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Describe the assessment and intervention frameworks for disabled children and young people and those

These changes are regarded as the most significant in two decades, with consequent implications for service provision. In this paper, we suggest that there is a gap between the theoretical approach to disability portrayed in the new policy and many of the practical changes consequently introduced. To examine this mismatch, a sequence of arguments is presented, as a critical analysis of the approach introduced by the new policy, in light of a framework recognized worldwide for conceiving and classifying disability — the International Classification of Functioning, Disability and Health for Children and Youth ICF-CY.

Although the ICF-CY is not mentioned in the new policy for special educational needs and disability, possible links between the two are presented, with implications for service provision. Introduction A considerable shift has recently been observed in the policy regulating the provision of special educational needs and disabilities SEND services for children and young people in England. In theory, this is a substantial change, as it entails a considerable move toward a new conceptualization of SEND, with implications for professional practice and service provision for vulnerable children and young people.

However, despite this philosophical shift, the new policy documents describe the assessment and intervention frameworks for disabled children and young people and those SEND provision in England — the Children and Families Act 2014 Part 3 Department for Education, 2014a and the Special Educational Needs and Disability Code of Practice 2014 Department for Education, 2014b — do not explicitly present a theoretical model underpinning its innovative approach.

Moreover, specific and practical guidelines for the regulation of professional practice regarding the implementation of the proposed changes have not been as yet sufficiently provided — for example, more systematic guidelines for the development of high quality Education Health and Care plans EHC plans are needed.

Therefore, in this paper, we suggest that there is a gap between the theoretical approach to SEND in the new policy and some of its implications for service provision. To support this argument, we offer a critical analysis of the new approach introduced by the Children and Families Act 2014 and the new SEND Code of Practice, which leads to recommendations for the implementation of the EHC assessment and planning process purported by law in England.

This analysis is based on the argument that the new approach to SEND provision is, in some respects, theoretically aligned with biopsychosocial and bioecological models of development and disability, which also form the basis for the development of the International Classification of Functioning, Disability and Health for Children and Youth ICF-CY WHO, 2007.

In the second part of this paper, we introduce the ICF-CY classification system in more detail and provide systematic suggestions as to how the ICF-CY can be applied to support the development and monitoring of EHC plans, as required by law.

This paper does not aim to provide a critical analysis of the Children and Families Act 2014 Part 3 as a whole, but focuses specifically on the lack of congruence observed between the principles introduced by it and the lack of an evidence-based framework to actually implement them. The changes introduced by the new policy imply the action of an integrated system, articulating education, health, and social care services.

However, this contradicts other aspects of the discourse presented in the policy documents themselves, namely, a discourse that is vague in relation to the definition of SEND; in fact, according to Norwich 2014 p.

In fact, according to Norwich 2014 p. The ICF-CY model provides the third way of looking at special needs which is similar to the approach proposed by Kristiansen et al.

This third approach provides a viewpoint between the medical model and the social model of disability, as it considers that the source of disability is the complexity of individual and social factors interacting to result in a unique individual functioning profile Simeonsson, 2006.

From this point of view, the cause of the SEND describe the assessment and intervention frameworks for disabled children and young people and those not the impairment in individual bodily functions per se, or the limitations that the society imposes on individual functioning as advocated by the social modelbut it is the dynamic conjugation of all these factors WHO, 2007.

For this reason, instead of providing a taxonomy for diagnosis, the ICF-CY classification system provides a thorough list of aspects of functioning covering all life dimensions. These functioning dimensions are organized into three main components: As illustrated in Figure 1the ICF-CY model proposes that within a specific health condition which may or may not be a diagnosis, and should therefore be regarded as health status there are aspects related to body functions, the activities in which we participate and the environments in which we are embedded, which influence our functioning profile at one particular moment in time.

Many of the changes have been gradually implemented since 2010, with the beginning of the coalition government, and in 2011 with the publication of the SEND Green Paper Department for Education, 2011. The argument that the ICF-CY model and classification system can facilitate the implementation of the new policy guidelines will be presented with a particular focus on the changes mentioned earlier.

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According to the Children and Families Act and the new SEND Code of Practice 2014, a child or young person has SEND if a learning difficulty is present that calls for special education provision services to be put in place to support their learning and participation. The criteria for deciding whether this is the case are twofold: The Equality Act 2010 is still considered the policy document that defines the range of disability types that, according to the SEND Code of Practice 2014, professionals need to be aware of.

