After reading this piece in @schoolsweek.bsky.social by @bennewmark.bsky.social, I'm hurtling towards the conclusion that schools should be legally exempt from following interventions listed in an EHCP if they are not backed by high-quality evidence. Any takers? schoolsweek.co.uk/send-provisi... - ThreadSky

tom-richmond.com • 2 days ago

After reading this piece in @schoolsweek.bsky.social by @bennewmark.bsky.social, I'm hurtling towards the conclusion that schools should be legally exempt from following interventions listed in an EHCP if they are not backed by high-quality evidence.

Any takers?

https://schoolsweek.co.uk/send-provision-is-the-last-bastion-of-unevidenced-practice/

Comments

edfinch.bsky.social•1 day ago

📌

running2staysane.bsky.social•2 days ago

Have you sent time in a complex needs dchool where some of these practices such as zones of regulation are embedded & seen how well they can work to help children & up to regulate & therefore learn. Regulation before expectation. As a parent with a child with massively complex sensory profile who

running2staysane.bsky.social•2 days ago

Has been totally overwhelmed in a mainstream setting, partly because school failed to provide basic sensory support & regulation. The idea of school being given free choice over what to implement, awful idea. Many don't follow & implement EHCPs anyway & there is zero redress for parents. Agree SEND

running2staysane.bsky.social•2 days ago

Provision is woeful & we are failing lots but taking away legal protections will not improve that.Having enough funding, resources, specialist settings & schools working together, sharing knowledge & often listening to parents wd help. Ehcps are increasingly wooly, vague, non specific anyway, quite

running2staysane.bsky.social•2 days ago

Deliberately to save money. Until the county council providing supports are not also looking at their budget instead of what children actually need it won't ever work. At the moment it's a game of how can we spend less, who cares about the fall out. Go spend some time working with a good sensory OT.

alihon.bsky.social•1 day ago

I would not want to put words into @bennewmark.bsky.social 's mouth, but I think his response might be to ask why every educational setting can't be calm enough to allow any student to thrive there. I could be wrong in my interpretation of course! I do fully appreciate your experience on this Sarah.

running2staysane.bsky.social•1 day ago

Also where is the evidence base that classes of 30, lessons of 2 hrs etc long are what works best? I get there is a need uniformity & control purely to manage numbers & cram in curriculum but I don't think it's working for a lot of kids.

running2staysane.bsky.social•1 day ago

I don't think they can be with the numbers in mainstream classes & the needs some pupils have. Many children have very complex sensory needs, they simply can't cope being in a space with that many people. My own child's school building has high victorian ceilings, the physical structure of the

nancygedge.bsky.social•1 day ago

I don’t agree with Ben’s analysis here. There is not enough taken into account if the work done by @marcrowland73.bsky.social and the MITA team.

isabellefk.bsky.social•1 day ago

That’s an interesting framing! I would prob go entirely the other way on this, and proactively 😉 make this 👇 type of low- or no-cost adaptation available to all, thereby building a robust in-house evidence base, eg for primary/secondary transition or EHCNA

https://autisticgirlsnetwork.org/reasonable-adjustments-possible-at-school/

isabellefk.bsky.social•1 day ago

Before we dismantle legal protection for #SEND children 😅😅 can I just suggest that wobble cushions, fidget spinners etc aren’t magic? If your school finds that they’re not ‘working’, it might be worth going beyond what’s on the EHCP - or tell the LA/MAT you can’t meet needs without more resource?

tom-richmond.com•1 day ago

Hi Isabelle. Surely the question is why are fidget spinners in an EHCP in the first place?

And saying schools should just 'go beyond' what is in the EHCP does not solve the problem of unevidenced practice being proposed by professionals in this sector (which Schools Week rightly highlighted).

isabellefk.bsky.social•1 day ago

Hi Tom. If a child has had an OT assessment, the OT’s recommendations for sensory support should be included in one or more sections of the EHCP. Fidget tools, movement breaks, opportunities to stand rather than sit, access to quiet spaces etc may be specified, according to need. Without this …

isabellefk.bsky.social•1 day ago

… the child may not (for instance) be able to establish and maintain focus on their learning or other tasks - particularly when the task is uninteresting or otherwise hard to access.

isabellefk.bsky.social•1 day ago

The ‘go beyond’ to which I made reference was intended to indicate a sincere, ongoing, sensitive attempt by staff to understand the child holistically and work to their strengths.

batshitcrazy.bsky.social•9 hours ago

Playing devils advocate here for a mo, why are those things even in a EHCP? They should be reasonable adjustments made available on a universal basis for any child who needs them. There are numerous children with sensory differences who benefit from this approach with having a diagnosis of anything.

