Lancashire SEND toolkit, chapter 6: the graduated approach in school

The Graduated Approach in School

• The Graduated Approach in school

6.1. Introduction This section should be used by school staff supporting children working towards key stages 1 - 4. Schools who take children from age 2 should also use the Early Years section. Due to funding arrangements and eligibility criteria for a number of services, this school section should also be used for young people in school sixth forms (although consideration should also be given to the post-16 ‘Preparing for Adulthood’ section for these young people).

Using the Graduated Approach means recognising that there is a continuum of need and that needs are met through the addition of increasingly specialist interventions as the level of need increases. In line with The SEND Code of Practice (January 2015), mainstream schools must designate a teacher to be responsible for co-ordinating SEN provision (the SEND Co-ordinator or SENDCO) and must inform parents when they are making special educational provision for a child. To access specific 'new to post' training for newly appointed SENDCOs please refer to Lancashire Specialist Teacher Traded Team. 6.2. What is Quality First Teaching?

QFT originates in the then Department for Children, Schools and Families’ guide to personalised learning published in 2008. The key characteristics are summarised as:

• highly focused lesson design with sharp objectives
• high demands of pupil involvement and engagement with their learning
• high levels of interaction for all pupils
• appropriate use of teacher questioning, modelling and explaining
• an emphasis on learning through dialogue, with regular opportunities for pupils to talk both individually and in groups
• an expectation that pupils will accept responsibility for their own learning and work independently
• regular use of encouragement and authentic praise to engage and motivate pupils. (DCSF, 2008) Personalised learning – a practical guide 00844-2008DOM-EN

QFT should be on offer to all students; the inclusion of all in high quality, everyday personalised learning.

6.3. The Graduated Approach for Schools Please click on the links below to take you to the correct section Broad Category of Need Cognition and Learning Learning difficulties cover a wide range of needs, including:

• moderate learning difficulties (MLD)
• severe learning difficulties (SLD)
• profound and multiple learning difficulties (PMLD)
• Specific learning difficulties (SpLD) which affect one or more specific aspects of learning, such as; dyslexia, dyscalculia and dyspraxia.

Communication and Interaction This includes:

• Children with speech, language and communication needs (SLCN) who have difficulty in communicating with others.
• Autistic children and young people.

Social Emotional and Mental Health Children and young people may experience a wide range of social and emotional difficulties, such as:

• Becoming withdrawn or isolated
• Displaying distressed behaviours
• anxiety
• depression
• self-harming
• substance misuse
• eating disorders
• attention deficit disorder (ADD)
• attention deficit hyperactive disorder (ADHD)
• attachment disorder

Physical and Sensory – Visual Impairment Physical and Sensory – Hearing Impairment Physical and Sensory – Multi-Sensory Impairment Physical and Sensory – Physical Difficulty

School - Universal Support Cognition and Learning

Impact on Learning What are their difficulties?

Action What should we do next?

Strategies What should we put in place?

• Ensure young person can see and hear tutor clearly
• Text and print should be easy to see – dyslexia friendly
• Learning environment should be calm, uncluttered and well defined areas
• Lessons should be differentiated to meet the needs of young people
• Extra time should be given for processing information, answering and completing tasks
• Use visual aids should as checklists, clear frameworks to support organisation of ideas
• Opportunities for overlearning
• Pre-teach topic vocabulary and use concept maps
• Present new information in small chunks and keep language simple
• Use colour highlighting for word patterns, prefixes, suffixes etc.
• Introduce new material in a multi-sensory way – show it, listen to it, look at it, hear it, say it, write it
• Use technology to support learning e.g. speech to text, typing rather than writing
• Use calendars to manage homework tasks and meet deadline
• Positive feedback given to celebrate achievements

Practitioners observe that the student has difficulties with:

Practitioners should:

• Seek pupil's views on their learning progress, regular self- evaluation.
• Contact parents to express concerns.
• Set targets and track progress.

Contact previous setting if deemed appropriate. Assessment:

• Gather any assessment data (tutor assessment) related to area of concern.
• Observe young person to see difficulties in a range of contexts and how the difficulty impacts on learning.

Discuss concerns with SENDCO Tutors to implement strategies of support.

