgets pilot – final evaluation report 119 Crosby, N., and Miller, C. (2007) Introducing individual budgets and self-directed Support for disabled children, young people and their families and carers. Report for Department for Children, Schools and Families 120 Rodriguez, R. J., Blatz, E. T., & Elbaum, B. (2013) Professionals’ views of schools’ involvement efforts. Unpublished raw data. Cited in Blatz, Erin T., "Multiple Perspectives on Parent Involvement for Middle School Students Receiving Special Education Services" (2014). Open Access Dissertations. Paper 1244 121 Blatz, Erin T., "Multiple Perspectives on Parent Involvement for Middle School Students Receiving Special Education Services" (2014). Open Access Dissertations. Paper 1244. 122 Lendrum, A. Barlow, A & Humphry, N (2015) Developing positive school-home relationships through structured conversations with parents of learners with special educational needs and disabilities (SEND) Journal of Research in Special Educational Needs 15 (2):87-96
Page 90 of 110
notebook124 are effective in improving educational partnerships with parents and
subsequently, better outcomes for children and young people.
7.6 Transition to adult care and support It is well documented that the transition from children’s services to adult services can have a
significant impact on current and future health and social care needs and experiences.
There appears to be comprehensive information available on ‘preparing for adulthood’,
which includes employment, for children with SEND and life limiting conditions, underpinned
by evidence-based best practice. A person-centred, phased base approach is deemed to be
effective, commencing from the age of 14 years125. It is not possible to synthesise all the
evidence available, but it includes key components to improve transition into health services,
social care and employment.
7.7 Gaps in the evidence The following gaps in the evidence of effective interventions for children and young people
SEND were identified:
effective interventions for children aged 4 and above
effective interventions for dealing with sleep disorders
robust data on outcomes for parents or other family members
data on fathers experiences as the large majority of studies on parental views feature the
opinions and experiences of mothers
research studies based on UK sources
long-term outcome studies depicting outcomes from childhood through to adulthood
studies that compare the effectiveness of different approaches
evaluation of interventions that support the transition to adult services
A study commissioned by the Department of Education highlighted key research gaps and
priorities within the SEN system, for the research community, sector communities and
practitioners to plan, prioritise and commission research126.
7.8 Summary The SEND code of practice calls for services to be commissioned based on the best
available evidence of effectiveness. Whilst there is a proliferation of policies, guidelines,
frameworks and strategies produced to support children and young people with SEND, the
strength of the evidence base that underpins the recommendations is limited to speech,
language and communications needs, with some fairly good evidence for children with
disabilities.
Some evidence is available to support personalisation, the promotion of educational
partnerships and the importance of transition to adult services. The exact components of the
123 Collier, M. Keefe, EB. & Hirrel, LA (2015) Preparing special education teachers to collaborate with families School Community Journal 25 (1): 117-135 124 Fiorvanti CML ((2015) Family-school communication notebooks: an effective tool or promoting learning in young children with special needs? PhD Dissertation: Columbia University 125 Department for Education (2013) Preparing for Adulthood Programme http://www.preparingforadulthood.org.uk [accessed 21st June 2016} 126 Department of Education (2014) Special Educational needs and disability: Research priorities and questions
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interventions that underpin these areas is not easily determined, however, there does
appear to be a degree of effectiveness and some demonstrable gain in terms of child and
parental outcomes.
There are acknowledged gaps in the available evidence, however, this does not prevent the
commissioning and delivery of services with subsequent evaluation to assess effectiveness
for particular population groups of children and young people with SEND. The components
of an effective intervention are clearly outlined in the literature and through engagement with
parents, children and young people, services can be developed to meet the collective needs
of these individuals.
8. Gaps in service provision
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The stakeholder engagement survey included questions on identifying the gaps in service
provision across health, social care and educational services from service provider/
commissioner perspective as well as the parent/carers perspective. It should be noted that
the gaps identified below only reflect the views of the respondents to the survey and are
therefore, not generalizable to all services provided for children with SEND and/or
representative of the views of all parents/carers of children with SEND.
