What if there's nothing wrong with the children?

The SEND paper has lots of answers but doesn't ask the most important questions.

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This article is the second in a series. I started by asking the question why there are so many more SEND children, and promised to follow up with an article that follows the money.

I’ll still do that. But while I was drafting it the government published their SEND white paper and this piece is a response to that.

Reminder - I’m a non-expert, but have grave and legtimate concerns with the situation as a grandmother, policy maker, former government minister and MP, and taxpayer. I have two degrees in psychology which underpin my unease. There is no hard science behind any label to do with the brain and mind. You can’t do a blood test or scan to find if there is anything wrong with children. All relies on judgement.

The media coverage of the White Paper illustrates a deeper problem. It has been written up almost entirely through a political lens: did it land well? Did it avoid a backbench rebellion? Is it good for Bridget Phillipson? Yes to all these things, but it is beside the point! What matters is will this policy make life better or worse for SEND children and their families? And that question is conspiciously absent from reporting.

The risk is that it will achieve neither better outcomes for SEND children and their families OR the taxpayer, as I shall go on to explain.

I had a fair bit of criticism for my first article even though I only have a small social media following, so I want to state again that I do not in any way think that children, parents of schools have done anything wrong for fighting for support for their children. Nor do I criticise the clinical experts who have worked on the policy. I know they have dedicated their lives to helping children and I’m sure that many of those children will have benefitted.

But that’s not the focus of this piece.

The striking bit of the white paper is the many things it is totally silent on:

• It never asks why there are more SEND children, or why the less severe conditions driving it, especially neurodiversity, anxiety, ADHD and autism, are rising.

• It never asks why factors outside school which have always existed in childrens lives (poverty, family breakup, complicated lives) are now expected to be addressed by a school.

• It never asked anyone who questions the basis of the autism spectrum as a helpful clinical concept.

• It took evidence ONLY from those who describe themselves as “neuro-affirmative.”

• It never asked about the role of social media.

• It never looked at the convergence between gender identity and neurodiversity.

The White Paper never asks why there are more SEND children

It assumes it is only a problem of escalating need and delivery.

It starts by acknowledging that it is not the most severe forms of disability that have risen but the other more subjective categories: autism, social and emotional difficulties, speech and communication needs. That’s exactly the pattern you would expect from diagnostic expansion rather than a genuine rise in disability.

But the paper doesn’t interrogate the data staring it in the face.

If it was the most severe forms of disability that had risen, we would be looking, rightly, for a biological or environmental factor. We would want to know what had gone wrong with our species to put it bluntly. The government would not simply leave that unasked. There would be a public outcry and calls for an investigation.

Yet the data tells a story where diagnostic expansion is a perfectly reasonable explanation. At the very least, the scientific method demands that we test this hypothesis rather than ignore it. Not doing so leaves logical, analytically minded people (like me!) with more questions than answers. From a public policy perspective, there are greater risks still. A £4 billion transfer of public money, from taxpayers whose own children receive no benefit, needs to rest on a credible evidence base. Without one, the settlement is inherently unstable. Under a different political future that we can already see clues of, the entire structure of SEND support could come to be seen as unjustified and be dramatically rolled back. The people who would suffer most from that backlash are the children with the most severe and genuine needs. Refusing to ask hard questions now doesn’t protect vulnerable children, it risks endangering them.

What we’ve got in front of us now is a white paper that treats all 1.7 million identified children as though they self-evidently need formal support, and builds a £4 billion reform on that unexamined assumption.

When I asked Jacqui Smith, the Lords Minister whether she had any concerns about the expansion of diagnostic criteria, she said the government would provide support based on “needs, not labels”. All this does is restate the problem. The underlying assumption is still that these children need more support over and above ordinary teaching. Once you accept this worldview there are no brakes in the system. If a quarter, a third, or eventually half of all children are deemed to need something extra within what is supposed to be a universal system of provision, then it is not the children who are the problem. It is the definition of "normal" - or even more troublingly - “neurotypical” - that has become so narrow that ordinary children and ordinary life problems no longer fit inside it.

Very few people in public life are willing to say this. Those who do - such as Dame Uta Frith this week, are accused of denying children's suffering.

If “everyone is neurodiverse” - no-one is special!

The government built these reforms on recommendations published in a paper by the Neurodivergence Task and Finish Group.

This is a panel chaired by a professor of autism studies and all its members are explicitly committed to a "neuro-affirmative" approach. What does this mean?

In the definition section, it states that neurodivergence has no nationally or internationally accepted definition nor is it included in any clinical diagnostic manual. It adds that its meaning is "evolving and may vary by context." It includes people who meet diagnostic criteria for a clinical condition but also many others who don’t.

So it’s a term with no boundary and no agreed meaning. It could apply to anyone whose behaviour differs from whatever is considered "typical." We don’t know who decides who is typical and who isn’t - in this view of reality, it is the individuals themselves.

