Sociodemographic variation in cumulative probability of recorded special educational needs and disability provision during primary school in England: A staggered cohort study of children with cerebral palsy

Background There is limited quantitative evidence on how equitable special educational needs and disability (SEND) provision is, particularly among children with complex health conditions. We compared the first recorded SEND provision in state-funded nurseries and primary schools (ages 2 to 11 years) for children with cerebral palsy, by gender and indicators of socioeconomic circumstances. Methods We used linked individual-level state-funded hospital and school records from the Education and Child Health Insights from Linked Data (ECHILD) database to create a cohort of children with cerebral palsy born in England between September 2003 and August 2012. We used inverse probability weighted pooled logistic regression to assess whether there were inequities (i.e., differences that are unfair or avoidable) in the first recorded SEND provision, stratified by school Year of entry into state-funded education. Comparisons were expressed in terms of cumulative probabilities. We separately assessed the first recorded education, health and care plans (EHCPs), which are the higher tier of SEND provision. Results Of the 5,670 children in the cohort, 5,399 (95.2%) had any SEND provision and 4,098 (72.3%) had an EHCP recorded during follow up. Male gender and free school meal eligibility were associated with higher estimated cumulative probabilities of any SEND provision during primary school, whereas children living in the most deprived areas had lower cumulative probabilities of EHCPs. Conclusions Our findings suggest that current SEND practices are inequitable for children with cerebral palsy.