Health and social care service providers and/or commissioners
Gaps in:
specialist provision for children and young people with ASD/ autism
early assessment and diagnosis of children and young people with SEND
the transition of children and young people from children’s services to adult services
data collection and future planning, as well as multi-agency working to ensure all the
needs of young people are met
provision for children with hearing impairment who need special school provision and
a signing environment or children with hearing impairment whose needs are not
being met in a mainstream school although British Sign Language (BSL) /Signed
Supported English (SSE) is their prime mode of communication
service provision for children with social, emotional, behavioural and mental health
difficulties including
support for older children with SEND (aged 19 and over), highlighted by the voluntary
sector
provision for children and young people with health and social care needs that do not
meet eligibility criteria for either children's continuing care or adults continuing
healthcare
referral routes to GEM centre and CAMHS
provision for speech and language therapy
provision for promoting independence in children and young people with challenging
and complex disabilities
provision for antenatal and family nurse partnership services for young women with
SEND
provision of specialist staff for utilising instruments for visual impairment
formal commissioning of some elements of children’s diagnostic pathways which
have led to inconsistencies in input by different professional groups into both
assessments and the diagnostic panel (e.g. ASD diagnostic Panel)
provision of short breaks for children with complex needs and demanding behavioural issues
Lack of:
services for children and young people with mild vision loss and visual stress
support with Auditory Processing Disorder
Improvement in:
in referral services, particularly the referral criteria
Insufficient transport available to meet individual needs and lack of travel training
Education
Gaps in:
provision to support children with social, emotional and mental health difficulties
knowledge and skills among staff to support children with dyslexia
provision for children with SEN in communication and interaction, particularly for
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those in EYFS and KS1
provision and suitable advice for sensory needs in mainstream schools
Lack of availability and access to educational psychologists was recognised
Difficulties in access to Occupational Therapy within the education sector
Parents/ Carers of children with SEND
Gaps in:
provision of educational psychologists in terms of access, cost and timeliness
liaison and communication between school and home
support for single parents and those with no extended family for support
overnight respite care and ad-hoc sitting service
promotion of information regarding available services and access to these
services
training of teaching staff to understand and support children with SEND were
identified
A stakeholder engagement face-to-face event was organised which aimed to share the
results of the stakeholder engagement surveys to inform the identification and development
9. Stakeholder Recommendations
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of the recommendations. Key personnel from health, education, social care and the
voluntary sector were invited and the contribution of all those who could attend the event
was invaluable in shaping the recommendations listed below.
Data for children and young people with SEND
1. The four areas of need, as described in the SEND Code of Practice, should be
applied for all data collections related to SEND across all organisations to ensure
consistency. (Short Term)
2. To develop shared definitions across all sectors informed by the SEND Code of
Practice (Short Term)
3. To develop a coherent data sharing protocol to ensure all relevant data can be
shared across education, health and social care. (Short Term)
4. To increase focus on early years to identify emerging trends (Short term)
5. To initiate a city-wide annual survey of children and young people with SEND to
improve qualitative data and obtain lifestyle data for children and young people with
SEND. (Medium Term)
6. To establish a single database for patients’ records, accessible by all partners
including health, social care and education and explore the use of EHC plans to
achieve this. (Medium term)
7. To raise the need for electronic records within health organisations nationally
(Medium term)
8. To convene a project to identify good practice on shared data systems in the UK
(Long term)
9. To develop a system of data mapping across health and social care including primary
care and secondary care (including clinical coding) (Long Term). To identify the
prospects of PI database which aims to link social care and secondary health care
data.
Transition to adulthood
10. To effectively utilise transition planning to drive commissioning by providing a clear
understanding of the needs of children and young people with SEND (Short Term)
11. To utilise EHC Plans for transition planning at an early age and plan ahead for
‘support intensive’ children (Short Term)
12. To identify and share good practice in transition to adulthood for children and young
people with SEND (Short term)
13. Education sector to develop protocols for obtaining information from other
educational authorities (Medium term)
14. To improve transition support at nurseries (Medium term)
15. To improve life skills and employability offer from the education sector (Medium
Term)
16. To review transition pathways to be person centred not condition or diagnosis based
and be based on achievable outcomes (Medium Term)
17. All organisations to incorporate 18 – 25 year olds in their SEND policies and
processes (Medium Term)
18. To encourage employers including local authorities and CCGs to provide
apprenticeship and employment opportunities for young people with SEND (Long
Term)
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19. To review the learning disability pathway (Long term)
Support for children and young people with SEND with complex needs and mental
health needs
20. To explore the role of Headstart and how it can be used to improve early
identification of children and young people with SEND (Short Term)
21. To explore the role of health visiting, school nursing and family nurse partnerships to
improve the early identification of children and young people with SEND (Short term)
22. Specialist training for staff in educational sector including schools, colleges and
universities (Short Term)
