Vulnerable Learners Service. Criteria for Education Health and Care Needs Assessment in the Early Years February 2015

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1 Vulnerable Learners Service Criteria for Education Health and Care Needs Assessment in the Early Years February 2015

2 Introduction... 3 Core Criteria... 4 Cognition and Learning... 5 Social emotional and mental health... 7 Sensory and/or Physical Needs... 7 Sensory needs... 7 Visual Impairment... 8 Hearing Impairment... 8 Multisensory impairment... 9 Physical Needs... 9 Speech Language and Communication Needs Social communication difficulties and Autistic Spectrum Conditions Page 2 of 12

3 Criteria for Education Health and Care Needs Assessment in the Early Years This guidance has been written for parents and professionals working with children in the Early Years Foundation Stage (up to and including their Reception Year). It outlines the criteria which will be used by the Local Authority in deciding whether to agree to an Education Health and Care (EHC) Needs Assessment for children with Special Educational Needs. The document should be read in conjunction with Education Health and Care Needs Assessment in North Somerset on_health_and_care_needs_assessment_guidance_2014.pdf Introduction The new 0-25 SEND Code of Practice describes the duties on and expectations of Early Years Providers with regards to support for children with Special Educational Needs and Disabilities. Providers are expected to contribute to the Local Offer, to adopt a graduated approach to meeting children s needs and to fulfill their statutory duties under the Equalities Act Adoption of the graduated approach ensures that the needs of all children with SEND are met through a cyclical assess, plan, do, review cycle, with increasing intervention over time if needed for those children who are identified as having the highest level of need. Chapter 5 of the SEND Code of Practice explains the specific actions early years providers should take to meet their duties in relation to identifying and supporting all children with special educational needs. As with school age children, the importance of assessment and intervention over time is stressed as part of a graduated approach to understanding and meeting the special educational needs of children in the Early Years. In addition, the Code focuses on the importance of settings exploring underlying causes for a delay in a child s development and intervening as appropriate, for instance using the Early Help approach if a child s family situation is thought to be contributing the their behaviour in their preschool setting. Early Years settings are expected to make special educational provision where a child has a significantly greater difficulty in learning than their peers, or a disability that prevents of hinders a child from making use of the facilities in the setting. This special educational provision should be matched to the child s difficulties with communication and interaction, cognition and learning, social emotional and mental health or sensory and/or physical needs. The provision for children with special educational needs in Early Years settings is not dependent on a child having an Education Health and Care Plan (EHCP). The Code also recognises that children s needs may change over time and may be present across more than one area. This is particularly true in the Early Years as young children change and develop more at this stage than any other in their education. Page 3 of 12

4 Paragraph 5.49 of Chapter 5 of the Code states that an EHC Needs Assessment may be appropriate where: Despite the setting having taken relevant and purposeful action to identify assess and meet the special educational needs of the child, the child has not made expected progress Core Criteria The core criteria that will need to be met and information that will need to be provided in order to agree that an EHC Needs Assessment may be appropriate are as follows: Evidence of SEN provision being made in an EY setting for at least six months demonstrating at least two cycles of the Assess Plan Do Review cycle This criterion ensures that sufficient time has been allowed for relevant and purposeful action to be taken to identify, assess and make provision for a child s SEN. Examples of what is meant by an EY setting in North Somerset include: A Private Voluntary or Independent nursery or playgroup A Childminder A Local Authority maintained nursery Springboard Opportunity Group If a child has been unable to attend preschool provision over time for reasons of ill health or parental choice, an exception to the six month/ two cycles criterion may be considered. This will be discussed on a case by case basis. Evidence of multi-professional assessment and intervention with the child. This might include the involvement of a Speech and Language Therapist, Community Paediatrician, Portage Worker, Area SENCo, Lifetime Service, Sensory Support Service, Health Visitor, Educational Psychologist or Social Worker. Not all of these professionals need to be involved for the criterion to be met. The involvement of the professional should in some way support the setting to better understand the child s needs and the nature of the provision put in place. Evidence of reasonable adjustments made in the setting to ensure the environment and EY curriculum can meet any needs resulting from any disability the child has and the impact these adjustments have had on the child s progress Evidence of the involvement of parents/carers in the SEN assessment, planning and review process Page 4 of 12

