(The FACT Plus) Assessment of children and young people
with additional (social communication) needs
Identifying and meeting social communication needs
Acknowledgements Parents and a multi-professional team from Milton Keynes Council and Central and North West London – Milton Keynes (CNWL-MK) have worked on reviewing the FACT and developing the FACT Plus. The documents are testament to the skills, experience, knowledge and hard work of a willing group of people who fitted this project into their busy professional lives. Their legacy is two profiling tools that will help vulnerable children and young people with additional needs in speech, language, communication and social interaction.
Team members: Linda Bartlett, Amanda Bousaki, Maggie Bovair, Louise Bridgens, Sally Cass, Julie Cawthorpe, Sue Crawley, Clare Doran, Sarah Dutt, Doris Evans, Jo Friday, Gurbax Ghattora, Candy Goodes, Nicolette Green, Fola Ikuyinminu, Alexis Judd, Nick Jackman, Julie Lack, Sarah Lawson, Mike Lewis, Wahida Malik, Caroline Marriott, Gill Messenger, Lisa Munro, Daniela Murphy, Gurpreet Panesar, Mary Peddie, Chris Rutter, Robin Scott, Chris Setchell, Nina Soloff, Sue Swann, Uday Thakrar, Sharon Weeks-Woodford, Jacqui Wheeler, Chris White.
Schools that helped to trial the materials: Milton Keynes Primary Pupil Referral Unit, Romans Field, New Bradwell, Charles Warren, Howe Park, Heronshaw, Priory Common, Summerfield, St Mary and St Giles, The Hazeley and Lord Grey.
FACT front cover: Sarah Briggs aged 10
FACT Plus front cover: Aiden Green aged 11
Team members for the original FACT (not involved in the current project): Sarah Armitage, Pauline Bentley, Marion Binks, Lyn Byatt, Helen Caldwell, Liz Corby, Jacqueline Hashemi, Diz Minnitt, Gill Rees Kay, Gill Shurrock.
Published February 2015
Due for Review June 2018
Revised June 2016
Copyright 2015 Milton Keynes Council
Contents Introduction Page 4 Guidance on using the FACT Plus Page 5 The FACT Plus Pathway in Key Stages 1 - 5 Page 8 Advice for profiling girls. Page 10 Social Communication Descriptors Key Stage 1 Page 11 Social Communication Descriptors Key Stage 2 Page 20
KS1 – KS5 FACT Plus (Speech, Language and
Communication) Descriptor Profile and
Outcome and Review Form Blanks and Examples Page 28
The FACT Plus Strategies KS1 & KS2 Page 37 Appendix I Social Communication Classroom
Audit Tool Page 84
Appendix II Monitoring Sheet Page 87 References Page 89 Glossary and Abbreviations Page 90
Introduction The purpose of this document is to profile the strengths and weaknesses of a child or young person (CYP) who is presenting with social interaction and communication difficulties. The broad areas that the CYP might be experiencing difficulties are:
Social communication, including language and non-verbal communication
Development of thought or play skills
In addition some experience co-ordination and sensory difficulties.
No two CYP with these difficulties will present the same profile. Their characteristics within the profile will change as they mature. Their rate of progress in the areas above may be uneven, but they may make good academic progress in some areas of the curriculum.
Some CYP may present with challenging behaviour, which can be managed and the CYP be supported towards better behaviour. There may be regression at times of stress such as changing teachers, classrooms, schools or personal circumstances. For these CYP social and emotional development often lags behind cognitive development. Support is needed for the CYP and for the key adults around them, and their classmates.
The Descriptors that follow identify the main characteristics shown by those with social interaction and communication difficulties. Once the profile has been done desirable outcomes can be written and then strategies and interventions selected to support the CYP. These are recorded on the Outcome and Review Form provided. The expectation is that settings and schools will complete one outcome and review cycle before requesting support from the Speech and Language Therapist and two outcome and review cycles before contacting the Specialist Teachers Team duty number Tel 01908 657825
High quality teaching, appropriately differentiated for individual pupils, is the first step in responding to possible special educational needs. For pupils that need special educational provision the code sets out the principle of a graduated response. This acknowledges that some children will benefit from specific support from the school or external experts (such as an Educational Psychologist or a Speech and Language Therapist). It is important that staff match their practice to the minimum standards of quality first teaching, targeted provision and personalised provision. The categories of School Action and School Action Plus no longer apply and have been replaced with a new system called special educational needs (SEN) support. The new approach is designed to ensure support is focused on individual need and personal outcomes rather than classifications, from Timpson (2014).
