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Print and use at home. This can be laminated and pictures drawn or words written into the boxes.

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Starting secondary school can feel like stepping into a whole new universe.

In this episode, I chat with students about the real worries that come with Year 7, from getting lost to making new friends, and even those wild myths about older kids that everyone swears are true. You'll also hear from Annabelle, fresh out of Year 7 with brilliant advice, plus Mrs Clarke from pastoral support sharing her best tips for both students and parents.

With practical strategies, mindset shifts, and a plenty of laughs throughout, this episode will leave you feeling ready to handle the big move with confidence.

04:12: Charlie and Harry share their biggest Yr7 worries

05:09: How to flip worries into opportunities

11:14: Why being yourself is the best strategy

14:02: Top 10 tips for making new friends

16:28: Annabelle busts more hilarious school myths

18:40: Mrs Clarke's turbo-charged transition tips

22:17: Joe's weekly anxiety-busting takeaway

This week's Downloadable Resource for the show is HERE
Disclaimer: The content shared in this podcast is for informational and educational purposes only. It's not a substitute for professional medical advice, diagnosis, or treatment. Always seek guidance from a qualified healthcare provider with any questions you may have regarding a medical or mental health condition. Please don't ignore or delay professional advice because of something you've heard on this podcast. Your wellbeing matters- and getting the right support is key.
If you are in crisis, please contact your Doctor.

If you or someone else is in danger, call 999 or go to A&E now

If you need urgent help for your mental health, visit NHS 111 online or call 111.

And if you're listening from outside the UK, please contact your local emergency services or support line.
Your mental health is as important as your physical health. You will not be wasting anyone's time.
Anxiety Uncovered Website

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Connect with Joe:
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Email: joe@anxietyuncovered.com

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EP8 - The Truth About Starting Year 7 (And What Really Matters)

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Starting secondary school can feel like stepping into a whole new universe. In this episode, I chat with students about the real worries that come with Year 7,

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My Hidden Chimp: From the best-selling author of The Chimp Paradox

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My Hidden Chimp: From the best-selling author of The Chimp Paradox : Peters, Prof Steve: Amazon.co.uk: Books

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With more than 150,000 books sold, this 3rd edition of the Happy Confident Me Daily journal for kids aged 6-10 includes different questions and quotes every day and promotes increased happiness, self-confidence, optimism, growth mindset, resilience and gratitude. it is different from other gratitude journals as kids get a free page each day to give them space to further write doodle or draw, kids get to mention the different feelings they felt each day, and they get a great activity to learn a key character building skill each week.
Developed by Psychotherapist Annabel Rosenhead and Parenting Expert and best-selling Author Nadim Saad, this beautifully illustrated, full colour journal offers children different inspiring quotes and questions every day . It opens up 6 to 10 years olds' abilities to better understand themselves, reflect on the positives each day and find it easier to discuss their feelings and identify their emotions. equip your kids to be stronger, happier and more confident. daily quotes to inspire
In a world where mental health issues among the younger generations are on the rise, this is the first of a series of Happy Confident Me Journals (see more on www.happyconfident.com). These journals take kids on a journey of 10 weeks of journaling, to allow new more positive habits to be formed and better and fun weekly activities , each day your child has four questions to complete about their day.
Packed with this is the only journal of its kind on the market today: YOUR KIDS WILL LEARN

To focus on the positive things they can be grateful for each day

To identify their feelings each day, both positive and negative

To understand themselves better

To develop a greater sense of pride in their actions

PARENTS WILL BENEFIT FROM

Stronger connection with your children thanks to sharing their thoughts and feelings

Being able to discuss feelings with your kids more openly

Helping your kids express themselves more clearly

Finding new ways to motivate your children

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HAPPY CONFIDENT ME Daily Journal - Gratitude and growth mindset journal to boost children's happiness, self-esteem, positive thinking, mindfulness and resilience

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HAPPY CONFIDENT ME Daily Journal - Gratitude and growth mindset journal to boost children's happiness, self-esteem, positive thinking, mindfulness and resilience

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'Jonathan Haidt is a modern-day prophet, disguised as a psychologist . . . He points the way forward to a brighter, stronger future for us all' Susan Cain

'Compelling, readable - and incredibly chilling . . . remarkably persuasive' 'One of the most terrifying books I have read . . . some of the statistics Haidt quotes are truly shocking' Evening Standard The Anxious Generation

After more than a decade of stability or improvement, the mental health of adolescents in many countries around the world deteriorated suddenly in the early 2010s. Why have rates of depression, anxiety, self-harm and suicide risen so sharply, more than doubling in many cases?

In this book, Social Psychologist Jonathan Haidt argues that the decline of free-play in childhood and the rise of smartphone usage among adolescents are the twin sources of increased mental distress among teenagers.
Haidt delves into the latest psychological and biological research to show how, between 2010 and 2015, childhood and adolescence got rewired. As teens traded in their flip phones for smartphones packed with social media apps, time online soared while time engaging face-to-face with friends and family plummeted, and so did mental health. This profound shift took place against a backdrop of diminishing childhood freedom, as parents over-supervised every aspect of their children's lives offline, depriving them of the experiences they most need to become strong and self-governing adults.

reveals the fundamental ways in which this shift from free-play to smartphones disrupts development - from sleep deprivation to addiction - with separate in-depth analyses of the impact on girls and boys. Grounded in ancient wisdom and packed full of cutting-edge science, this eye-opening book is a life raft and a powerful call-to-arms, offering practical advice for parents, schools, governments, and teens themselves.

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The Anxious Generation: How the Great Rewiring of Childhood Is Causing an Epidemic of Mental Illness

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Buy The Anxious Generation: How the Great Rewiring of Childhood Is Causing an Epidemic of Mental Illness 1 by Haidt, Jonathan (ISBN: 9780241647660) from Amazon's Book Store. Everyday low prices and free delivery on eligible orders.

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There’s Still No Such Thing As ‘Naughty’

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THE NO.2 SUNDAY TIMES BESTSELLER ‘THE MOST EYE-OPENING, GAME-CHANGING AND LIBERATING BOOK ON PARENTING I’VE READ.’ FEARNE COTTON ‘CHANGED MY LIFE’ JOE WICKS ‘THIS BOOK IS ONE THAT WILL PLAY A PIVOTAL ROLE IN HOW WE VIEW CHILDREN AND THEIR BEHAVIOURS FOR YEAR TO COME.’ GIOVANNA FLETCHER ‘A BRILLIANT, BRILLIANT BOOK.’ CH

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A therapeutic digital intervention (game) for childhood anxiety:

For 7-12 year olds (facing difficulties with anxiety)

Therapeutic basis: Psychoeducation and Exposure therapy

Embedded outcome measures

Built in safeguarding & accessibility features

Provides data to Authorised Professionals securely through the VitaMind Hub

Available on Android and iOS

Co-created with young people, guardians, teachers, clinicians, academics, game experts

Points of use:
Lumi Nova does not require constant clinical supervision.
INSTRUCTIONS FOR USE

Lumi Nova: Tales of Courage is a digital therapeutic that helps with the symptoms of worries or anxiety for children aged 7-12 years with mild to moderate needs, helping them learn skills to self-manage their worries/anxiety in an engaging intergalactic adventure game (app).

This app facilitates CBT (including psychoeducation and exposure therapy) recommended as a treatment intervention by NICE Anxiety disorders Quality standard and the Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of anxiety disorders.
Lumi Nova is not intended to be used by:

Young people who do not have parental or carer supervision

Young people who are currently experiencing suicidal thoughts or are at risk of self harm

Young people that have severe anxiety or are in crisis

Young people with severe mental health symptoms or diagnoses, who are not supported by a healthcare professional.

READ FULL INSTRUCTIONS FOR USE

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A therapeutic digital intervention (game) for childhood anxiety: For 7-12 year olds (facing difficulties with anxiety) Therapeutic basis: Psychoeducation and Exposure therapy Embedded outcome measures Built in safeguarding & accessibility features Provides data to Authorised Professionals securely through the VitaMind Hub Available on Android and iOS Co-created with young people, guardians, teachers, clinicians, academics, game experts Lumi Nova does not require constant clinical supervision.

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The encouraging and simple activities and exercises tackle anxiety, sadness and stress; children will enjoy using their creativity to combat negative feelings, work out why they feel worried and how to put stress back in its place through writing, colouring, doodling and drawing.

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editorial reviews

An interactive workbook for parents and children from the author of the bestselling titles Don’t Worry, Be Happy: A Child’s Guide to Overcoming Anxiety and You’re a Star: A Child’s Guide to Self-Esteem.

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Weekly timetable

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Mrs Coxhead is our HLTA in SEND. She is available every Thursday.

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Lumi Nova is being piloted to support children and young people to build confidence and learn lifelong skills to manage their worries through an intergalactic adventure game!

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Family Action is an award-winning national charity working from the heart of local communities. Find out more about our work and people.

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Attention and engagement

Attention and Engagement is an intervention model which aims to develop natural and spontaneous communication through the use of visually based and highly motivating activities. The primary objective is that the sessions are fun and "offer an irresistible invitation to learn"!

Aims of Attention and Engagement

To engage attention

To improve joint attention

To develop shared enjoyment in group activities

To increase attention in adult-led activities

To encourage spontaneous interaction in a natural group setting

To increase non-verbal and verbal communication through commenting

To build a wealth and depth of vocabulary

To have fun!

Stages of Attention and Engagement

The Attention and Engagement programme progresses through a series of stages, building on each skill level. Each new stage is introduced when the group is ready to expand attention skills.

Stage 1: The bucket to focus attention

A bucket is filled with visually engaging objects and toys, aiming to gain the shared attention of the group. The adult leader shows each item to the group and uses simple repetitive vocabulary to comment on the various objects.

Stage 2: The attention builder

Visually stimulating activities are shown to the group by the adult leader, aiming to sustain attention for a longer period. The activities are fun, visually engaging and can often involve delightful mess!

Stage 3: Turn taking & re-engaging attention

The adult leader demonstrates a simple activity, often modelled with another adult in the group. Some children are then invited to have a turn but only if they are comfortable to do so. Not every child in the group will get a turn, which then teaches important emotional regulation skills, as well as the essential skills of waiting, turn-taking and learning through modelling.

Stage 4: Shifting & re-engaging attention

Stage 4 aims to develop the skill of engaging and shifting attention. The adult leader demonstrates a simple creative task, and then gives each child an individual kit to copy the task. The children take their kits to a table, complete the task independently, and then everyone returns to the group to show their completed tasks.