Professionals must be aware of these types of disability, have enhanced knowledge or specialist knowledge about these types of disability, depending on whether they only interact occasionally with children with SEND, they need to adapt teaching strategies for these children, or they are advising and supporting those with enhanced knowledge, such as the Special Educational Needs coordinators SENCOs Cheminais, 2014.

These types of disability specified in the Equality Act 2010 are sensory impairments, physical impairments, developmental conditions, progressive diseases, mental health conditions and mental diseases, HIV, and cancer Cheminais, 2014.

The SEND Code of Practice also highlights that teachers are responsible and accountable for the progress of the pupils in their class, even when there is support and specialist staffing allocated to work with children describe the assessment and intervention frameworks for disabled children and young people and those SEND.

This accountability implies good knowledge of the range of disabilities that can be most frequently observed, and knowing the best strategies to support children with these types of SEND so as to remove barriers to learning Department for Education, 2014c. However, we argue that the terminology associated with the types of SEN that teachers should be aware of, considering the SEND Code of Practice and the Equality Act, contradicts the holistic and integrative model proposed as a whole in the Children and Families Act.

This argument will be further discussed in this paper. Although the idea of multi-agency working for the provision of integrated services is regarded as invaluable Hodkinson and Vickerman, 2009 ; Elliott-Johns et al. We suggest that these guidelines could be put into practice more systematically if an evidence-based system was implemented as a framework for the changes suggested, such as the ICF-CY. Recent research has also provided interesting data on factors affecting the sense of well-being of children with SEND, according to their own views.

In fact, the very definition of SEND previously presented does not include all the dimensions of life that were mentioned by children themselves as essential for a sense of inclusion, since it overemphasizes the importance of learning and school performance. These include more than learning and applying knowledge, such as the relationships established with others, and internal factors, such as coping and resilience, as well as environmental factors that can facilitate or restrict participation.

Consideration of the multidimensional aspect of inclusion would have been useful in implementing the holistic approach that the new policy attempts to introduce by integrating different services education, health, and social care. From the ICF-CY point of view, children with SEND are those whose full participation is restricted, whether because of their internal difficulties such as learning or any other diagnosisor the environment in which they are embedded, or the combination of both WHO, 2007.

This definition implies that services have to be brought together for an integrative approach to inclusion, without an overemphasis on education and learning, or on specific types of disability that are medical model based, but rather with a focus on overall participation.

Interdisciplinary approaches to disability have been consistently recommended as the most effective way of promoting full inclusion, representing an essential pillar of the ICF-CY theoretical framework Clarke et al. The main structure of the ICF-CY itself body functions and structures, activities and participation, and environmental factors is based on the assumption that we cannot separate education, health, and social care issues when describing the functioning profile of a child, as suggested by the biopsychosocial and bioecological approaches to development.

  • The way services prioritise and interact with each other is often complicated and people find it difficult to access the services they need when they need them;
  • Pressure on specialist places for children with SEND, particularly those with autistic spectrum disorders, is becoming acute locally and regionally;
  • In relation to local acute hospitals, there are a number of challenges in continuing to provide safe, sustainable services that meet the needs of Children and Young People with complex health needs;
  • Consideration of the multidimensional aspect of inclusion would have been useful in implementing the holistic approach that the new policy attempts to introduce by integrating different services education, health, and social care.

The biopsychosocial approach may be conceptualized within the systemic theories of development, which according to Engel 1977 — its first proponent — serve as an organizing framework for explaining complex phenomena comprising several levels of hierarchical interaction: The adoption of this framework in conceiving health and human functioning can largely improve communication between different disciplines in health care, according to Engel 1977.

Any developmental disturbance, delay, disability, or need would be the result of a unique dynamic interaction between individual and biological features and aspects of the environment, in one or more of the systems in which the individual is embedded Bronfenbrenner, 2005. The ICF-CY as a classification system enables the systematic mapping of individual characteristics and the influence of the environment coded with the environmental factors componentwhich results in specific forms of Participation — coded with the activities and participation component WHO, 2007 ; Anaby et al.

