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- 17/09/2011: Reflections on Med Soc 2011
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Archive for March 2011
Who am I when I write?
31/03/2011 by lizit.
Last evening’s #phdchat session on Twitter focused on academic writing. As always, it was a wide ranging discussion, but one aspect that got me thinking a bit more was my writing voice.
When I started my DPhil journey, I remember saying to my supervisor that one of the things I needed to do was to find my voice. At the time, I had just co-authored an article with her on a project we had been involved with and it was the first serious writing I had done for several years, and my first venture into academic writing as such, in the sense that this was something that might be read by other than my teachers and supervisors. I was used to presenting stuff in all manner of contexts, but writing and a writing voice was somehow different.
A further, personal complication was my longstanding reaction to much academic writing and language. As an undergraduate, way back when, I had found myself virtually struck dumb in seminars and other discussions because I just did not understand half of what was being said, and there was no way I could actually write such impenetrable stuff. I more or less made a promise to myself that anything I said or wrote should be in accessible English.
It is now about two and a half years since that conversation with my supervisor, and I realise I have found a voice - in fact I have found three different voices, all of which I will be expressing in my writing and my thesis.
First, there is the impersonal, authoritative voice. This is the voice most present in the theoretically based parts of my writing. It is the one that reports on what I have read, provides a context, discusses methodological frameworks and the like. From time to time it may use formal, academic language, but it aims to be accessible and clear. It is also the voice that identifies some of the issues and conflicts between theoretical perspectives and enters into debate with them.
Secondly, there is another voice which also discusses ideas and concepts, but not as impersonal researcher, but as ‘I’. This is the voice that makes observations on what the impersonal has written and brings a ‘real world’ perspective. When the impersonal talks about the number of different specialists a child with a disability might have seen, the ‘I’ voice talks from experience. This voice has a different type of authority from the impersonal voice. The impersonal is speaking from the body of research and professional experience which has been subjected to peer review and the like, but the personal voice is sometimes saying, that is the theory, but this is how it was for me in reality.
The third voice, which is a function of the type of work I am doing, and which in other circumstances might be part of that second voice, is me as participant in my research. Although, I am not taking an autoethnographic approach, my story and experiences are part of my research. Last summer I blogged on some of the ethical dilemmas I was confronting. I have now found a resolution to these in writing and analysing my own story in such a way that I can use it as data, the same as the stories others are sharing with me. This voice is not recognisable to the reader as being my voice, but nevertheless, it is allowing me more directly to introduce perspectives on my research topic which are not readily available through any other source and is reflective of the very different experiences of different participants in my research domain.
Somewhere along the line, I probably need to do more work on this, and even to find some theoretical framework to hang this approach on, but for the moment, I do know that my voice is very present and real in my writing, and that voice is not a whisper trying to be heard, but is vibrant, strong, objective and authoritative - and it has a story to tell.
Thanks #phdchat for helping me to articulate this.
Posted in voice, writing, empowerment | Print | 1 Comment »
Green Paper - chapter 5
22/03/2011 by lizit.
The final section of the green paper addresses the questions of reducing bureaucracy and services working together to support families and children with SEN/disability.
The local authority role will have 3 core features:
- strategic planning
- Securing a range of high quality provision
- Enabling families to make informed choices
The Department of Health is tasked with working with the new Health and Wellbeing Boards to consider how the needs of children and young people with SEN/disability are best addressed and with working with GP consortia pathfinders to explore the best ways of providing support for the commissioning of healthcare services for children and young people with SEN or who are disabled and their families.
Statutory guidance will be simplified and improved for all professionals working with children and young people with SEN/disabilities so that it is clear, accessible and helpful. The SEN Code of Practice will be retained but revised to incorporate other guidance that is considered helpful to professionals. The mention of the CoP, does not acknowledge the use made by parents of this publication in understanding how to obtain their child’s entitlements.
IEPs are retained, but advice on their use is removed and instead schools are encouraged to develop other approaches to enabling children with SEN to develop, progress and fulfil their potential (para 5.23). This seems strange given it is recognised that parents value these documents, but may reflect the fact that so many are poorly written and presented.