23. To develop shared definition of ‘complex needs’ across education, health and social
care (Short term)
24. To develop/ improve multi-disciplinary processes to support children with complex
needs (Short Term)
25. To develop a system to record children with SEN support to identify the levels of
support needed (Short term)
26. To incorporate decision makers at case review meetings (Short term)
27. To explore enhancing the short breaks service to incorporate children with complex
needs and behavioural issues
28. To identify and share good practice in providing support for complex needs and
mental health needs in schools, colleges and universities (Medium term)
29. To explore the provision of lower-tier/ Tier 2 multi-disciplinary workforce to improve
early identification of children and young people with SEND (Long term)
30. To explore the provision of lower tier/ Tier 2 multi-disciplinary workforce to provide
support to children and young people with SEND who do not meet the criteria for
CAMHS (Long term)
Promoting Independence among children and young people with SEND
31. To explore utilising existing services (including schools) to provide focused support
for parents and families on promoting independence early and during transition
(Short Term)
32. To explore utilising existing services to provide focused support on personal budgets
and direct payments (Short Term)
33. To identify and share good practice on what independence means and ways of
promoting it in children and young people with SEND (Short term)
34. To utilise EHC plans to identify support required to promote independence (Medium
term)
35. To explore enhancing the transport service for children with SEND in terms of the
criteria as well as improving the experience of the journey (Medium Term)
36. To explore utilising existing services including support groups, voluntary
organisations, schools and universities to promote independence for children and
young people with ASD (Long term)
Training needs
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37. To provide basic training on SEND Code of Practice across education, health, social
care and employment sector (Short Term)
38. To increase awareness of how and where training is available across organisations -
(Short Term)
39. Incorporate SEND training requirements into mandatory training across all
organisations (Medium Term)
40. Develop a specialist group of trainers for joint training across the city (Medium Term)
41. To develop online forums to discuss issues and learn from what others are doing
(Medium term)
Appendix 1: Current Services
The services for children and young people with SEND in Wolverhampton are commissioned
by the Wolverhampton Clinical Commissioning Group (CCG) and City of Wolverhampton
Council. The main healthcare providers in Wolverhampton are The Royal Wolverhampton
NHS Trust (RWT) and Black Country Partnership Foundation NHS Trust (BCPFT).
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The local offer on the City of Wolverhampton Council website provides information about all
the services available to children and young people with SEND and their parents/ carers.
Below is a comprehensive account of services for which we received information during our
stakeholder engagement processes as well as services mentioned in the Wolverhampton’s
SEND Strategy, Wolverhampton’s All age disability strategy and Review of the
Wolverhampton’s Local Offer.
1. Child Development Centre (CDC)
The child development centre (CDC) is a multi-agency service that coordinates all services
for children aged 0-5 years with special educational needs and disability (SEND) in
Wolverhampton. It aims to strengthen the early years’ identification of children with SEND
and aims to keep the child and family at the centre of service delivery. It delivers a co-
ordinated approach to provision of an integrated package of services to families of children
with SEND. This is achieved via the multi-agency referral panel for under 5s which includes
a consultant paediatrician, the special needs early years’ service, speech and language
therapy service, physiotherapy, occupational therapy service, educational psychology, a
health visitor and social worker.
The CDC Strategic group oversees the operations of the CDC, which is based at the GEM
centre and receives referrals from health care, social care or education sector.
Fig. 69: CDC Strategic group
The main role of the CDC is
To provide assessment, diagnosis and teaching for individual children within the
Child Development Service specialist groups at The Gem Centre or Warstones
Primary school
Co-ordinate the Multi-agency Referral Panel
Co-ordinate the Under 5 Autistic Spectrum Disorder Diagnostic Panel.
2. Special Needs Early Years’ Service (SNEYS)127; City of Wolverhampton Council
The Special Needs Early Years Service (SNEYS) consists of specialist teachers and
teaching assistants who support children aged 0 to 5 years who have SEND and are
127 City of Wolverhampton Council (2016), Head of SNEYS
CDC Strategic Group
Under 5s ASD
Diagnostic
Panel
Multi agency
referral panel
for under 5s
Specialist
groups
Specialist
services run
independently
Paediatric
Clinics
Page 98 of 110
resident in Wolverhampton or attending a Wolverhampton setting. The conditions supported
include autism, ASD and significant developmental delay. They work in partnership with the
parents and other agencies involved in the care of the child to provide a co-ordinated
approach to support individual assessments and intervention programmes, enabling the
child to fulfil their potential.
Children are supported in their homes, various settings, through the Child Development
Centre based at The Gem Centre or Warstones Primary School. The Service accepts
referrals only with parental consent from professionals who know the child , that is, health
visitor, GP, setting practitioner. The referral will need to show that the child has a significant
delay in more than one area of their development. The service does not accept referrals for
children with behavioural difficulties unless they have associated learning difficulties. The
referral is then discussed at the multi-agency panel that meets every three weeks.
The main activities of SNEYS are listed below:
To provide assessment, diagnosis and teaching for individual children99
within the family home (Portage based service).
To provide assessment and advice to children identified within settings,
Children’s Centres and mainstream schools.
To provide support and guidance to parents who have pre-school children
with additional needs
To co-ordinate the Team around the Child [TAC] a key working approach.
