Physical and sensory

Developmental co-ordination difficulties were previously known as dyspraxia. In addition to the strategies suggested in the cognition and learning section, the following may be of help.

To help with this need you can:

develop the child or young person’s core stability for example, through using a wobble cushion, exercises, and games
ensure correct seating position with appropriately sized table and chairs
provide support for letter formation through using a multi-sensory handwriting scheme, pencil grips or sloping boards for example
provide physical activities to support development of gross motor skills (throwing, catching, hopping and so on)
develop fine motor skills through:

hand and arm exercises
specialist scissors
pegboards
threading
play dough
pincer grip activities (for example, placing pegs onto a washing line)

provide support for sequencing and organisational skills for example now or next boards, writing frames or visual timetables
adapt PE and sports day activities by scaffolding and grading tasks - if required, use adapted apparatus
use the school age occupational therapy (OT) resource pack - this gives comprehensive guidance to support and develop a range of functional needs, including:

D/deafness can be mild, moderate, severe, or profound.

We use the term 'D/deaf' to refer to all types of hearing loss from mild to profound. This includes deafness in one ear or temporary hearing loss such as glue ear.

Indicators of possible D/deafness include:

the child or young person may not respond consistently to environmental sounds, voice, or their own name and there may be a change in their usual communication
the child or young person may use amplification equipment: a hearing aid, cochlear implant or bone anchored hearing aid
the child or young person may mishear words or instructions and need reinforcement and reassurance before beginning task - repeat instructions as necessary
if D/deafness is severe or profound, the child or young person may not hear words or instructions at all
the child or young person may experience fluctuations in attention or may struggle concentrating - If so, strategies suggested in the social, emotional, and mental health section of the OAIP may prove useful - their attention may seem fleeting or inconsistent or may appear to be ignoring at times
the child or young person may have delayed language, if they are unable to hear certain parts of speech and they may have delayed communication, understanding of language, spoken language or social skills
the child or young person may need more time to process information - if they are concentrating on accessing speech, they may experience fatigue due to the effort this requires
the child or young person may have difficulty understanding peers in group discussions or in noisier environments - to help, it is important to reduce background noise as far as possible
particular environments such as group or class discussions, noisy or busy spaces, corridors, school halls or canteens may be overwhelming or challenging for the child or young person to access - they may avoid these spaces
the child or young person’s progress may slow down
the child or young person may show signs of frustration or fatigue

If the child or young person has been issued with a hearing aid or hearing aids make a referral to West Sussex Sensory Team for specialist advice and strategies.

To help with this need you can:

remove or reduce background noise - establish a quiet working environment, particularly for specific listening work
employ techniques to monitor and support all children and young people with ambient noise levels
check amplification equipment daily - as the child or young person gets older, support them to develop independence in checking their equipment - keep spare batteries on site
seat the child or young person away from any source of noise, for example:

