[2023] UKUT 223 (AAC)

Targeted Intervention

Interventions offered in the education setting to support [Q’s] identified areas of need which may be delivered in a 1:1, small group or as a small class. This is to be delivered by designated education staff trained with working with a child with ASD, language and learning needs. Any intervention offered will be delivered throughout the academic year and included in class lessons, where possible. Communication targets linked to this intervention will be monitored by the teacher.

[Q] will need all adults to regularly use clear, explicit, unambiguous language when communicating with him. When explaining a task to [Q], all adults will need to use simple words combined with visual cues (e.g. pictures, objects, signs, symbols, and gesture, touch and actions) and simplified sentences that are broken down into manageable steps. [Q] will need daily practical experiences to reinforce language in teaching situations. For example, visuals can be worn on lanyards by all Teaching Staff working with [Q] to enable easy access and offer additional opportunities for him to understand information that is being shared with him. Adults will need to provide instructions to [Q] one at a time; gradually increasing the demands in terms of length and complexity. Adults will need to ensure understanding through, asking him to repeat instructions back where necessary / appropriate and/or checking that he understandse.g. asking him “what are you going to do?” after an explanation has been provided.

Through a range of play situations, adults will need to continue to make a commentary on [Q]’s actions and those of others to model the use of simple language, gestures and signs. Adults will need to repeat instructions or directions frequently and allow [Q] enough time to develop an understanding of what he is being told. Adults will need to support [Q] with increasing his vocabulary and develop his understanding of language with practical experience to reinforce language in teaching situations through using objects such as small world toys to model language.

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Say [Q]’s name to gain his attention, and give instructions to [Q] one at a time (chunking).

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[Q] also requires access to small group and 1-1 work to develop his play skills and early learning skills through modelling and direct teaching.

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[Q] will need a highly structured transition plan to support his move into school. A staggered entry into school, the use of visual cues / a transition book, and careful monitoring of his response to situations in the early term will be highly important. Adult supervision and support would be helpful initiallyto enable him to navigate his new environment and provide opportunities for teaching of the skills needed.

[Q] will need adult support to access a foundation stage curriculum with the continuous use of a range of differentiated techniques, with an emphasis on using visual prompts. The foundation stage curriculum will need to be personalised for [Q]. For example, he will need ongoing individual and group support to develop his skills in all areas of development. [Q] will also continue to need access to tasks that are short in duration and are clearly explained, modelled, scaffolded and broken into short, manageable chunks. …

[Q] needs access to individual adult modelling, repetition and overlearning throughout the school day to support his learning and retention of skills. It will be important for [Q] to continue to build relationships with key adults who can base learning and direction around his strengths and interests, develop his confidence and continue to promote his independence.

[Q] will need daily structured sessions, away from the main classroom

environment if needed, to engage in adult-led differentiated structured activities. Adults will need to continue to use techniques such as the now and next approach, with visuals, where [Q] does an adult-led activity and then engages in a highly motivating activity for him. The adult-directed activities will need to initially incorporate his interests and be very brief, with a view to extending the time that he is expected to engage before doing his ‘next’ activity. … In addition, to promoting [Q]’s sustained attention on one task, the backward chaining strategy will need to be used by a key adult daily. Backward chaining involves initially presenting an almost-complete task for [Q] to finish and gain a sense of achievement. As [Q] gains confidence, more and more of the task will need to be left for him to do without adult support. …

Once [Q] is more secure in his choice-making and engagement in his structured sessions, consider the introduction of a visual choice board (displaying pictures of a range of activities where [Q] has to select one) or the use of colour coding in conjunction with a choice board. Brief but regular opportunities for an adult to join [Q] in his play and attempt to model skills to extend his play will need to be woven into his daily schedule.

[Q] will need daily guidance and modelling/hand over hand support with the development of his early play skills and focus. For example, messy play activities will need to be introduced gradually with the consideration of his sensory sensitivities in mind. The use of a treasure basket may help to develop [Q]’s focus on an individual 1:1 basis. It will be important, when focusing on [Q]’s attention skills that he is in a calm, quiet environment with minimal distractions. …

Due to [Q]’s developmental stage and current attention levels, he will initially need adults to engage him in daily short activities of five minutes or less that are achievable, and the duration of the activity will then need to be gradually increased. …

[Q] will need adult support during group work/whole class work to develop his attention and focus, and build his understanding. Those leading the group will need to use a total communication approach to support [Q], and he requires physical/visual cues to support his understanding of what is happening. For example, during stories, [Q] could have his own copy of the book to look at and/or props which are used by the adult to support his attention. ...