tom-richmond.com•2 days ago

On top of that, this excellent article by @johndickenssw.bsky.social shows how we could get to a much better place on SEND interventions - potentially with the EEF as the focal point of a new approach to figuring out what is genuinely worth investing in (or not).

https://schoolsweek.co.uk/feature-the-case-for-a-send-evidence-custodian/

risu.bsky.social•1 day ago

Why do we do anything but discuss that schools in their current form are like prisons, follow an outdated Victorian model of workhouses and need to change. It is wild to me that we can look at modern workplaces, with accommodations, and say nah, school should stay in 1832.

sp1ngirl.bsky.social•1 day ago

Interesting, but 'evidence' is contested term. 1) Absence of evidence does not mean ineffective, more likely no research done. 2) Depends what counts as evidence: ethical/practical diff with 'gold standard' double blind randomised in SEND. 3) CYP with SEND all different, so provision individualised.

sp1ngirl.bsky.social•1 day ago

Evidence and QA are important, but complex. What works for one child may not for another due to individual needs. OTOH, research on 'what works' generally may lead to better 'intervention' choices. Agree CYP have no time to lose on 'intervention' that does not work for them, regardless of evidence.

tom-richmond.com•1 day ago

I agree 'evidence' needs unpacking, but we know what constitutes better quality studies even if they are short of 'gold standard'.

If no good research studies support an intervention then by all means fund more research, but why require schools to keep delivering that intervention in the meantime?

isabellefk.bsky.social•11 hours ago

From a research perspective (I have a master’s in soc res in ed, & mainstream & specialist classroom & parent/carer experience btw), ‘gold standard’ is not itself an ‘evidence-based’ label 😅 Provision is needs-based. Section F follows sec B. If school feels EHCNA didn’t adequately gauge need …

isabellefk.bsky.social•11 hours ago

… they should support parent/carer to improve provision, eg by helping p/c to seek a review (emergency or annual). IME, the element often missing from an EHCP is a sensory needs assessment. If the child is distressed, ‘interventions’ in an otherwise overwhelming sensory/social environment will …

isabellefk.bsky.social•11 hours ago

… prob add to everyone’s stress, incl for staff. So I can understand why staff might feel an ‘intervention’ 🙄 isn’t effective, but the answer isn’t to remove the child’s legal rights. It’s a complex & dynamic situation, with the child carrying most of the risk.

sp1ngirl.bsky.social•1 day ago

My point is that strength of research evidence is not the only indicator of what works for an individual. One could, for example, collect data on an individual level of response to an intervention, to provide evidence that it is effective for that person.

sp1ngirl.bsky.social•1 day ago

I'm sceptical of stopping delivery of interventions just on the basis of insufficient research evidence. It risks binning SEND support that works just because research base has gaps. Am not against more evidence and fidelity in delivery, think it is needed, just questioning how best to achieve it.

rlrossi64.bsky.social•21 hours ago

I think we need to think about provision linked very closely to outcomes; the Annual Review process should be much more co-produced than they generally are currently with child, families and professionals all contributing and this process will then provide evidence of what is “working” (or not)… /1

rlrossi64.bsky.social•21 hours ago

/2 and what needs to happen next. My experience is that it’s really difficult to get professionals (ie the Ed Psych who contributed to EHCNA/health/social care) to participate in the Annual Review process so meaningful conversations about effectiveness of provision in Section F from year to ….

rlrossi64.bsky.social•21 hours ago

/3 don’t happen. It’s essential that provision in SF is regularly evaluated against outcomes and adjusted where needed. Also, more scrutiny needed around provision in Section F and questions asked as to why *some* strategies/interventions are not being delivered at school support level. …

stevebroach.bsky.social•1 day ago

If the objective were to create work for lawyers, this would be an excellent idea.
The real problem here must be that interventions lacking in evidence should never be in section F of an EHCP as they are not reasonably required

sp1ngirl.bsky.social•1 day ago

Evidence is a contested term though? If it is to mean anything in SEND, think should be based on what support meets an individual child's needs and results in them making progress? Think not necessarily same as limiting to 'interventions' having positive results in research trials, for example.

thewoodbug.bsky.social•1 day ago

Gosh - so much to unpack here. The article is full of sweeping statements and generalisations, but not backed by evidence. Some assertions are simply not true. My own view is that the intervention culture is deeply problematic, but arguing to remove legal protections is a different matter entirely.

tom-richmond.com•1 day ago

Hi Becky. I'm interested in your use of the phrase 'remove legal protections'.

