Professor Barry Carpenter OBE

Associate Director (SEN), SSAT

Fellow, Harris Manchester College,
University of Oxford
 Worldwide, 780 million young children
are affected by biological, environmental
and psychosocial conditions that can limit
their cognitive development.

(Guralnick, 2004)
• Co-existing

• Overlapping

• Co-morbidity

• Co-occurring

• “The staff room”!!

“This is a wide and varied group of learners. They
include pupils who do not simply require a differentiated
curriculum or teaching at a slower pace but who, at
times, require further adaptations to teaching if they are
to make progress.”

Porter, J. Ashdown, R. (2002)

Pupils with Complex Needs – promoting learning through visual
methods and materials.
Tamworth : NASEN.
 …A complex aggregation of difficulties in more than one
area of [their] lives.

Dee, L., Byers, R., Hayhoe,H., Maudslay,L. (2002)

Enhancing Quality of Life: Facilitating transitions for people with profound
and complex needs.
Cambridge: SKILL/University of Cambridge.
 And the future…..?
• People with complex and multiple needs
require personalised solutions and very skilled
staff….
• The State of Social Care in England 2007-08
• CSCI, January 2009
• Attention Deficit Hyperactivity Disorders (ADHD)

• Autistic Spectrum Disorders (ASD)

• Speech/Language Impairment (SLI)

• Specific Learning Difficulties (SpLD)

• A biological basis which is not yet fully understood

• Symptoms that overlap with other disorders in this group

• A tendency to co-exist with each other or with other disorders

(Tutt, 2009)
www.nasen.org.uk
 „Even with disorders that have a neurological
basis, it is important to realise that the brain‟s
plasticity and its considerable resilience means
that there is always the potential to improve.‟

Tutt, R. (2009) ‘Complex support’, Special!, (July 2009)

www.nasen.org.uk
 „We must seek to build an inclusive
curriculum…around adaptation, modification ,
and design…that will be relevant to all
learners.‟

Carpenter, B., Ashdown, R., Bovair, K. (2002)

Enabling Access: Effective teaching and
learning for pupils with learning difficulties.
London : David Fulton
The continuum of vulnerability
Disadvantage
Deprivation
Disability

VULNERABILITY
 Children, lost in a system
… cognitively disenfranchised
… socially dysfunctional
… emotionally disengaged
 ‘Poverty can increase the risk of a child having an
impairment… Having a disabled child can also mean
that parents find it harder to maintain full-time
employment, their housing can be inadequate for
their child’s needs, and expenditure on basic needs is
increased.’

(Prime Minister’s Strategy Unit, 2005, p. 86)

From Count Us In: The National Inquiry into the
Mental Health Needs of Young People with
Learning Disabilities
„By 2020 depression will be the most
prevalent childhood disorder.‟

Pretis and Dimova (2007)

Knapp et al. (2007)
‘Mental health policy and practice across Europe’
 Mental capital …
Goswami (2008)

„…to deal with “the new social toxins”.‟

Sweeting et al. (2009) in Social Psychiatry and Psychiatric
Epidemiology, 44, 579-586.
‘375,000 newborn babies per year exposed in
the womb to cocaine, heroin, marijuana,
methadone, amphetamines.’

The Times (June 1995) reporting on an American study

 Babies of smokers are more likely to be miscarried or
born underweight, and research suggests that there is a
26% increased risk that they will be born stillborn. As
they grow up, the children of women who smoked are
more likely to suffer health problems.

