What is SEND

Speech Language and Communication Needs

Some children and young people find it difficult to listen, understand and communicate with others and may need support to develop the skills involved to interact and communicate effectively. 

Speech Language and Communication Needs (SLCN) is the umbrella term most commonly used to describe these difficulties.

Pupils with speech, language and communication needs may have difficulty in understanding and making others understand information conveyed through spoken language.

Children and Young People with SLCN may have difficulty with only one speech, language or communication skill, or with several. Children and Young People may have difficulties with listening and understanding or with talking or both. Each child also has a unique combination of strengths and differences. This means that every Child and Young person with SLCN is different.

For many young children, difficulties will resolve naturally when they experience good communication-rich environments. For some children SLCN are short term and can be addressed through effective early intervention. Others are more permanent and will remain with a person throughout their childhood and adult life.

Speech, language and communication needs can occur on their own without any other developmental needs or be part of another condition such as Down syndrome, general learning difficulties, Autism or attention deficit hyperactivity disorder. Children and Young People with Autism are likely to have differences with social interaction. They may also experience difficulties with understanding and using language and have communication preferences, which can impact on how they relate with others.

Children and Young People with SLCN may present in the following ways - acquisition of speech and oral language skills may be significantly behind their peers, speech may be poor or unintelligible. Pupils with speech difficulties may experience problems in articulation and the production of speech sounds. They may have a severe stammer.

Children and Young people with language impairments find it hard to understand or use words in context. They may use words incorrectly with inappropriate grammatical patterns, have a reduced vocabulary or find it hard to recall words and express ideas. They may also hear or see a word but not be able to understand its meaning or have trouble getting others to understand what they are trying to say.

Children and Young People who have communication differences may have frequent misunderstandings and communication breakdowns as they respond literally to abstract and figurative language such as metaphors, idioms and sarcasm. They may use language or gestures in different ways and may struggle to use and understanding language in context, interpret body language and facial expressions, such as: knowing when someone is bored, knowing how to take turns and to listen as well as talk, knowing how close comment or ask a question.

Autism

Autism is a lifelong neurodevelopmental difference that affects how people perceive, communicate, and interact with the world. Autism is referred to as a spectrum condition because, while there are similar core areas affected, each child or person identified will experience them differently.

It is important to remember that no 2 autistic people are the same; we would not assume that two neurotypical people are the same, so why would we assume two autistic children are?

We talk about autism as being a spectrum, but someone can't be a little bit autistic or very autistic. You are autistic, or you are not. Definitions such as high functioning and low functioning are inaccurate and unhelpful (and disliked by the autistic community) as the autistic profile is often very spikey. A person may have lots of strengths in some areas, but difficulties in others.

Characteristics will also change throughout life as the child or young person learns, develops, and adapts to the social world around them. Every person will also present differently depending on their situation and physical environment.

Autism is a difference in how the brain works and interacts with the world in 3 key areas: social understanding and communication, sensory processing and integration, information processing and understanding. In short, autistic people experience the world differently to neurotypical people.

Social Understanding and Communication

Autistic people have differences in the way they communicate, understand and use language. They engage in social life from a different perspective. This leads to differences in how the person interacts and develops relationships.

Sensory Processing and Integration

Sensory differences can include hyper (high) or hypo (low) sensitivity in relation the eight senses of sight, hearing, touch, taste and smell, interoception (internal sensations), balance (vestibular) and body awareness (proprioception). These differences will vary from person to person and can actually fluctuate in their responsiveness depending on a number of different factors for example the time of day, levels of anxiety, or the environment.

Information Processing and Understanding 

Autistic people have differences in their attention, interests and how they learn. This can include being very focused on particular interests. They have a different way of being flexible, so often feel safer and more comfortable with routines and structure as this lessens uncertainty.

To fully understand autism, it is important to appreciate how autistic people experience the world, and to listen to what autistic children and young people tell us about their experiences. Autistic Young Experts - YouTube

More information on autism can be found on the Neurodiversity Information Hub: Autism - MindMate, from the  NAS: National Autistic Society (autism.org.uk), and AET: Autism Education Trust

Physical and Sensory needs

A Physical and Sensory impairment means having challenged or diminished ability in body or one or more of the five senses.

A Sensory impairment, specifically, is the inability of the body to receive information from any of the five senses or to process the collected information.   Sensory impairment is the common term used to describe Deafness, blindness, visual impairment, hearing impairment and Deaf blindness or multi-sensory impairment.

