Participation Before Diagnosis: Reflections on Inclusive Teaching, Engagement and the Interim Review 

Yesterday, I published a reflection on a small-scale research study I had undertaken into engagement in secondary education. 

That study explored what helps young people remain connected to school and what may contribute to their gradual disengagement. The findings emphasised relationships, belonging, emotional safety, appropriate support and the experience of being understood. 

You can read that earlier post here: Beyond Behaviour: What My Secondary Engagement Study Taught Me About Disengagement  

I had not intended to return to the subject quite so quickly. However, two recent national publications have made the themes of that research feel particularly timely. 

The first is the interim report from the Independent Review into Mental Health Conditions, ADHD and Autism. The second is the Education Endowment Foundation’s new Guide to Inclusive Teaching. 

They are different publications, produced for different purposes. One considers significant national questions about prevalence, diagnosis and access to support. The other offers practical, evidence-informed guidance for teachers and school leaders. 

Yet both appear to point towards a shared principle: 

We should respond to barriers to access, participation and wellbeing when they become apparent, rather than waiting for diagnosis, failure or crisis. 

A Moment of Validation 

In my current role, I work within a local authority neurodiversity service supporting mainstream pupils and schools. I have also contributed to the development of a local authority Graduated Approach, intended to clarify the provision available through universal, targeted and specialist support. 

Reading the interim report, I felt validated – and, if I am honest, somewhat vindicated. 

For some time, I have argued that meaningful educational support should not depend upon a child first obtaining a diagnosis. 

That does not mean diagnosis is unimportant. An autism or ADHD diagnosis can provide explanation, validation and greater self-understanding. It can help a young person recognise their experiences as part of a shared neurotype rather than a personal failing. It may also inform clinical decisions and help families and professionals make sense of longstanding patterns. 

However, a child should not need a diagnostic report before adults respond to barriers and support needs already identified by the pupil, family or school. 

A pupil may find particular transitions inaccessible. They may experience sensory distress in certain environments. They may struggle to interpret classroom language, begin tasks, communicate that they need help or sustain participation throughout the school day. 

Schools do not need to diagnose the underlying neurotype before beginning to understand and address those barriers. 

The interim review considers the extent to which existing systems may have made diagnosis a practical gateway to support. It also distinguishes between diagnosis, functional impact and support need. 

The review uses the language of functional impact. In education, I find it more helpful to translate this into questions about access, participation, autonomy and wellbeing: 

• What is the pupil currently unable to access? 

• What demands are creating distress or exhaustion? 

• What support enables participation? 

• What is the pupil communicating about their experience? 

• Is participation sustainable, or is it being maintained through masking and significant personal cost? 

The review’s formal recommendations will come later. It would therefore be premature to treat its emerging conclusions as settled government policy. Nevertheless, the questions it raises are important ones for education. 

Inclusive Teaching and Graduated Support 

The EEF’s Guide to Inclusive Teaching provides a practical educational context for this discussion. 

Its starting point is that inclusive teaching should enable every pupil to participate and succeed. It recognises that children may experience multiple and interacting barriers to learning rather than fitting neatly within one category of need. 

Success should not be understood as conformity to a narrow model of participation. It may involve academic progress, belonging, autonomy, communication, emotional safety, meaningful relationships or sustained access to education. 

The guide presents a two-part model: 

1. Universal approaches: evidence-informed classroom practices that benefit all pupils and are particularly important for those who experience additional barriers. 

2. Adaptations and additional support: carefully chosen adjustments, targeted teaching and interventions that enable particular pupils to access high-quality teaching. 

These elements are complementary and overlapping. Strong universal teaching should sit alongside individual adaptations and additional support, rather than being treated as a sequence through which pupils must fail their way. 

This closely reflects the purpose of a Graduated Approach. 

Graduated support should help schools ask: 

• What should ordinarily be available to every pupil? 

• What specific barriers is this pupil experiencing? 

• Which adaptations are required? 

• What additional assessment or intervention may be needed? 

• When would specialist knowledge add value? 

• How will we know whether support is helping? 

• What does the pupil think about the support being offered? 

High-quality inclusive teaching is the starting point, but it will not be sufficient for every pupil. 

Some will require carefully planned adaptations. Some will need targeted teaching, additional adult support or specialist assessment. Others will need substantial and sustained provision. 

A pupil should not be required to experience prolonged failure before adaptations or specialist advice are introduced. 

A needs-led and barrier-informed approach does not mean giving everyone the same thing. It means identifying what is preventing access or participation and responding proportionately. 

Participation, Engagement and Environmental Fit 

What most clearly connects my engagement research, the EEF guidance and the interim review is the concept of participation. 

