The four broad areas of need

Children with communication and interaction needs, including autism, may have difficulty in:

• attention and listening,
• expressive language,
• understanding language,
• interacting with others and the world around them.

Some children with C&I differences will have had their needs identified at a very early age and may already be receiving support. For many children needs may not become apparent until they enter a group setting when their difficulties begin to impact on learning. Children need help to acquire language skills in order to develop their thinking as well as their ability to communicate. 

Needs in other areas can lead to and compound communication and interaction needs, for example a hearing loss or difficulties with attachment can impact on the development of communication skills; difficulties in other areas for example learning needs, social and emotional needs can be the result of unmet C&I needs. Look across all relevant areas of need to make sure that support is tailored appropriately. 

Children and young people with speech, language and communication needs (SLCN) cover the whole ability range. They find it more difficult to communicate with others. They may have difficulties with:

• fluency,
• forming sounds, words or sentences (expressive language) that impacts upon their ability to produce spoken or written language,
• understanding spoken language that they hear or read (receptive language),
• understanding, using and/or remembering words that they want to use. 

It may be a combination of these needs. 

Learners on the autism spectrum cover the whole ability range. It is called a spectrum difference as it affects everyone differently. Although no two children with autism are the same, individuals may have differences in the following key areas:

• Interacting - differences in understanding social behaviour and the thoughts and feelings of others, which impacts on the development of relationships and friendships.
• Communication - differences in expressing, understanding and processing language. Good verbal language skills may mask a deeper level of misunderstanding.
• Processing Information - Differences in planning, organisation, predicting, managing transitions and generalising skills.
• Emotional Regulation – some children will need to be taught specific strategies to help them to manage strong feelings
• Some children may focus on familiar activities as a source of reassurance, rather than showing a wider range of interests.
• Sensory Processing - differences in perceiving sensory information. Hypo (low sensitivity), hyper (high sensitivity), touch, sight, hearing, smell, taste, vestibular inner ear (balance) and proprioceptive (body awareness) can cause distress or discomfort.

English as an Additional Language (EAL) is not in itself a special educational need but it can be the case that a child who speaks English as an additional language may also have special educational needs. The approach to supporting all children with EAL is set out in Guidance for Early Years practitioners on supporting children learning English as an Additional Language (EAL). (oxfordshire.gov.uk)  Used alongside the descriptors this will help you to decide whether a child’s language competence should be giving rise for concern.

Support for learning difficulties may be required when children and young people learn at a slower pace than their peers, even with appropriate differentiation. Learning difficulties cover a wide range of needs, including moderate learning difficulties (MLD), severe learning difficulties (SLD), where children are likely to need support in all areas of the curriculum and associated difficulties with mobility and communication, through to profound and multiple learning difficulties (PMLD), where children are likely to have severe and complex learning difficulties as well as a physical disability or sensory impairment. 

Learning Difficulties (LD)

Children and young people with learning difficulties will learn at a slower pace than their peers, even with appropriate differentiation. It is often associated with speech and language delay.

Some children with learning difficulties, particularly those with severe or profound and multiple difficulties, will have had their needs identified at an early age and may already have received support. For many children needs may not become apparent until the child enters a group setting for the first time.

Needs in other areas can lead to learning needs, for example an unmet hearing need may impact on the child/young person ’s ability to learn at the same rate as his/her peers. Conversely unmet learning needs may impact on social development and emotional wellbeing. Look across all relevant areas of need to make sure that support is tailored appropriately. It is helpful to consider the child’s stage of learning rather than age.

Literacy and maths 

Some children will have general difficulties with cognition and learning.  Others may only have difficulties in specific areas.

Difficulties with literacy are unlikely to be fully observable until a child begins to engage with print and starts to become a reader. However, skills around sequencing, working memory, auditory processing and visual discrimination are needed for literacy and if these are delayed for any reason, then learning to read and write may be more difficult. 

Similarly, there are early skills that children need to make good progress in maths. Poor language skills also impact on a child’s ability to learn to read and comprehend or to acquire mathematical knowledge. Refer to the Communication and Interaction descriptors if a child’s language appears delayed.

