behavioural optometry: pros and cons

MUSEC is Macquarie University’s Special Educational Centre. Since 2005 it has been issuing one-page briefings on various topics relevant to special education; a brilliant idea and very useful for busy teachers. One of the drawbacks of a one-page briefing is that if the topic is a complex one, there might be space for a simple explanation and a couple of references only. The briefings get round that problem, in part, by putting relevant references on a central website.

Behavioural optometry is based on the assumption that some behavioural issues (in the broadest sense) are due to problems with the way the eyes function. This could include anything from poor convergence (eyes don’t focus together) to variations in processing visual information in different coloured lights. The theory is a plausible one; visual dysfunction can cause considerable discomfort and can affect balance and co-ordination, for example.

Behavioural optometrists are sometimes consulted if children have problems with reading, because reading requires fine-grained visual (and auditory) discrimination, and even small variations in the development of the visual system can cause problems for young children. One of the reasons systematic synthetic phonics programmes are so effective in helping young children learn to decode text is because they train children in making fine-grained distinctions between graphemes (and between phonemes). But phonics programmes cannot address all visual (or auditory) processing anomalies, which is the point where behavioural optometrists often come in.

The MUSEC briefing on behavioural optometry (Issue 33) draws on two references; a 2011 report by the American Academy of Paediatrics (AAP), and a 2009 review paper by Brendan Barrett, a professor of visual development at Bradford University.  Aspects of the briefing perplexed me.  I felt it didn’t accurately reflect the conclusions of the two references because it:

  • doesn’t discriminate between treatments
  • overlooks the expertise of behavioural optometrists
  • equates lack of evidence for efficacy with inefficacy
  • assumes that what is true for a large population must be true for individuals
  • gives misleading advice to readers.

Discrimination between treatments

In its second paragraph the briefing lists three types of treatment used by behavioural optometrists; lenses and prisms, coloured lenses or overlays, and vision therapy. But from paragraph four onwards, no distinction is made between treatments – they are all referred to as ‘behavioural optometry’ and evidence (for all behavioural optometry treatments presumably) is said to be ‘singularly lacking’. Since lenses and prisms are used in what Barrett calls traditional optometry (p.5), this generalization is self-evidently inaccurate. Nor does it reflect Barrett’s conclusions. Although he highlights the scarcity of evidence and lack of support for some treatments, he also refers to treatments developed by behavioural optometrists being adopted in mainstream practice and to evidence that supports claims involving convergence insufficiency, yoked prisms, and vision rehabilitation after brain disease/injury.

Expertise of behavioural optometrists

The briefing also appears to overlook the fact that behavioural optometrists are actually optometrists – a protected title, in the UK at least. As such, they are qualified to make independent professional judgments about the treatment of their patients. As Barrett points out, some of the controversies over treatments involve complex theoretical and technical issues; behavioural optometry isn’t the equivalent of Brain Gym. But teachers are unlikely to know that if they only read the briefing and not the references.

Lack of evidence for efficacy

Both references cited by the MUSEC briefing are reviews commissioned by professional bodies. Clearly, the American Academy of Pediatrics, the College of Optometrists or MUSEC cannot endorse or advocate treatments for which there is little or no evidence of efficacy. But individual practitioners are not issuing policy statements, they are treating individual patients. If they are using treatments for which a robust evidence base is lacking, that’s unsatisfactory, but a weak evidence base doesn’t mean that there is no evidence for efficacy, nor that the treatments in question are ineffective. Setting up RCTs of treatments for complex issues like ‘learning difficulties’ is challenging, expensive and time-consuming. As a parent, I would far rather my child try treatments that had a weak evidence base but were recommended by experienced practitioners, than wait for the Cochrane reviewers to finish a task that could take decades.

Populations vs individuals

The briefing paper says that “there is clear consensus among reading scientists that visual perception difficulties are rarely critical in reading difficulties and that the problem is typically more to do with language, specifically phonological processing.

Although this statement is right about the consensus and the role of phonological processing, one can’t assume that what’s true at a population level is true for every individual. Take, for example, convergence insufficiency (one of the areas where Barrett found evidence to support behavioural optometrists’ claims). According to the AAP report, the prevalence of convergence insufficiency is somewhere between 0.3% and 5% of the population (p.832).   So the probability of any given child having convergence insufficiency is low, but in the UK it still could affect up to 500,000 children. Although the report found no evidence that convergence insufficiency causes problems with decoding, comprehension or school achievement, it points out that it ‘can interfere with the ability to concentrate on print for a prolonged period of time’.   So even though in theory convergence insufficiency could be contributing to the difficulties of a quarter of the UK’s reluctant readers, it isn’t screened for in standard eye tests.

Advice to readers

The briefing recommends visual assessment for problems with acuity and refractive or ‘similar’ problems, but that’s not what the AAP recommends. It says:

Children with suspected learning disabilities in whom a vision problem is suspected by the child, parents, physicians, or educators should be seen by an ophthalmologist who has experience with the assessment and treatment of children, because some of these children may also have a treatable visual problem that accompanies or contributes to their primary reading or learning dysfunction.” (p. 829)

In the UK, that would require considerable persistence on the part of the child, parent or educator, although physicians might have more success.

The briefing also suggests an alternative to behavioural optometry; ‘explicit instruction in the specific areas causing difficulty’. Quite how ‘explicit instruction’ would improve problems with eye tracking, visual processing speed, visual sequential memory, visual discrimination, visual motor integration, visual spatial skills and rapid naming, never mind attention or dyspraxia where the difficulty is often discovered because the child is unable to carry out explicit instructions, is unclear.

