Cognition and Learning Severe Learning Difficulties (SLD

SEND Graduated Approach Framework

5 Cognition and Learning: Severe Learning Difficulties (SLD) and Profound and Multiple Learning Difficulties (PMLD) 1

Section 5

Cognition and Learning Severe Learning Difficulties (SLD)

Profound and Multiple Learning Difficulties (PMLD)

In this section: 5A Area of need description 2 5B Statutory guidance from Special Educational Needs and 3

Disability Code of Practice 0-25 (2015)

5C Inclusive whole school/setting systems 4-5 5D Steps for identifying, assessing and supporting the child’s/young 6-16

person’s needs (Assess-Plan-Do-Review)

Use this guide in conjunction with Bromley’s Ordinarily Available Provision guidance and resources provided on Bromley’s SENCO Hub.

Remember to signpost parents/carers to the Bromley’s Local Offer.

http://bromleyeducationmatters.uk/Services/5594

https://www.bromley.gov.uk/localoffer



5A Area of need description: Severe learning difficulties is a term used to describe a very low-incidence severe intellectual disability, which is marked by extremely low functioning across a range of cognitive assessments, normally below the first percentile. Profound and multiple learning difficulties is a term that encompasses severe learning difficulties and an exceptional and complex profile of co-existing special needs, sensory impairments, disabilities and/or health conditions.

Difficulties within this area of need may include: very significant difficulties with developing self-help/self-care skills; very significant difficulties with communicating verbally, beyond the use of limited phrases and signs and symbols; very significant difficulties with both verbal and non-verbal reasoning; very significant difficulties with understanding concepts and language across the curriculum; very significant difficulties with problem solving; very significant difficulties with acquiring and applying basic literacy and numeracy skills; very significant difficulties with concentration, attention and social skills; and difficulties with mobility and co-ordination

Most children and young people (C/YP) with severe learning difficulties and all C/YP with profound and multiple learning difficulties will be dependent on high levels of adult support for most or all aspects of their care and learning.

Difficulties within this area of SEN are identified by a qualified educational psychologist and a range of other professionals will also provide assessments. This includes consultant and specialist level medical practitioners, speech and language therapists, occupational therapists, mental health professionals and physiotherapists.

Speech and Language Resources Specific Learning Difficulties Resources

http://bromleyeducationmatters.uk/Page/15875




5B Statutory guidance from Special Educational Needs and Disability Code of Practice 0-25 (2015): This area of need is referred to in the Special Educational Needs and Disability Code of Practice 0-25 (2015) in the following sections:

Local authorities must publish a transport policy statement each year setting out the travel arrangements they will make to support young people aged 16-19 and learners with learning difficulties and/or disabilities (LDD) aged up to 25, to access further education. This should include any arrangements for free or subsidised transport. 4.50, pages 73-74

Support for learning difficulties may be required when children and young people learn at a slower pace than their peers, even with appropriate differentiation. Learning difficulties cover a wide range of needs, including … severe learning difficulties (SLD), where children are likely to need support in all areas of the curriculum and associated difficulties with mobility and communication, through to profound and multiple learning difficulties (PMLD), where children are likely to have severe and complex learning difficulties as well as a physical disability or sensory impairment. Extract from 6.30, Pages 96-97

Statutory Guidance Resources




5C Inclusive whole school/setting systems: Please note that early years providers should refer to the Bromley Early Years Providers SEN Toolkit, particularly: (a) the guidance and resources provided in the ‘Quality Universal Inclusive Practice’ section (pages 1-4); and (b) by using key word search items relevant to this area of SEN, such as ‘learning’.

An inclusive school/college/setting will have systems in place to: carry out their duties to safeguard and promote the welfare of all C/YP, in accordance with the statutory guidance Keeping children safe

in education and Working Together to Safeguard Children, alongside the guidance and processes outlined in the Bromley Safeguarding Children Board Thresholds of Need;

maintain a published and easily accessible SEN Information Report, compliant with The Special Educational Needs and Disability Regulations 2014: Schedule 1 Regulation 51, which is co-produced at least once every 12 months with the setting’s C/YP, staff, governors and parents/carers;

ensure that reasonable adjustments are consistently in place, in accordance with the Equality Act 2010, to ensure that disabled people (as defined by the Equality Act) can fully participate in the education and enrichment opportunities provided by the school/setting;

maintain a published and easily accessible Accessibility Plan, compliant with The Equality Act 2010 Schedules 3 & 4, to provide an overview of plans to increase the accessibility of the setting for disabled people;

work effectively in partnership with parents and carers and provide signposting to further sources of local advice, support and information, including:

o Bromley Local Offer o Bromley Parent Voice o Information, Advice and Support Service o Bromley Children's Disability Register

