YouGov survey: Teachers blame “parental pressure” for misdiagnosis of SEN

YouGov survey: Teachers blame "parental pressure" for misdiagnosis of SEN

A YouGov poll of more than 800 teachers across the UK, has shockingly revealed what is potentially one of the biggest reasons the SEND reforms are not making as big an impact as they should have in schools.

The research, commissioned by GL Assessment, found that 57 per cent of teachers questioned think there is a misdiagnosis of SEN in children, and 54% blame parental pressure for it. 62% of teachers questioned claim this means children with ‘genuine’ needs are missing out because resources are being diverted to children that don’t really need help, with less than a fifth (18 per cent) disagreeing.

Yes, dear parent, dear pushy, pushy parent (actually, assertive parent). It’s your fault that teachers cannot be honest and have a collaborative conversation (as per SEND Code of Practice) that they think little Johnny doesn’t have SEN, he’s just a bit thick. Or naughty. Or both. And what’s more, your teacher-badgering ways are ruining the life chances of children (presumably without a pushy parent) with “genuine need”. I’m not quite sure how these last two are connected.

I shall now pause and take a deep breath and hope these 800 were not representative of the teaching profession as a whole, but I must take the professionally produced survey as evidence that, on the face of it, it is.

Okay. How many parents, like me, had to seek our own outside diagnosis from a paediatrician or educational psychologist because the school just thought you had a naughty kid when you knew, in your bones, that there was a real, undiagnosed/undiscovered need? Mainly, this is the case for children with ADHD or autism/Asperger syndrome, that only starts to really manifest once the child is in the restrictive and confusing world of the school classroom. If teachers are coming in with the attitude that they’re sucking up resources because they don’t agree with a medical diagnosis, no wonder so many parents end up seeking Education, Health and Care plans so they can get their child into a more suitable school environment.

Individual, difficult parents...

Maybe I’ve just read this report wrong. After all, when taken as a parental 'herd', 65% teachers thought most parents were supportive and that parental interaction with them and their schools was appropriate. But...

“Individual parents, however, presented a much bigger problem. Over half of all teachers polled (52 per cent) complained that at least one parent took up so much of their time that it was difficult to give others sufficient attention, with two-fifths (41 per cent) saying they had to deal with more than one difficult parent.”

Look, I’m certainly not saying there are no nightmare parents or that no parent has ever sought a ‘label’ for their child to gain some sort of advantage. In fact, one former SEN department head once claimed lots of parents try to get (then) statements to get their children into a good school…

But many, many parents I know or who contact me, desperate for help, have so often had their fears dismissed by their school, and only through their own efforts have been proved right in their concerns. Some had been ignored only to see their child excluded or refuse to go to school because the proper interventions had not been put in place. Would these parents have been among the type described as label-hunting?

This survey shows that teachers feel parents often seek to stick a label on a child to excuse poor results or bad behaviour. 72% believe some parents want their child to be labelled as having a learning difficulty even though there is little objective evidence to support that status. In the report’s narrative, Lorraine Petersen, a special needs expert and former chief executive of National Association of Special Educational Needs said:

“Most parents will work on the assumption that the quicker you assess why a child is having difficulties and give him or her a label, the faster you can get extra support. There may also be a sense of relief that comes with being able to ‘blame’ a diagnosed disorder. Parents may think people will be a lot less judgmental of a child's behaviour - and their parenting skills - if they know the child has a label.”

This is true, in large part, but I don’t think Ms Petersen meant this in a negative way. Parents do not want teachers (or other parents) to think their child is just naughty, when they KNOW there is something deeper going on. They want to know what it is and how the child can be helped because they live with the child and may see a whole different picture at home. Often parents tell teachers that their child is distraught or angry when they come home and are told bluntly, “Oh we don’t see that here at school.” So it’s your fault, you’re just a bad parent.

Let's look at the SEND Code of Practice

There is ALWAYS a reason for bad behaviour and the Code of Practice (yes, that old chestnut), says the school should work with the parent to find out what could be behind it. Anyone who thinks I’m making this up, please read 6.21-6.35 of the Code. Or spoil yourself and read the whole thing. There is a schools’ version but the real thing isn’t a hard read and, though lacking in great detail, what it does say in this regard is quite clear.

Looking at the SEND Code of Practice 2014, there is also a section called “Involving parents and pupils in planning and reviewing progress” It’s on page 104.

6.64 Schools must provide an annual report for parents on their child’s progress. Most schools will want to go beyond this and provide regular reports for parents on how their child is progressing.