• Progressing alongside peers
• Understanding new concepts and applying prior learning
• Using topic vocabulary
• Focusing on set activities for extended periods.
• Literacy
• Phonics
• Numeracy
• Note taking
• Organising and planning work
• Written work in comparison with oral contribution.
• Following multi- step instructions
• Tiredness due to excessive concentration levels needed
• Social and behavioural difficulties arising from low self-esteem and frustration

School – Targeted Support Cognition and Learning

Impact on Learning What are their difficulties?

Action What should we do next?

Strategies What should we put in place?

Observe persistent difficulties (even with universal support strategies in place) with the following:

Teachers, SENDCO, pupil and parents discuss Continue with any relevant strategies from Universal difficulties and plan appropriate interventions/strategies to meet identified needs. Ensure the pupil's voice and aspirations are the focus. Encourage child with VI to be their own advocate level, plus:

• staff (teacher/support staff) to facilitate small group

interventions and aid learning and organisation within the classroom environment

• resources specific to the needs of the young person

e.g. personalised task management board, checklists, subject specific vocabulary books

• Literacy interventions such as, precision teaching for

reading and spelling, cued spelling

• Implement strategies recommended from external

agencies (e.g. EP)

• Progressing alongside peers.
• Attention and concentration span difficulties leading to reluctance to engage with tasks
• Organising tasks
• Following multi-step instructions
• Sequencing information in written work
• Remembering and recalling information
• Reading
• Written work in comparison with oral contribution
• Very specific difficulties (e.g. diagnosis of dyspraxia or dyslexia etc.) affecting literacy skills, spatial and perceptual skills and fine and gross motor skill
• Social and behavioural difficulties arising from low self-esteem and frustration

and understand what their needs and strengths are- celebrate their differences and offer alternative ways of completing learning tasks. Complete a SEND Support Plan: Smart targets are set and evaluated on a regular

basis. Record young person as SEND Support on SEND

register Teachers to implement targeted strategies of

support Are further specialist assessments needed? Seek external advice from appropriate educational

agencies such as specialist teacher, Educational Psychologist (EP) (See chapter 14 – EP involvement)

Outcomes and individual strategies should be shared with all staff involved (including support staff). Identify any staff Continuing Professional Development (CPD) that is needed

School – Specialist Support Cognition and Learning

Action What should we do next?

Impact on Learning What are their difficulties?

Strategies What should we put in place?

See actions from targeted support.

Persistent and significant difficulties are observed with the areas within targeted support, even when strategies and Smart interventions have been implemented. See targeted support for list of difficulties

Continue with any relevant strategies from Universal and/or Targeted Support levels, plus:

• Create a personalised curriculum tailored to

the young person’s needs (this may require consultation with all professionals involved with the young person)

If EHC Plan is not in place: Review SEND Support Plan (at least termly) Consider a request for EHC needs assessment (see chapter 11 on EHC needs assessments) If EHC Plan is in place: Record young person as having an EHC Plan on SEND register.

Continue to plan, do and review against the specified outcomes and provision within the EHCP (breakdown outcomes into smaller steps), support plans should be reviewed at least once a term, annual review held at least once a year.

EHCP outcomes and individual strategies should be shared with all staff involved (teachers and support staff). Ensure pupils and parents understand the outcomes and are aware of strategies in place.

School - Universal Support Communication and Interaction

Action What should we do next?

Impact on Learning What are their difficulties?

Strategies What should we put in place?

• Ensure young person can see and hear teacher clearly
• Cue in the young person using their name.
• Learning environment should be calm and quiet
• Extra time should be given for processing information, answering and completing tasks
• Use visual aids should as checklists, clear frameworks to support organisation of ideas
• Opportunities for overlearning
• Pre-teach topic vocabulary and use concept maps
• Present new information in small chunks and keep language simple
• Introduce new material in a multi-sensory way – show it, listen to it, look at it, hear it, say it, write it
• Use technology to support learning e.g. speech to text, typing rather than writing
• Positive feedback given to celebrate achievements
• Teach young person to ask for help
• Adult to model correct language
• React to what the young person says, not how clearly they speak

Practitioners observe that the student has Practitioners should: difficulties with:

• Seek student's views on their learning progress, regular self- evaluation.
• Interacting with others; preferring to be alone or unable to sustain friendships
• Social situations and respond inappropriately to social cues
• Difficulty with receptive and expressive language; Limited vocabulary, not generalising words, limited spoken language, Echolalia, Unusual accent
• Attention and concentration skills
• Speech pronunciation difficulties
• Stammer and/or difficulties getting words out
• Contact parents to express concerns.
• Set targets and track progress.