Parents/carers role:

Within the group:

At home:

Gradually increase the length of activities and the number of sequential activities to include stages 2-4 as advised by the therapist.

Stage 1 vidoes

Level 1 Bucket 1 Wind up teeth, pompom, spinner - YouTube

Level 1 Bucket 2 Popper, vibrating mouse, flow rings - YouTube

Level 1 Bucket 3 Jumping tube, Stretch ball, confetti balloon - YouTube

Level 1 Bucket 4 Rainbow scarves, baby shark, flying spinner - YouTube

Level 1 Bucket 5 Balloon car, beads, windmill - YouTube

Level 1 Bucket 6 Caterpillar, slinky and cup, sing a ma ling - YouTube

Level 1 Bucket 7 Extended bucket - YouTube

Attention and listening

Listening is not the same as hearing. A child may hear an instruction, but they may not be able to listen to it as their attention is fixed on another activity. Listening requires concentration and a child will need practise to establish good listening skills.

A child with attention and listening difficulties may be easily distracted and have difficulty focusing on tasks. Children with a hearing loss (including those with 'glue ear') may require some extra support to establish good listening.

Activities to support the development of attention and listening - level 1

Acknowledging the presence of another person

Looking, following and tracking objects

Activities to support the development of attention and listening - level 2

Identifying a named object from a choice of two

Joining in with nursery rhymes and action songs

Developing anticipation

Activities to support the development of attention and listening - level 3

Identifying one or two named objects

Full size objects; a teddy, a doll and a cup

Listening carefully to sounds

Activities to support the development of attention and listening - level 4

Listening, acknowledging their name and carrying out an action

Remembering and carrying out a sequence of two items or actions

Copying a rhythm

Activities to support the development of attention and listening - level 5

Following a series of instructions

Identifying four to five named objects

Joining in and interacting with a story

Listening for a given sound and recalling a linked action

Activities to support the development of attention and listening - level 6

Developing active listening

Top tips for attention and listening

The development of play is very closely linked to the development of language. Play helps to develop a number of skills including listening and attention, eye contact, turn taking, understanding and using language, problem solving and imagination.

Play is best when it is child led- let them choose, follow their interests and join in! Play enables a child to try out new skills and roles without fear of failure and it provides an opportunity for expressing emotions in an appropriate way.

Above all, play should be voluntary and fun.

The types of play:

There are lots of different types of play. A child may have difficulty in developing these skills for reasons including:

Types of play include:

People play

One of the earliest stages of play a child will enjoy is people play. This involves them interacting with others and can be done without toys. Children enjoy the repetitive nature of these games and they can support the development of turn taking, eye contact, anticipation, joint attention and listening.

People Play Ideas:

If a child does not respond to their name, try touching their arm as you say it.

Children struggle to focus when there is lots of background noise. It's always a good idea to have play times without the TV or radio on during the day.

Give the child one or two toys at a time- too many can be distracting!

Children love repetition! Repeat, repeat, repeat games they enjoy.

Exploratory play

A child will explore objects and toys using all their senses. This helps them to understand the world around them. The child should have access to a range of toys and everyday objects which are of interest to them. Observe how they play and if necessary demonstrate how to use the objects appropriately. Show them how to use objects in real situations e.g. give them a spoon to hold while they are feeding. Let the child explore and take the lead; your role should be to extend and guide their play. Activities should be adapted if the child has physical and/or sensory difficulties. Toys must provide experiences of looking, listening, feeling, smelling and tasting.

Exploratory Play Activity Ideas

Other resources can include

Cause and effect play

Cause and effect play teaches children that their actions have an effect on their environment. This is an important communication skill.

Cause and Effect Resources

Physical play

Physical play is motivating and fun. This type of play is particularly good for active children and for those who find it more difficult to concentrate. It encourages playing with others, sharing and turn taking. The adult can comment on the child's actions and model vocabulary which the child may find more tricky, for example 'jumping', and 'under'.

Physical Play Games

Hide and Seek

Chasing

Action Rhymes such as 'Wind the bobbin up' or 'Head, shoulders, knees and toes'

Ball Games

Racing Games using 'Ready, steady, go'

Peekaboo with play tunnels.

Soft Play Areas

Trampolines

Bikes & Scooters

Parachute Games

Dancing

Constructive play

Children learn to co-ordinate their fine motor skills through a variety of activities e.g. building, threading, stacking, interlocking games, craft activities. It can help them to develop a problem solving approach. The child stores visual information which they use at a later date, thus developing memory skills. Importantly it can give the child a sense of achievement when they complete a task.

Physical Play Games

Building with wooden blocks of varying sizes

Building with interlocking bricks e.g. Duplo, Lego

Train tracks

Threading cotton reels, beads, pasta shapes

Craft activities - cutting and sticking

Junk modelling with cardboard etc.

Stacking beakers or cups

Inset boards and jigsaw puzzles

Den building

Imaginative play

Imaginative play is very important in encouraging children's language development. Early imaginative play begins through imitating familiar events such as drinking from an empty cup. The child will move on by continuing to imitate everyday activities and starting to recognise that dolls and teddies represent people, for example when mum baths the baby, the child baths the doll. The child will then begin to recognise miniature 'small world' toys such as a doll's house. The child will begin to engage in 'make believe' play involving invented people or objects, for example playing 'schools', pretending to be a superhero or pretending an empty box is a spaceship.

Stage 1

Explore a range of everyday items. Carry out real life scenarios and model how to 'pretend' with the real objects. The adult can model this, for example pretending to drink from the child's empty cup, pretending to open the door with a key.

Stage 2

Introduce a teddy, doll or favourite character toy into the pretend play with familiar objects, such as giving the teddy a drink, washing the doll etc

Stage 3

Expand on your child's pretend play by encouraging them to copy sequences of everyday events, such as brushing the doll's teeth, putting pyjamas on and putting them to bed.

Stage 4

The child will begin to understand that miniature objects relate to real objects. Encourage a range of small world play such as playing with cars and a garage, trains and doll's houses.

Stage 5

The child will start to explore make believe play and take on the role of others, for example pretending to be a superhero or a teacher. Encourage dressing up and real life props to support this. At this stage children learn to pretend an object is something else (symbolic play), e.g. pretending a box is a boat.

Social play

Solitary: a child will initially play alone. They explore and learn with the objects they use but do not attempt to play with others. As they become older they may still have periods when they need to play alone but it is important to not become stuck at this stage.

Parallel Play: children start to play alongside each other, for example standing around the water tray. They watch each other and may attempt occasional interactions. Towards the end of this stage they may begin to co-operate with other children by sharing or passing toys and they may take turns with at least one other child.

Co-operative Play: children enjoy the friendship of other children and want to interact with them. They learn to play together, share and take turns in small groups. Disagreements will sometimes still occur. Later the children can take part in activities without close adult supervision. Their play routines become more imaginative and they should be able to take part in meaningful conversations.

Moving from Solitary to Parallel Play:

Moving from Parallel Play to Co-operative Play:

Some information and ideas based on Elklan Language Builders (2009)

Understanding language

Understanding language refers to the ability to make sense of spoken and written information. It is dependent upon a number of skills.

Children who may be experiencing difficulty in the area of understanding may also have problems with attention and listening skills and vocabulary development (see appropriate sections).

Children with difficulties with understanding may:

Need instructions to be given one to one

Need instructions to be repeated

Need support to join in group discussions

Engage in distracting behaviour, of self and others

Appear to follow instructions but are actually using visual cues such as, watching what others do in the classroom

Complete tasks inappropriately

Repeat instructions rather than carry them out

Have poor concentration

Need more time to respond

May try to hide their difficulties understanding e.g. watching other's faces to try to guess the answer, changing the conversation topic

An older child may learn to read but not be able to understand what they have read

May have difficulties storing information and remembering instructions given

Processing language and top tips

Language processing is complex. It is more than listening or understanding and is dependent upon the integration of a whole range of skills which include:

.......And it all happens AT SPEED!.....

For this reason, a child who has difficulties with understanding and processing spoken information will begin to rely on visual prompts and clues. These can be an essential support for learning e.g. Makaton signing to support early understanding.

Visual supports such as visual timetables, pictures and symbols and daily routines should be available in early year's settings to support understanding. In order to cope with busy and often noisy settings, the child will benefit from a range of strategies to support understanding and processing.

You can help by:

Making sure you have the child's full attention (see tip tops from the attention and listening section)

Keeping your language simple - giving short instructions

Giving the child time to think and respond

Emphasising the most important words in the sentences

Use visual supports to aid understanding e.g. gesture, facial expression, objects and pictures.

Early understanding

From around 9 months of age, a child begins to start using all the clues around them to understand what is going on. These include clues such as, gesture and tone of voice, as well as familiarity with the situation. For example, if a mother asks a child to sit down, whilst pulling out a chair, tying their bib on while food smells fill the room, the child is likely to understand what she wants them to do. The child, however, understands few of the words, interpreting them as part of the whole situation.

Strategies to develop early understanding:

Activities to try:

Mealtimes, bedtime, getting dressed, bath time, going shopping, family member arriving home, favourite television programme.

Choose one or two sentences to use consistently

Use gestures and actions to accompany these sentences.

e.g. Show your child their plate and cutlery

Let your child smell the food

Show them their bib, and then put it on

Pull out their high chair

Later, begin to say the sentence before you use the gestures and actions. This will help your child to learn to anticipate mealtimes on hearing just your sentences.

Understanding the key words in a sentence

This tells us the number of key words that a child has to understand in a sentence to carry out an instruction. It involves the child making a choice between objects, places etc.

In order to be sure that there is true understanding at any of the stages, there must be a choice for the underlined words.

For example:

1 word level Where's the car?

Equipment needed: car, brush

2 word level Give the ball to dolly.

Equipment needed: ball, car, teddy, dolly

3 word level Put the spoon in the bag.

Equipment needed: shoe, spoon, bag, box, in/on/under

As language develops, it is normal for a child's understanding to be at a higher level than their spoken language e.g. a child may understand a 3 word level instruction, but may only be joining 2 words expressively e.g. 'daddy car'.

1 key word level

To carry out simple instructions containing one key word.

When carrying out the activity, a choice of objects/people should be available for the underlined words.

2 key word level

To carry out simple instructions containing one key word.

When carrying out the activity, a choice of objects/people should be available for the underlined words.

3 key word level

To download the 3 key word level pack, please click here.