the window
corridor
fan heater
projector
the centre of the classroom

give the child or young person access to a D/deaf awareness programme - this may include equipment management, understanding of deafness, D/deaf role models and D/deaf identity
ensure that the child or young person has access to D/deaf role models
attract the child or young person’s attention before speaking to them, for example with a tap on the shoulder and ask the child or young person if they have a preferred way of attracting their attention
where appropriate, use acoustic materials to support sound clarity - hard surfaces cause echoes and may lead to sensory overload or processing difficulties - where possible, use sound absorbing materials such as hessian, felt or carpet
during PE or games lessons, it may be more difficult to access and follow instructions, particularly in large open spaces or in halls with echoes
the child or young person may use lip-reading and visual clues to support their hearing - ensure that they are face on when you are giving instructions and try not to move around the room whilst talking
avoid standing in front of a light source when speaking (for example windows) - this can make lip-reading difficult
stand or sit still when speaking to the child or young person
pre-warn the child or young person about fire alarm testing and if appropriate use an alternative exit route or devise a personal evacuation plan for the child or young person - ensure that alarms flash as well as ringing if the child or young person is severely or profoundly D/deaf and consider fire evacuation procedures and make plans for the eventuality that the child or young person does not hear the fire alarm
complete robust risk assessments for school trips - consider traffic noises, alarms and listening to unfamiliar adults
ensure staff work together with other professionals for example, the sensory support team and ensure all staff and visitors who work with the child are aware of how best to support them - they should be familiar with the child’s one-page profile or equivalent
ensure instructions are delivered clearly and at an appropriate pace and volume (raised voices and shouting distorts speech and lip pattern, whispering and mumbling are a challenge to hear)
check the lesson content has been effectively communicated and understood, particularly when delivering new information, instructions, or homework; or using unfamiliar vocabulary
ensure that the child or young person has heard comments by peers in group activities - this may be done by repeating or rephrasing and asking open questions to check understanding
explicitly teach new vocabulary with physical objects or visuals to support - D/deaf children and young people may not be able to overhear language so will not pick this up as quickly as peers with hearing in the normal range
always use subtitles when showing videos and support access to audio clips by providing a transcript - words spoken on an audio or visual recording may need a person to repeat what is being said - provide a written copy or use subtitles
repeat or rephrase pertinent comments made by other children and young people ensuring the child can access
repeat, rephrase or model the child or young person’s comments back to them, using correct grammar
use a variety of communication strategies - this includes good eye contact, body language and facial expressions
use visual reinforcement (pictures and handouts), to support learning and use gesture, British Sign Language (BSL) signs or Makaton as appropriate
use visual timetables and visual cues such as sand timers
encourage and model good listening behaviour: sitting still, looking, and listening
support children and young people to ask when they are not sure what to do - they may need a visual way of letting adults know that they need support
ensure all staff who work with a child or young person with hearing impairment (HI) are aware how best to support in school and settings
ensure all staff who work with a child or young person with hearing needs are aware of how best to support them in school, through deaf awareness training (delivered by the sensory support team)
arrange for adults working directly with children and young people with hearing impairment to have appropriate training - where the child or young person uses British Sign Language as their communication preference, staff need to be appropriately trained and they will need at least British Sign Language (BSL) level 1 or 2 proficiency

To help with this need you can:

work together with other professionals for example, the sensory support team, to share strategies and advice to enable the child or young person to access the learning environment, for example, using technology, alternative visual resources, or pre-learning
consider lighting and position for child or young person and how it supports their vision
provide uncluttered space and plain backgrounds to help the child or young person focus on the appropriate object or text
use auditory reinforcements and cues
use talking books and literature and use books with braille if the child or young person is a braille reader
use apps that can support text-to-speech functionality, so that the child or young person can access texts with independence
use talking equipment for life skills or curriculum activities
create a folder or toolkit of frequently used (transferable) resources, which the child or young person can access during lessons
provide additional resources for inclusive play, for example a bell in the ball, so all can play together
ensure the child or young person has time to map the room daily and allow re-mapping to occur when furniture and resources change place to reduce confusion and potential injury
consider lighting and position at group time or lunchtime
use a 3D printer to create tactile representations for the child or young person to feel
as appropriate, provide access for the child or young person to develop their mobility needs - they may need to access mobility or cane training
provide access to low light visual aids
provide access to quieter learning environments when the child or young person needs this

To help with this need you can:

speak to parent carers to identify potential trigger times and activities
conduct a sensory audit of the school or setting environment - some children or young people may need an individual sensory checklist assessment to identify their needs and inform which strategies to use
use sensory reduction planning if necessary to manage the triggers for over or under stimulation
provide individual workstations, where the child or young person would find this supportive
liaise with an autism and social communication advisory teacher to access sensory environment bitesize training - access further staff training (such as sensory integration) if needed
share strategies and advice with all members of staff to support the child or young person’s sensory diet
consider referral to the occupational therapy service
work together with other professionals to share strategies and advice to support the children and young people’s sensory diet
identify activities which help the child or young person to regulate and use these at appropriate times of day to promote access to learning
consider the impact of break times, lunch time and transitions - work with the child to develop strategies which help them feel ready to learn
build independence using timers

The child or young person may have an aversion to certain food tastes and textures or may also seek input from foods and food textures.

To help with this need you can:

consider the eating environment and discuss this with the child or young person - is it too loud, too messy or too busy?
speak to parent carers about eating preferences at home - are there particular foods or textures that the child or young person prefers or avoids?
use visual supports to support with choices and awareness of what is for lunch, snack, dinner
have a consistent mealtime routine involving opportunities for positive adult role modelling and support - support positive interactions with peers and staff to build confidence
offer an element of choice, for example peas or carrots
if supportive, separate foods of different types or texture on a plate
allow and provide opportunities for the child or young person to explore food texture with their hands
ensure that there are alternatives available at mealtimes and foods that suit a sensory preference
keep pressure to eat low, especially when trying new foods and plan how the child or young person will access meals and snacks to reduce stress and any pressure to eat - involve them when making this plan
try a range of cutlery to support the child or young person to find a preference - be mindful of cultural differences

The child or young person may have a strong aversion to smells or indeed seek smells out.