Training for parents, settings and schools.
Day to day management of the Child Development Centre Groups
To manage the 2 year and 3 year grant double funding process.
In March 2016, the service had a caseload of 400 children aged 6 months to 5 years: of
these, 157 (39%) receive SEN support in settings or at home, 112 (28%) are going forward
for an EHC plan, or will need to in the future due to the severity of their need, and 75 (19%)
are being monitored as they are below the SEN support level, but have some delayed
development. There are currently 53 (13%) young children who have been newly assessed
and have not yet received a code of their level of need.
In December 2015, the service had a total caseload of 321 children, of whom 42% (n=135)
had a developmental delay and 20%(n=64) had severe learning difficulty. Prime diagnosis
was available for 84 (26%) of these children and the most common diagnosis was Downs
Syndrome (n= 21;25%) followed closely by chromosomal abnormality (n= 20; 24%). Nearly
half of the children accessing the service were of white ethnic origin followed by children of
Asian Indian (n=35; 11%) ethnic background.
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3 Special Educational Needs Statutory Assessment and Review Team (SENSTART)128
SENSTART provides a statutory (single) assessment of children and young people (from
birth and up to 25 years) with SEND. The team is responsible for new referrals for statutory
assessment, this can range between 15 and 200 per year. and anyone can refer into the
service. Children and young people with Statements of Special Educational Needs
(SSEN)/EHC Plans are placed in appropriate educational provision and SENSTART review
and monitor provision and outcomes set out in the SSEN/EHC.
The team is responsible for children and young people aged 0 – 25 years with high needs,
and currently have 1,067 children and young people with an EHC plan and 211 with an
SSEN.
Fig. 70: SENSTART caseload (Source: SENSTART)
4 Child and adolescent Mental health services (CAMHS)129
CAMHS is a set of specialist services for children andyoung people of all abilities to provide
support with mental health, emotional and psychological difficulties. The service works with
parents, carers, siblings, and members of the wider care system. A Single Point of Access
(SPA) has been available since January 2015, which aims to bring together Wolverhampton
CAMHS services and children's learning disability services across the city.
4.1. Key Team
The Key Team is a multi-agency service with professionals funded from health, social care
and education working together in an integrated approach around the family. It is a specialist
(Tier 3.5) Child and Adolescent Mental Health Service that endeavours to prevent young
people being placed in services outside of Wolverhampton and to stop further deterioration
of highly complex cases.
4.2 Child and Family Service
128 City of Wolverhampton Council (2016), Head of SENSTART 129Black Country Partnership Foundation NHS Trust
34
457
581
203
3 0
100
200
300
400
500
600
Fre
qu
en
cy
Age group
SENSTART current list size (as at 8th March 2016)
Page 100 of 110
The Child and Family Service is a service with lots of different professionals who assess,
diagnosis and provide treatment for any child or adolescent up to 18 years of age who are
experiencing mental health difficulties.
4.3 Inspire
Inspire supports children and young people from Wolverhampton who have a learning
disability, as well as their families. Support and guidance is provided to other professionals
who work with children and young people with a learning disability from birth up to the age of
18yrs. Community based support is available and a range of ways to help that include 1-1
therapy support, group support, family working, consultation to professionals and services,
teaching and training, skills training. The support can be offered at home, at school or in
other community settings.
5 Children’s Continuing Care and Adults Continuing Healthcare (18+); Wolverhampton CCG
The children’s and young peoples’ continuing care 0-18 service and Adults Continuing
Healthcare 18 + service is delivered by Wolverhampton CCG. The Continuing Care Team's
main purpose is to coordinate an open and fair process for assessment of the highly
complex individual health and care needs of a child or young person to decide whether or
not their needs meet the eligibility criteria for continuing care funding.
A new Children’s continuing care pathway has been established by the CCG. This is
delivered in partnership with the local authority and other partner organisations to provide
seamless high quality care for disabled children and young people who have specialist and
complex needs that cannot be met by existing universal or specialist services alone. There is
also involvement in the consideration of the EHC plans and agreeing the funding for the
health component either via contracted activity or additional money if the services are not
available to meet the needs. This is for children and young people aged 0-25 years.
For children (under 18), who may have very complex needs that can’t be met by universal or
specialist services, a continuing care assessment is completed. To date the service has
assessed 34 children and of those, 16 are in receipt of support via CCC. The average CCC
eligible for a population the size of Wolves would be 15-20. Referrals to the service can be
made via any professional involved, directly to the CCG and a referral form is available via a
link on the Local Offer.
A continuing care package is for children and young people from birth to their 18th birthday.