Conclusion

I’m not claiming that behavioural optometry ‘does help children with reading difficulties’ because I don’t know whether it does or not. But that appears to be the nub of the problem – in the absence of evidence nobody knows whether it does or not. Nor which treatments help, if any. As the AAP paper says “Although it is prudent to be skeptical, especially with regard to prematurely disseminated therapies, it is important to also remain openminded.” (p.836)

I also had problems with the MUSEC briefing’s reading of Barrett’s conclusions. Although I wouldn’t go so far as to say the briefing is wrong (except perhaps about the lenses, and I’m not sure what it means by ‘explicit instruction’), its take-home message, for me, was that behavioural optometrists lack competence, that visual problems are unlikely to play any part in developmental abnormalities, and that if there are visual problems they will be limited to acuity and refractive or ‘similar’ factors. That’s not the message I got from either of the papers cited by the briefing. Obviously, on one side of A4, the authors couldn’t have covered all the relevant issues, but I felt that what they included and omitted could give the wrong impression to anyone unfamiliar with the issues.

References

American Academy of Pediatrics (2011). Joint technical report – Learning disabilities, dyslexia, and vision. Pediatrics, 127, e818-e856.

Barrett, B.T. (2009). A critical evaluation of the evidence supporting the practice of behavioural vision therapy. Ophthalmic and Physiological Optics, 29, 4-25.

Reforming the SEND system – for good

In the previous post, I claimed that teacher training and targets were two factors that explained why the current SEND system couldn’t work  –  and why it has never worked effectively.  In this post, I’ll explain my claims about teacher training and targets and suggest how the SEND system could become both effective and sustainable.

 Teacher training

For any system – education, health or social care – to meet the needs of a varied population, two ingredients are vital; expertise and flexibility. Practitioners need the knowledge and experience to deal with any needs they might encounter and the system has to be able to adapt to whatever needs arise.

Bizarrely, teachers have always been expected to teach the 98% or so of children who attend mainstream schools, but have only ever been trained to teach the 80% who don’t have SEN, not the 20% who do. And since funding was withdrawn for special education Master’s degrees in the mid-1980s, SEN expertise has gradually leached out of the education system as a whole as special education teachers have retired. It’s only since 2009 that new SENCOs (special educational needs co-ordinators) have been required to be qualified teachers, and only recent appointees are required to have SEN training. There is still a massive gap in SEND expertise within the education system. How can teachers teach children if they don’t know how to meet their educational needs?

Targets

Setting targets sounds like an obvious way to improve performance. You set the target, expect someone to meet it whatever that takes, and provide some sticks and carrots for their encouragement. Targets, accompanied by sticks and carrots, were part and parcel of the early education system but were abandoned because they didn’t work.  And as quality control researchers have been telling us since at least the 1920s, performance depends on the factors that contribute to it. In the current education system, the measure of school performance is actually pupil performance in SATs or GCSEs. But how children perform in tests is influenced by many factors; their health, family circumstances, life events, quality of teaching, their own learning etc. Schools have little or no control over most of those factors, so to measure school performance by pupil performance in tests is pointless.

Despite the evidence, the current education system still sets targets.  And the sticks and carrots expected to encourage schools to raise their (pupil) performance mean that there are no incentives for a school to invest resources in the education of students who are unlikely to improve the school’s test results. If students aren’t going to meet the ‘expected standard’ however hard they or the school try, why invest resources in them? Why not focus on the children likely to meet the ‘expected standard’ with a bit of extra effort.

So, teacher training and targets have been major factors in marginalising the education of children with SEND. But even if the government had a forehead-slapping moment, cried ‘How foolish we’ve been!’, required all teachers to be trained to teach all the children in their classes, and abandoned its ‘expected standards’ criteria, it would take years to transform the system into a SEND-friendly one. Children with SEND don’t have years to spare and their parents have to deal with the here and now. So what needs to be done?

Parents can’t police the system

This post was prompted by a recent conversation I had with a parent carer forum. The parent carer forum was of the opinion that parents with good knowledge of the national framework and their local offer can use that knowledge to get commissioners and providers to make suitable educational provision for children.

It’s certainly true that knowledge of the national framework and the local offer (however incomplete) can help. How effective it is at getting commissioners and providers to meet their statutory obligations is another matter. Since the new system was introduced, I’ve been told repeatedly that it’s improved outcomes for parents and children. Maybe – but I have yet to see any. What I have seen is parents who know the national framework backwards having to resort to mediation, tribunal, formal complaint, the Local Government Ombudsman and in some cases being advised that their only option is Judicial Review – exactly the kind of problems that prompted the revision of the SEN system in 2014.

Until I had the conversation with the parent carer forum, I’d assumed these hurdles were the unwanted and unintended consequences of flaws in legislation that had been rushed through (the pilot study didn’t finish until after the legislation came into force). Then the penny dropped. The only explanation that made sense was that individual parents challenging commissioners and providers is the government’s chosen method of enforcing the new legislation.

That’s a terrible way of enforcing legislation.  For many parents of children with SEND, it’s as much as they can do to hold the family together. To expect parents in already challenging circumstances to police a flawed system that was rushed through at a time when LAs are struggling with huge budget cuts is, to put vulnerable families in harm’s way. Not only is that strategy likely to fail to bring about compliance on the part of commissioners and providers, it’s morally reprehensible.  For 150 years, if a school failed a child parents have been able to appeal to school boards, independent governors or their LEA for support. Not any more. Parents (and children with SEND) are on their own.

What needs changing and who can change it?