Hearing Impairment

Hearing impairment is the term used to describe a loss of hearing that means you are not able to hear as well as someone with normal hearing, meaning hearing thresholds of 20 decibel (dB) or better in both ears. 

Hearing impairment refers to a range of difficulties from minor impairment through to total loss of hearing.

A hearing impairment can be classed as mild, moderate, severe or profound, and can affect one or both ears.

The main types of hearing loss are sensorineural, conductive and mixed (sensorineural and conductive.)

Equipment

A person with a medically diagnosed hearing loss would generally use some form of audiological equipment to amplify sound. The main equipment currently available is:

• Cochlear implants(CI) and Bone anchored hearing aids (BAHA)  - these are implanted devices that can amplify sound to someone with a severe or profound hearing loss. 
• Hearing aids - these  devices are worn externally to amplify sound.

Some people also use personal assistive listening devices. There are five general types of assistive listening devices: 

    • Audio induction (also called a hearing) loop, 

    • FM system, infrared system 

    • Personal amplified system 

    • Bluetooth systems

In education, assistive listening devices, such as teacher-microphones and pupil-microphones, can ensure an enhanced listening environment and thus induce a higher level of participation in the teaching.

Implications

Hearing loss is one of the most common causes of speech delay in children. Hearing loss can cause children to become delayed in their language development, as they may not be able to process what they hear as easily as their peers.

A Child or Young person (CYP) may require adaptations to their environment or specific differentiation of learning materials in order to fully access the curriculum. Overcoming educational challenges is vital to enabling CYP with a hearing impairment to reach their full potential.

Here are some top tips:

• Reduce the background noise to support a better listening environment: - close doors and windows, lower blinds, turn off unused electrical items 
• Seat the CYP at the front, in the middle and face them when you are talking (but not directly under a projector)
• Keep the light on
• Use their name to get their attention – then talk to them
• Give them small breaks. They are working hard to hear you and concentrate on the learning. (Cognitive overload)
• If the CYP uses a personal assistive devise, please use it properly               
• Recast other children’s questions before answering

Some people with a severe of profound hearing loss may use sign language as their first mode of communication.

Children and Young People with hearing impairments cover the whole ability range

Visual impairment

Visual impairment is the term used to describe a loss of sight that cannot be corrected using glasses or contact lenses.

Visual impairment refers to a range of difficulties from minor impairment through to total loss of vision.

A visual impairment can be classed as mild, moderate, severe or profound, and can cover a wide range of conditions including

Central vision loss 

Central vision loss is the loss of detail vision, resulting in having only peripheral vision remaining.

Peripheral vision loss 

Someone with peripheral vision loss can see what is right in front of them, but they may have gaps in their side vision. The term tunnel vision is often used to describe this type of vision loss.

Cerebral visual impairment (CVI) 

This is a disorder caused by damage to the parts of the brain that process vision.

There are also many other conditions, some of which are stable, and some of which are degenerative (worsen over time).

Implications

A Child or Young person 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.

A person can be diagnosed as being sight impaired or severely sight impaired depending on the extent of their vision loss.

Intelligence does not require sight; therefore, overcoming educational challenges is vital to enabling Children and Young People with a visual impairment to reach their potential. Such challenges may entail: Safely manoeuvring around the classroom, conceptualising objects, reading, operating standard educational tools such as calculators and word processing software.

Children and Young People who have very limited useful sight may require tactile methods of learning, such as Braille and 3-D representations, together with making optimal use of their hearing. Students who have more useful sight may also need differentiated materials and may use enlarged print or a mix of learning methods.

Children and Young People with visual impairments cover the whole ability range.

Multi-sensory Impairment

Children and Young People with multi-sensory impairment have a combination of visual and hearing difficulties.

A child or young person is regarded as Multisensory Impaired (MSI) if their combined sight and hearing impairment cause difficulties with communication, access to information and mobility. Many CYP also have additional disabilities; it may be difficult to ascertain their abilities.

Children and Young People with multi-sensory impairment need more support to access the curriculum and the environment than those with a single sensory impairment. Incidental (unintentional or unplanned) learning is limited.

Children and Young People have significant difference in perception, communication and acquisition of information. This combination can result in high anxiety and multisensory deprivation. Children and Young people need teaching approaches which make good use of their residual hearing and vision, together with their other senses.

Pupils with multi-sensory impairment may need alternative means of communication.

