Special Educational Needs (SEN) and brain injury

This section covers returning to education and the Special Educational Needs process.

It’s tempting to see the move back to school as a ‘return to normality’. While it's certainly a positive step, it’s also the beginning of a new stage of rehabilitation, one which comes with its own set of challenges.1, 2

It may be extremely tough for a child, as they realise they’re not as able to do things they found easier before.3 This can have a big impact on self-esteem.4 Children may struggle with the social aspects of returning to school, which we’ll come to later.5 Parents may feel their children’s needs aren’t being considered enough.6 

The danger of misunderstanding 

It’s in the classroom that many of the misunderstandings about acquired brain injury can take place.7 We know children with acquired brain injury struggle with concentration and attention. If the people around a child don’t know about this, there’s a risk the child will be unfairly thought of as ‘naughty’.8

The effects of acquired brain injury might be familiar to you and your family, but may seem invisible to others. It’s for this reason that you might hear acquired brain injury referred to as ‘the hidden disability’.9, 10

Sharing information and talking to teachers and school staff is extremely important here.11 If we list some of the effects of acquired brain injury, it’s easy to see how they might be misunderstood as a ‘bad attitude’ or ‘misbehaviour’.12

  • Tiredness, difficulty concentrating 13
  • Problems processing information and memory 14
  • Difficulties with social skills 15, 16
  • Irritability, feeling frustrated or angry 17, 18

The key to avoiding these misunderstandings is in involving teachers as early as possible.19 Keeping open the lines of communication can help with many of the difficulties in a return to school.20

Some parents have benefitted from having someone from their child’s school at the discharge planning meeting before leaving hospital. Perhaps the school’s Special Educational Needs Co-ordinator (SENCO) or head teacher.

This means the school hears about your child’s difficulties directly from healthcare professionals. If this isn’t possible, parents can talk to teachers to make sure they’re aware of the acquired brain injury.

It’s important that teachers are aware of the acquired brain injury even if your child doesn’t appear to have too many difficulties. It may be some time before the effects of the injury come to the surface, and it’s important for teachers to know this.21 

Schools are required by law to have a SENCO – a Special Educational Needs Cordinator.22 They are there to help school staff understand and help with any difficulties your child may have. In cases where the child’s needs are significant and complex there is an important process to go through before your child returns to school.

If the special educational needs process seems confusing, there are people who can help parents. See below for our section on ‘Who can help?’, which includes details of the Parent Partnership Services. 

Special educational needs: process for assessment 

Our information in this section is intended to support the official documentation for the process in your country (there are key differences between England, Scotland, Wales and Northern Ireland).

You can read these documents using the links below.

The process is about first establishing whether a/your child has special educational needs. It’s then about looking at what those needs are, before working out how those needs should be met.23

Your child might need help with getting around the school, or changes to the way they are taught.24

It can be a very strange and difficult time for a parent as their child’s future is decided, often by people they don’t know. There can also a lot of paperwork.25 Some parents may feel anxious about getting an Education, Health and Care (EHC) plan. Perhaps they feel this is an acknowledgement that their child has permanent difficulties. But we know this may not be the case.26

Agreements must be reached between parents, the local authority and the school. This can be time-consuming, and occasionally results in parents appealing the decisions that have been made. The local authority is obliged to send you information about how to do this.27

The Special Educational Needs process in different parts of the United Kingdom 

Important to note is that there are differences in the way England, Scotland, Wales and Northern Ireland manage this process.

If you’d like to read the official guidance on the processes for your individual country, then use the links below (countries listed in alphabetical order).

England

Northern Ireland

Scotland

 Wales


You can read on for more of our information on these processes.

Contact offers advice on the Special Educational Needs process. It has three dedicated Special Educational Needs advisors. Call 0808 808 3555 between Monday and Friday, from 9.30am to 5pm. Select ‘SEN’ from the menu when you call. You can also email: [email protected]

What does special educational needs actually mean? 

‘Special educational needs’ has a legal definition in the law of the United Kingdom. Children described as having special educational needs (SEN) have learning or behavioural difficulties, or disabilities that make it more difficult for them to learn than most children of the same age.23

For children with acquired brain injury, this might be because:

  • They’re struggling to process information
  • They’re having difficulty remembering things
  • They find it hard to concentrate 28

They have sensory or physical difficulties 29, 30

What is an Education, Health and Care plan (EHCP)? 23 

If your child already has a statement of SEN this will continue until the statement is reviewed. At this review it will be decided whether to change to the new EHCP which now replaces statements of SEN. You can discuss this with your child’s school’s SENCO to learn more about the process for your child. You can read a factsheet on Changing from the old system to the new produced by Contact here.

