Abstract

This study explored whether children identified in education and social care datasets as having learning difficulties or disabilities had corresponding paediatric clinical assessments documented in health records. Using a linked dataset combining school census, Children in Need (CiN) census, and paediatric health data for Sunderland, the research aimed to evaluate consistency in identification and documentation of learning disabilities across agencies. The data linkage was facilitated by a batch-tracing exercise which attached NHS numbers to local authority datasets, allowing these records to be linked to paediatric appointment records.

The study revealed significant discrepancies in how learning needs are described in education and health records. Education datasets use loosely defined terms such as Moderate Learning Difficulty (MLD), Severe Learning Difficulty (SLD), and Profound and Multiple Learning Difficulty (PMLD), while health records apply ICD-11 classifications such as Mild, Moderate, Severe, and Profound Intellectual Developmental Disability, based on clinical assessments. These differences mean that severity levels do not align between sectors, creating confusion and limiting the ability to build a coherent, cross-cutting picture of children’s needs.

Furthermore, a substantial proportion of children with a learning disability identified in the paediatric data had no corresponding learning difficulty recorded in the school census. In 2023/24, only 36% of children with a paediatric record of a learning disability had any learning difficulty record in their education data, and often only autism or other SEN needs were documented. This suggests that learning disabilities may be obscured by other SEN categories in education records, potentially affecting access to tailored support and reasonable adjustments. While CiN records of learning disability were more likely to align with education and health data, overall consistency across datasets was low. Only 4–5% of those identified in paediatric data appeared in CiN records. These findings highlight systemic gaps in cross-agency visibility of children’s needs.

Inferential statistics also confirmed well-documented patterns in learning difficulties in the school census, with boys and those eligible for free school meals significantly more likely to have a learning difficulty recorded in their school census data. These effects persisted across all three years of data, as was the finding that around 15% of variability in learning difficulties in the education data can be attributed to school-level differences.

These findings have implications for children and young people, their families, and services’ planning and commissioning. Families may face inconsistent support because agencies operate with different definitions and thresholds, and fragmented recording and documentation limits the effectiveness of joint planning and commissioning. There is a need for clearer, cross-sector terminology and improved data-sharing practices to ensure children’s needs are accurately identified and supported.