When School Staff Refuse to Accept a Diagnosis – some key questions to ask

Many things have shocked me to the core these last few years and one of them is the apparent ease with which people trained to teach can decide that Health Care Professionals that are trained to diagnose are wrong.

How can that be possible?

My first experience of this was when Peter was 6 and in Year 1.  It related to his very experienced Clinical Psychologist – you know with a Doctorate, many years of experience in neuropsychology and so on.  She had done months of assessments; home, school and clinic based.  She had told me that she felt that Peter was likely to have Asperger’s Syndrome.

A few weeks later and feeling very ‘green’ I trotted along the the Head Teacher’s ‘open door’ session.  The words I uttered that are engrained in my mind.  “Peter’s Clinical Psychologist says she thinks he may have Asperger’s Syndrome” I said “So if that is the case then how best do I communicate with school – how does it all work?”  I had no clue what I was supposed to do about this!

Her response was startling.  She was really angry.  “He is normal, normal NORMAL” she said over and over.  “Maybe it is an attachment problem she muttered”.  He was going to be one of the leading lights when he was in his final year at her school, she had already decided.

I left in complete shock with my question unanswered.

A few months later I was advised that the SENCO had observed Peter in class and that he was fine.  I was incredulous, but helped somewhat by my friend who reminded be about the phenomena of Unconscious Incompetence.

These were the first of many experiences ‘of refusing to accept clinical opinion’ but perhaps the most honest.  After this it all went underground – my Subject Access Request (see here) later revealed an account lasting more than 3 years where school staff refused to accept the diagnoses (that had followed) made by the medical team.  The repercussions are serious and endless and are documented in other blogs such as ‘itmustbemum the story’ and ‘the pathway to a diagnosis of dyslexia’.

If a professional disagrees with a diagnosis, then there should be be a pathway to follow shouldn’t there?  They can’t just put their head in the sand and decide that the expert is wrong!  Or can they?  The answer to whether they ‘can’ or ‘should’ is perhaps irrelevant.  The thing is – they sometimes do.

“I will never understand how we have reached the situation in which a teacher, with no significant training in Paediatric Mental Health or Neurodevelopmental Disorders, can wilfully ignore the recommendations of Psychiatrists, Paediatricians, Psychologists and Occupational Therapists; professionals who do have extensive post graduate training and experience in this field.  Teaching staff can apparently do this if they don’t ‘see the difficulties in school’.  So, if they don’t see things they are not trained to notice, they can disregard the recommendations made by experts in the field.  Who sanctioned that piece of genius?” 

I believe that each LA should have a published pathway / protocol / policy that professionals can follow if they disagree with a another’s diagnosis.  That it is reasonable for one professional to raise the question, but that it should be done formally.  That when this is happening it should be transparent and discussions should be open and professional.  There should be no slanderous whispers between badly behaved staff, or libellous records that they think no one else will read.

Most importantly the support required by a child should not be obstructed because a teacher decides that the Paediatrician, Clinical/Educational Psychologist / Occupational Therapist (etc) is wrong.  This support should be put into place, and the graduated approach followed, until the process of formal review of the diagnosis or recommendation has taken place.  

I also believe that there should be a protocol that NHS staff can follow in cases where school staff’s refusal (however subtle) to follow their recommendations will result in undue distress / harm in the child.

So, can your class teacher just decide that a diagnosis is wrong and therefore conclude that they don’t have to support the child as prescribed?  In the real world – unless we do some thing about it.  Yes.  Absolutely they can.  Is is right. No.  Is it professional? No.  Does complaining work? No. 

But I can recommend that you ask these three questions:

  • Who is responsible for the decision?
  • What policy are they following when deciding to ignore expert advice?
  • Who is accountable for any harm that results?

I can be fairly certain that you won’t get an answer.  What you may see, however, is a change in their behaviour.

There is a slight variation to this scenario.  That is the idea purported by some school staff (in our experience) that if you pay for a private assessment, then that professional will simply sign away a report that tells you what you ‘want to hear’.  Well isn’t that a loaded phrase, ‘what you want to hear’.

As it happens, in our experience, professionals offering private assessments demonstrate knowledge, skill and integrity in bucket loads.  They have to be a member of the same professional bodies as the LA experts and adhere to and must practice to the same standards.

However if comments like this are made, if a professional thinks that an accredited expert has made a diagnosis or recommendations ‘because a parent paid for it’ then that is another matter altogether.  If they really BELIEVE it’s true then as a professional then surely they are accountable for taking action: whistleblowing policies should be followed or the relevant professional body should be contacted.

Simply gossiping and using your own gossip as a reason not to implement the recommendations is surely just not appropriate professional behaviour.

If you are in a situation similar to these we hope that this blog will help you to challenge the staff involved and move forward the support your child is needs.