If your child’s needs are significant and complex and require a level of support that is at a higher level than the school can meet, it may be decided with you that a request is made for Education, Health and Care Needs Assessment, which can lead to a EHCP.

EHCPs can be issued for a child or young person between 0 and 25 years of age. They cover all educational, health and social needs of a child or young person and have a strong emphasis on their future aspirations. The various organisations that provide educational, health and care support work closely together to make sure children and young people get the best support.

If your child is refused an assessment or an EHCP and you are unhappy with the decision, you can appeal to the Special Educational Needs and Disability Tribunal. You must do this within two months or receiving the decision 31

How do I know if my child’s needs should be assessed in this way? 

“Every child is different”. You may read this phrase time and again in information on acquired brain injury, but this is only because it’s an important point to keep in mind.32, 33

The severity of some children’s injuries will mean they will certainly need more support than is available in a mainstream school. For others, it will be less clear-cut. Some parents have expressed their frustration that the ‘hidden’ nature of acquired brain injury means parents have a tough time convincing others that there are difficulties.34

Your first port of call might be your child’s school. If a/your child has taken time off, it’s important to get back in touch with teachers. Every school is required by law to have a SENCO – a Special Educational Needs Coordinator.

Who will support us through this process? 

There are a number of professionals you may deal with over the course of the process.23

Named officer

  • This is the person at your local authority who will deal with a/your child’s case. It’s not always possible, but the local authority should try to make sure parents are speaking with the same person throughout the process. 

Parent partnership service

  • These services provide support and advice to parents. They aim to provide accurate and unbiased information on the full range of options available to parents. In other words, they don’t ‘take sides.’ 
  • You can find your local service by searching online using the term ‘parent partnership service’ and your county or by contacting your local authority.

Disagreement resolution services

  • These services are an informal way of sorting out disagreements between parents and the local authority. They may also help out with any disagreements between parents and the school. 
  • The aim is to place someone in the middle of the disagreement who won’t take sides and will help sort out the dispute. It’s very important to remember that using this service does NOT prevent parents from appealing to a tribunal.

IPSEA – Independent Parental Special Educational Advice – is a registered charity offering free and independent advice to parents of children with special educational needs in England and Wales on:

  • Local authorities’ legal duties to assess and provide for children with special educational needs 
  • Exclusions of children with special needs/disabilities
  • Actions or inactions by local authorities and/or schools which discriminate against children with disabilities

Another good source of support through the SEN process is the Council For Disabled Children, they have lots of resources and information to help parents.

Parent partnership services can be important allies in the SEN process. They can come along to meetings, and may voice the concerns you might be wary of speaking about." Tip from our experts


Parents’ experiences 

Before you read on to the official SEN process for your individual country, you may want to read some parents’ experience of the process.

We feel like we had to become different people, in many ways. We’re not the sort of people who’d want to push to the front of the queue, but we just had to be very demanding to get what we could for our child.

We had lots of meetings. Meetings about rehabilitation, meetings about school... it can be hard to see people you don’t know making decisions about your child’s life."

We have updated our education pages in accordance with the government changes made in September 2014. If you feel you need additional information to understand these changes please refer to Contact's information guide. 