Assessment: Gather any assessment data (tutor assessment) related to area of concern.

Observe young person to see difficulties in a range of contexts and how the difficulty impacts on learning.

Sensory processing difficulties related to a Communication and Interaction difficulty e.g. Autism. E.g. Actions such as rocking, stroking, flapping and/or hands over ears, unable to sit still, fidgeting, Discuss concerns with SEND Support Team.

Tutors to implement strategies of support.

Social and/or behavioural difficulties arising from low self-esteem, anxiety, frustration, or communication difficulties

School -Targeted Support Communication and Interaction

Impact on Learning What are their difficulties?

Action What should we do next?

Strategies What should we put in place?

Observe persistent difficulties (even with universal support strategies in place) with the following:

• Interacting with others; preferring to be alone or unable to sustain friendships
• Social situations and respond inappropriately to social cues
• Difficulty with receptive and expressive language; Limited vocabulary, not generalising words, limited spoken language, Echolalia, Unusual accent
• Attention and concentration skills
• Speech pronunciation difficulties
• Stammer and/or difficulties getting words out

Sensory processing difficulties related to a Communication and Interaction difficulty e.g. Autism. E.g. Actions such as rocking, stroking, flapping and/or hands over ears, unable to sit still, fidgeting Social and/or behavioural difficulties arising from low self-esteem, anxiety, frustration, or communication difficulties

Tutors, SEND team, young person and parents Continue with any relevant strategies from Universal level, plus:

• staff (teacher/support staff) to facilitate

small group interventions and aid learning and organisation within the classroom environment

• resources specific to the needs of the young

person e.g. personalised task management board, checklists, subject specific vocabulary books

• Implement strategies recommended from

external agencies (e.g. Speech and language therapist)

• Use social stories and comic strip

conversations to aid understanding of social situations

• Access to a quiet workstation
• Build sensory/movement breaks into the

timetable, use ear defenders

• Social skills or friendship skills interventions

discuss difficulties and plan appropriate interventions/strategies to meet identified needs. Ensure the young person's voice and aspirations are the focus.

Complete a SEND Support Plan.

Smart targets set and evaluated on a regular basis.

Record young person as SEND Support on SEND register Teachers to implement targeted strategies of support Are further specialist assessments needed?

Seek external advice from appropriate educational agencies such as speech and language therapist, specialist teacher, Educational Psychologist (EP) (See chapter 14 – EP involvement) Identify any staff Continuing Professional Development (CPD) that is needed

School –Specialist Support Communication and Interaction

Action What should we do next?

Impact on Learning What are their difficulties?

Strategies What should we put in place?

See actions from targeted support.

Persistent and significant difficulties are observed with the areas within targeted support, even when strategies and Smart interventions have been implemented.

Continue with any relevant strategies from Universal and/or Targeted Support levels, plus: Follow individual plans from external agencies such as speech and language, occupational therapist, specialist teacher and educational psychologist.

If EHC Plan is not in place: Review SEND Support Plan (at least termly) Consider a request for EHC needs assessment (see chapter 11 on EHC needs assessments) If EHC Plan is in place: Record young person as having an EHC Plan on SEND Register Continue to plan, do and review against the specified outcomes and provision within the EHCP (breakdown outcomes into smaller steps), support plans reviewed at least once a term, annual review held at least once a year.

School – Targeted Support Social, Emotional and Mental Health

Action What should we do next?

Impact on Learning What are their difficulties?

Strategies What should we put in place?

Observe persistent difficulties (even with Teachers, SEND team, young person and parents Continue with any relevant strategies from Universal level, plus: universal support strategies in place) with the following:

• Following social rules e.g. sharing, turn- taking, challenges adults and peers, gets up out of seat frequently
• Maintaining attention to tasks
• Task participation e.g. avoids tasks, seeks attention from others
• Level of disruption
• Communicating feelings appropriately
• Controlling their emotions e.g. becomes frustrated easily. Emotional responses not seen by their peers
• With authority
• Anxiety and low mood
• Resilience to new tasks or tasks perceived to be hard
• Low self-esteem
• Self-harm
• Verbal or physical behaviours directed towards others which does not cease with de-escalation techniques and/or requires time out from the situation discuss difficulties and plan appropriate interventions/strategies to meet identified needs. Ensure the young person's voice and aspirations are the focus.
• Plan for unstructured times
• Daily check in with key adult
• Implement individual behaviour management plan
• Small group or individual lessons about emotional regulation, social skills, anger management.
• Use social stories
• Positive reward systems in place

Complete observation and analysis of the frequency of incidents using ABC.