Understanding concept words

Concept words are important for children to learn as we use them a lot in everyday language. Concepts words include:

TOP TIP: When introducing concepts it is important to introduce only one concept at a time. For example: Put together a collection of 'big' items and talk about them being 'big'. The next stage is to introduce 'big' and 'not big'. The final stage is to talk about things being 'big or small'. Make sure that at first the small objects are very small and the big objects are very big, so that it is easy to see and understand the difference. Introduce a colour such as 'blue'. Put together a collection of blue items and talk about them being 'blue'. Next, find a range of different coloured items and describe them as 'not blue'. Using sorting hoops can be particularly effective i.e. blue things in the 'blue' hoop and different colours in the 'not blue' hoop.

The activities below are designed to support the development of concept words. As the child gets older, you will need to expand these activities to give the child an opportunity to learn more complex concept words.

To match up to 4 colours (red, yellow, blue, green)

Language: red; yellow; blue; green; find; same; match; another

To sort objects by colour.

To identify big and little objects.

TOP TIP: Make sure the objects are very short or very long and use gesture initially to help with meaning.

To identify long and short objects.

Language: long; short; Which? Point to; show me; find

Playdough - 'Can you roll a long/short sausage?

Ribbons - Explore and play with long/short ribbons. Use the ribbons in the outdoor play area, watch them flow around in the air as the child runs. 'Wave the long ribbons in the air.'

Make a collage using long and short strips of paper. 'Can you find a long piece?'

Sort a range of equipment and toys according to length e.g. long and short trains, clothes, socks, skipping ropes, toy snakes.

To follow simple instructions involving 'in', 'on' and 'under'.

Language: in; on; under; put

Position words which develop later include: in front of, behind, next to, inside, outside, above, below. These can easily be introduced within the routines of the session e.g. snack time, outside play time etc.

To understand basic concepts of time

TOP TIP: Remember that the child's use of verb tenses is related to the child's awareness of the passing of time. Use the child's personal experiences to develop this for example, 'today you are painting the tree', 'yesterday you painted the house' and 'tomorrow you will do the sky'.

TOP TIP: In a setting, use a velcro picture/written timetable to teach the concept you wish to develop e.g. 'now', 'next', 'later'

Language: next; then; day; night

To understand the concept of negatives

Language: can't, don't, won't, didn't, wouldn't

Model in activities like PE e.g.

TOP TIP: Children need to recognise that 'n't' equals 'not'; 'can't' equals 'cannot', 'didn't' equals 'did not'. You will need to make this explicit for some children.

To carry out a simple request involving possession.

Language: .........'s

Understanding grammar

Grammar is a term used to describe how language is structured and organised.

For a child to understand language, they need to be able to make sense of a range of elements including:

To understand plurals.

Language: Plural 's' e.g. hats, balls, spoons

Give simple instructions throughout the daily routine for example,
- 'Can you put the chairs around the table ready for snack-time?' 'Can you bring me two books please?' Can you bring the paintbrushes?'
- Singing rhymes, songs and finger-plays - e.g. ten green bottles, five little frogs

Dressing up, getting changed/dressed - ask the child to put socks on, jumper on, so that they hear a range of plurals and singular nouns.

Language: Plural 'es' - e.g. buses, brushes, glasses, watches; Plural 'ves' - e.g. knives, leaves, scarves and Irregular plurals - e.g. mice, men, deer, sheep

Model these plurals to children throughout everyday routines and activities.

Children often confuse pronouns when they are developing their language. Examples of pronouns include: me, I, you, he, she, mine, yours, they, them, we, us.

To respond appropriately to a simple request involving pronouns i.e. 'I', 'he', 'she', 'they'

Language: I, he, she, they

To respond appropriately to a simple request involving possessive pronouns i.e. 'his', 'her', 'their'.

Language: his; her; their

To respond to simple questions involving tenses.

Language: painted, painting, going to paint

Language: and, because, but, so, or, if, until

To encourage the use of 'and' start with connecting nouns, e.g. bucket and spade. A simple pair association game or an opposite jigsaw will help to develop this stage.

When the child can cope with this basic level, you can introduce 'and' between phrases, e.g. 'the boy is standing and the girl is swinging'.

Again take opportunities throughout the day to encourage development of joining words.

Understanding reasoning and thinking

When talking to children, you will need to be aware of the complexity of the questions you ask. The Blank, Rose and Berlin (1978) model shows us the development of the types of questions children are able to understand. 3 year olds will generally be developing their understanding at levels 1 and 2. 5 year olds will typically be developing their understanding at levels 3 and 4. It is particularly important to be aware of these levels of questioning in teaching and SLT offer a range of training packages for practitioners which include more information about this model. Please contact us or see our 'professionals area' for more information. Previous learners have reported that this has made a huge difference to their practice.

Level 1- naming things e.g. 'point to the tree', 'what's this?'

Level 2- describing things e.g. answering questions with who, what and where? 'find something I can eat?' 'who is swimming?' 'where is the boy?'

Level 3- talking about stories and events e.g. 'what might happen next?' 'what will Mummy say?' 'tell me the story' 'how does daddy feel now?'

Level 4 - solving problems and answering 'why?' questions e.g. 'what will happen if it rains?' 'what could you do if you there are no paper towels left?' 'why is the boy crying?'

Activities to target specific questions words

To respond appropriately to a simple question involving 'where?'

To respond appropriately to simple instructions containing 'what?'

To respond appropriately to a simple question involving 'who?'

At the last stage of this model, children will start to develop reasoning and thinking skills.

Activities to develop reasoning and thinking for older children

Inference and Deduction are important thinking skills which enable us to work flexibly in the world. They involve using information to work things out.

Inference: basing a decision on an assumption

Deduction: basing a decision on a known fact

Prediction: using available information to suggest a possible outcome

Detective Games

Working from pictures, get the children to be detectives and answer questions which require some thinking

Provide a picture of a room with a high chair and ask the question 'Do you think a baby lives in this house?'

Provide a picture of a girl putting her wellies on and ask the question 'Why is she putting her wellies on?'

Work from pictures first, talking through the possibilities and make explicit the relationships where necessary. Eventually extend the skill into other forms, spoken passages or reading.

Double Meanings

Understanding that many words can mean more than one thing. The context is what helps us to recognise the meaning

I went to the park to play on the swing.

I was fed up because I could not find anywhere to park my car.

Non Literal Language

Understanding that there may be a hidden meaning which isn't made explicit

e.g. 'I've been waiting for this bus for years'.

Comparing one thing with another

e.g. As dead as a doornail.

Application of a word to something not literally possible

e.g. Food for thought.

An expression with a non-literal meaning

e.g. My mum has green fingers.

Sarcasm/Irony

Expressing the meaning by tone of voice/manner of speech where this then contradicts the words

e.g. That's a great idea (with non verbal communication suggesting the opposite)

During adolescence language becomes more sophisticated. It is often abstract and very specific to the subject being taught.

There is increased use of:

When a child or young person is unable to understand spoken language there may be an impact on their behaviour. The child or young person may:

Expressive language

Expressive language is the ability to use spoken words.

Early expressive language starts with early vocalisations progressing to single words and moves through a developmental pattern allowing children to develop skills to use spoken words for a range of purposes including:

The means, reasons and opportunities model (the one with the circles you did for us)- see the text for indication of where to put it.

Plurals, Pronouns, Use of verb tense leaflets: within 'activities to develop early grammar' section

Express needs, wants, feelings

Volunteer information and make comments

Direct others

Give an account

Start and take part in a conversation

Use language to interact with peers

Use of language to negotiate

Ask a relevant question

Use language to imagine

Give an explanation

Use language for reasoning

Use language descriptively

Please explore the following sections for more information:

About expressive language & top tips

Generally a child will be able to understand language before being able to use it expressively. Children who are having difficulties using spoken language may also have difficulties with attention and listening, vocabulary development, understanding and speech (please see appropriate sections).

Children who are experiencing problems with expressive language may:

You can help by:

Making sure that talking is fun and worthwhile for your child. It is mainly through play and real life situations that children learn to talk.

Speaking slowly, calmly and gently. Give the child an easy pattern to follow.

Listening to what the child is saying, instead of focusing on their pronunciation.

Letting the child know you are listening by turning to face them.

Being positive and giving praise and reassurance in order to develop the child's confidence.

Trying to reduce background noise when you want to talk to the child.

Following the child's interests.

Trying not to ask too many questions.

Try not to anticipate your child's needs, wait to see if they can ask themselves or if they need some help offer them a choice e.g. 'apple or banana?'

Repeat back clearly what you think the child has said and add another word for example, child says 'teddy tummy' and the adult repeats back 'tickle teddy's tummy' or 'teddy's big tummy'.

Repeat back grammatically correct sentences to your child to help develop their use of grammar e.g. child says 'he go shop', adult repeats 'yes, he is going to the shop'.

Give the child time to talk without interrupting them.

Provide visual clues to help the child order ideas effectively before expressing them.

With older children, you can explain word endings and why we need to use them e.g. 'when there is more than one, we add an 's' to the end'.

Remember, children get fed up with naming things which they know the adults really know!

Key word levels (expression)

One word level

First words generally appear around 12 months of age and are commonly:

Short phrases such as 'all gone', 'sit down', 'get up' are learnt as one unit and are therefore classed as being at a one word level rather than a two word level.

Two word level

When a child has around 50 words, they begin to join words together e.g. 'Daddy gone', 'want drink', 'Mummy car'. These could have several meanings e.g. 'this is mummy's car', 'mummy has gone in the car', or 'let's go in the car, mummy.'

At this stage, the child begins to use a few action words e.g. cry, sit etc. They try to talk about events using a mixture of jargon and words. They will ask for help (e.g. 'wash hands') and begin to ask questions.

Three word level

At around three years of age, the child begins to join three words together and possibly four e.g. 'Daddy gone work', 'Mummy go shop'.

Gradually the child will begin to use a wider variety of words as their understanding of the world around them grows e.g. descriptions using size (big/little); positions (in/on/under); colours (red/blue/yellow/green); properties (wet/dirty); emotions (happy/sad) etc.

Activities to develop key word levels

To produce a range of play noises modelled by an adult. E.g. shhh; mmmm; ssss

To use a range of early words spontaneously. E.g. more; again; gone; bye bye; fall down, help.

To use an increasing number of single words (nouns and verbs). In developing the use of language, ensure that the child is familiar with the objects/pictures and is able to give them on request (demonstrating one word level understanding).

Introducing 'action' words or verbs is really important to help develop a child's sentence structure. Other activities to help develop the use of verb words are:

To use short phrases containing two key words.

To use phrases containing at least three key words.

Activities to develop early concepts

Children will need to understand concept vocabulary before they are able to use it expressively (please see concept development in the understanding section).

COLOURS

To name up to four colours

Language: Red; yellow; blue; green; colour(s); Which one?

