The Jesuits had it all wrong. They famously insisted: ‘Give me a boy at seven and I will give you a man.’ Schooling could change everything. Today, neuroscientists, educationalists and psychologists know that the clay is set much, much, earlier. Whether boy or girl, the brain and its neural pathways will be formed by the time the child is into their third year. This is even more true of children with special educational needs and disabilities (Send): early detection of speech defects or cognitive failures can often reduce, and sometimes altogether erase, developmental issues.
If the government really wants to address Send issues, there is a better alternative
In the lead up to the much-postponed publication of the government’s schools white paper, Bridget Phillipson, the Education Secretary, had promised serious investment in the early years. This, it turns out, means a paltry £200 million to Best Start family hubs for dedicated Send support; while reserving more than £2 billion for, and pushing most of the responsibility on, mainstream schools.
Margaret Mulholland, Send and inclusion specialist at the Association of School and College Leaders, welcomes the white paper’s ‘focus on the experience of school as a measure of success: thriving and belonging’. Others beg to differ. Humphrey Hawksley, the BBC’s former star correspondent, has waged a long campaign to obtain support for his son Christopher, who has special needs. ‘For the children’s sake, do not make “inclusion” an ideology,’ he says. ‘Many of those with complex special needs must have a safe and secure environment where all staff are trained to recognise and meet their needs. In a busy mainstream school, the risk of being excluded and stigmatised is high and can damage for life.’
School staff would point to another issue resulting from the new onus on mainstream schools to take in more Send pupils: overwhelmed teachers. In a recent TeacherTapp poll, 43 per cent of respondents reported that supporting pupils with Send was a huge concern. Behaviour, attainment, safeguarding: all will be affected by the proposed influx of more vulnerable children. And as for the government’s mandated training in Send: our charity, which delivers funded parental engagement training in schools, has continuously heard one refrain: sorry, we have so little bandwidth.
If the government really wants to address Send issues, there is a better alternative. Listen to the science and get in early – at a fraction of the cost. Step forward, the Health Visitor.
While the government’s Send ‘outreach workers’ may help those families who have identified their child’s special needs or a disability, there are many, many more who do not know how to spot an issue with their infant’s development. The home visit by trained nurses or midwives can study not only the infant in question – can they hold their head steady by six months? Speaks simple words by age four? – but also the family’s circumstances, from the mother’s depression to the mould staining the walls.
The professional takes parenting seriously: their sanctioned snooping is all about ensuring that there is a good relationship (or ‘attachment’) between infant and parents, but also that both mothers and fathers feel engaged and confident in raising their child. The Health Visitor aims to equip the parents with the skills to pilot through their child’s early years – and the knowledge to seek the right assistance at the right time. Which is, early on.
Perhaps it is this emphasis on parenting that the government resents, argues Julian Tomkins, a psychotherapist specialising in adolescents. ‘Bridget Phillipson’s white paper preserves the notion that it is the state’s or the school’s responsibility to manage the Send issue. It is and it isn’t. Absolutely, children with special needs deserve the extra support, and schools are already bending over backwards to provide this. More resources will help, but perhaps this debate should be less about the state yet again trying to manage parenting, than attempting to bring about a change of attitude on the part of parents already heavily dependent on state support. Life is not always fair, but if we assume that it is someone else’s (the government) responsibility to solve this, we run the danger of creating another generation of victims.’
By equipping them with the right skills, health visitors give parents agency. Parents who know how to navigate the challenges of an ordinary childhood offer the Treasury and the taxpayer savings on everything from A&E and NHS dentistry; parents who know how to navigate the challenges of an extraordinary childhood, such as that experienced by a special needs or disabled child, saves us infinitely more: we have all learned about taxis ferrying Send children to specialist schools at a cost of £1.5 billion and specialist schools that cost as much as Eton. Surely, then, giving these parents timely and welcome support through a home visit by a trained nurse or midwife makes good sense?
The Health Visiting Institute has pleaded in vain for more investment and with an average salary of £40,000 these professionals would need only a modest portion of the billions being ear-marked for Send provision in mainstream schools. Yet even a fraction could transform this once-prized service – and secure their assistance in spotting and supporting Send children. With lockdown, home visits shifted online – and have stayed there. The narrow focus afforded a health visitor by a Teams or Zoom call is bound to miss some of the underlying issues in an infant and in their home. Clues may be missed, mis-diagnosis facilitated.
Jettisoning face-to-face visits has coincided with fewer visits altogether and, worse, with plummeting numbers: 71 per cent of practitioners from England reported a reduction in qualified health visitors in the last year. The parent’s great enabler is suddenly a shadow of their former self.
Timely, trusted, and trained, Health Visitors should be a priority investment for a government seeking to address the surge in Send children.
