Communication and Interaction (Autism and SLCN)

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Autism and Transition from Home Learning

Week 11 - Supporting Engagement in the Community

Supporting Engagement in the Community

PDFS to Download:

Typically this time of year we would be thinking of the impending school holidays and perhaps how we are going to plan our days and entertain the children over the summer. This year, however, the impact of Covid 19 has been remarkable and many families essentially have been organising their time like this since March.

From the 4th July more restrictions have been lifted which allows us to visit places such as playgrounds, hairdressers, restaurants and cafes to name but a few. We cannot foresee what other changes may happen during this time, nonetheless, within this theme we would like to provide some supportive and practical strategies to aid families in beginning to participate and engage within community and leisure activities.

We have previously discussed that understanding time concepts can be difficult for children and young people (CYP) with Speech, Language and Communication needs (SLCN) and/or Autism. Some CYPs may have felt that not attending school routinely since lockdown has felt like an ‘extended holiday’ – we have certainly had glorious weather to reinforce this feeling.

We know structure and routine are particularly important for CYPs with SLCN &/ or autism and whilst the summer holidays offer more flexibility it will continue to benefit them to utilise these strengths.

Some CYPs may have a set idea on what the summer holidays mean to them from their past experiences, enjoying unlimited time and freedom, going out with friends and away on a holiday etc., however despite more places and attractions opening it will still be a considerably different experience with social distancing measures and restrictions at the forefront. Many families may still not feel ready to visit attractions and decide to remain within their home environment.

Some CYPs may need support to explain the difference between the ‘normal summer holiday’s they are used to having and this one.

Explaining the ‘New Normal’ for Essential Trips

Being concise, using visuals to support your language and giving your CYP time to process the language and concepts will all be of benefit to them when explaining the “new normal”. Not only do we need to explain this but that other people may not follow them and that these rules will change (please see week 2 for more details on communication tips).

This video may go a little way to explain about the ‘new normal’ for young people with SEND in a positive manner. -http://www.reachingfamilies.org.uk/animations.html#covideo

Some CYPs may find wearing a face covering intolerable (due to sensory differences), the government has acknowledged this and provided guidance on “exemptions - people who do not have to wear a face covering” https://www.devon.gov.uk/educationandfamilies/archives/9945

They have also given the following general advice: https://www.gov.uk/government/publications/coronavirus-outbreak-faqs-what-you-can-and-cant-do/coronavirus-outbreak-faqs-what-you-can-and-cant-do-after-4-jul

and

https://www.gov.uk/government/publications/staying-safe-outside-your-home/staying-safe-outside-your-home

Current rules:

  1. Keep your distance from people outside your household
  2. Avoid being face-to-face with people if they are outside your household or support bubble
  3. Keep your hands and face as clean as possible
  4. Keep indoor places well ventilated (fresh air is most recommended)
  5. Avoid crowded spaces
  6. Work from home if you can
  7. If you have to travel (for example, to work or school), think about how and when you travel
  8. Wear Face coverings in enclosed spaces (public transport)
  9. Avoid shouting or singing close to people outside your household or support bubble
  10. Reduce the number of people you spend time with in a work setting
  11. Wash your clothes regularly
  12. When at work or in business or public premises, follow the advice on site

Hairdressers

Some CYPs may be eager to finally be able to have their hair cut as they have been irritated with the length it has grown and others may have accepted family members taking on the role as ‘hairdressers’ during lockdown and might prefer having it done in their home environment. For CYPs on the Autism Spectrum having their hair cut can be extremely distressing due to their sensory processing differences.

Some CYPs may have been gradually making progress with visiting the hairdressers/barbers prior to lockdown and now are anxious about doing so again.

You may wish to consider some of the following:

  • Plan your walks to include passing by your CYPs usual hairdresser/barber shop. You do not have to stop but just allow the CYP to ‘visually’ check in.
  • Next when you pass by, briefly stop outside.
  • Depending on your CYPs level of anxiety/distress begin to stop and comment ‘hairdresser open’ for example (ensuring it is at that time).
  • You could continue to practise particular routines at home that would typically take place in the hairdressers/barbers such as wearing a towel/cloak, washing/drying hair - to start with the adult may need to be the person having their ‘hair cut’ or role play with toys etc.
  • Your CYP may be reluctant to have their hair cut but are comfortable with watching you/others have theirs done (this can be through the window).
  • If the hairdressers/barbers have a website view this for information/photos of how the salon may now look (shields, PPE etc.), in some shops you may be asked to have your temperature taken and you may want to prepare your CYP for this.
  • Most appointments are now having to be arranged prior to visits rather than ‘drop ins’, consider speaking to the hairdresser and requesting for a brief visit (when the salon is empty/less busy).
  • When booking an appointment consider asking for the earliest/latest time of the day to ensure that the risk of transmission is low and the environment is not overwhelming. It may be that the expectation is for the CYP not to have their whole hair cut but a ‘time frame given’ or a particular number of ‘snips’ (little but often).
  • Using strategies such as ‘now-next/first-then’ (example below) may help the CYP to feel less anxious as they know what is happening next. Offering a motivating activity/toy/food immediately after their haircut may help them to cooperate more easily. Your CYP may enjoy brushing the hair up from the floor as this can provide them with good sensory feedback (proprioception), therefore this may be the ‘reward’ after the haircut.
  • A trip explanation book/social story/photo book may be beneficial to support the CYP to understand the changes and new expectations (see week 5 for an explanation and example). Request whether the hairdresser could email photos of the new layout/wearing PPE etc.

The National Autistic Society provides additional advice on visiting the hairdressers: https://www.autism.org.uk/about/family-life/everyday-life/hairdressers.aspx

You may wish to share with venue staff that your CYP has additional needs so they are aware and can support you as best as they can. Stagecoach are encouraging passengers who are unable to wear a face covering due to a health condition or disability to apply for a ‘face covering journey assistance card’ https://www.devon.gov.uk/educationandfamilies/archives/9945

Restaurants/Cafes

The strategies listed above may be beneficial to apply and practise when visiting other places.

Some additional considerations that may be taken for restaurants/cafes may include:

  • Being aware of extra sensory input - smells, visual, auditory (chatter and music) and movement.
  • Perceived concern about some people not wearing PPE (cannot eat/drink when wearing a face covering) or practising social distancing.
  • New rules may be in place e.g. can only order from an app/table service.
  • Request to book a table maybe at a particular location where the CYP feels safe i.e. maybe near the door, in a corner or outside?
  • Look at whether you can view the menu available on the website prior to your visit (some restaurants and cafes are operating a reduced menu). Perhaps your CYP may want to ‘plan’ what they are going to order before you visit or ask if you can ‘pre-order’ – this will reduce the time you have to wait.
  • Your CYP may find listening to music via headphones, wearing noise cancelling/ear defenders or using their phone/iPad helps provide a distraction.
  • Visual timetable highlighting when the ‘activity will be finished’ when you will be ‘going home'.

It is possible that your CYP may want to leave as soon as you have finished your meal and feel anxious about staying for longer periods. Therefore plan before your visit whether the CYP can be distracted with a motivating item or whether the whole family will leave or if the CYP can go home independently/with another family member.

Beaches

  • Select a location that is not typically ‘crowded’ and one of which has nearby facilities and adequate parking etc.
  • Plan a quiet time to visit the beach (perhaps first thing in the morning or early/late evening) As a family plan what are you going to do if the beach is too busy for comfort and you are unable to adhere to social distancing.
  • Plan how you’re going to show everyone that you’re socially distancing. Consider using visual indicators to support the CYP to understand the space they are allowed in – this can be marking it out in the sand with your finger/stick/using shells or could you use a tent/windbreak/specific rug/sheets/towel to inform the CYP where they can stay?
  • Decide if you will be going in the sea and show the CYP the social distancing still applies in the water
  • Have an ‘exit’ plan – See Week 1 resources

Parks - Outside

Prior to your visit it may be wise to check current guidelines on the Government website:https://www.gov.uk/government/publications/covid-19-guidance-for-managing-playgrounds-and-outdoor-gyms/covid-19-guidance-for-managing-playgrounds-and-outdoor-gyms

Some Things to Consider:

  • It is the adult’s responsibility to ensure social distancing and cleaning routines are adhered to
  • Taking your own disinfection wipes and how to explain ‘waiting’ whilst the equipment is being wiped
  • What to do if the area is too full - see above beach section
  • Social distancing rules – waiting for your turn and giving other’s space. Discuss/ show how you are going to do this, for example: the CYP will stay at the bottom of the steps until the CYP before them goes down the slide
  • What you are going to do if anyone needs the toilet. Are there facilities nearby and are they open?

Returning to School

Your CYP may be feeling anxious throughout the holidays and maybe preoccupied with wanting to know when they will be going back. They might find it difficult to comprehend that the expectation of ‘home school’ may not be prevalent anymore (as it is the school holidays) but this may resume in September or they might return to school.

Some Things to consider:

  • Plan your walks to include passing the school…. Etc.
  • Regularly look through photo/video transition book (do not leave until a few days before)
  • Refer to calendar to support understanding of time and to provide some structure and routine

See Week 10 for More Information & Tips on Transition

Although more places have now opened or partially (from the 4th July 2020) please be mindful that individual venues may remain closed. Please check before you talk about a visit with your CYP or travel to avoid any disappointment and unnecessary stress.

Websites and Resources

Socially Distancing Games and ideas:

Places to Visit

Virtual Tours Around Devon & the World

Managing Anxiety and uncertainty

Week 10: Supporting Back To School Transition

Supporting Back to School Transition

PDFS To Download:

This term we would usually be focusing on, planning and supporting Children and Young People (CYP) in preparation for their school transitions in the autumn term (September). However due to the current pandemic of Covid 19 ‘transition work’ has been an ongoing task since March 2020; when lockdown measures began significantly impacting upon the delivery of CYPs education. This transition work has taken many forms, for example schools have had to adapt to educating CYP through virtual learning platforms and at the same time Teachers have had to develop families’ confidence and skills to enable them to teach within a home learning context.

Everyone’s experience will be completely unique; some CYPs may have continued attending school (perhaps on a part time basis), many would have predominantly been learning from home throughout lockdown with occasional engagement with their peers and teachers (through technology), others may not of had accessibility to technology to enable them to complete tasks online and home learning packs may have instead been posted out, some CYPs may have had difficulty adjusting to a new routine of not attending school and being expected to learn within their home environment, others however may have excelled in terms of their academic progress as well as their social and emotional well-being; showing a preference for this ‘new’ style of learning that home has offered, of which they may wish to continue and some may have found the situation so overwhelming that they haven’t left their house, and a focus hasn’t been on their education but in supporting their mental and emotional health.

There is already a vast amount of information and resources available in relation to returning to school, however as we have mentioned we are in exceptional times and some different approaches may be needed. Within this theme we would like to explore the important role parents can play within the transition process. We hope to provide some thoughts, ideas and strategies to support you to prepare your child to return back to school.

Many CYPs with Speech, Language and Communication needs (SLCN) and/or Autism benefit from structure and predictability. Some families may have maintained as best as possible their usual routines during lockdown; setting the alarms for the same time, getting dressed as soon as they woke and preparing lunchboxes etc. Many families may have taken advantage of not having to be somewhere at a particular time and have been more relaxed and flexible throughout their days, enjoying later bedtime routines and longer lay in’s. With restrictions easing we are now having to plan and organise our time efficiently as more demands are being placed on us to do so. We are having to perhaps practice a work life balance again as some parents will be expected to return to work whilst juggling childcare (especially if their CYP has not been able to return to school). Some CYPs may have been offered a space at school and there may be an overwhelming pressure to ‘catch up on lost time both in the world of work and at school’ with families struggling to fit in time to reunite with family and friends they have longed to see again.

Although the idea of returning to school brings a sense of routine back to our daily lives (both for CYPs and their families), CYPs previous experience of school and what it represented has inevitably changed i.e. with reduced class sizes (which may not include close peers), social distancing measures in place and sanitisation procedures to name a few. For CYPs with SLCN and/or Autism this will be a critical point to remember in supporting them throughout their transition back to school. We cannot assume that because the building, school routines, staff and peers are familiar that the CYP will settle in straight away; it is possible that particular routines and skills will need to be reintroduced and explicitly taught. The most ideal time to start practising this is now whilst you still have a little flexibility and time available. Even if your CYP isn’t going back to school until the autumn term we don’t want to wait until this time when there may be high levels of anxiety around transition and as parents there will be less time to support CYPs, due to impending work/social commitments.

Supporting Separation Anxiety

Occasionally CYPs do not show an immediate response upon separation, this is usually when their attention is elsewhere (engrossed within a toy/task). Some CYPs are unable to shift their attention and therefore do not recognise the absence of their parent/carer until they move on from the activity they were engaged in and begin seeking them out, consequently they are not there. Sometimes CYPs do not show their upset until their parent/carer returns at the end of a session/day and it is then that they suddenly process that they were separated. It can be tempting to think “I won’t say bye because they are happy and I don’t want to upset them” however it is crucial that the CYP becomes familiar and comfortable with parents/care givers leaving but feel content knowing that they will return to collect them. It takes an incredible amount of self-control to separate from your CYP when they are distressed and calling out for you as well as trusting that they will eventually calm and be safe and happy with preschool/school staff.

CYPs with communication differences can find the concept of not being able to have access to something they can see incredibly difficult e.g. if they can still visibly see a person/item then it acts as a constant reminder that it must be available. The ‘out of sight out of mind’ approach can be supportive and the CYP is more able to transition onto something else once they understand that ‘something has finished.’ It can be difficult to have conversations with teaching staff at the beginning or the end of the day as the CYP may find it difficult to wait, and from their point of view (sometimes due to literal thinking) ‘school has finished, you have waved or said bye now it is time to go home.’ It can be helpful to plan an agreed time with your CYPs class teacher for you to discuss and share information, this may be through a weekly phone call, email or recording in a home/school diary. These may be useful ways to limit the incidences of your CYP becoming unsettled.

