Variable Services for Children with Special Needs. Summary of Countrywide Supervision in 2006 of Services for Children with Special Needs

The Offices of the County Governors and the Norwegian Board of Health Supervision in the Counties have carried out supervision of municipal health and social services and specialized health service units for children with special needs. Areas for supervision were whether children aged 0-18 with congenital, early manifested or early acquired neurological condtions or damage to the nervous system are identified, and whether they receive individually adapted and coordinated services. Supervision was carried out in 40 municipalities and 21 specialized health service units units for children with special needs.

Through supervision it was found that the services that are offered to children with special needs vary, in some areas to a great extent. The differences in the services that are offered by different municipalities and specialized health service units are unacceptable.

In almost three of four municipalities, deficiencies were detected in routines and measures to ensure coordinated planning and regular follow-up of services for children with special needs, and to ensure cooperation with children and their parents. An overview of needs and measures was often inadequate, and in practice it was often the parents who had the role of coordinator. Whether the regular medical practitioner was involved in planning and evaluating services for children with special needs varied. Almost half the municipalities did not have a coordinating unit, or the tasks of the unit were not clearly defined. In one third of municipalities respite care was not individually adapted and/or the service offered was minimal.

Some of the services for children with special needs could not provide the amount of counselling that was necessary, and two thirds of the services did not ensure that work with individual plans was initiated. One third of the services did not meet the deadline for assessment within 30 working days and the deadlines that were set for providing treatment. There was variation in the way the results of assessment and recommendations for futher measures were reported to the relevant services. In many places it was found that it was only in rare cases that the regular medical practitioner received a report from the specialized health service unit when others had referred the child. In a few of the places where supervision was carried out, the specialized health services could not provide the comprehensive services that young adults needed, and that these clients previously had received as children.