Physical Impairment

A Physical impairment limits a person's physical capacity to move, coordinate actions, or perform physical activities it is defined under the Equalities Act 2010 as a “limitation on a person's physical functioning, mobility, dexterity or stamina” that has a 'substantial' and 'long-term' negative effect on an individual's ability to do normal daily activities. 

Physical impairments can be mild or severe, affect a child or young person's development and can also be hidden. Every Child or Young Person with a physical disability is unique. Physical disabilities can range from: degenerative conditions, trauma (physical and birth), chromosome disorders, musculoskeletal conditions, limb differences, complex medical needs.

A Child or Young Person may be born with a physical disability or acquire it in life due to an accident, injury, illness or as a side effect of a medical condition

The two types of physical disabilities are musculoskeletal disability and neuromusculoskeletal disability. Musculoskeletal disability affects the joints, bones and muscles and Neuromusculoskeletal disability is the inability to move body parts due to diseases, degeneration or disorder of the nervous system.

Special equipment, specific support and reasonable adjustment

Visual or hearing impairments, or a physical need means some Children and Young People may need additional ongoing support and equipment.

Equipment is in the context of a learning setting that is accessible. There are duties on all schools to be prepared for children and Young People with sensory and physical needs.

Disability remains a protected characteristic in law and schools should be accessible by design and default. Children and Young People with a physical disability are entitled to reasonable adjustments. Children and Young People must have access to the full curriculum and range of experiences, including school trips and rewards schemes. 

Reasonable adjustments may need to be captured in a healthcare plan to ensure pupils are not discriminated against either directly or indirectly and their identified needs met and understood.

Identifying physical and sensory need

Children born in the UK with a hearing impairment, visual impairment or multi-sensory impairment will have been identified before they enter education and offered our sensory services.

Vision that can be fully corrected with spectacles is not a visual impairment.

Remember that physical disabilities can be invisible.

Cognition and Learning

Cognition refers to the thinking skills and thought processes that a child or young person has acquired through their prior experiences.

Learning needs are on a continuum and can vary across subjects and situations. Children and Young people with learning needs may learn at a slower pace than their peers despite appropriate adaptations. Learning difficulties can be general or specific and related to one or more areas of the curriculum. Difficulties may be short-term in one or more areas or severe and long term.

For pupils with moderate or severe learning difficulties cognition and learning needs may present across most of the curriculum. However, cognition and learning needs may only impact on specific areas such as reading, writing, spelling and mental calculations. Cognition and learning needs generally account for difficulties in accessing and making progress in curriculum-related areas such as English and maths. These can be associated with difficulties in, for example, processing information, sequencing, language difficulties as well as working or short-term verbal memory.

Moderate Learning Difficulty (MLD)

Children and Young People with MLD have difficulties in learning across the curriculum, requiring support in all or most areas of the curriculum. Difficulties are seen and evidenced as being wide ranging and with a significant impact on attainment. Attainment for Children and Young people is well below that expected of their peers in all or most areas of the curriculum despite appropriate adaptation and intervention. Children and young People with MLD are likely to have additional difficulties in speech and language development, this can be in expressive and/or receptive language and be apparent in spoken and written communication. They are also likely to have immature social skills, memory and/or processing difficulties, with limited concentration and attention.

A finely graded assessment tool such as B Squared will need to be used to track and monitor progress. 

Severe Learning Difficulty (SLD)

Learners with SLD have significant and severe difficulties in learning across the curriculum, requiring support in all areas of the curriculum. This descriptor of need is used when a child/young person’s difficulties are seen and evidenced as being wide ranging, complex, and with a very significant impact on attainment. Learning is significantly more difficult for these pupils, who experience difficulties across the curriculum, and in developing wider life skills. The wider difficulties usually include weaknesses in the development of mobility and coordination, the perception and development of self help skills, and the development of communication. Most learners with SLD will use sign or symbol to communicate.

A finely graded assessment tool such as B Squared will need to be used to track and monitor progress.   Children and young People with SLD are highly likely to have a Child Health and Disability (CHAD) social worker.

Profound and Multiple Learning Difficulty (PMLD)

Children and Young People with PMLD have severe and complex difficulties in learning and development. They are likely to have additional significant difficulties in relation to communication, sensory impairment and/or physical difficulties.

The Child/Young person’s difficulties are seen and evidenced as being wide ranging, very complex, and with a very significant impact on attainment. Learning and development for these pupils is significantly more difficult due to the severity and complexity of each pupil’s needs. Children and Young People will have difficulties in developing and maintaining mobility. They will require significant intervention in all areas of development. Children and Young people with PMLD will usually require a specialist setting.