The system still needs to change and if parents don’t change it no one else will, so what to do? Since my family entered the SEN ‘world’ 14 years ago, I’ve seen parents fighting lone battles with their LA; the same battles replicated hundreds, if not thousands, of times. I’ve seen parents new to the system set up support or campaign groups only to discover they are just one in a long line of support or campaign groups that have either burned out or at best brought about change that hasn’t actually made much difference on the ground.

What the individual parents and campaign groups have lacked is focus and organisation. I don’t mean they’ve been unfocussed or disorganised; some of them could focus and organise for England. And there’s no doubt that parent groups were instrumental in getting the SEND system changed. It’s rather that there’s been a lot of duplication of effort and the focus has been on single issues or fighting on all fronts at once rather than on the key points in the system that are causing the problems.

I think the key points are these;

  • Mainstream teachers should know how to teach all the children in mainstream schools.
  • Each child needs an education suitable for them as an individual rather than for the average child in their age group, as the law already requires.
  • Assessment and funding should be the responsibility of separate bodies – the new legislation didn’t do away with the LAs’ conflict of interest.
  • There should be an independent body (with teeth) responsible for implementation and compliance that should support parents in their dealings with commissioners and providers. Parents should not have to resort to legal action except in extreme cases.
  • Parents struggling with the system need more support than they are currently offered. A buddying system matching up parents in similar positions dealing with the same local authority might help. As would training in negotiation.

Much of the negotiation undertaken by individual parents and parent groups is with schools, LA officers or the DfE. And problems with the SEND system are generally seen not as being with the structure of the education system or the SEND legislation, but with implementation. But the problem runs deeper than implementation, and deeper than the SEND legislation. It lies with the structure of the education system as a whole, and with the market model espoused by successive governments. Instead of lobbying LA officers and DfE officials who are trying to implement the law as it stands, groups of parents should be lobbying their local councillors and MPs to ensure that teachers are suitably trained, arbitrary targets are abandoned, and responsibility for implementing the system is distributed more widely. These changes won’t require significant new legislation, but they might require a big shift in thinking.

 

 

 

A short history of special education

In 2006 a House of Commons Select Committee described the special educational needs system as ‘no longer fit for purpose’. By September 2014 a new system was in place. Two years on, it’s safe to say it hasn’t been an unmitigated success. To understand why the new system hasn’t worked – and indeed can’t work – it might help to take a look at the history of special educational needs and disability (SEND).

A short history of SEND

Education became compulsory in England in 1880. Some local school boards set up special schools or special classes within mainstream schools for physically ‘handicapped’* children, but provision was patchy. What took people by surprise was the number of mentally handicapped children who turned up to school.

At the time, teachers were expected to teach according to the official Code – essentially a core curriculum – and many schools in the fledgling national educational system were seriously under-resourced. Teachers were often untrained, paper was very expensive (hence the use of rote learning and slates) and many schools operated in conditions like the one below – with several classes in one room. They just weren’t equipped to cope with children with learning difficulties or disabilities.

Shepherd Street School in Preston in 1902

Shepherd Street School in Preston in 1902§

Two Royal Commissions were set up to investigate the education of handicapped children, and reported in 1889 and 1896 respectively. Both recommended the integration of the children in mainstream schools where possible and that special provision (classes or schools) should be made by school boards. The emphasis was on children acquiring vocational skills so they could earn a living. Those with the most severe mental handicap were deemed ‘ineducable’.

The Royal Commissions’ recommendations, and many others made over the next few decades, were clearly well-intentioned. Everybody wanted the best outcomes for the children. The challenge was how to get there. After WW2, concerns about the special education system increased. Parents felt they had little control, the number of pupils in special schools was rising, and children were still being institutionalised or marginalised from society. In 1973 Margaret Thatcher, then Education Secretary, commissioned a review of the education of handicapped children, led by Mary Warnock, whose Committee of Enquiry reported in 1978. A year later Margaret Thatcher became Prime Minister and some of the Warnock recommendations came into force in the Education Act 1981.

The Warnock report introduced a very different way of understanding ‘handicapped’ children. They were no longer seen as being different, but as having special educational needs – as did up to 20% of the school population. Special educational needs were defined in terms of the support children needed, rather than in terms of their physical or mental impairments. What was envisaged was that many children in special schools would gradually migrate to mainstream, supported by Statements of Special Educational Need. And mainstream schools would gradually become more inclusive, adapting their buildings, equipment and teaching methods to meet an ever wider range of educational needs. The new system might have worked well if the rest of the education system hadn’t changed around it.

Context is crucial; one size doesn’t fit all

The Warnock recommendations were made in the context of a very flexible education system. In 1981 Local Education Authorities (LEAs), schools and teachers had a great deal of autonomy in what was taught, how it was taught and when. That all changed with the 1988 Education Reform Act that heralded a compulsory National Curriculum, SATS and Ofsted. Central government essentially wrested control of education from local bodies, something that had been actively opposed for the previous 100 years – few people wanted education to become a political football.

The new education system was at heart a one-size-fits-all affair. Governments find one-size-fits-all systems very appealing. They look as if they are going to be cheaper to run because professional training, equipment and resources can be standardised and performance can be easily measured. Unfortunately for governments, human populations are not one-size, but are very varied. If a universal service is to meet the needs of a whole population, it won’t do that if it’s designed to meet only the needs of the average person. A stark choice faces those designing universal systems; either they can design a system that meets everybody’s needs and resource it properly, or they can design a system that doesn’t meet everybody’s needs and then spend years trying to sort out the ensuing muddle.

