Paces

Evidence-based practice & education (Part 3)

"I feared that my brain was actually heating up and might explode. I visualized brain matter flying all over the room, splattering the walls. Whenever I sat at a desk and tried to read, I caught myself putting my hands up to either side of my head, trying to hold it all in."

Elyn Saks had had bizarre thoughts and hallucinations since childhood. At 27 years old and in her first semester at Yale Law School, when she experienced these terrifying sensations, she was diagnosed with "chronic paranoid schizophrenia with acute exacerbation".

I do not think I have the courage to read Elyn Saks' evidently remarkable autobiography, "The Center Cannot Hold: My Journey Through Madness".  I did, however, read the review in the New York Review of Books (Vol 15 No 6. 17 April 2008, Infiltrating the Mind of the Enemy. Jay Neugeboren) with mounting fascination. The reviewer writes: "There is a long tradition, published and unpublished, of first person accounts of madness .... but [this] is the most remarkable of all. I know of no other account that, by its recall of each moment of short- and  long-term crises, allows us to begin to experience what being in this condition must be like and feel like to the person suffering it."

If this seems rather technical and some distance from conductive education and evidence-based practice, bear with me for moment longer and I will shortly come to the point that gripped me as I read the review.

Now 52 and having "suffered several major psychotic episodes" since, Elyn was never again hospitalised for psychiatric reasons. She has successfully managed her condition - she has married, become a Professor and a published author - by medication and psychoanalysis. I cannot do justice, in a few words, to the account that the reviewer summarises. Then he writes:

The prevailing view, beginning with Freud, is that when it comes to schizophrenia, psychoanalysis and most forms of talk therapy invariably cause relapse and regression.

Then came the sentence that grabbed my attention:

"More recently, especially given the ascendancy of evidence-based medicine and its emphasis on 'recovery' - on measurable reduction of symptoms that provides evidence of improvement - analysis and talk therapy have plummeted from favor". [My italics]

There is a lengthy footnote to this, the first half of which reads:

"Evidence-based medicine attempts to assess the quality of evidence relevant to risks and benefits of treatment (including lack of treatment). The term first appeared in medical literature in 1992: the most common definition is David Sackett's: Evidence-based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients" ....

One might conclude that the reason "analysis and talk therapy plummeted from favor" was because it lacked an evidence base. It "did not work" and was apparently, to use David Colquhoun's word, regarded as "baloney".  (Please note I am here only borrowing David Colquhoun's distinction about 'what works and what does not' and not attributing to him, in any sense, that he regards analysis and talk therapy as 'baloney'.] Our conclusion might be correct. The reviewer asserts that in the American Psychiatric Association's Practice Guideline for the Treatment of Patients with Schizophrenia (2004) the only 'talk therapy' recommended is the "evidence-based practice" cognitive behavioural therapy (CBT), a short-term therapy.

In the second half of that same footnote, the reviewer continues:

One problem, when evidence based medicine is applied to chronic mental illness, is that it is easier to measure - to quantify - symptoms and symptom reduction, and, thus, the efficacy of medications, than it is to measure intangibles that, in often grim, unenviable lives, pertain to quality of life, however diminished the quality of those lives might be." [My italics again]

Quality of life. The reviewer writes:

"While medications may reduce symptoms, what, for a person who has lived for any extended period with madness, of the fear and the shame, of the isolation and feelings of worthlessness that invariably accompany madness?"

Is there an evidence-based way to measure the benefits, the reviewer asks, to someone suffering the pain of psychosis of 'letting go' in talk therapy; or the difference that "tolerance, patience and understanding" can make in a person's life and to the quality of that life?

Quality of life. A generation later and a continent away from Elyn Saks, a young woman, wife and a mother of two small children, has had a course of chemotherapy that has apparently been successful. The cancer, however, returns and is again treated with chemotherapy but this time is less successful. She is offered the treatment for a third time, told that it will most probably only extend her life by some months. She thinks of her husband and her children and she thinks of the quality of her life while she undergoes treatment - and decides, quite rationally, to reject the treatment.

