Educational Advice For

Request for Statutory Assessment of Special Educational Need Primary and Secondary

Pupil’s name: Date of birth: Child’s UPN: Year group: School:

Signature of Headteacher: Date:

The following materials have been designed to assist in the collection of the evidence required when considering a statutory assessment. This pro forma should be completed and sent to the local SEN office c/o the Locality Casework Manager. Receipt of the completed information will be considered as the starting point for the request for statutory assessment.

Contents

Introduction Page 2 Instructions and checklist Completion of Evidence and Attachments Pages 3 – 6 Section 1 – To be competed for ALL pupils Pages 7 – 8 Section 2 – To be completed for ALL pupils Page 9 Section 3 – To be completed for pupils with behaviour, emotional and social needs Page 10 Section 4 – To be completed for pupils with physical and/or sensory Needs

ECC11108 Page 1 of 11 Instructions and reminders for completion of evidence

Actions Completed? Complete Section 1 and 2 for all pupils

Complete Section 3 and 4 where relevant

Items Attached? The three most recent Individual Education Plans (IEP), Individual Plans (IP) and/or Provision Maps and records of regular reviews

The two most recent Educational Psychologist’s visit summaries Other agencies’ reports, e.g. from specialist teachers, speech therapists, child and family support workers

Evidence of curriculum differentiation/classroom access (if not evident from IEP/IP) Two annotated examples of the pupil’s work (see Page 6)

A completed Speech and Language Framework Profile (p53 App.B of the SALF document) for pupils with speech and language difficulties This should have been completed in liaison with a speech and language therapist, a specialist teacher and/or an educational psychologist.

‘My Views’ document recording the pupil’s views gathered using their usual means of communication. Parents’ views if not recorded in reviews of IEPs/IPs/Provision maps?

Data on the performance of the cohort in which the pupils working e.g. Target Tracker or similar. Other supporting evidence – please specify e.g. further information re. behavioural difficulties and/or physical/sensory needs where relevant, as specified in sections 3 and 4; Section 251 8TN Notional Budget.

ECC11108 Page 2 of 11 Section 1 – to be completed for all pupils (a) Pupil and school details (i) Pupil’s name: Date of birth: Chronological age: years months Current NC year: Gende r: DfE Category of need:

(ii) Father/carer’s name: Address:

Postcode : Telephone no:

Mother/carer’s name: Address (if different from father’s):

Postcode : Telephone no:

Is the pupil looked after by the local authority? Yes No School (iii) name: DfE no. 881/ SEN Admin area: Mid / North East / West / South (iv) Please give the date(s) when this request and evidence were discussed with: Name of a) EP: EP: b) Parent/carer: Is the pupil’s attendance at school satisfactory? Yes No Has the pupil been excluded from school? Yes No

ECC11108 Page 3 of 11 ECC11108 Page 4 of 11 Section 1 continued – to be completed for all pupils If yes state whether fixed term or permanent with date:

(b) Type of Special Educational Need Main area of Other area(s) or Type of need difficulty (check difficulty (check one box only) as relevant) Cognition and learning Behaviour, emotional and social difficulty Communication and interaction Sensory and/or physical

(c) Essex School Action Plus records (i) Date of initiation of Essex School Action Plus. (ii) Dates of IEPs/IPSs/Provision maps in past 12 months.

(iii) Dates of Reviews in past 12 months.

(Remember to attach copies of the three most recent IEPs/IPs/PMs and review records)

(d) EP involvement Date school last consulted with EP regarding intervention: (Remember to attach the most recent summaries relating to this pupil)

(e) The involvement of outside agencies (other than the EP) Indicate which agencies have been involved over the past twelve month period and attach the most recent reports that have been used to inform individual planning.

Most recent Agency Dates of involvement report attached Yes No Yes No Yes No Yes No

ECC11108 Page 5 of 11 Section 1 continued – to be completed for all pupils If yes state whether fixed term or permanent with date:

(b) Type of Special Educational Need (f) Curriculum differentiation/classroom access (i) Provide evidence that the school has taken action to ensure appropriate curriculum differentiation/classroom access for this pupil in line with “Inclusion: providing effective opportunities for all children”. (Appendix 2) It is not necessary to provide additional evidence if this is available in the provision map or other individual plans. If it is not available, please attach the evidence for this from teachers’ plans/records. Evidence available in individual plans? Yes No Other evidence attached? Yes No (ii) Attach two examples of the pupil’s work. This may be in English, Maths or another area produced during the week previous to the completion of this document. Each piece of work should be annotated briefly to indicate: The aim of the activity, the task set, support (if any) and time taken to complete the activity. (g) Current support arrangements Please note this does not need to be completed if already available in attached provision map or individual plan.

Support Purpose From (role) Time (per week) Individual Small group Whole class Whole school (h) School’s SEN delegated budget as shown on the School’s Budget Share Section 52 that can be accessed on the Essex Schools Infolink > Service Areas > Finance > Budget and Funding issues if you scroll to the bottom of the centre page and select the type of school then enter your DfE number in the yellow cell before pressing Return.