6.65 Where a pupil is receiving SEN support, schools should talk to parents regularly to set clear outcomes and review progress towards them, discuss the activities and support that will help achieve them, and identify the responsibilities of the parent, the pupil and the school. Schools should meet parents at least three times each year.

6.66 These discussions can build confidence in the actions being taken by the school, but they can also strengthen the impact of SEN support by increasing parental engagement in the approaches and teaching strategies that are being used. Finally, they can provide essential information on the impact of SEN support outside school and any changes in the pupil’s needs.

6.67 These discussions should be led by a teacher with good knowledge and understanding of the pupil who is aware of their needs and attainment. This will usually be the class teacher or form tutor, supported by the SENCO.  It should provide an opportunity for the parent to share their concerns and, together with the teacher, agree their aspirations for the pupil.

6.68 Conducting these discussions effectively involves a considerable amount of skill. As with other aspects of good teaching for pupils with SEN, schools should ensure that teaching staff are supported to manage these conversations as part of professional development.

6.69 These discussions will need to allow sufficient time to explore the parents’ views and to plan effectively. Meetings should, wherever possible, be aligned with the normal cycle of discussions with parents of all pupils. They will, however, be longer than most parent-teacher meetings.

A little earlier:

6.20 ….In particular, parents know their children best and it is important that all professionals listen and understand when parents express concerns about their child’s development.

And even earlier:

6.7 In particular, they should ensure that children, parents and young people are actively involved in decision-making throughout the approaches set out in this chapter.
risks of average

Parents are not the enemy

So, here it is clear that the LAW expects schools and teachers to work collaboratively with parents, both putting the best interests of the child at heart. If parents’ concerns are taken seriously, then presumably teachers would, at the least, seek advice from the SENCo, carry out one or more related in-school assessments or, if needed (as it says in the CoP) call in experts such as an autism outreach teacher or an educational psychologist. It's hard to believe so many find it is impossible to discuss a parent’s concerns openly and honestly to understand why they are worried and then discuss an appropriate course of action. Parents are NOT the enemy and it is up to the school to ensure that they work to create good relationships where open discussions can take place as a matter of course.

It almost seems like few of those questioned have ever read the SEND Code of Practice and, if they have, just thought it was a load of rubbish and tossed it in the recycle bin.

I am now convinced, if I wasn’t before, of the vast need for culture change in schools of training in how the new system is supposed to work. No (sane) parent actively wants their child to have special needs or a disability. We send our children to school with the expectation that all will be fine, that they will make friends, get reasonable, if not good, grades and progress through to secondary and further education without significant incident. Most do, but plenty do need extra support and they have a right to get the correct help, in a timely fashion. An assessment, whether in-school tests or calling in experts to ascertain what that need is, should not be resisted by the teacher. On the contrary, only by understanding the issue and providing holistic support, involving the parent in the process, can the optimal interventions be put in place.

Barney's view

So, the above is all about involving the parent as a central partner in the education of the child. Our columnist, Barney Angliss, a former SENCo who was interviewed for the report, says:

“I’m often asked to observe children who have a numberof developmental traits which create a special need, but some may just be under pressure and progressing slightly differently from others. Reaching for a label should not be our first response. Reductionism is an occupational hazardin education. Professionals must be able to work holistically and hold a fluid construct of the child’s difficulty. Focusing on the learning environment is every bit as important as focusing on the child. The vogue in teaching may be didactic, but understanding special needs will always be dynamic.

“So do labels matter at all? Do they only matter to the SENCo? Or the parent? Without a label, will a child be denied assessment or support that is badly needed?

“Firstly, it’s clear from recent judgements in the Upper Tribunal that every case and every context is different. Therefore, labels should not determine outcomes. Secondly, it’s becoming recognised that the boundaries between common diagnoses in the school population are false: Professor Dorothy Bishop, writing about the heated debate on dyslexia4, wrote:

“Other neurodevelopmental disorders such as autism spectrum disorder, specific language impairment, attention deficit hyperactivity disorder, developmental dyspraxia and dyscalculia are all beset by the same issues: there is no diagnostic biomarker, the condition is de ned purely in terms of behaviour, different disorders overlap...”

A problem of trust

When asked why they thought parents pushed for a diagnosis, 64 per cent said it was because some parents wanted a medical or psychological explanation rather than being willing to accept that their child had a classroom problem that could be addressed by a teacher. However, a large minority of 39 per cent thought it was because some parents wanted a label to help their child gain a competitive advantage in exams, though a slightly smaller proportion (37 per cent) thought that wasn’t the case.