The 1880 education system was one-size-fits-all and the next century was spent sorting out the problems that resulted for handicapped children. There was a brief period after 1981 when the education system took a big step towards meeting the needs of all children, but seven years later it flipped back to one-size-fits-all. The last 30 years have been spent trying unsuccessfully to limit the damage for children with SEND.

So what’s the alternative? The answer isn’t further reform of the SEND system, because the causes of the problems don’t lie within the SEND system, but with the broader education system. Two key causes are teacher training and targets – the subjects of the next post.

*I’ve used the term ‘handicapped’ because it was in widespread use in the education system until the Warnock Committee changed the terminology.
§ © Harris Museum and Art Gallery http://www.mylearning.org/victorian-school-and-work-in-preston/images/1-3215/

we’re all different

We’re all different. Tiny variations in our DNA before and at conception. Our parents smoked/didn’t smoke, drank/didn’t drink, followed ideal/inadequate diets, enjoyed robust health or had food intolerances, allergies, viral infections. We were brought up in middle class suburbia/a tower block and attended inadequate/outstanding schools. All those factors contribute to who we are and what we are capable of achieving.

That variation, inherent in all biological organisms, is vital to our survival as a species. Without it, we couldn’t adapt to a changing environment or form communities that successfully protect us. The downside of that inherent variation is that some of us draw a short straw. Some variations mean we don’t make it through childhood, have lifelong health problems or die young. Or that we become what Katie Ashford, SENCO at Michaela Community School, Wembley calls the ‘weakest pupils‘.

Although the factors that contribute to our development aren’t, strictly speaking, random, they are so many and so varied, they might as well be random. That means that in a large population, the measurement of any characteristic affected by many factors – height, blood pressure, intelligence, reading ability – will form what’s known as a normal distribution; the familiar bell curve.

 The bell curve

If a particular characteristic forms a bell-shaped distribution, that allows us to make certain predictions about a large population. For that characteristic, 50% of the population will score above average and 50% below average; there will be relatively few people who are actually average. We’ll know that around 70% of the population will score fairly close to average, around 25% noticeably above or below it, and around 5% considerably higher or lower. That’s why medical reference ranges for various characteristics are based on the upper and lower measurements for 95% of the population; if your blood glucose levels or thyroid function is in the lowest or highest 2.5%, you’re likely to have a real problem, rather than a normal variation.

So in terms of general ability that means around 2.5% of the population will be in a position to decide whether they’d rather be an Olympic athlete, a brain surgeon or Prime Minister (or all three), whereas another 2.5% will find everyday life challenging.

What does a normal distribution mean for education? Educational attainment is affected by many causal factors, so by bizarre coincidence the attainment of 50% of school pupils is above average, and 50% below it. Around 20% of pupils have ‘special educational needs’ and around 2.5% will have educational needs that are significant enough to warrant a Statement of Special Educational Needs (recently replaced by Education Health and Care Plans).

Special educational needs

In 1978, the Warnock report pointed out that based on historical data, up to 20% of school pupils would probably have special educational needs at some point in their school career. ‘Special educational needs’ has a precise but relative meaning in law. It’s defined in terms of pupils requiring educational provision additional to or different from “educational facilities of a kind generally provided for children of the same age in schools within the area of the local education authority”.

Statements of SEN

The proportion of pupils with statements of SEN remained consistently at around 2.8% between 2005 and 2013 (after which the SEN system changed). http://www.publications.parliament.uk/pa/cm200506/cmselect/cmeduski/478/478i.pdf https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/225699/SFR30-2013_Text.pdf

It could be, of course, that these figures are an artifact of the system; anecdotal evidence suggests that some local authorities considered statutory assessments only for children who scored below the 2nd percentile on the WISC scale. Or it could be that measures of educational attainment do reflect the effectively random nature of the causes of educational attainment. In other words, a single measure of educational attainment can tell us whether a child’s attainment is unusually high or low; it can’t tell us why it’s unusually high or low. That often requires a bit of detective work.

If they can do it, anyone can

Some people feel uncomfortable with the idea of human populations having inherent variation; it smacks of determinism, excuses and complacency. So from time to time we read inspiring accounts of children in a school in a deprived inner city borough all reading fluently by the age of 6, or of the GCSE A*-C grades in a once failing school leaping from 30-60% in a year.  The implication is that if they can do it, anyone can. That’s a false assumption. Those things can happen in some schools. But they can’t happen in all schools simultaneously because of the variation inherent in human populations and because of the nature of life events (see previous post).

Children of differing abilities don’t distribute themselves neatly across schools. Some schools might have no children with statements and others might have many. Even if all circumstances were equal (which they’re not) clustering occurs within random distributions. This is a well-know phenomenon in epidemiology; towns with high numbers of cancer patients or hospitals with high numbers of unexpected deaths where no causal factors are identified tend to attract the attention of conspiracy theorists. This clustering illusion isn’t so well known in educational circles. It’s all too easy to assume that a school has few children with special educational needs because of the high quality of teaching, or that a school has many children with SEN because teaching is poor. Obviously, it’s more complicated than that.

What helps the weakest pupils?

According to Katie what ‘the weakest pupils’ need is “more focus, more rigour and more practice if they are to stand any chance of catching up with their peers”.   Katie goes on to unpack what she means. More focus means classrooms that aren’t chaotic. More rigour means expecting children to read challenging texts. More practice means practicing the things they can’t do, not the things they can.

Katie’s post is based on the assumption that the weakest pupils can and should ‘catch up with their peers.’ But it’s not clear what she means by that. Does she mean the school not needing a bottom set? All pupils attaining at least the national average for their age group? All pupils clustered at the high end of the attainment range?  She doesn’t say.