The guide to SEN Funding in Essex is on the same Infolink page as this form and contains explanations of the SEN Notional Budget and on what it should be spent. Current year’s delegated SEN Budget: = £

ECC11108 Page 6 of 11 Section 1 continued – to be completed for all pupils If yes state whether fixed term or permanent with date:

(b) Type of Special Educational Need

Number of pupils at:

Essex School Action = Essex School Action Plus =

(i) Pupil involvement and views: See the Essex pro forma ‘My Views’ under SEN Paperwork on the Infolink to record pupil’s views and attach them to the application.

(j) Parental involvement and views: Please give evidence of how the school has actively sought involvement of parents and the pupil and summarise their views, if not included within the current individual education plan or other planning format.

ECC11108 Page 7 of 11 Section 2 – to be completed for all pupils Attainment information

Name of child: Date of birth: Please record two sets of results of reading accuracy and spelling age assessments carried out, using the same test, over a period of the last two years.

Standardised scores Actual Reading/ Test Date of test Test used age on spelling score test date age

Reading accuracy

Reading comprehension

Spelling

Current attainment – please indicate clearly whether levels given are: National Curriculum (NC) or P Scale (P) English Maths Science Strand Level Strand Level Level = Speaking Using and applying Listening Number Shape, space and Reading measurement Writing

ECC11108 Page 8 of 11 Section 2 continued – to be completed for all pupils

Personal and social development Most recent end of Key Stage SATs Attribute Level or Teacher Assessment results Interaction and working with others Year group: Independent and Date: organisational skills English Maths Science Attention

Information about other attainment and achievements:

Completed by: Designation:

N.B. Please make sure that the name of the pupil, his/her date of birth and the date of the application are written on any additional information and accompanying evidence, then firmly attached to main the document. It goes without saying that a copy of everything should be retained and a note made of the date on which the request was sent to the SEN Area Office.

ECC11108 Page 9 of 11 Section 3 – to be completed (where relevant) for pupils whose difficulties include behaviour, emotional and social difficulty

(a) Evidence of behavioural difficulty and intervention

Where a pupil’s difficulties include behaviour, emotional and social difficulties the school will need to provide clear evidence of significant and long standing difficulties and the interventions that have been implemented and evaluated.

This information should be largely available within the individual plans and reviews attached to this request and the evidence of curriculum differentiation and access.

Schools should supplement this information with one recent piece of structured information such as an observation record, ABC record or behaviour checklist that has been used by the school at Essex School Action Plus. It would be expected that schools would have been using formats similar to those in SENCO Manual 2 or The Essex Approach: Promoting Positive Behaviour.

Indicate on the front summary if other information is attached. Please note incident logs alone are not helpful in evaluating pupils’ needs in relation to interventions and should not usually be included as evidence.

(b) Other agencies

It is expected that a referral to a specialist behaviour support teacher would have already been made where the pupil’s behaviour, emotional and social difficulties are a very significant area of need. Please indicate:

Date of referral to Behaviour Support:

The most recent reports are attached where available: Yes No

If not available please give the reason:

N.B. Please make sure that the name of the pupil, his/her date of birth and the date of the application are written on any additional information and accompanying evidence, then firmly attached to

ECC11108 Page 10 of 11 main the document. It goes without saying that a copy of everything should be retained and a note made of the date on which the request was sent to the SEN Area Office. Section 4 – to be completed (where relevant) for pupils whose difficulties include physical/sensory needs

(a) Evidence of physical/sensory needs and intervention

Where a pupil’s difficulties include physical and/or sensory difficulties the school will need to provide clear evidence of significant difficulties, how these impact on access to the curriculum and what special arrangements are made by the school. Please note that, as set out in the guidance for schools on statutory assessment, a medical diagnosis or label is not necessarily an indicator of special educational need. It is the impact on the pupil’s education that should be considered.

This information should be largely available within individual plans or personalised provision maps and reviews along with the evidence of curriculum differentiation and access arrangements attached to this request.

(b) Other agencies

It is expected that reports from other agencies will also be available where a pupil has significant physical and/or sensory needs. The school should demonstrate how it has incorporated this advice into individual plans to meet the pupil’s needs over a period of time. Please attach relevant recent reports from those outside professionals involved. These might include: medical practitioners, consultants, paediatrician, physiotherapist, speech therapist, occupational therapist or specialist teachers.

(please indicate in Section 1 (e) which agencies are involved and whether a recent report is attached)

N.B. Please make sure that the name of the pupil, his/her date of birth and the date of the application are written on any additional information and accompanying evidence, then firmly attached to main the document. It goes without saying that a copy of everything should be retained and a note made of the date on which the request was sent to the SEN Area Office.

ECC11108 Page 11 of 11