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… It seems she thought that the year of Clinical Psychology Assessments could simply be overruled by a 30-minute teacher observation!  I was incredulous but helped somewhat by my friend who reminded me 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 his Asperger’s diagnoses (that had a year later followed).  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 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 willfully 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 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.  See here for more on this.

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 something about it?  Yes. 

Absolutely they can. 

Is it right?

No. 

Is it professional?

No. 

Does complaining work?

No. 

But I can recommend that you ask these three questions:

1. Who is responsible for the decision?
2. What policy are they following when deciding to ignore expert advice?
3. 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 on 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 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 brings 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.

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