“In the field of special education, there is a spectrum at one end of which lie decisions which are heavily influenced by policy and which come close to being non-justiciable. In relation to such decisions, the court is unlikely to find negligence proved unless they are ones which no reasonable education authority could have made. At the other end of the spectrum are decisions involving pure professional judgment and expertise in relation to individual children such as, for example, whether a child is dyslexic or suffering from some other learning difficulty. In relation to these decisions, the court will only find negligence on the part of the person who made the decision (for which the authority may be vicariously liable) if he or she failed to act in accordance with a practice accepted at the time as proper by a responsible body of persons of the same profession or skill: see Bolam v Friern Hospital Management Committee[1957] 1 WLR 582 .”
“Anthony comes into school each morning quite happily. His co-ordination has improved and his manual dexterity shows steady progress – he tries extremely hard to form his letters correctly and his colouring has improved. His reaction or inter-reaction with the rest of the class is very limited and he often appears vacant. The week of his birthday in November, we saw a different child. He was animated and full of confidence and we all hoped that this was a breakthrough. He was obviously made to feel very important at home as the ‘birthday boy’ and this paid dividends, but sadly he has since gone back to his old self. We know he is very different from his sister Dominique, who is in her second year with us. Her progress is excellent and I am delighted with her, I wish I could say the same for Anthony.”
“Teacher and Head feel [Anthony] has benefited little since his arrival in [September 1987], that there is a widening gap between his peer group. This applies both to verbal inter-reaction [songs, rhymes, communicating], and to pre-reading/pre-writing skills. The general approach is very prep school/academic, i.e. [Anthony’s] group will have achieved basic reading and writing by the end of this term. This accentuates [Anthony’s] learning difficulties. Head and Teacher think [Anthony] is in no way ready to move into the next class, and to repeat the same year with the next group with younger children would only delay a decision for a more appropriate placement. Mrs Fry intends to give both parents an appointment during this week. I will contact Mrs Crowley and offer an appointment for an up to date assessment, support and assistance in considering alternative placements. Has Anthony been notified for ‘Special [Educational] Needs’?”
“I feel he would benefit from a short course of therapy preferably in a group setting. I intend to see him as soon as there are (sic) a group of children with similar difficulties and when the waiting list eases off a little.”
“I saw Anthony Crowley recently. He has started at St Paul’s School, Thames Ditton, and has settled in there well, according to his mother. I gather he is due to have speech therapy in group sessions at Thames Ditton Clinic, and I believe Ann Jozefowicz will be visiting the school in the next few weeks. I think Mrs Crowley is very keen that Anthony should receive any extra help he may need as early as possible. My feeling is that he has made some strides with his language. His articulation is still rather immature. No doubt you will be keeping an eye on him at St Paul’s School. We can be in touch when I next see you at the Child Development Team meeting.”
“Feeling that he is generally delayed developmentally and in attainment but that he has made progress … [Ann Jozefowicz] has visited school once. [Educational Psychologist] collected samples of free writing and drawing. Letters poorly formed and no spaces between words. Discussion with [class teacher] about ways of spacing the words and about use of cursive scripts. Drawings of people below average range. [Educational Psychologist] carried out informal assessment. Knows some letter sounds. Wrote first name without the h and o and with the n rotated through 180 degrees. Uncertain about recognition of some digits.”
“I was able to have a quick look at Anthony in class towards the end of last term. He certainly seems to be making a slow start with some aspects of his school work and I am sure he would benefit from extra help. However, I am not yet certain whether the source of the extra help should be from within the school’s own resources or whether we should organise things from outside for him. I have suggested some specific ideas to the staff to try with Anthony to help with that decision and I hope to follow up those ideas with the staff on a future visit. I have called Mrs Crowley recently to explain how far I have got and what we will be doing next. I will let you know any further developments.”
“He has now completed one term at St Paul’s School ... where he seemed to be quite settled. Mrs Crowley thought that his writing deteriorated initially, but things are beginning to pick up now. Within the classroom his attention span is short and according to his class teacher he will not stick to the task in hand. His language has improved since I last saw him and his articulation is improved, although he still has some difficulty with sh and ch. In the last six months his drawing of a man has improved quite dramatically. In June 1988 it was little more than some disjointed scribble. Now he is able to draw a recognisable man. He attempted to write his name which he achieved with some prompting. Also, he was able to write the letter 5 for his age with some prompting.”
“Before the end of the last summer holidays, the Education Psychologist for our area had promised us Anthony would be receiving 5 hours a week individual instruction to help him grasp the basics of his education. Unfortunately, this has not transpired due to lack of staff.”
“I would be grateful if you could see this little boy who has considerable difficulties. He has progressed well since his admission to school but would, I feel, benefit from your unique approach.”