We have written a post that follows on from this with more practical recommendations about what could be done to improve this crazy situation.  Click here to read more.  

Please click here to see a linky blog hop that bring peoples’ posts together: on SEN & labels, difficulties with getting diagnosed, pushy parents, private assessments, and other challenges in getting SEN support for children in schools.

If you have found this post helpful and you think others may too, please click one of the share buttons below

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23 thoughts on “When School Staff Refuse to Accept a Diagnosis – some key questions to ask

  1. excellent blog, can i ask what was covered in the subject access request/reports? as i am considering doin one for my daughter for the first school she left in july (who funnily enough had a similar “we dont see that here” approach!

    Like

  2. I sound like I am sticking up for my mainstream colleagues here, and stand by to get shot down…(context: 20+ yrs experience working with people with learning dis, pmld; 17 years teaching – 9 mainstream secondary, rest special)

    Mainstream teachers have very little (if any) training in the specific needs of specific children. In my experience, the SENCo takes the decision who to train to best support these children. That might mean you see a child for 3 hours a week (max) and you have 20 children with differing needs. It’s really hard to remember all of the strategies all of the time, and, actually, in a 50 minute lesson you might not ‘see’ the things that a child is struggling with. I remember having a young person with CP in my tutor group, who really struggled in the afternoons as they were sooo tired. Staff complained work was poor, etc…’have you taken into account…?’ ‘don’t see that in my lessons’. There’s 29 other kids, true you might not notice. The training for staff in mainstream, I have found, is poor. My last SENCo carefully filed the ASD students’ pen portraits that the ASD service had written alongside primary teachers – never to be seen by even form tutors, let alone class teachers.

    On the other side of the coin, I have transitioned many young people into special school who arguabley should not have been there, but whose mainstream schools could not/would not make the appropriate adjustments…had the training been available, these kids might have stayed with their peers.

    I think what I am trying to say is that sometimes it’s not that staff don’t accept the diagnosis, they don’t understand it, and they don’t understand how to manage it.

    Liked by 2 people

    1. I think the author of the blog post is quite clear in what she is saying, the staff actively denied/refused to accept the possibility. They did not with any humility say “well we don’t see any issues here but we are willing to read the report and offer support”. So even if sometimes it is the case that staff don’t understand it, that is only some of the time and they should be willing to listen. There are plenty of times they simply don’t and there is no excuse. Don’t teachers go into the job to help children? Teachers are unqualified to challenge a diagnosis and therefore this situation should never have happened. In fact the very reason you are citing, regarding lack of teacher training in autism etc. is the very reason why they shouldn’t! A SENCO especially has no excuse because it’s their job to recognise SENs and ensure the support is in place.

      Our eldest child, suffered the same reaction from the school SENCO and EP and because of them, she was not diagnosed as autistic until over 4 years later, by which time her mental health had really suffered and she rejected the very idea of being autistic as she was diagnosed too late and did not want to be considered different, refusing the support she needed and going into a downward spiral. Mental health problems at least 75% of the time start in childhood, there is supposed to be early intervention to prevent them escalating and becoming entrenched. Otherwise the child can be doomed to a lifetime of failed opportunities and poor wellbeing. This costs them as well as society.

      Our youngest child had major red flags for autism in school. Yet the staff didn’t say a word and didn’t think to tell me until months after she joined the school that she was just standing around looking sad and not interacting. Another 2 years for a diagnosis. More mental ill health to contend with.

      This is what the author means about harm caused. Teachers are acting in loco parentis and yes, we all know they have 30 odd children and cannot be expected to notice everything, but they are expected to work in partnership with parents. Parents are excellent at recognising when there is a problem:

      “Parental Recognition of Autism – Professionals Must Listen!” http://media.wix.com/ugd/58c8f1_86f4d0a01e5e4c1485ebfb47dd69dbb3.pdf

      We have way too much of this going on:

      “Professionals/Authority and the Parent Blame Culture” http://media.wix.com/ugd/58c8f1_a481c4f0b37540ddbac0bdd4ad9851eb.pdf

      As for clinicians, well that is their very job and it’s not a teacher’s place to question their diagnoses! How would a teacher like it if a clinical psychologist came along and said they didn’t believe a teacher was teaching the child properly and didn’t believe they were qualified to teach?!

      There is plenty of free information out there on the internet that teachers can read the same as parents, there is no excuse about lack of training in autism and plenty of that information is listed here:

      “Different Behaviour Between School and Home & Elsewhere Phenomenon in Autism” http://media.wix.com/ugd/58c8f1_c505444bbbf44a45aab6acbad9255e1a.pdf

      Like

  3. No messenger’s are shot on here! Thank you so much for taking the time to read this and to make a comment. The only way forward here is for genuine multiagency working with involvement of the parents – so scrapping is definitely not going to help… and I don’t think many, if any would disagree with you at all. We can see the crazy pressures and unrealistic targets on staff. Like you we experience the controlling HTs and SENCOs 😦 alongside the awesome ones. The last thing any of us want is for exhausted professionals from any field feeling worse.