Children and Young people with PMLD will be known to Child Health and disability services (CHAD) 

Specific Learning Difficulties (SpLD) 

Specific Learning Difficulties affect one or more specific aspects of learning. This encompasses a range of conditions such as dyslexia, dyscalculia and dyspraxia. 

Learners with SpLD are seen to have difficulties in one or more specific aspect of their learning, but not all of them. SpLD can occur across the whole ability range and the severity of the difficulty can range from mild to very severe.

In addition to a specific area of need, learners with SpLD may have memory and processing, difficulties, difficulties in organisational skills and also coordination difficulties.

Dyslexia

Dyslexia is a learning difficulty that primarily affects the skills involved in accurate and fluent word reading and spelling. Pupils with dyslexia will have a marked and persistent difficulty in learning to read, write and spell, despite progress in other areas.

Pupils may have poor reading comprehension, handwriting and punctuation. They may also have difficulties in concentration and organisation and in remembering sequences of words. They may mispronounce common words or reverse letters and sounds in words.

Dyslexia occurs across the range of intellectual abilities.

Dyscalculia 

Dyscalculia is a specific and persistent difficulty in understanding numbers which can lead to a diverse range of difficulties with mathematics. Therefore Children and Young people with dyscalculia will have significant difficulty in acquiring mathematical skills.

Pupils may have difficulty remembering 'basic' facts and understanding simple number concepts, lack, be slow to perform calculations and have  weak mental arithmetic skills. They will have a poor sense of numbers & estimation.

Dyspraxia 

Developmental Coordination Disorder (DCD), also known as dyspraxia, is a common disorder affecting fine and/or gross motor coordination.

Children and Young People with dyspraxia are affected by an impairment or immaturity of the organisation of movement, often appearing clumsy.

Gross and fine motor skills are hard to learn and difficult to retain and generalise. Children and Young people may have poor balance and co-ordination and may be hesitant in many actions (running, skipping, hopping, holding a pencil, doing jigsaws, etc).Their articulation may also be immature and their language late to develop. They may also have poor awareness of body position and poor social skills.

Social, Emotional and Mental Health (SEMH)

There are a wide range of social and emotional difficulties which Children and Young People may experience and needs can manifest themselves in many ways.

SEMH is only a special educational need where provision over and above what is ordinarily available  is required to access the curriculum. For example, a child or young person who has had a bereavement may have some immediate SEMH needs relating to this, however with quality short-term, support their needs can be effectively met and therefore would not be described as having SEN in relation to SEMH.

A medical diagnosis does not necessarily mean that a pupil requires additional provision in a setting - a pupil with a diagnosis may not have a special educational need. Some pupils are able to access the curriculum and learn effectively with reasonable adjustments and without the need for additional educational provision. 

At the milder end of the continuum, pupils may have difficulties with social interaction and find it difficult to work in a group or cope with unstructured time. Some children may find it difficult to manage relationships with other people and this may affect their behaviour and the way they learn. They may have poor concentration, exhibit externalising behaviours such as temper outbursts and verbal aggression to peers and adults. They may exhibit internalising behaviours and be extremely withdrawn, quiet and find it difficult to communicate.

Some behaviours may reflect underlying mental health difficulties such as anxiety or depression, self-harming, substance misuse, eating disorders or physical symptoms that are medically unexplained. Other children and young people may have difficulties such as attention deficit disorder, attention deficit hyperactive disorder or attachment disorder. Some pupils may have learning disabilities or other special educational needs which impact on their presentation and ability to engage in learning.

Pupils diagnosed with attention deficit disorder or attention deficit hyperactivity disorder (ADD/ADHD) are considered to have a social, emotional or mental health need if additional educational arrangements are being made to support them.

Behaviour is a form of communication. The need a child communicates with their behaviour may be an unidentified cognition and learning need or communication and interaction need. Behaviour can also communicate underlying mental health difficulties, neurological difference (like ADHD) or may be a response to difficult life circumstances. It is important to fully explore the reasons why a child may be presenting in a particular way.

Schools and colleges should have clear processes to support children and young people, including how they will manage the effect of disruptive behaviour so it does not adversely affect other pupils, in addition to ensuring the child has their needs assessed and met in an appropriate way.

Pupils with social emotional and mental health (SEMH) needs cover the whole ability range.