“He should make slow but steady progress but could well need a more intensive input in the near future.”
“I gather you have taken over from Miles Halliwell in managing Anthony’s educational difficulties. I enclose a copy of the letter I wrote recently to the General Practitioner. I think Mrs Crowley is a little concerned that despite recommendations for extra help for Anthony within the school, so far this has not happened. Anthony has made steady progress since I last saw him. His drawing and writing have improved and also his language development is making steady progress. I would be very interested to have your opinion on his management within the school and I am sure Mrs Crowley would be pleased to hear from you about it. I will be contacting [Mrs Bentley] about her opinion on his language development. It may be helpful to discuss Anthony further at the Child Development Team meetings, and I will be delighted to meet you, if you can get up to Maple Children’s Centre on a Tuesday morning, between 9.30 and 10.30.”
“He does need it so follow up in September to make sure that this is happening.”
“The ITPA was a detailed assessment of choice for investigation of a child’s processing. In particular, those parts of the tests that dealt with auditory and visual abilities were considered to be very accurate. The test provided information about the patient’s auditory-vocal channel and visual-motor channel and which of these was superior.”
“By grouping the scores in a certain way, it is possible to get information to compare the auditory-vocal channel with the visual-motor channel. (All the sub-tests are in one or other channel.) Anthony’s auditory-vocal channel is marginally superior to his visual-motor channel. Anthony also shows little difference between the levels of functioning but he does achieve the sub-tests at the automatic level (e.g. memory tests) slightly better than those requiring language representation. However it is at the process level that his difficulties are exposed. His receptive process is weaker than the association process which, in turn, is weaker [than] the expressive process. This I felt to be, in part due to his poor attention control although there are some features of a language disorder. I therefore feel that Anthony’s language development should be very carefully monitored, and this detailed assessment repeated regularly in order to assist in the remediation programme.”
“Can Anthony be statemented, please?”
“Anthony is progressing. His fine motor co-ordination is improving and his letter formation is markedly better than the previous occasion when seen. Anthony is receiving help each day in a small group setting. Mrs Noad is also to advise on a programme of help for Anthony.”
“Letter formation is markedly better than the previous occasion when seen”, although this is hardly the message conveyed in the class teacher’s comments to which I referred in paragraph 69. It is difficult to know when the two assessments of letter formation (which there must have been to justify this observation) were made – and indeed by whom. Equally, it is unclear whose assessment underpins the observation about “fine motor coordination”
“It is apparent that Anthony’s verbal skills are better developed than his non verbal skills. The strengths suggested in the speech therapist’s report are again evident in terms of his auditory memory. He still finds perceptual and tasks involving visual memory difficult. Anthony was able to attempt the Burt Rearranged Word Reading Test, where he gained a reading age of 5 years 7 months. He wrote his name correctly with a neat hand. (His hand/eye coordination has obviously improved greatly.) Anthony only managed to spell one word correctly and he is obviously not finding learning an easy matter. In terms of the 1998 Education Act, Anthony’s learning difficulties/under-functioning would not be considered to be severe and/or complex and his needs should be met from the resources which are normally available within schools. At the moment, Anthony receives additional support on 4 days of the week for a period of 30 minutes in a small group.”
“He is … being taken out of the class, in a small group with another teacher everyday, for half an hour.”
“This programme used colour-coding of grammatical word classes, and the materials, in three sequential levels, were developed for children with severe specific language disorders, hearing impairments, and moderate learning difficulties.”
“Anthony was seen in Dr Christie’s clinic yesterday. He is coming on well. He has extra help of ½ hour for 4 days in the week and he is happy at school. He can write his name clearly, draw a man, house with a chimney and a dog and a tree. He has been having regular speech therapy from February. His mother has seen the educational psychologist in February and his assessment was that Anthony was better in verbal skills than in non verbal skills. His learning difficulties are not severe, hence he is having extra help at school”
“Anthony finds it very difficult to absorb new information and needs plenty of repetition and reinforcement. He does not listen attentively to instructions and needs to develop his concentration span.”
“Anthony achieved success slowly and needs much practical reinforcement. He works well on a one-one basis, but must be encouraged to apply himself more to his work with more independence.”
“Associated language delay: this term will be used to describe the slowed speech and language skills associated with children who have associated learning difficulties, and are learning all intellectual skills more slowly. Innate, “hardwire” slowed processing, reduced learning speeds, reduced memory capabilities all result in reduced potential for learning language skills, both in understanding an expressive use of language. For children best described in this way, their test results in many areas of development will be comparable. The group is defined by their even profile of development: many of the more recently published verbal and non-verbal measures, which will be obtained from testing to establish this profile, now have statistical calculations available to demonstrate the evenness/unevenness of profile scores across different areas of development. Specific language disorder: in contrast to associated language delay, this description is made via “cognitive referencing”: the child’s communication skills are at odds with “much lower than” other more general aspects of development. A child with “classic” specific language disorder will, right from the onset of concern, show non-verbal (visual reasoning, problem solving) abilities in the normal range for their age, but with contrasting and marked deficits in their communication skills.”