The alternative to evidence-based practice, as I noted in Part 2, following David Colquhoun, is not "magic" or "baloney", but more evidence-based practice: discovering what works and what does not. However, as the reviewer notes, and as the young wife and mother weighed in the balance for herself, there may be factors beyond or outside or maybe even in conflict with the proper application of evidence-based practice.

For Elyn Saks, evidence-based medication may well have alleviated her terrifying symptoms - she came to terms with the need for life-long medication alongside talk therapy - but what can alleviate the fear that the symptoms will re-occur?  The answer is surprising: rather than medication or talk therapy "friendship can be as powerful as either"; she is, she says of her friends, "both comforted and moved that they'd come at all".

My apologies to those who may have seen an early draft of Part 3 which I posted by error and then cancelled.

[Part 4 follows]

                                                                                                                                       

Evidence-based practice & education (Part 2)

Things that work and things that don't. 

As I reported in the Part 1 of this discussion about evidence-based practice and education, David Colquhoun, Research Professor of Pharmacology at University College London, argues strongly that, in medicine, "things that work and things that don't" is the only distinction that matters. Might the same distinction be applied to Education?

I offer this for you to ponder on, taken from the Executive Summary to Understanding the Brain: Towards a New Learning Science published in 2002, by the Organisation for Economic Co-Operation and Development.

"Education is not an autonomous discipline. Like medicine or architecture it relies on other disciplines for its theoretical foundation. But, unlike architecture or medicine, education is still in a primitive stage of development. It is an art, not a science.

"Consider the following account:

"The distinctive feature of medical education today is the thoroughness with which theoretical and scientific knowledge are fused with what experience teaches in the practical responsibility of taking care of human beings…’ Can the same yet be claimed for teacher-training? Experience of the practical responsibility of teaching young people or adults reveals the over-riding importance of motivation, confidence and a good example of success. With these, learning rarely fails; without them, it rarely succeeds. These, and similar, simple observations drawn from the practical experience of teaching are not as yet underpinned by a secure basis of scientific and theoretical knowledge. The science of learning, a branch of human psychology, is still in its infancy. The theory of learning is pre-scientific –in the sense that it lacks as yet either predictive or explanatory power. We do not understand sufficiently well how children and adults learn to dare to offer an educational or training guarantee. The science of education is in its Linnaean phase, drawing up lists of examples of successful learning, clarifying and sorting effective teaching practices; but it still awaits its Darwin with a powerful explanatory theory of learning."

One sentence strikes especially: "We do not understand sufficiently well how children and adults learn to dare to offer an educational or training guarantee".  In other words, when it comes to Education, we do not know "what works and what does not" in the sense that we quite unable to predict outcomes of applying this or that method or whatever in the classroom - at least, according to the OECD.

Do you not find that shocking? The OECD is saying that when it comes to Education - unlike Medicine - we do not know "what works and what does not".

In a Comment to Part 1, David Colquhoun left a thought that I quite enjoyed. Sometimes, when you don't know, he says, you just have to say there isn't much we can do. "The answer .... is clearly not to resort to magic". As I say, I enjoyed that. The other word he used in his Comment was "baloney".

I - a teacher - became involved in Conductive Education all those years ago because I was searching for a better education for my daughter. At 6 years old, she was "going backwards" at her special school compared with her parents judgement as to what she was then capable of at home. The "explanatory power" of her teachers' assessments became increasingly less satisfactory or compelling. We fundraised and went to Budapest.

[Part 3 follows]

Evidence-based practice & education (Part 1)

How do we know conductive education works? For that matter, how do we know anything, anyone, does in education "works"?

Serendipity this week:
- I was asked (by Andrew Brereton of Snowdrop), in a Comment to a previous posting here, the entirely reasonable question, "Can CE provide any independent evidence that it is effective?"
- Andrew Sutton posted a news item "Complementary Medicine Coup for Island"  first carried in the Isle of Wight County Press of a new partnership between The Shen Clinic, which specialises in acupuncture according to the paper, and The Peto Institute, jointly to set up a new CE Centre on the island and degree-level training.
- The Times carried news of a report to the Department of Health from Professor Michael Pittilo, Vice-Chancellor of the Robert Gordon University, Aberdeen, recommending that therapies such as acupuncture, herbal medicine and traditional Chinese medicine should have statutory regulation run by the Health Professions Council, and that entry for practitioners should normally be through degree-level training.