The use of visual prompts (e.g. visual timetable and a waiting sign) will need to be provided for building [Q]’s understanding of routines and expectations rather than just using spoken or written words during interactions. Also, [Q] will need to be provided with visual aids by a key adultto support with transitioning from one activity to another. For example, the use of a sand timer and counting down towards the end of activities can be used to help [Q] with the understanding of when to transition from one task to the other. This will also provide [Q] with an understanding of task duration and completion. Constant prompting will be neededfor [Q] to understand the duration of the task. …

Give daily opportunities for [Q] to experience a Special Times approach, where the adult follows his lead; observes what he is doing or showing interest in and imitates his actions and sounds. Use the strategy of ‘intrude’ to get in on his act, give a running commentary on his play, copy his actions – it may be easier initially to have a duplicate set of toys to copy with to work towards sharing. Gently insist on a go, but finish the games before he gets too frustrated and move him onto something else if he is getting angry or distressed. Keep trying briefly and opportunistically through the day. …

In a structured learning and predictable environment, [Q] will need a high level of support on a daily basis from adults who have experience of, or access to, training and understanding of children with Autism Spectrum Disorder (ASD),Global Developmental Delay, speech and language difficulties and sensory processing needs.

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Daily, adults will need to continuously make use of the Intensive Interaction approach to support [Q]’s understanding.

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[Q] will need adults to model appropriate play skills (e.g. cooperative play) with one or two children and encourage him to participate effectively in small group learning activities on a daily basis. For example, reciprocal play could be used as part of group activity where [Q] can be encouraged to take turns when interacting with one or two other children and adults in various contexts. [Q] may find it easier to understand the world and his environment through engaging in role play facilitated by an adult with the use of visual support. Role play could be used to promote the development of [Q]’s play, where adults could demonstrate turn-taking (e.g. building train tracks and pretending to feed a doll) and encouraging [Q] to do the same. Adults will need todescribe on their actions and make use of language such as “your turn” and “my turn” which will help [Q] to follow his own agenda as well as being led by others (children and adults). Adults will need to use visuals (e.g. wait card) and or an object of reference (coloured cloth) that symbolises when it is [Q]’s turn during an activity. …

To demonstrate a graduated approach to developing [Q]’s interaction skills, he will need adult support (from a qualified teaching professional) to help him to verbally communicate with other children and respond to their initiation. This can be done by adults scaffolding and modelling appropriate simple language and non-verbal approaches to [Q] that he can use in social situations on a daily basis. When required, adults will need to also intervene in situations where [Q] requires support to initiate and respond to play and peer work with other children. [Q] will need adults to help other children understand how he communicates best with others. Ready, Steady, Go games will need to be implemented by an adult to contribute to supporting [Q]’s engagement with others. Once [Q] is confidently engaging in play with adults, he could be encouraged to interact with one peer, this could then be extended to two and then three peers. …

When encouraging [Q] to follow adults directed and chosen activities, he will need adults to model out loud ‘their thinking’ when engaging with him, e.g. “I do this when I… and I think this when I do”. For example, when [Q] is playing with kitchen toys, adults could join in by pretending to bake a cake and showing him the steps while demonstrating their thinking aloud. The use of sand timers and counting down will need to be used to help [Q] understand and cope with the ending of tasks. …

Education staff will support [Q]’s Occupational Therapy needs as part of daily curriculum and school life, using universal strategies, including trial of general sensory strategies to support regulation.

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[Q] to receive targeted intervention. Interventions offered in the education setting to support identified areas of need which may be delivered in a 1:1, small group or as a small class, for example fine motor and pre-writing activities.

[Q] requires individualised sensory circuits based on needs and engagement.

Interventions will be delivered by designated education staff trained with working with a child with ASD and receiving support from OT.

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[Q] requires adult support to implement the OT’s recommendations.

He would benefit from small group working/class sizes where there is less noise and fewer distractions.

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[Q] will require an ongoing systematic toilet training programme until he has fully developed this skill (e.g. using the toilet independently without adult prompts:

Continue to give [Q] daily access to a variety of different sensory experiences and activities. … [Q] may respond best to adults modelling and scaffolding activities for him initially before the expectations upon him are gradually increased (e.g. starting with touching the items indirectly, building up to adults allowing [Q] to repeat the modelled actions independently following practice with an adult).

Staff will need to consider the physical environment carefully, particularly on transition between year groups and ensure that [Q] has adequate supervision in new environments, e.g. on school trips, given his reduced danger awareness and reduced attention to his environment.

Adult will need to facilitate the use of visuals and role playwith [Q] to help him identify and develop his understanding of safe and unsafe behaviours. [Q] will need adults to give him plenty of processing time to develop an awareness of danger and increase his awareness of danger for himself and for others: for example, take care when climbing on the climbing frame. [Q] will need constant daily adult supervision during structured and unstructured times of the school day due to his limited sense of safety. …

[Q] will need monitoring in the playground, at least initially at school to ensure his safety – this will be best accomplished by creating a ‘circle for friends’ or a number of buddies, who take turns to play with him to ensure he is safe. …