TOP TIP: Begin by focusing on one or two colour names and then increase the number of colours.

SIZE

To describe objects as big or little

Language: little; big; which is..?

(Remember children may use 'small' instead of 'little')

TOP TIPS: Start with big objects and give the child chance to begin to understand the concept of 'big.' Then introduce small items.

Make sure that the small objects are very small and the big objects are very

big, so that it is easy to see and understand the difference.

Use gesture and a 'big' or 'little' voice to emphasise your meaning.

LENGTH

To describe objects as long or short

Language: long; short; which?

TOP TIPS: Make sure the objects are very short or very long!

When you say the word 'long' extend it e.g. 'L-o-n-g'. Say the word quickly to indicate 'short'.

POSITION

To use language to describe position

Language: in; on; under

Early grammar

As a child's understanding of word endings, word order and structure develops, the child begins to use those elements in spoken language. The development of grammar occurs in stages, as the number of words used increases.

Tenses - children begin by using the present tense '-ing' e.g. 'it going'. By around 4 years of age, they are able to use the past tense, though not always correctly e.g. 'me falled down', 'he wented'. Talking about future events is the most difficult for children to learn and to express grammatically in spoken language.

Negatives - children use 'no' at an early stage to refuse/reject an object or action. This later develops into the use of the word 'not' and later still the shortened version e.g. 'don't', 'won't.'

Plurals - 's' is used early on in development to mark more than one of something e.g. 'my cars', 'apples'. Remember if the child cannot produce the sound 's' they will not be able to use plurals. Some children will not develop a clear 's' until they are 5 years old.

Pronouns - children begin to use early pronouns 'you' and 'me' at around 3 years of age. They then begin to use other pronouns such as 'he', 'she' and 'they' before developing 'his', 'her' and 'their' at a later stage.

Possession - at around the age of 3 - 4 years, children begin to use 's' to show possession e.g. 'mummy's hat', 'daddy's book'.

Question words - by age 3½ children are using 'what', 'where', 'who' questions routinely. Later they begin to use 'when', 'how' and 'why' to question. By 4 years of age, sentences are becoming grammatically correct most of the time. For further information on question forms, please see 'understanding reasoning and thinking' in the 'understanding' section.

Activities to develop early grammar

PAST AND FUTURE TENSES

To use the past tense to describe an action

Language: action words ending in 'ed' e.g. jumped, painted, looked

Copy me- perform an action e.g. jump into a hoop and then ask 'What did I do?' be careful to use a verb that in the past tense has an 'ed' form. Repeat this with a variety of actions and ask the children to describe what you have done.

Simon did- ask the child to copy an action as in 'Simon Says', and then ask 'What happened?'

To use the future tense e.g. 'going to.....'

Language: 'going to.., we will'

NEGATIVES

To use 'yes' and 'no' appropriately.

Language: yes; no

To use 'not' + object/action.

Language: not

Encourage the child to describe actions during group games e.g. 'Jonathan is jumping.' 'Katie is not jumping.'

Ask the child to hide an object in the playhouse or around the room/outside. The adults and other children ask questions to help find it e.g. 'Is it in the sand?' Child responds 'Not in the sand'

PLURALS

To use simple plurals.

PRONOUNS

To use simple pronouns e.g. 'he', 'she', 'they'.

Language: he; she; they

POSSESSION

To use possessive pronouns e.g. his, her, their.

Language: his, her, their

QUESTION WORDS

To ask questions involving 'what?' 'where?' 'who?'

Language: what? where? who?

JOINING WORDS

These are the words that we use to join two pieces of information together in one sentence.

Language: and, because, then, so, but

Have a selection of items e.g. pictures/toy foods and model the use of the word 'and' e.g. 'please may I have an apple and some crisps and some chocolate?' Then ask the child to take a turn, encouraging them to use 'and' themselves.

Play silly games with some 'why?' pictures and ask the child 'why?' something has happened to encourage them to use the word 'because'. You can model this for them first.

TOP TIP: You can also use the 'why/because?' jigsaw on the Twinkl website.

Activities to develop expressive language skills in older children

Barrier games

This can be used for both talking and listening. The child or children either side of the barrier have identical sets of equipment.

One child has a picture or constructs an assembly of objects and then gives instructions to the other to enable him/her to duplicate the picture or assembly.

How do I feel?

In a small group imagine a situation and talk about how you would each feel and what you might say (speech bubbles resource is good here).

Silly stories

Collection of objects/pictures, e.g., horse, lady, man, child, dog, ball, pirate, dinosaur. Adult starts story "Once upon a time there was a dinosaur". Next child (house) continues the story "He lived in a house made of chocolate". Next child (ball) "One day he found a ball under his bed" .....

Narrative

Colour Coding approach. Children take one colour question 'Who, What, Where, When' and sequence a story using their own ideas. For more information, visit http://www.talkingpoint.org.uk/resources/colourful...

Mind map activities

An excellent way for supporting new vocabulary and talking.

Defining and describing

Have a range of objects in a bag or a range of pictures. One child takes an object or picture and is allowed to give 3 pieces of information to describe their item. The rest guess.

Question

Barrier game. One child has an object or picture and the rest ask questions to find out what it is. You cannot say the name of the item.

A good resource is guess Who?

What do you know?

Use a composite picture and take turns in the group (mini circle time). Each child gives a new piece of information about the picture. Extend by talking about a particular object or event in which everyone has been involved.

Tell me how to do it

Use a classroom activity or event which has already been experienced and get a child to re-tell the event in his/her own words.

Allow a child to explain to the others how to play a particular game.

Developing story telling (narrative) skills

TOP TIP: Ask your Speech and Language Therapist about the Blacksheep resources to support narrative skills.

Sequencing skills

Sequencing is an essential skill which underpins many aspects of speech and language. It is the ability to recognise and predict pattern and order. We need sequencing skills to give information such as telling someone about a specific event.

Speech and language is all about sequences:

As children approach school age they will need to learn the special vocabulary of sequencing, words such as start, next, finish or first, second, third.

TOP TIP: Some general work on sequencing will be beneficial for all children but particularly for children with specific speech and language difficulties such as dyspraxia.

Visual sequencing activities

There is often more than one word that can be used in sequencing e.g. first or start, middle or next etc. It is therefore important to decide, in planning, the vocabulary you will use. Use this regularly and consistently, allowing for lots of opportunities for repetition. Make sure that everyone uses the same vocabulary. Begin with visual pattern experiences.

Display visual timetables depicting the routine of the pre-school/school. If the pictures are velcroed to the wall the children can sequence the events themselves.

Copy and continue patterns of two items:

Increase the number of objects as the child becomes more competent.

In group games encourage children to copy an action after you. Introduce another one, then see if the child can sequence the actions e.g. wave, then clap. Puppets could also be used to demonstrate the actions.

Dressing and undressing skills are useful to encourage a child's ability to sequence. They need to know the order in which the clothes are put on. This can be practised when getting undressed for P.E. or dressing a doll or teddy. Commercially made picture games can also be used.

Auditory sequencing activities

This involves the child following sequences of information that they have heard rather than seen.

Word finding difficulties

Learning vocabulary is an ongoing, lifelong process. Each new word has to be effectively processed, stored and then retrieved when needed. Some children have difficulty recalling names for people and objects. Many of us experience this from time to time when we say the word is 'on the tip of my tongue'.

Strategies to help with word finding difficulties:

Encourage the child to use gesture or mime to supplement speech.

Ask the child to show you what they mean, by pointing to the object or a picture of it.

Cue the child in with the first letter or syllable e.g. 'It's a ba.....banana'

Give the child choices to help him/her remember the word e.g. is it a carrot or a potato?

Avoid speaking for the child. This may frustrate them or stop them from trying.

Reflect back and question - repeat the child's phrase.

Accept any reasonable attempt at a word. It doesn't have to be perfect. The important point is the child to get his message across - COMMUNICATION in its widest sense.

Closure - use a build up sentence but let the child 'close it' by saying the last word e.g. 'You'd like a drink of........ ' or 'You need to go to the .........'

Please see the 'vocabulary' section for further information and activities.

Vocabulary

Children who:

MAY be experiencing problems with vocabulary.

Children who are having difficulties with vocabulary will benefit from a structured approach to TEACH them the skills to effectively organise, store and retrieve new words. Learning vocabulary is a lifelong experience.

"Vocabulary at age 5 is a significant predictor of educational success at 30" (Feinstein and Duckworth, 2006)

"Vocabulary experts agree that adequate reading comprehension depends on a person already knowing between 90 and 95% of the words in a text" (Hirsch, 2003).

Please explore the following sections for more information:

Vocabulary

In order to effectively process, store and retrieve words, we need to be able to use two sorts of information: semantic (what it means) and phonological (how it sounds).

Semantic (What it means)

Phonological (How it sounds)

Unless we know a range of words our ability to use language to communicate will be limited. Essential building blocks for sentences will be:

TOP TIP: Make vocabulary important in the classroom. Research has shown that even the most able child will not quickly acquire new words without explicit teaching.

Teaching topic vocabulary

For each new topic, the class teacher should categorise new topic words into the following categories:

Essential - These words are integral to the topic and should be words used in everyday conversation.

Desirable - These words are useful for the topic and they will be encountered again.

'Might be nice' - These are less common words which are topic specific.

Have a few sessions before the topic starts to talk about the new words and record which words the child already knows. Ensure the child understands the essential words and then use a word map or vocabulary grid to work on learning the desirable words. This will support the child to learn how the word sounds, its meaning and how to use it in a sentence.

Review how many words the child understands/uses half way and at the end of the topic. Send the list of words home so that parents can talk about the words with their child too.

For example- a 'Rivers' topic:

Using a multisensory approach:

Use a multisensory approach to ensure accurate storage of the words, for example if focussing on the word 'gorilla':

What does the word mean? Can the child describe where we might see/find it. What it is used for etc. Something else with wheels or that is transport.

Phonological Awareness - Can the child say what sound it begins/ends with? How many syllables? A rhyming word (doesn't have to be a real word)

Speech - Ask the child to say it several times

Grammar - Put the word in a sentence

Orthographic - read and write the word.

From the Tall Ships Project

Vocabulary activities to support word learning and retrieval

Use this activity to reinforce the names of items and the categories to which they belong. For example, have a range of food items to sort into fruits or vegetables.You can make it more interesting for younger children by hiding items around the room or by placing picture cards face down so the child does not know which one they have selected.