Accordingly, services should work in an integrated manner, as interdisciplinary teams that address a whole profile of abilities and disabilities in context. Theoretically, the three core services purported in the Children and Families Act 2014 that should work collaboratively are clearly aligned with the ICF-CY structure — body functions and structures healthactivities and participation educationand environmental factors social care. These three mutually interact to characterize individual functioning and well-being, as illustrated in Figure 1.

Based on this theoretical match, we argue that all the conditions are in place for the ICF-CY to be regarded as the classification system that can support the implementation of this integrative approach. Moreover, in spite of advocating for holistic service provision, the SEND Code of Practice does not provide any specific guidelines on how to implement this interdisciplinary service provision. Local Offers and the Documentation of Environmental Factors While the recommendation for the integration of services can be regarded as a positive change in the new policy, there are not specific enough guidelines on how to achieve this interdisciplinary EHC assessment.

In fact, local authorities LAs must cooperate with governing bodies of schools, national health services, and social services, but no specific directions are provided on how to achieve these aims. We argue that the ICF-CY classification system could be used to present the Local Offer in each LA by matching each service with the environmental factors component of the classification.

The ICF-CY codes describe the support of systems, services, and policies in education, health, and social care, as well as the work developed by specific professionals in each of these subcomponents WHO, 2007.

Any parent or caregiver seeking more information about various Local Offers would have a better way of comparing between them if they were all classified using the same system — the ICF-CY common language. Therefore, we argue that not only should the conditions for the implementation describe the assessment and intervention frameworks for disabled children and young people and those the ICF-CY as a classification system to support the EHC assessment process be put in place but also a striking need for a common system to describe Local Offers across different LAs.

Moreover, according to the Children and Families Act 2014, once the EHC plan has been agreed to be issued by the LA, parents can request a personal budget to be developed regarding the provision of SEND services for their child Department for Education, 2014c.

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Using a common system such as the ICF-CY to describe the different services to be provided for all children could enable a fairer definition of personal budgets, since the ICF-CY system would enable a rigorous comparison between cases. Therefore, the needs assessment must be accurate, interdisciplinary as proposed by the EHC model itself, and timely. The law specifically describes what the EHC plan should include. However, it leaves the how to be decided by the LA, with no indication of any guidelines or recommended practices for interdisciplinary assessment and subsequent development of EHC plans.

Therefore, we suggest that the application of the ICF-CY for this purpose would facilitate the development of an integrated system of assessment.

The availability of functioning dimensions to be classified and coded across all life domains in the ICF-CY means that professionals can address all of those domains equally, not overemphasizing body functions and structures in relation to environmental factors, for instance, which often happens when designing intervention plans that are not based on a holistic system Castro et al.

Similarly, in the absence of guidelines on how to define outcomes, it is likely that we will observe various outcomes being specified, from very specific to very vague, which are not comparable across EHC plans and LAs. When using the ICF-CY classification system to develop functioning profiles for each child, the outcomes to be achieved could be selected from these functioning profiles and, thus, documented in a universal language and classification system.

  • Any developmental disturbance, delay, disability, or need would be the result of a unique dynamic interaction between individual and biological features and aspects of the environment, in one or more of the systems in which the individual is embedded Bronfenbrenner, 2005;
  • In part, this is because they are more exposed to causes of ill health; greater levels of material deprivation, poorer health-related behaviours and physical conditions often associated with causes of learning disabilities;
  • Develop a standard set of expectations for all professionals involved in EHC Planning process based on Code of Practice;
  • The answer to this question is twofold;
  • The needs of young people who are diagnosed with an eating disorder also require improvement;
  • Pressure on specialist places for children with SEND, particularly those with autistic spectrum disorders, is becoming acute locally and regionally.

Education, health, and social care provisions that are required to be included in the plan may also be described using the ICF-CY environmental factors component, thus enabling the comparison of provision across plans. Because the ICF-CY system enables the monitoring of functioning profiles over time Lollar and Simeonsson, 2005 ; WHO, 2007its use to support the development of EHC plans would also facilitate reviews, reassessment, and transition planning.

Moreover, the presence of a diagnosis does not necessarily mean that the child has SEND, and similarly, there are symptoms that do not fit into a single diagnosis.

