Introduction
In our previous briefing, we used our Wandsworth Mime SEND Forecasting Model to project the growth in the number of young people with an Education, Health and Care Plan (EHCP) in England over the next 15 years. The forecasted growth was stark, estimated to peak at over 920,000 EHCPs by the year 2040, an increase of over 60% from 2024.
While understanding the overall scale of likely growth in the cohort is important, it is crucial to understand the range of need within this cohort as it informs decisions around the additional support that should be put in place, including investment in new or expanded specialist provision. The right provision and right interventions are crucial to ensuring that all young people with SEND can achieve the best possible outcomes.
This briefing builds on our previous briefing which explored how the cohort of young people is forecast to grow. Again, we use our Wandsworth Mime SEND Forecasting Model to:
- Explore how the specific needs within the cohort may change over time
- Outline some of the drivers behind these changes
- Discuss impacts this may have on provision planning and the wider sector
The chart below uses data published by the DfE from the school census and breaks down the primary needs within the cohort of young people with an EHCP in 2024.
Figure 1 – Primary need breakdown of young people with an EHCP in England in 2024
Abbreviations: Autistic Spectrum Disorder (ASD), Social, Emotional and Mental Health Difficulties (SEMH), Speech, Language and Communications Needs (SLCN), Specific Learning Difficulty (SPLD), Moderate Learning Difficulty (MLD), Severe Learning Difficulty (SLD) and Profound and Multiple Learning Difficulties (PMLD). The “All Other” group consists of those with a primary need of Hearing Impairment (HI), Visual Impairment (VI), Multi-Sensory Impairment (MSI), Physical Disability (PD) and Other (OTH).
The most common primary need within the EHCP cohort is Autistic Spectrum Disorder (ASD), followed by Speech, Language and Communications Needs (SLCN) and Social, Emotional and Mental Health Difficulties (SEMH). Almost 7 in 10 pupils with an EHCP have one of these three needs listed as their primary need. The majority of the rest of the cohort is made up of pupils with a learning difficulty as their primary need[1].
The changing make-up of need
The animation below displays the forecasted changes in the make-up of need over the next 15 years, with each primary need denoted by a separate colour.
Figure 2 – Forecasted changes in the need make-up of England’s EHCP cohort in the next 15 years
As we discussed in detail in our previous briefing, the growth within the overall cohort of young people with an EHCP is forecast to be stark. However, focusing specifically on the make-up of need within the growing cohort highlights some important shifts in the coming years. The largest change we see is for the cohort of young people with a speech and language need (SLCN) (green), which we forecast to grow from 17% of the cohort in 2024 to 26% by 2035, equivalent to 135,000 additional young people with SLCN. We also see a growth in the proportion of the cohort with Autistic Spectrum Disorder (ASD) (blue) recorded as their primary need and a steady cohort with a social emotional and mental health primary need (red). On the other hand, there is a fall in the proportion of the cohort with a primary need of moderate or severe learning difficulties. These changes are summarised within the chart below.
Figure 3 – Change in the distribution of need among England’s overall EHCP cohort
Some interesting differences also arise when we look at the primary and secondary age cohorts in further detail. Focusing specifically on primary age young people with an EHCP, between 2024 and 2035 we project:
- A 4% point increase in the proportion of the cohort with ASD as their primary need
- A 6% point increase in the proportion of the cohort with SLCN as their primary need
- A 6% point fall in the proportion of the cohort with SEMH as their primary need.
However, the chart below shows that among secondary age young people with an EHCP, we see:
- Similar growth in those with ASD as their primary need (5% point increase)
- Double the increase in the size of the cohort with SLCN (12% point increase)
- A comparable fall in the proportion of the cohort with a primary need of SEMH (8% points) to the primary age cohort (6% points). However, this is still an increase of 700 young people.
We will delve deeper into the implications of these differences later on in this briefing.
Figure 4 – Change in the distribution of need among England’s secondary age EHCP cohort
The drivers behind the changing make-up of need
The immediate driver of the changes in the make-up of need is the different distribution of need among those being issued with new plans compared to the existing EHCP cohort, as demonstrated in the chart below. This shows that ASD and SLCN both make up a larger proportion of the new cohort than the existing cohort.
Figure 5 – Modelled need breakdown among the existing and new EHCP cohorts in 2024
The model used for these national forecasts uses publicly available DfE data to inform our assumptions around the different types of need present among different age groups. With the majority of new plans being issued to younger children, it is the range of needs within this cohort that are most important for predicting the distribution of need in the coming years.
As can be seen in the chart above, the proportion of young people with SLCN as their primary need is 7% points larger in the cohort with new plans compared to the overall cohort. This increase in the prevalence of SLCN within new plans being issued will go on to drive the large growth in the overall number of young people with SLCN as their primary need. Likewise, a slightly higher proportion of new plans issued are going to young people with ASD compared to the overall cohort, which will result in a growth in the proportion of young people with an EHCP with ASD as their primary need. It is also possible that as young people age, their primary SEND needs change, altering the need profile.
The growth of communication and interaction needs
Communication and interaction needs, one of the four broad areas of SEND, includes both Speech, Language and Communication Needs (SLCN) and Autistic Spectrum Disorder (ASD). Together these account for a significant and growing share of England’s EHCP cohort.