If a child's EHCP contains unevidenced interventions that could do more harm than good, is that 'protection' really saving? Shouldn't we be actively protecting children from bad practice and pseudoscience?

thewoodbug.bsky.social•1 day ago

Isn’t that what you were suggesting? It’s a false argument anyway - there may be legal battles to get EHCPs but v rarely to enforce them. There’s a real confusion about the idea of ‘what works’. Working how? To what end? Bad practice and pseudoscience? Says who? Where is the evidence?

bobbymurray232.bsky.social•11 hours ago

This a great discussion and one that is full of nuanced implications around judging efficacy… I wish our SEND provision nationally was in a position to have this unfortunately getting the EHCP process working effectively first is going to be a huge challenge

kmcatamney.bsky.social•1 day ago

That's what the annual review process is for (in a properly functioning system) - teachers report that the additional support they are providing doesn't seem to be helping and make suggestions to remove that provision and replace it with something they expect to work better.

kmcatamney.bsky.social•1 day ago

I've seen this work - particularly where a child has made progress and everybody agrees they no longer need x or y. The problems are nearly all to do with LAs being slow at dealing with Annual Review paperwork.

kmcatamney.bsky.social•1 day ago

Other than that this looks strange - provision doesn't get put into EHCPs without evidence that either an LA has accepted or a Tribunal, with the benefit of a quasi adversarial system (ie. evidence can be tested through cross examination), has accepted.

kmcatamney.bsky.social•1 day ago

Teachers aren't EPs/SALTs/OTs etc and don't have the expertise to say 'x support is rubbish' in general terms. If teachers are eg. thinking an OT provision isn't working for a child there's probably a lack of OT oversight for that strategy and what's often missing from the EHCP is time for the OT

phonicsforsen.bsky.social•7 hours ago

Are we finally going to talk about this? I hope so!

Yes - many issues raised around what 'evidence-led' constitutes and evaluating the effectiveness of interventions - there are practices that may prove not to be effective - there a differences in 'interpretation' of what is written on EHCPs

phonicsforsen.bsky.social•7 hours ago

Surely it's time to start some hard thinking and engage in debate to navigate through this.

Thanks, Ben.

susanebbels.bsky.social•11 hours ago

One issue though is that it is very hard to get research studies of specialist interventions funded. This is particularly the case for those which are on the boundary of health & education (such as occupational or speech & language therapy).

joolzie.bsky.social•8 hours ago

Applied behaviour analysis had lots evidence but ignored as perceived as more expensive.My son (ASC/LD) had all the interventions described and apart from regular breaks they were all useless & I’d include NHS and OT in that. If NHS/LA joint funded ABA in early years the outcomes would change.

susanebbels.bsky.social•11 hours ago

Funders of health research see interventions that are carried out in schools where the main focus is on educational outcomes as outside their remit.

susanebbels.bsky.social•11 hours ago

Funders of education research don't appear to be interested in funding research focused on specialist interventions that are carried out by "health professionals" (such as OTs and SLTs) even if delivered in schools because they are not viewed as scalable.

susanebbels.bsky.social•10 hours ago

So, a major reason for lack of evidence for many interventions listed in EHCPs is a lack of funding for research investigating their effectiveness.

Research funding into specialist interventions needs to be available first, otherwise you will be throwing the baby out with the bathwater.

susanebbels.bsky.social•10 hours ago

I agree that we should not be providing interventions that have been shown not to work. But interventions may have "no evidence" because the studies have not been funded.

susanebbels.bsky.social•10 hours ago

In the meantime, while we wait for studies to be funded & carried out, the priority should be establishing whether each intervention is working for each individual child. If not, then the intervention or the delivery of that intervention should change.

moderncassie.bsky.social•10 hours ago

This is what I talked about in the 2nd article in this series. Schools are told which interventions to complete (usually by support staff) by SALT’s, and often they have no robust research or evidence base.

sp1ngirl.bsky.social•10 hours ago

SaLT assesses provision to meet need based on prof exp of 'what works'. Monitoring of delivery/progress reveals if effective. This is evidence & QA.

Research evidence not a guarantee will work for every child: complex.

Tldr: research evidence not the only source of evidence/QA. Susan explains why.

susanebbels.bsky.social•10 hours ago

Doesn't mean they don't work though (although that may be the case), often just means robust research studies haven't been done (maybe because they haven't been funded).

moderncassie.bsky.social•10 hours ago

No. It doesn’t mean they don’t work.

susanebbels.bsky.social•10 hours ago

Agree, some interventions have evidence of effectiveness when delivered by a particular type of professional at a particular frequency, but there is no guarantee that when delivered by a different person with different skills and knowledge & at a different frequency that it will still work

susanebbels.bsky.social•10 hours ago

Can you post a link to that article?

moderncassie.bsky.social•10 hours ago

https://schoolsweek.co.uk/fidget-spinners-and-learning-styles-ehcps-questionable-interventions/

alihon.bsky.social•1 day ago

Immediate follow!

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