Use a selection of items from one category and one item from another. Can the child spot the odd one out? e.g. apple, sock, banana

Word association games: finding links

The first person chooses an item, the next person chooses another item to go with it and so on. For example 'sock', 'shoe', 'welly', 'rain', 'puddle'.

Explain a link

An extension of the game above. Ask the children to explain their link and decide as a group if the link is acceptable.

Making sentences

Have a pile of pictures. The first person chooses a picture and has to say a short sentence containing the target word. To help children develop flexibility several children could make up a sentence for the word. At the higher levels this could be used to explore words with double meanings.

Silly or sensible

The adult says a short sentence containing a target word. The child or group have to decide whether the sentence is acceptable - SENSIBLE or not - SILLY.

To extend this activity, can the children sort out the silly sentences by changing words to make more sense? Again this activity can help children develop flexibility by seeing that a silly sentence can be corrected in more than one place.

e.g. I like to eat worms
Correction- I like to eat toast
Correction- I like to hold worms

Alphabet names

Have a sheet with the alphabet listed. Take a category e.g. animals and then think of an animal for each letter of the alphabet. This can be really hard - encourage the children to seek help and use the opportunity to send them to another area to ask a teacher if they know the item you are stuck with.

Children listen to clues about the item they have to guess. Remember that this game is much easier when the items are physically present.

e.g. This is something we use to open the door. It is silver and shiny.

Role reversal of the above. Young children find it impossible not to say the name of the item, but with practice, can learn to play this game. As a group you can work together to think about which clues work well and which are not very helpful.

e.g. target word: cat
clue: it says miaow
clue: it has a tail

Pick a category and see how many words you can come up with in one minute i.e. animals, transport, parts of the body, vegetables, things you can wear. This can be done individually or in a group. Repeat this category again after a week or 2- can you beat your score?

TOP TIP: Encourage children to use strategies if they cannot think of the word they need. For example:

Speech sounds

Children start to listen to sounds before they are even born. Babies begin to play with sounds through babbling, this then progress to using real words. A child's speech sound development is gradual, some sounds develop much later than others so they will not be able to say them all straight away. For example the "m" sound is usually present by 3 years of age whereas the "r" sound may not develop until the age of 7.

Phonological awareness

Phonological awareness is our ability to hear and recognise the sound patterns in words. It involves rhyming, identifying the syllables in a word and breaking words up into individual sounds e.g. c-a-t. Phonological awareness skills are very important for speech sound production and are essential for the development of reading and writing.

A guide to typical speech sound development

Some speech sounds are usually developed earlier than others. This table can be used as a guide for typically developing children.

Children who have additional needs can be expected to develop sounds later. This should be taken into account before referral. Please speak to your named therapist for further advice.

Typical speech errors and when to refer
Some speech errors are commonly made by typically developing children. They will usually resolve without intervention as the child matures.

Some examples are listed in the table below along with when to refer if the error doesn't resolve on its own. Remember children with additional needs may need longer.

Some errors are more unusual (see below) and it is a good idea to refer to speech and language therapy for assessment if they are present

Top tips

Speech-Sound-Record-Images1 (2)Speech-Sound-Record-Images1 (2)Accept the child's attempt at a word but also repeat the correct version back to them. For example, if they say "tup, mummy" (meaning "cup"), adult says: "yes, there's your cup". Avoid asking the child to try again or repeat after you as they may not be able to do this at the moment and it may cause frustration. Giving a clear model will help.

Try not to correct the child as this may make them anxious. We want to encourage them to talk as much as possible to help to practise these sounds.

If you have not understood, describe the difficulty as yours. For example 'sorry- I'm not listening very well today'. Ask them to show you instead.

Make quiet times. Turn off the television or radio when you are talking, playing or looking at the books together. This will help the child to listen to your speech more easily. Face the child when you are talking together. Sit opposite each other when playing or talking. This helps them listen and see how sounds are made.

Speak simply in short sentences, for example, "here's teddy", "cuddle teddy". This gives the child time to listen to words and how they sound. It's easier for them to copy if you keep it simple.

Listen to the child with patience however unclear they are. Focus on what they say rather than how they say it.

Ask relatives or friends to do these things too. Talking should be fun, not hard work.

Get interested in sounds! Find some fun sounds that you hear every day e.g.

In the street: car starting, fire engine siren, bicycle wheels

In the park: ducks quacking, dog barking, children playing

Inside sounds: clock ticking, vacuum cleaner, mobile phone ringing

All about dummies:

Dummies can be comforting for babies, but overuse may result in:

Activities to support: syllables

Level 1: Moving to Sound

LEVEL 2: Copying Patterns

Nursery Rhyme Rhythm - Beat out the rhythm of a known nursery rhyme or song on a drum or tambourine.

Me then You - In small groups practise clapping loudly, softly, quickly and slowly. Introduce the idea of clapping/tapping patterns, e.g., three short sounds followed by two short sounds. Talk about the pattern as you are clapping/tapping it. Encourage the children to repeat or echo the pattern.

LEVEL 3: Clapping the beats

LEVEL 4: Clapping the beat/s in a given word

Activities to support: rhyme

LEVEL 1: Exposure to rhyme

LEVEL 2: Rhyme Play

Variations: Children can do it in turns round the circle. Introduce the idea that the same 'end bits' are rhyming. At the end, run through all the "words" you have made.

LEVEL 3: Finish the Rhyme

Rhyming Pairs - Make up some silly rhyming couplets with children:
I like rice - it's very nice
I like fish - on a dish
I like jelly - it wobbles in my belly

Forgetful Puppet - Sing or say nursery rhymes using a 'forgetful' puppet who sometimes forgets to say the rhyming words, for example:
'Jack and Jill went up the .....?'
Sometimes the puppet could accidentally put in the wrong word!
'Jack and Jill went up the stairs!'

Talk about how some of the words sound the same - they rhyme!

LEVEL 4: Making a rhyming string from a given word

LEVEL 5: Rhyme Detection

Activities to support: alliteration

LEVEL 1

Recognising Sounds

LEVEL 2

Recognising Differences in Sounds

Butterflies and Elephants - Shake a tambourine and the children run like butterflies. Bang the tambourine and the children stamp like elephants.

"Spot the Difference" - Introduce two identical shakers to the child. Talk about how they look and sound the same. Let the child play with them and listen to the sound they make. Put the shakers to one side and repeat the above with two identical drums. Next choose one shaker and one drum, play them and point out how they sound different. Explain to the child that you are going to play a listening game. Place either a shaker or drum in front of the child but out of reach. Place the other shaker and drum behind the screen. Make sure the child is ready and ask them to listen carefully. Play one of the instruments behind the screen. Ask the child if the instrument makes the same sound as the one in front of them. If it does talk about them being the same, if not then talk about them being different.

LEVEL 3

Introducing Speech Sounds

LEVEL 4

Identifying initial sounds in easy words

Sound plays videos

Top tips videos

Social communication

Social skill is the term used for relating to and interacting with others. It involves social understanding, social communication and social relationships. Social skills include an awareness of self and others, an understanding of the communication process, a desire to communicate and a means to communicate with others. The skills of social communication include:

Joint (shared) attention

Proximity

Eye gaze

Interpreting and using facial expression

Understanding and using body language

Prosody (volume, speed, tone of voice)

Turn taking

Conversational skills

Understand implied meaning

Using language for a range of functions

TOP TIP: Whilst we have split these skills into separate areas, in everyday life these skills overlap and are not used in isolation. Children need to understand the social meaning behind each aspect of good social communication. This is more important

than prompting pupils to use the skills. Simply teaching the children 'the what' will not be enough as they will also need to understand 'the how, where and why' of social communication, demonstrated within situations that are meaningful to them.

Advice and activities to develop social communication skills

JOINT ATTENTION

The foundations of early interaction involve learning to share attention, wait, and take turns. This can start with early activities/games a parent and child do together e.g. blowing bubbles, tickling games.

Please refer to the Play and Attention and Listening sections for more ideas.

Some good strategies to remember:

Reduce the clutter. Only have the activity you want to work on available.

Use visual means to help the child focus e.g.

Objects of reference: Show real objects to your child to help them make sense of what is about to happen, for example, show them the same plate every time they are due to have their dinner. The child can then begin to associate objects with a routine or activity.

Now/next board: these boards can be used with the child to indicate what is going to happen but also highlights the end point of the activity by showing them what is going to happen next. For example: "Now painting then play with cars".

Visual timetable: put photos/pictures in order on a timeline to help the child understand what is happening over a period of time/throughout their day.

Finish box: Once an activity is finished you can put the symbol/work activity in a finish box to signify it has ended.

Start from where the pupil is at - join their focus of attention.

Use the pupil's name first to attract their attention before you speak.

PROXIMITY (personal space)

Children with social communication difficulties may feel uncomfortable when others are within their personal space.

Be aware of the child's tolerance of the proximity of others - stay outside their personal space.

Be aware of any sensory needs the child may have and adjust for these as much as is possible.

Children with social communication difficulties can find it tricky to understand social rules. They may need help to know where it is appropriate to: say hello, shake hands, kiss, cuddle, hold hands. Teach socially acceptable alternatives.

Having a carpet can help the child understand where it is appropriate to sit and can protect their personal space.

EYE GAZE

Good timing of eye contact is important for social interaction and communication.

Children need to learn when, why and for how long to look at others.

Holding objects at eye-level may encourage a pupil to look at you, or prompting with a 'Look' symbol or gesture.

Make sure you are at the right level for the child to make eye-contact - 'get your face in the right place!' (Dave Hewitt, Intensive Interaction). Some children may find eye to eye contact uncomfortable, encourage them to turn towards others rather than look at their faces.

Give praise as appropriate e.g. 'good looking'.

FACIAL EXPRESSION

Facial expressions can be difficult to 'read', especially for children with social communication difficulties. Sometimes we give mixed messages - what we say may not be what we mean, for example, saying 'no' whilst smiling. For older children, social skills programmes, like the Social Use of Language Programme and Socially Speaking contain a range of teaching activities.

Some ideas to consider:

BODY LANGUAGE

Teach social gestures, including: head nod (yes); head shake (no); handshake (hello); wave (bye); finger-point (requesting and responding); thumb up (like or good); thumb down (don't like or not good); standing alongside (to gain attention) hand up (to speak in class); raised palm (stop/wait); shrug (don't know).

Use real contexts and video clips to explain the meaning of body language, linked to facial expression and tone of voice.

Use visual cues such as signs or symbol cards to prompt appropriate body language and social gestures such as, helping children to show 'good listening'.

E.g. Here are 5 ways to SHOW that you are LISTENING to people:

Turn towards the person who is speaking.

Nod your head.