References

  1. Walker S (2009). Educational Implications of Acquired Brain Injury: a resource for educational psychologists. Brain and Spine Foundation, p33.
  2. Baldwin T, Demellweek C, Rankin P, Carleton F (2006). Cognitive problems. In Appleton R, Baldwin T (Eds.), Management of Brain-injured Children (pp171-222). Oxford: Oxford University Press.
  3. Baldwin T, Demellweek C, Rankin P, Carleton F (2006). Cognitive problems. In Appleton R, Baldwin T (Eds.), Management of Brain-injured Children (pp171-222). Oxford: Oxford University Press. Ylvisaker M, Turkstra LS, Coelho C (2005). Behavioural and social interventions for individuals with traumatic brain injury: a summary of research with clinical implications, Seminars in Speech and Language, 4 (26), pp256-267.
  4. Baldwin T, Demellweek C, Rankin P, Carleton F (2006). Cognitive problems. In Appleton R, Baldwin T (Eds.), Management of Brain-injured Children (pp171-222). Oxford: Oxford University Press.
  5. Baldwin T, Demellweek C, Rankin P, Carleton F (2006). Cognitive problems. In Appleton R, Baldwin T (Eds.), Management of Brain-injured Children (pp171-222). Oxford: Oxford University Press.
  6. Savage RC, Depompei R, Tyler J, Lash M (2005) Paediatric traumatic brain injury: A review of pertinent issues. Pediatric rehabilitation, 8 (2), pp92-103.
  7. Savage R, Pearson S, McDonald H, Potoczny-Gray A, Marchese N (2001). After hospital: working with schools and families to support the long-term needs of children with brain injuries. Neurorehabilitation, 16, pp49-58. Norrie J, Heitger M, Leatham J, Anderson T, Jones R, Flett R (2010). Mild traumatic brain injury and fatigue: a prospective longitudinal study. Brain Injury, 24, (13-14), pp1528-38.}) @refDefine(159a,{|NICE guidelines. Head Injury: Triage, assessment, investigation and early management of head injury in infants, children and adults.
  8. Appleton R, Furlong L, Baldwin T (2006). Head (brain) injury rehabilitation team. In Appleton R, Baldwin T (Eds.), Management of Brain-injured Children (pp41-63). Oxford: Oxford University Press.
  9. Middleton, JA (2001). Brain injury in children and adolescents. Advances in Psychiatric Treatment , 7, pp257-265.
  10. Walker S (2009). Educational Implications of Acquired Brain Injury: a resource for educational psychologists. Brain and Spine Foundation. Rees SA, Skidmore D (2008). The classical classroom: enhancing learning for pupils with acquired brain injury. Journal of Research in Special Educational Needs, 2 (8) pp88-95.
  11. Walker S (2009). Educational Implications of Acquired Brain Injury: a resource for educational psychologists. Brain and Spine Foundation, P33. Baldwin T, Demellweek C, Rankin P, Carleton F (2006). Cognitive problems. In Appleton R, Baldwin T (Eds.), Management of Brain-injured Children (pp171-222). Oxford: Oxford University Press. Gore H, Wood, S (2006). Speech and language difficulties. In Appleton R, Baldwin T (Eds.), Management of Brain-injured Children (pp152-170). Oxford: Oxford University Press.
  12. Baldwin T, Demellweek C, Rankin P, Carleton F (2006). Cognitive problems. In Appleton R, Baldwin T (Eds.), Management of Brain-injured Children (pp171-222). Oxford: Oxford University Press.
  13. Middleton, JA (2001). Brain injury in children and adolescents. Advances in Psychiatric Treatment , 7, pp257-265. Baldwin T, Demellweek C, Rankin P, Carleton F (2006). Cognitive problems. In Appleton R, Baldwin T (Eds.), Management of Brain-injured Children (pp171-222). Oxford: Oxford University Press. Middleton, JA (2001). Brain injury in children and adolescents. Advances in Psychiatric Treatment , 7, pp257-265. Baldwin T, Demellweek C, Rankin P, Carleton F (2006). Cognitive problems. In Appleton R, Baldwin T (Eds.), Management of Brain-injured Children (pp171-222). Oxford: Oxford University Press.
  14. Powell, TJ (2004). Head Injury: a practical guide (revised edition). Milton Keynes: Speechmark, p75. McCormick A, Curiale A, Aubut J, Weiser M, Marshall S. Paediatric interventions in acquired brain injury rehabilitation, Evidence-based Review of Moderate to Severe Acquired Brain Injury <www.abiebr.com > [consulted 15/12/11], PDF p17. Moran C and Gillon G (2004). Language and memory profiles of adolescents with traumatic brain injury. Brain Injury, 18 (3), pp273-288. Ylvisaker M, Szekeres SF, Haarbauer-Krupa J (1998). Cognitive rehabilitation: organisation, memory and language. In Ylvisaker M (Ed.), Traumatic Brain Injury Rehabilitation Children and Adolescents (pp181-265). Boston: Butterworth-Heinemann. Savage RC, Depompei R, Tyler J, Lash M (2005) Paediatric traumatic brain injury: A review of pertinent issues. Pediatric rehabilitation, 8 (2), pp92-103.