Additionally having ‘set phrases and strategies’ during times of transition can be beneficial e.g. countdown/timers/first-then language/comforter/transitional object or something of their parents’ to look after/hold onto/the CYP coming into class at a less overwhelming time/ or a staff member meeting the family out in the playground etc. By modelling routine strategies and language consistently the CYP will begin to familiarise themselves with what they mean and in turn this will help them anticipate what is happening next, enabling them to cope and manage any potential anxiety (as they have a better understanding and therefore feel more in control). Times of transition and ‘farewells’ are most supportive when they are kept short and sweet, for example ensure you gain your CYPs attention before you inform them that you are leaving. Depending on their needs your CYP may turn their head when you call their name or some may need you to get down to their level (especially if the environment is busy and noisy, the CYP could be overwhelmed processing additional information and may find it difficult to cue into your voice/conversation) and you may need to briefly place your hand over their toy/activity to direct their attention towards you. Visual supports such as timetables, first-then boards and social stories can help provide a concrete explanation to support the CYPs understanding of transition and time related concepts (for more information on why visuals can be supportive and practical ways on how to use them please see weeks 3-7).

Your CYP may not have had any previous difficulties with separating and may not have noticeably shown any distress when you dropped them off at pre-school/nursery/school. This may have been a relatively smooth transition in which they were able to independently engage within tasks or may have needed minimal assistance to ease them in. It can be incredibly upsetting for all when a CYP is displaying signs of separation anxiety. The CYPs keyworker may have successfully directed their attention with a highly motivating toy/object or typically provided physical comfort (opening their arms/holding out a hand for the parent to pass the CYP over to). Setting and school staff are highly skilled in demonstrating distraction techniques to support transition processes whilst managing anxiety from both the parent and CYP. However due to contact restrictions being in place this may no longer be possible or effective. Schools and parents are in a dilemma of how best to support CYPs emotional mental well-being whilst ensuring everyone’s safety. When we talk about separation anxiety we also have to appreciate that this may not just be the CYPs – some families may have conflicting feelings about whether it is safe for their CYP to return to school but at the same time wanting them to socialise with friends and engage in formal learning, many parents may feel they have limited choices available due to return to work initiatives and other families may have seized the opportunities that lockdown has created by enjoying and valuing extra family time and the transition to a ‘new normal’ can be painfully hard. Even our pets may experience separation anxiety after getting used to the new routine of having family members at home.

Before returning …

As previously stated some CYPs may never have experienced separation anxiety, nonetheless it is important to anticipate and be mindful that some CYPs may begin to show some signs of this, following the recent disruption to their daily lives. So even before we expect the CYPs to physically arrive at school, we may wish to consider:

  • Liaising with your CYPs setting/school staff about their presentation at home e.g. have they been finding it difficult to separate from parents/carers/siblings within the home environment? Do they appear anxious when you are not in the same room? Have they appeared to withdraw themselves or perhaps begun displaying behaviour that challenges? Has their sleep or eating habits changed? This is really important information to share with the school before expecting the CYP to return to school, because if they are finding separation difficult within the home setting they are likely to be overwhelmed and anxious transitioning back into the school environment (regardless of whether it was previously familiar). Despite CYP benefitting from routine and predictability and enjoying this aspect that school offers, it will not be the ‘school experience’ they were familiar with before. We have to appreciate that from a CYP with SLCN and/or autism perspective this is a NEW transition and has to be supported as if the environment and context was being introduced to them for the first time. See PDF ‘My lockdown experience’, ‘We will be going back to school sometime’ and ‘Teenager guide to returning back to school’ by Reachout ASC as well as ‘Transition leaflet for parents’ for more guidance.
  • Practising opportunities where the CYP has to wait (particularly if the CYP is finding times of separation difficult within the home) e.g. if the CYP is requesting something motivating such as something to eat or a particular toy explain “wait”, alongside a gesture (briefly pausing) before giving access to the item, once the CYP is consistently hesitating build this expectation up to “wait, 1” before giving the item and extend the waiting time gradually etc. If your CYP is familiar with timers being implemented you can use these to support waiting e.g. “when sand has finished/gone to the bottom then … (name item), practising ‘first- then’ language will also help the CYP to listen and attend more effectively. See week 7 – ‘Supporting Change’ and PDF ‘teaching waiting skills.’
  • CYPs within some households may have become accustomed to receiving one to one attention and where their needs may have been met relatively quickly with no expectation to have to wait. CYPs who do not have any siblings and where opportunities for sharing can usually be encouraged may need to practise turn taking skills; emphasising language such as “my turn/your turn/ Mummy’s turn etc.” Simple games and toys such as ‘peek a boo’/rolling, kicking and/or throwing balls/car ramps/jigsaw puzzles/board games and ‘hide and seek’ can support listening and attention skills as well as the CYPs ability to ‘wait’ (sometimes referred to as ‘delayed gratification’).
  • Frequently practising separating for brief moments (to start with this may be seconds) from your CYP, ensure you give adequate warning e.g. cue them in by calling their name and explain “Mummy/Daddy be right back/ Daddy’s just going to the kitchen/toilet then he will be back” (using gestures alongside spoken language such as waving will support the CYPs understanding and ability to process what is happening), when you return welcome the CYP by waving/hugging/giving a high 5 and/or explaining ‘Daddy’s back etc.’ If the CYP is becoming distressed when you tell them you are going somewhere, suggest that they can come with you, try not to abandon your plans and instead stay with the CYP as this may reinforce their fear and anxiety further (as you may be giving the message of confirming that they should feel upset when you leave, rather than it being something that naturally happens). When your CYP is beginning to accept you leaving the room for short periods begin to gradually extend the time you are away from the CYP. Again you may wish to use a timer (that makes a sound so you can hear it) as a representation to indicate when you will be back. If you are in another room it may be reassuring for the CYP to hear your voice, you could provide a commentary of what you are doing, for example “Mummy’s just getting the milk from the fridge, now she is pouring it in the cup’ etc.
  • Give the CYP some responsibility to encourage brief separation e.g. requesting that they go and get something for you from another room or playing ‘treasure hunts’ where they have to go off and find items, you could take turns ‘hiding and seeking.’
  • Desensitising your CYPs anxiety about back to school transition. This can be done by planning your walks and driving routes so you pass the preschool/school setting. Depending on the needs of your CYP and their level of anxiety, you may visually walk past the school without making a reference to it specifically, the next step may be to briefly comment (pointing out particular aspects e.g. the gate/door they will go in etc), point or wave to the school as you pass, without actually stopping. Your CYP may acknowledge the familiar surroundings, anticipating the location and start talking about school before you, some CYPs may just want to sit/stand ‘looking on’ which is ok and it is an important way of helping them to process the current situation, others may be keen to ask questions (be sure that you allow enough time when you are planning your ‘visit’ so you can listen attentively and engage in conversation about school). Some CYPs may need additional warning that you are planning on passing the school and may interpret that they are expected to ‘go to school.’ A ‘first-then-next board’ may be supportive to shown the CYP ‘first car, then look/wave at school then home’ for example. An ‘eye spy game’ may be motivating for other CYPs and help distract them from any anxiety and provide a focus on things that they can spot e.g. you may have a checklist/photos/chant/gesture which signifies when you have found certain places/items etc.

The end aim in the CYPs eyes isn’t to look or necessarily engage within conversation about school but it just so happens to be part of the walk.

  • Viewing the school website to familiarise the CYP with its surroundings and physical layout.
  • If the school are able to video call they would benefit from having something highly motivating with them to gain the CYP’s attention and motivation to interact e.g. a staff member could read a favourite book for example.
  • Creating a photo/video transition book for the CYP to familiarise themselves with key areas/people within the school and where particular routines will take place, even if this is the same as ‘pre-lockdown.’ Informing the CYP what parts of the school environment remain the same and not just focussing on keys things that will be different will enable the CYP to feel safe and secure. Reachout ASC have wide-ranging resources to support ‘back to school transitions’ https://www.reachoutasc.com/resources/transition-to-new-class
  • Creating an ‘All about me book.’ For most CYPs they will transitioning back into a school environment that they previously attended, despite this their needs may have changed and been influenced during the Coronavirus period. This can be a nice activity and a way for CYPs to reflect and process their thoughts, feelings and experiences – for examples please see ‘About my feelings’ and ‘All about me’ PDF by Reachout ASC.
  • Use or create a calendar which highlights what is happening on particular days. Even if your CYP isn’t going back to school until September, you can start to prepare them now e.g. either write, draw or use an image to represent ‘home/Granny’s/shopping’ etc. When you know the days/dates your CYP is returning to school you could either write ‘school’ or have an image such as the school logo displayed on the calendar. Once typical routines resume you can include ‘weekends and holidays.’ Depending on your CYPs needs and anxiety levels, consider whether you use ‘daily, weekly or monthly’ calendars to show them this information. If too much is shared (too long-term) this may exacerbate their anxiety.
  • Speaking with setting staff to arrange additional transition visits (perhaps on a day or at a time where there are no other CYPs present to ensure the risk of transmission is low). Gain permission to take photographs/videos of the school (maybe this is something the CYP could do).
  • Viewing PDF information on ‘Autism and transition from home learning.’

Supporting CYPs understanding of the ‘new normal’ within school

  • Depending on the CYPs needs and level of understanding, explain, practice and show them examples of what terms such as ‘social distancing’ and ‘social bubbles’ mean as well as introducing and raising awareness of personal, protective equipment (PPE) and hand washing measures that will be in place at school. For visual support examples - see PDFs ‘Easy-Read Safe in School’, ‘How can I be safe in school’, ‘Social bubble explanation’ all by Reachout ASC.
  • Talk about ways you could greet friends and others at school without physical touch e.g. saying hello/hi, virtual high 5’, writing them a letter, a message on the white/interactive board, blowing a kiss, learning some sign language or slang gestures such as sending a ‘distance hug’ (which can be shown by hugging yourself, followed by pointing to the person you are sending it to).
  • More and more people are wearing face coverings/masks and although most teachers and school staff do not have to wear these, there may be some visitors to the school whom wear PPE. Additionally this may cause anxiety to not only CYPs with SLCN or Autism but most CYPs. However for individuals that rely on other non-verbal communication cues it creates another barrier in them interpreting the world around them. They may resist interaction and engagement, potentially experiencing a ‘fight or flight’ response solely from the physical appearance of those wearing PPE. As this may be a long term measure to prevent the risk of the virus spreading further we need to support CYPs in understanding the positive message that ‘masks can keep us safe’. Again a strategy of ‘little but often’ can help to expose and desensitise the anxiety gradually. Some practical ideas may include: placing the face coverings/masks around the house so the CYP can ‘look on’ without the expectation of wearing it, look at personalising face coverings with CYPs favourite colour/sports team or pattern etc., model wearing a face covering yourself when you pop out to the car or garden then remove when you are inside, due to sensory differences your CYP may be adverse to having something on their face therefore you may need to work on desensitising this area by trying massage and/or oral motor activities (such as bubble/balloon blowing/sucking through a straw etc. see PDF ‘Oral defensiveness’ for some more strategies. Although we want the CYP to understand that the masks are for ‘safety measures’ and not ‘a play item’ we want them to feel comfortable wearing them therefore ‘doctor/hospital ‘role play and dressing up activities (using scarves, superhero masks) may be supportive or your CYP may want to design and make their own mask. See PDF examples ‘I can wear a mask’ and ‘ppe social story.’

Reintroducing and practising school routines

The closure of schools and a need for learning to be carried out at home may have caused some CYPs and their families a considerable amount of stress and anxiety. This potentially could have resulted in them disengaging from learning tasks and being in a constant ‘fight, flight or freeze response’ (see week 1 for more information). CYPs may have appeared to lose particular skills and abilities they once demonstrated, repetition to embed these principles across a range of settings will be key. Other CYPs may have found learning from home less demanding from a social and sensory perspective therefore have exceeded expectations and been able to reach their full potential. Some CYPs may find it hard to reintegrate back into the school environment and possibly ‘refuse.’ Transition work will need to be carefully planned and based on the individual needs of the CYP.

We have discussed in previous weekly themes that CYPs with SLCN and/or Autism can have differences in relation to their ‘Executive functioning skills’ this means that their ability to organise, plan, predict and sequence their thoughts, behaviour and actions can be an area of difficulty for them (see week 3 for more information). Although during lockdown CYPs would have learnt new skills and made progress in areas, they would not have had to follow particular routines which they would typically experience and practice within a school setting. Some useful things to try and consider before your CYP returns to school may be:

  • Reintroduce/ how to put on uniform. You may want to begin with having the clothes out in view, or washing them in a normal wash, hang them out on the line etc. so the CYP can see them subtlety. The next stage maybe allowing them to try the uniform on, particularly as they may have grown since they last wore them. For a simple way of helping your CYP to organise themselves for dressing routines, see link https://www.youtube.com/watch?v=KjP8-Jwg17g
  • Involve the CYP in preparing their lunch (either the night before) or morning if there is time to
  • Practise lining up – as a family washing your hands before meal times as this is a routine that will be commonly expected at school
  • Beginning to structure meal times to coincide with the school routine. You could create a menu where the CYP has to ‘order’ or ‘choose’ from the options available.
  • Having specific times to ‘tidy up’ – giving specific jobs and responsibilities to ‘help’
  • Using visual aids to support times of transition e.g. at school a particular chant/bell/musical instrument/chime etc. may be used to represent particular routines such as tidy up time/group time/story time etc. If your CYP requires visual indicators to help organise themselves at school e.g. by having a particular chair/mat/area they sit on, you could practice this at home.
  • Creating opportunities to rehearse school scenarios - For some CYPs this may be through teacher/child role play such as ‘doing the register’, ‘sitting for story time’, ‘raising your hand before speaking.’ For other CYPs it may be through discussion and using visuals such as ‘flow charts’ to help develop resilience and problem solving abilities i.e. how to get to different rooms using the map, learning to wait to answer questions within group discussions, what to do if you are lost (solutions could be written onto small prompt cards and put in personal planner). CYPs may need additional practice on how to ‘read’ and ‘use’ their schedule or timetable (See week 3 for more information).
  • Trial ‘school runs’ – Including ‘getting dressed/breakfast/teeth brushing/packing school bag/walking or driving to school.
  • Practicing ‘asking for help.’ Model different ways of requesting help e.g. ‘raising your hand’, using a ‘help prompt card’ that the CYP holds up or exchanges to express they need support.
  • Packing a school bag: a checklist/schedule could be made with symbols or words written on card and used at home as well as in school.