5 Evidence that the child s progress has been monitored over time (at least 6 months) by MAISEY (Multi-Agency Information and Support in the Early Years), the Early Years setting and the Area SENCo. Evidence of the child s likes and dislikes in respect of their play and learning opportunities Details of whether the setting consider that an assessment would result in a positive change for the child and if so what this would be Information regarding the child s health and care needs (where appropriate) Records of the child s achievements and progress using the Development matters in the Early Years Foundation stage, 2012 and Early Years Outcomes, 2013 Evidence that despite relevant interventions being put in place over time by the EY setting, progress is not being made or is significantly less than could be expected given the support being provided N.B. The core criteria will inform the decision about whether to proceed with an EHC needs assessment in the vast majority of cases. However each case will be considered on its merits and where necessary and where there are compelling reasons to do so, requests may be agreed outside of these criteria. In addition to the above, the following relevant criteria must be met for the child s area of need in order to provide evidence of the significance of the delay experienced by the child in their development. Cognition and Learning EY settings need to provide support to children who learn at a slower pace than their peers. 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. As a child enters more formal schooling, it can also become apparent that they may have specific learning difficulties which affect one or more specific aspects of learning. This encompasses a range of conditions such as dyslexia, dyscalculia and dyspraxia. As the development of children in the Early Years varies widely, it can be hard to assess the extent and pervasiveness of a child s learning difficulties, even when there is an underlying medical condition such as Down Syndrome which might account for the difficulties. Specific learning difficulties are also difficult to identify as the child s progress over time within a specific area of their learning and experience of a range of structured learning opportunities, will be limited. Page 5 of 12

6 EY settings are expected to meet the needs of children who appear to be demonstrating difficulties in one specific area of their learning from within their own resources and those made available to them from the Local Authority. This is also true of children whose attainment is significantly below age related expectations in most areas of the curriculum despite appropriate support. Top up funding is available to support learners with difficulties at these levels. In order to be considered for an Education Health and Care Needs Assessment children with the most significant learning difficulties will need to meet the core criteria and have additional difficulties (for instance medical physical sensory or behavioural difficulties) associated with their learning difficulties which increase the complexity of their needs. The criteria which would need to be met for an EHC needs assessment to be agreed are as follows: Medical, physical, sensory or behavioural difficulty associated with their learning difficulty The child requires modification and explicit teaching of the curriculum for all of the timetable in order to facilitate their inclusion. This will involve detailed task analysis and teaching approaches such as prompting, explicit modelling etc. Such approaches will be required for social skills/responses, the learning of routines and personal development in addition to learning attainments. Significantly delayed receptive and expressive language skills which may require Alternative and Augmented Communication Vulnerability at mealtimes and during free play due to delayed development of social skills (as a result of their wider developmental delay) leading to concerns over their safety and/or the safety of others. The child s development is significantly below their chronological age in all three prime areas as described in Development Matters in the Early Years Foundation Stage, 2012 and Early Years Outcomes, The table below indicates the delay which would need to be present for an EHC needs assessment to be considered appropriate. Developmental age in all 3 areas of the Child s chronological age Early Years Outcomes (2013) months 8-20 months months Birth11 months Up to 30 months See below NB Due to the difficulties associated with understanding the extent and significance of a child s learning delay at a very early age, children up to the age of 30 months will not be typically considered for an EHC needs assessment on the grounds of Cognition and Learning. Page 6 of 12