Fifteen paragraphs focus on joint working and how this might be best achieved. Interestingly, no mention is made of the CAF and its attempts to foster joint working between professionals.
Further sections focus on speech and language therapy services and educational psychology services.
Encouragement is given to local authorities to work together through joint commissioning and management of services
Attention is paid to the voluntary and community sector in providing advice and support, services and as a strategic partner to the Department for Education.
Finally, funding is addressed with the proposal for a national banded funding framework for funding high-cost provision. This seems to be a way of evening out provision for children living in different localities. The document concludes with a discussion of alignment of pre-16 and post-16 funding arrangements.
Posted in SEN, Government policy | Print | No Comments »
Green Paper - chapter 4
22/03/2011 by lizit.
This is one of the shortest chapters in the document and concludes by acknowledging :Many of the problems with the system to support young people with SEN or who are disabled are complicated and longstanding” para 4.50.
The proposed Education, Health and Care Plan will extend to age 25, which may ameliorate lack of clarity about post-18 opportunities.
The only mention I can find in the document about high achieving young people with SEN/disability is para 4.22, which recognises some of these young people will go on into HE. For some reason, this is connected to the National Scholarship Programme for supporting disadvantaged young people, but apparently one of the criteria for the progamme will be the support for disabled students.
Informal adult and community learning also gets a mention (para 4.23) and is connected with the Big Society.
Twenty per cent of the chapter focuses on employment including the role of Job Centre Plus and Disability Employment Advisers. Nothing is said about how training will be provided to ensure these personnel are equipped to support the full range of SEN/disability, something I find worrying given some of the accounts I have heard of experiences with employment services of young people on the autism spectrum.
A further area of transition is from child to adult health services and it is recognised that the transition from CAMHS to adult mental health services can be particularly difficult.
The final section of the chapter focuses on independent living and the planned change from DLA to PIP.
Posted in SEN, Government policy | Print | No Comments »
Green Paper - chapter 3
22/03/2011 by lizit.
This chapter is entitled learning and achieving and focuses on the training available for teachers and others employed in school contexts, identification of SEN, achievements, special schools and BESD.
One of the issues addressed is that of over-identification of SEN as highlighted in the Ofsted review published last autumn: “We intend to tackle the practice of over-identification by replacing the current SEN identification levels of School Action and School Action Plus with a new single school-based SEN category for children whose needs exceed what is normally available in schools…” para 3.6
The first issue addressed is improving teaching by placing more emphasis on SEN in initial teacher training courses, offering more placements in special schools and specialist training resources for post-qualification CPLD. “We also propose to fund scholarships for teachers to develop their practice in supporting disabled pupils and pupils with SEN, including in specific impairments” para 3.14. This emphasis on training and skill building should extend to FE sector.
The roles of school leaders, governors and SENCOs are discussed. LSAs are identified as an important part of the support structure, but not as “substitute for teaching from a qualified teacher” 3.26 and “Children with SEN need more, not less, time with the school’s most skilled and qualified teachers.” It is unfortunate that there is no discussion of the distinction in role between support staff and teachers and of the range of activities involved in education that are not about subject learning, but for many children with SEN/disability are about social and communication skills and life skills where an LSA may well be more qualified than a teacher to address the child’s needs.
There is a strong statement of intent to move away from a culture of low expectations of children with SEN/disability by developing the Achievement for All programme which “has led to schools declassifying children previously classified at School Action, because with a culture of high expectations and provision of personalised school-based support the label itself is not longer necessary” para 3.30. The pupil premium should be used to provide targeted help, including extra one-to-one tuition or catch-up support. Emphasis is also given to literacy and numeracy through the Every Child a Reader and Every Child Counts programmes.
Para 3.38 recognises that for some children and young people, their SEN may emerge once they go to school or when they move from primary to secondary school. Teachers need to be able to differentiate SEN from other barriers to learning which should be addressed in other ways, and their should be a move away from using the term SEN as an excuse for low achievement.
