Vulnerable children face “slipping through the net” under plans for schools to provide help for conditions such as ADHD without a diagnosis, experts are warning.

They fear that children with parents who do not know how to “navigate the system” risk losing out vital support like access to teaching assistants, with schools facing increased requests for help.

A landmark review of rising ADHD and autism diagnoses, published on Friday, said pupils should get learning support for such conditions, alongside mental health issues, without a diagnosis.

It called for schools to make reasonable adjustments to learning based on pupils’ needs, rather than whether they have a formal diagnosis.

School leader Anne Heavey, who sits on the government’s expert advisory group on mainstream inclusion, said the report and wider reforms for pupils with special educational needs (SEND) “call on us to do more earlier for pupils with barriers to learning”.

But teachers warn funding shortages already limit the support they can provide.

Heavey, the director of SEND and Alternative Provision at the Kemnal Academies Trust, which runs 45 schools, added: “It’s really important that we support schools to do this well, especially to ensure that children whose families aren’t able to advocate for them aren’t missed out or left behind.”

The extra help children can already get

Professor Peter Fonagy’s 600-page review included a recommendation for “a fundamental shift from a diagnosis-dependent system to a needs-led plus diagnosis system”.

According to the review, support should be available according to a child’s needs “before, during and after assessment, and not be withheld while waiting for a diagnosis”.

Schools can already make “reasonable adjustments” for pupils they believe have additional needs.

For children with ADHD and autism, this can include putting visual timetables up in classrooms and breaking down instructions into single steps.

Children can also be provided with writing frames, sand timers, fidget toys and wobble cushions to help them focus in class.

Those with more significant needs might require a one-to-one teaching assistant (TA) during lessons. 

The government has promised new guidance for teachers on reasonable adjustments to “support inclusion” in schools.

It is part of government reforms to the SEND education system which will see more pupils with additional needs taught in mainstream schools.

The guidance will “make clear that children do not need a diagnosis to receive reasonable adjustments, and help settings consider how some disabilities can be addressed at a universal level”, the government has said.

They hope this will lead to children getting support without having to wait sometimes years for assessments.

‘Another system where those with strongest advocates benefit?’  

Rhian Walker, national director of SEND for the multi-academy trust E-ACT, said the “real test” of reforms to the system “will be whether they make support more accessible for our most vulnerable children, rather than creating another system in which those with the strongest advocates benefit most”.

“No child should have to wait for a diagnosis before receiving the support they need in school,” she told The i Paper: “Equally, no child should be disadvantaged because their parents are less confident or less able to navigate the system.”

Schools are already “hamstrung” in their efforts to make adjustments for pupils by shortages of funding and health expertise, said Paul Whiteman, general secretary at school leaders’ union the National Association of Head Teachers (NAHT).

“It is crucial that any additional expectations on schools mitigate this rather than add to pressures on schools, coming with extra funding, specialist capacity and external support,” Whiteman said.

“This must also ensure access to support is consistent and equitable across all parts of the country, and not dependent on how effectively parents can navigate the system or advocate for their child.”

Vicki Collins, a former teacher who now runs a tutoring agency, also said moving away from a diagnosis requirement for support could also lead to parents of children who don’t require extra help to start asking for it.

Jodie Lopez, a former primary school teacher in London who now works as an education technology consultant at schools in Nottingham, said this shift could also put “a lot more pressure on teachers”.

They will have to be “that advocate for the child whose parents don’t realise”. Lopez said. But overstretched teachers could struggle to spot those children, with some “slipping through the system”.

Connie Muttock, director of policy and insight at the Centre for Young Lives, which supports young people, said it welcomes the review, and it is “right to argue that support should be driven by need rather than diagnosis alone”.

‘dy be offering support’

Nicole Bateman, a SEND inclusion specialist from Dorset, whose own son has autism and epilepsy, said she was sceptical that the review will lead to change.

Schools are already obliged to provide support to children based on need under the Equality Act.

“Schools should already be doing this because you can be on the SEND register without a diagnosis already anyway… if emotional, sensory, communication, learning needs are noticed by the school or the parent,” she said.

Bateman was wary of an approach that leaves diagnosis behind all together, as some schools push back on parents’ requests for support and require medical evidence.

Cutting costs to pay for support

Meanwhile, former headteacher Sara Donnelly said school leaders will be “worried” about how they will pay for the additional support they may now be asked to provide to more children.

“Most schools are [already] unable to fund a full-time TA in each classroom. How are they meant to meet the emotional needs of the children?” she said.

“There’s a finite amount of resources, funding and time,” she said. “Staff is your biggest cost, so it’s often the first thing to do. You lose TAs, but you need those TAs to put this needs-based support in place, you can’t do it without them… so, it’s a really vicious cycle.”

After staffing, Donnelly said schools look to cut “extracurriculars” such as PE coaches, or basic classroom resources like glue sticks or ingredients for a cooking lesson.

A government spokesperson said they “inherited a SEND system under immense strain with children waiting months for support”.

“Our reforms will change that by moving to a system where effective early intervention is the norm for every child, with or without a diagnosis.

“We have consulted on our proposals to make sure we get these reforms right, and we will continue to work closely with schools and families so everyone has confidence in the system we’re building.”