We should be worried about the construction of a £4 billion spending package and comprehensive reform on top of a term that doctors can’t define, and that, potentially, all children would be eligible for.

You wouldn’t create a screening program for a major health condition in this way, for instance. But nobody seems to be asking this question.

The White Paper never mentions social media

TikTok and Instagram have created a culture in which neurodivergent labels have become a form of social currency and identity. Teenagers are doing what they always have done, creating a status for themselves among their peers and identifying with people they think are cool in some way.

The neurodiversity “movement”, for that is what it calls itself, is a big thing.

Videos under the #ADHD hashtag have been viewed over 11 billion times, but over half of them contain misinformation. Child psychiatrists report teenagers arriving in clinics with self-diagnoses formed from social media. They use terms learned online, for example, describing fidgeting in class as “stimming.”

Of course there’s a snowball effect. Children and teenagers are influenced by peers. Once these ideas reach a critical mass social contagion occurs. We are already at that point. Even if children are too young to be on social media, their parents certainly are.

Teens also see this as a route to end what they see as unwanted demands from others such as going to school or sitting exams.

The White Paper does not once look at any of this.

Identity: not illness: we've heard this before

I'm afraid this reminds me of the gender self-identification debate. In that context we see a group of people asserting that they are who or what they say they are, supported by parents, schools and authority figures. Everyone else needs to accept their version of reality and provide public services to support them across all spheres of their lives. In both cases, social media has turbocharged the trend. Anyone who asks questions or doesn’t accept this is accused of ignorance or causing harm. There is a statistically significant overlap between the two cohorts. Around 11% of transgender young people are autistic which is roughly ten times the general population rate.

We learned, painfully, that affirming every child or teenager's self-diagnosis on gender was not always in their best interests. I fear we may be making a similar mistake with neurodivergence on a much greater scale. Granted, we are not performing non -reversible surgery on children’s reproductive organs, but we are administering cocktails of drugs and providing significant levels of societal and educational interventions at sensitive developmental stages.

The paper did not look at the interaction between these two cohorts.

Who else is worried

I’ve privately thought for some time that diagnostic criteria are being stretched too far, based on my knowledge of psychology.

I would happily shut up if I was the only one saying this and accept I don’t know anything.

But many respected people share my worry.

Baroness Spielman, who ran Ofsted from 2017 to 2023, warned in a Sunday Times interview last September, that schools have reconceived themselves as therapeutic institutions, and that when they look for things wrong with children, they’ll probably find them. The risk here is creating a negative spiral that encourages children to understand ordinary adolescent difficulties as disorders.

At a Policy Exchange event in November, she went further, arguing that dyslexia simply means “bad at reading” and that we lack “a hard enough conception of where labelling is counterproductive, as it almost certainly is for many of the children being given labels.” She drew a pointed comparison with healthcare: in medicine, if a treatment has no clinical value, it is accepted that it should not be provided at public expense, but “we’re not there yet with SEND interventions,” and risk “burning through eye-wateringly large budgets on things that actually aren’t helping those children and might even be doing them harm.” In the Lords debate on the Children’s Wellbeing Bill, she opposed proposals for a mental health practitioner in every school, arguing that spending too much time talking about mental illness to young people who are not ill can itself be counterproductive, and that schools may need less mental health awareness training, not more.

The White Paper proposes precisely the opposite. More specialists, more formal identification, more support infrastructure.

This week, Dame Uta Frith, emeritus professor of cognitive development at UCL and one of the pioneering researchers who helped establish autism as a condition of the brain rather than the result of bad parenting, told Tes magazine that she no longer believes autism is a spectrum. Frith says the spectrum has widened to the point of collapse. "I've been swept up by the autism spectrum idea," she said, "and it's only in the past 10 years that I have felt things have gone too far. Very slowly, I have come to say, 'No, this is not right.'"

You can't have it both ways. The elephant in the room

I feel very uneasy about the contradiction at the heart of the White Paper. Why does nobody name the elephant in the room?

The government has adopted the language of the neurodiversity movement, which holds that conditions like autism and ADHD are not disorders but natural variations in how human brains work. Yet it simultaneously proposes to spend £4 billion identifying and supporting these children. As the philosophers Jaarsma and Welin observed, if neurodivergence is simply natural variation — like being left-handed or having red hair — then by definition it does not require a multibillion-pound apparatus of support plans and specialist intervention. And if it does require all of that, then we should stop pretending it is merely a difference and be honest about where the boundary lies between a genuine condition and ordinary childhood difficulty.

Next week, I’ll follow the money and show who profits from the system as it stands.

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As with part one, I have used AI to help research and draft this piece. I’ve written more about my use of AI on LinkedIn. The arguments and conclusions are my own.