There does seem to be confusion in the way the document is written as to what is SEN and what is low achievement - possibly because some children with SEN are low achievers. But the plan is to develop new measures in performance tables for disadvantaged pupils and the lowest attaining 20% of pupils.
The reclassification of SEN “will mean fewer children are identified as having SEN, while deterring a low expectations culture and allowing teachers and schools to focus on providing the help that every child needs” para 3.44
Four pages of this chapter are devoted to difficult behaviour, behaviour support and BESD.
26% of pupils at School Action Plus and 14% with statements have BESD identified as their primary need.
Attention is drawn to the needs of other pupils with SEN/disability who may be bullied and the greater likelihood of children with SEN/disability being excluded - why these two different aspects are dealt with in a single paragraph is unclear para 3.50.
Para 3.53 recognises that it can be difficult to identify the root causes of behavioural problems and mentions some children may have underlying communication difficulties, but nothing is said about contested diagnoses and the possibility that some of these children may have underlying and undiagnosed SEN/disability such as dyslexia or autism spectrum conditions. It is recognised though that without appropriate support, these children are more likely to be excluded, achieve less well at school and are less likely to proceed to employment or training leading to wider social and financial costs. The emphasis should be on identifying root causes of behaviour difficulties rather than focusing on symptoms.
It is suggested exclusions will be reduced by making the excluding school responsible for the placement and progress of excluded pupils.
A multi-agency assessment is recommended for children that are subject to multiple exclusions without the cause having been ascertained.
At present, 72% of all permanently excluded pupils have an SEN and pupils on SA+ are 20 times more likely to be excluded than pupils with no SEN. Young people with SEN also over-represented in the offender population. Para 3.56.
Over 40% of children with statements (about 1% of school population) attend special schools of one type or another. Document suggests there is scope for increasing the options for special schooling through flexible placements between a mainstream and special school and the development of special free schools.
The final section of the chapter returns to achievement levels.
My concerns
One of the things that worries me most in this chapter is the apparent focus on academic attainment without seeing the child holistically. One would hope that the move to a Health, Education and Care Plan might lead to a more holistic perspective, but there is little sense of the child other than in a school context except where respite care or special resources are needed.
A further concern is the section on BESD, where there is almost a suggestion that the children with BESD are bullying other children with SEN/disability. The strongest part of this section is the acknowledgment of the need to identify the root causes of BESD rather than just responding to the symptoms.
Posted in SEN, Government policy | Print | No Comments »
Green Paper - chapter 2
22/03/2011 by lizit.
The focus of this chapter is on giving parents control. It starts from the premise that parents know their child best (but elsewhere in the document, it is recognised that parents may have a different agenda from their children.)
Para 2.5 “Parents should feel well supported through the system with clear information on how it works and who does what, and what the funding is. Parents know their children best and should receive support that works flexibly with their family circumstances. They should have more influence over support for their child through personalised funding, be able to participate in local decisions, have a clear choice of school and access to short breaks from caring. When parents and professionals disagree on the right approach for a child, they should use mediation to resolve disagreements over their support.”
The idea of key workers introduced again - this was first mooted in Warnock and was present more recently in CAF, but not really implemented effectively yet.
There is some recognition of costs, especially unexpected, and role of Family Fund Trust in making direct grants. There is a lengthy section in this chapter relating to personal budgets.
Information is seen as central - parents “need to be clear about their options and understand how decisions are made that affect their child’s support” para 2.14. The implication is that if parents knew more about what was available, there would be a financial saving to parents and public authorities in avoiding costs of appeals. Not only should local authority provide clearer information, but individual schools should provide information on what additional or different provision they make:
- Curriculum - and how tailored to meet individual children’s needs
- Teaching - adaptation to meet SEN and access to specialist expertise
- Assessment - teacher assessment and assessment of barriers to learning for children with SEN
- Pastoral support - involvement of parents, how school supports education and well being of children with SEN/disabilities
Identifies problem of low expectations of children with SEN - need to raise expectations/achievements.
Para 2.43 Funding for parent forums and involvement of parents in planning and developing local services.
