Advice, Strategies, Support & Resources

I am worried about my child's health and development

All children are individual and will develop at different rates. However, to get a general idea ‘milestones’ are used to help track your child’s development and to give an indication as to whether they are progressing at a ‘typical’ rate.

This page contains responses to the most commonly asked questions in relation to child development as well as useful links to information and services.

As a general rule, if you are worried about your child's development, your GP, Health Visitor or child's education setting will be best placed to offer you advice and support.

Is my child developing at the expected rate?

You can find lots of useful advice and an indication as to whether your child is developing at the expected rate here: Greenwich 0-4 Health Visiting Service

Who can I talk to if I am concerned about my child’s development?

My child is under 5yrs old

Speak to your Health Visitor or GP (Doctor). They may share your concerns and make a referral to a child specialist i.e. a community paediatrician for further investigation.

If your child is in an education setting you should speak to their key person or the SENCO (Special Educational Needs Coordinator). They may share your concerns and suggest that you request a referral from your GP to a specialist or decide to monitor progress more closely.

My child is over 5yrs old

Speak to your child or young person’s class teacher or SENCO. They may share your concerns and recommend that you speak to your GP about a referral to a specialist for further investigation.

You should ask about the additional support that the education setting can put in place to support your child’s development. Further information about the support that schools must put in place for pupils with SEND can be found on our Education Offer.

Who can I talk to if I feel my concerns are not being listened to?

If your school is not concerned about your child but you still are, you might want to contact the Royal Greenwich Special Educational Needs Information, Advice and Support Service (SENDIASS). This service offers free confidential and impartial advice and support to Royal Greenwich parents and carers who have children and young people (up to the age of 25) with SEND (Special Educational Needs and Disability).

You can call SENDIASS on 020 8921 8402.

Receiving a diagnosis

The process of getting a diagnosis can take a long time. It may involve your child being seen by paediatricians, and will usually result in them being seen by the IND team (Integrated NeuroDevelopmental) for an autism assessment. Through this process your child may be observed by various professionals, and you and their school staff will have to give information about the child's development and profile, including things they find difficult. At the end of this process you may be told your child has Autism, or you may be told that they have another additional need. This can be a overwhelming time for you and your family. You will be signposted to support and resources that may help. there are lot sof services locally and nationally, a a number of professional agencies available. You will find these listed on the Local Offer. Again, SENDIASS will be able to assist.
  

These NHS pages contain useful information on receiving a diagnosis:

A Guide to Care and Support

Children with a learning disability - Coping with diagnosis

Related Advice

• Disabled Children and Young People's Register
  

  The Disabled Children and Young People's Register (DYCPR) is a voluntary and confidential list of names and basic information about children and young people with disabilities, special or additional needs who live in Royal Greenwich. It is held by the Families Information Service.

Although each child is an individual, there are certain strategies and techniques that tend to work well to support Autistic children. They are:

Adapting Communication

Autistic children often have language processing difficulties. They may not have any language yet or may have lots of language but do not know how to use it appropriately. They may understand considerably more or considerably less than they are able to communicate, or may repeat or ‘echo’ things they have heard.

To help, it is advised to use shorter, simpler sentences, using fewer ‘key words’ – these are the important words you want to communicate. Sometimes you may only need one word, eg, ‘Coat!’

Say your child’s name at the start of anything you are telling them, to get their attention, eg ‘Sam, coat!’

Give processing time for your child to respond – up to ten seconds is recommended – before repeating the instruction.

Use visual supports (photos, gestures, objects) to back up your communication. When a word is said, it has vanished, but a visual support remains – the photo of the park can still be seen, a written schedule of the day can be referred back to by the child, or an adult holding up the coat as they say it both reinforces the name of the object, as well as telling the child what is happening.

Model and explicitly teach social skills. These may not come naturally.

Adapting the Environment

Reduce sensory stimulation in the environment. This may be visual stimulation which needs to be decluttered, or auditory stimulation such as TVs or other noise.

Children may benefit from a quieter space they can go to.

They may also need to have space and resources to meet their sensory needs.

Meet Sensory Needs

We all have sensory preferences, but Autistic children’s likes and dislikes can be much greater. They may be seeking or avoiding sensory input. In general, it is advisable to try to meet their sensory needs rather than trying to stop them as this can cause distress. There is more information on the sensory systems and strategies in the Sensory tab, below.

Routine and Structure

Autistic children don’t just want routine, they need it. You can help by making things predictable for them, and where possible, preparing them in advance for any changes. Visuals and timetables can really help with this as they show the child what is happening and can reduce anxiety.

This applies to behaviour management as well, where it is important for all caregivers to be following the same approach. Things may not change overnight so it is important to persist with strategies to allow them time to embed. When something works, keep using that strategy. It is easy to think the child may not need it any more, when they still do.

Allow for the Autism

Although your child will make progress and will change over time, they will always be Autistic. The better you understand their needs, likes, dislikes, challenges and strengths, the better you will be able to support them.

Behaviour is Communication

All of us show our views and feelings through our behaviour. For Autistic children and young people who struggle with communication and interaction, behaviour is often the most effective method of getting across their needs, wants and views. If the child has learned that the behaviour provides a function for them, even if it impacts negatively on others, it is likely to continue.

What is Behaviour That Challenges?

‘Challenging behaviour’ is how we classify a range of behaviours which some children and young people with autism may display to get needs met.

Behaviours might be things like:

Hurting others (e.g. hair pulling, hitting, head-butting, biting)

Self-injury (e.g. head-banging, eye-poking, biting, pulling hair, scratching)

Destructive behaviours (e.g. throwing things, breaking furniture, destroying work)

Eating inedible objects (e.g. stones, pen lids, bedding)

Other behaviours (e.g. spitting, smearing, removing clothes in public, running off, verbal abuse)

We all perceive behaviour that challenges differently. It is worth thinking if your child’s behaviour is challenging to them or just to the adults.

How to address behaviours

It is important to try to identify the causes of behaviours. Questions to think about might be:

• What is the child achieving by the behaviour, what is the result for them?
• Is there a pattern to the behaviour? Does it occur in a particular place, with a particular adult, or at particular times?
• What was happening just before the child displayed the behaviour?

A lot of behaviour is communication or meeting (or avoiding) a sensory stimulus.

If you do not know the cause of a behaviour, it is advisable to keep a record over several weeks in order to see if there is a pattern.

Knowing your child and analysing what they are telling us by their behaviour means that we can put in place strategies to help manage that behaviour.

This may mean:

• Teaching new skills (of communication or self-regulation)
• Providing sensory input before they start to display the behaviour
• Offering more appropriate alternatives to the behaviour
• Adapting the environment and others’ communication

Autism Behaviour Strategies

Below are some common strategies for supporting behaviours. Find the strategy that is at the right level for your child. 

Sensory needs are now recognised as a factor in the Autism diagnosis.

Many, though not all, Autistic children will have some sensory processing difficulties, which may present as strong preferences toward some sensory experiences (eg always being on the move, or seeking out strong flavours) or an aversion to sensory experiences (eg avoiding noises – even ones that appear quiet to us).

We cannot stop having sensory preferences. Instead, we try to meet a child’s sensory needs, which, it is important to note, can change throughout the day and over the course of their life.

More information about the different sensory systems is available here: ASD and Sensory | Greenwich Community Directory

Autistic children are often referred to as 'visual learners'. Visuals are hugely beneficial for Autistic children, whether that is to help them understand, to communicate, or make choices. 

Visuals can help increase a child's independence and reduce their reliance on adults. They are universal, do not have an attitude, and are permanent - they remain to be referred to after the spoken word has vanished.

There are a range of visuals, including symbols for various activities and schedules, available to download and print here: Visual Support resources | Greenwich Community Directory

Royal Greenwich has a visual policy for the borough but it is worth noting that 'visuals' can be objects, gestures, photos, written checklists - anything that helps to back up verbal communication.