Transition planning for young people moving into adult health services begins at the age of
14 years so that they can be considered by Adult Continuing Healthcare services at the age
of 16. At the age of 17 to 17½, a young person’s eligibility for Adult Continuing Healthcare
will be decided in principle so that care packages are in place by their 18th birthday. So far,
there have been 7 children with transition needs and 1 of those meets criteria for ACH. The
ACH team ensures that the NHS commissions the care that a person needs if they have
very complex healthcare needs, and helps individuals to develop a personal health budget.
6 Specific services for Hearing impairment and Vision Impairment
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6.1 Children's Hearing Services; Royal Wolverhampton NHS Trust
Children’s hearing services are provided by the Royal Wolverhampton NHS Trust at the
GEM Centre, New Cross ENT Department and special schools. The key purpose of the
Children's Hearing Services is to provide assessment, treatment (e.g. hearing aids) and
support to children and young people with hearing and balance difficulties. Referrals for this
service can be made by health professionals such as GP’s, Nurses or Health Visitors as well
as by parents of children aged 3 and over. Children from birth to 16 years old can access
this service, and transition planning for children using hearing aids begins at 14, to transfer
them to the Adult Hearing Service.
6.2 Sensory Inclusion Service: Hearing Impairment Team; City of Wolverhampton Council The Sensory Inclusion Service Hearing Impairment Team works with children and young people aged 0 – 25 years who have a hearing impairment, as well as their families and their schools/colleges/early years’ settings. Their aim is to enable children and young people with hearing impairment to reach their full potential by:
Supporting families from the time of diagnosis of hearing loss, giving advice and guidance to carers, nursery settings and school staff;
Assessing functional hearing (how hearing is used in everyday situations);
Giving audiological support;
Providing in-service training for settings;
Directly supporting class teachers;
Teaching one to one and small groups;
Providing educational advice for EHC plans;
Offering support for transition to adult services;
Providing a free pre-school playgroup;
Offering signing classes for family and friends;
The service works closely with the Children’s Hearing Services. In addition to this, the
Educational Audiologist works with the services for half a day per week. The services are
notified quickly if a child is identified as having a hearing loss, and they contact the parents
to visit the child at home, pre-school or school. Referrals also come through from ENT
colleagues, schools, and occasionally from parents. Demand for the service is managed
through their benchmarking system to identify the level of support that they can offer. Urgent
referrals are given priority.
The following chart shows the distribution of clients currently on the Hearing Impairment
team’s caseload. A total of 308 children were seen by the Hearing Impairment team in the
year up to March 2016. Of these, 200 (64.9%) were receiving some level of SEND support.
The majority of the children seen by the Hearing Impairment Team are aged 5 – 10 years old
followed by 11– 16 year olds (Fig. 71).
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Fig. 71: Hearing Impairment team Caseload (Source: HI team)
6.3 Sensory Inclusion Service: Vision Team; City of Wolverhampton Council:
The Sensory Inclusion Service Vision Team works with children and young people aged 0 – 25 years who have a visual impairment, as well as their families, and their schools/colleges/early years settings. Their aim is to enable children and young people with visual impairment to reach their full potential by:
Supporting families from diagnosis of visual difficulty, giving advice and guidance to carers, nursery settings and school staff;
Liaising with medical and other professionals;
Assessing functional vision (how vision is used in everyday situations);
Providing in-service training for settings;
Directly supporting class teachers and support staff;
Teaching one to one and small groups;
Providing educational advice for EHC plans;
Offering support for transition to adult services;
Providing a free pre-school playgroup;
Offering Braille introduction classes for family and friends;
Offering habilitation (mobility and life skills) assessment and training for children and
young people.
Referrals are accepted from schools, medical professionals and parents via telephone, email
or in writing. Demand is managed through benchmarking criteria derived from National
Sensory Impairment Partnership (Nat SIP) guidelines regarding what constitutes a visual
impairment and recommended levels of support based on the outcome of the assessment.
Over the past 12 months, the service has worked with 186 children: 156 are on the caseload
and are supported regularly. The remaining 30 not on the caseload were assessed and
found to be outside of the criteria for support, but advice was given.
The following chart shows the distribution of clients currently on the Vision team’s caseload.
A total of 156 children were seen by the Vision Team in the year up to March 2016. Of these,
122 (78.2%) were receiving some level of SEND support. The majority of the children with
SEND seen by the Vision Team are aged 5 – 10 years old, followed by 11– 16 year olds,
then 17 – 19 year olds (Fig. 72).