Section on school choice expresses a commitment to removing any bias to inclusion and offering a real choice to parents - basically local authority has to agree to placement in any state-funded school as long as this does not compromise education of other children. “A local authority must consider the parent’s preference and cannot simply place the child in a school irrespective of the parents’ wishes” para 2.52.
Specialist expertise should be provided in local schools - suggestion that this is more cost-effective than independent school placements.
Short breaks mentioned again, but doesn’t really add anything significant to chapter 1.
Mediation to precede appeal to First-tier Tribunal (SEN and Disability) - “It can be better for parents and a better use of public funds if disputes about assessments and statements are resolved earlier and through non-judicial means” para 2.60. Does not take away right of appeal, or right to use NHS or local authority complaints processes. However there are changes to legal aid - no legal help or advice preparing appeals in SEN cases (I thought that had already gone) but legal aid available for disability discrimination cases. A right for secondary school-aged children to appeal to Tribunal on both SEN and disability grounds is introduced.
Para 2.64 is one of the very few references to independent schools in the whole document: “Although the Tribunal must take into account the efficient use of resources when consideration decisions on school placements, some decisions by the Tribunal can have significant financial implications for the local authority. For example, when the Tribunal rules that a child needs an expensive school place, this can represent a new large share of the local authority budget. Given the potential impact on the local authority budget, we would like to ensure that the Tribunal continues to give both priority to ensuring that children’s SEN are met and full weight to the efficient use of resources when considering the best way to meet their needs.”
My concerns
This section covers a lot of different areas.
The provision of better quality information is to be welcomed, but experience has shown that sometimes schools will claim what they cannot deliver, or what they can deliver may be appropriate to some children but not to others with apparently similar SEN.
Appeal to Tribunal could become more daunting if it can only follow failed mediation - this is potentially more of a battle-zone.
It’s probably inevitable, but the emphasis on cost is worrying. There is no doubt that some redistribution of resources could be potentially cost-saving, but again there is a need to recognise that meeting needs of children with SEN/disability can be very expensive sometimes.
There is no mention of the needs of some children for a 24 hour curriculum. The implicit assumptions seems to be that a mix of choice of school and short break will do the job, when this is not always the case.
Posted in SEN, Government policy | Print | No Comments »
Green Paper - chapter 1
22/03/2011 by lizit.
This chapter focuses on early identification and assessment.
Para 1.2 “Too often, the particular support that children and their families require is put in place needlessly late. Although some impairments are normally identified at birth or soon after, other types of need emerge as children grow up. Not knowing why children are developing differently can be tremendously stressful for the child and for their parents. And even when needs have been identified, parents tell us that it can feel like a struggle to get the right support for their family from education, health and social care services. It can be slow and complicated, with different services working in isolation and each having its own approach.”
Features of new system:
- assessment of development by health professionals (HVs) and early years professionals - identify where additional support is needed
- Early years education and child care available and accessible to all
- Replace Statement of SEN with Education, Health and Care Plan - single assessment process - same statutory protection as statement
Plan is to reduce over-assessment, but unclear exactly how this will be achieved. Presumably some assessments that effectively duplicate each other can be removed. A common Plan that can be used as basis for the different types of input would be useful, but difficult to envisage various agencies accepting each others conclusions, especially if costs involved. Currently with more complex situations, health, education and social care have to plan together - and can take months to come to a conclusion - how will this be improved in practice?
Note mention of efficient use of public funds in para 1.48 - how much of the think is about saving money and how much about providing a quality service to needy children and their families?
Voluntary and community sector role placed in context of finances - I find that worrying as perpetuates myth that voluntary sector is cheap or free. Specific roles identified for voluntary and community sector:
- providing information on assessment process - preparing parents on what to expect
- Advocacy for families
- Supporting families through the assessment process
- Putting support package together that reflects family needs, circumstances and ambitions
So a mixture of support, advocacy and direct services, but no indication of who is paying.
Quite a lot about short breaks which seems to be a variation on respite care. Given this was one of our initial requests that was never fulfilled, I do wonder how likely this is to happen, especially if aim continues to be to provide this through a pseudo-fostering arrangement rather than in specialist facilities.