To help with this need you can:

set up a ‘no scent’ zone, free from air fresheners, flowers, perfumes and so on
staff should consider the perfume or aftershave and other products that have a smell that they wear
consider if the cleaning materials used in the setting have a strong smell
provide access to scented resources, if the child or young person is sensory seeking in this way
allow the child or young person to have opportunities to bake and cook to create different smells
be aware of smells from the outdoor environment, for example refuse collection and mitigate these smells where possible

To help with this need you can:

consider the proximity of others - would a carpet tile or a chair help?
if helpful, allow the child or young person to be at the front or the back of a line
approach the child or young person within their visual field
consider the challenges that the child or young person may face with different floor surfaces
allow the child or young person to transition to another place a few minutes before their peers, to avoid busy spaces
ensure that there are opportunities for the child or young person to engage in sensory opportunities to meet their tactile seeking needs - provide a sensory box of items to feel
adjust and adapt uniform policies for individuals who experience tactile differences

The child or young person may seek extra input for their proprioceptive sense.

To help with this need you can:

offer need-appropriate movement opportunities for the child or young person to regulate, for example:

run
jump
join in weight bearing
deep pressure activities

recognise that a child or young person may seek further sensory input via leaning and provide an opportunity for them to access table or wall pushes
the child or young person may rock on their chair or place the chair legs on their feet to seek grounding - gym bands around the front chair legs may help to provide feedback
provide a weighted lap pad or jacket to support grounding
ask the child or young person to carry a box or bag (heavy) of toys or work to their next activity
offer jumping on a trampette or provide a space hopper or alternatively, a wobble cushion may be used
use timers to support the start and finish of the activity
provide sensory circuits or regular access to a gym trail
offer alternative seating arrangements or a standing desk

To help with this need you can:

give the child or young person daily opportunities to perform gentle stretches, rocking back and forth, slowly marching; or try yoga activities
provide opportunities to work in pairs with another child or young person working on ‘rowing’ (sitting opposite, legs in a ‘V’ touching feet with partner, holding hands, gently ‘row’ forward and back) or wheelbarrows
a child or young person may need support negotiating space, for example, walking up the stairs and with balancing activities
allow the child or young person to transition to another place a few minutes before their peers, to avoid busy spaces
vestibular activities can help to raise a child or young person’s level of arousal or alertness - activities may include:

jumping or working against gravity
hanging upside down
swinging
crunchy strong-tasting foods
climbing
running
movement breaks
moving furniture

To help with this need you can:

ensure adults regularly talk about internal feelings both physical and emotional - model through description, for example “I wonder if you are tired today, because you are yawning”
build mindful activities into daily routine
use body mapping to support the child or young person in developing their interoceptive awareness
plan activities that link physical sensations to labelling emotions

To help with this need you can:

ensure that transition arrangements have been put into place prior to the child or young person joining the setting - this would include ensuring that the necessary adaptations are in place:
- refer to the child or young person’s individual health care plan if they have one - check in with parent carers if you are unsure whether there is a plan in place
- undertake appropriate moving and manual handling training
- use support equipment for example work chairs, walkers, standing frames and hoists
- ensure that appropriate accessibility plans are in place for example, a personal emergency evacuation plan
- undertake appropriate care training and use of school and setting’s hygiene facilities
- procure and learn how to use and maintain (where necessary) specialist or supportive equipment
use adapted equipment to facilitate access specific activities throughout the day for example cutlery, crockery or scissors
maintain progress by having a detailed handover with the child or young person’s previous setting or teacher to have a clear understanding of their strengths, coping strategies, and any areas of need - consider those that also relate more broadly to their development or emotional well-being such as opportunities to develop confidence or developing and maintaining friendships
keep a focus on promoting independence and resilience within planning and adaptation
provide accessible ‘stretch’ opportunities if the child or young person needs this - some children and young people require support to change their position to ensure comfort and readiness to learn
refer to an occupational therapist for support, and consistently implement suggested strategies and advice

Physical and sensory​

Identified barrier or need