14. A Pre-School Child with (Undiagnosed) Autistic Spectrum Disorder

Background A nursery child in his pre-school year was attending a Local Authority nursery on only 2 mornings per week. His reduced attendance was due to his unpredictable behaviour and several incidences of aggressive behaviour towards other children and members of staff. He found it particularly difficult to cope with changes of routine and large group activities such as the weekly gym class. Solution Focused Approach The nursery team worked closely with the child’s parents and a Pre-School Home Visiting teacher (PHVT). They wished to understand this child’s additional support needs so that he might receive his full entitlement to education. The team included the Speech & Language Therapist, the Educational Psychologist and health professionals. Assessment by the team led to a diagnosis of Autistic Spectrum Disorder. Strategies Key success factors included the following: • a reduction in the visual ‘ clutter’ within the nursery environment • a visual timetable to help the child cope with changes with his routine; • sequence strips to support him in areas such as snack, tooth-brushing, gym, party time; • a daily work station using the TEACCH approach in order to focus on the following skills: •fine motor; •turn taking and sharing; •play skills; •social rules; •controlled interaction with his peers in a game situation. • social stories to teach some social skills such as how to behave on his trip to ‘ Macdonald’s’; • gradual and positive introduction to the gym, supported by the Home Visiting teacher which enabled withdrawal when it became too much and a positive return when possible. Range of Strategies to Promote Positive Behaviour and Improve Learning The nursery was committed to ensuring maximum attendance for this vulnerable child. Staff demonstrated real flexibility of approach and provided much encouragement fro the child’s parents. Individualised Planning and a Flexible Curriculum in Line with Curriculum for Excellence The nursery was open to planning highly individualised approaches which were agreed by parents and other partners at Additional Support/Individualised Educational Programme meetings. Their approach resulted in the child accessing significantly more of the nursery curriculum albeit in the way which suited the complex needs of this child. One significant and successful strategy was the reduction in the complexity of speech used with the child. Partnership Working The Pre-School Home Visiting teacher developed strategies with the child’s parents at home, his child-minder and the nursery to ensure consistency and support the child with his behaviour. This work acted as a strong meaningful link between nursery and home when problems arose. Successful Outcomes included:
  • the child received a diagnosis of Autistic Spectrum Disorder in the September of his pre-school year;
  • he managed to attend the Nursery 5 mornings per week for the full session;
  • although he did still present with challenging behaviour at times, it became a lot less frequent due to the support of the visual timetable;
  • he became more integrated with his peers and they involved him in their imaginative play;
  • the child started to learn successfully within a mainstream environment due to the work station strategy;
  • staff became more confident about the strategies to use with a child who presents with Autistic Spectrum Disorder;
  • the child successfully transitioned to an autism specific setting for his P1 year where it is now reported that there have been no incidents of challenging behaviour.