7 Social emotional and mental health The development of appropriate behavior towards others and within an educational setting is central to all children s early years. There are wide variations in children s behavior, emotional management and social skills which may reflect their learning opportunities, parents approach, home situation, personality, or be affected by other areas of their development. If a child is presenting with significant delays or difficulties in these areas, it is expected that the educational setting would work with the parents and other professionals to understand the underlying cause of the difficulties, as well as putting in place provision to help the child learn new skills. For these reason, it is not anticipated that difficulties with behavior, social skills or emotional management alone would be sufficient to justify an Education Health and Care Needs Assessment. Sensory and/or Physical Needs Some children and young people require special educational provision because they have a disability which prevents or hinders them from making use of the educational facilities generally provided. These difficulties can be age related and may fluctuate over time. Early Years settings have a statutory duty to make reasonable adjustments in line with the Equalities Act (2010) which when made will remove the hinderance preventing a child with a disability making use of the facilities in their setting. These reasonable adjustments include auxillary aids and services for disabled children. This duty is anticipatory it requires thought to be given in advance to what disabled children and young people might require and what adjustments might need to be made to prevent that disadvantage. All publicly funded early years providers must promote equality of opportunity for disabled children. Sensory needs Many children and young people with vision impairment (VI), hearing impairment (HI) or a multisensory impairment (MSI) will require specialist support and/or equipment to access their learning. Children and young people with an MSI have a combination of vision and hearing difficulties. Visual impairment refers to a range of difficulties from minor impairment to blindness. Pupils with this impairment cover the whole ability range. For educational purposes a pupil is considered to be visually impaired if they require adaptations to their environment or specific differentiation of learning materials in order to access the curriculum. Similarly pupils with a hearing impairment range from those with a mild hearing loss to those who are profoundly deaf. Again they cover the whole range of ability. For educational purposes pupils are regarded as having a hearing impairment if they require hearing aids, adaptations to their environment and/or particular teaching strategies in order to access the concepts and language of the curriculum. Page 7 of 12

8 A number of pupils with sensory difficulties have their needs met within mainstream settings with the support of the Sensory Support Service and support from setting resources. The SEND code of practice makes it clear that children with disabilities such as a sensory impairment do not necessarily have Special Educational Needs. Their needs can often be met through reasonable adjustments (including the support of the Sensory Support Service). Top up funding is available to EY settings to support those with more severe sensory impairments to allow these reasonable adjustments to be put in place. It is sometimes the case that the needs of children with sensory difficulties will become more apparent when they enter more formal education as the demands of the curriculum change. Therefore a child with a sensory impairment will only be considered to have a Special Educational Need if their sensory impairment impacts on their progress in other areas of development despite appropriate reasonable adjustments being put in place over time. EHC needs assessment will only be considered for EY children with a visual or hearing impairment where the core criteria are met AND The Sensory Support Service has provided support in the educational setting and there is evidence that recommendations have been implemented over time The sensory impairment is having a severe impact on the child s progress in other areas of development The sensory impairment meets the level of severity described below Visual Impairment Be diagnosed as blind or experiencing a degree of sight loss that requires access to learning through alternative nonsighted means e.g. Braille and tactile materials as appropriate to age/stage of development Requires 100% differentiated resources/materials to access learning Receives regular monitoring and support from a Qualified Teacher from the Sensory Support Service on at least a weekly basis Hearing Impairment Receive a significant level of audiological and learning support delivered by a teacher of the deaf, for assessment, monitoring of progress, advice and guidance to preschool staff. Have severe or profound hearing loss in the better ear as advised by medical diagnosis or the Sensory Impairment Service Unable to access a range of learning opportunities or understand the speech of adults and peers in the setting without constant individual support, whether signed or oral/aural. Require daily 1:1 support from specialist / qualified teacher of the deaf in a quiet environment in order to develop listening / language skills (for instance at Mendip Green Hearing Impairment Base) Page 8 of 12

9 NB It is recognised that the majority of children with this level of hearing impairment will have severe language delay and/or difficulties accessing the curriculum and/or be lacking in confidence in communicating independently in the setting. This additional language difficulty alone will not be grounds for seeing the hearing impairment as a Special Educational Need. Multisensory impairment Children with multisensory difficulties may have very serious medical needs which may be linked to a physical disability. The additional criteria for agreeing an EHC needs assessment for these children are: The child has a combination of severe visual and hearing difficulties The child may require a significant level of alternative means of communication The child may also have additional disabilities which make it difficult to ascertain their understanding and cognitive skills Requires an extremely high level (100%) of individualised specialist support to meet their education and health care needs Physical Needs There are a wide range of physical disabilities and pupils cover the whole ability range. There are also a number of medical conditions associated with physical disability which can impact on mobility. These include cerebral palsy, heart disease, spina bifida, hydrocephalus and muscular dystrophy. Some pupils are able to access the curriculum and learn effectively without additional special educational provision. They have a disability but do not have a special educational need. Some children and young people have a physical disability which requires additional ongoing support and equipment to access all the opportunities available to their peers. This support and equipment is seen as a reasonable adjustment under the Equalities Act (2010). All early years providers should also take steps to ensure that children with medical conditions get the support required to meet those needs. This is set out in the SEND Code of Practice: 0-25 (2014). Some children with a physical disability will have Special Educational Needs if their disability significantly impacts on their progress in other areas of their development in spite of the reasonable adjustments being made in their EY setting. In order for an EHC needs assessment to be considered for a child with a physical or medical difficulty who has SEN, the following would need to apply in addition to the core criteria: Nonindependent specialist buggy user unable to transfer without support Requires Alternative and Augmented Communication aid because of physical impairment Requires long term therapy support Page 9 of 12