It’s important to identify difficulties early, so that children can be supported in these key areas in order to ensure needs are addressed as soon as possible.

All young children are learning how to make friends and interact with others and its expected children will develop these skills gradually through experience and with caring adult support. However, children who have emerging difficulties in this area may find it significantly harder to:

• make and maintain appropriate and healthy relationships
• regulate their emotions
• communicate their emotions
• manage transitions
• experience a positive sense of self 

Children may experience a wide range of social and emotional difficulties which manifest themselves in many ways.  These may include becoming withdrawn, isolated, distressed, behaving in ways that could cause harm to themselves and others, difficulty with following routines and instructions. 

These distressed behaviours may be persistent and may indicate social, emotional, mental health needs.   

It must be recognised that behaviour is a way of communicating 

Children can develop social, emotional needs or mental health difficulties for many reasons. Sometimes these are related to:

• Attachment disorder
• Adverse childhood experiences (ACES)
• Autism spectrum difference
• A medically unexplained condition.
• A response to an unmet need, for example, a child who has difficulty with communicating thoughts and ideas may find inappropriate ways to express him/herself.
• Other learning needs, either as part of a condition or disorder, such as: Attention deficit hyperactive disorder (ADHD) or attention deficit disorder (ADD) This is rarely able to be clearly identified in the early years although there may be indicators.
• Sensory processing difficulties

A small number of children will have social, emotional and mental health needs identified at a very young age. For many children needs may go unrecognised until they reach a group setting and are exposed to the multiple demands of a bigger peer group in a highly interactive environment. You may observe behaviours that communicate anxiety, fear, frustration, feeling out of control. Such feelings may manifest themselves in a range of ways e.g high levels of activity, lack of concentration, over reaction to events, withdrawn behaviour, self-harm or fight or flight. It is usual for children to display unsettled behaviour when starting in a new setting, so allow time for children to adjust to a new environment/being away from home. 

For children with SEMH needs there are sometimes home circumstances that impact on behaviour and development and in these cases Early Help should be considered and the opportunity to complete a Strengths and Needs form should be offered to the family.

Risk factors are cumulative. Children exposed to multiple risks such as social disadvantage, family adversity and cognitive or attention difficulties are much more likely to develop relationship problems. DfE guidance in Mental Health and Behaviour in Schools outlines risk and protective factors (p. 13). (Updated 2018).

When children display distressed behaviour that are of continuing concern it is essential to try to address any underlying social, emotional or mental health needs, and not just the presenting behaviour. Close observation and discussion with parents will help to explore what the child may be communicating through the behaviour. 

Assessment, planning and provision for a child with social, emotional and mental health needs should be located within a nurturing approach and consistent use of positive strategies with training for all staff.

Foundations for an Emotionally Healthy Setting: Team Assessment Tool

A resource to support early years settings develop a whole-setting approach to emotional and physical wellbeing. 

Wellbeing and Involvement

The Leuven Scale Tool has been developed by a team based at the Research Centre for Experiential Education (Leuven University – Belgium) under the supervision of Dr. Ferre Laevers. The tool focuses on two central indicators when planning any educational setting: ‘Wellbeing’ and ‘Involvement’. Wellbeing refers to feeling at ease, being spontaneous and free of emotional tensions and is crucial to secure ‘mental health’. Wellbeing is linked to self-confidence, a good degree of self-esteem and resilience. Involvement refers to being intensely engaged in activities and is considered to be a necessary condition for deep-level learning and development.

Physical Disability (PD)

This section describes children who have greater needs than most of their peers for support with their physical needs which can impact on their learning.

Some children with physical difficulties will have had their needs identified at an early age and may already have received support e.g. Cerebral Palsy, Hypermobility, will need ongoing support and interventions. For others, needs may not become apparent until the child is older, and they impact on his/her learning. Some children with physical difficulties may also have hidden learning difficulties such as planning and organisation that impacts their learning e.g. children with Developmental Coordination Disorder/Dyspraxia.

Many children with physical needs require on going minor adaptations to the learning environment and for the learning tasks including access to play that would be considered as reasonable adjustments under the Equality Act 2010. For some this is the only support that is needed, they do not need additional SEN support. With the right support and knowledge children with physical difficulty can achieve as much as other children (PDNet Standards 2018).