0
20
40
60
80
100
120
140
160
0 - 4 years 5 - 10 years 11 - 16 years 17 - 19 years 20 - 25 years
Nu
mb
er
of
child
ren
Age group
Sensory Inclusion Service Hearing Impairment Team's current caseload, 12 months data, as at March 2016
SEN Statement / EHC plan
SEN support at School
No SEN Support
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Fig. 72: Vision team caseload (Source: VI Team)
7 Children’s Community Nursing Service; Royal Wolverhampton NHS Trust130
The children’s community nursing service provides specialist care to children with SEND and
includes Child Development Centre (CDC) and special school nurses. The service provides
support to all children and young people aged 0-18 years (or 19, if they are in special school)
residing in Wolverhampton or are registered with a GP in Wolverhampton. Open referrals to
the service can be received from professionals or parents.
The teams provide the following services:
Specialist Nursing Care for children who have chronic health problems and/or disabilities, who often remain with the service on a long-term basis. These children are supported in schools, respite centres and home. Nursing care may include assessing care needs and providing nursing/medical equipment such as suction machines, feeding pumps, and syringes.
Provision of feeds and medicines via a naso-gastric or gastrostomy tube. This care
is for children who are dependent upon technology and is provided to enable them to
access nurseries, schools, and the Child Development Centre. Special school
nurses are available in two special schools to provide this service.
Bereavement support and confidential counselling is available for both children and
parents of children with palliative care needs.
Assessment and management of incontinence and treatment and/or provision of
continence aids.
A clinical suite (outpatient department) for children is available at the Gem Centre.
Community children’s nurses provide support to consultant clinics and hold nurse-led
clinics.
8 Community Paediatrics
Community paediatrics is a specialist consultant led service for children and young people in
Wolverhampton who are vulnerable due to disease, disability and/or disadvantage. They
work with other children’s services and parents/carers to provide child-centred care.
Community Paediatricians see a range of children with SEND in addition to those with
General Paediatric problems, and those referred for child protection assessments. There
130 Royal Wolverhampton NHS Trust
0
20
40
60
80
0 - 4 years 5 - 10 years 11 - 16 years 17 - 19 years 20 - 25 years
Nu
mb
er
of
child
ren
Age group
Sensory Inclusion Service Vision team's current caseload, 12 months data, as at March 2016
SEN Statement / EHC plan
SEN support at School
No SEN Support
Page 104 of 110
are general paediatric clinics in localities such as Bilston, Pendeford and Phoenix. Children
are seen as part of Child Development Centre assessments, for autism, ADHD, and ASD.
Children are also seen for assessments for medical advice as part of the EHC plans, and
also seen at the Team Around the Child (TAC) meetings.
Referrals to the Community Paediatrician are made by GPs, health visitors, school nurses,
therapists, the Early Years team, and acute paediatricians/neonatologists. The Community
Paediatric Service sees children who live in Wolverhampton, but the general paediatrics
clinic can have children from other areas.
9 Children’s Therapy Services
9.1 Occupational Therapy
The occupational therapists support babies, children and young people who have
neurological, developmental and orthopaedic conditions which affect their physical and
functional development, and have complex long-term medical, social and learning needs.
The team support children and young people from birth to 16 years of age, or up to 19
years of age if they are still in full-time education.
9.2 Physiotherapy service
The physiotherapists support babies, children and young people who have neurological,
developmental and orthopaedic conditions which affect their physical and functional
development, and have complex long-term medical, social and learning needs. The team
support children and young people from birth to 16 years of age, or up to 19 years of age
if they are still in full-time education.
9.3 Speech and Language Therapy
The speech and language therapy (SaLT) service provides support to children and young
people who reside in Wolverhampton or are registered with a GP in Wolverhampton or
attend a school in Wolverhampton. It has an open referral system for most patients;
however those with voice problems require an ENT referral. The SaLT service assesses
children with SEND to inform their prioritisation of need.
The service aims to provide in depth assessment of individuals’ communication /eating and
drinking/swallowing abilities as well as identify communication and/or eating and drinking
difficulties. It also provides individualised packages of care to improve an individual’s ability
to communicate/eat /drink and facilitates access to alternative and augmentative
communication systems. In addition, it provides training to parents/carers and other
professionals to enable them to support the implementation of packages of care. Direct
advice and guidance is provided on appropriate interventions that teachers, teaching
assistants and parents can implement.
10 Equipment Service for Children and Young People with Complex Needs
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Wolverhampton Clinical Commissioning Group (CCG) is responsible for assessing
children and young people with complex health care needs who may be eligible for NHS
Children's Continuing Care. As part of this work they also consider whether a child or
young person needs specialist equipment in order that their care needs can be met. This
service is available to all children and young people aged up to 18 years. Once a young
person reaches 18 years of age, the National Framework for NHS Continuing Care for
adults is used.