This indicates that parents don’t trust teachers to diagnose their child’s extra needs or put the right support in place. Who can blame them when the attitude coming across in the survey is one of hostility? Parents KNOW that teachers have little, if any, training in SEN (this is changing) and, quite rightly, would like to ascertain the exact nature of a problem so they know the support is the RIGHT support.

How can we solve this?

We solve this by working towards fostering good and open relationships between teachers and parents. By not forgetting what it is to be a parent (if you are one) when you walk into your classroom. By passing on information about the child between year groups and changes in setting. By listening to parents’ concerns seriously, asking them questions to help build up a full picture and then working together to decide the best way forward.

Perhaps the parent will be happy then to go for classroom-based tests and build from there. If the parent feels there may be a medical reason, discuss it with them and then support their decision – it’s their child and they know them best. A paediatrician may discover something you had never suspected – and they don’t give out diagnoses at the drop of a hat.

Working collaboratively with parents is not giving anything away, it’s not losing or gaining control or power between one side or another. It’s about trust, listening, discussing, exploring, explaining and supporting. If teachers give this respect to parents, they are almost certain to get it back in grateful spades. And who knows, acting quickly may mean a child’s life is transformed and the parent never needs to resort to the arduous marathon that is an EHCP application. Wins all round, I’d say.

I will leave you with Barney Angliss’ six steps because they are pure gold:

Before referring a child to a specialist who may be qualified to offer a specific explanation of a child’s needs, here are my six simple principles of good intervention in school:

  1. Only respond to specific evidence for which you can offer reliable comparison, but...
  2. Be prepared to consider a wide range of evidence
  3. Actively engage families and let their story guide your thinking
  4. Build resilience, from ‘can do’ to ‘do next’
  5. Work together, from home to school, from classroom to classroom, to achieve consistency
  6. Follow the intervention cycle: Assess, Plan, Do, Review

barney's six principles

Read the report

And, teachers and parents, do read the report because, aside from the figures, there is good advice from experts in SEND that you can follow and improve practice (not including parents voices though, I note.)

Research was conducted for GL Assessment by YouGov, which polled 810 teachers between 19th January and 1st February 2017.
GL Assessment’s ‘Hooked on labels not on needs’ is available to download from gl-assessment.co.uk/hookedonlabels from Friday 24 February.

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Tania Tirraoro
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Tania Tirraoro

Founder, CEO at Special Needs Jungle
Founder of Special Needs Jungle. Parent of two sons with Asperger Syndrome. Trustee, Genetic Alliance UK.
Journalist & author of two novels and a guide to SEN statementing. PR & social media expert. Rare Disease & chronic pain patient advocate.
Tania Tirraoro
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  • Planet Autism

    Shockingly poor attitudes and mistrust by a high number of school staff. Sadly, unsurprising given this: “Professionals/Authority and the Parent Blame Culture” http://media.wix.com/ugd/58c8f1_a481c4f0b37540ddbac0bdd4ad9851eb.pdf

    I disagree with the attitude “Reaching for a label should not be our first response.” because it’s not about reaching for the label it’s about assessing the reason for the child’s difficulties. Every individual has the RIGHT to know what condition they have, especially when it’s a neurodevelopmental condition which is lifelong and impacts everything they experience. Schools do not have the right to interfere in that, even if they don’t see the child’s difficulties in school.

    I would bet the numbers of parents who deliberately seek to obtain invalid labels for their children are infinitessimally small. Who would want to have a disability label just to gain an ‘advantage’? They would have to be seriously warped to prefer their child to be labelled disabled as an excuse to have extra time in exams. That whole argument is paradoxical. Because if they wanted their child to gain an advantage, the disadvantage of the disability nullifies the supposed advantage. Such a parent would have to be a social climber, a keeping up with the Joneses, superior type, which is not the type of parent who would want a disability label. So this is a ridiculous myth.

    You cannot “misdiagnose” SENs either. It would have to be an even smaller amount of private clinicians who would put their whole livelihood and reputation on the line to “misdiagnose” because a parent was paying them to. I simply can’t believe it. They would gain a reputation very quickly for handing out false diagnoses and then nobody in the authorities would take their reports seriously anyway, so the parent would have wasted their money. As it is, some private diagnoses are rejected by authorities. Or are these teachers suggesting the NHS is handing out misdiagnoses?!

    You have to meet diagnostic criteria to get diagnosed with anything. Parents cannot pull the wool over clinician and yes. The child is often tested alone anyway and even if a child was coached, only an incompetent clinician would be unable to see through that and there are many things you simply can’t fake. The NHS is extremely resistant to diagnosing any but the most obvious cases of autism as many parents will testify. They far prefer (due to the aforementioned parent-blame culture) to misdiagnose neurodevelopmental conditions as attachment disorder and send parents on parenting courses!

