There are seven grant-aided special schools in Scotland, which are funded by the government as national centres to serve the needs of the most disabled children. In three to five years’ time, that picture may be very different, in the wake of the recent Doran report.

The schools’ specialisms cover a wide spectrum - from hearing and visual impairments to severe physical disabilities and behavioural problems.

The establishments started in an era when local provision was virtually non-existent and some children with very complex needs were considered “ineducable”. Their legal status dates back to legislation passed in 1948 and revised in 1990; the Royal Blind School was founded in 1835. But demands and capacity have changed beyond recognition over the years.

Not only must local authorities now operate within a legislative presumption in favour of mainstreaming, they are also being forced to count their pennies more carefully and have become increasingly reluctant to pay the higher cost of out-of-authority placements in one of the specialist centres.

These centres have enviable facilities and are staffed by multi- professional teams - but some are only half-full. At the same time, medical advances in recent years mean that a greater number of low- birthweight and premature babies are surviving and have complex support needs.

In November 2010, against this backdrop of tensions between local authorities, independent providers and grant-aided national provision, Peter Doran, the former head of Harmeny School for children with social, emotional and behavioural difficulties, began his review of learning provision for children and young people with complex additional support needs.

Two years later, his report, The Right Help at the Right Time in the Right Place, has achieved the seemingly impossible - broad-based support from parties who at the beginning of the process held diametrically opposed views.

The report recognises that while there is much good practice across Scotland, there is also a lack of consistency, training and delivery.

It recognises, too, the emotional context in which families operate, referring to “tears arising from frustration and anger” on the part of parents and carers battling against barriers and bureaucracy, while others express “feelings of relief and joy” when their children’s needs are met.

It recommends better training for specialist staff in the sector, pointing out that a high proportion of current staff - and those who deliver their training - are nearing retirement.

An underlying theme is the need for greater partnership working: “Differences in approach can be productive, but can also cause loss of potential synergy and duplication of effort,” it warns.

“Conditions such as autism, hearing impairment and visual impairment are addressed in differing and sometimes competing ways by different provision within local authorities, health boards, national provision and voluntary organisations,” it continues. “It is likely that more could be achieved if the different interest groups worked more closely together to create clear networks of communication and support for children, young people and their families as well as for the practitioners who are responsible for supporting them.”

The most far-reaching proposal, however, is that over the next five years the Scottish government should lead “a national strategic commissioning service” - in other words, consider the whole picture of what services are needed and how best to get them.

The government has promised to maintain current funding levels for the national special schools for the next three years, as it works with local authorities and health boards to create a more evidence-based process for allocating national funding.

As part of its review of their funding, it will look at some of the other services that receive government financial support: the Scottish Sensory Centre, CALL (Communication, Access, Literacy and Learning) Scotland and Enquire.

Two months after the publication of the Doran report, it is still too early to predict exactly how a national strategic commissioning service for complex needs will work (see panel, page 14).

In contrast to the current service, which sprang up in an “unplanned and reactive” way, any future approach must take as its starting point what is needed at a national and regional level that local authorities and health authorities cannot provide, Mr Doran says.

It is clear from his report that the current data on complex needs is flawed and incomplete, but the government has agreed to set up a sub-group to provide the necessary facts.

Mr Doran clearly envisages the national centres developing more flexible approaches.

“National specialist services aimed at supporting local authorities’ capacity building, developing expertise and contributing to best practice would be the most helpful use of national provisions in future,” the report states.

Instead of the child always being brought to the service - all seven schools are located in the central belt - he talks of the services’ expertise being brought to the child.

“The idea is to move away from the feeling of being in competition with local authorities where there are issues about costs,” he says.

Instead, there should be greater transparency of costs determined by key partners.

Delivering such a national commissioning process will require strong leadership from the Scottish government to bring everyone to the same table, he adds.

Local authorities currently bear the brunt of out-of-authority placements, he acknowledges, suggesting that discussions in future may have to look at health authorities contributing a greater share of the money.

“There is a strong argument for increasing funding overall for children with complex needs, but in the current climate conversations about increasing funding don’t tend to get very far,” he admits.

While the government has committed itself to maintaining the existing funding levels until the end of its period in office, Mr Doran says he has heard nothing to suggest a future government would not continue it for a further two years to cover the five years of transition that he recommends.

It looks unlikely that the national centres will disappear altogether, as long as they are prepared to adapt. But the option will remain for them to become independent operators.