Say "Mmm", "Aha" or "Yes".

Ask a question about the speaker's topic.

Make a comment (say something) about the speaker's topic:

PROSODY- volume, speed, intonation, emphasis

Volume:

Speed:

Use a video or tape recorder to provide feedback as to whether the speed of the child's speech is too fast / too slow / acceptable.

Use a gesture or symbol card e.g. to remind the child to speak more slowly.

Turn-Taking:

SOCIAL USE OF LANGUAGE

Language can be used for a range of reasons:

Express needs, wants, feelings

Volunteer information and make comments

Direct others

Give an account

Start and take part in a conversation

Use language to interact with peers

Use of language to negotiate

Ask a relevant question

Use language to imagine

Give an explanation

Use language for reasoning

Use language descriptively

Supporting social communication skills in older children

As children get older, they may present with:

You can help by:

Restricting your language to short unambiguous phrases.

Trying to keep children 'on topic'.

Keeping your instructions direct and in the order you wish them to be carried out e.g. 'first go and get your history book then go to the library' instead of 'before you go to the library, go and get your history book'.

Be clear in what you want the child to do e.g. 'I want you to go and fetch Mr Smith' instead of 'Would you like to fetch Mr Smith for me?'

Make instructions e.g. 'please sit down' rather than 'don't wander around'.

Make use of the child's motivations and real life experiences to help their learning.

Help the child through demonstration to understand appropriate conversational rules e.g. how to ask for help, how to request clarification.

All children respond well to a clear system for rewards e.g. a visual sticker system. Consistent use of this is important, particularly for a child with social communication difficulties.

Certain situations such as, transitions between lessons and/or activities can cause an element of anxiety. Try to maintain a routine that is safe, calm and predictable. Consider the use of pen portraits to support children in an unfamiliar situation.

Work to the child's strengths such as, use visual means of teaching and learning e.g. written instructions, information and key words; diagrams; tables; charts; maps; illustrations; photos; objects.

Provide extra support for subjects with a high language content e.g. English, RE, History.

Group tasks can be difficult because of the social demands of working with others- support by:

Allocating students carefully

Working with the same person / people where possible

Making sure the student understands what to do within the group

Supporting and withdrawing gradually

Making sure the others are listening

Giving time to organise and settle

Home-school communication is important. Families can supply useful information about the pupil's anxieties and coping strategies. Try a home school diary.

Children may need to be forewarned of changes in routine or planned events.

Children with social communication difficulties can at times say something that can be misinterpreted as being rude. Carefully explain the rules/social requirement- you can use social scripts to support this. A social script will support a pupil's understanding of a particular issue and explain how to respond in a socially acceptable way.

Children may find unstructured times difficult e.g. break times, school holidays. Help them to plan their time, such as by using visual schedules, calendars, diaries or planners. Other suggestions include:

Provide a safe haven where the student can go

Introduce a buddy system

Encourage them to attend clubs/games

Yr 11s could help in Yr 7 clubs

Undertake Role Play

Give defined options - give them choices about what they can do at break

Structure / separate the key stages

Rotate or stagger lunch breaks

Provide activities to be getting on with

Teachers to get there before students

Teach the cues that indicate unstructured time

Pre-teach through role play

Use Buddy systems

Pre-teach through using social scripts

Work on friendship skills - concept, strategies for making and keeping friends. 'Friends' club and special interest groups can help.

Explicit discussion of class rules including 'good listening' behaviour and a visual display of these.

Stammering

Learning to talk, like learning to walk, is never completely smooth and does not happen straight away. Young children often stop, pause, start again and stumble over words. Between the ages of 2 and 5 years it is normal for a child to repeat words and phrases and hesitate with "um's" and "er's" when they are sorting out what to say next. Approximately 5 in every 100 children stammer for a time when they are learning to talk. Many find it easier to talk fluently as they get older.

What is stammering?

A child who stammers may:

More information can be found on the British Stammering Association website .

Means, reasons and opportunities

Research has found that children and babies learn to communicate when they have a means, a way of communicating, opportunities to communicate and reasons to communicate. They also need adults who are responsive to how they communicate.

Means

Reasons

Opportunities

For example: if your child is in the garden playing on their own and everything is available to them, they do not have any reason to communicate as they are happy and can meet their needs independently. You are not there so there is no opportunity for them to communicate and a means of communication will not be developed as this is not being modelled to them by an adult.

Means of communication

Everyone needs a means to communicate but there is a lot more to communication than just talking! Think about Pingu and Mr Bean, they do not not use many words but everyone understands what is happening including what they are thinking and feeling. Communication can be verbal, for example babble, making noises, saying words, phrases and sentences or non-verbal for example; crying, facial expressions, showing emotions, pointing, gestures or using signing or symbols. Research show that only 7% of communication is verbal, even for adults, therefore developing non-verbal communication is really important. It is also importamnt for all of the adult in the childs environment to be aware of their preferred method of communication whether its verbal and/or non-verbal.

Observe your child: How do they communicate?

Spend some time watching and observe your child to see what methods of communication they use. Do they make eye contact, pass you things, tap you, take you by the hand, point, reach for items or gesture.

Just because they might not be talking does not mean that they are not communicating. Interpret their attempts at communication as meaningful.

Reasons for communication

Everyone needs a reason to communicate. Children are unlikely to communicate unless they really want to and are motivate otherwise there is simple no point.

Children may communicate to:

express feelings; e.g. tired, hungry, poorly, happy, etc.

indicate wants and needs e.g. to make requests, choices, reject items or to gain attention

Later children may communicate to greet, instruct, comment, ask questions or for the pleasure of chat, socialising, forming relationships and to share information.

What is your child motivated by?

Identify the things that motivate your child. For example; they might love certain food, toys, activities, songs, TV characters, rough and tumble play, numbers or letters, materials such as sand and water, ordering, filling and emptying.

We much encourage communication by creating opportunities for children to request the things that motivate them.

Opportunities to communicate

As parents and carers and adults we need to provide opportunities for children to communicate. Strategies to help include:

Activities to develop requesting

Offer choices

The easiest choices to make are between something that you are really motivated by and something that you are not; don't be afraid to offer items that you know your child does not want/like as this will help them to develop their cause and effect understanding and their ability to choose (e.g. 'Do you want broccoli or car?').

Hold up the objects so that they can see them and say the words.

When they become good at indicating their choice, make the choice harder by offering 2 motivating things e.g. 'Do you want car or train?'.

If this becomes too frustrating for your child offer choices in less motivating situations (e.g do you want to wear the yellow t-shirt or the blue t-shirt?, do you want red bubbles or blue bubbles in the bath?).

Remember to offer a choice, wait for your child to respond and then reward them.

Watch this video for further information: https://youtu.be/sh7RcN9Hoyo.

Offer items bit by bit

Give your child a small amount of something motivating, for example; one piece of jigsaw, one brick, one crisp, one piece of train track, one slice of banana, etc.

Ensure that they can see that there is more available and wait for them to respond.

Then model a key word such as more, chocolate, bubbles, etc. and reward them with more.

Watch this video for further information: https://youtu.be/nYAAt2xEpLg.

Place items out of reach, but in view

Put a highly motivating toy or snack in a clear bag or box and wait for your child to communicate to request it. For example; put your child's comforter in a clear bag or box, put out all of the train set but have the trains in a clear box , put an out Inset puzzle board but keep pieces in clear bag.

Place their favourite toy on a shelf and wait for them to respond - this may cause some behaviours and frustrations (please consider that if your child likes to climb it may be safer to put their toy in a clear bag/box that they cannot open instead). This behaviour is a means of communication from which you can model how to respond (e.g "want", "open", "more").

Watch this video for further information: https://youtu.be/yKGBsIVSZiU.

Use toys that they need help with

Use toys that your child can not operate on their own such as: wind up toys, pop up toys, bubbles, balloons, jack in a box, spinning tops, music boxes, etc.

Watch this video for further information: https://youtu.be/KyVjZAyjKHY.

Create people games

These are games that you play together without toys, for example peek-a-boo, chasing, tickling, rough and tumble play, etc.

Establish a simple play routine and then pause and wait for them to respond.

When your child responds reward them with more of the activity

Watch this video for further information: https://youtu.be/bu2_ElaFmZ8.

Pause a familiar activity or routine

Sing a familiar interactive nursery rhyme or song such as Row Row Row the boat, Horsey horsey, Round and round the garden, This little piggy, The Grand Old Duke of York, etc. Then pause, and wait.

Look for opportunities at the park or in the garden: For example: When pushing them on a swing, catch the swing to stop it, and wait, or when on the roundabout, see-saw or slide.

Develop a play routine at bath time or during water or sand play; fill a jug and lift it up up up and then pour. Repeat the routine but pause before you pour and wait for our child to communicate. Try pausing at the end of the play routine to see if you child can request more or again

Watch this video for further information: https://youtu.be/9w7zzbF0uhw.

Use Sabotage: give all but one item

Think about routines that your child is familiar with such as snack time, toy play, leaving the house, bath time etc. Think about what you could change to create an opportunity for communication.

Give all but one item. Hold the item out of reach but in sight, and wait

For example:

Give the bubble wand, but not the bubbles.

Give the tools and cutters but not the playdoh

Give a cup but not the drink

Give road mat but not the cars

The train track but not the trains

Some paper but no pens

Their coat but no shoes

Give then the tablet but don't turn it on

Put the TV on but not one of their programmes

A battery operated toy that's turned off

Watch this video for further information: https://youtu.be/-JBxlgq1nKw.

Top tips

Introducing these new strategies may initially cause some frustration because your child is no longer getting their needs and wants met immediately and will now have to work for these. It's important to choose the right time to introduce the strategies (e.g. not when they are playing with their favourite toy/when they are tired/ hungry or frustrated).

Strategies can be introduced gradually; for example, at one point in the day initially and then build these into more activities throughout the day until it becomes part of your daily routine.

When carrying out the recommended activities, remember to:

Model: To support development; encourage family members to model requests so the child can

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Attention and Engagement is an intervention model which aims to develop natural and spontaneous communication through the use of visually based and highly motivating activities. The primary objective is that the sessions are fun and "offer an irresistible invitation to learn"!

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This board is an excellent way to show children what activity they’re doing and what they will be doing next, once the first activity is complete.

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The workshops and groups we deliver are easy to access virtually.

It can be quite scary attending a group or a workshop when you don't know anyone else in the group. If you are worried about coming to a group or workshop there are lots of things we can do to support you.

Here is some feedback from other young people:

It is really good! Everyone is friendly and you learn some really helpful things which you can keep practicing.