Websites, Links and Resources

Week 9: Supporting Structured Learning Activities

Supported Structured Learning Activities

PDFS to Download:

Within this theme we will explore visual support strategies such as task planners, ‘concentration/ work’ stations as well as discuss how the ‘TEACCH’ approach can support Children and Young People (CYP) with communication differences and/or Autism to engage in both ‘work’ tasks and leisure time.

Children and Young People with Speech, Language and communication needs (SLCN) and/or Autism respond positively to:

  • Routine and predictability
  • Information being presented visually alongside speech (real objects, photos, pictures, symbols, words)
  • Having a clear structure and ‘finish’ to activities

They can therefore find ‘unstructured’ times such as lunch/break and ‘free play’ difficult. Continuous ‘free time/independent learning’ at home/school can be confusing to understand as there are no ‘clear boundaries’ and the unlimited choices available can be overwhelming. CYPs may focus repetitively within particular activities for long periods of time, struggle to transition and explore a variety of tasks independently, display sensory processing differences i.e. pacing up and down, spinning around etc, they may have limited attention skills and have a tendency to flit between activities that are insight and free to access rather than functionally engage within a task.

Often CYPs with SLCN and/or Autism rely on additional cues to support their understanding of what is expected within a certain context and task such as ‘what do I have to do?’, ‘when does it finish?’ and ‘what is available for them to access next?’ An effective resource tool that provides a clear structure; ‘beginning, middle and end’ are known as ‘closed ended/self-contained activities’ – these enable the CYP to engage with a variety of tasks but also give them the opportunity to successfully complete them. Most activities in life can also be presented in this way.

How to present a learning task – ‘Using supportive principles for everyday activities’

The Communication and Interaction Team (C & I) have recognised the importance of utilising these ‘principles’ within their practice when supporting CYPs with communication differences and/or Autism.

When introducing an activity or piece of work to your CYP, it is most supportive when an activity is presented clearly to show:

What is to be done

  • Can they see the expectation?
  • Do they understand how to complete the ‘work’ task?

How much is to be done

  • Use of a task list/ schedule/ planner
  • A clear start & finish indicator such as green & red dots/tick
  • Present only what needs to be completed
  • Cut/ cover/ fold what has been done or is not to be done (to minimise additional visual information that is not necessary)

When is it finished

  • They have ticked off all the parts of the task list/ schedule/ planner
  • There are no more parts to finish or complete

What to do after

  • Another piece of work which is in their “to do” area/ on their individual task list, timetable or first-then board
  • Item on their “working for” which then follows on to the timetable

 

TEACCH Style Approach

This is a structured teaching method which has been found to work very effectively in supporting the learning and development of children with social communication and interaction differences. It is not a standalone strategy and can be used alongside other systems.

For more information please see PDF of ‘TEACCH’ approach and the following link: https://www.youtube.com/watch?v=vkymZzmg4jw

CYPs with SLCN and/or Autism may have difficulties in focusing in on the information being taught as it is likely they will find it difficult to filter out nonessential information such as visual/ auditory stimuli (such as busy walls and other people talking etc.). However, this level of distraction depends on the individual. The idea of arranging a ‘concentration/ work’ station is to limit distractions and cue the CYPs attention to ‘what is to be done’, ‘how many times’ and when is it ‘finished.’

https://www.milton-keynes.gov.uk/assets/attach/24070/workstation.pdf

Above is a pictorial example of a ‘concentration/work’ station; trays/ bags/baskets etc. containing activities that are placed on the CYP’s left arranged top to bottom & or left to right (usually on shelves). A ‘schedule’ of images that correspond (e.g. by colour/ number etc.) is in the ‘concentration station’ which shows the CYP the order and how many tasks are to be completed.

The CYP removes the top square off the ‘schedule’, takes the corresponding tray and matches the image to a Velcro spot on the bag/basket/tray. They then complete the activity & put it to the ‘finished’ area on their right either on the table, floor or in box.

This process is repeated until all images have been removed from the ‘schedule’ and thus all the activities are complete. When all of the tasks are finished a symbol/ word/ object of reference is provided to cue the next activity, this can be presented either on the bottom of the ‘schedule’, on an individual timetable or ‘first – then’ board.

Strategies that Support Structured Learning Tasks

As discussed in previous weeks there are many visual strategies that support CYPs with communication needs to learn efficiently. There are many different learning styles but CYPs with SLCN / Autism will be best aided when their Executive Functioning Skills are supported- see PDF. Please see Weeks 3 – 8 for further information on the use of visual strategies such as:

  • First and then boards
  • Timetables
  • Task Planners- also see ELKLAN Task Planner PDF
  • Tick/ Chore Lists
  • Jigs
  • Visual flip books of instructions
  • Videos of the task being completed
  • ‘Pause’ Symbols

Examples of Structured ‘Work’ Tasks:

In the above example the CYP is investigating the notion of floating and sinking within a structured learning style. The activity is teaching two different concepts (float/sink), however if the CYP is finding this approach difficult to understand the activity could be broken down further and introduced as a single concept of ‘float / not float.’

An extension of this task could be for the CYP to write an answer on a chart, utilising the images to support their understanding.

A picture dictionary can be used to support your CYP’s within activities and when ‘learning new vocabulary.’ In this lotto game, the aim is to select cards from the covered tin and place them on their picture boards. If the CYP doesn’t yet know how to read the word they pick or need to check if their memory of the word is correct, they can refer to the picture dictionary. As the CYP gains more practice with these vocabulary words, the picture dictionary is faded when they play the game, so they begin to read the words without the reference.

These examples are from the website: http://tasksgalorepublishing.blogspot.com

 

This simple activity can support CYPs to learn colour and size concepts. It can be further enhanced by talking about ‘family members’ e.g. Daddy/Mummy/Baby bear etc. Additionally it can create opportunities to model ‘who’ questions for example ‘who is bigger/smaller?’

Everyday items such as milk carton lids, lollipop sticks and cutlery etc. can be used to practise patterns. In the example above the adult demonstrated ‘creating a pattern’ whilst labelling the colours as the item was placed down. This helped the CYP to process the activity visually but was also supported by hearing the auditory information to help him develop a ‘rhythm’ to remember the sequence. Initially the activity only presented the same colour lid/stick and the CYP had to match the single colour but concentrate on the ‘amount of items.’ Gradually the task was extended by adding another colour and the pattern became longer and more complex. The CYP practised concepts of colours, positional language such as ‘up/down’ (milk lids turned upside down at times), ‘horizontal/vertical’ (sticks arranged in different ways) and his counting skills.

Activities that practise ‘following patterns’ strengthens our capability to organise and sequence – part of the Executive Functioning skill, leading to enhanced abilities to develop everyday life skills such as: – getting ready for the day (order to put on clothes), sorting dirty washing, where items belong – prioritise, ordering, what has to be done first, next then to complete a task successfully.

Structuring Everyday Life Tasks

Just like an academic activity, an independent life skill is best presented with structure to enable the CYP to engage, understand the expectation and complete it successfully. Each CYP will need different levels of structure to scaffold their learning & achieve their goal.

The task of ‘stripping the bed’ can be a relatively simple task in terms of the CYP understanding ‘what they have to do’ and ‘for how long’ – from a visual point of view the CYP sees the bed sheets with their covers on, they are expected to take them off and the task is noticeably finished when all the covers are removed from the bed. This activity may not be motivating to the CYP, but it is an essential and important life skill to learn. It may be useful to provide additional supports such as a ‘first then board’ to illustrate ‘what is happening next’ (rewarding activity), which may cue the CYPs interest in.

Making Mousse

To ensure the environment is structured and to prevent the space becoming cluttered and overwhelming for the CYP, there are visual indicators to highlight where the equipment belongs. It is also placed in the order in which they need to be used.

 

The CYP found it difficult to understand the concept of money as he tended to select the biggest coin (by size) when their family member was trying to support the CYP to demonstrate their knowledge about ‘value.’

The task was broken down and differentiated slightly (see photo); the CYP was able to show his ability to order the coins according to their ‘numerical value’ by matching up the ‘real’ coin to its corresponding image and use of the ‘numicon’ grids further embed the value of the coin (i.e. the 2p is the ‘largest’ coin however by referencing to the grids it helps the CYP to understand that the 5p is the largest in value).

 

Practising DIY skills

To support the CYP to learn about which tools and equipment needed to be used together, they categorised the various screws/nails/nuts to the tool. The adult modelled this task first by placing the correct item in the cup and gradually withdrawing their intervention. This activity would be in preparation for the CYP to use the tools in a structured learning activity and then go on to learn some DIY.

 

 

This task is designed for a CYP who was learning to spell words in a ‘word family’; the purpose of the task is to choose the container with the matching picture. Inside includes the individual letters that will spell that word. The CYP then velcros the letters in the correct order on the card to form the word. The next step would be working towards removing the image on the container and the CYP independently distinguishing the correct letters to form the word.

 

 

Activities such as ‘Treasure Hunts’ can be visually structured. Above shows a list of areas where the items described can be found. This can help CYPs to remain on task and minimise the chance of being distracted as they transition around the area. Additionally having a ‘known number’ of items to find can reduce the anxiety about when the activity will finish and keep it enjoyable for the CYP.

https://best-practice.middletownautism.com/approaches-of-intervention/the-teacch-autism-programme/structured-tasks/

The CYP is given the exact number of bricks he requires to complete the model. He uses the iPad as a visual reference to ‘check in’ and follow the ‘step by step’ instructions to help him with the construction. Although the environment may have been visually overstimulating for some, this individual CYP chose to engage with the task on his bed, where he felt content and able to focus. This type of structure can help with other activities such as cooking, craft and DIY/flat pack assembly as it provides a useful guide.

 

Although this guide is set out in a step by step approach, the CYP would need to have developed an understanding of many concepts and acquired skills to be able to independently complete this task. For example- ‘being able to distinguish the pieces by observing minor details’, ‘good pincer grip control’, ‘ability to follow a number sequence correctly’ and ‘comprehend that the ‘shaded boxes’ relate to the number above.’ This may not be explicit to CYPs with SLCN and/or Autism as it relies on inference skills and reading between the lines (of social norms) – this may need to be overtly taught. To enable the CYP to make such a ‘complex’ model they need to grasp the above attributes.

 

 

 

Making a sandwich – Using flipchart instructions with minimal language & only providing the ingredients/equipment needed to achieve the task independently.

The visuals are displayed inside the kitchen cupboard to support the CYP to unpack and arrange the groceries according to their ‘material property.’

Miniature images of the real item of clothing is hung on the pegs to teach the CYP to match the item to the label. These labels are then used on chest of drawers to aid the CYP to put clothes away confidently.

 

 

 

 

This example is from the book ‘Task Galore from the Real World’ by Laurie Eckenrode

The chore of ‘washing clothes’ can be a complex task for CYPs with SLCN and/or Autism; involving many stages and sequences. They will need to understand that firstly they need to categorise and sort clean clothes from dirty and then even according to their colour/type. They will need to familiarise themselves with how to operate the washing machine and collect the necessary items such as detergent/softener to use. They will also need to comprehend that they will need to ‘come back’ to the task when the washing has finished and know what is required ‘next’ (e.g. put on the line to dry/tumble drier etc.). This task alone can be allconsuming for the CYP with the amount of mental energy, executive functioning skills, planning, organising and sequencing it entails. Utilising visuals can support the success of achieving this task.

CYPs with SLCN and/or Autism can find it difficult to predict what might happen and/or why (also known as executive functioning). Supporting CYPs to understand inference can be scaffolded in ways which are illustrated in the example. Possible answers are provided to the questions to guide the CYPs thinking and both options are radically different. Also note that there are only 2 available to choose from which makes the question less ambiguous.

Websites, Resources and Links

 

 

Week 8 - Creating Spaces for Learning

Creating Spaces for Learning

In this theme we will discuss making small, simple adjustments within the home to create areas to aid concentration for learning activities, play and life skills. Furthermore, how these environments can support Children and Young People’s (CYPs) attention, focus and engagement.

One of the ways we can do this is by setting up a space at home that will support their learning. Although how this looks will depend on a variety of factors: the space that is available, the type of work/learning set by schools, whether the CYP will be sharing space and technology with siblings or adults who are working from home, and how your child learns best, to name a few.

The environment plays a key role in supporting and extending CYPs development and learning; it is more than just the physical space, it has the power to enable or disable a calm mental and emotional state. When CYPs feel safe, secure & regulated they are able to learn.

Opportunities for learning can take place everywhere not just within the school setting. Parents and carers are children’s first and most important educators.

