Neurodevelopmental needs

We have recently received confirmation from JCQ regarding evidence needed for students applying for Access Arrangements, Reasonable Adjustments and Special Consideration including where extra time may be needed. The exam board have confirmed that in order to apply for these arrangements the exam officer or SENCo can use existing correspondence from Mindworks Surrey to support an application. Appropriate evidence may include letters and emails sent to parents/carers from Mindworks Surrey that indicate a child is on the Neurodevelopmental Pathway or receiving healthcare for their emotional wellbeing or neurodevelopmental needs. For students awaiting a school consultation with the Neurodevelopmental Spoke team, the confirmation email may be used as evidence that a child is on the waiting list for consultations. If the child receives support from other services for their school-based needs, this may also be used as evidence for the exam board. In the absence of a diagnosis or confirmation that a child is on the Neurodevelopmental Pathway, the exam officer or SENCo can provide other evidence of a child’s specific needs including comments and observations from teaching and support staff which produces a compelling picture of need.

Unfortunately due to administrative capacity within our Mindworks Teams we are unable to re-issue any documentation including copies of letters, as evidence a child is waiting for a consultation.

Access to the neurodevelopmental pathway is via a school consultation. The consultations bring together the support networks around the child or young person including school staff, parent/carer and Mindworks experts, to work together on ensuring the needs of a child or young person are met.  

Consultations aim to enhance the collective understanding of the child or young person’s needs and build on support and strategies that have already been implemented. During the consultation, those present will agree a plan of continued care and support for the child or young person and consider whether it is the right time to add them to the waiting list for diagnostic assessment. 

Schools can contact the Neurodevelopmental Service to book a consultation for children and young people where;    

• School is supporting a child or young person experiencing high levels of distress, that is impacting their behaviour and ability to participate in school (note that this includes the more subtle behaviours such as shutdown). 
• School is supporting a child or young person whose attendance is below 50%.
• School is supporting a child or young person who is already known to mental health or specialist services and whose neurodevelopmental needs require more urgent interventions. 

How do I book a consultation: 

Please review information on how to book a consultation here: Forms for requests for support

What to do if my child or young person is homeschooled: 

For CYP who are currently not attending school but remain on school roll and where the child or young person is experiencing high levels of distress, that is impacting their behaviour and ability to participate in learning, consultations can be booked by the school.   

For children and young people who are being home-schooled and are not on the school roll and where the child or young person is experiencing high levels of distress, that is impacting their behaviour and ability to participate in learning, a half an hour consultation can be booked by parents/carers by calling; 0300 222 5856 or emailing neurodevworkrequests@sabp.nhs.uk. For these children and young people, a referral to Early Help must have taken place (self-referral is possible).  The diagnostic assessment requires information on how the child or young person functions in at least 2 different environments, and for this reason, it is necessary to involve another professional who knows the young person. This could be another practitioner/ clinician, their home tutor, or an early help practitioner.   
 

Attention Deficit Hyperactivity Disorder (ADHD) is a condition that affects people's behaviour. People with ADHD can seem restless, may have trouble concentrating, and may act on impulse.

Symptoms of ADHD tend to be noticed at an early age and may become more noticeable when a child's circumstances change, such as when they start school. Most cases are diagnosed when children are 6 to 12 years old.

The symptoms of ADHD usually improve with age, but many adults who were diagnosed with the condition at a young age continue to experience problems.
People with ADHD may also have additional problems, such as sleep and anxiety disorders.

The symptoms of Attention Deficit Hyperactivity Disorder (ADHD) can be categorised into two types of behavioural problems: inattentiveness, hyperactivity, and impulsiveness.

Most people with ADHD have problems that fall into both these categories, but this is not always the case.

For example, some people with the condition may have problems with inattentiveness, but not with hyperactivity or impulsiveness.

This form of ADHD is also known as Attention Deficit Disorder (ADD). ADD can sometimes go unnoticed because the symptoms may be less obvious.

Symptoms in children and teenagers

The symptoms of ADHD in children and teenagers are well defined, and they're usually noticeable before the age of six. They occur in more than one situation, such as at home and school.

Inattentiveness

The main signs of inattentiveness are:

• having a short attention span and being easily distracted
• making careless mistakes – for example, in schoolwork
• appearing forgetful or losing things
• being unable to stick to tasks that are tedious or time-consuming
• appearing to be unable to listen to or carry out instructions
• constantly changing activity or task
• having difficulty organising tasks

Hyperactivity and impulsiveness

The main signs of hyperactivity and impulsiveness are:

• being unable to sit still, especially in calm or quiet surroundings
• constantly fidgeting
• being unable to concentrate on tasks
• excessive physical movement
• excessive talking
• being unable to wait their turn
• acting without thinking
• interrupting conversations
• little or no sense of danger

All children and young people should be being supported to consistently engage with Early Help and strategies at home and in school or in the environments that are important to them. An enhanced range of materials and resources are available on the Mindworks Surrey website, which now includes new videos of our workshops, flashcards and strategy sheets. 

If your child's challenges do not improve, and both you and the school believe it's negatively affecting their day-to-day life, you should consult with the school in regards to booking a consultation.  

Mindworks out-of-hours phone line provides advice to parents and carers who are struggling with behaviours, challenges, or difficulties which could be related to neurodevelopmental needs, such as ADHD or Autism.   

