Using linked data to enhance understandings of the prevalence of common neurodisabilities amongst children looked after relative to the general population of school age children in Wales.

Abstract

Objectives

1. To compare the reported prevalence of common neurodevelopmental disorders such as ASD, ADHD, learning difficulties and TIC disorders amongst care experienced children relative to their peers at key milestones in their educational journey.


2. To establish the extent to which their additional learning needs are recognised by different services.

Methods
Common neurodevelopmental disorders (NDDs) have been identified through a combination of linked educational (‘SEN types’) and healthcare records (primary and secondary care) held within SAIL Databank. A population-based retrospective cohort design has been adopted, based around the academic year to enable comparisons to be made.

Data has been structured to enable both age-effects and the increasing awareness of NDDs to be examined. By linking to the children’s social care data, it has been possible to explore the relationship between being looked after, the age at diagnosis and provisions made at educational milestones aligning to the Key Stages.

Results
The study highlights the value of utilising supplementing data from the annual school census returns with information from primary and secondary care. Whilst not without its limitations, not least due to misdiagnosis, underdiagnosis and lack of awareness, use of clinical codes to identify where there has been a diagnosis of a common NDDs provides a more complete picture of neurodisability amongst the school age population in Wales.

Notably, results highlight the extent to which NDDs such as ASD, ADHD and learning difficulties which typically require a medical diagnosis, appear to be significantly more prevalent amongst those with care experience relative to their peers, with the difference in the rates increasing at each educational milestone. Rates of identified dyslexia, dyspraxia and dyscalculia appear to be similar.

Conclusion
The methods employed in this study lay the foundation for further research to understand the relationship between neurodiversity amongst care experienced children and educational outcomes for this group. Whilst increasing awareness of neurodiversity presents a challenge for services, this study highlights the importance of a timely multi-disciplinary assessments process.