A positive early year’s home learning environment (HLE) can lead to substantial social and educational benefits that can have lasting and life changing impacts.

“There is a wealth of literature on the relationship between early home learning activities and enhanced cognitive, social and physical development of children. Home learning has been found to predict higher levels of vocabulary, spelling and emergent literacy in young children. Home activities such as counting and doing simple sums with children or playing games with numbers have been found to predict better numeracy ability and attitudes…

Children with better early years HLE were also better adjusted in terms of behaviour, well-being and school during both the primary years and secondary schooling. The impact of early HLE was still apparent in late adolescence, predicting both A level uptake and achievement.”

Action for children (see in Website & Resources for further information)

What type of learning can be supported?

  • Academic learning tasks
  • New information & activities
  • Extending vocabulary/ categorising
  • Supporting language phonic sounds
  • Sequencing, organising and processing
  • Life skills – independence
  • Creativity
  • Social and emotional development

Why do we need to prepare a space for learning?

Careful planning and consideration will be needed when ‘creating a space for learning.’ The environment should be flexible and will depend upon the CYPs changing interests and individual needs.

Due to the very nature of our homes they are filled with objects that are enticing and interesting, therefore can be very distracting. Thinking about where your CYP is being asked to concentrate in is a great step in aiding them to achieve & be successful. Consider concentration levels and the length of time that the CYP is expected to engage within tasks; ensuring frequent ‘movement and brain breaks’ are routinely scheduled (see attention span link website section for average statistics).

Remember you are not expected to replicate the school setting and structure by devoting 6 hours a day to learning; within a CYPs typical day at school this would consist of break and lunch times, P.E, assembly etc. Teaching is usually delivered amongst a class of up to 30 CYPs, it can be intense and overwhelming for both the adult and CYP when the teaching is solely on a 1-1 basis and even more challenging when the expectation is to learn in an environment that was previously used for a different purpose.

A thought out and reviewed environment can support:

  • CYPs ability to focus as there are fewer distractions
  • A reduction in noise levels - studies show that noise has a great impact on everyone’s ability to concentrate and engage in tasks. The German Association of Engineers has set noise standards in their country for various types of work. 55 decibels is the requirement for what the association terms “mainly intellectual work.”- Dr. Wolfgang Babisch.
  • Lab studies on humans as well as animals have shown that exposure to noise arouses the nervous system, causing rising blood pressure and the release of stress hormones. Over time, these instinctive responses can stress the cardiovascular system and give rise to negative outcomes such as anger and exhaustion (Sound Advice: Tune into Listening By Teresa Barnes RN)
  • A case study in Time to Talk: Implementing Outstanding Practice in Speech, Language and Communication by Jean Gross showed “The more open the space, the noisier it became, and the more it was dominated by confident children. The more intimate the space, the more those children who were relatively lacking in confidence felt able to engage, and the more children talked to adults and each other- and could be heard.”
  • Understanding by allowing the CYP to hear language clearly and to hear the sounds in words so they can store them correctly aiding speech production, spelling and literacy
  • The CYP to recognise the area, expectations and so enter it with a focused frame of mind. Attention and listening skills - a quiet environment enables the CYP to hear clearly
  • Information processing

What ‘Spaces for learning’ Might Look Like

Most families do not have access to separate/additional rooms that can be designated for ‘learning.’ However the importance is not on the amount of space you have but in providing a consistent and specific area where the CYP is able to learn. This creates a set routine to help everyone differentiate between family life and learning time. By giving time and thought into creating a ‘space for learning’ for the CYP this provides a positive example to them that their education and learning is important. You do not need to purchase additional equipment or have an idea about it looking ‘perfect’ in order for it to be successful. One of the main things when creating ‘spaces for learning’ is that the individual learning needs and style of the CYP are considered, for example some CYPs find playing music in the background whilst engaging within learning can support them to maintain their focus, whilst others can find it distracting and a barrier which inhibits their learning.

Some key environmental factors you might think about before creating a ‘learning space’ is whether the area is:

  • Calm – both visually and auditory (a plain background and away from noise, if this is how the CYP learns best) Away from thorough fares/ corridors
  • Clear of “clutter” (reduce unnecessary items in the area)
  • A distraction free environment (normal room for everyday tasks but without as many distractions)
  • Cosy/ comfortable - The presentation and layout of the area may include the CYPs favourite colour/scent which can be inviting so they are likely to extend their learning and length of time engaged within tasks.
  • Attractive and appealing to the CYP but without distractions e.g. mobile/ items of special interest
  • Sitting positions – Are the CYPs feet stable on the floor (if not could you place some books or a box underneath as a prop?)
  • Adequate lighting/ well-lit area (if there are limited opportunities to benefit from direct light exposure and there isn’t space for your CYP to sit near a window, mirrors can be positioned to help reflect light. However we want to ensure that this doesn’t disrupt learning e.g. creating too much visual stimulation, especially when using screens).
  • Opportunities for hydration and food/snacks to aid concentration

Examples of ‘creating spaces for learning in the home’

  • Mats
  • Calming Corners
  • Enclosed and Cosy Spaces
  • Tuff Spots
  • Masking Tape to Signify Areas

  • Using cardboard as a privacy screen to aid concentration and minimise additional distractions (a distraction shield)

  • Furniture as Distraction Shields

  • A standard tray which could be turned upside down to create a ‘table’ or a ‘lap tray’

  • Table with different covers to indicate different activities, for example removing the table cloth for learning times but placing back for a meal times
  • Using cardboard as a privacy screen to aid concentration and minimise additional distractions
  • Hula hoop/tyres to enclose an activity
  • Beanbags/cushions
  • Foldable chairs
  • Storage – trays
  • Learning box

Language Rich Environments for Everyday Tasks, Learning and Play

The ability to communicate – to say what you want to and to understand others is essential to acquiring positive life outcomes. Poor language skills in childhood predicts poor employment prospects. Many studies have shown that language ability is an indicator to academic progress and that there are strong links between language skills and life chances. With this in mind this section will discuss how to support an optimum space for talking and listening - language development (receptive), vocabulary and speech (expressive) using a multi-level approach.

Every home has ‘hotspots’ of conversation and listening, and ‘coldspots’ where there is little opportunity to do so. Think about your home and areas which may be one or the other, some areas will be ‘red hot’ and others only ‘lukewarm hotspots’. The same can be looked at in your daily routines; are there some naturally chatty times of the day and can you enrich other tasks?

The language and listening inducing spaces may have these features:

  • Quieter - so listening is easier
  • Out of the way of through traffic
  • Undistracted time e.g. turn off the TV, radio and phone
  • Cosy and more enclosed - dens, moving furniture to create a space where the focus is another person e.g. the chairs face each other more and not the TV
  • Have strong sensory experiences such as smell, touch and sound
  • Have an engaging activity in them such as ribbon threading, cooking or a DIY project
  • A defined area e.g. a table and chairs, cushions around a board game, a Tuff Spot with Lego in it, a sofa next to a pile of books or magazines to look at
  • Soft and comfortable environment makes it easier to nestle down and chat creating a space in which you want to spend more time, Elizabeth Jarman (founder of Communication Friendly Spaces) refers to this as ‘linger time.’

Key strands of Elizabeth Jarman’s research include:

  • Maximising the use of space to set the context for learning and interaction
  • Effective storage and resource management
  • Resources ‘worth investigating’
  • The impact of noise
  • Informed use of colour
  • The effects of light

There is further information and a short video about this approach at: www.elizabethjarmantraining.co.uk

Strategies for Enriching Language & Listening

  • Try to comment rather than question e.g. “that’s really interesting”, “I wonder how”, “you’ve used”…
  • Giving additional processing time
  • Being aware of the length of adult sentences
  • Being aware of child’s language level and speak accordingly
  • Don’t have all the equipment out that you need – this is to encourage the CYP to make requests, organise and problem solve what is required for the task
  • Having pictures of the equipment may be supportive so the CYP can point to what they want if they don’t know its name
  • Model/label “thingy/ do-hicky/ whatsit” and point to the corresponding picture using the accurate language, repeat the label a number of times during your conversations e.g. ask them to pass you/ wash up the X. regularly revisit/ use these labels again
  • Increase role play, problem solving and investigation which can lead to more co-operation and communication
  • Taking the opportunity to face your CYP during interactions can open up opportunities for chatting, developing vocabulary and conversation skills. Choosing a quieter time of day can support listening and attention skills as they don’t need to filter out background sounds and therefore, are able to concentrate on the speaker.

And finally...

Websites and Resources

 

Week 7: Supporting Change

Supporting Change

Within this theme we will explore practical strategies to help Children and Young People (CYPs) with Speech Language & Communication Needs (SLCN) and/or Autism cope with unpredictable changes within their everyday lives. We will look at how we can explain (using some visual aids) ‘when things are not available’, ‘when plans have to change and are out of our control’ and ‘how to manage when a mistake happens.’ Some of the suggestions may appear simplistic however they have been found to be very effective in supporting all CYP’s anxiety and self-regulation during times of change.

PDF Downloads - 

Why is change difficult for CYP’s with SLCN and/or Autism?

Change can be difficult for us all, no matter how small. However, for CYP’s with SLCN and/or Autism change can be particularly difficult and sometimes distressing. They often rely on consistent routines in order to support their understanding of the world around them.

People with SLCN may find change challenging due to having limited access to higher level words and abstract concepts (Blank Level 4 see week 3) that can support understanding within new situations. These include difficulties in being able to justify why or how events may have occurred, the ability to interpret information i.e. inference/interpretation from an observation and to problem solve from their own or from another person’s perspective. Due to differences in understanding language, environmental clues and known routines become crucial.

An assumption is that CYPs on the autism spectrum resist and do not tolerate change. They may also have a tendency to think in a logical &, at times, literal way. However, research and brain imaging studies show ‘change’ can be difficult for them to process within the brain. https://www.bbc.co.uk/news/health-12937009

Therefore ‘resistance to change’ must not be viewed as a behaviour issue but as a result of a multitude of reasons and difficulties the CYP may experience.

Some ways CYPs with SLCN and/or Autism may respond to change….

  • Flight/ Fight/Freeze response (refer to week 1 for more information)
  • Feelings of being overwhelmed, stressed or anxious
  • Perceived resistance and displaying of controlling ‘behaviours’ over others and the environment
  • Engaging in self-injurious behaviours
  • Sensory seeking/avoidance of stimuli
  • Verbal tics (repetitive phrases, monopolising conversations)
  • Throwing/casting items
  • Rigidity of thought and attachment towards familiar routines
  • Develop literal thinking (viewing situations in a black/white fashion)
  • Over focused on special interest and small details
  • Withholding bowel movements
  • Restricting food intake
  • Smearing faeces
  • Withdrawal

Many of the above responses may impact upon and disrupt family life. Therefore it is vital to understand why CYPs may at times respond in some of the ways listed above….

  • In order for them to feel safe and secure
  • Gain a sense of control over an aspect of their life
  • As a way of coping and managing anxiety
  • To help them understand and make sense of the world around them
  • Helps to provide structure and clarity

Both CYPs with SLCN &/ or autism may find abstract concepts such as time illusive and so waiting can be extremely hard. Times of transition can be difficult as they do not know how long they have to wait or what is expected of them particularly during break times and ‘free play’ due to the unstructured nature of them. Therefore, adults may need to guide CYPs and provide direction to help them engage within activities.

Ways we can support CYPs to cope with change:

  • Communicating with all those involved with the CYP will enable consistency and an opportunity to share ‘what is working well’
  • The CYP may be feeling anxious therefore it is important that adults minimise their spoken language, using key words as much as possible in order to help them process information more effectively (see week 1 for more information)
  • Allow additional time/preparation before change is happening (no matter how small these may be)
  • Continue to offer choices (ensure the CYP is calm enough to engage) - Although the adult decides what choices are offered, it allows the CYP to make the final ‘choice’ which creates a feeling of control and security
  • Create opportunities to practise turn taking skills. For example people games such as ‘peek a boo’, stop/go or ready/steady games and chasing, pausing during songs (allowing the CYP to ‘fill in’ but also accept delays), party games such as ‘Simon says’, pass the parcel, building a tower, pushing cars down a ramp, rolling/throwing/kicking a ball, penalty shoot outs, sharing equipment and resources e.g. pouring drinks, laying the table and board games etc.
  • Building attention skills and CYPs ability to wait through overt practice (please see PDF for Teaching Waiting Skills)
  • Offer praise explicitly when the CYP is naturally waiting well, labelling the skill ‘good/great waiting.’
  • Continue to provide structure and boundaries – being clear on what behaviour we want the CYP to practice, not focusing on what we want them to stop doing, for example “walk slowly” rather than “don’t run.”
  • Key people to create opportunities to model ‘out loud’ alternative thinking/behaviour responses (problem solving) for example “oh dear I really wanted fish fingers for dinner but we’ve run out, what else could I have? I’ll look in the freezer and choose again.” This is to demonstrate how different people find alternative solutions when things do not go the way we anticipated.
  • Practise things not going the way we planned/create opportunities to practise (safe sabotage – See PDF). Examples can be: The child is given their meal but the cutlery is not provided, the adult may use ‘out loud’ thinking such as “oops, I’ve forgotten to give you a knife and fork, I’ll get them now” -Immediately passing the CYP the cutlery. Or another scenario could be that the CYP makes a cup of tea but finds that there are no teabags in the canister, so the adult would say “oops no tea bags, I’ll get some from the cupboard.”
  • Timers can enable CYPs to hesitate and develop their ability to wait (also known as delayed gratification). Begin by introducing timers/counting during situations where the child has to ‘wait’ for something that is motivating e.g. if the CYP is requesting ‘iPad’ support them to wait by using a timer as a reference “when timer is finished then iPad.’ Try to avoid using the timer solely to ‘finish’ a favoured activity; this may become counterproductive as the CYP may associate the timer with losing control which can lead to frustration and challenging behaviour occurring.
  • Introduce visuals as another way to explain the situation (please see week 5 for more information on how to use) 
    • First and then boards
    • Timetables
    • Jigs
    • Trip/photo books
  • Social stories/social narratives – Assist CYPs with communication and interaction needs to develop greater social understanding. A social story is a short description of a particular situation, event or activity which includes specific information about what to expect in that situation and why.
  • Flow charts - Can help CYPs to practice making alternative choices within difficult situations; providing additional overt learning opportunities and exposure to more abstract concepts (blank level 4); enabling them to develop flexibility of thought. Some CYP’s with SLCN and/or Autism may struggle to predict other’s thoughts, feelings, actions and behaviours and so, may find it difficult to understand ‘consequence.’ Flow charts can explicitly support the learning and development of ‘problem solving skills’ as they provide a visual representation of scenarios and help explain abstract concepts in a concrete way.
  • ‘Pause’ Symbols - Can help CYPs to transition from a motivating activity to a less preferred one. A ‘pause’ symbol can provide the opportunity to ‘come back’ and ‘revisit’ the CYPs first (and preferred) activity and knowing this may encourage them to be more willing to transition onto another task. Using a pause symbol in conjunction with other strategies such as a first- then can make the sequence tangible.
    • How to Use:

      If it is time for the CYP to change activity give them warnings and use a visual to show what

      will be happening next (see- First-then, timers information in week 5) Tell them that the favoured activity will be paused and they will be returning to it, reassure them that you will ‘keep it safe.’ Place the ‘pause’ symbol onto the item and redirect the CYP to the new activity. Once the non-favoured activity is complete take off the pause symbol from the desired item and encourage the CYP to re-engage with it.