“The definition is, therefore, one of discrepancy: the child with a specific language disorder has poorer developed language skills (receptive, expressive or both those) than their stronger, better developed non-verbal skills (of such abilities as visual reasoning/problem solving). These definitions above are those which are internationally accepted and widely used in diagnostic assessments. Furthermore, the Royal College of Speech and Language Therapists (UK) offer guidance through the best practice governs document Communicating Quality with regard to the detailed definition of specific language impairment: • Language skills, as assessed on standardised tests, are below the two standard deviations limit for the child’s age • Language skills are at least one standard deviation below non-verbal IQ assessed on standardised tests • There no neurological sensory or physical impairments that directly affect the use of spoken language, nor is there a pervasive developmental disorder” • Language skills, as assessed on standardised tests, are below the two standard deviations limit for the child’s age • Language skills are at least one standard deviation below non-verbal IQ assessed on standardised tests • There no neurological sensory or physical impairments that directly affect the use of spoken language, nor is there a pervasive developmental disorder”
“In the mid-late 80s, [specific language impairment] was definitely viewed as a “discrepancy” diagnosis, with many of the resources aimed to support children targeted at those children who had a demonstrable difference between their testable non-verbal (performance) abilities, and their verbal (language skills). Since that time, the understanding of the relationship between developing cognition and language abilities has changed, and it has come to be recognised that children may show additional and specific deficits in language processing abilities, in conjunction with (or even arising from?) generalised cognitive impairment. The concept of “discrepancy” a gap in language/non language skills remains key, however, to deployment of diagnosis and resources for this group.”
“I think it would be worthwhile having Anthony assessed by an educational psychologist to see what his intellectual potential is and also to see if there are any underlying problems which we could help him with.”
“I … found that he was functioning in the below average range of ability. The result of the present assessment is a little lower than that which I previously carried out, suggesting that he is functioning within the bottom 10% of the population with regard to his verbal skills. I administered a number attainment tests and found that Anthony is making excellent progress in the areas of reading, spelling and numeracy and this must reflect great credit on both himself and his school. Anthony does not appear to have any specific learning difficulties but will need a good deal of support and encouragement in the context of his present school in order to foster his confidence and self esteem. It was particularly noticeable that Anthony gave up very quickly when he encountered the slightest difficulty and needed to be encouraged to attempt tasks for which he was perfectly capable of performing.”
“As discussed on the phone, I would be most grateful if you could do a detailed assessment for Anthony. There are a lot of anxieties about his education and would be a good idea if you express his difficulties and recommendations.”
“Anthony does not have any specific language difficulties rather his language delay is part of a more global development delay. It is therefore recommended that the aims of provision should be to improve communication skills by his placement in a small class where a language programme geared to the children’s overall learning ability forms a regular part of classroom activity in a language stimulating environment. Access would also be available in this setting to individual or group speech and language therapy as appropriate.”
“I am requesting this appeal because Anthony is very near the borderline with his IQ score. He has recently undergone a speech therapy test to determine the required help he needs in this area, a copy of the speech therapists findings are enclosed, which I feel are quite significant. During Anthony’s education so far, several teachers … have told me that our son needs help on a ‘one to one’ basis. Whilst I appreciate there are others who have more extensive problems, I feel Anthony is slipping through the net … [He is] not getting the help and guidance to which he is entitled …”
“The Authority has looked again at Anthony’s case in the light of your letter, but considers that Anthony does not meet our criteria for formal assessment, and is in fact currently performing at the expected level, given his age and ability.”
“Anthony’s only remaining articulatory immaturity is an inter-dental ‘s’ sound. He will be offered a short course of therapy to remediate this. Speech is sometimes unclear, but Anthony is able to rectify this himself when he is made aware that he has not been understood. No other speech and language therapy input is required.”
“…her report gave none of the essential information from the background of the case, or recommendations for supporting Anthony in school. Enough time had elapsed since testing for her to have made a valid reassessment using the CELF-R to inform the Statutory Assessment process. Most statement reports give at least a brief chronology of involvement of the speech and language services up to that point, give assessment of all relevant communication skills, and recommendations for the impact of any communication difficulties in the classroom.”
“Hilary Stirling felt that this was a very thorough report and, for the first time, it gave the LEA an in-depth report on Anthony’s difficulties. Arno Rabinowitz agreed that the report gave a clear view of the level of Anthony’s difficulties which had not been clear prior to the report, in particular his speech and language difficulties.”