To say that writer, David Colquhoun, Research Professor of Pharmacology at University College London, is sceptical of Professor Pittilo's report and recommendations is an understatement, as you may judge from the title alone of his article:  "Regulating quack medicine makes me feel sick" and he asks "If alternative remedies are either untested or ineffective, why are we promoting them?  [Actually, David Colquhoun blames The Times sub-editor for this title and sub-title, but it captures the gist of his article well enough].

You should read David Colquhoun's whole article for yourself when you have a moment. For now, I would like to draw your attention to another posting on his blog: "Dilemmas at the heart of alternative medicine", where he writes:

All forms of ineffective treatment, ‘alternative’ or otherwise, pose real dilemmas that are usually neglected. I use here the term ‘alternative medicine’, rather than CAM (complementary and alternative medicine), because things that don’t work are not medicine at all and can’t be ‘complementary’ to anything.

The only distinction that matters is the distinction between things that work and things that don’t work.

Things that work and things that don't work. In the medical world, of course. Because that is the world David Colquhoun is talking about. It's not quite as simple as that of course, not "work or not work", not black-and-white. Even in the medical world, it's about probabilities: this treatment, this therapy, this surgery has a likely effectiveness in most cases of so-and-so per cent. (When my daughter had her osteotomy first on one hip and then on the other, the first was 100% successful, restoring full mobility; the second was a 0% successful. Should she not have had the second operation? Should she not have had the first? In both cases, the condition being treated by surgery was much the same and the predicted outcome of 'the procedure' would have been about the same.)

Nonetheless. Things that work and things that don't.  If, for the moment, we agree with David Colquhoun, it is the only distinction that matters. Might the same distinction be applied to "Education"?

(Part 2 follows.)

 

 

Conductive Education Knols

A Knol is a unit of knowledge, according to the good people at Google, who dreamed it up. A Knol is also an authoritative article about a specific topic.

A moment ago, a search on Google's Knol homepage generated two Knols about conductive education.

1. "Conductive Education. History, Definition and Basic Concepts" by Rony Schenker, Professional Director, Head of Conductive Education Studies, Tsad Kadima, The Association for Conductive Education in Israel.

2. "Conductive Education. Theoretical Background" by Gabor Fellner, Headteacher, Paces School, Sheffield, UK.

Each Knol offers the opportunity to award a star-rating, leave a comment, a write a review.

Things that pop up while Googling

I was actually checking on the weather forecast. I noticed that the Google Blog Search tool hadn't up-dated itself and set off poking about to find out why.

Which explains how I came across this charity commission adjudication into the affairs of the Cerebral Palsy Children's Charity, apparently posted on 28 July 2008, but looks dated. (There's a posting on the Charity Commission website too but undated). This led me to "brainpalsy.com" which appears to be a blog but lacks any kind of identification of the author, other than perhaps a picture of her.  Maybe I'm missing something? What's it all about?

From there, I noticed an ad at the top of the page for "Snowdrop" - based in Cullompton, Devon (just up the road, as it were, from where my Dad was born), offering "Neuro-cognitive therapy for cerebral palsy, autism and other developmental problems". Snowdrop's home page states that it's a "private consultancy in child development which provides treatment for cerebral palsy and children who suffer other development difficulties". Aside from the use of the word "suffer" which I shall always object to seeing used in such contexts and the unresolved intellectual muddle between "therapy" and "learning" evidenced in these pages, I also noted the references to and reliance on the theoretical undertandings of Vygotsky to underpin the author's consultancy in neuro-cognitive therapy for cerebral palsy. Maybe I'm just betraying a vast hole in my own knowledge? What's all this about then?

Then I came across The Partridge Trust. Apparently a grant-giving organisation in Andover, Hampshire, helping children access conductive education. However, its "Events" and "News' pages seem to relate only to 2001 and 2002.  I pondered on the Cerebral Palsy Children's Charity calling itself The Yorkshire Conductive Education Centre and under that name, children attending getting funding from The Partridge Trust. Is all this just the detritus of the history of conductive education in the UK? Is Snowdrop and the rest part of a wider attempt to break the education of children with cerebral palsy free from the strangehold of health, therapy and rehabilitation?

