1.

2 Conceptual Frameworks for Diagnosis and Identification of

Disability and SEN
There is no universally accepted system of classification that is used within the field of special
education across different countries. Classifying children into particular categories of disability and
special educational need is difficult and many relevant questions arise.

1. what definitions of a category of disability or special educational need are used?

2. How do these relate to the learning difficulties children face in school?
3. How do they relate to particular interventions designed to help these children learn?

Both national and international approaches to classification such as ICD-10 (World Health
Organisation, 2001), and DSM IV (American Psychiatric Association, 2001) assume that such
distinct groups exist, that they can be described coherently, and that reliable and valid
assessments can be made in order to place an individual within a particular diagnostic category.

However, our review of current practice across a number of countries indicates a variety of different
approaches based on different assumptions and theories about individual difference and disability.

We argue that there are three main models guiding special education assessments and
interventions. It is important to note that these are not three diagnostic models. These reflect
different conceptualisations of the causation and necessary interventions for children and young
people with SEN.

Three Main Model in Guiding Special Education Assessments:

1. medical
2. social
3. interactionist/ecological models.

The medical model views individual difference in terms of deficit, disability or disease, and tries to
see impairments in ways that have direct links with treatments or interventions. As in medicine,
diagnosis is necessary to ensure effective treatment. In this model the function of assessment is
to find the correct diagnosis which will lead to a particular intervention to remediate the condition,
and some fundamental assumptions are made:
• That the categories used are valid
• That it is possible to make reliable judgements about which category should be applied to a
child
• That particular interventions are differentially effective with different categories of learner.

Each of these assumptions has been challenged (Florian et al, 2006). If SEN are seen as part of
the broad spectrum of individual differences in development, the point at which a difference is
delineated as SEN is problematic. This way of looking at individual differences challenges the
concept of discrete categories.

The NCSE Implementation Report (2006) acknowledges that estimates of incidence are
confounded by different definitions by education and health services. It is of interest that a disability
rate of 14-18 per cent of the school population is estimated, which is very high for ‘disability’, as it is
often conceptualised. Further, if these individual differences in development are the result of
complex interactions between within-child factors and external social and environmental factors, it
is unlikely that similar identified difficulties will have exactly the same causes in different children, or
that the same educational interventions will be successful in each case (see McLaughlin et al
2006).

Also, individual children may have more than one (within child) impairment, for example, both a
hearing impairment and intellectual impairment (Rutter, Tizard and Whitmore, 1970).

Norwich (2007) reviews the use of disability categories in SEN, and distinguishes the use of
categories of disability for administrative purposes, such as allocation of scarce resources, and
those used for teaching/intervention purposes. He concludes that research reviews and analyses
consistently show the limited usefulness of categories of disability in many areas. According to
Norwich, even when they have some educational significance, their general nature means that they
inform rather than determine specific educational planning and provision.

The social model sees disability as a social construct and argues that disability and SEN must be
understood in the context in which they occur. By exploring ways in which schools and classrooms
create difficulties in learning, and how they stigmatise the pupils so labelled, this model argues for
whole-school approaches to preventing and tackling learning difficulties (Booth and Ainscow,
2002). By concentrating on changing conditions of teaching and learning in schools to better meet
the educational needs of all children, exponents of this approach challenge the need for systems of
classifying or categorising SEN and disability.
3
The interactionist/ecological model takes into account the various forces impinging
on the developing child, forming a complex array of stress and support factors that interact at
particular times during the life of a child to help protect an individual from difficulties or, conversely, to
make them especially vulnerable. The factors can be grouped under three headings; those intrinsic to the
child (e.g. genetic, neurological damage), stress and support factors in the child’s home and school
environment, and finally wider socio-economic factors, such as housing or societal attitudes to disability –
(Lindsay and Desforges, 1998).
A representation of contributory factors is presented in Figure 1.1.
Areas of Special Educational Needs

• Communication and interaction

• Cognition and learning
• Behaviour, emotional and social development
• Sensory and/or physical

Medical conditions are referred to because they may have a direct significant impact on cognitive
and physical abilities or on behaviour and emotional state. They may also have an indirect affect
through absence from school due to treatment or chronic illness. However the Code of practice
states explicitly that a medical diagnosis or disability does not necessarily imply SEN.