See Implementing a new 0 to 25 special needs system: LAs and partners (DfE, 2014) for more information.
Guidance on using the FACT Plus 1. ASSESS
When profiling the child using the FACT, if Listening & Attention, Understanding and Interaction difficulties are identified in the ‘trigger’ descriptors, profile again using the FACT Plus Descriptors. If a CYP is not presenting with any difficulties in the areas on the FACT Plus, and there are no concerns, record a ‘0’.
Use the FACT Plus to highlight the relevant descriptors and decide the CYP’s level using a ‘best fit’ approach. The level selected will be the one where you have done the most highlighting.
Level 4 is the most severe. Level 1 is the least severe.
Use the FACT Plus descriptor profile form to record the CYP’s levels.
2. PLAN and 3. DO
Having carried out the FACT Plus profile, decide which area to focus on. Usually this would be the area the CYP is having most difficulty in or the area that you feel would have the biggest impact on the CYP’s progress. If the CYP is profiling at level 4 in one area then choose that area. If the CYP is profiling at the same level in one or more areas then decide which area you feel would have the biggest impact. Tick the area on the descriptor profile form to show which social communication areas you are going to focus on and write in the comments box to help you to decide on the outcome.
Having decided the area to focus on, use the descriptors to (a) help to identify the baseline level at which the CYP is working and (b) decide on a suitable outcome. A baseline should be positively phrased, but also have an indication of the next level of the skill which might be challenging for the child (see examples on p.4). Set an outcome that is achievable within the timeframe (outcomes should be reviewed at approximately 6 weeks). Decide how you will know if the outcome has been achieved, i.e. how you are going to measure the outcome. Decide which provision and strategies you will put in place to meet the outcome. Using the outcome and review form, record this information. More guidance on outcome-setting is given on the next page.
Decide on the environmental and Quality First teaching strategies that will be put in place. All children (Levels 0 to 4) should have access to environmental and Quality First strategies. Following the ‘Outcome and Review’ instructions on the next page, decide whether targeted and personalised provision should be in place. When using the strategies recommended, there are links to resources that can be viewed and printed. Click on the link that is italicised in brackets. This will take you to the appropriate resources.
Ideally parents should be involved throughout, and their aspirations taken into account when setting outcomes for their children. CYP should be involved in setting and monitoring outcomes with staff.
Guidance on the FACT Plus Outcome and Review form Use the ‘Outcome Setting and Review Form’ to record the areas that you are going to focus on, the outcome you want to achieve, how you know if the outcome has been achieved and the provision and strategies that you are going to use.
Set an outcome that is achievable and measurable within the timeframe. Outcomes should be reviewed after approximately 6 weeks. The outcome and review form is a working document so if the strategies are clearly not working for the CYP do not wait until the 4-6 week review before deciding on next steps. Strategies can be added or amended at any time and recorded on the outcome/review form to show what has been tried and what has worked / not been successful. There is a monitoring form to support the monitoring of outcomes (see Appendix II).
Carry out a classroom audit (Appendix I - Specialist Teacher Social Communication Friendly Classroom audit) to ensure that environmental and Quality First teaching* is in place. Also check the Fact Plus environmental and Quality First teaching strategies. Put in place any additional environmental and Quality First teaching strategies and record these on the outcome and review form. Usually all levels (0-4) should have environmental and Quality First strategies in place. If the CYP is profiling at level 0 or 1, this may be all that is required.
If the CYP is profiling at level 2, in addition to environmental and Quality First teaching, targeted provision** should be in place to ensure the CYP can make progress from the baseline identified.
If the CYP is profiling at level 3/4 then in addition to environmental and Quality First teaching strategies and targeted provision, personalised provision*** will be required as part of a graduated response.
Outcomes that are targeted or personalised should be reinforced and generalised in the classroom, with the teacher maximising opportunities for this across the curriculum.
Examples are given on the next page for setting an outcome at each Level for ‘Social Communication’ at KS1&2. Other examples are given after the blank Outcome/Review form in each of the respective Key Stages.
* Quality First teaching refers to good practice that can be expected from practitioners in any setting for all CYP in their care. These are strategies that benefit all CYP whatever their need and ability.
** Targeted provision refers to what is needed additionally to Quality First teaching to enable a CYP to make progress in an area of concern, usually from a known and available resource. This is usually reflected in the settings provision management.
*** Personalised provision refers to a strategy that is devised specifically for a particular CYP. It may be a known intervention or resource but one that is individualised.