To access specialist equipment the child or young person must :
be registered with a Wolverhampton GP
be referred by a specialist involved with their care, such as a nurse, doctor,
physiotherapist or occupational therapist
require equipment that has been assessed as essential by an appropriately qualified
person, such as a nurse or occupational therapist, and that is not available from Social
Care or The Gem Centre
However, at present equipment is not transferred from school to home, or other services
and so a young person can have multiple pieces of the same equipment, in different
localities.
11 Health Visiting Service
Health visitors offer advice and support in relation to family health needs and child health
promotion to all families with pre-school children up to five years old. Families that require
some extra support will have an Early Years assessment, which will help to identify which
specialist support, is needed. The service refers into the community paediatrics service for
assessment.
12 Family Nurse Partnership
The service provides a strengths-based programme for first-time young mothers aged 19
years and below. They receive intensive visits during the pregnancy, and up until the child is
2 years old. Referrals to the service are received via the midwife. Currently, there are 3
nurses in post and each has a caseload of 25 (which is the maximum due to the intensity of
the work).
Most of the clients seen by the FNP are Not in Education, Employment or Training (NEET),
and some have safeguarding issues. Some of the clients also have SEND and the support
they have received has been variable due to educational establishment, and the
engagement of the client with the education service once pregnant.
13 Palliative Care Services
These services aim to care and support children, young adults and their families (from the
Wolverhampton area with a Wolverhampton GP) who have a life limiting illness and wish
to be cared for at home. They will already be receiving medical and nursing care from the
Children's Community Nursing service and/or the Adult Community Nursing Service.
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Referrals can be made by a number of professionals involved in the child’s care, such as the
Consultant, GP and Specialist Nurse. The referral can be made to the Children's Community
Nursing Service (0 – 18 years) or Adult Community Nursing Service (16 – 24 years).
14 Transition service
The transition service users are all children and their families who have specific health care
needs, complex or specific health conditions who have been supported in childhood by a
Paediatrician and are ready for the journey of care to be transferred into adult health
services. This service is provided by the transition team based at the GEM centre.
15 Wheelchair service
The Wheelchair service provides buggies, wheelchairs, postural supportive seating and
powered wheelchairs to those who have a long term condition which impairs their mobility.
The service is available for all those registered with a GP in Wolverhampton and offers a
weekly clinic dedicated to our Paediatric service users, home and school based
assessments. Bi-monthly clinics are delivered at the Willows Green Park school and Penn
Hall school and monthly Special Seating clinics for more complex needs. Currently, the
service has 6,700 service users of which 500 are under 18 years of age.
16 Educational Psychology
The Educational Psychology Service works with 0 to 25 year olds, whilst the SEND
Specialist Teachers and Counselling/ behaviour support work with children of school age,
predominantly 5 to 16 years. The work undertaken by these services are commissioned by
individual schools, and referrals come in via schools.
The service is funded by the City of Wolverhampton Council to undertake statutory and core
work, which includes: providing advice for EHC needs assessments; contributing to multi-
agency developmental pathways for Autism Spectrum Disorder and Attention Deficit
Hyperactive Disorder; supporting the Youth Offending Team; supporting the Corporate
Parenting and Education (COPE) team; and responding to early years requests for
assessments. Referrals for this council funded work comes from the relevant agencies
linked to the work.
17 University of Wolverhampton Student Enabling Centre
The centre provides a comprehensive range of services to students with sensory, physical,
mental health, specific learning differences (SpLDs) or 'unseen' conditions such as epilepsy
or long-term health conditions, including information and advice on funding available,
enabling technologies which assist study and learning, and adapted accommodation.
18 Personal Health Budget and Direct Payments
A Personal Budget is made available if a child/young person is assessed as needing additional and individual support from education, health and/or social care. The local authority or health service traditionally uses this money to purchase services on behalf of the child/young person and their parents. However, a Personal Budget can be used to give the child's parent and/or the young person choice and control about the services they receive.
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As part of an EHC Plan, a child's parent or the young person will have the right to request a
Personal Budget to meet an assessed need within an EHC Plan. Personal Budgets are
optional for a child's parent or the young person but local authorities have a duty to prepare
a budget when requested.
Personal Budgets for Short Breaks Funding is availableand as part of an EHC Personal Budgets can be offered for:
Special Educational Needs Funding (High Needs Funding) Continuing Health Care Funding
Home to School Transport Funding
At present, a funding matrix is established for the education component of the personal
budget, children and young people assessed as meeting the continuing health criteria can
have a direct payment from the CCG and children assessed as having social care needs can
have direct payment to meet their needs in the community. A multi-agency funding panel has
been established to consider all requests for personal budgets following an EHC plan. To
date, areas that have attracted the most requests for personal budget are home to school or
home to short breaks transport131.
