Using the four additional needs from the previous slides (hearing impairment, autism, cerebral palsy and SLCN) this slide outlines some adjustments strategies and early help interventions that can be used in settings.
Hearing impairment
The best communication outcomes for deaf children - whether spoken or signed or a combination of both - are associated with early diagnosis and early enrolment in effective Early Intervention programmes. Without such intervention, deaf children are at greater risk of leaving primary school without developing the expected standard of reading, writing and mathematics compared to their hearing peers. Deaf children struggle to catch up from their lower starting point through secondary school. Listening is dependent upon the stimulation and development of the auditory cortex in the brain. By the age of three and a half, the human brain has completed 85% of its physical growth, a significant part of the foundation for all thinking and learning. Neuroplasticity - where the brain remains receptive to new stimuli – is most active during this sensitive period, creating a limited window during which a child can learn to make sense of sound. This means that effective early intervention needs to occur as early as possible and ideally within the first 3 and a half years. (AV UK).
Early intervention in settings can include:
An individual education plan so all staff are aware of the intervention plan
Positioning of the child and or practitioner to ensure the child can see your face when you speak as they may well be developing lip reading skills
Speaking slowly and clearly and giving the child time to process what is being said
Using a form of signing such as Makaton
Using symbols or picture exchange communication system (PECs) so the child has visual cues
Strong links with the family to share progress
Medical interventions
Medical treatments and interventions may help manage or cure the hearing impairment (depending on the nature of the hearing loss). Parents should access medical professionals to allow investigation into the cause of the hearing loss, so possible treatment (for example for glue ear), devices (such as hearing aids) can be considered.
Technology assisted learning can support those with hearing impairment. Devices such as a hearing loop can be used
Autism
Each autism intervention or treatment plan should be tailored to address the person's specific needs. A person’s treatment plan can include behavioral interventions, other therapies, medicines or a combination of these (Autism Speaks, 2022).
Developmental approaches focus on improving specific developmental skills, such as language skills or physical skills, or a broader range of interconnected developmental abilities. Developmental approaches are often combined with behavioral approaches.
The most common developmental therapy for people with ASD is Speech and Language Therapy. Speech and Language Therapy helps to improve the person’s understanding and use of speech and language. Some people with ASD communicate verbally. Others may communicate through the use of signs, gestures, pictures, or an electronic communication device.
Occupational Therapy teaches skills that help the person live as independently as possible. Skills may include dressing, eating, bathing, and relating to people. Occupational therapy can also include:
Sensory Integration Therapy to help improve responses to sensory input that may be restrictive or overwhelming.
Physical Therapy can help improve physical skills, such as fine movements of the fingers or larger movements of the trunk and body.
The Early Start Denver Model (ESDM) is a broad developmental approach based on the principles of Applied Behavior Analysis. It is used with children 12-48 months of age. Parents and therapists use play, social exchanges, and shared attention in natural settings to improve language, social, and learning skills.
Educational treatments are given in a classroom setting. One type of educational approach is the Treatment and Education of Autistic and Related Communication-Handicapped Children (TEACCH) approach. TEACCH is based on the idea that people with autism thrive on consistency and visual learning. It provides teachers with ways to adjust the classroom structure and improve academic and other outcomes. For example, daily routines can be written or drawn and placed in clear sight. Boundaries can be set around learning stations. Verbal instructions can be complimented with visual instructions or physical demonstrations.
Social-relational treatments focus on improving social skills and building emotional bonds. Some social-relational approaches involve parents or peer mentors.
The Developmental, Individual Differences, Relationship-Based model (also called “Floor time”) encourages parents and therapists to follow the interests of the individual to expand opportunities for communication.
The Relationship Development Intervention (RDI) model involves activities that increase motivation, interest, and abilities to participate in shared social interactions.
Social Stories provide simple descriptions of what to expect in a social situation.
Social Skills Groups provide opportunities for people with ASD to practice social skills in a structured environment.
There are no medications that treat the core symptoms of ASD. Some medications treat co-occurring symptoms that can help people with ASD function better. For example, medication might help manage high energy levels, inability to focus, or self-harming behavior, such as head banging or hand biting. Medication can also help manage co-occurring psychological conditions, such as anxiety or depression, in addition to medical conditions such as seizures, sleep problems, or stomach or other gastrointestinal problems.
It is important to work with a doctor who has experience in treating people with ASD when considering the use of medication. This applies to both prescription medication and over-the-counter medication. Individuals, families, and doctors must work together to monitor progress and reactions to be sure that negative side effects of the medication do not outweigh the benefits.
Psychological approaches can help people with ASD cope with anxiety, depression, and other mental health issues. Cognitive-Behavior Therapy (CBT) is one psychological approach that focuses on learning the connections between thoughts, feelings, and behaviors. During CBT, a therapist and the individual work together to identify goals and then change how the person thinks about a situation to change how they react to the situation (CDC,2022).
Cerebral palsy
The intervention for cerebral palsy depends on the severity and the presentation of the condition. The condition affects how the child can move, it can also affect speech, eating, drinking and swallowing, learning difficulties. Therefore, the individual needs will determine the inteventions needed.
Examples of interventions can be:
Adapted eating and drinking utensils
Making space in the classroom for the child to move with any assistance devices such as sticks
Specific furtniture such as chairs or tables to ensure access is easier
Ramps and handrails to assist access
Occupational therapy can assist in preparing the environment to ensure the child can access all areas of the setting
A one to one practitioner may be requried to help with care needs as well as learning
https://www.smallsteps.org.uk/wp-content/uploads/2014/02/1.1-including-children-with-cp.pdf
https://www.nurseryworld.co.uk/News/article/cerebral-palsy-moving-ahead
SLCN needs
Interventions for SLCN are designed to help the child communicate themselves, or understand when others communicate with them.
Supporting speech delays:
PECs
Makaton
Now and Next/ visual cues
Technology assisted learning
Small group work
Using singing
Using stories around the child's interests
Supporting understanding other's communication:
PECs
Makaton
Now and Next/ visual cues
Small group work
Using singing and stories
Referral to speech and language therapy (SALT) may be needed if interventions in the setting are not supporting progress.