For now, I shall dig a little deeper.

Accessible vehicle needed in Perth Australia

Here's a challenge. If we could solve this then the value of the internet and the case for a world-wide community of conductive education is proven.

Lightnur is the mother of 5 children, one of a whom, a daughter has cerebral palsy, who lives in Perth, where she accesses conductive education. She needs to replace her wheelchair-accessible vehicle. Lightnur is also a Moslem, so just popping down to the local high street bank and getting a loan is not possible, the payment of interestin Islam being forbidden.

Can we help with two questions:
1. Where in Perth might she look for such a vehicle (I think may be not a new one)?
2. Is there a bank in Perth - or anywhere in Australia - that can arrange Islam-compliant finance? I have read in the UK of an Islamic mortgage for a house (I think this is called an Ijara Mortgage: you find a property you wish to buy, and agree a purchase price with the vendor. The difference is that your lender - the bank, for instance, will then purchase, and gain ownership of the property. You enter into a lease agreement with the lender for an agreed term, at the end of which the house passes to you.) Is there anything similar for buying a car.

Who knows? Do you?

Lightnur is a blogger featured on The Conductive Web. You can read her own account of her tribulations - and contact her directly if you wish.

What was it that touched me? Having expressed her wish that someone offer her a loan with zero percent interest, Lightnur writes of and to herself : "Get real Lightnur! I can imagine people laughing at my silly thought. I am so serious." I too know that "Get real, Parent" moment. Every parent in the conductive world has such a moment, at some time or other. That was all.

Blogging for Conductive Education

Two stories. Two extreme worlds.

Andrew Sutton posts from Hong Kong his "Chinese Puzzle": "What is happenning out here is BIG, bigger than anyone in Conductive Education has ever experienced, and it will begin to effect EVERYBODY in Conductive Education over the next couple of years or so."

Meanwhile, from Vancouver, Canada, James Forliti posts "Think I oughta say something" - but seems barely able to find the words to do so, faced with "a system that is locked closed, taking advantage of their "king of the hill" position to even give CE a mumbling chance at the table."

What, for me, unites these two worlds, these two stories, is that I know so little about the deep circumstances of each. How can we learn more?

The sub-title to Dan Tapscott's book "Wikinomics" is "How mass collaboration changes everything." But you don't need to buy in to the whole Tapscott Web 2.0 world to know that blogs (one of the key collaboration tools)  more easily convey the continuing, changing, evolving richness of conductive education stories around the world than the static, one-way, read only traditional web-sites. So we learned of Buddy Bear's travails and the struggles of Xavier - initially from Andrew's blog.  I have no idea whether my letters to the Northern Ireland Assembly and Education Queensland can have had any possible effect.  It amuses me to imagine the reaction of the person who opened the letters, wondering how on earth their little local difficulty attracted a letter from someone in Sheffield UK. 

Imagine if that same person had received 10 letters, 100 letters, from all over the globe. Imagine if these letters had directed the recipient to best practice in your centre, your school, local authority, town or city - in partnership working, training, consulting parents, engaging professionals, working with conductors, research ....

A start on collaboration is to set up your own blog. What's happening where you are? Tell the conductive education world. What help do you need? Ask the conductive education world. Who are you trying to persuade? Involve the conductive education world on your side.

And, James, please post on your blog the online link to the Province newspaper article on August 3rd - and maybe we can surprise the Editor with contributions to the Letters page.

 

Xavier Response

On 24th June, I posted ("Xavier Support") a copy of a letter which I sent to Jenny Haddrell, Assistant Director-General, Education Queensland, about the future of the Xavier Special Education Unit.

I have received the following response. (Is there someone who might update the Xavier weblog with the latest news?).

Dear Mr Perrin

Thank you for your letter dated 23 June 2008 regarding recent OECD research, conductive education and the work of Queensland's Xavier Special Education Program.