  15. Walker S (2009). Educational Implications of Acquired Brain Injury: a resource for educational psychologists. Brain and Spine Foundation, p26.
  16. Baldwin T, Demellweek C, Rankin P, Carleton F (2006). Cognitive problems. In Appleton R, Baldwin T (Eds.), Management of Brain-injured Children (pp171-222). Oxford: Oxford University Press.
  17. Middleton, JA (2001). Brain injury in children and adolescents. Advances in Psychiatric Treatment , 7, pp257-265.
  18. Savage RC, Depompei R, Tyler J, Lash M (2005) Paediatric traumatic brain injury: A review of pertinent issues. Pediatric rehabilitation, 8 (2), pp92-103.
  19. Walker S (2009). Educational Implications of Acquired Brain Injury: a resource for educational psychologists. Brain and Spine Foundation, P33.
  20. Gore H, Wood, S (2006). Speech and language difficulties. In Appleton R, Baldwin T (Eds.), Management of Brain-injured Children (pp152-170). Oxford: Oxford University Press.
  21. Middleton, JA (2001). Brain injury in children and adolescents. Advances in Psychiatric Treatment , 7, pp257-265. Walker S (2009). Educational Implications of Acquired Brain Injury: a resource for educational psychologists. Brain and Spine Foundation, p7,p17. Middleton, JA (2001). Brain injury in children and adolescents. Advances in Psychiatric Treatment , 7, pp257-265. Baldwin T, Demellweek C, Rankin P, Carleton F (2006). Cognitive problems. In Appleton R, Baldwin T (Eds.), Management of Brain-injured Children (pp171-222). Oxford: Oxford University Press.
  22. SEN code of practice. P34. Item 4:15.
  23. Special educational needs and disability code of practice: 0 to 25 years (2014). Department for Education and Department of Health. available at:https://www.gov.uk/government/uploads/system/uploads/attachment_data/fi…
  24. Baldwin T, Demellweek C, Rankin P, Carleton F (2006). Cognitive problems. In Appleton R, Baldwin T (Eds.), Management of Brain-injured Children (pp171-222). Oxford: Oxford University Press.
  25. Savage RC, Depompei R, Tyler J, Lash M (2005) Paediatric traumatic brain injury: A review of pertinent issues. Pediatric rehabilitation, 8 (2), pp92-103.
  26. Baldwin T, Demellweek C, Rankin P, Carleton F (2006). Cognitive problems. In Appleton R, Baldwin T (Eds.), Management of Brain-injured Children (pp171-222). Oxford: Oxford University Press.
  27. Directgov website. http://www.direct.gov.uk/en/Parents/Schoolslearninganddevelopment/Speci…
  28. Middleton, JA (2001). Brain injury in children and adolescents. Advances in Psychiatric Treatment , 7, pp257-265.
  29. Walker S (2009). Educational Implications of Acquired Brain Injury: a resource for educational psychologists. Brain and Spine Foundation, p23.
  30. Furlong L, Sellars J, Doyle T, Appelton R (2006). Immediate medical and nursing needs. In Appleton R, Baldwin T (Eds.), Management of Brain-injured Children (pp65-106). Oxford: Oxford University Press.
  31. Special educational needs and disability tribunal (2014) available from https://www.gov.uk/special-educational-needs-disability-tribunal/overvi…
  32. Taylor HG (2004). Research on outcomes in pediatric traumatic brain injury: current advances and future directions. Developmental Neuropsychology, 25 (1/2), pp199-225. Fletcher JM, Ewing-Cobbs L, Francis D, Levin HS (1995). Variability in outcomes after traumatic brain injury in children: A developmental perspective. In Broman SH and Michel ME (Eds.), Traumatic head injury in children (pp3-21). Oxford: Oxford University Press.
  33. Anderson VA, Catroppa C, Morse SA, Haritou and Rosenfeld J (2000). Recovery of intellectual ability following traumatic brain injury in childhood: Impact of injury severity and age at injury. Paediatric Neurosurgery (32), pp282-290.
  34. Middleton, JA (2001). Brain injury in children and adolescents. Advances in Psychiatric Treatment , 7, pp257-265. Savage R, Pearson S, McDonald H, Potoczny-Gray A, Marchese N (2001). After hospital: working with schools and families to support the long-term needs of children with brain injuries. Neurorehabilitation, 16, pp49-58. Norrie J, Heitger M, Leatham J, Anderson T, Jones R, Flett R (2010). Mild traumatic brain injury and fatigue: a prospective longitudinal study. Brain Injury, 24, (13-14), pp1528-38. Appleton R, Furlong L, Baldwin T (2006). Head (brain) injury rehabilitation team. In Appleton R, Baldwin T (Eds.), Management of Brain-injured Children (pp41-63). Oxford: Oxford University Press. Baldwin T, Demellweek C, Rankin P, Carleton F (2006). Cognitive problems. In Appleton R, Baldwin T (Eds.), Management of Brain-injured Children (pp171-222). Oxford: Oxford University Press.