Research into child development confirms what experienced professionals already know: that little children need to have lots of opportunities to run, climb and jump before they are able to hone fine motor skills or even pay attention in a learning environment. However, children develop at different rates and reasonable adjustments need to be made to ensure children are fully included in activities at their own ability.
For example, this might mean having adapted scissors or chunky pencils readily available as part of the basic provision. With lots of opportunities to practise, and lots of encouragement, a child will make progress. If progress does not happen, there may be an underlying difficulty.
Hand over hand when needed, adult to correctly position child’s hand when not grasping objects effectively.
Offer adapted resources and /or a range of resources. This may include resources of other sizes, shapes and textures.
Encourage interest in and handling of a range of books such as board books and textured books. Adult to model page turning, allowing child to complete a page turn adult has begun.
Use a consistent approach agreed with parents when working on independence.
Play with dough and tools for cutting, pinching & stabbing e.g., small children’s cutlery. Empty and fill sensory materials using scoops and spoons.
Encourage dressing up play.
Use the outdoor equipment for practise and any stairs within the setting supported by an adult. Provide fun activities and games you can do with the child to further develop their balance and coordination. Fun and games for balance and coordination skills such as wheelbarrows, kicking balls, stomping on bubbles to pop them, playing on a trampette.
Some children may benefit from adaptions such as:
Have dolls and teddy bears that children can dress and undress: make it a focus for the day asking the children, what is the weather and what should teddy wear to go out?
Repetition of adult prompting child to meet own self care needs. Modelling hand washing etc. action rhymes and games to model self-care actions, such as washing the doll/teddy. Children are encouraged to begin to use the potty/toilet when are beginning to show an awareness.
Risk assessments related to children’s physical skills and needs.
It is important that the child is appropriately dressed to carry out activities as per physical demands.
Overall Early Years setting approach.
Use of EYFS curriculum/ screeners. Specific staff teaching/ support.
Set-up of indoor and outdoor play areas.
Involvement with parents/ carers and child.
Link with assess-plan-do-review-learn.
Staff training and awareness in all areas.
Awareness of key documents such as the SEND Code of Practice and Children and Families Bill.
Overall Early Years setting classroom approach.
Whole setting staff training.
Use of EYFS curriculum/ screeners/ assessment.
Targeted teaching/ support, including targeted group interventions.
Understanding of effective differentiation.
Involvement with parents/ carers and child.
Link with assess-plan-do-review-learn.
Overall Early Years setting approach.
Use of EYFS curriculum/ screeners/ assessment.
Request involvement from external services eg, Occupational Therapy (OT), Learning Support Service (LSS), Educational Psychology Service (EPS) to create more personalised curriculum, including specialist advice and support, individual interventions.
Staff with increasing knowledge and experience/ specialist teachers.
Capacity building and training for Nursery/ Preschool staff using support from the Early Years Inclusion Advisors and online sources eg, Nasen.
A more individualised programme of support/ highly personalised EYFS curriculum including specific staff teaching/ support, including targeted small group and individual interventions.
Individualised set-up of play area eg, taking into account accessibility, safety and environmental stimulation.
Impact and approach:
Expected Ordinarily Available Provision in Salford early years settings and family hubs or children with vision needs.
All settings and family hubs should have the following in place:
It is also important that the setting is aware of signs and symptoms that a child may have a vision needs. Where these are observed the setting should first:
Parents/Carers should be advised to arrange for their child to be seen by an optician, or community orthoptist (GP can facilitate this). They will make a referral to the relevant eye specialist if appropriate. The setting/hubs should check the outcome of this with parents/carers.
Signs and symptoms that a child may have a vision needs include:
If a child has a diagnosis of vision needs the setting/ family hub should also ensure:
A mainstream setting should be able to accommodate the needs of the most severely visually impaired child, including those who need to use non-sighted methods to learn and engage with the world. For a child with a diagnosed vision needs, ongoing support, advice and training will be available from Salford Learning Support Service.
Concerns about a child’s vision should be raised with parents/ carers and a referral should be made to the local Orthoptist and Visual Impaired Team (Learning Support Service).
Information to aid understanding of visual impairment should be shared with parents/ carers and staff.
Develop staff awareness of the child’s needs, SEND guidance, specialist support and available resources.
Staff to be aware that the child may be experiencing visually related learning difficulties and provide support to enable them to plan appropriately.
Information relating to learning and play, social inclusion, mobility and independence and appropriate Early Years settings can be found at RNIB.
Incorporate ideas for the inclusion of children with sight loss in Early Years settings, using the Early Years Foundation Stage (EYFS) curriculum.
