Karen is a specialist speech and language Therapist with 25 years’ experience in early years. Following a 19 year career in the NHS in Northamptonshire, she has worked independently supporting children and families in their homes and helping practitioners and children in Early Years Settings through government funding.
As Early Years Professionals we meet children and their parents at the start of their family’s journey. Building a trusting relationship with parents and carers is vital, particularly if their child has differences in learning which is affecting their development.
When children are referred for an autism assessment there is usually a long wait. This can often mean that the child will not receive a diagnosis until they have started school. However, children don’t need to have a diagnosis to begin intervention and there are key strategies that can be used with children who are already diagnosed and those with social communication differences who may be on the pathway to a diagnosis.
What Early Years Professionals need to know about supporting autistic children in their settings:
Have confidence in your own knowledge and skills. You don’t have to wait for outside agency involvement before you implement strategies.
Autistic children play differently. Our aim is not to teach them how to play like their neuro-typical peers but to join them in their world. This is how we make a connection and support interaction.
Each child is an individual and a diagnosis (or potential diagnosis) does not mean that they are the same as another child with the same diagnosis.
Start where the child is at. Look at their interests. Sit quietly and watch what they are doing. What sort of toy or object are they seeking? What other toys and resources in your setting offer similar properties? Ask parents what the child likes to do at home. If they are into technology, what are they watching? Can you draw any themes from this? Do you need additional staff training, e.g. The Curiosity Programme (reference 1) to understand the play development of autistic children in your setting?
The child may not want toys – they might like people play, e.g. singing, action rhymes, climbing, cuddling, tickles etc. People play games can be really motivating for some autistic children. Look at the Hanen article (reference 2) for more ideas. Be mindful that some children can’t tolerate this so wait for the child to initiate interaction. If they like contact with people, they will soon let you know!
Don’t set an agenda. As soon as you bring your ideas to play, the child is likely to move away. Sit quietly and wait. The child needs to get used to you. Remember, the activity is more likely to motivate them than the person, so you need to be patient.
Start to copy how the child is playing and their sounds, but be sensitive. If the child moves away it is too much. It is fine to sit quietly. There will be a magic moment when the child will realise you are doing what they are doing and you will have a moment of connection or “joint attention”. This approach is called Intensive Interaction (reference 3).
Look at how the child reacts to the world around them. Sensory differences affect autistic people in different ways. If you are struggling with engagement, consider the sensory needs of the child. Seek advice from an Occupational Therapist if possible. If a child is dysregulated, they cannot learn.
The benefit of partnership working– a case study:
Recently a nursery I work with used SENIF+ to fund monthly speech and language visits. I had worked with the child and her parents at home for several months.
Although the child had made good progress at home, she had not generalised the skills she had learnt at home into nursery. The child was frequently dysregulated. She often had to be collected early by her parents as she was distressed.
The staff were using visual support to help the child to understand what was expected during the day, but this had been very dysregulating for her and she had protested using actions and sounds when shown a now and next board or offered visual choices using objects or symbol pictures.
I was able to discuss what I had learned about the child at home, feeding back about strategies that her parents had successfully implemented. These included: following the child’s lead, looking at how she used objects in her play and encouraging adults to reduce the amount of spoken language they used when interacting with her. Over the course of a few visits, the staff team understood more about the child’s unique learning profile, her sensory preferences and interests. They felt more confident about how they offered support. Once the child was more relaxed, the staff and her parents were also more relaxed and we were then able to talk about the next steps to support her learning.
Visuals were still used and readily available in the environment but not presented to the child, therefore reducing the sense of “demand” she felt. Everyone acknowledged that when the child was dysregulated she wasn’t able to learn. Some of the SENIF+ money was used to purchase sensory resources including a peanut ball and chewy tubes and also to create a cosy safe space in the area where she liked to sit. We added a tent, a weighted blanket and some books.
The importance of working with parents:
Communication with parents is vital. Keeping in touch about appointments and the outcomes of any assessments is part of this but, to truly make a difference, staff need to work with parents at a deeper level, finding out about the child, what they like to do at home (they might not yet play with toys) and how to connect with them.
How we communicate with parents about their child will set the tone for all of their interactions with professionals for the rest of their child’s life. Listening to parents and responding sensitively to their concerns provides the basis for a trusting relationship. It also empowers parents and allows them to be confident advocates for their child.
Share information with other agencies before or after the child’s appointments, with parental permission. You know a lot about the child and other professionals will only have a snapshot of that child in a clinic setting. Your insight will be invaluable and is always appreciated.
Use the funding that is available to support children with SEND and look at what the child needs. This may be called SENIF/SENIF+ or Inclusion Funding or they may have funding from their EHCP. Do they need specific resources, e.g. sensory supports? Do they need visual support? Do you have the equipment needed to make and display visuals? Do they need specialist assessment and intervention from outside agencies? Do you and your team need staff training? Discuss the options available with parents and utilise their knowledge of their child. It is recognised that children require additional support in the Early Years so utilise the funding that is available to proactively support the children in your setting.
References
https://attentionautism.co.uk/curiousty-programme/
https://www.hanen.org/SiteAssets/Helpful-Info/Articles/people-gameshandout_1-0-1.aspx
https://www.oxfordhealth.nhs.uk/oxtc/good-advice/intensive-interaction/