I am pleased that the worthwhile work of the teachers and specialist staff at Xavier Special Education Program is internationally recognised. I have forwarded your letter to my colleagues Mr lan Hawke, Assistant Director-General, Strategic Policy and Performance and Mrs Clare Gardiner-Barnes, Acting Assistant Director-General, Student Services for their consideration. The Strategic Policy and Performance Division oversee the department's research program while the Student Services Division oversee funding and support strategies for students with disabilities.

The Queensland Department of Education, Training and the Arts has an active program of research which informs evidence-based decision making in policy and program development. I would encourage you to examine the department's research website as it provides information on the department's research and development priorities, research application process and summaries of recent educational related research.

If you have some preliminary ideas or a more developed research proposal I would encourage you to contact one of the above officers. In the first instance, I believe that Mrs Gardiner-Barnes may be the most appropriate contact. She can be contacted on telephone (617) 3235 4172 or by email clare.qardinerbarnesädeta.gld.gov.au

Once again thank you for your interest in Queensland education and the Xavier Special Education Program.

Jenny Haddrell
Assistant Director-General

21 today! On being the parent of an adult with care needs.

The essence of 'care' is the relationship between the person cared for and the carer.

The terms need to be used with a strong note of caution. Today, 'care-giving' carries with it a history that is suffused with notions of dependency and "otherness". Where the recipient is also disabled, that notion is reinforced with cultural views of the meaning of disability. The prevalence of the notions of dependency and "otherness" is simply illustrated by the carer who, when challenged that she had arrived early to help our perfectly healthy 25-year old daughter to bed: "Would you like to be put to bed at 8.00pm?", replied "No. But I'm not disabled". In the context of public services founded in an ethos of paternalism such a response is unsurprising. Increasingly, however, such notions are unsupportable and the delivery of public services must change, partly in response to service users demands for control and individuality of service, partly led by national policy-decisions based, for instance, on human rights agendas, which all three major parties largely espouse. New understandings of "care", new delivery of "care" needs all involved to throughly understand the primacy of the individual's right to independence and control.

Care is a personal matter. It is not a function. The 'care plan' sets out the tasks that the carers need to undertake. It is a mechanistic document setting out tasks. It is functional. "Care", properly understood, is more than the care plan. True "Care", I suggest, exists in the relationship between the givers and receivers.

It follows that it is possible to rigorously complete all the tasks on the care plan without "care".

Yesterday evening, in the 19 days since our daughter's care was reinstated, she has had 21 different carers. Leave aside that she was promised a team of 8. Leave aside that, by simple arithmetic, it could have been even worse; that in 19 days, with two visits each day by two carers, she might have had 76 different carers (less the two nights she was in respite, giving a maximum of 68).

The fact of the matter is that 21 different carers in 19 days simply cannot engage in the personal relationship which is the essence of "care". Whatever it is they are doing, however we describe what they are doing, the word we are looking for is not "care". Whatever the 'care company' thinks it is doing, whatever it's managers are managing, it is not "care".

So, revising the question above that we asked of the carer and addressing it to all the care company managers and social service delivery managers and local council contracts managers and Quality assurance managers: "Would you like 21 different people in 19 days, dressing and undressing you; washing you and attending to your personal hygiene?" And when you think of your answer to that, do not dare even to think of answering, "No. But I'm not disabled."

And lest we forget the parents in this, whose home this is, let's ask them too: "Would you like 21 different strangers in 19 days trampled through your home, morning and evening, every day?"

---------------------

In supposing that "care" is more than the functional completion of tasks, I am reminded of postings by Andrew Sutton about "love" and by Susie Mallett about "der seele" (the 'soul') in conductive education. On this occasion, my apologies for not hunting down links to their specific postings.

Still "No Voice"

It seems that Sheffield parents were a little premature in detecting a change of heart in respect of consultation, which I reported a couple of days ago.  Claire sends the following update, which I copy in full.  There is obviously considerable turmoil, but the strong sense that parents have that they are not being properly consulted clearly does not reflect well on the SEN Team. It does not take great wisdom to see that it would be a sensible course to address these consultation concerns and the concerns that parents have that significant changes are being implemented without consultation.  A contributory root cause of the current turmoil is that Sheffield does not have a Strategic Plan for the education of children with special needs. As a Strategic Plan is simply a document that sets out an agreed course of action (What? Why? When? How?) which all stakeholders can share and understand, then it might, (a) not unreasonably, be said that the SEN Team cannot know what it is doing in any planned way and (b) that it is not surprising that other stakeholders are concerned and confused. 