    I think the point that I would most like to make here is that teachers don’t need to know everything. They can’t! We just want them to work more closely with those who do. How on earth we make a start on any of this when the most basic information is filed away I don’t know! I think you may be interested in the wider picture here, as Peter ended up in tier 4 CAMHS age 9 – and still school was saying he was fine! If you are, then there is more here https://itmustbemum.wordpress.com/2017/02/05/about-the-book/

    Thank you for visiting us. It really does mean a lot that professionals check in. Please come back! 🙂

    Like

    1. Thank you! I have watched your video and downloaded the book! I had to smile at the idea of a teacher / SENCO *ENCOURAGING* us to become warrior mums!! It is very reassuring to know that as well as parents there are professionals who can see a way forward that will work better for all of us 🙂

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  4. Our school took it one step further and report my family to social service for fabricated illness as my child showed they where intellectual ok so a diagnosis shouldn’t have been needed. We been investigated, it’s made me ill, how can a school who like you say have no experience in such field be able to question a diagnosis which consisted of 5 or more assessment over a 18 months period then a panel of experts sit around a table and make the decision to diagnosis a child (it consisted of 3 high trained paediatric professions all expert in their field of autism) but school called me silly, nothing would change, I wouldn’t get a statement for my child (I did not want that for my child, I wanted them to know who they are and answers to their questions why they where so different and support in later life and we can only get support as a family with a diagnosis in place.

    Our life’s have been turned upside down these last 4 weeks having to justify why we went for a diagnosis even though the school disagreed, I have to justify why I fought for 8 years. Like I was the one in the wrong.

    I have lost all faith in thr education system, I have moved my child school and I hope my faith returns.

    They should be a system in place to stop families like us being under investigation because we believed and fought for our child, and the school failed my child and failed my family.

    Liked by 2 people

    1. Oh my word, case in point. I literally just finished replying to the author’s comment about warrior mums saying that there are many cases across the UK of parents fighting for their children being accused of MSBP/FII, I scroll down and see this has happened to you! It is frighteningly common for this to happen. Schools do this in retribution. Councils do it too. If it’s not MSBP/FII it’s emotional harm. It’s disgusting. You don’t have to justify why you sought a diagnosis, even if your child were not diagnosed, but most especially when they were. A medical diagnosis is not dependent on school agreeing! You have parental authority and you do not answer to the school! If you haven’t already, you should join Parents Protecting Children on FB.

      Liked by 1 person

  5. Reblogged this on Planet Autism Blog and commented:
    Couldn’t have said it better myself. Please do read this reblog. The point being, school staff are totally unqualified to reject a medical or clinical diagnosis. Have they not heard of masking! Plenty of information free to read on the internet about different behaviour between school and home. Perhaps such teachers should start here: “Different Behaviour Between School and Home & Elsewhere Phenomenon in Autism” http://media.wix.com/ugd/58c8f1_c505444bbbf44a45aab6acbad9255e1a.pdf (various links about it within that).

    Like

  6. yes – me too. School contacted my daughter’s medical team POST ASD DIAGNOSIS (and this is the LA’s own medical team, not a private diagnosis) to make spurious safeguarding allegations about me and question my mental health (because I had complained about the disciplinary procedure of a teacher shaming and blaming SEN children in front of OTHER parents). This is all too common and, I believe, a result of the pressure on schools from OFSTED for high attendance, results driven teaching practice, and pressure on teachers. While parents are being PROSECUTED and in some cases children are being removed from families because of school refusal and mental health problems the education system in the UK is fundamentally NOT FIT FOR PURPOSE. I will repeat it because I’m so livid. THE EDUCATION SYSTEM IN THIS COUNTRY IS ILLEGAL (in contravention of the UN rights of the child) and NOT FIT FOR PURPOSE when it comes to SEN children. It is a national disgrace and should be in every newspaper and media outlet.

    Liked by 1 person

  7. myquirkygirl yes this is very common. Schools and local authorities do this in retribution when parents challenge them or fight for their children’s needs. It’s plain evil and I don’t know how they sleep at night. Have a look at this petition, including the updates at the bottom of the main page. All related to LA retribution and malice for a parent fighting for autistic children’s needs and winning at SENDIST: https://www.change.org/p/edward-timpson-mp-make-brighton-hove-city-council-cease-unlawful-section-47-ss-investigations?source_location=minibar

    On two of the updates you will see law firm articles about this very deliberate malicious behaviour against SEN parents. Signatures and sharing of the petition appreciated.