implement robust and effective transition processes, including targeted support programs for C/YP who require additional support during transition periods;

embed Preparing for Adulthood, from the earliest years, in universal, targeted and specialist provision, to support C/YP to achieve paid employment, independent living, housing options, good health, friendships, relationships and community inclusion;

offer a broad, balanced and inclusive curriculum, including appropriate timetabling and grouping arrangements to provide C/YP with optimum learning opportunities;

ensure that learning environments promote the engagement of all C/YP with special educational needs and disabilities; work effectively in partnership with local external professionals/agencies;



regularly capture the views of C/YP and parents/carers, so that their preferences, ideas and aspirations can contribute to whole setting development and improvement;

provide staff with a broad range of regular continuing professional development opportunities to extend their knowledge, awareness and skills of special educational needs, disabilities and inclusive practice;

regularly monitor the quality of teaching and learning (including the deployment of support staff) for C/YP with special educational needs and disabilities;

regularly and robustly evaluate the impact of SEN provision on the outcomes for C/YP, using both quantitative and qualitative evidence; undertake regular whole school/setting strategic reviews of SEND provision and inclusive practice to support whole school/setting self-

evaluation, improvement and development; and ensure that the governance of special educational needs, disabilities and inclusion for the setting provides regular and highly effective

leadership support and challenge For this area of need, consideration should be given to:

ensuring that strong underpinning safeguarding systems are in place; providing regular training to staff about more significant and complex learning difficulties, including associated difficulties within other

areas of need (i.e. physical disabilities and related health needs, Autism or related social communication difficulties and social, emotional and mental health difficulties);

accessing resources from the British Institute of Learning Disabilities, the Challenging Behaviour Foundation, the Physical Disabilities Network and other relevant organisations to support a whole school/setting approach;

undertaking relevant whole school/setting strategic reviews; organising awareness-raising events, ensuring that your school/setting has a designated Autism Champion and Mental Health Lead and that they access the respective

Bromley Development Network events, resources and weekly e-Digests; and signposting parents/carers and C/YP to local agencies for support, for example Bromley MENCAP

Communication Champions Ordinarily Available Provision Bromley Early Years Providers SEN Toolkit



https://www.bromley.gov.uk/downloads/file/4706/early_years_providers_sen_toolkit



5D Steps for supporting and identifying the child’s/young person’s needs (Assess-Plan-Do-Review): Usually, a C/YP with severe or profound and multiple learning difficulties will be identified before they commence their placement at your setting. Please also note that Section 5D should be read with reference to other areas of need within this framework.

Please also note that early years providers should refer to the Bromley Early Years Providers SEN Toolkit, particularly: (a) the guidance and resources provided in the ‘Provision for children not making expected progress’ section (pages 5-6); and (b) by using key word search items relevant to this area of SEN, such as ‘learning’. The link for this toolkit is provided below.

The following Assess-Plan-Do-Review steps provide a structured and sequential approach to identifying the C/YP’s needs. This should be implemented before the C/YP is placed on the SEND register. Please note also that work undertaken in each step can and should be reviewed, revisited and changed, not necessarily in the sequence outlined. This is marked by the symbol between each step.

If the C/YP commences their placement at your setting with a profile of evidenced SEN or disabilities, including one or more assessments from assessing professionals that meet the criteria outlined in Section 5A (above), it may not be necessary to undertake all of the work outlined in each step. For example, if the work undertaken prior to the C/YP’s placement in your setting has established a full and comprehensive profile of needs, the work outlined in Steps 1, 4 and 5 may not necessary. However, the listed quality first teaching strategies (provided in Step 2) and other types of support, provision and intervention (provided in Step 3) should be implemented, as this also forms part of SEN provision referred to in the thresholds of need within Bromley’s SEND Graduated Approach (Section 10).

Graduated Approach Resources Bromley Early Years Providers SEN Toolkit


https://www.bromley.gov.uk/downloads/file/4706/early_years_providers_sen_toolkit



STEP 1 Initial indicators that the child/young person may experience barriers to learning (Assess): Concerns may be raised that the C/YP is not – or is at risk of not – achieving good or better progress, from their individual starting points. This indicates that the C/YP may be experiencing – or may be at risk of experiencing – barriers to learning. Concerns may be raised by parents/carers, teachers and/or the C/YP themselves. These concerns may be initially raised via an analysis of attainment and progress data, baseline testing, a staff concerns form, informal observations and meetings with parents/carers. Transition periods are a key time for identifying these initial concerns and to start this work; please refer to the Bromley Toolkit for Effective Transition.

At this early stage, consideration should be given to possible causal and contextual factors in the C/YP’s life. This includes possible difficulties associated with this area of need, but it is important also to consider aspects of their personal development, life experiences and any other possible additional needs.