    It’s teachers and schools who make “difficult” parents. By not listening, by not working in partnership with parents and by refusing to believe parents. Because those parents have their children coming home from school exploding every day due to the school difficulties they are enduring. Unless a child is disrupting classes, schools simply don’t want to know. If a parent fails to fight for their child when they are in these difficulties, that makes them a neglectful parent. Is that what schools want? Are these people that went into teaching to supposedly help children happy to maintain an ‘out of sight out of mind’ attitude whilst children suffer?

    And as for how they judge a child to have SENs, the state has a legal duty to ensure children reach potential*. So if an SEN child is muddling along as average whilst in great difficulty and they are capable of above average, the school is failing in their legal duty to that child. Never mind that they are in loco parentis and are responsible for the wellbeing of that child when they are under their care as well.

    *The SEN Code of Practice (https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/398815/SEND_Code_of_Practice_January_2015.pdf) states:

    5.8 “…local authorities should promote equality and inclusion for children with disabilities or SEN. This includes removing barriers that prevent children accessing early education and working with parents to give each child support to fulfil their potential.”

    “6.1 All children and young people are entitled to an appropriate education, one that is appropriate to their needs, promotes high standards and the fulfilment of potential. This should enable them to:

    • achieve their best
    • become confident individuals living fulfilling lives, and
    • make a successful transition into adulthood, whether into employment, further or higher education or training”

    • All very good points, thank you.

    • David N. Andrews MEd, CPSE

      You may be surprised by this, but on everything that is important in what you said, I actually agree with you.

  • Emma Richardson

    For years following on my from son’s diagnosis of ‘high functioning autism’ I was told he’s not that bad doesn’t need a statement etc. He didn’t get one till he was nearly 10 after being refused twice. He has an IQ of 61 so has severe LDs and he isn’t high functioning at all. In fact he’s gone unmanageable in the home environment. I wasn’t pushy enough! I’m now going down the legal route. Sadly that’s the only way it can be done in my area.

    • I don’t think you’re alone, sadly, from all the comments on Facebook about this post! It’s as if the reforms were a mirage

    • David N. Andrews MEd, CPSE

      I’m disgusted that this is happening.

      HFA is not, and never has been a diagnosis: it’s autism (F84.0), atypical autism (F84.1) or Asperger syndrome (F84.5) – at least, as far as ICD 10 Ch5 is concerned. Levels of functioning are dealt with outside of the diagnostic classification. You are right to be miffed at this.

      That IQ is more than two standard deviations lower than the mean for the test (assuming a mean of 100 and a standard deviation of 15). A 1SD difference is said to be statistically significant. A difference of 2SD is said to be clinically significant. This means that you have been lied to. They may, under any threat of court action, decide to admit to having been mistaken. They would be lying, were they to say so.

      This situation in your son’s case has malpractice plastered all over it. I’m sorry that they’re doing this to you.

      • Emma Richardson

        He does have a EHCP now but it is a load of rubbish. That’s why I’ve had to get legal representation. He needs a specialist autism residential school with a waking curriculum because he is a safeguarding risk to the family. I think the issues with diagnosis is tricky. He did present better at school than at home, but as he got older it has become very apparent that he has severe learning difficulties. The SEND team took far too long to get him a statement of SEN. The local autism “expert” didn’t help and she undermined his diagnosis because he was too “social”. She also told me that he didn’t need TEAACH etc. when he was younger and we never had any training on this. This meant that any intervention now is “late intervention” hence all the behavourial difficulties we are having. He also regressed a lot with puberty, which happens. I know he was a lot worse than the teachers thought because we could never get him to eat with cutlery, he did faecal smearing, urinated on furniture etc. That’s not the behaviour of a high functioning child. It is very frustrating and the appointments take far too long as most parents of children with SEN know. They do the bare minimum from what I can tell. He has been very badly let down the the local authority. And we are having to pay thousands to sort this out.

  • Jenny Koenig

    Just to point out that it’s worth bearing in mind when reading the report that GL Assessment is a company whose business is about selling various tests to schools. There is absolutely nothing wrong with that and they do provide a very useful service but I think it’s helpful to read the report with that perspective in mind. So much of this whole problem is mixed in with issues of lack of resources in schools – both time and money. It’s easy to criticise schools and teachers but worth recognising that they are dealing with pressures from all sides and that budgets are being increasingly squeezed.