The emphasis in this section is really on those children with most complex needs, effectively the 2% who currently are statemented. It is unclear whether this helps in any way those children who are currently on school action or school action plus and who would be subject to a single level of school SEN assessment.
My concerns
- Position of those children whose needs are not complex enough to be dealt with under new assessment arrangements, but at the same time are not trivial.
- The practicality of an assessment by Health, Education and Social Care - and getting all to agree - but good if can be made to work and can include DLA/PIP
- The implicit and explicit expectation that this will reduce duplication and therefore save money
- Lack of realism about true costs of voluntary and community sector involvement
- The practicality of short breaks - desirable but how achievable?
Posted in SEN, Government policy | Print | No Comments »
SEN Green Paper - some initial thoughts
15/03/2011 by lizit.
The long-awaited government consultation document “Support and aspiration: A new approach to special educational needs and disability” was published last Tuesday. I have now had time to read it and and some of the early responses to it. My initial response last week was to question whether my research is still of any relevance given that the green paper addresses many of the areas I am interested in and that some of the discussion is underpinned by government commissioned research. I also had a sense that what I am doing might be anachronistic, even before it sees the light of day.
During the past few days, I have been able to reflect on the document and to begin to look at it more objectively. The fact that the green paper acknowledges problems in the existing system and suggests ways of addressing these does not mean that my work is irrelevant. In fact, in some ways it may be that some of the areas I am exploring are of even greater relevance as they are areas which receive scanty attention in the green paper.
The potential strength of the recommendations is a move to a single assessment of SEN and disability culminating in an ‘Education, Health and Care Plan’ which will replace the Statement of SEN. The advantage of this is the potential reduction in the number of separate assessments a child or young person with complex SEN/disability might have to face and the shared responsibility and accountability of Health, Education and Social Care. However, it is unclear from the green paper which children and young people will have the opportunity of this single assessment and at what stage in their development. Clearly, it is applicable to those children with complex needs recognised very early in their life - and the green paper does lay emphasis on early identification of needs - but what of those children and young people who are apparently developing normally, but are a bit quirky and whose differences become evident at a later developmental stage. In particular, at present it is known that many children with Aspergers or HFA do not receive a diagnosis until they are into their primary education years - and some later still.
This leads to a further question. Many of these children with Aspergers or HFA (and others with neurological differences) have a record of behaviour difficulties and possibly exclusions prior to diagnosis. The green paper draws attention to the much higher risk of children and young people with SEN of both fixed term and permanent exclusion from school, but says nothing about the contested diagnoses which lead to some of these young people receiving a diagnosis of an autistic spectrum disorder and others being labelled as BESD. The section of the document discussing BESD is in my opinion the weakest in the whole document.
Although the green paper does focus on raising expectations of the potential achievement level of children and young people with SEN/disability, it is unclear to me how realistic some of the implicit, if not explicit, assumptions are. Yes, children with SEN/disability frequently leave school with lower qualifications than other young people and no doubt some could achieve more given the right support structure, but it is unlikely, I would have thought, that the achievement curve for school leavers with SEN/disability would ever mirror completely that for those with no SEN/disability. However, for high functioning young people, it is crucial that they are enabled to reach their potential rather than under-achieving as a result of missed education through exclusion or inappropriate or insufficient learning support.
Another area addressed in the green paper is that of the role of parents. It is acknowledged that parents frequently have insufficient information in the current system and recommendations are made to remedy this. It is also suggested parental choice will be increased, especially in relation to choice of school. Although there is no doubt parents have strong views about what is best for their children, it is disappointing that the voice of the child and their own aspirations has not been similarly strengthened, except when it comes to appeals where children will be able to enter their own appeals to the First Tier Tribunal. Parents are not necessarily always the best advocates for their children, though this is an area fraught with difficulty. Returning to choice of school, little is said about the continuing role of independent and non-maintained special schools…
There are very clear political themes underlying the green paper. Reducing expenditure is clear through reductions in bureaucracy and in multiple assessments. It is also there, so not so evident in other financial arrangements - who will be eligible for the new personal budgets and what restrictions will there be on their use. Free schools receive a mention - it is suggested that part of the increased school choice will include the establishment of new free schools and academies. The Big society is writ large with suggestions that the local community and voluntary sector might facilitate the new assessment system.