Mr Doran points out that 82 per cent of respondents to his review, including local authorities, agreed that there is a need for resources outwith the capacity of local authorities.

“There is a small number of people ideologically opposed to any child going past the end of their street. In the case of some of these services, they are so specialist that they cannot be provided locally,” he says.

Some children could benefit from shorter, rehabilitative stays at the national centres, rather than, for instance, a 10-year placement, he suggests, and the national centres could perform more of an outreach, capacity-building role.

Capacity building is a focus for local authorities, too, according to Bryan Kirkaldy, who represented the education directors’ body ADES on the Doran review.

ADES sees educational psychologists as having a key role in building teachers’ and social workers’ capacity to work with young people with additional needs. But it is locked in a battle with the Scottish government over the withdrawal of funding for postgraduate training for educational psychologists.

It is becoming increasingly difficult to fill psychologists’ posts, particularly outwith the central belt, and a high proportion of psychologists are approaching retirement.

A senior manager with Fife Council, and an educational psychologist by training, Mr Kirkaldy points out that the Doran review’s focus on children with complex additional needs was concerned with only “the tip of the iceberg”; the 1978 Warnock report into special educational needs estimated that 20 per cent of the population would have additional support needs at any one time.

If education authorities are to be truly inclusive, that means building greater capacity, he says. And while he believes his own authority has a strong track record in meeting parents’ expectations, he accepts the need for better quality assurance and introduction of meaningful performance data related to complex needs - one of the Doran report’s recommendations.

ADES regards moves towards the strategic commissioning of services driven by analysis of need as “a great step forward”, compared with having “seven schools providing stuff needed in 1950 just held up by grant aid”, Mr Kirkaldy says.

He believes that certain areas of provision are under particular pressure - notably autism and attention deficit hyperactivity disorder (ADHD).

Capability Scotland makes the point that four of the seven national special schools currently cater for children with cerebral palsy andor complex health, communication and physical requirements, but there is no national school specifically for autism.

It believes national provision should be focused around three areas: children with complex health, communication and physical needs; children with autism; and children with social, emotional and behavioural difficulties.

The national schools themselves feel that local authorities tend to view their provision as an expensive last resort. Donaldson’s, for instance, argues that they sometimes fail to grasp the real cost of providing a full package of support for a deaf child with complex needs at local level.

The Scottish Centre for Children with Motor Impairments, better known as the Craighalbert Centre, gives a flavour of some of the trepidation that remains about the future.

It says: “SCCMI is pleased by the Scottish government’s commitment to funding which will not be less than that currently provided, particularly in a challenging economic climate.

“There is concern, however, that future funding of a national framework, which is as yet undefined, is merely being redirected from the grant-aided special schools and will result in the cessation of direct funding from the Scottish government in due course.”

KEY RECOMMENDATIONS

Recommendations in the Doran report, The Right Help at the Right Time in the Right Place. Strategic Review of Learning Provision for Children and Young People with Complex Additional Support Needs.

- Develop learning communities of expert professionals at local, regional and national levels to support teachers and other staff working with children with complex needs.

- Improve specialist training in complex needs.

- Consider creating a register of teachers with qualifications in complex needs to assist workforce planning.

- Provide sufficient government funding for university and other research into the education and development of children and young people with complex needs.

- The Scottish government should take action to ensure a consistent approach to implementing national policies and legislation so that parents and children can expect similar responses, regardless of where they live.

- Within the next five years, the government should lead Cosla and health boards in the development of a national planning and commissioning service for complex needs.

IN NUMBERS

40% - Proportion of respondents to the Doran review who felt that education services were providing `well’ or `very well’ for children with complex additional support needs

22% - Proportion who thought provision was `poor’

82% - Proportion who agreed that Scotland requires national provision for complex needs

4% - Proportion who disagreed the national provision was needed

60% - Proportion of teachers specialising in visual impairment who are over 45

68% - Proportion of teachers specialising in hearing impairment who are over 45

STRATEGIC COMMISSIONING

The Scottish government defines strategic commissioning as “the process of considering what services are needed and how best to get them”.

It adds: “The focus is on the need that requires to be met, rather than the services that are available to provide them, and to do this by considering the system as a whole.”

The strategic commissioning process to meet the Doran review recommendations will be established in partnership with various parties, including the local authorities (Cosla), education directors (ADES), social work directors (ADSW), the health boards, parents and seven national special schools.