10 Requires manual handling risk assessment Requires adult support for toileting Requires adult support to enable access to and for adaptation of almost all learning opportunities/experiences including access to outdoor learning. Have an additional significant difficulty in at least one other area of their development (for instance cognition and learning or language) Speech Language and Communication Needs Speech and language needs Pupils with speech, language and communication needs may have difficulty in understanding and/or making others understand information conveyed through spoken language. Their acquisition of speech and their oral language skills may be significantly behind their peers. Their speech may be poor or unintelligible Pupils with language impairments find it hard to understand and/or use words in context. They may use words incorrectly with inappropriate grammatical patterns, have reduced vocabulary or find it hard to recall words and express ideas. They may also see or hear a word but not be able to understand its meaning or have trouble getting others to understand what they are trying to say. In the Early Years, the development of children s language skills can vary significantly. Some children can be slow to develop language as a young child and then catch up to the extent that there is no difference between them and their peers when they are older. For this reason, a language delay (including a delay in spoken language, understanding and/or speech) alone will not be sufficient grounds to agree an Education Health and Care needs assessment for an Early Years child. In addition to the core criteria, the following criteria would need to be met for an Education Health and Care Needs Assessment to be agreed for a child with a Speech and Language need: The child has a severe language disorder as indicated by a recent assessment by a Speech and Language Therapist The severity of their needs is such that their needs could be met in a Speech and Language Resource Base Page 10 of 12

11 Social communication difficulties and Autistic Spectrum Conditions Pupils on the autistic continuum will find it difficult to: understand and use nonverbal and verbal communication understand social behaviour which affects their ability to interact with children and adults think and behave flexibly which may be shown in restricted, obsessional or repetitive activities These difficulties are known as the Triad of Impairment. Pupils on the autistic continuum cover the full range of ability and the severity of their impairment varies widely. Pupils may have a difficulty in understanding the communication of others and in developing effective communication themselves. Many are delayed in learning to speak and some never develop meaningful speech. They are literal thinkers and fail to understand the social context. They can experience high levels of stress and anxiety in settings that do not meet their needs or when routines are changed. This can sometimes lead to inappropriate behaviour. Some pupils have a different perception of sounds, sights, smell, touch and taste and this affects their response to these sensations. Pupils with Asperger s Syndrome share the triad of impairments but have higher intellectual abilities and their language is more developed. Pupils with social communication difficulties may have some difficulties in common with those with a diagnosis of an Autistic Spectrum Condition but will not necessarily have difficulties with flexible thinking or processing sensory information. For pupils on the Autistic Spectrum there would need to be evidence of significant difficulty in accessing the curriculum, which results directly from the triad of impairments described above. There would also be evidence of appropriate special educational provision in place within their educational setting, and despite this progress within the areas of behaviour, emotional management and social interaction would be significantly slower than expected. In the Early Years there can be wide variation in children s social interactions, behaviour and language. This means that diagnosing Autistic Spectrum conditions or identifying that a child has a significant social communication difficulty is particularly complex, as difficulties which are seen when children are very young may be transient, or there may be a number of reasons why the child is experiencing them. In addition to the core criteria the following would need to be evidenced for an EHC needs assessment to be agreed for an EY child with an Autistic Spectrum Condition or a significant social communication difficulty: The child is identified by a multi-professional team as having a specific social communication impairment or has a diagnosis of an Autistic Spectrum Condition Page 11 of 12

12 Child requires trained / specialist adult support to access learning through play, language and communication and social development/learning for 100% of funded hours. Child exhibits challenging behaviour that very often impacts on the safety of himself / herself or other children/staff. Child requires verbal communication to be supported by alternative communication (PECS, Makaton or ipad) for 100% of interaction. All learning opportunities need to be extensively differentiated and will include the need for regular targeted activities designed to develop specific skills Page 12 of 12

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