Professor Andrew Shennan (2007)

King‟s College London
www.tommys.org
 Drugs
Alcohol Smoking

Social
Genetics
Foetal Brain Circumstances
Development

B.Carpenter (2009)
 • Down‟s syndrome - 1:166
• Fragile X syndrome - 1:500
• ASD - 1:86
• FAS - 1:500
• FASD - 1:100

B.Carpenter (2009)
• Established 1995

• 80% survival of children born at less than 26 weeks

• Longitudinal study

• http://www.nottingham.ac.uk/human-development/EPICure/

(Marlow et al., 2005)

Low normal scores/
mild impairments No problems
32% 22%

Severe disability
22%

Moderate disability
24%

Proportion of children with disability out of

241 children seen at 6 years
by comparison with their classmates
(Marlow et al., 2005)
(Russell, 1998)
 1 in every 200 babies is born with a rare
chromosome disorder: 1 in every 1000 babies
having symptoms from birth or early childhood,
the rest being affected when they grow up and
try to have babies of their own.

www.rarechromo.org
• Dyslexia – difficulties in learning to read and spell

• Dyspraxia – difficulties with co-ordinating the muscles

involved in movement

• Dyscalculia – difficulties with understanding mathematical

concepts

• Dysgraphia – difficulties with producing written language

 60 per 10,000 (1 in 91 per 10,000 in the 1 in 800 school
166) children under total population (1 in children (previously
8 years every 110 people) 1 in 1,000)

Medical Research National Autistic Department of

Council, Society, Health,
2001 2002 2002
• ADHD affects 1 in 20 children in the UK (around 500,000 children) (National
Institute for Clinical Evidence)
• Further twin studies have indicated the roots of the disorder are 80%
genetic.
• Brain scans indicate that ADHD is a biological phenomenon.
• At its severest level, it is a hyperkinetic disorder, (about 100,000 children).
• Increasing prevalence of co-morbidity (e.g. learning difficulties, autism)
• Scans of the right frontal lobes, the basal ganglia and the vermis of the
cerebellum are appreciably smaller in children with ADHD.
• These regions involve self-control and inhibit impulsive behaviour.

Continued…/
 • 7 million school children in the USA – nearly one in five – are on Ritalin
(Angold, 2005)

• In the UK prescriptions of Ritalin rose from 2,000 in 1991 to 259,000 in 2004

• ADHD is not linked to inadequate parenting.

• „Chaotic environment‟ may trigger the condition in genetically susceptible

children.

• Children with ADHD are four times more likely to experience mental health
problems in adulthood.

• „[ADHD] should be seen as a long-term, subtle disability.‟

Sources:
Professor Eric Taylor (2004),
Institute of Psychiatry, University of
London
Mark Henderson and Nigel Hawkes (2004),
British Association of Science Conference
(Reported in ‘Scans show it’s not easy to be good’, The
Times, 9th September 2004)
 ‘At 7 to 10 years, those whose mothers were
stressed or anxious in pregnancy, were
significantly more likely to have ADHD
symptoms, behavioural problems and anxiety.
All these disorders relate to abnormal cortisol
levels, which would have been set prenatally!’

O’Connor, T.G. (2008) Biological Psychiatry, 58, 211–217.

 There are 340,000 children on
Ritalin or associated medications.

(O’Connor, 2008)
 Children need ….
• engagement
• to be active learners
• not to be peripheral participants

cf. Carpenter, B., Egerton, J. (Eds) (2007)

New Horizons in Special Eduation: Evidence-based
Practice in Action.
Understanding of Planned solution Clear expectation
difficulties of what is to be
achieved

[The label for a disability] is only of interest to us in so

far that it helps us to help [students] to be successful at
school…[not] as an excuse for failure or
underperformance…
(Cooper and Bilton, 2002, pp. 6, 49)
 Research into learning styles
 Inclusive practice that engages children as
learners
 A richer teaching repertoire
„Resilience factors are those processes which
buffer or minimise the effects of adverse
stimuli on a person.‟

Pretis and Dimova (2007)

 Three challenges to learning:

• Self-regulation (keeping calm: managing arousal systems)

• Working memory (holding task information)

• Mental flexiblity (adapting to change during the day)

Woods, C. (2007)
Complex Learning Difficulties and
Disabilities Research Project
• DCSF Funded
• Managed through SSAT
• Research Team, including Lead Teacher
Researchers
• 12 Development Specialist Schools
• 50 Trial Schools
• Reports March 2011