Complete a SEND Support Plan review at least termly.

Smart targets set and evaluated on a regular basis.

Record young person as SEND Support on SEND Register Teachers to implement targeted strategies of support Are further specialist assessments needed? Ensure cognitive assessments have been done to check if there is an unmet need within cognition and learning.

Carry out a strengths and difficulty questionnaire (e.g. from https://www.sdqinfo.org/) to strengthen understanding of need.

• Low or decreasing attendance Seek external advice from appropriate educational

agencies such as Gp, CAMHS, specialist teacher, Educational Psychologist (EP) (See chapter 14 – EP involvement)

Identify any staff Continuing Professional Development (CPD) that is needed e.g. de- escalation techniques

School – Specialist Support Social, Emotional and Mental Health

Action What should we do next?

Impact on Learning What are their difficulties?

Strategies What should we put in place?

See actions from targeted support. If EHC Plan is not in place: Review SEND Support Plan (at least termly) Consider a request for EHC needs assessment (see chapter 11 on EHC needs assessments) If EHC Plan is in place: Record young person as having an EHC Plan on the SEND register Continue to plan, do and review against the specified outcomes and provision within the EHCP (breakdown outcomes into smaller steps), support plans reviewed at least once a term, annual review held at least once a year.

Persistent and significant difficulties are observed with the areas within targeted support, even when strategies and Smart interventions have been implemented.

Continue with any relevant strategies from Universal and/or Targeted Support levels, plus

• Follow individual plans from external agencies such as CAMHS, specialist teacher and Educational Psychologist.

School – Universal Support Physical and Sensory – Visual Impairment

Action What should we do next?

Impact on Learning What are their difficulties?

Strategies What should we put in place?

A recognised visual impairment and/or an assessed visual deficit, which is not fully corrected by glasses/lenses. Practitioners observe that the student

Practitioners should: If a child has a recognised visual impairment and has support from QTVI follow advice from the specialist. Find out about the actual eye condition- they often have specialist websites with specific advice. Strategies that may need to be implemented:

• Seek student's views on their learning

progress, regular self- evaluation.

• Contact parents to express concerns- if child

does not have recognised visual impairment but appears to be having these difficulties- have they seen an optician, does there need to be a GP referral to orthoptist or ophthalmologist.

• A child with poor vision in one eye but

normal in the other eye (monocular) they will generally not be classed as having VI but some general advice can be sought from a Qualified Teacher for the Visually Impaired (QTVI)

• A child with a recognised VI but no EHCP

would be entitled to support from QTVI up to 10 hours per year as per the NATSIP Criteria (The National Sensory Impairment Partnership) (QTVI to assess)

• QTVI to do Functional Visual Assessment and

provide advice about resources that would help, provision and strategies.

• Set targets and track progress.

has difficulties with:

• Reduced access to standard print
• Holding work books and objects close to eyes
• Unusual head postures, squinting, closing one eye
• Access to whole class presentations, including interactive whiteboard and information on walls.
• Practical activities and demonstrations
• Reading their own and teachers writing.
• Note taking.
• Incidental learning – vocab, general understanding of everyday situations
• Standard class computers and tablets- researching information
• Mobility and moving around the classroom/school.
• Positioning in the classroom
• Cue in the young person using their name.
• Be aware that VI students may miss out on non-verbal communications and gestures- these should be verbalised and made explicit.
• Use of magnifiers and low vision aids
• For most children and young people, class or subject teacher will be able to use resources and strategies available in the classroom
• Try out different paper or Smartboard colours to try to find best contrast
• Dark pens, dark lined exercise books.
• Take advice from specialist teacher related to font style and size
• Clumsiness, tripping over obstacles, bumping into edges of furniture.
• Peer relationships and friendships – understanding personal space
• Organising equipment and resources.
• Tiredness due to excessive concentration needed.
• Completing work in the timescales and keeping up with peers
• Self-esteem and recognising strengths and difficulties- not being the same as peers
• Task avoidance- possibly due to not being able to access information

Assessment - Gather any assessment data (tutor

• Intersperse short spells of visual activity with less demanding activities
• Eliminate inessential copying from the board
• Where copying is required, ensure appropriate print size photocopy is available
• Use multi-sensory activities when possible- use of objects and real experiences
• Alternative ways of recording work
• Provide occasional use of enlarged copies, as advised (Don't just enlarge everything onto A3 as this may not be appropriate)
• Avoid standing in front of windows – your face becomes difficult to see
• Ensure child or young person has own text or monitor
• Plan and support opportunities for information sharing and liaison between school staff, Specialist teachers, parents, and other agencies, as required
• Provide recommended equipment.

assessment) related to area of concern. Observe young person to see difficulties in a

range of contexts and how the difficulty impacts on learning. Seek advice about making a VI friendly school-

professional development Discuss concerns with SENDCO.

• Move close to items to view them or hold

them at an angle

• Adopts a noticeable head tilt or position
• Students struggle to access work without

additional support from TA for the majority of their work- to modify and enable access to lesson

Seek external advice from appropriate educational agencies such as specialist teacher, Educational Psychologist (EP) (See chapter 14 – EP involvement) Identify any staff Continuing Professional Development (CPD) that is needed- Visual awareness training and training on child's specific needs in relation to eye condition. QTVI to ensure school understand all the medical reports and implications of eye condition. Students who require additional support from TA for over 75% of curriculum and require modified and differentiated work and alternative resources and technology will require an EHCP.

• Increased input from TA to access curriculum and wider school curriculum.
• Support to develop appropriate social skills

School – Universal Support Physical and Sensory – Hearing Impairment

Action What should we do next?

Impact on Learning What are their difficulties?

Strategies What should we put in place?

CYP has: A diagnosed hearing loss which is confirmed by letter from the audiology clinic. They might wear hearing aids. Or They are waiting for assessments from an audiologist/hearing clinic after referral from the GP or school.

Practitioners should:

• Speak to the CYP about their views of their learning including what they think is going well and not as well.
• Speak to parents to discuss whether they have noticed any difficulties with their hearing at home.
• If they already have a hearing loss diagnosed ask when the next routine appointment is and possibly suggest that they get an earlier review.
• If child has not got a diagnosed hearing loss then parents should be encouraged to see their GP to get a referral to audiology.

If a child gets a diagnosis from the audiology clinic they will be asked to sign a referral form which will go to the Learner Support Team who will liaise with school. A Teacher of the Deaf (QTOD) will assess their needs using the NATSIP Criteria (The National Sensory Impairment Partnership) They will determine how many visits the CYP will get from The QTOD.

Key staff should become NDCS members and access resources such as deaf-friendly teaching; primary schools and deaf-friendly teaching; secondary schools. Staff should promote deaf awareness within the classroom using resources such as NDCS Look, Smile, Chat Strategies that may need to be implemented:

Conductive hearing loss (is not usually permanent) are very common in young children. 8 out of 10 children will experience glue ear before the age of 10 and 1 in 5 pre-school children can have it at any one time. So all staff need to be aware. Practitioners observe that the student has difficulties with:

• Following instructions
• Saying they have understood when they clearly haven't
• Missing key points in their learning
• Not retaining new vocabulary
• Good positioning in the classroom so child has

sight of the teacher, is near the front of the classroom, is away from external noise sources and can see other children in the class.

• Daily checking of child's speech

processors/hearing aids/BAHA's and radio aid system by a trained member of staff

• Use of visual clues and practical equipment to

aid understanding.

• Asking the child to repeat back instructions to

ensure they have fully grasped what they need to do.

School should request Deaf Awareness Training from a QTOD

• Failing to grasp the meaning of new vocabulary
• Difficulties with attention and concentration especially in the presence of background noise
• Limited communication in high noise environments such as the dinner hall
• Speaking more loudly or more quietly than is usual or expected
• Asking for lots of repetition.
• Difficulties in social situations – missing the point or not fully understanding the rules of games.
• Difficulties in maintaining friendships
• Becoming very tired very easily due to listening fatigue
• Ensure that you have child's full attention before

talking.

• Reiteration of the comments made by others

during classroom discussions.

• Differentiated planning/curriculum/outcomes

where needed.

• Scaffold support using visual prompts where

possible.

• Staff to be aware of the effects of tiredness due

to the demands of listening and concentrating and understanding.

• Models of good language applied to any

grammatically incorrect comments and incorrect facts.

• Increased use of visual aids and practical

equipment to aid understanding.

School – Targeted Support Physical and Sensory – Hearing Impairment

Action What should we do next?

Impact on Learning What are their difficulties?

Strategies What should we put in place?

The child or young person:

• has hearing aids or cochlear implants
• is likely to have a personal radio aid system
• is unable to access the mainstream curriculum through personal amplification alone within the allowed timescale and at normal teaching pace

In addition, the child or young person may be observed showing persistent and moderate difficulties with the following (even with universal support strategies in place):

• Perception of some speech sounds
• Delayed language development in one or more areas
• Accessing linguistic aspects of the curriculum
• Requires elements of the curriculum to be differentiated or more heavily supported.
• Accessing speech in TV programmes, DVDs and YouTube clips where lip

Complete a SEND Support Plan. Ensure the young person's voice and aspirations

Continue with any relevant strategies from Universal level, plus:

• Staff (tutor/support staff) to facilitate small

group interventions and aid learning and organisation within the classroom environment

• May need one to one support from TA to help

with:

• revisiting work to consolidate learning,
• Ensuring that the pupil understands the next

part of the activity and is able to explain it using some of the relevant vocabulary.

• notes on a white board to ensure CYP

understands the vocabulary (specific vocabulary and carrier language), concepts, and has followed the gist of the lesson

• opportunities to work in quieter environments

for some of the day

• Some pre and post tutoring for more complex

language and technical language

• Promotion of deaf identity, confidence and self-

esteem

are the focus. Smart targets set and evaluated on a regular

basis. QTOD to complete extra assessments to ensure

needs are met and progress can be made by the young person Identify any staff that require Continuing

Professional Development (CPD) from the QTOD regarding the child's individual needs Ensure key staff know how to complete basic

troubleshooting of all audiological equipment. (as advised by the QTOD) Consideration of the listening environment and

adaptions which can be made to improve the acoustics.

pattern is not present (e.g. ‘hidden narrators’ and voiceover)

• Accessing speech where there is

competing background noise, including music

• Difficulty establishing friendships with

hearing peers

• May need to focus their visual attention for

long periods of time (e.g. to watch a signer or lip read)

• QTHI to do assessment and provide advice about resources that would help, provision and strategies.
• Set targets and track progress.

Assessment - Gather any assessment data (tutor assessment)

learning needs: See list of difficulties for VI and HI for impact on learning and also consider the holistic needs of the child. Are there PD difficulties alongside MSI? - see PD section. How does the learner get about-

• For most children and young people, class or subject teacher will be able to use resources and strategies available in the classroom
• Try out different paper or Smartboard colours to try to find best contrast
• Dark pens, dark lined exercise books.
• Take advice from specialist teacher related to font style and size
• Intersperse short spells of visual activity with less demanding activities
• Eliminate inessential copying from the board
• Where copying is required, ensure appropriate print size photocopy is available
• Use multi-sensory activities when possible- use of objects and real experiences
• Alternative ways of recording work
• Avoid standing in front of windows – your face becomes difficult to see
• Ensure child or young person has own text or monitor
• Staff to be aware of the effects of tiredness due to the demands of listening/looking and concentrating and understanding.
• Models of good language applied to any grammatically incorrect comments and incorrect facts.
• Plan and support opportunities for information sharing and liaison between school staff,

mobility difficulties How does the learner communicate? -

See communication and Interaction for advice, also HI section. What is the best route for learning;

related to area of concern. Observe young person to see difficulties in a range

of contexts and how the difficulty impacts on learning. Seek advice about making a VI and deaf friendly

generally they will have one sensory channel that works better than the other.

school- professional development Discuss concerns with SENDCO

Specialist teachers, parents, and other agencies, as required

• Provide recommended equipment.

• Adopts a noticeable head tilt or

position

• Students struggle to access work

without additional support from TA for the majority of their work- to modify and enable access to lesson

Seek external advice from appropriate educational agencies such as specialist teacher, Educational Psychologist (EP) (See chapter 14 – EP involvement) Identify any staff Continuing Professional Development (CPD) that is needed- Visual and hearing awareness training and training on child's specific needs in relation to eye condition and hearing impairment. QTMSI to ensure school understand all the medical reports and implications of conditions and syndromes. Students who require additional support from TA for over 75% of curriculum and require modified and differentiated work and alternative resources and technology will require an EHCP.

School – Specialist Support Physical and Sensory – Multi-Sensory Impairment

Action What should we do next?

Impact on Learning What are their difficulties?

Strategies What should we put in place?

Multi-sensory Impairment (MSI) or Deafblindness Persistent and significant difficulties are observed and student has severe or significant visual impairment and severe to profound hearing impairment. See targeted support for list of difficulties. (VI and HI sections) In addition students may have:

• deteriorating visual impairment
• deteriorating hearing impairment
• A requirement for alternative modes of communication
• Inability to access any auditory information.
• Additional learning difficulties and disabilities
• problems with lighting levels
• severe peripheral vision loss
• colour vision difficulties

Follow action from targeted support.

Continue with any relevant strategies from Universal and/or Targeted Support levels, plus:

• Create a personalised curriculum tailored to the young person’s needs (this may require consultation with all professionals involved with the young person)
• Seek advice from QTMSI/ QTVI/ QTHI and implement strategies as appropriate.
• Seek outside agencies to offer professional advice; Sense , Ndcs, BATOD, RNIB
• Seek advice from other professionals such as Slt, Ot, Physio
• Additional support from specialists such as Habilitation officers for independent mobility and life skills training.

In addition students may require:

• Braille, tactile resources
• Alternative and specialist resources and technology to access the curriculum.
• Radio aids, sound field systems

In addition: If EHC Plan is in place: Record young person as having an EHC Plan on SEND Register Continue to plan, do and review against the specified outcomes and provision within the EHCP (breakdown outcomes into smaller steps), support plans should be reviewed at least once a term, annual review held at least once a year.

Does the learner require appropriately trained support staff? - intervener, communication support worker with BSL skills if necessary- at a higher level than the learner. Seek advice from QTMSI about syndromes and difficulties- staff training to understanding learning implications and how to enable student to access curriculum.

CYP may require additional time and modified examination papers- this should be part of their normal way of working.

• Inability to access any visual medium- requiring non-sighted methods of learning.
• Only able to access very large print
• Difficulties with independent mobility
• Socially isolated and struggling with maintaining peer relations
• BSL, deafblind manual alphabet
• AAC- Augmentative and alternative communication
• Modified and differentiated curriculum
• Mobility training
• Independent and life skills training
• Training in age appropriate social skills

If EHC Plan is not in place: Review SEN Support Plan (at least termly) Increased input from TA to access mainstream curriculum and wider school curriculum. Child may have complex needs alongside MSI, Physical difficulties, learning difficulties- see these sections for impact on learning, actions and strategies that may be required.

Consider a request for EHC needs assessment (see chapter 11 on EHC needs assessments) Consider if the YP requires a Deafblind Guidance Assessment- carried out by Social Care to ensure the YP is able to access all the services at home, school and in the community that would be available to peers of a similar age.

The guidance would make recommendations about how to support YP to access services.

some children struggle with the angle of the board in addition to the physical control required to copy.

• The pupil may need to write much larger letters

than their peers in order to form the letters.

• Alternative ways of recording work. Consider the

use of laptops and iPads plus photographs and video.

• Provide additional resources e.g. sloping board/

pencil grip/scissors.

• Adapt the pace of learning

Risk assessments for any trips off site. Moving and Handling assessment and plan. PEEP (Personal Emergency Evacuation Plan)

• Some difficulties in physically accessing

the curriculum and practical activities.

• Working at a markedly slower pace due to

fatigue

• Poor engagement
• A need for supervision or support in

unfamiliar or hazardous situations

• Copying from the board- even when

sitting close

• Children or young people may tire easily

or be easily distracted from precision tasks

• Students struggle to access work without

additional support from TA for the majority of their work- to modify and enable access to lesson

• Allow child or young person to leave early

when travelling between classes to avoid busy corridors and to allow more time to get to next class.

• Provide hand rails on stairs and consider rails

(and a step for small children) within toilets or access to disabled toilet

• Ensure child or young person is able to reach

and use facilities e.g. hand basins/taps/coat pegs /lockers

• Support may be needed to carry food at

lunchtime

• Provide a locker for child or young person to

store books etc. rather than needing to carry them around during the day. Ensure the height of the locker is accessible

• Provide option for child or young person to sit

on a chair rather than on the floor at carpet time/ assembly.

needed An evacuation chair may be needed and should be

identified through the risk assessment. Staff will need to be trained to use it. Seek external advice from appropriate educational

agencies such as specialist teacher, Educational Psychologist (EP) (See chapter 14 – EP involvement)

• Ensure that staff involved with moving and

handling have attended certified training and that certificates are still valid.

• Adapted and specialist resources to access lessons at high school.
• Independent and life skills training