Some of the specialisms we’re proud to support
Autism, or Autistic Spectrum Disorder (ASD), or Autistic Spectrum Condition (ASC) - is a lifelong condition affecting how people communicate and interact with others and how they relate to the world about them.
Autism is diagnosed by two elements: social communication difficulties and restricted, repetitive behaviours or interests. It can be described as a continuum of normal development or a spectrum, from mild, or high-functioning autism, often known as Asperger Syndrome, to a severe, non-verbal condition.
It is estimated that about one in 100 people are autistic, a greater number of boys than girls. Autism can co-exist with other pervasive conditions, such as ADHD, PDA or dyslexia. The diagnostic criteria for autism are continually being reviewed and developed.
All people with Autism have some degree of social and communication difficulties. Some people may have accompanying learning disabilities, others have average or above-average intelligence.
People with learning disabilities will sometimes have multiple conditions that co-exist, overlap and interlock to create a complex profile. These conditions can mean that they present with a range of issues and combination of needs that affect their: –
- mental health
- ability to form and manage relationships
- physical appearance
- sensory input
- communication ability
- cognitive ability
These needs often interact in ways that are specific to the individual, and therefore challenging to diagnose or treat. Where someone’s needs aren’t being understood, complex needs can present as challenging behaviour, resulting in services not being delivered in a way that meets the person’s needs.
Specialist person-centred support can help individuals to engage effectively and to participate meaningfully in the wider community.
Social Emotional Mental Health (SEMH)
The term originated in the 2014 SEN Code of Practice and replaced the term SEBD (Social Emotional Behaviour Difficulties). This move towards recognising the behavioural link to Mental Health has been a long time coming in the eyes of many. Although the term “behaviour” has been removed from this acronym, within the SEN Code of Practice behaviour linked to Mental Health and emotional wellbeing underlying needs is a common theme. The concept of addressing needs rather than attempting to subdue behaviours has led to a more informed, whole child approach.
Emotional & Behavioural Difficulties (EBD)
‘EBD’ Emotional and Behavioural Difficulties refers to a condition in which behaviour or emotional responses of an individual are so different from generally accepted norms, that they adversely affect that child's performance. The term EBD is a broad term often used to group a range of more specific difficulties such as behaviour which interferes with a child's own learning or the learning of their peers. EBD is generally a specific diagnosis where the child displays persistent and severe behaviours. It can also be referred to as 'Social, Emotional and Behavioural Difficulties' (SEBD). Due to the potential emotional difficulties or disturbance, children with EBD may refuse or unsuccessfully be able to utilise educational opportunities offered to them and are therefore potentially difficult or challenging to manage. Often due to the fact that the child’s brain receives and processes information differently than a child who does not suffer from EBD.
Moderate Learning Difficulties (MLD)
Moderate Learning Difficulties (MLD) is a term applied to children who have difficulties resulting in school attainments below expected levels in many areas of the curriculum, despite academic support and differentiation.
There may be other, specific special needs such as dyspraxia or it may occur as part of a larger condition such as Down's Syndrome. It is sometimes called Intellectual disability or generalised learning difficulty. However MLD is not a recognised international diagnostic term and tends to be applied fairly loosely when a child’s IQ test results fall below the normal range. This should be ascertained in an assessment by an educational psychologist.
Children with MLD may have some or all of the following:
Difficulty understanding basic concepts. Problems acquiring basic skills in reading, writing and numeracy with a resultant lack of confidence to use and develop the skills they do have. A lack of logic. Poor problem-solving skills. An inability to generalise learning and adapt it to new situations. Limited communication skills coupled with immature social and emotional understanding. Difficulty with personal organisation. Poor auditory/visual memory. Poor long and short term memory; difficulty remembering what has been taught. Speech and language delay. Emotional and behavioural difficulties.
Severe Learning Difficulties (SLD)
The term Severe Learning Difficulties (SLD), or Severe Learning Disorder, is applied to a child who finds it difficult to understand, learn and remember new skills and has trouble adapting their skills to daily life.
Difficulties may be further compounded by emotional and behavioural issues, difficulties with communication, or within a diagnosed condition like autism. The term is loosely applied to children with a significantly low score in a formal IQ test, which can be measured by an educational psychologist.
Profound Multiple Learning Difficulties (PMLD)
Children with profound and multiple learning disability (PMLD) have difficulties in more than one area, including severe learning disability, combined with other significant problems and complex needs. Many are lifelong wheelchair users.
The problems and complex needs experienced by children with PMLD may include physical disabilities, sensory impairment (sight and hearing), autism, social-emotional and mental health needs and severe medical issues such as epilepsy. These children have considerable difficulty communicating, very limited understanding, and many show challenging behaviours. They require a high level of adult support for both learning needs and personal care throughout their lifetime.
But it’s important to remember that people with PMLD are a diverse group of individuals with their own personalities, preferences and ways of communicating. The abilities of these children vary considerably.