Participation is more than physical attendance. Nor should it be defined solely through visible compliance, spoken contribution, eye contact, stillness or doing the same thing in the same way as everyone else. 

Meaningful participation may look different for different pupils. 

A pupil may be present in every lesson but unable to contribute in the expected format. They may complete their work while experiencing significant anxiety. They may appear quiet and compliant but expend enormous effort masking confusion, sensory distress or social uncertainty. 

A pupil may need to communicate in writing rather than speech, observe before joining an activity, use movement in order to concentrate or withdraw temporarily to regulate. These are not necessarily signs of disengagement. 

Equally, a pupil who avoids work, leaves lessons or struggles to enter school may be communicating that participation has become difficult, unsafe or unsustainable. 

This does not mean every episode of refusal, absence or disruption can be explained by neurodivergence. It does mean that behaviour and attendance data should prompt curiosity rather than immediate judgement. 

Instead of asking only: 

How do we make this pupil comply or attend? 

we might also ask: 

What is making meaningful and sustainable participation difficult? 

That question encourages us to consider: 

• the clarity of classroom communication; 

• the predictability of routines; 

• sensory and social demands; 

• relationships with adults and peers; 

• previous experiences of success or failure; 

• the accessibility and relevance of the task; 

• the pupil’s confidence in requesting help; 

• whether the expected form of participation is necessary; 

• what happens before, during and after apparently successful participation. 

It also requires us to listen to the pupil and family. 

A young person’s presentation may differ substantially between settings. Some pupils maintain a composed appearance throughout the school day but experience exhaustion, shutdown or distress when they return home. 

Academic success and compliant behaviour do not automatically demonstrate that participation is comfortable, meaningful or sustainable. 

My secondary engagement research also led me to question the way we describe pupils as either engaged or disengaged. Those words can make engagement sound like a fixed characteristic that children bring with them: 

• this pupil is motivated; 

• that pupil lacks resilience; 

• this pupil wants to learn; 

• that pupil refuses to engage. 

In reality, engagement develops through an interaction between the pupil and the environment around them. 

Relationships matter. Belonging matters. The experience of competence matters. Being able to understand what is expected, anticipate what will happen and recover safely from difficulty matters. 

The social model of disability asks us to consider how people are disabled not only by individual differences or impairments, but also by environments, systems and expectations that do not accommodate those differences. 

In schools, these barriers may include: 

• inaccessible communication; 

• difficult sensory environments; 

• inflexible behaviour policies; 

• attendance systems that interpret distress as non-compliance; 

• narrow expectations about acceptable communication or regulation; 

• curriculum tasks containing unnecessary barriers; 

• sanctions for behaviour that may be communicating overwhelm; 

• pressure to demonstrate learning in one prescribed way; 

• assumptions that visible compliance means successful inclusion. 

Schools cannot remove every challenge, and the environment does not explain everything. However, we should be cautious about locating the whole problem within the child while leaving the conditions around them unexamined. 

A pupil described as struggling with change may experience frequent alterations to routines without preparation. 

A pupil described as avoiding demands may be responding to tasks that feel confusing, unpredictable, unsafe or beyond their current capacity. 

A pupil described as unmotivated may have experienced repeated failure or see little relevance in the work they are being asked to complete. 

A pupil whose distress becomes visible may have spent much of the day coping with demands, sensory input or uncertainty that adults have not recognised. 

Understanding context does not mean removing all challenge. It means ensuring that expectations are accessible, proportionate and supported. 

Support Before Diagnosis, Not Instead of Diagnosis 

Schools should not postpone appropriate support while a pupil is awaiting assessment. 

Diagnostic pathways can take considerable time. During that period, the pupil continues to attend school – or may become increasingly unable to do so. 

Schools can still: 

• gather pupil and family views; 

• identify particular barriers; 

• observe patterns across settings; 

• adapt communication; 

• increase predictability; 

• adjust sensory or task demands; 

• strengthen trusted relationships; 

• provide different ways to participate; 

• agree ways to request help, space or a break; 

• review whether support is making participation more sustainable. 

None of this requires a school to decide whether the pupil is autistic or has ADHD. 

The pupil may still require diagnostic assessment, specialist educational advice or clinical support. Early adjustments should not replace those pathways where they are needed. 

Assessment and support should happen alongside one another. 

Diagnosis-independent support must mean support that begins earlier – not support that is reduced. 

The Role of Specialist Services 

This also raises questions for local authority and other specialist education services. 

Specialist involvement should not be limited to producing lists of strategies for individual pupils. Nor should specialist professionals become the only people responsible for understanding neurodivergent learners. 

