-->PONE-D-25-23111-->-->Barriers, enablers and outcomes reported by parents engaged with the special educational needs system in England: A qualitative study-->-->PLOS ONE

Dear Dr. Saxton,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

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Thank you for your submission. Based on the reviewer’s detailed feedback and my own evaluation, I am recommending a major revision at this stage.

The manuscript addresses a relevant and timely topic and meets PLOS ONE’s criteria for methodological soundness and ethical research. However, several key revisions are needed to ensure clarity, alignment of study components, and compliance with journal policies.

Changes required for acceptance include:

• Clearer alignment between the stated purpose of the study and the research questions, particularly regarding claims about links between provision and outcomes.
• Reorganization and clarification of the literature review, ideally structured around the stated research questions.
• Expanded detail about participant demographics and child characteristics.
• Improved explanation of UK-specific terms (e.g., SEN, EHCP) for an international audience.
• Relocation of methodological details currently found in the Results section (e.g., interview duration).
• Clearer presentation of children's needs in the Results section.
• A revised Data Availability Statement that aligns with PLOS ONE’s policy, including appropriate justification if data cannot be publicly shared.

Recommended changes (not mandatory for acceptance):

• Enhancing clarity through subheadings within the Introduction.
• Minor improvements in reporting analytic rigor and theme development.

There are no conflicting recommendations across reviews. The reviewer’s suggestions are constructive and coherent, and I encourage the authors to address them thoroughly in the revision.

Once these issues are addressed, the manuscript will be suitable for reconsideration.

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We look forward to receiving your revised manuscript.

Kind regards,

Ramandeep Kaur

Academic Editor

PLOS ONE

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[This research was supported by Health Data Research UK under grant No. LOND1), which is funded by the UK Medical Research Council and eight other funders. TF is supported by a National Institute of Health Research (NIHR) senior investigator award (https://www.nihr.ac.uk/). All research at the Department of Psychiatry in the University of Cambridge benefits from the NIHR Cambridge Biomedical Research Centre (NIHR203312) and NIHR Applied Research Collaboration East of England. This study/project is funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research Programme (Grant Reference number NIHR- NIHR202025). The funders did not play any role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.].

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Additional Editor Comments:

Thank you for submitting your manuscript entitled "Barriers, enablers and outcomes reported by parents engaged with the special educational needs system in England: A qualitative study." The paper presents important insights into the lived experiences of parents navigating the SEND system in England.

Based on the comments from Reviewer 1, I am requesting a major revision of your manuscript. While the overall study is well-conceived and contributes to the literature, the reviewer has raised several concerns that must be addressed to strengthen the manuscript:

Clarify the alignment between the study’s purpose, research questions, and findings. The reviewer noted that the stated purpose (examining the link between provision and outcomes) does not align well with the qualitative nature of the study, which explores reported experiences rather than explicit causal links.

Improve the organization of the literature review. Please consider restructuring this section around your two research questions, possibly using subheadings to enhance clarity and coherence.

Clarify terminology and context. Please spell out acronyms (e.g., SEN) at first mention and provide brief explanations of UK-specific terms like EHCPs to aid international readers.

Expand on participant details. Include additional demographic and contextual information about participants (e.g., gender, caregiver role, whether children were home-educated).

Relocate interview duration detail. This currently appears in the Results but should be moved to the Methods section.

Clarify the description of children’s needs. Reformat this information for clearer presentation and understanding.

Address the data availability policy. As your current statement does not meet PLOS ONE’s data sharing requirements, please revise it to explain any ethical or legal limitations on data sharing and provide what is possible within those constraints.

Please revise your manuscript accordingly and include a detailed point-by-point response to the reviewer comments.

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Reviewers' comments:

Reviewer's Responses to Questions

-->Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. -->

Reviewer #1: Yes

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-->2. Has the statistical analysis been performed appropriately and rigorously? -->

Reviewer #1: N/A

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The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.-->

Reviewer #1: No

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Reviewer #1: Yes

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-->5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)-->

Reviewer #1: Brief Summary

This manuscript presents the results of a qualitative study in which the authors examined “the experiences of 22 parents in identifying their child’s needs, securing provision, and its impact on the child and their family.” Results suggests that “Thematic framework analysis identified legal protections and the advocacy efforts of parents and professionals as key enablers. Barriers included professionals’ lack of understanding about SEND (particularly autism), poor communication between services and families, and system failures. Positive outcomes from SEND provision included improved health, education and social outcomes, and young people gaining autonomy and independence. Negative outcomes included lost educational opportunities, worsening mental health for both children and their parents, and educational policies lacking long term vision.”

General Comments and Overall Evaluation

This study is important because it adds to the literature that examined parents’ experience with their child’s Special Educational Needs and Disabilities (SEND) services. Overall, the study described in this manuscript examines these issues in a way that might be of interest to the readers of PLOS ONE. However, the manuscript would benefit from a better alignment between the purpose of the study, the research questions, and the results, as well as a more organized literature review. I summarize below my comments and suggestions along these lines.

Introduction

The review of research literature was not well organized. The authors may want to consider organizing the literature review according to the two research questions and adding subheadings to make it easier for readers to follow.

The identified gap in literature does not align with the purpose of the study. The authors stated that “few peer-reviewed studies have examined the link between SEND provision and children’s and families health, education and other outcomes, or the antecedent barriers and enablers of identifying SEND and securing appropriate provision.” However, the current qualitative study did not address this gap (the link between these variables).

Research Question 1: Please spell out SEN.

The research questions are clearly stated. However, the manuscript would be strengthened if the purpose of the study aligns with the two research questions.

Methods

Participants: The manuscript would benefit from more descriptions about the participants and their children. For example, are participants parents and/or grandparents? Mothers or fathers? How many children were home-educated?

Data Collection: The authors may consider moving the information on the interview duration (2.5 hours) to the Data Collection section in the Methods from the result (p. 11, line 245).

Data analysis was clearly described and appropriate.

Results

Line 247, please provide more explanations on this statement “Nineteen children had EHCPs or a SEN statement and three were receiving SEN support” to provide a context for readers from other countries.

Line 251-254: “Parents described their children’s SEND as including at least one of the following: autism (n=13), several having further needs such as ADHD and hypermobility, a mental health problem (n=5), a learning disability (n=5), a brain injury (n=4), and speech and language difficulties, some of whom were non-verbal (n=5).” This information needs to be more clearly presented.

Four main themes were identified and within each main theme, subthemes were clearly presented in Table 1. Results were systematically presented.

I hope that these comments are helpful.

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Reviewer #1: No

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Barriers, enablers and outcomes reported by parents engaged with the special educational needs system in England: A qualitative study

PONE-D-25-23111R1

Dear Dr. Saxton,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

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Kind regards,

Ramandeep Kaur

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments: