'Sometimes it's harrowing. Many parents find it very upsetting to acknowledge that their child has difficulties; but we do try to be very upbeat, and show that we're here to provide support. And we're helping to do what's most important - picking up on the issues as early as possible.'
One of the advantages of working with pre-school children with special needs is that you can intervene at a point where you really make a difference. Bernice Shamplin and Sheila Alletson's Early Years Intervention Team, which works with children with emotional/behavioural difficulties (EBD) across the London borough of Camden, has another advantage as well; it offers a range of different perspectives and disciplines.
The service has been running since 1999, when it was originally a one-year pilot based in Camden's education department. This was also the time when centres were just getting to grips with the Special Educational Needs Code of Practice, and the requirements to provide inclusive support. Ms Shamplin and Ms Alletson job-shared one full-time post (as they still do) with one assistant. They pooled their complementary expertise in special needs to work with children, staff and parents across Camden's maintained nursery centres.
As with most new services, a lot of time went into building up relationships with centres and parents. They always discuss any approaches that have already been tried. 'We always work in partnership with others. It is difficult because many people can be very defensive about areas such as emotional and behavioural difficulties. They feel it's a sign of some sort of failure. We went in and talked about what we had to offer. We kept stressing the fact that this isn't a problem, it's a difficulty - and that as professionals we can assist with addressing that difficulty.'
During that first year, Ms Shamplin and Ms Alletson provided a mixture of hands-on work in centres, and training for fellow practitioners. 'For instance, we worked with two children who couldn't actually play at all. We worked with them on language and play, using particular toys and creating quite a structured, quiet environment; and we videoed the whole experience to use with colleagues.'
Other training covered issues like managing behaviour, implementing the Code of Practice, and strategies for addressing EBD. They also realised that they were seeing a high proportion of children with language and communication problems. At the end of the one-year project, when Camden decided to make it a permanent service - attached now to the early years department - the two decided to build up their own and their team's expertise in this area.
Visionary approach
Three years later, the team works with every setting in Camden's Early Years Development and Childcare Partnership. It has expanded to four members: Ms Shamplin and Ms Alletson, who are now both SEN teachers; speech and language therapist Deirdra Leahy; and an educational psychologist. It's this multi-disciplinary approach which London University's Institute of Education described as 'visionary' - whoever is leading an assessment has immediate access to complementary skills. As emotional and behavioural difficulties can involve a complex interaction of emotional needs, learned behaviour and developmental problems, this yields real dividends. Ms Alletson describes a child whose challenging behaviour caused her particular concern. 'I brought in the educational psychologist because it was important to get a new perspective, and the boy really benefited.'
Language difficulties, adds Ms Leahy, can be a crucial part of this interaction, not least because some behavioural difficulties actually stem from communication problems. 'Managing language and communication difficulties can lead to significant improvements.'
As a result, the team now offers training in special needs and emotional and behavioural difficulties as well as language and communication. The training side of their work, they say, is 'less than it used to be, but it's more focused'. The rest of their time is pretty fully occupied with parent workshops and drop-ins, support groups, screening and assessments, support with transition to school, direct interventions and telephone consultation. 'As you can see,' says Ms Alletson drily, 'we're kept busy.'
In fact, they now have a waiting-list for children requiring hands-on work.
The emphasis on trust and good relationships has also become even more important as their remit has broadened to all early years providers. 'Every time you go in you have to be sensitive and read the situation. Unless you can achieve a good relationship you won't achieve your ultimate goal, which is to support the child and their family. For instance, we were called in to one nursery to assist with behavioural support, and our assessment was that the child needed speech and language therapy as well. When we first told the mother this she was absolutely against it - it was only our close working relationship which made it possible.' One important aspect of gaining an educational psychologist is that they can deliver work directly in homes, which wasn't possible before.
What they would really like to do now is expand further. 'We could use a family support worker, or more speech and language work, or an occupational therapist, or a teacher to manage the transition to school.' Of all the options, this last is probably the one they'd like most - because, however effective their work undoubtedly is, it cuts off sharply once children start school and they would much rather see it continue. However, the team's crucial work is there at the most important stage of all. 'We're the first point where people start to meet authorities and institutions. If we get it right they're much more likely to make positive relationships for the future.'
Helping the parent
A month before Belinda Gaffney's son Connor started nursery in September 2001, he was diagnosed with attention deficit disorder (ADD) - in addition to an already diagnosed speech delay of 18 months. 'I didn't feel too bad, because I knew something wasn't quite right,' she says. However, she did feel at a loss as to what to do. 'I read library books, but nothing told me how to cope or deal with it. I didn't know what support there was. So when he started nursery, and after about a week when they suggested a referral, I thought, "Yes, any help we can get".'
Ms Alletson came in and observed Connor, who now has a half-hour session every week tackling both his ADD and his speech problems. 'Sheila does the behaviour side, Deirdra does the speech - you can mix and match, you're not wasting your time having support for something the child doesn't need. They play games, and ask him things like, "Where is it?" so that he has to reply. Even after a half-hour session he speaks much more clearly. We're still working on his behaviour, but he's doing very well.' The support has also been good for her younger son, who also has ADD. 'Connor will come home and show Jamie what's he's done in the morning session.
'He's made such progress between his initial assessment and now. And he's really excited when he goes off to his session, he's really pleased he's going to play his game. They've helped him deal with whatever's wrong.'
Helping the practitioner
Margaret Connolly manages Sington Nursery, run by Camden Community Nurseries. She has been working with the Early Years Intervention Team since it started.
'I've always felt very strongly,' she says, 'that if you catch children early enough, you can do something to change the direction they're going in. The team made the initial contact and we immediately said we had two children for them. They came and talked to the staff and found out what the problems were; then they asked us to gather information and speak to the parents. They then assessed the children and spoke to the parents themselves. There were meetings all the way along, both with the nursery and with the parent.'
This approach has really impressed Ms Connolly. 'Parents need to know what's happening, and we need their input. When the team's established a programme, parents get information about it, and they know what they can do at home, while we carry on with our side of it.' Her nursery has now referred four children to the team.
'Children have acquired social skills and confidence which they didn't have before,' she says. 'I've been working in childcare for 35 years or so - I'd have loved to have seen something like this years ago. The thing is, it works.' NW