  • These are literally “button/ tokens” on a strip of card – usually with the next activity displayed on it. The adult counts down at intervals taking off a button until all 3 are gone and it’s time for ‘X’. These are particularly useful during situations when you don’t have an exact idea on when something is due to change or expect to transition e.g. waiting in a queue, waiting for dinner, when a person is going to return home etc. (See PDF Teaching Waiting Skills - for a more in depth look at how to use them and how they can support CYPs).

  • ‘Wait’ cards –These can be useful for CYPs that are able to wait but may have difficulty with understanding how long they need to wait for or get anxious that you may forget that they are waiting. Both CYPs with SLCN &/ or autism may find abstract concepts such as time illusive and so waiting can be extremely hard. (See PDF Teaching Waiting Skills).

  • Not available’ signs - This is a visual aid to show what items/objects/areas are not available at the moment. Initially we would suggest displaying the ‘not available’ sign on items that would routinely be unavailable and that the CYP does not show much interest in… e.g. ‘medicine/laundry cupboards.’ Adults reference to the sign and say the phrase that they have decided to use, for example ‘not available’/ ‘not allowed’. Praise the CYP for listening to the instruction and redirect them to an alternative choice (activity/object/area) that is available. If the CYP removes the ‘not available’ visual, place it immediately back and repeat “X (item) not available” and redirect to available choices. If or when the item becomes available you can gain the CYPs attention and take the symbol off. Once the CYP is beginning to respond to this strategy consistently start to use the ‘not available’ visual on toys/items/activities of interest to support their ability to ‘wait’ and encourage them to explore a variety of other tasks.

  • ‘Not available’ baskets/tray/posting boxes – Another strategy to show that particular items are ‘not available’ at the moment as it clearly is ‘out of sight’ therefore no longer ‘available.’

    ‘Oops!’/ ‘Change’ Visual - These can be used on a timetable/ schedule to show a change of plan in advance (please see PDF on ‘supporting children with Autism cope with change’).
    • How to use:

      Once you have knowledge that a change of plan is going to happen you can show this to the CYP by putting the image of your chosen phrase over the symbol of the activity that is changing. The new activity can be placed above them and when the CYP has processed this information it can replace the initial activity & change card. Example phrases that may be used are: ‘something different’/’don’t know’ ‘wait and see’, oops!

Transitioning between activities

  • Cue the CYP in and allow additional processing time (up to 10 seconds before a response)
  • First/then boards to visually explain what the CYP is expected to transition onto.
  • Pause button
  • ‘Show and wait’ strategy (see PDF)
  • Pause button
  • Ensure the next activity is immediately available. Depending on the CYPs ability this may need to be bought to them opposed to expecting them to transition to a different area (as they would need to process more information which may distract them from engaging within the task in hand)
  • Principles to support everyday activities (see PDF). Making information such as ‘How long (time/turns) the CYP is expected to engage within the task’ clear
  • ‘Working for’/Reward boards/token economies (see week 4)
  • ‘Not available’ signs
  • 5 point scale – (see YouTube video on Babcock’s main page - ‘Exploring Stress and Anxiety using the Incredible 5-Point scale)’ https://www.youtube.com/watch?v=UUCWWu2F_9E&feature=youtu.be
  • ABC chart – are there particular activities that are triggers? – (See week 1 resources & information)

 

Transitioning between areas/places

  • Calendar – indicating when and where are you going
  • Show a leaflet of ‘theme park’/ view on internet/ look at photos and consider object of reference to represent place
  • Adults may want to carry out a prior visit before taking the CYP & ask about attractions SEN policy/ supports
  • Write down a rough outline of the day/daily timetable e.g. ‘coming home…’ who would be going/where going/who seeing
  • Trip explanation book, reward (see week 5 for more information)
  • Role play different situations that may occur
  • Practice key phrases to support understanding, initiate and respond to interactions e.g. what to say if lost, where the toilets are or where a chosen meeting place is on site
  • Sequencing activities to explore different scenarios that may happen
  • Social expectations/rules- lining up and waiting, where they can/ not go, that they will be able to use the toilets there etc.
  • What to do if it becomes ‘too much’ – ‘phrase/card’ to go back to the car/quiet area to regroup
  • Consider putting together a ‘Flight plan’ – (refer to week 1 for more information)
  • Create a ‘Grab bag’ to help the CYP self-regulate these may be breathing exercises/headphones/fidget toys etc. (see week 1 for more details)
  • Make a list – If you are visiting the supermarket, decide on the items you are going to get before going. Environments such as supermarkets can be very overwhelming from a sensory perspective therefore prepare the CYP to cope with these difficulties e.g. offering sunglasses (light sensitivity)/ headphones (noise sensitivity). More importantly do not expect to carry out your full shop, focus on purchasing 1-2 items and do not deviate from what you ‘listed to buy.’ This will make the shopping experience more successful and inspire the CYP to visit again.

General tips

  • Speak to all those involved with CYP and discuss current good practice and strategies that are in place for supporting times of change
  • Praise specific behaviour (good sitting/great waiting/good taking turns) rather than generic phrases e.g. “good boy” or “well done”
  • Avoid sarcasm, idioms etc. as CYPs with communication and interaction needs find concepts such as these difficult to comprehend e.g. CYP has knocked a glass of drink over and the adult responds “that was clever!” CYP interprets this literally that they did something positive and may repeat it in the future
  • Ensure terminology is clear ‘x is finished”, “last turn” rather than “one more turn” – CYP may just focus on the word ‘more’
  • Avoid making assumptions that because a CYP has transitioned with ease previously that they will be ‘fine’ on other occasions to similar experiences e.g. CYP enjoys water play but struggles to transition to swimming

Websites

Apps

  • Vis timer lite
  • Time timer
  • Grid player
  • Visuals2Go
  • DayCape
  • Brain in hand
  • AutonoMe
  • Autism iHelp – language concepts

Resources and Books

  • The Incredible Five Point Scale - Kari Dunn Buron and Mitzi Curtis
  • The New Social Story Book – Carol Gray
  • When My Worries Get Too Big- A Relaxation Book For Children Who live With Anxiety – Kari Dunn Buron
  • Red Beast (Controlling Anger) – Kay Al-Ghani
  • My Hidden Chimp – Professor Steve Peters
  • Panicosaurus (Anxiety) - K. I. AL-Ghani
  • The Disappointment Dragon - K. I. AL-Ghani
  • Teaching Children with Autism to Mind Read - A practical Guide by Patricia Howlin, Simon Baron-Cohen and Julie Hadwin

To see previous weekly themes please go to: https://www.babcockldp.co.uk/campaigns/coronavirus-support-for-schools-parents-and-pupils/links-for-home-schooling-resources-and-activities/communication-and-interaction

Week 6: Practical Ways of Using Images and Writing to Support Everyday Routines

Following on from ‘weeks 4 & 5’ we will look at additional visual aids such as symbols, drawings and writing and ways they can promote children and young people’s (CYPs) communication and interaction as well as their independent life skills.

An overview of visual supports, ways to use them and how they can support CYP’s with communication needs and/or Autism have been discussed in previous weeks, it may be helpful to review some of the information prior to reading this section (please see weeks 3, 4 and 5).

Downloads - 

A brief recap – How do I know which visual will support my CYP?

www.do2learn.com explains:

Most of us learn about objects and actions using the following common levels of abstraction:

  • Actual objects and actions (most concrete way of understanding what others mean)
  • Photographs of objects and actions
  • Black and white line drawings of objects and actions
  • Written words (most abstract)

The ability to understand different levels of abstraction will vary between individuals and change depending on anxiety levels, sensory differences and the environment etc. It is ok to use a range of mediums to get your message across, even if it means that you need to step back to an earlier ‘level of abstraction.’

The power of pictures!

Research shows the human brain can process images up to 60,000 times faster than words. ... With a picture, you can convey so much more information than you can with words. In fact, it can take a 1000 words just to describe what is in one picture!!

Studies confirm that 93 % of communication is non-verbal and 60% of people are visual learners.

https://www.linkedin.com/pulse/5-reasons-why-images-speak-louder-than-words-gabe-arnold

Ever thought why some CYPs appear to navigate technology such as phones/tablets easily, at pace and are able to effortlessly use these better than us adults? People with communication difficulties and/or Autism find processing visual information easier than auditory (listening to explanations).

With this in mind it is important that we use speech alongside visual supports, so the CYP is able to make connections (between expressive language and their understanding of language).

Using images and writing in the environment –

Symbols are already widely used around us in society. For example, on signage to help locate and find places, to give instructions and to provide additional information such as safety instructions and social rules.

Children and young people with communication differences and/or Autism often find it difficult to decode the world around them; this can take a great deal of mental energy and can lead to misunderstanding, frustrations and becoming overwhelmed.

Visual routines and environmental clues help us to gain understanding of everyday events and their expectations. Especially during times of uncertainty (such as now) these clues can provide structure to enable the CYP’s world to become more predictable; manageable & they are then more likely to achieve their potential.

Labels for organisation and sorting -

Visuals displayed on boxes/baskets/drawers or in particular areas can further indicate where items can be stored/ found. Simple, additional cues such as these can support the CYPs memory, categorising skills, organisation, independence and co-operation as it informs them clearly of what the task involves and expects them to do.

Jigs – ‘Please see weeks 3, 4 and 5’ for more information on how to use.’

Timetables, Schedules and Calendars –

See ‘Using a visual timetable’ – Oxfordshire County Council PDF.

‘Please see weeks 3, 4 and 5’ for more information on how to use.’

Above example uses routine colour and images to highlight particular lessons and equipment required. This can support the CYP’s ability to process the visual information more quickly and efficiently; enabling them to retain key details.

A schedule can be used to plan meals for the day/ week; this can be particularly useful for CYPs who may have a limited diet and/or sensitivity to food textures and smells. Allowing them additional time to process the information can support them to feel less anxious and more in control as they have a greater understanding of what is happening in the future. In turn this may enable the CYP to become more accepting to explore a variety of different foods.

This calendar example can inform the CYP when it is a ‘school day’, when they are staying at home or visiting someone else in their home. It can also help support them to understand time concepts and when it is a weekend and/or holiday which may disrupt their usual routine.

Using images and writing to support choice making

Symbol/ word choice board- ‘Please see weeks 3, 4 and 5’ for more information on how to use.’

Daily/ weekly menus for home/ school can encourage a CYP with dietary sensitivity to engage within meal times and/ or widen their variety.

Visually showing the CYP what ‘food choices’ are available can help them to actively make a request/choice and begin to introduce them to ‘different’ food options.

Technology – some children with communication needs and/or Autism can appear to navigate technology well and at speed (due to their visual processing abilities); this skill can enable them to make choices using apps on tablets etc. and can be convenient when out and about for example when ordering food in restaurants.

Creating opportunities for communication and developing independence skills

Using images/ words to promote life skill routines can aid independence and raise self-esteem. Utilising the Principles to Support Everyday Activities - see PDF allows the CYP to achieve and complete the task without having to use large amounts of energy in trying to make sense of the purpose, steps and expectations.

Flow charts can help CYPs to practice making alternative choices within difficult situations and help them to develop flexibility of thinking. Often CYP’s with social interaction and communication needs struggle to predict other’s thoughts, feelings, actions and behaviours (theory of mind), they can therefore find it difficult to understand ‘consequence.’ This may reinforce particular patterns of behaviour and responses reoccurring as they do not consistently learn from their previous experiences and adapt their actions (as the situation and time has changed). Social rules need to be explicitly taught and in a way that the CYP can regularly go back and reflect upon a visual representation of scenarios.

First-Then/ Now-Next boards – ‘Please see weeks 3, 4 and 5’ for more information on how to use.’

Task planners – ‘Please see weeks 3, 4 and 5’ for more information on how to use.’