Create a ‘clutter-free’ environment. Pay attention to layout of furniture, seating and adult position in the setting. It may be helpful to complete an environmental audit of the setting including indoor and outdoor areas.
Creation of a One-Page-Profile which is shared with all staff.
Recommendations of the report implemented in the setting to enable full inclusion within the setting.
The Early Years setting must monitor progress in this respect. Learning materials must be selected and prepared for their clarity. Make basic adaptations to activities and materials to facilitate access for a visually impaired child eg, oral descriptions of visual materials, saying child’s name before asking question.
Information about adapted resources is available at Sight Advice. Low level adjustments may need to be made to activities eg, reducing length of visual tasks.
Break up visually demanding tasks with other activities.
Standard adjustments advised include:
Teaching methods which facilitate access to the EYFS curriculum, social/ emotional development and class/ group participation.
ICT is used to increase access to the curriculum, where appropriate eg, iPads for reading.
Use of information relating to a range of resources and agencies, within the Local Authority and the wider community eg, Victaparents and LOOK UK and RNIB.
Involvement of parents/ carers and provision of information relevant to them e.g. using resources available at RNIB and Guide Dogs UK.
Considerations for good transitions between rooms, and how to plan and prepare for these eg, opportunities to walk with an adult, repeating the process, moving towards more independence, talking the child through the route, noting key points, textures or space to feel for.
Development of a transition plan for children starting pre-school or moving between nursery and reception.
Early Years practice which facilitates access to the EYFS curriculum, social/ emotional development and participation. Draw upon information contained within specialist websites, such as RNIB.
Development tracked using the Oregon Project or the Developmental Journal for Children with Visual Impairments.
Setting must access specific VI related training provided by the VI Team (Learning Support Service). Access to wider staff training eg Early Developmental Support Programme, e-learning for Health Care and RNIB.
On-going assessment, advice, support, monitoring and training from a QTVI, up to 6 hours annually. Staff must implement advice as suggested by the Qualified Teacher of the Visually Impaired (QTVI). Provide access to a quiet space for VI Teacher to work with the child.
Curriculum plan reflects levels of achievement and must include an individually focused Play Plan. Teaching methods based on experiential and tactile learning with a strong verbal emphasis, which facilitate access to the curriculum and participation.
Opportunities for individual and small group work. Opportunities for explanation, and exploration of resources before they are used in an activity eg, through pre-teaching.
Specific interventions may be necessary and advice should be followed from QTVI.
Opportunities for group interventions to develop social inclusion with peers eg, Circle of Friends.
Environmental adaptations: must have attention to seating and lighting in the setting. Accessibility of outside environment including edges clearly marked.
Access to equipment, including the use of iPad, as necessary. Further information about assistive technology can be found at Sight Advice, RNIB, Living Made Easy.
Home visits as necessary, ongoing support for parents/ carers and training to be attended.
QTVI Liaison with the local Eye Hospital.
QTVI to make referral to a local Low Vision clinic.
Parents/carers to use the Developmental Journal for Children with Visual Impairments.
Opportunities will be provided for the child/ parents/ carers to meet other students with VI in the local area (eg, Henshaws).
VI Team to attend all review/ planning meetings. On-going assessment, teaching, advice, support and monitoring from a QTVI, to work with the child, their family and with setting staff.
Allocated key person with time to adapt resources/ attend training and conduct individual work.
Regular planning sessions between QTVI and key person. Planning based on previous visual performance and/ or prognosis of possible changes.
30 hours (20 annual sessions) from a QTVI to provide all the teaching and support outlined above.
Advice, assessment, teaching, support and programme of work from Mobility Officer regarding mobility and independence skills; frequency based on assessed need, block of work equivalent to weekly contact.
The report written by a QTVI in conjunction with the Mobility specialist will be shared with all stakeholders and will include information as outlined in the Universal offer.
Staff member to become a Vision Champion within the setting by completing a training course offered by the Visual Impairment Education Team - Learning Support Service or companies such as positive eye.
Training for staff on Cerebral visual impairment RNIB along with implications for learning and necessary CVI resources.
Input from a QTVI to work with the child and with Early Years staff, and to facilitate contact with parents, as above.
Access to assistive technology and equipment such as an iPad, a Brailler etc.
Access to VI Service technician, as appropriate. Opportunities for tactile exploration of the environment and resources.
Pre and post tutoring of activities. Presentation of learning materials in alternative formats, including Braille, tactile diagrams, audio/ speech.
Staff to facilitate a pre-Braille learning programme as advised by the QTVI.