Speech, Language and Communication Needs
SLCN among young people can present in a variety of forms, such as when young people have difficulties in communicating with others, saying what they want to, understanding what is being said to them, or understanding and using social rules.
Data published by the DfE highlights that the prevalence of SLCN has increased in recent years, with one in five young people with an EHCP in England now having SLCN as their primary need, compared to 16.4% in 2021. The specific factors driving this increase are unclear however, a recent report by Speech and Language UK highlights the potential impact of the Covid-19 pandemic on the development of children’s speech and language for reasons such as being unable to talk face-to-face with their friends, and overuse of tablets, phones and computers.
Our forecasts show continued and marked growth in SLCN numbers and by 2035, we estimate that over one in four young people with an EHCP will have SLCN as their primary need. With a large young SLCN cohort within the system already, and a higher proportion of new plans being issued to young people with SLCN, there is a large and immediate need for support for these pupils within the primary sector. However, as this cohort ages, we will then see an increase in communication needs within the secondary sector. While some of these pupils’ needs may evolve and not require specialist SLCN provision, or their needs may be met suitably within mainstream schools, many will, and the lack of currently available secondary specialist provision presents a risk to the outcomes of these young people. Should this forecasted growth materialise, it is clear that a focus on increasing the availability of suitable secondary provision is key.
Autistic Spectrum Disorder
While SLCN is the fastest growing need, ASD remains the most prevalent primary need among young people with an EHCP in England, accounting for almost one in three young people with an EHCP. We forecast that ASD will remain the most common primary need among young people with an EHCP despite the surge in numbers with a primary need of SLCN. If available mainstream provision isn’t suitable, many of these young people, especially when entering the secondary phase, may go into expensive independent or non-maintained special schools, with almost 2 in 10 of these institutions in England listing ASD as a specialism. This places additional strain on the stretched budgets of local authorities, so addressing this shortfall in mainstream support should be a key priority for both financial sustainability, as well as improving the inclusion and outcomes for of young people with ASD.
A formal diagnosis of autism is often beneficial in understanding exactly the type of support that may be necessary for the young person. However, the waiting lists for diagnosis continue to increase, as demonstrated in the chart below. Around 9 in 10 young people with an open autism referral as of March 2025 have been on the waiting list for more than 13 weeks, the limit of which the National Institute for Health and Care Excellence say somebody should have to wait for an assessment. These long waits not only delay the implementation of appropriate support for young people with ASD, they also contribute to emotional distress for families, and even bring about financial challenges as families turn to private specialists.
Figure 6 – Percentage of Autism referrals open for more than 13 weeks (May 2022 – March 2025)
This problematic situation is compounded by the recent announcement that Integrated Care Boards must reduce their running costs by 50%. Integrated Care Boards are central to coordinating autism assessments in collaboration with schools and local authorities, and cuts to already overburdened diagnostic services will make it difficult to address this backlog and provide timely support in the future. With many people waiting an extended period of time to receive an often crucial diagnosis of autism, we often hear that young people are issued with EHCPs for other primary needs such as SLCN or MLD, masking their true autism-related primary need until their formal diagnosis. Consequently, the true scale of ASD within the EHCP cohort may be underestimated.
Conclusion
Using the Wandsworth Mime SEND Forecasting Model, we have taken a closer look at how the make-up of England’s EHCP cohort is likely to change over the next 15 years. As highlighted upfront, our analysis is limited by the primary need definitions used in DfE data collections. In order to facilitate better commissioning and planning which supports the need of the child, not just the diagnosis, the DfE must collect and also publish more comprehensive data which better reflects the range and intersections of the needs of young people with EHCPs.
We forecast substantial growth in the prevalence of Speech, Language and Communication Needs (SLCN), alongside continued increases in Autistic Spectrum Disorder (ASD). In contrast, Social, Emotional and Mental Health difficulties (SEMH) is projected to decline as a proportion of the cohort. These shifts are largely being driven by the characteristics of newly issued EHCPs, which are increasingly being granted to children with communication and interaction needs.
The growth in the SLCN and ASD cohorts will have significant implications for provision planning, particularly in the secondary sector where current specialist support for SLCN needs is limited. The government has recently announced additional targeted support for up to 20,000 children through their Early Language Support for Every Child programme to help overcome speech and language challenges before they escalate. While early intervention such as this may dampen the requirement for specialist support to some extent, they are unlikely to be sufficient on their own. It is likely that additional non-preventative measures, such as additional SLCN-focused specialist provision or resource bases will be required to meet this future need. Questions also remain over the best strategy to provide the support required by the growing ASD cohort, historically more reliant on the use of independent placements and in the midst of a health sector focusing on budget cuts to already overstretched diagnostic services.
The briefings in this series so far have focused on an “unmitigated” forecasting model, where growth is a result of practices around for example, requests for new EHCPs or the refusal of issuing new EHCPs remaining similar to that which we have seen over recent years. In our final briefing, we will explore how changes to these practices may impact the growth of the cohort.
Read the third briefing in the series here.
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[1] The recent introduction of Down Syndrome as a separate primary need code may shift this distribution slightly over time, though its use across local authorities has so far been limited and the numbers of young people across England with Downs Syndrome are small.