In a twitter discussion, Katie agreed that there is variation inherent in a population, but

katie ashford bell curve

I agree with Katie that there is often room for improvement, and that her focus, getting all children reading, can make a big difference, but improvement is likely to entail more than more focus, more rigour and more practice. In an earlier post Katie complains that “Too many people overcomplicate the role of SENCO”.   She sees her role as very simple: “I avoid pointless meetings, unnecessary paperwork and attending timewasting conferences as much as possible. Instead, I teach, organise interventions, spend lots of time with the pupils, and make sure teachers and support staff have everything they need to teach their kids really, really well.

Her approach sounds very sensible.  But she doesn’t say what the interventions are. Or what the teachers and support staff need to teach their kids really, really well. Or what meetings, paperwork and conferences she thinks are pointless, unnecessary and timewasting. Katie doesn’t say how many children at Michaela have statements of special needs or EHCPs – presumably some children have arrived there with these in place. Or what she does about the meetings and paperwork involved. Or how she tracks individual children’s progress. (I’m not suggesting that statements and EHCPs are the way to go – just that currently they’re part of the system and SENCOs have to deal with them).

What puzzled me most about Katie’s interventions was that they bore little resemblance to those I’ve seen other SENCOs implement in mainstream schools. It’s possible that they’ve overcomplicated their role.   It could be that the SENCOs I’ve watched at work are in primary schools and that at secondary level it’s different. Another explanation is that they’ve identified the root causes of children’s learning difficulties and have addressed them.

They’ve introduced visual timetables, taught all pupils Makaton, brought in speech and language therapists to train staff, installed the same flooring throughout the building to improve the mobility of children with cerebral palsy or epilepsy and integrated music, movement and drama into the curriculum. They’ve developed assistive technology for children with sensory impairments and built up an extensive, accessible school library that includes easy-to-read books with content suitable for older kids for poor readers and more challenging texts with content suitable for younger kids for good readers. They’ve planted gardens and attended forest schools regularly to develop motor and sensory skills.

As a child who read avidly  –  including Dickens – I can see how many hours of reading and working through chapters of Dickens could improve the reading ability of many children. But I’m still struggling to see how that would work for a kid whose epilepsy results in frequent ‘absences’ of attention or who has weak control of eye movements, an auditory processing impairment or very limited working memory capacity.

I’m aware that ‘special educational needs’ is a contentious label and that it’s often only applied because children aren’t being taught well, or taught appropriately. I’m utterly committed to the idea of every child being given the best possible education. I just don’t see any evidence to support the idea that catching up with one’s peers is a measure of educational excellence, or that practicing what you’re not good at is a better use of time than doing what you are good at.

Section 7 of the Education Act 1996 (based on the 1944 Education Act) frames a suitable education in terms of an individual child’s age, ability and aptitude, and any special educational needs they may have. The education system appears to have recently lost sight of the aptitude element. I fear that an emphasis on ‘catching up’ with one’s peers and on addressing weaknesses rather than developing strengths will inevitably result in many children seeing themselves as failing to jump an arbitrary hurdle, rather than as individuals with unique sets of talents and aptitudes who can play a useful and fulfilling role in society.

I’d be interested in Katie’s comments.

joining the dots and seeing the big picture

I’m a tad cynical about charitable bodies these days, especially if they’re associated with academies. Whilst reading their ostensibly ‘independent’ reports I’m on the lookout for phrasing calculated to improve their chances of doing well in the next funding round, or for ‘product placement’ for their services. So a report from the Driver Youth Trust – Joining the Dots: Have recent reforms worked for those with SEND? was a welcome surprise.

The Driver Youth Trust (DYT) is a charity focused on the needs of dyslexic students. Its programme Drive for Literacy is used in ARK schools. I’m well aware of the issues around ‘dyslexia’ and haven’t investigated the Drive for Literacy; in this post I want to focus on Joining the Dots, commissioned by DYT and written by LKMco.

Joining the Dots one of the clearest, most perceptive overviews of the new SEND system that I’ve read. Some of the findings and explanations for the findings are counterintuitive, often a sign of report driven by the evidence rather than what the report writers think they are expected to say. The take-home message is that the new SEND system has had mixed outcomes to date, but the additional autonomy schools now have should allow them to improve outcomes for children regardless, and it presents some inspiring case studies to prove the point.

Here are some of the findings that stood out for me.

SEND reforms interact with the rest of the education system

Reforms to the school system since 2010 have had an even greater impact on young people with SEND than the 2014 Act itself…we find that changes have often enabled those previously succeeding to achieve even better outcomes, while things have only got tougher for those already struggling. As a result unacceptable levels of inequity have merely been reinforced. It is also clear that changes have been inadequately communicated and that many stakeholders (including parents in particular) are struggling to navigate the new landscape.” (p.7)

Fragmentation

“I think that what we did is picked up all the fragments, dropped them on the floor and made them even more fragmented… and now it’s a question of putting them back together in the right order…” – LA service delivery manager (p.15)

SEND pupils and their families have therefore found themselves lost in a system that has yet to reform or regroup.” (p.17)

Funding

Three levels of funding are available for schools: Element 1 is basic funding for all pupil, Element 2 is a notional SEND budget based on a range of factors, and Element 3 is high needs block funding mainly for pupils with EHC plans. The lack of ring-fencing around of the notional SEND budget means that schools can spend this money however they want. (p.20)

Admissions

Pupils with SEND require additional resources and their often lower attainment can impact on the school’s standing in league tables. Parents and teachers reported concerns about admissions policies being stacked against students with SEND.

