Archived decisions

Contact: Tracey Sanders, Head of Early Education and Childcare Unit. Tel: 01962 813872, email: [email protected], and Janet Hoff, Deputy Head, Vulnerable Children, Tel: 01962 813878, e-mail [email protected].

1. Introduction

1.1 This paper sets out the current process by which young children access therapy services, and describes the support role offered to families and early years education providers by teams within, and commissioned by, Children's Services Early Education and Childcare Unit (EECU). It also provides information on how the EECU is addressing the issues raised by the Area Inclusion Co-ordinators (Area INCOs - formerly Area SENCOs) in the `Review of Access to Therapy Services for Children in School and Pre-School 2004'. The scope of this report is limited to the work of the EECU and Commissioned services. It should be considered in conjunction with information from Health colleagues, the Special Educational Needs (SEN) department, the Specialist Teacher Advisory team, the Educational Psychology service, and Children's Services officers involved in implementing the children's centre programme, the development of locality teams, and the Common Assessment Framework (CAF).

2. Background : Current support available for young children with SEN and disability

2.1 Therapy services for young children within Hampshire are provided by the Primary Health Care Trust (PCT) and include physiotherapy, occupational therapy, and speech and language therapy. Young children are identified as requiring therapy services at varying stages. For some children, it will be evident at birth that therapy services are required and this is usually identified by a paediatrician in collaboration with parents. However, for other children, their developmental delay and the need for therapy services may not become apparent until later. In these circumstances a child's need is usually identified by health professionals, but may also be identified by others involved with the child's care, such as an early years education provider, an Area INCO, an Educational Psychologist or a Specialist Teacher Advisor who will then liaise with parents and relevant health professions to plan how the child's needs can best be met. Liaison between the early years education provider, Area INCO, the Educational Psychology services, Children's Services, and Health professionals may either take place directly or may take place with an early years multi-agency forum.

2.2 Once a child is identified as requiring therapy, interventions are usually delivered at a clinic, special school, or specialist nursery provision. Generally, therapeutic programmes are also shared with a child's early years education provider. At times, the responsibility to inform the early years provider about a therapeutic programme falls upon a child's parents or alternatively providers may be contacted directly by the therapist who will help in the implementation of the programme. Currently, practice varies across the county although it is understood that this will align as the new single PCT further evolves.

2.3 In 2004, a review of access to therapy services for children in school and
pre-school was undertaken and evidence was collected from a range of professionals and a number of recommendations were made. Key issues raised by the Area SENCOs service included:

· A lack of opportunity for early years and childcare providers to be involved in the assessment of children's needs

· A lack of liaison between therapists and early years education providers to support the delivery of interventions

· A greater need for speech and language therapists and occupational therapy compared to physiotherapy

· A need for children with disability to access specialist equipment

· Difficulties in referring to therapy services with waiting lists which, varied between 6 to 12 months

· Differing referral routes

· Confusion over roles and responsibilities.

3. The role of Children's Services Early Education and Childcare Unit in supporting children with SEN and disability

3.1 The EECU co-ordinates and provides direct support to nurseries, pre-schools and childminders to enable children with SEN and disabilities to be included within the childcare and early years education setting. This support is delivered through the Area INCOs service.

3.2 The Area INCOs service consists of 18.7 full time equivalent members of staff who are located within five locations countywide. Their role is to provide advice to setting SENCOs on implementing the Code of Practice, deliver training, and support practitioners in planning to meet the needs of children with SEN and disability and to liaise with outside agencies. This support is provided at the early years action stage of the SEN Code of Practice. The Area INCOs also signpost settings and parents to other agencies where it is felt a referral would be appropriate.

3.3 In addition to the work carried out by the Area INCOs service, the EECU commissions SEN outreach provision that is available across the county. SEN outreach provides in depth consultation, advice and support to early years providers at an individual child level. The outreach providers have a high level of knowledge and expertise in the area of SEN and are based in special schools, special nursery provision, and Portage. This service is available countywide and is provided at the early years action plus stage of the SEN Code of Practice. Outreach providers may also be involved in providing training and support groups for settings.

3.4 This work takes place in alignment with support provided by the Educational Psychology Service and the Specialist Teacher Advisory team. These professionals tend to become involved when children's needs are most complex.

3.5 The EECU also provides a Portage service, which supports 250 pre-school children and their families across Hampshire. This support is delivered through home visiting and an emphasis is placed on working in partnership with parents. Portage home visitors work closely with therapists and help parents follow therapeutic programmes at home, which ensure a joined up approach. Portage home visitors also refer to other agencies if appropriate.