In terms of the recommendations in the green paper being enacted, some things are already being trialled such as short breaks; some things will begin to be trialled later this year, such as single assessments; but implementation of the whole will be over the next few years. Inevitably there will be considerable interest in the SEN community in both the discussion of the green paper, its implications and implementation and the effects of that implementation on the life chances of children and young people. My task is two-fold - to ensure that I complete my research and write a thesis which meets the academic criteria and to find ways of contributing to the debate and analysis of the change over the coming years.
Posted in SEN, Aspergers/HFA, Government policy, education | Print | No Comments »
Learning by doing - imposter syndrome strikes again!
03/03/2011 by lizit.
Let’s get this clear to start with. I enjoy presenting. From the response I get when I present, it would seem people enjoy my presentations, and sometimes even are challenged by them.
However, on the 3 occasions when I have presented since starting my DPhil, I have found myself getting nervous and generally just not doing as good a job as I know I can. The first time, I gave a presentation, I dried. OK, in the informal context of the lab meeting it didn’t really matter, and in some ways it was helpful finding out that I could recover and carry on and not lose face, but I do not suffer stage fright, so what was that all about.
The second presentation I gave was as part of a course focusing on communication skills. We used blogs, designed posters, wrote abstracts and gave a short presentation. That time, I didn’t dry but I was aware of being very nervous and not really saying things as clearly as I wanted to.
The third time was yesterday. I wasn’t as nervous, but I had over-prepared and had far too much material so I ended up rushing and missing out important aspects of what I had to say.
During the same period, I have given other presentations in other contexts and I have not had the same difficulties - in fact in other situations, I have enjoyed the experience and made a good job of the task. So what is it that affects me adversely in those situations when I am presenting to peers and colleagues as a research student?
I think part of the answer is what I wrote on my facebook page prior to yesterday:
I usually quite enjoy presenting, but get much more nervous doing stuff at Sussex than I do anywhere else - maybe I think they are more likely to blow my cover, or think I’ve got to be clever instead of just being me….
It’s that old enemy known as “imposter syndrome” - there is something about having to prove myself, so I over-prepare, include too much content, trip over my words, and almost turn into a gibbering wreck, only managing to perform at all because I have done so many successful presentations in the past and know the drill.
Another part of it, which was very evident yesterday, and is related, is losing confidence in my belief that I know what I am doing, and taking too much notice of the advice I am given without weighing up whether it will actually fit. What I should have done yesterday, given it was a research in progress presentation to my colleagues, was to focus on what I was doing, what my preliminary findings were, and why these were relevant. I had plenty to say and could easily have put together a tight, but challenging presentation. Instead, I not only put my presentation in context - it did need some kind of brief contextualisation, but not 6 slides worth - but I also threw in a summary of the tension between the medical and social models of disability to give what I was saying theoretical credibility. Some of the extraneous stuff was there because I chose to include it, but some of it was there because I had been through the slides with my supervisors and they had suggested how I might ‘improve’ the presentation. Their comments were valid and well meant, but rather than weighing them up and deciding what I had room for, I took all their ideas on board - after all, they are the experts - and did not use my own judgment or knowledge of timing.
To make matters worse, having got an acceptable presentation worked out, instead of pruning it to fit the time available, I added additional slides and re-ordered the sequence so that those slides which didn’t really fit had a proper place.
So I had too much material and inappropriate material. Combined with my nervousness which meant I took longer than necessary to settle into the presentation, which made the early part even more clunky than it might otherwise have been, no wonder I ran out of time, had to rush through stuff and omit the most interesting elements.
People are nice and forgiving. There was enough there to satisfy those present. But I know I can do better - and if I am going to do better I need to believe in myself and sort out my own priorities and be willing to prune in order to communicate what matters effectively.
At least, I know that I have enough material for about 3 different presentations if I slice it up appropriately, so I guess it wasn’t a complete loss!
Posted in imposter syndrome, presenting, ownership, learning | Print | 3 Comments »