Impact and approach:
Expected Ordinarily Available Provision in early year settings/ family hubs for children with hearing need.
All settings/ family hubs should have the following in place:
It is also important that the setting is aware of signs and symptoms that a child may have a hearing need. Where these are observed the staff in the setting should:
Parents/ carers should be advised to take their child to the GP, who will make a referral to the audiology department if appropriate. The setting/ family hub should check the outcome of this with parents/carers.
The signs and symptoms that a child may have a hearing need include:
If a child is diagnosed with a hearing need staff will:
A mainstream setting should be able to accommodate the hearing needs of all children with a hearing-impairment. If a child is diagnosed by the audiology department, as having a hearing need, ongoing support, advice and training will be available from Learning Support Service Hearing Impairment Teachers.
Settings can seek further advice regarding additional funding if appropriate.
Concerns about a child’s hearing should be raised with parents/ carers and a referral should be made to the local Audiologist and Hearing-Impaired Team (Learning Support Service).
Information for staff and parents/ carers can be found at NDCS and RNID - National hearing loss charity.
Awareness of the child’s needs and how key developmental milestones are affected by hearing loss, particularly communication, language acquisition and play and fine and gross motor skills N.B. Some forms of hearing loss are associated with balance and delayed milestones eg, late to walk/ sit/ balance issues.
Creation of a One Page Profile which is shared with all staff.
Assessment by Qualified Teacher of the Deaf (QToD) and report distributed to key staff.
Recommendations of the report implemented in the setting to enable full inclusion within the setting. The Early Years setting must monitor progress in this respect. Make basic adaptations to activities and materials to facilitate access for a hearing-impaired child. Follow advice about how to support and include young children who are deaf or hearing impaired in the EY setting.
Seek advice from the HI Team on effects of hearing loss and classroom strategies.
Carry out an assessment of room acoustics and make reasonable adjustments by adapting the physical environment and reducing background noise.
Staff awareness of areas of potential risk associated with childhood hearing impairment eg, social, and emotional impact, reduced opportunity for incidental learning.
Involvement of parents/ carers and provision of information relevant to them.
Use resources available at Council For Disabled Children. Considerations for good transitions between rooms, and how to plan and prepare for these eg, allowing the child to have extra visits to the new setting and ensure transfer of information.
Development of a transition plan for children starting pre-school or moving between Nursery and Reception. An example plan can be found at twinkl.
Teaching practice which facilitates access to the curriculum, social/ emotional development and nursery participation.
Development tracked and monitored using the Early Support guidance.
Involve the HI Team in completion of baseline assessments and development of Play Plans.
Setting must access specific deaf related training provided by the Hearing Impaired (HI) Team. Access to wider training for staff eg, National Deaf Children's Society.
Staff must implement advice as suggested by the Qualified Teacher of the Deaf (QToD). Provide access to a quiet space for Qualified Teacher of the Deaf/ specialist TA/ audiologist session/ visit.
Curriculum plan reflects levels of achievement and must include individually focused Play Plan.
Specific interventions for language development, speaking and listening eg, Lip reading, Auditory Verbal Therapy, Natural Aural Approach, Cued Speech, Sign Language, Total Communication Approach.
Opportunities for explanation, clarification and reinforcement of session content and language. Must have attention to seating, lighting and acoustics of the setting.
Opportunities for individual and small group work in a quiet room.
A key person, who is trained in working with children with a hearing impairment and understands hearing equipment, to:
Use of equipment and technology, including use of Radio Aids and Soundfields speaker systems as appropriate to meet assessed needs. Also seek advice about how to link equipment to interactive white boards, computers, iPads etc.
Key worker from the HI Team identified from initial audiology referral, who will link with the setting, parents/carers and professionals.
Home visits, as required, arranged in agreement with families for newly diagnosed deaf babies up to school entry. Opportunities for parents/carers, children and extended family to attend a local High Hopes parent support group.
Attendance at audiology clinic appointments by a QToD to support families through diagnosis and hearing aid fitting. Support by a QToD through the referral process for cochlear implantation. Access to Radio Aid equipment for use at home and nursery until school entry.
Advice and guidance on suitable technology and apps eg NDCS.
Specifically devised programmes targeting attending, listening and vocalising on the advice of the HI Team and following Early Years research findings eg NDCS.
Clear monitoring and recording process eg using Early Support Monitoring Protocol for deaf babies and children or MacArthur-Bates Communicative Development Inventories CDI.
Liaising with other, external agencies for advice and guidance to offer a multi-agency approach. Regular reviews of nursery-based interventions to ensure progression and adaption, if necessary. Qualified Teacher of The Deaf providing individual support sessions based on National Sensory Impairment Partnership (NatSIP) criteria.