This lack of strategic planning compares poorly with that of the Adults with Learning Disabilities Team, whose consultation during the latter part of 2007 and into 2008, whilst not perfect, was a model that the SEN Team might consider.

It is also unfortunate that this turmoil - and apparent disregard of parents as key strategic stakeholders and partners - should be happening in the inter-regnum between the departure of former Director of Children and Young People services, Jonathan Crossley-Holland and the arrival of the new Director, Sonia Sharp.

Anyway, this is the email from Claire:



UPDATE ON “NO VOICE” CAMPAIGN

 

Thank you to all of you who have supported the “no voice” campaign. The campaign’s focus continues to be insisting on the right of parents/carers to be consulted about changes to special educational needs provision in Sheffield.

 

Unfortunately, the information we conveyed to you in our last email has since proved to be wide of the mark. The CYPD (Children and Young People’s Directorate) are not going to start consultations on the changes to the SEN/LDD service from scratch.  As far as we can understand, they are only going to consult on the fate of the integrated units. This means that they are standing by all the changes that have already been made, (ie delegation of sen budgets to mainstream, absorption of the autism specific service into a generic LDD service, management restructure etc).  We apologise for this misinformation but it is an indication of the difficulties we face in trying to obtain any information whatsoever.

 

In spite of promising the protesters last week, Ms Ludlam, (Director of Specialist Services at Council’s Children Service), has not contacted parent groups to talk.  In view of the lack of communication we have today written to CYPD, asking them to confirm/explain simple factual information relating to the action that the LA has already taken. (Copy of questions asked at bottom of this email).  The questions do not relate principally to future proposals for change, nor do they encompass parent’s concerns about specific changes.  This is because the CYPD has yet to acknowledge that there has, to date, been a need to consult parents.  So, it is necessary for us first to establish exactly what has happened to date.

 

 

HOW YOU CAN HELP

 

We have been overwhelmed by the number of parents, (representing children with autism and other disabilities), who have wanted to support the “No Voice” Campaign.  Below are suggestions for ways you can help:-

1  Write to you MP and your Councillors

If you wish to support the No Voice campaign please write to/attend the surgeries of your MP/Councillors explaining that parents have not been consulted about changes to SEN that have already taken place.  Forward to them a copy of the questions we have asked the CYPD, which are shown at the end of this email.  Ask them to ask the CYPD the same questions. ( Nb we have addressed the questions to Ms Ludlam at jayne.ludlam@sheffield.gov.uk )

 

2  Come to the “Autism Alliance” meeting

We would like to use the support we have received for the No Voice campaign, both from the “autism community” and from parents/carers of children with other disabilities, to establish a permanent campaigning voice.

 

We do not wish, ever again, to find ourselves in this dreadful situation where we are having to fight to hang on to a less than perfect service because the proposed service is much worse.  As parents we wish to be involved, in partnership with the schools, teachers and Local Authority, in “building” services that our children “need” and deserve.  We are, therefore, proposing that we set up the “Autism Alliance” as a permanent campaigning body. Whilst the Alliance’s first task will be to continue with the No Voice campaign, it is our intention that it would ultimately be the campaigning organisation for all issues affecting children and adults with autism in Sheffield.

 

Whilst this body will principally concern itself with issues relating to autism, we are hopeful that parents of children with other disabilities will come to our meetings and either support what we are doing, or consider organising similar bodies with the ultimate goal of creating a “multi-disability” campaigning group.  So, please come to our setting up meeting even if your child does not have autism.

 

We will be holding an open meeting between 7 and 9 pm, on Tuesday 15 July 2008, at the Salvation Army in Psalter Lane to set up the Autism Alliance.  We will write to you again before then with details of some of the issues we will want to address at the meeting.  Please put the date in your diaries.