19 Short Breaks
The City of Wolverhampton Council currently commissions two main types of short breaks: through community-based provision, and overnight/residential provision. In April 2015, 800 community based short breaks were provided. In community-based provision, the following is offered:
Groups which meet at weekends, school nights and during school holidays. Referrals are made by a social worker.
Outreach Support, where a worker will work with a child in the home or take them
into community and universal settings. Referrals are made by a social worker.
Buddying Service, where young people are supported to access mainstream
provision and activities.
After-school/evening groups for children with autistic spectrum conditions. Referrals
can be self-referrals or made through a key worker.
Residential short breaks are available to a small number of children with higher level or more
complex needs: approximately 37 children currently have this level of service. These breaks
are predominantly at residential units, but a small number have a short break with their
family (shared care) or receive a direct payment to pay for a personal assistant for the
duration of the break. Referrals for this service are through a social worker.
The service also currently funds two short break caravans: one in Wales and one in
Somerset, which can be booked by families who care for a child with a disability.
20 Home to school Transport
131 City of Wolverhampton Council (2016) Joint Strategy for Children and Young People with SEND 2015-2020
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Home to school transport is provided to children with SEN where transport to an identified
school is assessed as being necessary to fulfil the pupil’s statement of Special Educational
Needs132. Currently, 830 pupils under the age of 19 years use this service133.
21 Connexions
Connexions provide a city wide early intervention and targeted service for young people with
SEND aged 13-25 years. A connexions personal adviser provides guidance, support and
advice to young people who are preparing for adulthood. This support will help young people
explore their aspirations and identify which of the many post 16 education and training
options open to them are appropriate.
Fig. 73: Wolverhampton Supported Employment (Source: City of Wolverhampton Council)
22 Supported Employment; City of Wolverhampton Council
The service is involved as leaders of a project entitled “Employment is Everyone’s Business
in Wolverhampton”: this is a network of people, organisations and work streams aimed at
increasing the paid employment opportunities for young people with disabilities in the city.
23 Information, advice and support
23.1 Local Offer
From 1 September 2014 the Children and Families Act required all local authorities to
publish and maintain a ‘local offer’. A local offer is a wide range of information about all the
support and facilities which families can expect to find in their area for children and young
people who have special educational needs (SEN) and disabilities. The information should
132 City of Wolverhampton Council Home to School travel policy 133 City of Wolverhampton Council
Page 109 of 110
cover education, health and social care support and services for children and young people
aged between 0 and 25.
Wolverhampton Local Offer has now been ‘live’ since 1st September 2014. Recently the SEND Partnership Board undertook a review of the local offer and good practice was identified in the following areas134:
The Local Offer includes information about services and how to access them, and how to get support. It is more than just a directory of services.
The Local Offer is co-produced with young people and other organisations such as
CCG and schools.
All of the services included in the local offer include the required information about
referral process, eligibly and accessibility.
Information is available on each service area page about now to make a complaint or
a compliment
There is comprehensive information about out of area schools that parents can
access.
The SEND Health workstream requires all information to be checked by parents to
make sure it is easy to understand, does not use jargon and provides relevant
information.
Local Offer feedback cycle is in place
There is some information that needs to be included or improved on the Local Offer,
including the leisure offer for disabled children, improved information about short breaks
options, and how they differ from after school provision, personal budgets and how to access
them, criminal justice, and quality assurance of the schools local offer information. The
development of the Local Offer and its first annual review has identified the need for
dedicated time to keep it updated, and support on-going involvement of families and young
people. The All Age Disability Commissioning team are therefore, creating a new post that
will have this as part of its responsibilities.
23.2 Information, Advice and Support Service (Formerly known as the Parent Partnership Service)
This service provides impartial information, advice and support to families of children with
SEND as well as children and young people themselves aged 0 – 25 years. Currently, the service has around 1500 registered families. The service offers information,
advice and support about:
Education, health and social care matters and relevant law Support available in schools, early years and post 16 settings
Funding arrangements
How needs are identified and met
Disagreements and moving forward
23.3 Action for Children
134 City of Wolverhampton Council (2015) Annual Review of Wolverhampton SEND local offer 2015
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Wolverhampton Buddy Service is a unique partnership between Action for Children and
Wolverhampton Short-term Breaks. The service provides one-to-one support for 14 – 18
year olds with various disabilities. The buddy supports the young people to access a variety
of activities within their local community as well as further afield. Sessions encourage the
development of independence and social skills, which in turn, expands the young people’s
confidence and self-esteem. The focus of the programme is to encourage the young person
to reach their full potential through dedicated one-to-one support.
23.4 Other Organisations
Other organisations such as Voice4Parents and ‘Changing Young Lives’ which is a local
young people’s rights based organisation provide advice and support to children and young
people with SEND and their families.