Where some children have a diagnosed progressive physical condition, e.g. Duchenne muscular dystrophy, it is important to plan and prepare early for later needs. 

Other children have a temporary condition such as injured limb or post-operative care and need appropriate support to access learning.

Unmet physical needs may impact on the child/ young person’s ability to learn in the same way and at the same rate as their peers.  The child/young person may also have linked social and emotional needs. Look across descriptors for all relevant areas of need to make sure that support is tailored appropriately.

Hearing Loss/Deafness (HL)

Many children with hearing loss will have their needs identified early through the Newborn Hearing Screening Programme and will be supported by the SENSS Deaf and Hearing Support (DHS) team. Children may have a temporary hearing loss that fluctuates or a hearing loss that is permanent. Some children benefit from a hearing aid(s) or other amplification devices.

Some younger children may have needs that go unrecognised until they reach a group setting or are expected to undertake tasks that require them to use hearing skills in a different context.  It is also possible for some children to acquire a hearing loss. This could be caused through illness or accident or might be because they have a progressive condition or a condition that has a late onset. The most common cause of temporary and fluctuating hearing loss in childhood is commonly known as ‘Glue Ear’. Information about ‘Glue Ear’ is available on the Oxfordshire Local Offer.

Hearing loss can affect language acquisition and development in young children.

Some children with a hearing loss will require on-going specialist teaching support from teacher of deaf children and young people to access the curriculum alongside their peers. Others may require a routine advisory visit to check the function and management of any equipment, to observe the child and feedback on their learning and to ensure that the setting is empowered to take responsibility for all aspects of the child’s inclusion.

Sometimes a child can meet many of the descriptors for a hearing need but when clinically assessed their hearing is within normal limits. It could be that they have a fluctuating hearing loss. If this is the case repeated assessment will usually determine the type and level of hearing loss. 

If there is no underlying physical hearing loss it may be that the child/young person has auditory processing difficulties. In this case, the descriptors and guidance for supporting children with communication and interaction (C&I) needs should be used. A medical confirmation of a hearing loss does not necessarily mean a child has Special Educational Needs. However early intervention with specialist advice from the SENSS (DHS) Team ensures that the impact of the hearing loss on the child/young person’s progress is minimised. 

The SENSS (DHS) Team will not usually become involved with a child unless a paediatric audiologist has first made an assessment. This is because there can be many reasons why a child may not appear to hear well, and a formal hearing assessment is needed to ensure that the guidance offered to a setting is appropriate. 

If a child has not been seen by the community paediatric audiology team or a hospital audiology department, the first step is a GP referral to community paediatric audiology for further assessment. Parents should be asked to discuss this with their child’s GP.

Vision Impairment (VI)                                                                                

Visual difficulties range from mild through to profound. Many children have their vision fully corrected by spectacles.  A child should be considered to have a vision impairment if the visual difficulties are not due to basic refractive errors and cannot be fully corrected by glasses.

Many children with vision impairment will have their needs identified early and will be supported by the SENSS Vision Impairment (VI) team. Some children may have needs that go unrecognised until they are expected to undertake tasks that require them to use visual skills in a different context. Some acquire a visual loss through illness or accident. 

A vision impairment can impact on many areas of child development, for example a child’s social and emotional development, learning and independent living skills. Check across all relevant areas of need to make sure that support is tailored appropriately. 

Multi-Sensory needs (MSI or Dual Sensory Loss)

This section describes children who have multi-sensory impairment. The term ‘multi-sensory impairment’ usually refers to children who have a combination of hearing loss and vision impairment (i.e. dual-sensory loss) which used to be known as deaf blindness. 

Children with multi-sensory impairment usually have their needs identified at a very early stage. Occasionally multi-sensory impairment may occur as a result of an accident, trauma or a progressive syndrome in an older child, for example Usher syndrome, Alstrom syndrome. Some children also have additional difficulties or developmental delay.

Support and advice from a range of professionals is essential to meet the complex nature and pattern of needs displayed by these children.