I would say that I was worried before I started a group but once you get in to it it's completely fine and you forget about being nervous. From my experience once the session had started I felt more confident in myself

Although the groups and workshops are to support your emotional wellbeing, they are not like attending a lesson in school. They have been proven to have a positive effect on your emotional wellbeing and are there to help you with life's problems before they get too much to handle.

Top three benefits of groups and workshops:

You're not alone and they help you to realise that we all have similar experiences, but cope with them differently

Making new friends and building positive relationships

Groups and workshops include lots of interactive activities, games, quizzes, alongside learning some new skills to manage your emotional wellbeing.

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The workshops and groups we deliver are easy to access virtually. It can be quite scary attending a group or a workshop when you don't know anyone else in the group. If you are worried about coming to a group or workshop there are lots of things we can do to support you.

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Helping your child sleep
Many children have sleep issues. But for those with autism, sleeping well may be particularly difficult. Here we look at how families can help their child to sleep well.
Sleep disorders

How do you define a sleep disorder?

It's important to consider your own expectations about when and how much a child should sleep.

There are no guidelines on how long a child should sleep.

Most babies do not sleep all night every night until they are around a year old.

Having 'slept through', many babies return to night waking.

Children can't simply go to bed early and wake up late. They won't remain asleep for more than a certain period of time.

How much sleep a person needs can vary considerably.

All children are likely to have brief periods of poor sleep after illness, during holidays and festivals like Christmas or during periods of particular stress such as exams or if somebody close to them is ill. After events such as these, a normal sleep pattern should be established again within a few days.

If your child is regularly unable to sleep or has a period of good sleep which is disrupted, they may have a sleep disorder.

We recommend keeping a sleep diary to record when, where and for how long your child sleeps. This can be a first step in addressing any issues. If your child is at nursery or school, speak to staff so that they know about the problem and can offer support. Approach your GP or social worker too, and ask about a referral to an expert in sleep disorders.

What causes sleep disorders?

The answer to this is likely to be different for every person. Unfortunately, it seems that virtually all children with autism are likely to suffer from disturbed sleep patterns at some point or another, but we don't know why.

Sleep problems can be divided into:

settling problems, where a child has difficulty going to sleep

waking problems, where a child wakes repeatedly during the night

'social cueing' problems, where your child doesn't make the connection between the family going to bed and their own need to sleep

melatonin issues

sensory issues

problems caused by allergy and food sensitivities

hypersomnia - sleeping too much.

Settling and waking problems
Donna Williams, who has written extensively about living with an autism spectrum disorder, describes her fear of falling asleep in her autobiographies:
Sleep was not a secure place. Sleep was a place where darkness ate you alive. Sleep was a place without colour or light. In the darkness you could not see your reflection. You couldn't get 'lost' in sleep. Sleep just came and stole you beyond your control. Anything that robbed me of total control was no friend of mine.
Somebody somewhere, Donna Williams
I was afraid to sleep, always had been. I would sleep with my eyes open and I did this for years. I guess I did not appear to be terribly normal. 'Haunting' or 'haunted' would have been better adjectives. I was afraid of the dark, though I loved the early dawn and dusk.
Nobody nowhere, Donna Williams

These descriptions are subjective and do not necessarily describe the experience for everyone. They do suggest that Donna had more problems with settling than waking. We don't know which problems children with autism are most likely to suffer from although we are aware of children who have problems with both.

In Donna's case her fear of the unknown prevented her sleeping and this may well be true for some children with autism. For most children with autism this is unlikely to be the only explanation. Many children will have disturbed sleep as a result of a number of root causes.

Waking problems may in some cases be a continuation of settling problems - like the child who wakes up to go to the toilet but then finds it difficult to fall asleep again. In very young children waking problems are an indication that they still haven't developed mature sleep patterns. As babies they woke up to feed every couple of hours and this pattern has persisted. In the older child with autism there may be an indication that they suffer from sleep disturbances. This could mean anxiety making it difficult for them to fall into a deep sleep or acute nightmares waking them up.
Social cueing problems
Although many experts would suggest approaches to settling and waking problems which require the parent to gradually give less and less attention to the child, we would suggest that attention is unlikely to be the main motivation for a child with autism. Instead, coping with waking problems may require consistent reassurance on your part and a creative approach to your child's needs.
Melatonin
Children with autism may have difficulty understanding why and when they need to sleep. Problems with 'social cueing' - that is learning why and in what order things should happen - are common in autism and this may mean your child does not make the connection between their family going to bed and their own need to sleep. Some children may find the transition from sleeping in their parent's room to their own room by themselves difficult. This can be related to difficulty with change but also the need for reassurance around bedtime and sleeping.
Sensory issues
This is a hormone secreted by the pineal gland. It has been shown to regulate sleep patterns in animals and that taking melatonin supplements can help to ward off jet-lag. It is also thought that patterns of melatonin secretion may be irregular in children with autism. It isn't that they don't produce it but that they don't produce it at the right times of day.
Food and drink
Children with autism can have significant problems with hypersensitivity to touch, visual stimuli or sound. This can be both distracting and distressing and make the process of falling asleep very difficult. For more on sensory issues, see www.autism.org.uk/sensory
Hypersomnia - sleeping too much
If your child has caffeinated drinks close to bedtime, such as tea, coffee or cola, this might disturb their sleep. Some people with an ASD also have gastrointestinal problems, so they may experience discomfort during or after eating, such as wind or constipation, which might disturb their sleep.

If you keep a sleep diary, you may find that your child sleeps for far longer than you would expect. This is a condition known as hypersomnia. Contact your GP for advice or a referral to a paediatrician.

For some children with autism, their bed or bedroom may simply be a place where they feel comfortable and relaxed. You could try cues or incentives for getting up, eg

Making waking up sessions as gentle and relaxed as possible. One suggestion from the Parent survival manual came from the family who woke their son up by sending their pet cat into his bedroom. This meant he got up in a good mood. You could try doing something similar with your child's favourite toy or glove puppets.

Playing gentle music at around the time your child is waking up.

Using breakfast or other reward as an incentive.

Sticking to the same structured routines each day.

Older children and teenagers are especially likely to have motivational difficulties. They may have very real fears about the day ahead, or be experiencing depression. Excessive sleep in this age group could signify psychological problems and it is important to investigate.

What can we do?

Keep a sleep diary

Sleep diaries can be useful for a number of reasons:

They can help to establish any unusual patterns of sleep.

If you do decide to try any routines, behavioural modifications or dietary changes to help your child to sleep, then a sleep diary will allow you to see if what you're doing is working consistently, sporadically or not at all.

You can show a sleep diary to professionals involved in your child's life, such as teachers, GPs or social workers, to give them a clearer idea of the impact your child's sleep patterns are having on your son or daughter, and on you and your family. People may assume you're exaggerating if you tell them you only get an average of two hours sleep a night but if you can show them charts with times specified they may take more notice.

Certain benefit application forms, for example the one for Disability Living Allowance (DLA), ask you how often you have to get up in the night to help your child. You can send in a copy of the sleep diary to support your application.

A sleep diary can act as a visual reminder for more able children with autism of their disruptive sleep patterns. They can then be used to establish incentives for staying in bed and trying to sleep, eg a gold star for every night when the child doesn't get out of bed plus a small reward if the child doesn't get out of bed for three nights in a row.

For an example of a sleep diary, see page 16 of the National Children's Bureau's Information about sleep.

Establish a routine

Children with autism respond well to routines because they allow them to feel safe and in control. Create a routine that you can use every day and anywhere. If you make playing on a particular climbing frame part of the routine, this will be a problem if you stay overnight somewhere else. Here's an example:

6.00pm: dinner

6.30pm: quiet time

6.45pm: drink

7.15pm: bath

7.25pm: clean teeth

7.30pm: bedtime/sleep

7.30am: waking up/getting up.

A new routine can take time to get used to. It may help to present the routine visually and you could include quite a lot of detail, for example: close the curtains, get into bed, turn the light off, lie down, pull the cover up. It may also be worth setting aside time to prepare for the next day in the routine. This could include getting the school bag ready or making a list/timetable of things that need to be done the next day.

Consider changes to food and drink

Changing bedtime routines can be stressful and if your child is used to having certain drinks or snacks near bedtime, suddenly switching to something different may be counterproductive. However, you could try changing to decaffeinated tea, coffee and cola, or reducing the amount of the food which could be causing wind or constipation.

Alternatively, you could try gently phasing certain foods out over a period of days or weeks so that less and less is consumed overall without anything suddenly being taken away. For example, you could offer one biscuit instead of two, or mix decaffeinated and caffeinated drinks together.

Some people advocate making radical changes to a child's diet like completely eliminating caffeine. We suggest that this is only worth doing if you have already tried a more moderate approach. We also suggest that you visit a dietician before introducing any major changes just to check that you're continuing to offer your child a balanced diet.

Use relaxation techniques

Children with autism may feel particularly anxious around bedtime and not be able to articulate their need to unwind. Relaxation techniques can helpful. Here are some examples.

A few drops of lavender oil to your child's bath.

A gentle foot, hand or scalp massage.

An hour's quiet time before bedtime. Doing a quiet activity could help your child to unwind. It also provides a social cue: if everyone in the house is quiet and relaxed then it is time to get ready to sleep. You could mark the quiet time on a daily timetable so the child knows what to expect and becomes familiar with this routine.

Music.

Gentle exercise, such as yoga.

Gentle lighting in the bedroom.

Time each evening when your child can talk about their day. It may help to have a "worry book"; so your child can write down or draw any concerns before they go to bed.

Rough and tumble play. Although this is the opposite of quiet time, it might be more effective for your child.

Make sleep more comfortable

Your child might find being in bed uncomfortable. Some children are very sensitive to light, sounds, smells and touch. Here are some ideas that could help.

Block out light using dark curtains or black-out blinds.

Reduce noise using thick carpet, shutting doors fully, turning off appliances, and moving your child's bed away from a wall with activity going on on the other side.

Block out noises by letting your child use ear plugs or listen to music through headphones.

Remove labels from bedding and night clothes, or try bedding and nightclothes made from other materials.

Reduce smells coming into the room by closing the door fully, or by using scented oils that you child finds relaxing.

Use a weighted blanket - these are made from thick material with bean-filled pockets - which some people believe can calm children with autism by allowing them to better feel their movements and understand where their bodies are in space.

Remove distractions, such as toys on the bed and pictures on the wall (unless your child finds these relaxing), and consider a different colour on the walls.