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In fact, comorbidity of symptoms often hinders the definition of clear diagnoses, especially in early childhood, in which development is fast and not always predictable Gillberg, 2010.

However, the absence of a clear diagnosis or type of SEND does not mean that the child does not need support to fully participate.

For this reason, a classification system is needed to address functioning in addition to diagnosis. Similarly, children who are not included are not participating in their natural settings at their full potential.

The introduction of such a theoretical orientation in conceiving SEND could probably help to clarify the current absence of agreement about the definition of inclusion in England Norwich, 2014.

SEND Code of Practice: a summary

In fact, while the concept of SEND is still medically based, the possibility of having children who are not provided with adequate and individualized support is still open, as they may not fit into one of the predefined categories. Diagnosis is important and should therefore be considered as a starting point to intervention, but not as the ultimate goal of the assessment, as this leaves behind more individualized and invaluable information for intervention purposes Castro and Pinto, 2015.

For example, a child with autism spectrum disorder ASD is very likely to present difficulties at the level of social interaction, communication, and to have restricted and repetitive thought, because these are the main criteria for this diagnosis American Psychiatric Association, 2003.

However, there is evidence that the nature of the difficulties in the domain of social interaction may vary substantially when compared with another child of the same age with ASD Castro and Pinto, 2015thus leading to very different intervention strategies to be adopted.

Therefore, for educational purposes and early intervention in particular, we need to move beyond the diagnostic category and address the individual functioning profile of the child. This is particularly important in early years, when development changes rapidly and diagnosis is particularly challenging and often inherently diffuses Gillberg, 2010.

  • In South Tyneside, 34;
  • Author Contributions Both SC and OP have written the whole paper in collaboration, and the ideas provided are the result of shared reflection;
  • More boys than girls had an identified LD;
  • The Equality Act 2010 is still considered the policy document that defines the range of disability types that, according to the SEND Code of Practice 2014, professionals need to be aware of.

For this reason, it is regarded both as a theoretical model for disability and as a classification system WHO, 2007. Another advantage of the ICF-CY, proposed by the WHO, is that it constitutes a common language across professionals with different areas of knowledge as it uses common codes to classify functioning and, therefore, has the potential to support multi-agency working. In fact, once all professionals are familiarized with the system, documents and intervention plans developed in any service or country can be systematically comparable WHO, 2007.

The ICF-CY provides specific codes to describe numerous dimensions of functioning within body functions and structures, activities and participation, and within the environmental factors component WHO, 2007. In addition to the codes used in these components, a universal qualifier follows each code. The universal qualifier scale provides a way of describing the magnitude of the functioning difficulty in each dimension or code, ranging from 0 — absence of functioning problem — to 4 — total functioning problem.

Therefore, the code d710. By analyzing sample, EHC plans that have been provided through various sources as an attempt to provide guidelines for its development, and it is possible, in our view, to identify some common problems.

SEND: Children and Young People with Special Educational Needs and Disability (JSNAA)

Having comparable data are important for LA and national monitoring for special needs provision. Some plans do not include all dimensions of life, often focusing only on physical well-being and communication which is again a return to a medical model approach and is not representative of the approach proposed in the new law.

To overcome these needs, we propose that a series of steps should be adopted to ensure that the basic principles of the new law are put into practice, by introducing the ICF-CY classification system in the EHC assessment process.

Local initiatives and trials are necessary to gather evidence of how the ICF-CY can, in practice, support the EHC assessment process and development of EHC plans, as well as evidence about the views of professionals and parents about its usefulness.

Second, this bottom-up approach needs to be supported by a clear investment in cutting-edge research in this field.

Research Priorities and Questions, in which clear research orientations are defined: These research priorities can be put into practice in light of the ICF-CY by investigating how the classification can contribute to measurement and identification and impact on participation. Third, experts on the ICF-CY model and classification system should be allocated to test its utility in local predefined contexts, to train professionals on how to use it, and to gather the aforementioned and much needed research evidence.

Trained professionals should include all those contributing to EHC plans development, from all three sectors. Finally, the results of this bottom-up approach should be integrated in specific, integrated, and systematic guidelines that generalize the use of the ICF-CY classification system to support the development of EHC plans, thus contributing toward a real shift in SEND provision toward a more integrative, holistic, and contemporary approach to disability and inclusion.