It may be appropriate to initiate the Common Assessment Framework (CAF). The CAF process is used as a holistic assessment of need to support professionals to work in partnership with families to assess needs, identify plans and check that the needs are being addressed. The process supports families to identify their own strengths, networks of support and additional services that they might need.

The description for this area of need, provided in Section 5A, above, should be read thoroughly. Additional guidance resources should also be reviewed, in Sections 5A and below. Further baseline testing, for example of literacy and numeracy skills, may also be beneficial. Finally, an initial checklist should be completed to review the possible areas of SEN, linked with the presenting concerns. This will support consideration and identification of the C/YP’s barriers to learning, enabling teachers/lecturers to then plan and implement quality first teaching strategies (Step 2).

Identifying SEN Resources Forms for Requests, Referrals and Reviews Local Information and Services






STEP 2 Quality first teaching strategies (Plan-Do-Review):

Quality first teaching is a broad term, applicable to all C/YP, which refers to high-quality, personalised teaching. Such teaching will, for example, be based on clear objectives that are clearly communicated and returned to at the end of the lesson; carefully explain new vocabulary; and use lively, interactive, multi-sensory teaching methods. For C/YP who have or may have special educational needs or disabilities, the SEN Code of Practice refers to this as ‘high quality teaching’.

The quality first teaching listed below for severe and profound and multiple learning difficulties – provided to teachers/lecturers/support staff to guide differentiation and supported by appropriate information-sharing systems with staff (e.g. one-page profiles), resources/equipment (see Step 3), staff coaching, training and evaluation – should be put in place following consideration of a range of factors. These include the specific types of difficulties experienced by the C/YP (including barriers to learning that are associated with signs of severe or profound and multiple learning difficulties), their strengths, interests, preferred learning styles and their age.

From this step onwards, in addition to the whole school provision map, class or subject teachers/lecturers should maintain clear records of the quality first teaching strategies and in-class provisions available in lessons; this may be in the form of a class provision map (common in primary schools) or via annotated class registers, lesson plans and seating plans (more common in secondary schools and colleges). This may include: interventions and specified higher levels of support within the class; current attainment and progress (from starting point) data; and narrative/qualitative outcomes, i.e. to capture progress which is not directly measured by attainment and progress data. Quality first teaching strategies should be regularly reviewed and modified, in line with the ongoing work undertaken in Steps 3, 4 and 5, and with up to date assessment information about the C/YP’s progress from their starting points.

Quality first teaching strategies for severe learning difficulties and profound and multiple learning difficulties should include at least some of the following:

Provide a multisensory approach to learning – this includes visual, auditory and kinaesthetic activities. Ensure that classroom routines are strongly supported by visual cues. Use objects of reference to support the C/YP’s understanding, as part of experiential, practical and concrete activities. Pre-teach and then keep reinforcing basic key vocabulary. Sessions should start with an achievable activity. Consider what interests and motivates the C/YP and try to incorporate these interests into lessons as often as possible. Keep language simple and familiar. Keep instructions short and concise and say and show things more than once. Ensure that learning activities are broken down into small steps and are clearly focused.



Provide alternative methods of recording and demonstrating progress. Ensure that each small achievement is recognised in a way that is meaningful to the C/YP. Organise activities to develop listening and attention skills. Provide explicit links using different colours and known symbols when appropriate. Relate text to illustrations, photographs and video clips. Use clear display references in the room as regular prompts and reinforcements.

Please also refer to the guidance for Speech, Language and Communication Needs (Section 1D), Autism Spectrum Disorder (Section 2D), Hearing Impairment (Section 6D), Vision Impairment (Section 7D) and Physical Disability (Section 8D).

Quality First Teaching Resources




STEP 3 Other types of support, provision and intervention (Plan-Do-Review):

The provision of equipment/resources and interventions listed below should be planned following consideration of factors such as the specific types of difficulties experienced by the C/YP, their strengths, interests, personal preferences and their age. From this step onwards, a provision/intervention record should be maintained by the staff member planning and implementing this. This record should in place for C/YP accessing specific intervention programs, as well as teacher/lecturer-directed additional support. This should be for a time-limited period (e.g. half-termly) and includes: entry criteria; exit criteria; targets; planned activities; outcomes to evaluate impact (this include data/scores and RAG rating, for example); and ‘next steps’.