The local offer

The DfE Final Impact Report for the Pathfinder LAs trialling the new SEND framework found that only 12% of Pathfinder families had looked at their Local Offer and only half of those had found it useful. That picture doesn’t seem to have changed. An FOI request revealed that the number of LA staff with responsibility for SEND varies between 0-382.8 full time equivalent.

Schools

Schools often don’t know what information to give to the LA about their SEND pupils, and the information LAs give schools is sometimes inaccurate. The Plumcroft Primary case study illustrates the point. Plumcroft’s new headteacher tried to improve LA support for pupils with SEND but realised that services available commercially and privately were not only often better, but were actually affordable. As he put it; “If a local authority says ‘no you can’t’ most people just go ‘alright then’ and carry on with the service and whinge about it. Whereas the reality is, you can… there’s no constraint at all.” (p.35)

Categories

The new SEND system does away with the School Action and School Action Plus categories, partly because of concerns that children identified as having SEN were stuck with the label even when it was no longer applicable. The number of children identified with SEN has dropped substantially since, but concerns have been voiced about how children with additional needs are being identified and supported.

Brian Lamb highlights another concern that emerged in the early stages of the legislation, that pupils who would previously have had a Statement, would, under the new system, find it ‘difficult to impossible’ to qualify for an EHCP unless they also have health difficulties or are in care (p.39). This fear doesn’t seem to have materialised, since LAs are now transferring pupils from statements to EHC plans en masse, and it’s in the interest of service providers to ask for an EHC plan to be in place in order to resource any substantial support a child needs.

All teachers are teachers of children with special educational needs

Even though the DfE itself said in 2001 that ‘all teachers are teachers of children with special educational needs’ teacher training funding has consistently failed to recognise this. The new system hasn’t introduced significant improvements.

Exam reform

A shift to making public examinations more demanding in terms of literacy automatically puts students with literacy difficulties at a disadvantage. A student might have an excellent knowledge and understanding of the subject matter, but be unable to get it down on paper. The distribution of assistive technology varies widely between schools.

Reinventing the wheel

LA bureaucracy has been seen as a significant factor in the move over recent years to give schools increased autonomy. This has resulted, predictably, in increased concerns over transparency, accountability, expertise and resources. Many schools are now forming federations in order to pool resources and share expertise. There is clearly a need for an additional tier of organisation at the local level suggesting that it might have been more sensible to improve local authority practice rather than marginalise it.

The content of the report might not be especially cheering, but it makes a change to find a report that’s so readable, informative and insightful.

the new SEN legislation and the Dunkirk spirit

In less than a week an event will take place that’s been awaited with excitement, apprehension, or in some cases with something approaching the Dunkirk spirit. On 1 September part 3 of the Children and Families Act 2014 comes into force. It’s been described as the biggest change to special educational needs in 30 years.

It won’t work
. If I were a betting sort of person, I’d put money on the next government having to review the system again in a couple of years. How can I be so sure? Or so pessimistic? It’s because the ‘problem’ with special educational needs and disabilities (SEND) isn’t the special educational needs and disabilities, it’s the education system. And not just the SEN bit of it – it’s the education system as a whole. To find out why we need to go back in time…

we have a history

Education became compulsory in England in 1870. The new education system was essentially a one-size-fits-all affair focusing on reading, writing and arithmetic. Or more accurately one-size-fits-most; what took the government by surprise was the number of children turning up to school who didn’t fit the education system. Government essentially saw these ‘handicapped’ children as a problem, and its solution was to provide special schools for them. Although the solution made perfect sense, it wasn’t entirely successful. Handicapped children often ended up socially marginalised and sometimes institutionalised, and there were still children in mainstream schools who were struggling.

By the 1970s, the education system had changed considerably. There was more emphasis on an individualised education and local education authorities (LEAs), schools and teachers had a good deal of flexibility in the education they provided. The time was right for Margaret Thatcher as Secretary of State for Education to commission a review of the education of handicapped children, headed by Mary Warnock. The Warnock Committee reported in 1978. It defined special education as ‘provision not generally available in normal schools’ (p.45). In other words it saw the ‘problem’ of special education not as the children but as the educational provision available in mainstream schools. The committee’s recommendations fed into the 1981 Education Act that:

• assumed children would attend mainstream schools where possible
• did away with the old categories of handicap
• introduced the concept of ‘special educational needs’
• gave LEAs a duty to assess children’s special educational needs and to fund the additional provision required for their education.

The Act had the potential to transform the lives of children marginalised by the education system, but it clearly hasn’t done so – not in a good way, anyway. In the last 20 years we’ve had three SEN Codes of Practice, numerous inquiries, reports and tinkerings with SEN legislation and regulations. One select committee described the system as not fit for purpose. So…

what went wrong?

The Warnock recommendations were made in the context of a highly flexible education system. A contemporary account describes a fruitful collaboration between a school for children with visual impairment (VI) and a mainstream junior school, pioneered by a keen LEA officer (Hegarty & Pocklington, 1981). Children with VI were gradually integrated into the mainstream school and teachers trained each other. Everybody won.

In order to undertake such a project, LEAs, schools and teachers needed a fair amount of control over their time and budgets. Projects like this might have eventually been rolled out nationwide, except that within a decade the introduction of a compulsory national curriculum and standardised testing had begun to steer the education system back towards a one-size-fits-all approach. Within a few short years central government had essentially wrested the responsibility for education and its funding from local authorities and education had become a serious ‘political football’. Successive governments have focused on raising educational attainment as an indicator of their own effectiveness as a government and ironically that’s what’s resulted in SEN becoming a problem again in recent years.