    Liked by 1 person

  8. Long ago and far away, I wasn’t even able to get a diagnosis for my youngest child, now 21 and believed & generally accepted to have PDA, but not yet officially diagnosed, because, “they keep asking me personal questions!” Despite a record of crying or withdrawn silence throughout playgroup (where I worked, and could see she “didn’t stop crying two minutes after you left” as they always say) and first school (“We think it’s a great day if we have an hour without her crying” – I spent most of that 5 years in school too!) the head-teacher at her middle school completely refused to accept that there might be anything different about her, although my four older children had gone or were going through the school, attending & achieving well. She was just naughty, manipulative and not very bright… And when I asked our GP for help, I was told that we could not be referred to anyone anywhere without a head-teacher’s letter, which I know now to be wrong, but didn’t then.

    Things escalated to the point where I was informed the head teacher was calling in Social Services with a view to having her taken into care; she had “attacked staff” (independent witnesses say it was more like resisting arrest) and ran away constantly; always straight home, where she felt safe. (He did in fact have several other children from fairly ordinary middle-class families taken into care; one family fought in court & was completely vindicated, but still don’t see their now-grown-up child. And one staff member was observed by another, unrelated, child calling my then 9 y.o. daughter “Mumsie’s little baby – ah, Diddums!” and poking her more than once, quite hard, when she turned away from him.) There are a number of families crushed and grieving in this little town, thanks to that man…

    Informal advice from my parents’ solicitor, a personal friend, was to de-register her from school before the HT could act, which I did. Thus, incidentally, removing any possibility of help from “the system”… but she flourished at home, once the pressure of school was removed. The local authority, who inspect home-educators regularly, did eventually accept that she was “on the Autism spectrum” two weeks before her 16th birthday… We’re still far from out of the woods; she has no formal qualifications though she did turn out to be rather bright & capable, and still suffers from sensory overloads, mild processing difficulties with the spoken word, and occasional meltdowns, so “normal” employment isn’t really an option yet, but she does have friends, and is slowly working towards becoming a dance teacher; she dances beautifully.

    I’ve been unable to work in the formal economy all this time, and have no pension to look forward to. Luckily my other half does have a job, so we have kept our heads (just) above water one way or another, but will undoubtedly struggle in the years to come. My anger & frustration at “the system” that totally failed my daughter is second only to the parents of two other girls I know of, who were just like my S. at the playgroup/first school stage, and who are now both in permanent residential care hundreds of miles away from home, heavily medicated and only able to have family visits once or twice a year, often cancelled at short notice. Lives wrecked by a system that cannot “see” that children who are not academically disadvantaged may still have crippling problems that are not necessarily caused by influences outside the academic system…

    Liked by 1 person

    1. My reply will most definitely be inadequate, but thank you for sharing. One head teacher with little/no training in neurodevelopmental disorders and everyone believes him. Just incredible what power some can have. thank you again. 😦

      Liked by 2 people

    2. Thank you for sharing this. It makes me more determined to protect my daughter from the ‘normalisers’; the people who would rather see her as naughty, lazy, rude & arrogant with a mad mother than contemplate that THEIR behaviour (and her ASD) might be causing her problems with attending school. I am truly shocked and appalled by your treatment, and your daughter’s treatment. I’m angry that two children in this case have been effectively consigned to a permanent place in the mental health system & denied their human dignity purely because they were not NT. It is widely acknowledged that mental health problems begin in childhood and yet OFSTED, the DfE and some deluded, arrogant narcissist head teachers/teachers refuse to see that THEY could be responsible for this barbaric outrage.
      We should NOT be in this position in 2017. In 1917 maybe this was understandable, but we are more informed now – while the health/education divide continues into the future we are ruining too many lives.

      Liked by 1 person

  9. This made me so annoyed and I’m not a parent/teacher/etc!

    Isn’t it ridiculous how people can act in such a flippant way about somebody’s actual life? I mean this isn’t just a disagreement on a favorite TV show or snack but a child’s diagnosis that can affect their entire life – especially when school is such a big part of it. You would think a teacher – someone who has a commitment to care- would want to find more out, speak to more people – whether they’re right or wrong in their opinion.

    I hope you eventually had success in your battles! 🙂

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  10. We had this happen . To the point that our son was so anxiety ridden from lack of services he had to be hospitalized. The anxiety caused him to stop eating for 6 weeks and he dropped 30 lbs . To add insult to injury the school accused me of Munchausen by proxy . See if you reject the ASD Dx you have to look for another reason for the anxiety and resulting illness . This son is now 23 yrs old and able to speak . He say’s that the hardest part for him during all of that mess was watching me getting accused when I hadn’t done anything .

    Liked by 1 person

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