Schools are being legally required to deliver interventions for childrens with special needs that evidence suggests do not work and could even cause harm, a Schools Week investigation has found.
The finding is part of a special investigation that exposes how education, health and care plans (EHCPs) fail the most vulnerable children.
We asked 25 councils for a copy of section F of their 10 most recent EHCPs. This sets out the education provision that must be delivered. While this duty sits with the council, it falls to schools to carry out the provision.
Most councils refused to release plans, citing privacy concerns (Schools Week asked for personal details to be redacted).
Of the four councils that provided plans, many include interventions that studies suggest have no evidence to back their impact – or could do more harm than good.
Fidget toys mandated for SEND pupils
Fidget toys, or a variation of this such as “fiddle”, were mandated as interventions in 10 plans across all four areas.
Sunderland had four EHCPs containing the intervention. For one, “sensory breaks and sensory tools or fidget toys” was included in four separate sections. Another plan said the child needed “use of a basket of fidget toys”.
Milton Keynes had three EHCPs with the intervention. One plan stated: “Allow him to use fiddle toys (such as Blu Tack or a bowl of flat tokens) if he is feeling anxious, or overstimulated, or needs help to concentrate.”
But many studies say they are ineffective. A 2022 US paper even suggested “the negative effects of fidget toys on attention and learning outweigh [any] potential sensory benefits”.
Applying interventions that are not validated “sometimes can do more harm than good”, it added.
Parents fight, fight, fight for EHCPs – but if they don’t make things better, what is the system delivering?
Sunderland council refused to comment.
Debunked ‘learning styles’ feature in EHCPs
The long-debunked “learning styles” intervention appeared in three EHCPs.
One Sunderland plan said that “teaching style and tasks should be adapted to suit [redacted’s] developmental level and learning style”.
Another mandated a “broad and balanced differentiated curriculum which is underpinned with specific strategies, including consideration of her preferred learning style”.
But there is “very limited” evidence of “any consistent set of learning ‘styles’ that can be used reliably to identify genuine differences in the learning needs of young people”, the Education Endowment Foundation (EEF) states.
Any “impacts recorded [in studies] are generally low or negative”.
David Thomas, a former Department of Education adviser, said parents often “fight, fight, fight for this thing that should make a difference”.
“But if what they get at the end is a plan that doesn’t make things better – then what is the system delivering?
“We talk a lot about the challenges of getting an EHCP … we don’t talk enough about whether the plans are any good and whether the interventions they mandate work.”
Ben Newmark added such examples also showed the “leap between identifying a child as having a SEND need, and helping them, could often be a yawning chasm”.
“We cannot assume identification does any good, and must be open to the plausibility it might do harm.”
EHCPs are written by councils, but based on advice from professionals involved with the child, including educational psychologists who must assess pupils.
David Collingwood, president of the Association of Educational Psychologists, said “evidence-based interventions don’t work for everyone” and “some of the evidence can be around what works for that particular child”.
“For me, fidget spinners would be OK if there’s evidence on the ground that actually it does help this particular child – the child is reporting that, and the classroom teachers are reporting that.”
And Andre Imich, the Department for Education’s former SEND professional adviser, said you can “only make a good plan if you have good-quality advice from professionals”.
“The LA is the recipient of lots of advice – these [interventions] have come from professionals who put them forward.”
Where is the evidence?
Many experts pointed to a lack of robust evidence for what interventions work in SEND.
Children taking physically active breaks, or “brain” or “movement breaks”, featured in plans across all four areas.
One Milton Keynes plan stated: “Movement breaks and sensory aids should be explained to in simple terms, ie, that these can help him to stay focused and be a better learner.”
A plan issued in Manchester mandated “short brain breaks of up to five minutes throughout his lessons to prevent cognitive overload”.
Few were recommended in the “physical/sensory” part of EHCPs. Most were in the “cognition and learning” section.
But studies show mixed results in relation to the latter.
A University of Edinburgh paper last year found “existing research evidence is inconsistent in finding support” for claims the intervention improves academic achievement and cognitive function.
The plans featured other schemes that leave SEND experts sceptical, inclluding Lego therapy, wobble cushions, chew buddies, zones of regulation, dough disco and squiggle while you wiggle.
Cassie Young, an inclusion executive officer for a Kent academy trust, said the “limited” research into specific SEND interventions left schools “relying on anecdotal evidence or practice-based wisdom rather than robust, large-scale studies”.
“It does seem surprising given the number of interventions in circulation, but this is largely because SEND is not a homogeneous group, making it difficult to conduct universal, conclusive research that applies to all children with additional needs.”
Newmark added it was difficult to learn from best practice “because we don’t have a shared understanding” of “what SEND means”.
“We can’t study something if no one can agree what that thing is…we’re all just talking past each other.”
‘We should be using reasonable adjustments’
A solution is needed, quickly. The high-needs budget now sits at £11 billion – a 60 per cent rise in real-terms since 2015.
But despite spiralling funding, outcomes have not improved.
“If identifications and associated interventions aren’t useful, then spending more on them will just waste money,” Newmark said.
“Without reform in the way it is spent, more funding will not have a proportionate impact.”
Some are now calling for SEND to have a National Institute for Health and Care Excellence (NICE), which evaluates health interventions (see story here).
Thomas said that while it was legitimate for schools to try different things – especially when things were not working for a pupil – “we should not be creating legal requirements to do a particular intervention unless we are certain it works.”
Read the rest of our special, five-part investigation:
Fidget spinners and learning styles: EHCPs’ interventions exposed
Copy and paste: Poor quality EHCPs shortchange schools
Schools pick up the pieces of absent health and social care providers
Feature: The case for a SEND evidence ‘custodian’
Comment: SEND provision is the last bastion of unevidenced practice
Experts were also surprised some EHCPs included interventions such as ear defenders, a “structured learning environment” or “additional time to complete activities”.
One trust said it had an EHCP that mandated a “structured programme” to “help develop [a child’s] ability to be toileting independently” by the end of key stage 3.
But the plan added provision needed to include him “really enjoying using his personalised handwash that is available in the classroom” – legally binding the school to provide this.
Anne Heavey, who sits on the government’s school inclusion reforms panel, said to achieve ministers’ aim of more inclusive mainstream schools, “we need to support more to make reasonable adjustments as part of their everyday universal offer.
“Some of the content in these EHCPs should just be in place for pupils without jumping through the hurdles of a statutory assessment.”
A spokesperson for Milton Keynes council said its plans were “structured in a uniform way to ensure consistent support”. Specifics of plans were “co-produced between parents, schools, youngsters and local partnership professionals”.
However, it faced increased demand for EHCPs and a shortage of professionals in critical areas.
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