A recent national audit of ‘low-incidence’ special needs shows that local authorities generally have some level of specialist service and provision to meet low incidence needs, in terms of education support teams and mainstream unit/special school provision.

However the shape, form and the extent of these varies. Even where there is dedicated educational provision for particular types of low incidence needs, this does not always cover the full range of individual pupil difficulties.

This audit was commissioned by the DfES as part of its strategy for SEN and Inclusion. The audit arose from concerns about the availability and consistency of support provided, across the country, for children with low incidence needs, and the need for some to be placed at a considerable distance from home in order to access the provision they require.

The term ‘low incidence’ is used to describe needs that occur less frequently and may require a more specialised response. The categories included in the project specification were as follows:

  • severe multi-sensory impairments
  • severe visual impairment
  • severe/profound hearing impairment
  • profound and multiple learning difficulties
  • severe autistic spectrum disorders
  • severe behavioural, emotional and social difficulties.

Focus on three groups

Three groups were linked together as follows, with a focus on the more complex end of the continuum: (i) severe sensory/multi-sensory impairments (visual/hearing/deaf-blind) (ii) severe autistic spectrum disorders (ASD)

(iii) severe behavioural, emotional and social difficulties (BESD).

In line with the holistic emphasis of Every Child Matters, the audit looked at a broad range of needs and services/provision (education, social care, health, social/leisure). The summary below is mainly focused on educational aspects of most relevance to SENCOs:

Key issues

A similar picture has emerged across all sources of evidence (scoping interviews, literature review, questionnaire responses and focus group discussions). While there are some differences between the three main groups (sensory/ASD/ BESD), in the issues they present, there is also a high degree of commonality, particularly at the severe end of the continuum, where needs are more complex and multiple. There are also similarities in relation to other types of low incidence needs (such as physical/health care and profound/multiple learning disabilities).

ASD and BESD issues are regarded as more challenging, compared to the area of sensory/multi-sensory impairments. However, in the latter, there are concerns about recruiting and retaining practitioners with relevant expertise.

Gaps in services, support and provision

The key gaps in service, support and provision for these three groups are not in relation to specific skills and interventions, but to the broader areas such as family support/respite care, support for mental health issues, and better social/leisure opportunities, where greater skills and capacity are needed. Priority needs to be given to developments in support and provision for older children as they move towards adulthood.

The task is not to improve individual elements of provision in isolation, but to develop more coherent packages of support that address all aspects of children’s lives. Provision for more complex difficulties has to be supported by improvements in universal provision for the broader continuum of special educational needs. Difficulties experienced in this mainstream secondary school sector are leading to placement breakdown for some pupils with low incidence needs who, with better support, should be able to access the broader curriculum.

Sensory and multi-sensory impairment

In relation to services/provision for young people with severe/profound sensory/multi-sensory impairment, local authorities are trying to address the gaps through:

  • better liaison with local LSCs and other partners, and broader regional/ subregional planning of FE options
  • multi-agency transition teams and transition protocols
  • improving access to extended care/leisure opportunities
  • closer links between specialist workers and CAMHS
  • joint commissioning of specialist services and provision.

Autistic spectrum disorders (ASD)

For those with severe/complex autistic spectrum disorders, the priorities have been to develop:

  • more flexible provision within local services and schools (special and mainstream) in order to cater better for more significant individual needs
  • increased opportunities for extended care and leisure activities, with staff better trained to respond to ASD needs
  • more personalised planning for young people at the 14-19 stage
  • multi-agency training and increased partnership with parents and the voluntary sector.

Behavioural, emotional and social difficulties (BESD)

Local authorities seek to address the gaps through:

  • more flexible/accessible services (eg intensive multi-agency support teams) linked to young people whose education/care placements are most vulnerable
  • multi-agency decision-making panels, able to target a range of resources at critical points in some children’s lives
  • development of mental health worker and keyworker roles.

Unitary framework for Standards

There is currently a range of Standards for provision and services. The DfES should bring these together within a unitary framework that is accessible to all relevant providers. The framework should be clearer in its principles and recommendations (in particular, the importance of provision should be made locally wherever possible; and the value of a multi-agency approach to planning and delivery of services). It should cover desired outcomes (linked to Every Child Matters) as well as processes, and ensure that it encompasses all relevant services (including health).

The DfES should consider extending the existing standards for services for sensory-impairment (DfES 2002) to include a broader range of outcomes/service areas and a similar approach could be taken to other areas of low incidence need.

National Audit of Support Services and Provision for Low Incidence Needs

Peter Gray: The Special Needs Consultancy Research Team: Pat Bullen, Lynne Duckett, Sue Leyden, Ian Pollard and Rob Skelton, with support from: Gervase Leyden and Katie Fraser.
Research report RR729 online at www.dfes.go.uk/research.