Children with special educational needs.

Sir, It was good to see Dr Ni Brolchain's interesting study of children with special educational needs (February Journal, p.56). They form a small but important subgroup of a practice child population. I suspect these children and their families may well have higher consultation rates than a control group without special educational needs. I trained for general practice (including nine months in acute hospital paediatrics) without learning about the 1981 education act but hopefully course organizers are now including it in their programmes. I would like to emphasize a few practical points about the education act: 1. Any person who is concerned that a child may have an educational problem may request an assessment under the act (parents, teachers, doctors and so on). 2. The district health authority is obliged to inform the education authority about children who may have such needs. 3. Three professionals have to assess and report on the child's needs: a teacher, an educational psychologist, and a doctor with experience in educational medicine (a community paediatrician or senior clinical medical officer). Others may also be asked to make an assessment. 4. Parents are involved at all stages and can have copies of all reports made under the act. 5. Assessment is often a long and daunting process for both parents and children. General practitioners have an important role to play in the early detection and care of these children and their families and Dr Ni Bhrolchain illustrates the range of handicaps suffered. Specialist knowledge may be required in order to arrange for a radio hearing aid to be provided for a deaf child in a junior school or to diagnose the cause of deteriorating performance in a secondary school child. Effective liaison between the different agencies is essential if good care is to be achieved. Dr Ni Bhrolchain has probably underestimated the number of children with special needs as many may not be identified under the terms of the 1981 act. As many as 20070 of children will have special educational needs at some point and only 2%o undergo formal assessment.