Although not always the case, some children may also have signs of other problems or conditions alongside ADHD, such as:

• Anxiety disorder – which causes your child to worry and be nervous much of the time; it may also cause physical symptoms, such as a rapid heartbeat, sweating and dizziness
• Oppositional Defiant Disorder (ODD) – this is defined by negative and disruptive behaviour, particularly towards authority figures, such as parents and teachers
• Conduct disorder – this often involves a tendency towards highly antisocial behaviour, such as stealing, fighting, vandalism and harming people or animals
• Depression
• Sleep problems – finding it difficult to get to sleep at night, and having irregular sleeping patterns
• autistic spectrum condition (ASC) – this affects social interaction, communication, interests and behaviour
• epilepsy – a condition that affects the brain and causes repeated fits or seizures
• Tourette's syndrome – a condition of the nervous system, characterised by a combination of involuntary noises and movements (tics)
• Learning difficulties – such as dyslexia

Looking after a child with ADHD can be challenging, but it's important to remember that they cannot help their behaviour.

Some issues that may arise in day-to-day life include:

• getting your child to sleep at night
• getting ready for school on time
• listening to and carrying out instructions
• being organised
• social occasions
• shopping

• ADHD Resource pack (parents/carers)
• ADHD Guide for teenagers
• Explaining ADHD to young people
• ADHD Post diagnostic support pack (child/young person)
• ADHD Medication Advice

Autism (also known as Autism Spectrum Condition (ASC) and Autism Spectrum Disorder (ASD) is a lifelong developmental condition that affects how people communicate and interact with the world. Autism is a form of neurodiversity which means that those with autism move, interact, sense, and process differently to those who are neurotypical. 

One in 100 people are on the Autism spectrum and there are around 700,000 Autistic adults and children in the UK.

Autism is a spectrum condition that affects people in different ways. Like all people, autistic people have their strengths and weaknesses. Below is a list of difficulties autistic people may share, including the two key difficulties required for a diagnosis. 

Social communication

Some autistic people are unable to speak or have limited speech while other autistic people have very good language skills. There may be an in-balance between expressive language and receptive language. Other areas of differences include:

• Taking things literally – “It’s raining cats and dogs’
• Using different skills to process information or answer questions
• Repeating what others say to them (this is called echolalia)
• May struggle with eye contact.
• May be repetitive with their language – linked to sensory and/or anxiety
   

Social interaction

Due to communication differences, Autistic people may prefer to socialise differently:

• Express ‘black and white’ thinking which could make them appear to be overly honest.
• Want to socialise with others in a way that suits them. May struggle with expectations of type, frequency and duration that non autistic people expect.
• May need to spend time alone on special interest to energy account.
• Autistic people may prefer to socialise and communicate online

Repetitive and restricted behaviours  

With its unwritten rules, the world can seem a very unpredictable and confusing place. Autistic people often prefer to have routines as a way to manage this and make the world feel more predictable, for instance wanting to travel the same way to and from school, wear the same clothes, or eat the same food for breakfast.  
 
Change to routine can be very distressing for autistic people and can cause anxiety, for instance having to adjust to big events like Christmas or changing schools, facing uncertainty at work, or something like a bus detour. 
Autistic people may also repeat movements such as hand flapping, rocking, or the repetitive use of an object such as twirling a pen or opening and closing a door. Autistic people often engage in these behaviours to help calm themselves when they are stressed or anxious, but many autistic people do repeat movements because they find it enjoyable.   

Over or under sensitivity to light, sound, taste or touch  

Autistic people may experience over- or under-sensitivity to sounds, touch, tastes, smells, light, colours, temperatures, or pain. For example, they may find certain background sounds like music in a restaurant, which other people ignore or block out, unbearably loud or distracting. This can cause anxiety or even physical pain. Many autistic people prefer not to hug due to discomfort. 

Many autistic people avoid everyday situations because of their sensitivity issues. Schools, workplaces, and shopping centres can be particularly overwhelming and cause sensory overload. Many simple adjustments can be made to make environments more autism-friendly. 

Highly focused interest or hobbies 

Many autistic people have intense and highly focused interests, often from a young age. These can change over time or be lifelong. Autistic people can become experts in their special interests and often like to share their knowledge. Like all people, autistic people gain huge amounts of pleasure from pursuing their interests and see them as fundamental to their well-being and happiness. 
 
Being highly focused helps many autistic people do well academically and in the workplace but they can also become so engrossed in particular topics or activities that they neglect other aspects of their lives. 

Extreme anxiety  

Anxiety is very common for many autistic individuals, particularly in social situations or when facing change. It can affect a person psychologically and physically and impact the quality of life for autistic people and their families.   
 
It can be helpful for autistic people and those around them to learn to recognise their triggers and find coping mechanisms to help reduce their anxiety. However, many autistic people have difficulty recognising and regulating their emotions and might need additional support with this. 

Meltdown and shutdowns  

When everything becomes too much for an autistic person, they can experience a meltdown or shutdown. These are very intense and exhausting experiences. 
 
A meltdown happens when someone becomes completely overwhelmed by their current situation and temporarily loses behavioural control.  This loss of control can be verbal (e.g. shouting, screaming, crying) physical (e.g. kicking, lashing out, biting), or both. Meltdowns in children are often mistaken for temper tantrums.  
 
A shutdown appears less intense to the outside world but can be equally debilitating. Shutdowns are an involuntary response to being overwhelmed, and can appear more passive - e.g. an autistic person going quiet or 'switching off'. 

• ASD post diagnostic pack (parents/carers)
• Explaining ASD to young people 12+
• Pathological Demand Avoidance (PDA) Support: The Panda on PDA by Dr Gloria Dura Vila
• ​​​​​​​Family relationships - a guide for parents/ carers
• Guidance on diagnosis
• ​​​​​​​​​​​​​​​​​​​​​What can I do if my child won't go to school?
• Stories from people with autism - #NowIKnow

• Autism Level UP!
• National Autistic Society - Resources for autistic teenagers