Access to support from an additional person in the setting to facilitate and support, providing opportunities to model:
Access to a Communication Support Worker (CSW) with appropriate British Sign Language (BSL)/ communication skills, when advised.
Concerns about a child’s physical needs should initially be raised with parents/ carers and discussed with relevant professionals eg Health Visitor.
Information from a child’s 2 year old check may be available.
Awareness of a child’s physical needs and how these may impact on developmental milestones particularly in communication, play and socialisation. Use observation in a variety of settings and contexts eg home visits, indoor and outdoor play to identify any particular barriers that affect the child’s access to play and participation.
Discussions with parents/ carers to identify strengths and any needs can be helpful for planning. Early Years practice which facilitates access to the EYFS curriculum, inclusion and participation.
Creation of a One-Page-Profile which is shared with all staff. Create a ‘clutter-free’ environment. It may be helpful to complete a risk assessment of the setting including indoor and outdoor areas and trips outside of the setting.
Consider the organisation of play areas and make sure that it enables children to move freely between them and allows for sufficient playing space.
Implement an accessibility plan to move around the setting and give thought to if an individualised fire evacuation plan is required.
Provide additional equipment or resources such as sloping board, adapted cutlery/ chairs/ scissors and pencil grips etc. Include different Physical Literacy and physical play activities into as many aspects of the EY curriculum as possible to support specific skill development and targets.
Consider activities which focus on spatial awareness, planning and body awareness.
Consider whether the child is developing hand dominance and complete activities to support and encourage hand dominance. Monitor the child’s performance and preference.
Take account of potential fatigue and reduce the pace of structured sessions and provide opportunities for breaks and rest.
Use technology to support early learning including apps eg Dexteria, BlobbleWrite, Hairy Letters and LetterSchool. Teach sequencing skills for everyday tasks to increase independence eg putting on clothes in the right order etc. Use of visual timeline can assist with dressing sequence.
Attach paper to table, easel or wall with masking tape when mark making to assist the child and improve shoulder stability.
Incorporate pre-handwriting/ hand strengthening activities into daily plans eg using playdough, thickened sand, elastic bands, tying skills, tweezers, peg boards, threading, funky fingers and finger gym and tennis ball mouth.
Consider completing a gross motor task prior to a focused or challenging fine motor task as this can facilitate improved concentration and focus.
Consider if avoidance of activities is evident. If a child is struggling with fine/ gross motor skills, they may avoid these activities especially during free play.
Ideas for whole setting interventions:
Considerations for good transitions between rooms, and how to plan and prepare for these eg opportunities to walk with an adult, repeating the process, moving towards more independence.
Talking the child through the route, noting key points, textures or space to feel for.
Development of a transition plan for children starting pre-school or moving between nursery and reception.
Access to support from an additional key personin the setting to facilitate access to the EYFS curriculum, help the child manage their needs, or move with safety around their environment.
Flexible support in the setting to include personal care eg dressing and toileting.
Ensure access to additional and specialist equipment, as advised by professionals such as Occupational Therapists (OT) and Physiotherapists (PT).
Ensure all staff in the setting receive relevant training eg manual handling.
Provide the child with additional time to complete activities.
Use of Now and Nextor visual activity timeline to increase motivation and reinforce achievements. Use appropriate size and height chairs and tables to encourage a correct posture and to support fine motor function and writing. Should appropriate height tables and chairs not be possible for all activities, consider support for the child’s feet.
Provide handrails on stairs. Consider grab bars or rails within the toilet area or provide access to a disabled toilet.
Consider the use of a ring reducer for toilets as well as support for feet to promote correct posture and feeling of safety.
Ensure the child is able to reach and use the equipment and facilities in the setting, such as wash basins, taps and pegs.
Provide additional resources eg sloping board, adapted cutlery, bowls, cups, scissors and pencil grips etc.
Provide a peg for the child with a visual prompt of their name and relevant picture to store their book bag, coat, spare clothes etc.
Provide the option for the child to sit on a chair rather than on the floor at carpet time/ group sessions. Allow a peer or peers to do the same, if appropriate.
Consider trialling a Disc ‘O’ Sitto improve sitting posture and attention and concentration.
Contact other EY settings to observe and share good practice.
Set up an indoor or outdoor obstacle course using equipment of different heights to encourage a range of movements eg climbing, crawling, tummy wriggling, rolling and sliding.
Support children and their families to access universal and targeted services as appropriate in their local Children’s Centres and Local Offer.