 

3  Write to the Press

The “Star” published a letter (26.06.08) and a report of the protest (27.06.08) on the “No Voice” campaign.  Further letters in support of the campaign would ensure that more parents get to hear what is happening.

 

4  Petition

A number of people have asked to sign a petition in support of Parents’ rights to be consulted over changes to SEN.  We will shortly be setting up an Autism Alliance website, and will post a petition on-line. Hard copies of the Petition will also be available through the Sheffield Autistic Society newsletter, at local autism meetings, at the Aspergers Conference on 30 June, downloading from the website once it is up and running.

 

+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

 

Thanks again to everyone who has supported the No Voice Campaign

 

Please keep in touch.  Let us know about any progress with MPs etc

 

Claire le Feuvre

Phil Cooney

 

 

COPY OF CYPD QUESTIONS TO USE WHEN CAMPAIGNING

 

A  “Learning Difficulties and Disabilities (LDD) Development Paper” – Agenda item 3, 6 June 2007, Council papers

1  Is the above paper the policy document for special education needs in Sheffield?

2  If it is not, please could you tell us what is the policy document.

3  Please can you tell us whether the current policy document has been distributed for consultation to the following:-

(a)  Parent/carers (individual)

(b)  Parent/carer groups

(c)  Mainstream schools

(d)  Special schools

(e)  Integrated Resources

 

  4 In the “LDD Development Paper” you write “ ..all other developments (ie development of city-wide outreach programme/review of integrated resource provision/development of role of special schools/review of SEN transport policy), rely on the need to substantially reduce the link between Statements and funding.”  Since you believe all the policy changes are dependent on each other it would seem that you should have consulted on the proposed policy changes as a whole.  Yet, you seem to be adopting a phased consultation/implementation approach. For instance, you have consulted on the new internal management structure, but not on service delivery. Given this, how do believe it is possible to consult in any meaningful way, since any single change to an individual proposal could render the overall Plan unworkable?

 

5   In one letter about the proposal to re-structure the LDD Services you wrote “The first stage of the process is to create the management structure within LDD Services to enable work to begin on shaping frontline service delivery …”  It is our understanding that management structures should reflect effective service delivery, not precede it, and that planning is a“bottom up” (ie based on the needs of individual children) not a “top down” process.  Please explain why you have not done this?

 

B  Other consultation documents

1  Have any consultation documents relating to the policy document above been distributed?

2  If so, (a) which documents?

(b) To whom have they been distributed?

(c) Please indicate when they were distributed, the closing date for consultation and the outcome of consultation, including which groups have  access to minutes of consultation meetings.

3  We understand that Sheffield Council is to ratify some/all aspects of the LDD changes at their September meeting.  Can you tell us what exactly they are ratifying and can you confirm that none of the action  they are ratifying has already taken place.  For instance, job adverts for posts in the new management structure appeared in the Star this month.

 

C  Delegated funding and Statements

1  Have you delegated SEN funding to mainstream schools?

2  On which date did you do so?

3  What is the formula for the delegation of funds? Please include references to Paper B, “Proposals for Changing SEN Funding linked to Statements”, Sheffield Schools Forum, 19 February 2008, where it appears that delegated budgets will be assessed solely on the index of multiple deprivation, free school meals, mobility and various academic attainment tests.

4  Please explain how delegated funds relate to existing Statements.  Specifically, do Schools continue to receive monies to support individual, named children with Statements?

5  Are Statements still being written for children with special needs.

6  Are school or LA staff advising some parents that they no longer need a Statement?

 

D  The Autism Service

1  Does the autism specific service still exist.  (We understand that there was an early years service, based at Ryegate, and a schools’ service).

 

2  Is the LDD support service now a generic service?

2  If a teacher in mainstream wants advice/support about an autistic child can you assure us that an autism specialist will be available?

 

E  Integrated Resources/Special Schools

1  Please can you indicate where the policy statement is for Integrated Resources and Special Schools?

2  Have you consulted on this?  If so, with whom?

3  What is the timetable for consultation and implementation for proposals affecting Integrated Resources and Special Schools?