Something to consider -

In this example you are shown (using pictures) what tools and equipment you need and what the end result is expected to look like. Unfortunately there is no ‘step by step’ guide to explain or break the task down. People without communication and interaction needs may be able to use a trial and error approach and ‘read between the lines’ of what they have to do to achieve the end goal. However individuals who experience difficulties in relation to organising, sequencing and prediction may need information clearly documented. Having an example of the finished result/product can be a great guide as long as the CYP is able to make an approximation and not become overly focused on producing an exact match.

Reward Board/ Working For – ‘Please see weeks 3, 4 and 5’ for more information on how to use and ‘Working For Explanation & Board PDF’

Jobs list - ‘Please see weeks 3, 4 and 5’ for more information on how to use.’

General tips –

  • Place the image/symbol/ writing at your CYPs eye level
  • Check the name of the area/item is written with the image
  • Label toys and toy shelves with images of the items on them
  • Ensure the CYP and others have a clear interpretation – this is crucial when choosing images/symbols for words which can have more than one meaning e.g. the phrase for ‘good looking’ can represent eye contact but also be illustrated in terms of appearance. Sometimes it may be more effective to use a photograph of the exact item/place/person.

Websites links and resources -

Apps -

  • Developing independence and life skills and managing anxiety - https://braininhand.co.uk/for-me/
  • Supporting independence, sequencing and life skills - https://www.autono.me.uk/
  • Brili Routines
  • Day Cape
  • Visual schedules lite
  • Words in pictures
  • Visuals 2 go
  • I Timetable
  • Autism Help!
  • Autism visuals
  • Meal planner
  • Shopping list 2017
  • Daily Routine
  • MinimaList
  • TimeBloc
  • Prologuo2go

To see previous weekly themes please go to: https://www.babcockldp.co.uk/campaigns/coronavirus-support-for-schools-parents-and-pupils/links-for-home-schooling-resources-and-activities/communication-and-interaction

 

Week 5: Using photos to support everyday routines.

Practical ways of using photographs to support every day routines

Following on from weeks 3 & 4 we will look at supporting Children and Young People (CYP) to understand routines, using strategies such as first- then and visual jigs etc. We will also explore simple ways of creating opportunities for choice making; promoting communication and interaction as well as enabling independent life skills.

An overview of visual supports, ways to use them and how they can support CYP’s with communication needs and/or Autism have been discussed in previous weeks, it may be helpful to review some of the information prior to reading this section (please see weeks 3 and 4).

Companion PDFS -

Choices
Making a Sandwich
Principals to Support Everyday Activites
Show and Wait Strategy
Cook Spaghetti
Trip Book - Shoe Shopping
Writing a Trip Book 

A brief recap – How do I know which visual will support my CYP?

www.do2learn.com explains:

Most of us learn about objects and actions using the following common levels of abstraction:

  • Actual objects and actions (most concrete way of understanding what others mean)
  • Photographs of objects and actions
  • Black and white line drawings of objects and actions
  • Written words (most abstract)

https://do2learn.com/picturecards/howtouse/index.htm

The ability to understand different levels of abstraction will vary between individuals and change depending on anxiety levels, sensory differences and the environment etc.

Once you feel the CYP is able to consistently respond to the use of objects we would begin to introduce photos, thinking about….

  • Are they able to match objects to identical photos?
  • Match photo – photo
  • Select/ name the photos when requested?
  • When shown a photo of an area/ room are they able to transition to ‘said place.’

When moving on from using objects of reference as the main visual support to introducing photos, it may be effective to use them alongside each other. This will enable the CYP to make connections between real objects and their photograph. https://do2learn.com/organizationtools/setup/activitychoiceboard.htm

We all use photos to help us gain further information and to support our understanding, for instance to find out the ingredients within food, following a recipe or completing a DIY project.

Using photographs in the environment

Display photographs in particular areas around the home/setting. For some CYP’s this may help them to make associations between areas and activities and the equipment needed e.g. a photo of their shoes and hat by the back door to provide a prompt for the CYP to put them on prior to transitioning or reminding them to source an apron before water play (locate visual of apron on the water tray)

For an older CYP this maybe a checklist to remember key items they may need such as ‘mobile phone, house keys, bus pass’ etc. (locate near the front/back door)

To support ‘fixed routines’ put the visual ‘jig’ in the specific area the task will be carried out e.g. ‘making a cup of tea’ - near the kettle/canisters.

At times, we may want CYPs to eat their lunch in a particular order or drink after eating to avoid them filling up on liquid and miss the nutrients in the food. The example above is a simple jig which can be displayed inside their lunch box to support their understanding of social rules i.e. ‘main meal before pudding’.

If you feel your CYP’s does not have a balanced food intake these visual jigs, in partnership with choice boards can help them to feel more comfortable around eating and act as a springboard to extend variety.

Tidying is a very abstract concept so being direct and using specific language will enable the CYP to have better understanding of the task, what they have to do and encourage them to co-operate. Photographs placed on drawers/cupboards etc. help to indicate where particular items belong. Modelling short key phrases as “books on the shelf” rather than “tidy up this mess” will support the CYP to focus their attention and concentrate on the ‘task in hand.’ Some CYPs will be able to follow the verbal instruction and begin tidying but some will need the task breaking down further and the adult may need to tap/point to the particular area (if CYP can follow a point). In a busy environment the CYP may find it more difficult to process and plan their transition and therefore the adult may need to bring the box/bag etc. to the CYP. Depending on the individual’s needs we may backward chain (see week 4) this task and tidy the majority of the toys but expect the CYP to do the last few/one (maybe even with hand over hand support).

Creating Opportunities for Communication 

Storing desired objects out of reach but in sight, enclosed in a clear tub, in a bag, or on a shelf with a photograph representing the item can support the CYP to direct their request by involving another person.

Guide your CYP to the choice board so they can make an appropriate request – especially if they are prone to climbing to get what they want. Use all the cues/ prompts they need to be successful e.g. hand over hand support to give the photo to you, place your hand out overtly to receive the photo. Immediately give the chosen item to reinforce the CYP to see the benefit of using the system.

Other examples to scaffold ‘using a photograph’ to request, include:

  • Blowing bubbles
  • Blowing up a balloon
  • More crisps/biscuits/sweets
  • Different coloured pens for drawing
  • Marbles for marble run
  • Trains for track
  • Cars for ramps
  • Bricks according to particular colour/size etc.
  • Furniture for dolls house
  • Props for role play
  • Or board games where they need to ask for the dice (e.g. monopoly etc.)

Using Photos to Support Choice Making

Having a ‘photo visual’ of particular items supports the CYP to understand what is available and what is not.

When introducing a choice board it may be supportive to introduce it using the method in Week 4.
Choosing Development

  1. One desired alone
  2. Desired V undesired
  3. Desired V desired

Above are some example choice boards using photos, these do not have to be specially taken, they can be from an image search or from a packet etc. However, they do need to be clear and as uncluttered as possible; it is preferable to use a clear background. Having the name of the item alongside the picture can support those around the CYP to consistently use the same language.

Display an activity choice board in the same place as much as possible and consider having a portable one to support during meal times and when out of the house etc.

Depending on the CYPs needs, an adult may need to position themselves immediately next to the choice board, this is so we do not miss any subtle attempts of communication (touching/ pointing/ looking at the photo). The adult may need to provide hand over hand support to help the CYP pass the photograph to request an item or offer their hand out as a clue. We do not want to focus on demanding the CYP to verbally ask for or physically pass the photograph to make a choice, however, the adult will be responsive to any attempt at communication be it verbal or nonverbal.

First - then (now – next) boards –

These are a concrete way of showing a two stage sequence e.g. an adult directed activity followed by and activity that is favoured by the CYP.

How to Use

Decide on what words are to be used & write them on the card so all those supporting the CYP use the same language. When you want the CYP to complete a task or activity place a photo of the task you want completed in the ’first’ section and a photo of something rewarding in the ’then’ section. The CYP’ preferred activity needs to be readily available, charged etc. to reinforce the CYP to follow the principles of the ‘first- then strategy’ now and in the future. Show the board to your CYP and use minimal language “first x then y” and point to the pictures as you label the photos, model “Show & Wait Strategy” if needed (see PDF). When the first task is complete remove the photo and show the CYP the ‘then’ photo, move it to the “first” section and quickly guide them to/ give them that activity.

When they are engaged with this activity you can put another photo in the “then” section, this could be an overview activity like “free time” or “play”.

It may be supportive for the CYP to be shown how long/ how many turns they will have on an activity before they choose/ start it.

First Then Next/ Now Next Then Boards –

It may be supportive for your CYP to progress onto a three step visual before using a full timetable. This provides a little more information to them but is still manageable to process:

Photo Timetables –

These show a sequence of tasks or events as an over view of part of or the whole of the day. This can give a broad overview of activities so the CYP can understand, plan and prepare for transitions. Additionally the information can help them feel comfortable as well as allowing the family flexibility e.g. “breakfast, teeth, get dressed, free time, lunch”. “Free time” might sound vague but a first- then, choice board could be used during this time to provide support and structure.

How to Use- 

We suggest displaying a timetable left to right or top to bottom for ease of “reading”, processing information and to support later literacy skills. Keeping the timetable in sight at the CYP’s eye level will help them access and understand the routines more effectively.

The photos are generally removed once the activity is completed or the current one is indicated by a pointer. This is to enable the CYP to quickly understand what the activity is, what’s next, where they are in the day developing awareness of time concepts (and supporting their Executive Functioning skills – see week 3 for more information).

A video demonstration on how to implement visual strategies such as ‘now and next boards and visual timetables to help structure your CYPs day at home can be found here: https://www.youtube.com/watch?v=AQhubfbRpIc

Apps are also a good source of visual timetables. This free example is from PicturePath:

Jobs board/ To Do Lists -

These can be referred to as various other things ‘chore chart/my responsibilities.’ Having a visual for this allows the CYP to see what they have to do, how much to do and when it’s finished. Many life skills can be supported by using visuals such as these such as shopping and self-care.

Another variation is to transfer the ‘photo visual’ from the left to the right side once completed. Adding coloured text such as ‘red and green’ can further help signify what the CYP is expected to do.

http://www.she-wears-flowers.com/2011/03/tutorial-kids-shopping-book.html

Task Planners -

Illustrates the steps of a task/ activity and what might be needed (see Week 3). These visuals explain the task using many of the ‘Principles to Support Everyday Activities’ – see PDF

  • What is to be done
  • How much is to be done
  • When is it finished
  • What to do after

https://www.wikihow.com/Use-a-Dishwasher

Task planners can also be video instructions such as: https://www.youtube.com/watch?v=nWo-ya3a1G8

Reward Board/ Working For…

A reward or ‘working for’ board keeps the motivating choice insight; acting as a reinforcer for the CYP. This can be differentiated for the individual’s needs; for example: a reward can be given immediately after a task where the tokens can be earned for parts of it or an extension of this may be that the CYP gains a token for one activity and completes 5 tasks to gain the reward. The length of each step for a token will depend on CYP’s focus (see week 4 for more information).

Trip / Explanation Books -

These can be an effective way of showing and preparing the CYP for an activity when going out. It doesn’t have to be printed with great pictures, the key aim is that it provides the CYP with something concrete to explain to them the general routine and rules of the trip. It can be hand written and held together with string, the most important thing is that your CYP is supported visually.

You may want to show this book a few days before or just before the trip depending on what will support your CYP the best. For further information see: Writing a Trip Book PDF

A key advantage of using consistent visual strategies, such as those discussed here, is that the CYP doesn’t have to decode the method of presentation- they can learn the goal within it.

General tips –

  • Discuss with your CYP’s Teacher/SENCo which visuals may already be in place
  • When taking photographs ensure these are on a plain background/ minimal distraction
  • Display text under the photograph to encourage consistency by modelling the same language
  • When presenting a photograph to the CYP use speech alongside
  • Check that the photograph is a clear representation of the physical object e.g. if you are saying you are going in ‘Daddy’s car’ don’t show a photo of ‘Mummy’s car’
  • Gain their attention first i.e. call their name, get down to their level, tap their shoulder, cue them in by showing/referencing to the photographs etc.
  • When presenting visuals allow processing/ decoding time of at least 10 seconds before repeating the question and/or waiting for the CYP to respond (Show and wait strategy)
  • Use specific language when giving choices/ labelling items e.g. try to avoid “do you want this or that?”
  • Minimise language, use key words and offer a manageable amount of choices

Websites links and resources

Apps

  • DayCape
  • iDo hygiene
  • Choiceboard creator lite
  • KidsToDoList
  • CanPlan
  • PicturePath

To see previous weekly themes please go to: https://www.babcockldp.co.uk/campaigns/coronavirus-support-for-schools-parents-and-pupils/links-for-home-schooling-resources-and-activities/communication-and-interaction

Week 4: Using Objects of Reference in Everyday Routines

Why do we need a Routine?

Children and young people (CYP) with communication differences often find it difficult to understand the world around them; this can take a great deal of mental energy and therefore lead to misunderstanding, frustrations and becoming overwhelmed.

Routines particularly, if they are visual, help us to gain understanding of everyday events and their expectations.

Especially during times of uncertainty (such as now) visual routines provide structure to enable the CYP’s world to become more predictable and in turn creates a sense of control. It helps us all to feel safer, calmer and provides focus and stability.

http://www.hanen.org/Helpful-Info/Articles/Power-of-Using-Everyday-Routines.aspx

Examples of objects to represent daily routines could be:

  • Going out in the car – Car keys
  • Pre-school/school/swimming – Particular bag/ piece of clothing
  • Mealtimes - Particular bowl/plate/beaker/mug
  • Toileting – Nappy/potty/pants/pad
  • Watching TV – Remote control/DVD/Game
  • Bathing – Flannel/ Bath toy/Sponge/Bubble bath
  • Tooth brushing – Toothbrush/paste
  • Going outside – Shoes/Coat/Pushchair/Reins/ flower/ tree bark (maybe more useful for shoes as may not always need a coat)
  • Getting dressed
  • Bedtime – particular story/ pyjamas/ comforter

These may also include key phrases/gestures and/or signs to further support your CYP’ understanding and engagement.