Most children with VI attend their local school with specialist support from a local authority service; some go to a mainstream school that is specifically designated for blind and partially sighted pupils; others go to a special school for blind pupils.
Those with VI and additional or complex needs will probably attend a special school.
Wherever pupils with VI are educated, it is essential to provide a range of educational and social opportunities to enable them to participate on an equal basis with their fully sighted peers. Some will need minimal adaptations; others may have substantial needs.
Attachment Disorder (AD)
Attachment Disorder (AD) arises when an infant or child under the age of five suffers an early life trauma and then fails to form normal loving relationships with their primary carers.
Children with AD have difficulty developing normal emotional attachments to others, usually formed within the first few months of life with a parent or caregiver.
It is an emotional and behavioural condition and symptoms include low self-esteem, lack of trust, difficult behaviour, mood swings and poor response to being comforted. Attachment disorder is the result of early childhood trauma, abandonment, abuse or neglect.
In a classroom situation, the child may experience difficulty with acquisition of core academic skills and forming relationships with adults and peers. This may result in poor language acquisition, impaired cognitive development, and contributes to negative behaviour patterns.
AD is just one strand of Developmental Trauma Disorder (DTD), which includes Reactive Attachment Disorder (RAD), characterised by withdrawal from social relationships and Disinhibited Social Engagement Disorder (DSED) in which a child may show excessive but inappropriate friendliness to strangers.
There can be an assumption that AD is only associated with looked after children but although there is a strong correlation, many other children without this background are affected.
Children with attachment disorders are often misdiagnosed as many of the characteristics are also seen in conditions like autism, ODD and ADHD.
Treatment focuses on creating a safe family environment and promoting positive relationships between the child and their trusted caregivers. It may include individual play therapy for the child as well as family therapy.
Attention Deficit Hyperactivity Disorder (ADHD)
ADHD is a behavioural disorder characterised by inattentiveness, impulsivity and hyperactivity. It may occur without the hyperactive element and is then described as ADD.
Children with ADHD seem unable to sit still, finish tasks, concentrate or even notice what is going on around them. They may seem fine one day, while the next they are whirling round in frenzied activity. School reports may say, ‘Needs to concentrate and pay attention’. Or they may be daydreamers.
A child with an attention deficit has trouble maintaining attention for long and is easily distracted. A low stimulus environment can be very helpful. A hyperactive child has a constant need to be moving. They cannot control their impulses.
Children who have ADHD may be of normal to high intelligence, highly creative and intuitive, and physically able. Many well-known and successful names have experienced ADHD, such as John F Kennedy, Bill Gates and Simone Biles.
Oppositional Defiant Disorder (ODD)
All children disagree with their parents or teachers from time to time, but ODD isn’t a temporary phase. It involves extreme long-lasting, aggressive and defiant behaviour, often to people in authority.
‘Children with Conduct Disorders are different. It's not a bit of tantruming or getting into trouble now and then. It's picking up the 14in TV and throwing it through the window,’ says Professor Steven Pilling, National Collaborating Centre for Mental Health.
ODD is a behaviour disorder like Conduct Disorder. Both terms are used to refer to children who persistently argue (‘oppose’) and disobey (‘defy’) those looking after them, much more than would normally be expected at their age. These behaviours have a negative impact on their lives and learning, on their psychosocial development and, if untreated, a significant effect on mental health in adulthood.
Often a child with ODD has trouble at home with parents and siblings, in school with teachers, and usually struggle to make and keep friends. ODD is first seen in younger children; some may persist with conduct disorder through life, others may find it resolves; another form tends to begin with adolescence. These behaviour disorders form half of all referrals to the Children and Adolescent Mental Health Service (CAMHS).
ODD affects around five per cent of boys and two per cent of girls. Children with ODD very often have other mental health and behavioural problems, particularly ADHD, depression, anxiety, and learning and communication disorders.
Studies show 35-60 per cent of those with ADHD also have ODD. This may be because children with ADHD receive a lot of negative feedback and are less likely to form good peer relationships – both of which can lead to ODD.
Specific Learning Difficulties (SpLDs)
Specific Learning Difficulties (SpLDs) is a name given to a range of conditions including dyslexia, dyspraxia and dyscalculia and can be linked to other conditions such as speech and language difficulties and ADHD.
They are sometimes referred to as Specific learning differences or may still be considered under the more generalised heading, dyslexia. Frequently, the individual difficulties co-occur. A child with a SpLD will demonstrate a significant gap between their potential and their performance in academic subjects.
It is thought SpLDs are of a neurological origin, as many cases run in families and they occur independent of composite IQ. However, having a specific learning difficulty means a child is vulnerable to academic problems and likely to struggle at school and college.
We are still learning the root of these difficulties, but know that there is a genetic component. Similar difficulties are passed down within families or may present as one difficulty in one child and another condition in another eg the older child may have reading difficulties, while a younger sibling experiences attention needs. There is no cure for a SpLD, but with professional support a child can learn to recognise and manage the condition to maximum effect, to enable them to do well at school.