Our role should include helping schools to: 

• understand how barriers affect access, participation, autonomy and wellbeing; 

• recognise environmental and systemic barriers; 

• identify less visible presentations; 

• understand masking and delayed distress; 

• connect neurodiversity with attendance, wellbeing and engagement; 

• involve pupils in decisions about support; 

• evaluate whether adjustments are effective and sustainable; 

• strengthen whole-school practice. 

Success may sometimes mean that a school becomes more confident in sustaining inclusive practice while continuing to seek specialist input when it adds value. 

It should not automatically mean reduced support. 

Some pupils will continue to require specialist involvement or long-term provision. Progress should be understood through access, autonomy, wellbeing and sustainable participation, not simply through the withdrawal of support. 

Ten Inclusive Changes You Can Make Tomorrow 

Inclusive practice does not always require a new programme, expensive resources or extensive training. Small changes to everyday classroom practice can remove avoidable barriers quickly. 

These suggestions are not substitutes for adequate staffing, accessible policies, suitable environments or specialist provision. Nor will every approach suit every pupil. 

Wherever possible, adaptations should be developed with the young person and reviewed in relation to access, comfort, autonomy and sustainable participation – not simply whether they produce immediate compliance. 

1. Make the lesson sequence visible 

Briefly show or explain what will happen: 

First we will review yesterday’s learning, then I will explain the new task, you will have time to work, and we will finish by checking the answers. 

This can reduce uncertainty and help pupils understand what is happening now and what will happen next. 

2. Give instructions in manageable steps 

Avoid giving several spoken instructions at once. Give the first step, allow processing time and then add the next. 

This makes the route into the task clearer without reducing the intended learning. 

3. Check understanding without putting pupils on the spot 

Rather than asking, “Does everyone understand?”, quietly ask: 

What is the first thing you are going to do? 

This checks whether the instruction was accessible rather than whether the pupil was “listening properly”. 

4. Build in processing time 

Pause after asking a question. 

Avoid immediately repeating or rephrasing it unless the pupil asks you to do so. A new version may restart the processing process. 

5. Remove unnecessary barriers 

If copying from the board is not the learning objective, could pupils use a printed prompt, photograph the board, access a template or begin directly with the thinking task? 

Removing an unnecessary barrier is not reducing the learning expectation. 

6. Offer different ways to participate 

Allow pupils to respond through writing, a mini-whiteboard, pointing, partner discussion, an agreed communication method or a “pass for now” option with another opportunity later. 

Participation should not always require public performance. 

7. Prepare pupils for changes 

Communicate known changes to rooms, staffing, routines or activities as early and clearly as possible. 

Where possible, explain what will remain the same as well as what will change. 

8. Agree an accessible way to request help 

Ask whether a discreet help signal would be useful and agree one together. 

This might involve a card, symbol, written mark, digital message or agreed object position. 

9. Replace immediate judgement with curiosity 

When a pupil withdraws, refuses or becomes distressed, pause before assuming laziness or defiance. 

When they are able to engage, ask: 

What is making this difficult? 

They may not be able to explain immediately. Sometimes the most helpful first response is to reduce demands, support safety and return to the conversation later. 

10. Notice what supports sustainable participation 

When a pupil participates successfully, identify what made it possible. 

Was the task clearer? Was the environment quieter? Did they know what to expect? Were they able to move, choose how to respond or access a trusted person? 

Record and repeat what supports access, comfort and autonomy – not simply what produces immediate compliance. 

Small Changes, Not Lower Expectations 

Inclusive teaching does not require educators to lower expectations or remove all challenge. 

It means clarifying the learning intention, identifying barriers that are not essential to that learning and providing pupils with a realistic route to participation. 

These adjustments may be essential for some pupils, but they are likely to benefit many others too. 

The central question is not: 

How can I create a completely different lesson for every pupil? 

It is: 

What small change might make access and participation more possible? 

From Engagement to Inclusion 

Publishing my engagement research prompted me to revisit what helps young people feel connected to education. 

The interim review and the EEF’s inclusive teaching guidance have extended that reflection. 

Together, they suggest that engagement, inclusion and neurodiversity should not be treated as separate conversations. 

A pupil is more likely to engage when they can understand, access and influence what is happening around them. 

A school is more inclusive when it notices barriers early, listens to pupils and responds proportionately. 

A graduated system is effective when it combines strong provision for everyone with adaptations and additional support for those who require them. 

A diagnosis can be an important part of understanding a young person. It should not be the point at which understanding begins. 

The final recommendations from the independent review will matter. In the meantime, the EEF’s guidance gives schools something practical to consider now: how universal teaching, careful adaptation and additional support can work together so that every pupil has a meaningful opportunity to access education, exercise agency, participate and succeed. 

For me, that is where engagement and inclusion meet.