Naturally we use gestures and key phrases to indicate and prepare for routines. Some examples may include:

  • Toileting - “Change nappy”, “toilet time”, “wee wee”
  • Meal times – “snack”, “food is ready”, “dinner’s ready” gesture eat/drink
  • Bathing - “Bath time”, “Splash splash”, “Bath”
  • Going outside - “Outside time”, “shoes on” “go for a walk” ‘opening the door’
  • Bedtime – “Night night”, “bed time” “sleepies” “time for bed”, gesture sleep

Key Things to Remember:

  • Liaise with key people that support your CYP and agree on same objects to represent routine.
  • Decide on terminology and language when referring to object/item, for example ‘food/snack/dinner time/lunch’ or ‘change nappy/toilet/toilet time’ etc.
  • Place objects in a designated place (out of reach to CYP but accessible to the adult) this is to ensure items are not misplaced
  • When presenting an object to the CYP use speech alongside

Using Objects in the Environment

  • Displaying item in the area e.g. nappy/ flannel in the bathroom or flower on the doorframe that the CYP can match on transition so they associate the object representing the activity/ task.

  • Adult may need to show the object and guide the CYP to the new area/ activity
  • For some CYPs holding the object during transition is very supportive and for others just seeing it is enough to cue them in
  • Showing the item and waiting before expecting your CYP to transition can lead to a much smoother/ co-operative response – See Show & Wait Strategy PDF
  • Mat/ blanket/ masking tape on the floor to indicate an area for a certain activity e.g. lining up cars, messy arts and crafts
  • One table but many uses different cloths may support your CYP to quickly identify the activity e.g. table cloth/ bare surface/ place mats for eating, newspaper for art

Using Objects to Support Choice Making

Make a list of loved items and those the child hates or is not bothered with. Although be aware of those items that might raise your CYP’s anxiety. It might be helpful to have a collection of hated items to hand during that stage.

Choosing Development

  1. One loved (desired) alone
  2. Desired V undesired
  3. Desired V desired

To encourage CYP to make meaningful and informed choices it is useful to begin offering a motivating item (desired), such as ‘bubbles’ versus something that would not be of interest (undesired) a ‘tissue.’ The CYP may reach out to select both items and may not understand that you are offering a choice but instead thinks you are offering both. In this case support them by practicing stage a) tuning them in and offering one motivating/ loved item alone and labelling it.

Be mindful of whether your CYP is making an informed choice, or whether they seem to be echoing and copying either the first or last word they have heard you say.

It may be helpful to offer the choices in a different order to check if they are choosing the item in the same position e.g. “cars or book?” (Child says book) rephrase as “book or cars?” (Child says cars)

A way of checking this is once they have made their choice either verbally or non-verbally deliberately give them the ‘other item’ to see if they accept what you have given them or in some way refute this and possibly correct you (gesture the item back).

This also supports CYP’s flexibility of thinking and routine.

Ways in which CYP’s may Communicate their Needs and Wants

  • Attempt to access it themselves
  • May briefly look/eye track
  • May reach out to select item/object
  • Refuse by pushing the undesired item away
  • Tap item they want
  • Exchange (if using photos/images/PECS)
  • Lead/guide another’s hands hand towards item
  • Gesture/point/sign/name item

Creating Opportunities for Communication

Using objects to support making requests (store things out of reach but in sight), enclosed in a clear tub, in a bag, on a shelf. 

Using props to request songs- objects of reference can easily be household items such as a cardboard star, a toy bus, a small world figure for Old MacDonald. The quality of the homemade items does not matter; it’s the meaning that you give it that counts.

Watch video: Using Objects to Choose Songs

In order to present ‘objects’ on a choice board the CYP will need to demonstrate the ability to make a choice between desired objects (refer to ‘choosing development’, as previously mentioned). The adult cues the CYP in by showing a manageable amount of choices available on a plain board. Once a choice has been made the choice board is taken out of sight. The aim of this is to support the CYP to direct their choices and requests rather than allowing free access which limits opportunities for communication.

Watch video: Using a Choice Boards with Objects

Watch video: Using Objects to Develop Choice Making

Watch video: Using Objects to Support Everyday Routines

Breaking Tasks Down

Teaching an activity by breaking it down into smaller manageable steps can be taught through backward chaining.

Backward Chaining- A way of teaching activities

We can think of any activity we want a child to learn as a series of separate smaller actions. A CYP joins these together to form a “chain”. The “chain” is the total activity.

This last bit is much easier for a child. He/she can see what needs to be done, so success is more likely → Result: learning, increased confidence, pleasure

For example; completing an inset puzzle, building a tower, putting on a sock, or using a spoon.

But what if he/she cannot do even the last bit? Then you split that last bit up into smaller steps, and you try and think of other ways of making it clearer and easier.

From: Backward Chaining PDF by Oxfordshire County Council

Watch video: Supporting Dressing through Backward Chaining

Watch video: Supporting Executive Functioning

Reward Board/ Working For…

A reward or working for board keeps insight what the motivating choice the CYP has chosen. This can be differentiated for the individual’s needs. Immediately receiving the reward for completing the task or an extended system e.g. earning a token for each part of the activity they complete or for a number of whole activities. The length of each part for a token will depend on how long the CYP’s focus is.

Website links and Resources

Week 3: What do we mean by visuals and how do they support Children and Young People’s (CYP) with communication and interaction needs?

What do we mean by visuals and how do they support Children and Young People’s (CYP) with communication and interaction needs?

Within this theme we will provide an overview of the different types of visuals; ways in which they can enable CYPs learning and development, exploring which level of visual would benefit them.

What do we mean by visuals?

When we refer to “visuals” it can include written words, hand drawn pictures, printed symbols, photos, objects or gestures/signs & they are usually used alongside the spoken word.

Types and examples of Visuals:

Objects of reference - an object to represent an activity, area, place or person; they can be used when giving an instruction or as part of a wider strategy 

Signing/Gesture – Makaton signing is more commonly used to support CYP with learning or communication difficulties. It uses signs or symbols with speech in spoken word order as a mode of communication.

First then (now – next) boards - a concrete way of showing a two stage sequence e.g. an adult directed activity followed by CYP’s choice

Choice boards - a board of available items or activities for them to request

Lists – a record to help remember key information

Calendars - to help prepare for upcoming events, visits and activities

Timetable – a sequence of activities, tasks or events showing an over view of part of or the whole of the day, generally removed/, folded over or indicated by a pointer to quickly show what the current activity is.

Timers - these can be sand timers, on your phone/ tablet, an alarm, kitchen timer or a count down on your fingers. Additional ways of informing the CYP can be through having familiar sounds or alarms e.g. using a wind chime, ringing a bell, blowing a whistle, clapping a pattern, singing or a chant/mantra.

Labels – can be pictorial or written information to help the CYP to identify key areas, for example where particular items belong.

Jigs - a series of objects, pictures and/or words that are a set routine such as: shoes- sunhat- outside or handwashing.

Task Planner/schedule – showing parts of a task broken down into steps to be ticked off/ crossed out to indicate when the activity is completed:

How do visuals support CYPs?

CYP with communication needs experience differences in their working memory; this can often impact upon their ability to order, sequence and predict an outcome (also known as Executive Functioning Skill). This can therefore make it difficult for CYPs to organise themselves to carry out and complete tasks, as this requires them to ‘plan’ what the steps are & which order they need to be carried out. Even if this is a commonplace daily routine e.g. teeth brushing the CYP may not be able to recall and order the steps spontaneously and require additional visual cues to support. This skill is part of their Executive Functioning and is not linked to intelligence levels.

Furthermore the use of visuals may help:

  • Support understanding
  • Retain information, as often the spoken word can be fleeting
  • Maintain consistency and routine
  • Support listening and cue attention
  • Give alternative ways to explain what we mean
  • Assist CYP to communicate their needs, wants and feelings and respond to interaction
  • Structure tasks
  • Organise key information
  • Offer predictability
  • Provide opportunities for choice making/ requests
  • Make information explicit e.g. understanding social rules etc.

Presenting Information at the Right Level

Knowing your CYP you’ll be able to gauge how to pitch the information e.g. if they are calm & they can read; a list may be a good option. Alternatively, if they need reduced information perhaps cueing them in with an object, a photo or gesture would be more supportive.

Consider driving on the motorway at 70 MPH – the signs are not written in full sentences but instead use pictures to support you to understand quickly and enables you to attend to key information.

Also a list in the supermarket helps to provide focus on what is needed and supports you to choose efficiently.

Keeping visuals ‘in sight’ (accessible, in designated places and displayed at eye level) will help increase the likelihood that the CYP will keep ‘in mind’ the steps that need to be carried out (which others are able to recall more naturally).

How do I know which visual will support my CYP?

We tend to usually learn in steps which begins with the most concrete (objects) and becomes more abstract (text). The ability to understand different levels of abstraction will vary between individuals and change depending on anxiety levels, sensory differences and the environment etc.

do2learn.com explains:

Most of us learn about objects and actions using the following common levels of abstraction:

  • Actual objects and actions
  • Photographs of objects and actions
  • Black and white line drawings of objects and actions
  • Written words which describe objects and actions

For example, consider how someone with special needs might learn to request a drink: Starting with a picture to make a request for a real object can be too abstract. Initially, a person might need a real cup to request juice. You can teach that a picture of a cup and a real cup represent the same thing by first using the real cup with the picture, and then transitioning to just using the picture. Some learners may always prefer the real object. The goal is simply to provide whatever makes the connection for an individual. If you see confusion or frustration in the learner's attempts to communicate, decrease the level of abstraction.

https://do2learn.com/picturecards/howtouse/index.htm

If you are unsure what level of abstract thinking your CYP is learning at, you may want to consider the following questions:

  • Are they able to match a number of identical objects? e.g. 3 different items are laid out, adult presents a ‘matching object’ and CYP puts with same
  • Are they able to select/ name the objects when requested? e.g. CYP points to, names, signs, looks towards or picks up the items.

Once you feel they are able to consistently respond to the use of objects we would begin to introduce photos, again thinking about….

  • Are they able to match objects to identical photos?
  • Match photo – photo
  • Select/ name the photos when requested?
  • When shown a photo of an area/ room are they able to transition to ‘said place.’

Once you feel they are able to consistently respond to the use of photographs we would begin to introduce drawings and repeat above system if needed.

Supporting ‘an uneven profile of needs’

Some CYP’s present with an uneven ‘spikey’ communication profile; this may mean that they speak at a higher level (using more complicated words, sentence structures and have a large vocabulary) than they can readily understand and vice versa. Therefore others may often find it difficult to pitch language and present tasks at the right level.

Blank Levels of Language – helps us to identify whether we are using the right level of spoken language according to the CYP’s understanding. 

Blank, Rose & Berlin (1978), categorized questions according to levels of complexity from concrete to more abstract. In their system, the more the adult’s language matches the CYP’s understanding the more successful it will be.

General tips for using visuals:

  • Discuss with your CYP’s Teacher/SenCo which visuals may already be in place
  • Gain their attention first i.e. call their name, get down to their level, tap their shoulder etc
  • When taking photos of objects/people ensure there is minimal background distractions
  • Consistently use the same language, photo, symbol for an item/activity etc
  • When presenting visuals allow processing/ decoding time of at least 10 seconds before repeating the question and/or waiting for the CYP to respond
  • Use specific language when giving choices/ labelling items e.g. try to avoid “do you want this or that?”
  • Model good language at the right level for your CYP
  • Minimise language, use key words and offer a manageable amount of choices

Websites and resources

Apps

  • Vis timer lite
  • Time timer
  • Grid player
  • Visuals2Go
  • DayCape

Additional Resources:

AET - Shortened Package of Teaching Tools and Guidance

Supporting Children with Communication Differences during Covid-19

Week 2: Communication tips to support anxiety

Communication Tips – To support children and young people’s raised anxiety and conversations about Covid-19

During this unparalleled time, the impact that Covid 19 has had on everyone’s everyday lives and the need for radical social changes has been overwhelming.

It has been difficult to interpret all of the information being given about the pandemic. Parents in particular have needed to manage their own emotional needs and quickly learn how to support their children and young people (CYP) to understand and make sense of the current situation. Helping CYPs cope and deal with increased anxiety around uncertainties and disruptions to normal life has become a main focus for families and schools.

So what is anxiety?