Essentially, if you want an efficient one-size-fits-all education system and world-beating exam results it makes perfect sense to remove from the equation children who don’t fit into the system and are unlikely to do well in exams however hard everyone tries. That’s what the government did in the 1890s. If you want an education system that provides all children with an education suitable to their individual needs, you can forget about one-size-fits-all and world-beating exam results; you’ll need a lot of flexibility. That’s what the education system had developed into by the time of the Warnock committee. If you want both you’re likely to end up where we are now.

"Relativity" by MC Escher

“Relativity” by MC Escher

The Warnock committee defined special educational needs in terms of the educational provision ‘generally available in normal schools’. By definition, the better the provision in normal schools, the smaller the number of children who would be deemed to have special educational needs. The committee couldn’t have emphasised the need for SEN training for all teachers more strongly if it had tried, but perversely, the education system appears to have taken a step in the opposite direction.

teacher training

The Warnock committee recommended the inclusion of SEN training in the initial teacher training (ITT) for all teachers. Following the 1981 Education Act, the assumption that many children with SEN would be taught in mainstream schools and that all teachers would be trained in SEN led to the cessation of many special needs teacher training courses. They obviously haven’t been replaced with comparable training in ITT. This, coupled with the retirement of special education teachers and a reduction of the number of children in special schools, has meant that the education system as a whole has suffered a considerable loss of SEN expertise.

Reviews of SEN provision have repeatedly reported concerns about there being insufficient emphasis on SEN in ITT. But it’s only been since 2009 that Special Educational Needs Co-ordinators (SENCOs) have been required to be trained teachers, and only new SENCOs have been required to have SEN training. The current government has allocated additional funding for SEN qualifications (para 53) but only up until last year. This isn’t going to touch the problem. DfE figures for 2011 show that only around 7% of the total education workforce has SEN experience and/or training, and most of those people are concentrated in special schools. And special schools report ongoing difficulties recruiting suitably trained staff. This, despite the fact that the Warnock report 35 years ago pointed out that based on historical data, around 20% of the school population could be expected to need additional educational provision at some time during their school career. The report made it clear that all teachers are teachers of children with special educational needs.

Teachers’ expertise, or lack of it, will have a big impact on the attainment of children with SEN, but that hasn’t prevented government from developing unrealistic targets for all children under the guise of raising aspirations.

expectations of attainment

I mentioned earlier that over the last three decades education has become a ‘political football’. Concern is often expressed over the proportion of young people who leave school functionally illiterate or innumerate or without qualifications, despite evidence that this proportion has remained pretty constant for many years. In the case of literacy, it’s remained stubbornly at around 17%, by bizarre coincidence not far from the equally stubborn 20% figure for children with SEN.

But the possibility that some of those young people might be in the position they’re in because of lack of expertise in the education system – or even because they are never going to meet government’s arbitrary attainment targets and that that might actually be OK – doesn’t seem to have occurred to successive governments. In her keynote address to the inaugural national conference of the Autism Education Trust in 2009 the then Minister for Schools and Learning Sarah McCarthy-Fry, saw no reason why young people with autism shouldn’t achieve 5 A-C grade GCSEs. Some of course might do just that. For others such an aspiration bears no relation to their ability or aptitude, part of the definition for the ‘suitable education’ each child is required, by law, to receive.

Currently, funding for post-16 education requires young people to have or be studying for A-C grade GCSEs in both English and Maths. Post-16 providers are rolling their eyes. Although I can understand the reasoning behind this requirement, it’s an arbitrary target bearing no relation to the legal definition of a suitable education.

it’s the system

Currently, local authorities, schools and teachers are under pressure from the SEN system to make personalised, specialised educational provision for a small group of children, whilst at the same time the education system as a whole is pushing them in the opposite direction, towards a one-size-fits-all approach. This is a daft way to design a system and no matter how much effort individual professionals put in, it can’t work. But it isn’t the SEN system itself that needs changing, it’s teacher expertise and government expectations.

Over recent decades, successive governments have approached education legislation (and legislation in general, for that matter) not by careful consideration of the historical data and ensuring that the whole system is designed to produce the desired outcomes, but essentially by edict. A bit of the education system is wrong, so government has decreed that it should be put right, regardless of what’s causing the problem or the impact of changing part of the system without considering the likely consequences elsewhere.

In systems theory terms, this is known as sub-system optimization at the expense of systems optimization. That mouthful basically means that because all the parts of a system are connected, if you tweak one bit of it another bit will change, but not necessarily in a good way. Policy-makers refer to the not-in-a-good-way changes as unintended and unwanted outcomes.

The new SEN legislation is a classic case of an attempt at sub-system optimization that’s doomed to fail. It requires the education, health and social care sectors to do some joined up thinking and extend the support offered to children with SEND for a further decade – until they are 25 – at a time when all three sectors are undergoing massive organisational change and simultaneously having their budgets cut. It introduces personal budgets at a time when all three sectors are changing their commissioning arrangements. It fails to address the lack of expertise in all three systems. (Recent reports have pointed out that teachers aren’t trained in SEN, GPs don’t have paediatric training and children’s social workers don’t know about child development.) It fails to address the fundamental systems design problems inherent in all three sectors; a one-size-fits-all education system, and health and social care sectors that focus on cure rather than prevention.

This approach to systems design isn’t just daft, it’s incompetent and reprehensively irresponsible. People who have made hopeful noises about the new SEN system have tended to focus on the good intentions behind the legislation. I have no doubt about the good intentions or the integrity of the ministers responsible – Sarah Teather and Edward Timpson – but they have been swimming against a strong tide. Getting through the next few years will be tough. Fortunately, in the world of SEN there’s a lot of Dunkirk spirit – we’re going to need it.