3.6 The Early Support Programme is available across Hampshire and is delivered by key worker co-ordinators who are placed in each district. This programme is developed from the guidance provided in `Together from the Start' (May 2003) and is available to disabled children aged (0 - 5 years) who have 3 or more professionals involved, including a paediatrician. The programme aims to promote:

· Better joint assessment and planning processes for individual children

· Better co-ordination of services where there are several professionals involved

· Better information for families

· The introduction of a key worker or lead professional as a key point of contact and co-ordination for the family

· Better exchange of information about children and families

· Joint review of multi-agency service provision with the family

· The development of family held records and standard materials that can be shared across agencies.

This programme is in its early stages and so far, evaluations suggest that it is highly effective in meeting the above aims.

3.7 The EECU provides equipment for disabled children in early years education and childcare. Currently, 56 children have benefited from such equipment. The equipment loan programme is undertaken in partnership with occupational and physiotherapy services that carry out an assessment of the child's needs and provide advice to the setting on the use of the equipment. Equipment remains with the child for a year or when it is no longer appropriate for use. Equipment is then returned to a local store and loaned to other children as required. It is anticipated that, in time this early years equipment programme will be incorporated into the joint equipment system for school age children.

3.8 The EECU provides additional funding using the General Sure Start Grant (GSSG) for disabled children to enable them to be included in childcare. This is provided at a rate of £8.50 per session and to date 49 children have been funded. This mirrors the additional SEN funding which is set at the same rate and is provided through the Dedicated Schools Grant and administered by the SEN department for children in early years education.

3.9 Finally, a programme of training is provided for registered childcare and early years education providers, including childminders covering a range of topics relating to supporting children with SEN and disabilities. This includes generalised induction training on the role of the SENCOs, the SEN Code of Practice and inclusive practice, in addition to specialised courses relating to speech and language development and physical development. A full list is available in Appendix 1.

4. Review of Access to Therapy Services for Children in School and Pre-school (2004)

4.1 Services for pre-school children with disabilities have developed significantly over the past few years with the emphasis on ensuring that children attending childcare (0 - 3 years) settings have access to the same level of support as those who are in early years education settings (3 - 5 years).

4.2 The role of the Area INCOs has been evaluated and identified as an effective service leading to increased understanding and confidence of providers in supporting children with SEN and disabilities. Linked professionals report clarity over roles and responsibilities.

4.3 Through the early support programme, multi agency reviews take place at least six monthly. These reviews are attended by all professionals working with the child including the setting the child attends. Therefore, early years practitioners are now firmly embedded in the assessment and planning process and there is better co-ordination of services for young children and families to enable choices.

4.4 The provision of equipment for children with disabilities has been established and is well utilised.

4.5 The outreach support described earlier is now more equitable across the county and is based on a formula approach relating to population size. However, it does not yet take into account the levels of need in particular areas and this is an area that will be considered in more detail in the next strategic planning phase.

4.6 Within the `Review of Access to Therapy Services for Children in School and Pre-School', it was acknowledged that transition was working well. The Area INCOs service has been enhancing the transition process for children with SEN and disability from early years provision to school by developing clear guidance so that there is consistent practice. This guidance is due to be piloted by early years providers in September 2007 and reviewed following an evaluation of its effectiveness.

4.7 Area INCOs remain concerned about waiting lists for therapy services and differing referral routes. However, it is anticipated that the targeted delivery of therapeutic services through children's centres, the implementation of CAF, the development of locality teams, and the alignment of Health services into a single PCT will significantly help in redressing these issues.

5. Conclusion

5.1 This report has set out the current support available for young children (0 - 5 years) with SEN and disability provided by the EECU. It highlights the key areas of concern raised in the `Review of Access to Therapy Services for Children in School and Pre-School' by the Area INCOs and describes a number of actions taken to address these concerns. This report also confirms that links between Health professionals and Children's Services officers are strengthening and it is anticipated that with the formation of a single PCT, the establishment of the children's centre programme, the implementation of CAF and the development of locality teams will all contribute to enhanced planning and delivery of provision for children with SEN and disability.

Section 100 D - Local Government Act 1972 - background documents

The following documents discuss facts or matters on which this report, or an important part of it, is based and have been relied upon to a material extent in the preparation of this report.

NB: the list excludes:

1. Published works

2. Documents which disclose exempt or confidential information as defined in the Act.