Mind charity explains:

“Anxiety is what we feel when we are worried, tense or afraid – particularly about things that are about to happen, or which we think could happen in the future. Anxiety is a natural human response when we perceive that we are under threat. It can be experienced through our thoughts, feelings and physical sensations.” https://www.mind.org.uk/information-support/types-of-mental-health-problems/anxiety-and-panic-attacks/about-anxiety/

CYPs may exhibit some of the following signs of anxiety/ stress, for example:

  • Repetitive questions, or other behaviours that happen over and over
  • Being silent or mute
  • Insisting on routines and preventing changes
  • Taking a prolonged time to settle to sleep
  • Bed wetting, soiling, bloating, constipation
  • Withdrawing, refusing to join in
  • Screaming, shouting and behaviour outbursts
  • Developing new or excessive phobias
  • Flight, fight or freeze response
  • Stomach aches, butterflies
  • Headaches, migraines
  • Self-injurious behaviour such as nail biting, pulling hair out, biting, head banging, teeth grinding, digging at skin etc.
  • Physically or verbally challenging to others
  • Change in appetite
  • Lack of self-care or obsessive hygiene rituals/routines
  • Rapid breathing

General tips for supporting CYPs communication in times of anxiety

  • A natural reaction to anxiety is that it can impair our understanding of language (listening skills) and our use of verbal communication (speech), the ability to hear high pitched sounds also reduces. Keeping these physical reactions in mind when talking to a highly anxious person is important and you may find the following suggestions supportive:
  • Try to minimise spoken language, using key words to get the message across for example ‘computer off - dinnertime’ rather than ‘come on dinner’s ready turn your computer off before your food gets cold.’
  • Visuals (written words, hand drawn pictures, objects, photos, gesture) to support your language
  • Allow extra time to decode (time to think about what’s been said, process the information & respond. “Pause after asking a question for at least 10 seconds (and longer if a child or young person is using a communication aid) to give them enough time to answer” https://www.thecommunicationtrust.org.uk/media/449470/involving_cyp_with_slcn_toolkit.pdf
  • Model expectations with minimal language and carry out the action you want them to do e.g. hang your coat up, shoes off, wait so people can pass, walk one behind the other, deep breathing etc.
  • Support choices using visuals and reduce the amount on offer to support a successful response.

Useful websites and resources - anxiety

Talking about COVID-19 with a child or young person

Having conversations about worrying subjects such as Coronavirus can be a difficult and anxiety provoking in itself. Some tips to help support you are listed below:

  • Plan ahead & be prepared– as much as you can be
  • Be as calm as possible
  • Keep to the facts
  • Minimise time spent watching, reading about Covid19 related information
  • Be willing to openly & visibly use your own calming strategies when needed e.g. practising breathing techniques/exercise

Useful websites and resources - talking about COVID-19

Supporting wellbeing during COVID-19

A few other useful links:

Snippets are a weekly round-up of information relating to Children with Additional Needs, produced by Signpost Plus:

Support for Schools, Parents and Pupils – Babcock LDP https://www.babcockldp.co.uk/campaigns/coronavirus-support-for-schools-parents-and-pupils


Extra Resources - 

 

Week 1: Supporting staying at home concerns - Flight Responses

Flight Responses

In these changing and uncertain times using known strategies consistently and continuing with familiar routines will help to make sense of the world around us.

To minimise the chances of your child or young person (CYP) feeling overwhelmed and potentially becoming a flight risk / leaving the home unaccompanied; the following resources and strategies may help them to feel safer/ in control/ and regulated. In addition it will support them to understand & follow the social rules that we are living with at the moment.

It is important to remember that each person is an individual and will need different support at different times. All behaviour is communication, not just for CYP’ with additional needs but for us all and acknowledging this will help us to understand why CYPs may be responding in certain ways.

Flight responses by your CYP may happen for a number of reasons. We have tried to focus on 2 possible key areas:

  1. Are they aware that outside is unavailable at that particular moment in time?
  2. Are they overwhelmed/ anxious/ in flight or fight?

You may want to consider:

  • Are there any/regular opportunities for them to go to a safe area (garden, bedroom, cosy corner or tent/den)?
  • Are there any/regular opportunities for them to exercise/ be active indoors, in the garden or on a balcony?
  • Where do they go to when they leave the home? Is it running towards somewhere in particular or typically just away from the house?
  • Where do they leave through? i.e. front door, window, garden wall etc.

Safeguarding

During incidences where a CYP has gone missing, advice on social distancing measures have been relaxed. Police have advised families to continue with their ‘normal parenting response to their CYP’ flight’ and if unsuccessful in locating them, for the family to contact the Police immediately and report the CYP as a missing person

If your CYP already knows a strategy at home/ in school continue to use this. If you are unsure on what specific language is used in school please contact the SENCo or teacher who can help.

The strategies shown in this information are examples that may benefit your CYP. They are presented at different levels of need and can be adapted to suit your CYP.

Some of the strategies use visuals (symbols/ drawings/ photos) that are used differently in other documents e.g. a green tick means “available” in one and “finished” in another. It will be most supportive to choose one meaning for one visual to reduce confusion.

1. Unaware they are not allowed to leave home at the moment

Try to keep the message as positive as possible.

“Can I exercise more than once a day if I need to due to a significant health condition?”

You can leave your home for medical need. If you (or a person in your care) have a specific health condition that requires you to leave the home to maintain your health - including if that involves travel beyond your local area - then you can do so. This could, for example, include where individuals with learning disabilities or autism require specific exercise in an open space two or three times each day - ideally in line with a care plan agreed with a medical professional.

Even in such cases, in order to reduce the spread of infection and protect those exercising, travel outside of the home should be limited, as close to your local area as possible, and you should remain at least 2 metres apart from anyone who is not a member of your household or a carer at all times.”

  • For evidence to support extra outdoor exercise please take documents such as Disability Living Allowance, Blue Badge, Diagnosis letter, Max Carer’s card. You may want to also utilise a sunflower lanyard, wristband or badge which signifies a hidden disability that can be picked up from some supermarkets when you do your shopping (please check the supermarket you shop at) or bought for a small fee (under £1)
  • Redirect using a choice of what physical activities they can do (both inside & the safe outdoor spaces) until it’s “outside time” (please use the phrase that is natural to your family) e.g. skipping, trampoline in the garden, gardening, football, Joe Wicks exercise classes on YouTube 5/8/30 minutes/ indoor “PE”, go noodle, yoga, chair push ups. As they’re anxiety is probably higher than normal it is worth making this visual- written, hand drawn (don’t worry if you can’t draw), photos, pictures cut out of magazines etc. are all good options
  • Choice of activities they can do outside e.g. running with members of the household, skipping, football with members of the household, self-contained activities e.g. circuit training ideas 5 star jumps, 10 push ups etc. riding their bike
  • Not available (no entry sign) in a book of visuals of where they can’t and where they can- possibly with a green tick. This makes it very visually clear and is a reminder they can check and help them to understand the social rules in place at the moment
  • An indicator such as a not available on door/ window frames (if needed) until they can have “outdoor time”. At this point the adult takes down the “not available” sign and you can go through the exit
  • If support required a sign showing wait for an adult before leaving – see Widgit wait prompts for outside doc
  • Social story/ visual schedule explaining when they can go outside- please see guidance in the documents and tweak to be specific to your CYP, this will make it more powerful and successful. Information on how to write them can be found at https://www.autism.org.uk/about/strategies/social-stories-comic-strips.aspx

2. Being overwhelmed

In the Moment:

  • Have a flight plan and share this with relevant people – even if your CYP hasn’t flown before e.g.
    • Key people to tell and what they can do to help - places they may go, who is going to check where & who is to stay at home
    • Who do people call to tell them they have the CYP safe
    • Who will take the emergency bag
    • A list of key strategies to calm them
    • Take their phone if they haven’t done so. They may be able to use this to text when calm enough (be careful not to give when heightened as it may be damaged)
    • Ideas how to get them home e.g. walk, car, bike, scooter
  • Naturally when your CYP becomes heightened those around them will do so too. This is why having a plan in place and items to hand will help you to respond more effectively
  • Use reduced language, increase visual communication (show rather than say). Be mindful that your CYP may not be able to use/ understand spoken language well leading up to and during a period of feeling overwhelmed. This is a normal physical reaction that everyone has to going into the fight, flight or freeze response
  • CYP may be comforted by reassuring phrases such as “you’re safe” but be aware that if they are still very heightened talking to/ around them may add to their stress and prolong the situation. If in doubt; leave it out.
  • They may need alternative ways to communicate such as texting, writing, drawing, actions (pointing to area you want them to go to, using your hand as a visual prompt to indicate them to lead you, show an object to represent a calming activity.
  • Have an emergency bag to take with you if a flight occurs with visuals, pen & paper/ white board, calming items (e.g. iPod, chewing items, food, drink), sensory items (e.g. sunglasses, squeeze item, ear- defenders, blanket to hide under), necessary documents and phone numbers etc.

Preventing Stress & Anxiety:

  • Explore the concept of Stress Buckets (a way to represent triggers and factors that influence heightened anxiety and stress) - see documents
  • It may be helpful to write down flight incidences on an ABC- antecedent (what was happening before), behaviour, consequence) form to see if there are triggers or patterns of behaviour e.g. times of day, routine changes/ transitions – see documents for blank and example forms
  • May benefit from a 5 point scale or speedometer which highlights levels of emotional regulation and enables families to become detectives for signs of stress and what might be supportive to manage stress and anxiety– see blank scales and examples
  • Use reduced language, increase visual communication. Be mindful that your CYP may not be able to process spoken language well leading up to and during a period of feeling overwhelmed. They may need alternative ways to communicate such as drawing
  • Timetabled sensory regulation activities, chair push ups, blowing bubbles/ balloons, carrying heavy items
  • Choice board (visual options) of regulation activities for them to use as a reminder of activities that support them. As they’re anxiety is probably higher than normal it is worth making this visual- written, hand drawn (don’t worry if you can’t draw), photos, pictures cut out of magazines etc. are all good options. The frequency of these activities may need to be increased as the CYP may be experiencing a heightened level of anxiety
  • Timetable calm/ chill out in a low stimulus area, low sensory environment e.g. low/ no lighting, limited interaction with others, quiet or relaxing music/ sounds, no demands/ requests
  • Social story re: when I feel stressed I can X,Y,Z – information on how to write them can be found at https://www.autism.org.uk/about/strategies/social-stories-comic-strips.aspx

Useful Websites:

https://icahn.mssm.edu/research/seaver/resources/covid-19-autism-resources Talks about “compliance” rather than co-operation as it is American based

https://www.sunshine-support.org/covid-19 A dedicated COVID-19 SEND Advice Team

https://asiam.ie/social-story-covid-19-lockdown/ information story to help explain lockdown

https://www.autism.org.uk/about/strategies/social-stories-comic-strips.aspx guidance on how to write social stories and comic strip conversation

https://www.autism.org.uk/services/helplines/coronavirus/resources/stories-from-the-spectrum.aspx adults with autism explain how feel at this time and what they’ve found helpful

https://www.youtube.com/watch?v=xq8ZBn-7oKo Coronavirus and staying safe - Makaton Version

https://www.babcockldp.co.uk/campaigns/coronavirus-support-for-schools-parents-and-pupils Support for Schools, Parents and Pupils – Babcock LDP


5 Point Scale (Example)

5 Point Scale (Blank)

ABC Behaviour Observation and Analysis (Example)

ABC Behaviour Observation and Analysis (Blank)

Just Right Speedometer (Example)

Just Right Speedometer (Blank)

Outside Schedule

Places I Can Go During the Virus

When I Go Outside

Regulation Activities (Example)

School Closure Toolkit

Stress Bucket

Ticklist for Undertanding When CYP Can Go Outside (Example)

Snippets


Useful Speech, Language and Communication Needs (SLCN) Links

Children and Family Health Devon - Resources to help you while you wait to see a Speech & Language Therapist and for use with children already seeing a Speech & Language Therapist.

Speech Link Multimedia Ltd - link to their Facebook page

UNC Frank Porter Graham Child Development Institute Autism Team - Supporting Individuals with Autism through Uncertain Times

Speaking Space - Making a visual timetable for home (Using Makaton and speech to explain)

http://thinkingtalking.co.uk/free-resources-schools-families/

https://speechandlanguage.info/parents

Working from home with kids - The Importance of Words

Learning words and how to use them is one of the most powerful activities we can do with our child to support them to succeed at school.

Talking and more importantly listening to our children is a powerful learning opportunity.

What we know:

  • Education and the world of work is built on language – both spoken and written
  • Children's language ability at age 2 is an indicator of reading ability at 5 and children's reading ability at 5 is an indicator of academic success at 16
  • The words children know will help them read, understand and gain new viewpoints 
  • The rate at which children develop language is related to the language they receive from parents and carers – we can make a difference

What we can do:

While we are at home with our kids, helping children know more words is possibly the best thing we can do.  Language is learnt through conversations – make sure you chat with your children every day and not just tell them what to do.

  • Create some talking time and space and make this part of the daily routine
  • Reduce background noise i.e. television or music for some of the day
  • Create den's and places to chat and read books
  • Create 'word awareness' - talk about words, share new words and learn their meanings together

For our youngest children:

  • Make more comments: use less questions – reducing questioning helps build confidence and gives models of how language works
    Adult: You are eating an apple / the apple is green/juicy/sweet / the apple grows on a tree  
  • Match and add on – repeat what they say and add another word 
    Child: I have an apple
    Adult: Yes you have a big / delicious / rosy / crunchy apple
  • Don't ask questions you know the answer to - Do you like apples? What is your favourite fruit?
  • Sometimes it takes longer for younger children to work out what they want to say – give them lots of time, count to 10 before prompting
  • Share picture books and discuss what they can see in the pictures, words they do or don't know, sing rhymes and songs often
  • Make collections – things from the garden, things from the beach, things we find in the kitchen

For Primary Age children: 

  • Share books that are above their reading age, read to your child and discover new words together
  • Play with language, make mistakes by using the wrong words and let your children correct you
  • Play word and memory games together
  • See if you can find as many words that mean the same or similar to … and discuss why they are similar and what is different – look at shades of meaning
  • Have a competition to see who can find the most new words by the end of the day or the most words about a topic

For Older children:                                          

  • Encourage reading or listening to audio books and ask them about new words they have heard that they didn't know
  • Ask them about new words they have discovered linked to the subjects they are studying
  • Play word and memory games  – there lots of ideas online including A-Z board (a grown up version of making collections) Taboo, Twenty Questions, Ghost, Behind the Green Door
  • Discuss topics and debate current issues – don't let it get too heated!
  • Use word puzzles

There are lots of ideas online to help you build word awareness and encourage your children to enjoy learning vocabulary.

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