Opportunities for individual and small group fine motor skill development work using play equipment eg aqua beads, chopsticks game, Lego, iron on beads and jigsaws.
Specific fine and gross motor skill interventions (previously listed) that may be carried out in small groups and targeted towards a child’s needs.
Seek advice from the appropriate health profession should the child have a diagnosis that affects their participation in play and physical activities.
Request involvement from external services eg Occupational Therapy (OT)/ Physiotherapy (PT) Services.
Staff to access training provided by Learning Support Service eg fine motor skills, gross motor and co-ordination skills training.
Inclusion of OT/ PT on any reviews and planning meetings for the child. Ensure any suggested specialist advice from OT/ PT is shared with all staff, parents/carers and incorporated into the child’s Play Plan.
Settings must allocate the key person with time to adapt resources/ attend training and conduct individual work.
SENDCo to support the key personin planning and using differentiated activities and more specialist strategies and resources to support the child.
Incorporate moving and handling plans and care plans into planning, as advised by professionals. Ensure the plans are meeting need. Request a review should any aspects change.
Ensure any specialist equipment continues to meet the child’s needs and contact relevant OT/ PT/ liaise with family regarding any repairs or alterations.
Carry out risk assessments on a regular basis and incorporate any actions and strategies into planning.
Information to aid understanding of a child’s sensory needs should be shared with parents/ carers and staff and can be found at: Making Sense of Sensory BehaviourA Practical Approach at Home for Parents and Carers Making Sense of Sensory Behaviour.
Whole staff training eg Be Sensory Aware
Creation of a One Page Profilewhich is shared with all staff.
Introduce new activities or play equipment in a multi-sensory way to the child eg by showing, listening, saying, looking, writing, drawing.
Use observation in a variety of settings and contexts eg home visits, indoor and outdoor play to notice how the child responds and make changes to environmental aspects such as lighting, noise level, smell and tactile materials.
Consider creating low stimulus areasin the setting, using neutral backgrounds for displays, minimising hanging items in the carpet area and paying attention to the colours of equipment and décor.
Provide an area such as a calm, quiet space by zoning off or using a small pop up tent.
Talk with parents/carers about the child’s preferences and provide materials and play equipment that they enjoy using at home.
Have a corner/area/box or bag with sensory activities and toys that the child can use at any time. Include ideas and resources such as:
If children are unwilling to touch certain play materials, offer alternatives such as tools in the sand, zip bags filled with messy play items, cling film over Play Dough etc.
Considerations for good transitions between rooms, and how to plan and prepare for these eg opportunities to walk with an adult, repeating the process, moving towards more independence, talking the child through the route, noting key points, textures or space to feel for.
Development of a transition plan for children starting pre-school or moving between nursery and reception.
Increase activities meeting the child’s sensory needs in the day, eg with regular movement breaks, sensory play activities/ circuits, use of a beanbag or specific chair, weighted blanket or pop up tent.
Consider providing a small calm, quiet space, eg a small pop up tent or room with reduced noise and lighting.
Consider providing a workstation and/or set up a low stimulation area for targeted small group or individual activities.
Use a privacy board on a group table or a personal table with few distractions but informative visual information and support.
If appropriate, complete an initial sensory processing audit.
Increase the child’s tolerance of certain messy play activities slowly eg start off with dry sand and slowly add liquid, use a favoured toy in the sand tray etc.
Implement strategies and advice given by professionals, such as Occupational Therapists and the Learning Support Service.
Training to develop staff and parents/carers understanding of sensory needs. Understanding sensory processing challenges.
Plan individual and small group activities focusing on sensory play such as resistance activities eg pushing heavy play equipment, leaning into a wall, using resistance bands and peer massage.
Increased use of sensory resources, as appropriate eg fidget/chew toys (Chewelry), putty, Therabands, weighted equipment and ear defenders etc. Consider adapting unstructured provision in the setting.
Carry out sensory audits and implement appropriate modifications in the setting.
Devise a bespoke sensory diet for the child using the sensory assessment checklists and implement it.
Continue to liaise with any Health Professionals, as appropriate, and involve parents/carers in planning and reviews.
Seek advice from the appropriate health professional should the child have a diagnosis that affects their participation in play and physical activities. More specialist advice can be found online.
SENDCo to support the key person in planning and using differentiated activities and more specialist strategies and resources to support the child.
Ongoing monitoring and reviewing of specific strategies and advice given by professionals, such as Occupational Therapists and the Learning Support Service.
Staff and parents/carers to access further training to develop increased understanding of sensory needs and behaviours.
Access to sensory room or space such as the sensory room available at Higher Broughton Nursery.
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