The Code of Practice sees assessment as a process involving partnership, careful monitoring,
and regular review of progress. It can be characterised by:
• Local authorities, school and educational settings working together to ensure early
identification of SENs
• Educational professionals and parents working in partnership
• Interventions reviewed regularly to assess the impact on children’s progress
• Close cooperation between all agencies concerned, and a multi-disciplinary approach
taken, involving a partnership between the local authority, school, parent, pupil, health, social
services and other agencies
• Any statutory formal assessment being made within clearly prescribed time limits
• SEN of each pupil being reviewed at least annually.

It is essential that all professionals actively seek to work with parents and value the
contributions they make … All parents of children with special educational needs should be
treated as partners. They should be supported so as to be able and empowered to: recognise
and fulfil their responsibilities as parents and play an active and
valued role in their child’s education have knowledge of their child’s entitlement within the
SEN framework make their views known about how their child is educated have access to
information, advice and support during assessment and any
related decision making process about SEN provision. (Source: Code of Practice, paragraph
2.2:16)

2.5 A Framework for Identification and Assessment of SEN

Assessment is seen as taking place within the framework provided by the National curriculum,
and is divided into three phases –”early learning”, primary and secondary.

The “early learning” goals set out what most children will have achieved in each of six areas by the
end of the foundation stage or infant school reception year, and the statements represent expected
outcomes in the following areas:
• Personal, social and emotional development
• Communication, language and literacy skills
• Mathematical development
• Knowledge and understanding of the world
• Physical development
• Creativity

Assessment then involves the collection and recording of information on rate of progress, and a
description of the child’s strengths and weaknesses. Information from parents, health services,
social services, and the child’s own views can all contribute to this process.

Stages of identification, assessment and intervention are described at levels of Early Years Action
and Early Years Action Plus for children in early education settings, and School Action and School
Action Plus for primary and secondary schools.

At the Early Years Action and School Action levels, interventions additional to or different from
those provided as part of the usual differentiated curriculum are offered.

At School Action Plus, additional or different strategies to those at the Action level typically involve
professionals external to the school.

The input of a statutory multi-professional would usually only be considered after documentary
evidence of what has been tried, what has been provided, and to what effect has been gathered.

The exception to this would be cases of severe and complex needs where the SEN will be clearly
evident, and a request for statutory assessment can be made without these prior stages.

In this framework, identification and assessment of SEN is placed firmly within the cycle of
planning, teaching and assessing that is central to the teaching and learning process for all children
in all classrooms. The Code of Practice also has an explicit interactionist/ecological perspective,
stating that the assessment process should always focus on four different aspects of the teaching
and learning process:
• The child’s learning characteristics
• The learning environment the school is providing
• The tasks to be learned
• The teaching style.

It states: It should be recognised that some difficulties in learning may be caused or exacerbated
by the school learning environment and the adult/child relationship. This means looking carefully at
such matters as classroom
organisation, teaching materials, teaching style and differentiation in order to
decide how these can be developed so that the child is enabled to learn
effectively. (Source: Code of Practice, paragraph 5.6)

The role of relationships and settings is also raised, and the implications for assessment
outlined:

Some children’s performance can be exceptionally varied across settings.

Therefore, where possible, it is important to look for multiple sources of
evidence of children’s performance in different roles and settings”.
(Code of Practice, paragraph 5.7)

Assessment then is seen not as a single event, but rather as a continuing process, involving the
collection and recording of information on the rate of progress and a description of the child’s
strengths and weaknesses. Progress and difficulties are seen within the context of National
Curriculum levels and expectations of what children might be expected to achieve at each stage.
Information is gathered not just from within the school, but from many sources, such as parents
and health and social services. The complex of factors within the child’s total environment – home,
neighbourhood and school – are all considered to be potentially significant in the pupil’s experience
of SEN.
The graduated responses through the stages of School Action and School Action Plus recognise
there is a continuum of SEN. Where necessary, increasing specialist expertise can be brought in to
help assess the difficulties a child may be experiencing, and to develop intervention strategies.