For more, see our information about environment and surroundings at www.autism.org.uk/environment

Explain sleep

Children can have difficulty understanding the need for sleep. A social story™ (developed by Carol Gray) could be used to explain this. Here is an example of a social story™ by Carol Gray, taken from My social stories book, Jessica Kingsley Publishers, 2002.

What does it mean when people say, "Time to go to bed"?
All people sleep. Most people sleep on Monday, Tuesday, Wednesday, Thursday, Friday, Saturday and Sunday. They wake up each morning. I sleep in a bed. Usually Mom or Dad says, "Time to go to bed." This means it is time to get into bed and go to sleep.

Copyright © Jenison Public Schools and the Gray Center for Social Learning and Understanding 2002
Reproduced by permission of Jessica Kingsley Publishers

For more information, see www.autism.org.uk/socialstories

Visual supports such as flow charts could also be used to explain sleep or children's books that provide the biological explanation for sleep. For more, see www.autism.org.uk/visualsupports

Medication

Medical interventions are typically seen as a last resort in treating sleep disorders in children as they can be habit-forming and they don't always treat the root cause of the problem.

Melatonin supplements are only available on prescription in the UK. For further information you should consult your GP. Some foods are rich in melatonin such as oats, rice, sweetcorn, tomatoes, plums, bananas and brazil nuts, but current research is not clear whether a melatonin-rich diet could be effective in helping children to sleep.

As a general rule it is better to minimise the medication your child is on but at certain times it may be desirable to have a mild sedative to hand, for example, if you are going on holiday and are concerned about the consequences of jet-lag, or if you feel that your child's health is genuinely suffering as a result of their poor sleep. GPs may be prepared to prescribe under these circumstances.

Some parents have found that using medication in tandem with a behavioural approach can help to restore a good sleep pattern. The combination is crucial as without the behavioural intervention when the medical treatment ends the child is likely to return to their old sleep patterns.

Natural remedies

Health food stores offer "natural" remedies which claim to treat insomnia and other sleep disorders. It's important to consider how such products might interact with any other medication you child is taking. If you are thinking of trying a "natural" or "alternative" remedy, you should discuss this with your GP first.

Common problems and possible strategies

David Bramble is a consultant psychiatrist who works for Shropshire CAMHS and specialises in the mental health of children with learning disabilities. He has a longstanding interest in children's sleep problems and works with a number of children with autism and their families. He suggests the following strategies to be tried for common sleep problems: (Taken from the 2006 BILD conference: Valuing good practice in autism)
Children who insist on parent's presence
Graded withdrawal

Lie next to child on bed for three nights.

Lie on mattress next to bed for three nights.

Move mattress closer to door every three nights.

Sit on chair in bedroom at door with door open for three nights.

Sit outside door whilst still visible to child for three nights.

Sit outside door not visible to child for three nights.

Sit outside room with door closed for three nights.

Social stories could also be used to reassure your child that they are safe when sleeping/alone.
For night waking
Scheduled awakening

From sleep diary see when child wakes up during the night.

Set alarm clock for 30 minutes before this.

Wake child and allow to fall back to sleep.

If child doesn't fall back to sleep try waking 45 minutes before on the next night and experiment until you find the best time.

To ensure your child is sleepy at bed time
Restricting sleep:

From sleep diary see average hours of sleep per night.

Calculate ninety percent of this and make this the new sleeping time (delay bedtime and/or waking time) - never restrict below five hours.

If lying awake occupy in another room until sleepy.

Avoid naps in day/oversleeping at weekend.

After a week move settling/waking time by 15 minutes - continue until desired pattern of sleep occurs.

Summary

None of these suggestions can be guaranteed to work in themselves. You may find that a combination of them proves most effective. Close examination of your child's sleep diaries is likely to give you the greatest insight into what is causing your child's problems and which solution is most likely to work. When implementing these strategies, problem might get worse before it gets better. However it's important to remain consistent in your approach. Rewarding and praise following a better night's sleep will help to positively reinforce it.

Getting some sleep yourself

Getting proper night's sleep is hugely important. It may have been suggested that you sleep when your child sleeps, but this won't necessarily be convenient and it can be difficult to 'switch off' on demand. By the time you have got your child to sleep, particularly if they needed calming down, you may feel too wound up to sleep yourself.
Safety-proofing
Making your child's room safe can be one of the easiest ways to improve your own sleep. If you know that your child cannot do any harm while you are asleep, it can help you to relax.

In the Parent's Survival Manual author Eric Schopler cites a number of parents who have found creative ways of achieving this. One parent installed a stable door in their child's bedroom. In the evenings after the child had gone to bed but was still awake the parents left the top half of the door open but the bottom half closed. The child stayed in the room but was able to call his parents should anything happen. This meant the parents had time to relax in the evenings before going to bed, could look in on their child without disturbing or distracting him and were able to respond quickly if the child had any accidents. For more, see our information about environment and surroundings at www.autism.org.uk/environment
Getting respite
All parents of children with disabilities are entitled to be assessed to see if they're eligible for respite services. Unfortunately, there's no specified minimum and the amount of provision families receive can vary enormously. If you're not currently receiving any services then you should contact your local social services department and request an assessment of need for your child and a carer's assessment for yourself. For more, see our community care information at www.autism.org.uk/benefits

Further information

What other help is available?
The approaches recommended in some parenting books can often be inappropriate for children with autism for a number of reasons. We also recognise that long term lack of sleep can make it very difficult for parents to effectively implement a behaviour modification programme when their primary agenda is getting back to bed. For this reason we would suggest trying to get someone outside the immediate family to support you during this time.

There are far too few specialists able to help parents of children with autism who have sleep disorders. But there are some and you can contact your GP, social worker or your child's school for help and advice.

You could talk through the issues with an adviser at our Autism Helpline (0808 800 4104, www.autism.org.uk/enquiry).

You may also find that other parents have been in the same position and are able to talk it through with you. Use our Autism Services Directory to find National Autistic Society branches and other support groups in your area: www.autism.org.uk/directory

We also operate a telephone support service called Parent to Parent provided by parent volunteers. Call 0808 800 4106 and leave a message on our 24 hour answer phone. We will call you back as soon as possible at a time that suits you, including evenings and weekends. Alternatively you can use our online enquiry service at www.autism.org.uk/p2p

Useful reading

Betts, D.E and Betts S.W. (2006). Yoga for children with autistic spectrum disorders. London: Jessica Kingsley Publishers ISBN: 978 1 84310 817 7

*Dunn Buron, K. (2003). When my worries get too big: a relaxation book for children with autistic spectrum disorders. Shawnee Mission, KS: Autism Asperger Publishing Company ISBN: 978 1 93128 292 5

Durand, V.M. (1998). Sleep Better! A guide to improving sleep for children with special need s. Baltimore, MD: Paul H. Brookes Publishing ISBN: 1557663157

Gray, C. and White, A.L. (2002). My social stories book. London: Jessica Kingsley Publishers ISBN: 978 1 85302 950 9

Harrison, J., Price, S. and Sanderson, H. (1991). Aromatherapy and massage for people with learning difficulties. Birmingham: Hands On Publishing

Williams, D. (1992). Nobody nowhere. London: Jessica Kingsley Publishers. ISBN: 1853027189

Williams, D. (1994). Somebody somewher e. London: Jessica Kingsley Publishers. ISBN: 9781853027192

If an item is marked *, it is available from the NAS. Please contact:

Central Books
99 Wallis Road
London E9 5LN

Tel: 0845 458 9911 (overseas: 0044 208 525 8810)
Fax: 0845 458 9912 (overseas: 0044 208 525 8879)
Email: nas@centralbooks.com

Contact the NAS directly by emailing publications@nas.org.uk

Order online at www.autism.org.uk/pubs

Contacts

Cerebra Sleep Service
Cerebra is a charity for children with brain-related neurological conditions. They have a team of sleep practitioners covering parts of the UK who can offer help and advice on sleep issues.
Tel: 01267 244210
Email: sleep@cerebra.org.uk
Web: www.cerebra.org.uk

ISIS: Infant Sleep Information Source
The ISIS website gives information about normal infant sleep for parents who wish to make informed choices about infant sleep and night-time care and for health professionals who wish to share evidence-based information with parents about infant sleep. Web: www.isisonline.org.uk

Rompa
Sells weighted blankets and other sensory products.

Tel: 0845 230 1177
Email: sales@rompa.com
Web: www.rompa.com

The Children's Sleep Charity
The Children's Sleep Charity was set up by a sleep practitioner to support parents and children to improve sleep patterns. The charity runs workshops for parents in autism and sleep issues.

Tel: 07912 667676
Email: info@thechildrenssleepcharity.org.uk
Web: www.thechildrenssleepcharity.org.uk

TFH UK
Sells weighted blankets and other sensory products.

Tel: 01299 827820
Email: info@tfhuk.com
Web: www.specialneedstoys.com

Adapted from National Autistic Society - www.autism.org.uk

February 2016

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Skip to content ↓ Many children have sleep issues. But for those with autism, sleeping well may be particularly difficult. Here we look at how families can help their child to sleep well. Sleep disorders It's important to consider your own expectations about when and how much a child should sleep.

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Please see our homepage or go via FAQs - Upcoming events for more information on the training events and links to book.

WTT support for Lincolnshire mainstream settings and individual children/young people through working with those settings, is via the WTT Ladder. Please see the attachment below for more information on the Ladder.

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Please see our homepage or go via FAQs - Upcoming events for more information on the training events and links to book. WTT support for Lincolnshire mainstream settings and individual children/young people through working with those settings, is via the WTT Ladder. Please see the attachment below for more information on the Ladder.

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SEND Review.
"The SEND review sets out government's proposals for a system that offers children and young people the opportunity to thrive, with access to the right support, in the right place, and at the right time, so they can fulfil their potential and lead happy, healthy and productive adult lives"
"The SEND review is a response to the widespread recognition that the system is failing to deliver for children, young people and their families"

LPCF will be exploring these proposals and will be giving parents on the LPCF membership a chance to give your views on them.
Your views will then be fedback to the Government through the LPCF response to the consultation.

Please join LPCF to hear more about them and tell us what you think.

If you are a member of LPCF you will receieve the Invitation through your emails or on the Facebook events page.

If you would like to join the Consultation but have not joined LPCF please sign up here

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SEND Review. "The SEND review sets out government's proposals for a system that offers children and young people the opportunity to thrive, with access to the right support, in the right place, and at the right time, so they can fulfil their potential and lead happy, healthy and productive adult lives" "The SEND review is a response to the widespread recognition that the system is failing to deliver for children, young people and their families" LPCF will be exploring these proposals and will be giving parents on the LPCF membership a chance to give your views on them.