Part 3 - continued

3.4 — Failure to Recognise Neurological Features

The 2026 assessment did not recognise or measure the neurological features that define the young person’s permanent impairment. These features have been documented for decades and form the core of the long‑term clinical baseline.

Failing to identify them meant the clinician could not understand the nature, severity, or permanence of the condition.

What neurological features should have been recognised

A neurological visual impairment typically presents with:

• vertical nystagmus

• impaired gaze stability

• reduced pursuit and saccadic control

• visual instability during movement

• spatial‑awareness deficits

• difficulty with depth perception

• functional‑vision challenges in real‑world environments

These features are not subtle. They are long‑standing, well‑documented, and central to the young person’s clinical profile.

What actually happened

The 2026 assessment:

• did not identify vertical nystagmus

• did not measure gaze stability

• did not assess pursuit or saccadic control

• did not observe visual instability during motion

• did not recognise spatial‑awareness deficits

• did not link findings to the neurological baseline

Instead, the clinician relied solely on ocular tests designed for eye‑health conditions, not neurological impairment.

Why this is a procedural failure

Recognising neurological features is essential for:

• accurate diagnosis

• continuity with the long‑term baseline

• understanding functional impact

• identifying risk

• ensuring clinical safety

• meeting professional and safeguarding standards

When a clinician fails to recognise the defining features of a neurological impairment, the assessment becomes:

• clinically inaccurate

• procedurally unsafe

• inconsistent with the clinical record

• misleading for professionals who rely on it

Impact on the young person

Because neurological features were not recognised:

• the impairment was misinterpreted

• the permanent nature of the condition was overlooked

• functional‑vision difficulties were minimised

• risk was underestimated

• the clinical record became unreliable

• continuity with the 30‑year baseline was broken

This failure contributed directly to the incorrect conclusion that the impairment was “intermittent” or “variable,” a conclusion that contradicts decades of clinical evidence.

The failure to recognise neurological features meant the assessment could not reflect the young person’s true clinical picture. The next section examines another major procedural failure: the omission of the 30‑year clinical record that should have guided the assessment.

Next 3.5

Failure to Access or Reference the 30‑Year Clinical Record

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