The government is about to announce major changes to the SEND service, but how strong is the evidence for the principles guiding the reforms?

The HOPE study (Health Outcomes for young People throughout Education), published in a report by researchers at UCL and the University of Cambridge, provides qualitative evidence that SEND services can work well. Reported experiences by young people and parent-carers of SEND provision suggest that timely, high-quality, tailored SEND provision can improve engagement with lessons and school, anxiety management, and that children feel happier, less distressed, and better able to socialise.

While these findings indicate what can work, they are not the same as quantitative evidence that the SEND service, as delivered in practice, benefits children overall. Such evidence is limited and requires that specific questions be tested in trials or through statistical approaches that emulate trials. The HOPE study used the ECHILD database of all children in England to emulate trials, drawing on past health and school records from children more than a decade ago and following them up since then. The study showed that for certain groups, such as children with cerebral palsy, SEND provision in Year 1 of primary school reduced unauthorised absences but did not improve school test scores or reduce hospital use.

The researchers emphasise that these methods underestimate the benefit of SEND provision. This is partly because the severity of need affects who receives SEND provision, but is not measured in the ECHILD data. Another reason is that no information is collected about the support received. This can range from extra time for tasks to one-to-one support from a teaching assistant.

The government could generate stronger evidence by implementing changes to SEND services systematically. For example, schools could be randomised to early provision in nursery compared with usual practice, or to intensive training of teachers and teaching assistants compared with usual training. Stepped implementation or other randomised designs, combined with improved data, would provide stronger evidence. This way, the government would generate evidence on what works and what does not, so it can be changed as reforms progress.

The HOPE study demonstrated how ECHILD data could be used by the government to monitor whether those who receive SEND provision are fair and in accordance with need. Nearly 1 in 3 children had SEND provision by age 11, largely driven by differences in pupils’ health conditions, social disadvantage, school test scores, and school type. Voluntary schools and academy sponsor-led schools were less likely than community schools to provide the more intensive form of SEND provision, called an education, health and care plan (EHCP). There was very little variation in SEND provision between local authorities, after adjusting for these other factors.

Find the report here.

Contact Professor Ruth Gilbert, r.gilbert@ucl.ac.uk or Professor Tamsin Ford, tjf52@cam.ac.uk

More information on the HOPE study is here, and all published articles are here.