Note also that the following is a list of equipment/resources and interventions which are commonly provided in schools, colleges and other education settings; it is not, however, an exhaustive/definitive list, nor or an endorsement of any commercial products. Equipment/resources, generally for use in regular class settings, may include one or more of the following:

5-Point Scale Adapted text or diagrams to make them visually accessible Choosing board Communicate In Print 3 Widget Symbol Software Communication passports Ear defenders Easi-Speak Pro Microphone Easygrip and long loop scissors Fans (e.g. feelings, needs, letters, numbers, etc.) Illuminated mark making board Illuminated writing boards Individual work stations Key ring symbols Large print books Letter formation whiteboard Low vision aids Magnetic tinted wipe-clean boards Magnetic whiteboards



Magnifier sheets Now and next boards/first and then boards Picture Exchange Communication System (PECS) Pop up sensory space Radio aid system Recordable buttons Recordable talking pegs Recordable talking wall panel Reference flip stands (e.g. sentence builders, place numbers, etc.) Sound bank mirror Sound lights Tactile curriculum resources Talking recordable photo albums Talk-Time recordable postcards Textured hand massagers Visual timetables Weighted ankle bands Weighted palm buddy Weighted pen/pencil Weighted support wristbands Write and wipe pockets

Interventions may include one or more of the following:

Lego Therapy / Build to Express Picture Exchange Communication System (PECS) Sensory Circuit Sensory room sessions Social skills programs TEACCH program, including individual work station, trays, visual supports, etc. Transition support programs



Specific Learning Difficulties Resources Speech and Language Resources What Works Resources Provision Mapping Resources







STEP 4 Methods and resources for exploring possible difficulties within this area (Assess):

If the C/YP continues to experience barriers to learning, the outcomes of the support provided via quality first teaching strategies (see Step 2, above) and other types of support, provision and intervention (see Step 3, above) should be reviewed and further work should be undertaken to explore whether a profile of moderate learning difficulties is likely.

This should usually include: feedback from teachers/lecturers and support staff (for example, via a staff round robin) feedback (‘pupil voice’) from the C/YP consultation with the C/YP’s parents/carers (‘parent voice’), which may include use of the Common Assessment Framework (CAF); and undertaking observations in lessons and/or in less structured settings.

It is helpful to use basic screening tools and checklists during this process. When the work for this step has been completed, it should be established whether consultation with/referrals to one or more assessing professionals (Step 5) is necessary.

Contributing to person-centred planning and the setting of holistic outcomes, individual provision maps for the C/YP should be established by this stage, especially if the C/YP is now accessing significant levels of additional support. Their provision map should include the following: clearly listed and personalised Quality First Teaching strategies (i.e. specific to the C/YP, not generic) clear and measurable entry criteria set for each targeted provision/intervention specific, measurable, achievable, realistic and timed (SMART) targets set for each intervention/provision, linked with baseline

assessments progress clearly evidenced, including very ‘small steps’ progress from the C/YP’s starting points each provision/intervention evaluated against exit criteria and clear outcomes (‘next steps’) identified for each provision/intervention evidence of co-production with parents/carers and, where appropriate, the C/YP

Identifying SEN Resources Provision Mapping Resources





STEP 5 Consultations with/referrals to assessing professionals (Assess):

If there is comprehensive evidence collated within the school/setting and in liaison with parents/carers, from the work being undertaken in Steps 1 to 4 (above), that the C/YP continues to experience barriers to learning that include difficulties associated with moderate learning difficulties, consultations with/referrals to one or more of the following assessing professionals may now be appropriate:

Educational Psychologist Occupational Therapist Physiotherapist Speech and Language Therapist Bromley Wellbeing Community Paediatrician Tertiary Centre Paediatrician Dietician Bromley Sensory Support Service (Vision and Hearing Teams) Disabled Children’s Team

If the C/YP is now accessing significant levels of additional support and the school/setting and parents/carers are considering whether additionally-funded provision or an Education, Health and Care needs assessment may be requested, check if:

there is clear, up-to-date information about the C/YP’s academic attainment/developmental milestones and rate of progress (note: is this related to English as an Additional Language, poor attendance, home/family circumstances or a medical condition, rather than SEN?)

there is clear, up-to-date information about the nature, extent and context of the C/YP’s SEN there is clear evidence that relevant, purposeful action has been taken to identify and assess the C/YP’s SEN, including access to local

services across (where appropriate) education, health and care there are three complete individual provision maps which evidence all of the following:

- clear integration of external professional advice (i.e. explicitly cross-referenced) - appropriate and evaluated utilisation of funds (i.e. the provision map needs to be fully and accurately costed) - clear links between the outcomes of previous provision maps, showing adjustments that have been made over time



- how any progress that has been achieved is a result of much additional intervention and support at a sustained level, over and above that which is usually provided

- information, based on the outcomes, as to why this provision is now insufficient, linked clearly with the C/YP not making expected progress across the curriculum

Forms for Requests, Referrals and Reviews Local Information and Services





Please now refer to SEND thresholds and funding information provided on the SENCO Hub for

the Bromley Banded Funding Guide, Pupil Resource Agreements and Education, Health and Care Assessments





Documents

Cognition and Learning Severe Learning Difficulties (SLD