References
Hegarty, S & Pocklington, K (1981). A junior school resource area for the visually impaired. In Swann, W (ed.) The Practice of Special Education. Open University Press/Basil Blackwell.
Warnock, H M (1978). Report of the Committee of Enquiry into the Education of Handicapped Children and Young People. HMSO.

the MUSEC briefings and Direct Instruction

Yesterday, I got involved in a discussion on Twitter about Direct Instruction (DI). The discussion was largely about what I had or hadn’t said about DI. Twitter isn’t the best medium for discussing anything remotely complex, but there’s something about DI that brings out the pedant in people, me included.

The discussion, if you can call it that, was triggered by a tweet about the most recent MUSEC briefing. The briefings, from Macquarie University Special Education Centre, are a great idea. A one-page round-up of the evidence relating to a particular mode of teaching or treatment used in special education is exactly the sort of resource I’d use often. So why the discussion about this one?

the MUSEC briefings

I’ve bumped into the briefings before. I read one a couple of years ago on the recommendation of a synthetics phonics advocate. It was briefing no.18, Explicit instruction for students with special learning needs. At the time, I wasn’t aware that ‘explicit instruction’ had any particular significance in education – other than denoting instruction that was explicit. And that could involve anything from a teacher walking round the room checking that students understood what they were doing, to ‘talk and chalk’, reading a book or computer-aided learning. The briefing left me feeling bemused. It was packed with implicit assumptions and the references, presented online presumably for reasons of space, included one self-citation, a report that reached a different conclusion to the briefing, a 400-page book by John Hattie that doesn’t appear to reach the same conclusion either, and a paper by Kirschner Sweller and Clark that doesn’t mention children with special educational needs, The references form a useful reading list for teachers, but hardly constitute robust evidence for support the briefing’s conclusions.

My curiosity piqued, I took a look at another briefing, no.33 on behavioural optometry. I chose it because the SP advocates I’d encountered tended to be sceptical about visual impairments being a causal factor in reading difficulties, and I wondered what evidence they were relying on. I knew a bit about visual problems because of my son’s experiences. The briefing repeatedly lumped together things that should have been kept distinct and came to different conclusions to the evidence it cites. I think I was probably unlucky with these first two because some of the other briefings look fine. So what about the one on Direct Instruction, briefing no.39?

Direct Instruction and Project Follow Through

Direct Instruction (capitalized) is a now commercially available scripted learning programme developed by Siegfried Engelmann and Wesley Becker in the US in the 1960s that performed outstandingly well in Project Follow Through (PFT).

The DI programme involved the scripted teaching of reading, arithmetic, and language to children between kindergarten and third grade. The PFT evaluation of DI showed significant gains in basic skills (word knowledge, spelling, language and math computation); in cognitive-conceptual skills (reading comprehension, math concepts, math problem solving) and in affect measures (co-operation, self-esteem, intellectual achievement, responsibility). A high school follow-up study by the sponsors of the DI programme showed that was associated with positive long-term outcomes.

The Twitter discussion revolved around what I meant by ‘basic’ and ‘skills’. To clarify, as I understand it the DI programme itself involved teaching basic skills (reading, arithmetic, language) to quite young children (K-3). The evaluation assessed basic skills, cognitive-conceptual skills and affect measures. There is no indication in the evidence I’ve been able to access of how sophisticated the cognitive-conceptual skills or affect measures were. One would expect them to be typical of children in the K-3 age range. And we don’t know how long those outcomes persisted. The only evidence for long-term positive outcomes is from a study by the programme sponsors – not to be discounted, but not a reliable enough to form the basis for a pedagogical method.

In other words, the PFT evaluation tells us that there were several robust positive outcomes from the DI programme. What it doesn’t tell us is whether the DI approach has the same robust outcomes if applied to other areas of the curriculum and/or with older children. Because the results of the evaluation are aggregated, it doesn’t tell us whether the DI programme benefitted all children or only some, or if it had any negative effects, or what the outcomes were for children with specific special educational needs or learning difficulties – the focus of MUSEC. Nor does it tell us anything about the use of direct instruction in general – what the briefing describes as a “generic overarching concept, with DI as a more specific exemplar”.

the evidence

The briefing refers to “a large body of research evidence stretching back over four decades testifying to the efficacy of explicit/direct instruction methods including the specific DI programs.” So what is the evidence?

The briefing itself refers only to the PFT evaluation of the DI programme. The references, available online consist of:

• a summary of findings written by the authors of the DI programme, Becker & Engelmann,
• a book about DI – the first two authors were Engelmann’s students and worked on the original DI programme,
• an excerpt from the same book on a commercial site called education.com,
• an editorial from a journal called Effective School Practices, previously known as Direct Instruction News and published by the National Institute for Direct Instruction (Chairman S Engelmann)
• a paper about the different ways in which direct instruction is understood, published by the Center on Innovation and Improvement which is administered by the Academic Development Institute, one of whose partners is Little Planet Learning,
• the 400-page book referenced by briefing 18,
• the peer-reviewed paper also referenced by briefing 18.

The references, which I think most people would construe as evidence, include only one peer-reviewed paper. It cites research findings supporting the use of direct instruction in relation to particular types of material, but doesn’t mention children with special needs or learning difficulties. Another reference is a synthesis of peer-reviewed studies. All the other references involve organisations with a commercial interest in educational methods – not the sort of evidence I’d expect to see in a briefing published by a university.

My recommendation for the MUSEC briefings? Approach with caution.