`CARING MEANT CHANGING OUR LIVES TO FIT ALAN’

Alan Archibald was a bright and happy six-year-old when, in 2001, he suddenly became progressively ill with a rare neurological condition called Landau-Kleffner syndrome (LKS). A major feature of this childhood disorder is the gradual or sudden loss of the ability to understand and use spoken language.

For Alan and his parents, David and Elaine, it was the start of a decade of medical and educational interventions.

“As parents, we wanted to care for Alan in the best way we could. For us, caring meant changing our lives to fit Alan, rather than using external support to help us carry on as if nothing had changed,” Mr Archibald says.

“Alan required 24-hour care, so we did this naturally ourselves. We had to deal with night-time epileptic seizures and medical issues, in addition to educational needs.”

But unlike many families, their experience has a happy ending. Alan is now a first-year student at the University of St Andrews, where he is studying molecular biology, having gained five Highers, all band A1 passes.

His parents praise staff at their local authority, Perth and Kinross, for being prepared to assess Alan’s needs continually and make the appropriate adjustments to his support.

Unlike many children with complex additional support needs, Alan’s condition fluctuated significantly. Over the years, they liaised with a number of specialist staff - medical specialists at Great Ormond Street Hospital and in Finland; at local level, speech therapists, teachers and social workers.

Initially, LKS affected Alan’s speech and schoolwork. At the age of 8, his condition became much worse and he lost the ability to hear and speak properly. At this point, he was withdrawn from mainstream school and home- educated by his mother; Perth and Kinross Council provided home visits from his school. Then his condition deteriorated further to the point of aphasia - he was unable to speak, hear or even understand basic communication.

After meetings with support staff, Alan’s parents decided he would not be able to return to mainstream education and a place at a grant-aided national specialist school was agreed. The placement was non-residential and his parents continued to provide his overnight medical care.

Alan stayed at the school for five years. The lowest point was when his motor skills deteriorated. But then his medical condition started to improve, although his parents do not know why. He was able to begin reading again, learned sign language, recovered his hearing and learned to talk once more.

During this time, his progress was being monitored by the council. When Alan was 13, it was agreed that he should be integrated back into mainstream schooling. His parents visited a number of secondaries in their area and eventually decided that the Community School of Auchterarder was the most appropriate for his needs. Two large secondary schools closer to his home would have been overwhelming because of their size, they felt, as Alan had spent the previous five years in very small classes and still had communication difficulties.

With continued medical improvements and the school’s support, Alan found his place within the school. By the time he reached senior school, he was flourishing academically. He gained UK Maths Challenge “best in school” and “gold” awards, and with very hard work overcame his speech and language difficulties to gain a grade 1 pass in Standard grade English.

He chose not to do Higher English, having checked that it was not essential for entry to the university courses he was interested in. For Alan, English was like a second language as he effectively had to relearn it. In a classroom situation, it brought home to his parents that some teachers were better able than others to adapt their teaching methods to Alan’s needs.

“Some employed a range of audio and visual aids - for Alan, visual aids are very important,” Mr Archibald says. Alan found it harder to learn from teachers who employed only “chalk and talk” approaches.

Mr Archibald attributes Alan’s success to hard work - reading additional material on his own - but acknowledges that individual teachers in all the schools Alan attended made a real difference.

The main thing the various support professionals did, Mr Archibald says, was to “listen to us as parents and accept our judgement, although they had to do their own checking.

“Occasionally, as his illness progressed, we reached points when we had to tell the authority that Alan’s needs had changed. With good communications established, the authority listened, evaluated and acted appropriately. We shared respect with those involved, thinking of some as friends as much as professionals,” he says.

ON THE GASS

Scotland’s seven national grant-aided special schools (GASS)

- Capability Scotland’s Corseford School, Renfrewshire.

- Capability Scotland’s Stanmore House School, Lanark - for children with complex needs.

- Donaldson’s School in Linlithgow (for children who are deaf or have severe communication difficulties).

- Harmeny School in Balerno - social, emotional and behavioural difficulties

- The Royal Blind School, Edinburgh - visual impairment

- The Scottish Centre for Children with Motor Impairments (Craighalbert), Cumbernauld.

- East Park School, Glasgow - a significant learning difficulty coupled with additional disabilities including physical disability, sensory impairment, ADHD, attachment disorder, autism spectrum disorder and challenging behaviour.

Original headline: Special schools must adapt to stay in the picture