Having reviewed the outcomes after 4-6 weeks, follow the pathway to decide next steps. If the CYP has exceeded progress in the outcomes, monitor in school and continue with environmental and Quality First strategies. If the child has made expected progress, continue to meet the CYP’s needs through the FACT Plus ‘outcome and review’ cycle, focusing on the area to be developed that will have the most impact on the child's progress. If the CYP has not made expected progress, discuss with the Specialist Teaching Team- duty number Tel 01908 657825 to decide on next steps. It may be that more targeted/personalised provision is required or - after having reviewed the outcomes and discussed with the specialist teacher - a request for involvement is submitted to the Inclusion and Intervention Team.
NB At least one ‘outcome and review’ cycle should be completed before a request for involvement can be accepted by the Speech and Language Therapy Service and two ‘outcome and review’ cycles should be completed before a request for involvement can be accepted by the Inclusion and Intervention Team
The SENCo will identify training needs.
Examples Level 1 example: Social Communication
Descriptor: Does not always follow social etiquette, e.g. may ask for chocolate rather than wait to be offered
Baseline: CYP sometimes follows the social rules in the classroom, e.g. asks to go to the toilet, but can appear rude by taking equipment without asking
Outcome: CYP will follow the social rules in the classroom How will we know this has been achieved: CYP has demonstrated on ten occasions the right social etiquette in the classroom by following the classroom rules
What strategies will be used to achieve the outcome?
Environmental/Quality First Teaching strategies: Ensure there are clear rules that are agreed and displayed for all to see; Exaggerate good social rules which should be modelled and reinforced by all in all environment; Reward appropriate social behaviour by providing constructive feedback
Level 2 example: Social Communication Descriptor: Limited understanding of social rules of communication (interrupts conversations to have needs met)
Baseline: CYP uses polite language, e.g. ‘excuse me...’, but interrupts conversations to have needs met
Outcome: CYP will wait appropriately and does not interrupt adult conversations
How will we know this has been achieved: CYP will transfer skills from the social group to the classroom to wait appropriately and not interrupt adults on 5 consecutive occasions
What strategies will be used to achieve the outcome?
Environmental/Quality First Teaching strategies: Good social rules are reinforced by staff
Targeted provision: Group set up to work on specific social rules, (waiting appropriately/ not interrupting) choose resources dependent on the social and emotional development of the child; Provide opportunities to transfer skills in the classroom
Level 3 example: Social Communication Descriptor: Inappropriate introduction of topic interest (goes off at tangent when talking to others and does not realise they are not interested)
Baseline: CYP is able to share information, but interrupts class with own topic of interest
Outcome: CYP will stay on topic and not interrupt the class inappropriately
How will we know this has been achieved: CYP can keep to the topic when in class in 5 consecutive lessons
What strategies will be used to achieve the outcome?:
Environmental/Quality First Teaching strategies: Reward appropriate social behaviour
Targeted Provision: Talk box (favourite food/hobbies). Jotter for ideas to talk about at an appropriate time
Personalised Provision: Provide opportunity to talk at a specified time; Social scripts to explain other people’s perspectives
Level 4 example: Social Communication Descriptor: Avoids speaking / selective communication / uninterested in communication
Baseline: CYP tolerates presence of adult, but doesn’t communicate their needs
Outcome: CYP communicates needs to an adult
How will we know this has been achieved?: CYP will communicate a choice on 5 occasions when presented with a choice board
Environmental/Quality First Teaching strategies: Praise any attempt if the child communicates
Targeted Provision: Developing Baseline Communication Skills group work and transfer to the classroom; Set up opportunities to use set phrases
Personalised Provision: Encourage the child to communicate through picture choice boards; Provide opportunities to develop communication through 1:1 picture exchange for something they want, using objects motivating to the child
The FACT Plus Pathway in Key Stages 1 - 5
continue on next page…
Work out the degree of progress, record it on the review form and
to support language and communication development and overcome barriers to learning and participation
# If the child is in F1 and SLT Service involvement is needed, the parents should be requested to take the child to the Speech and Language Therapy Early Years Drop-In (details of sessions available on 01908 209305) after one cycle of Plan-Do-Review is completed. NB. The Drop-In is not for childrenbeyond F1.If the child is F2+ send a request for involvement to the SLT Schools’ Team after one cycle of Plan-Do-Review is completed.
When completing a request for involvement form, please ensure you indicate which other services are involved, and the type of advice already requested/received.At least one ‘outcome and review’ cycle should be completed before a request for involvement can be accepted by the Speech and Language Therapy Service and two outcome and review cycles completed before a request for involvement can be accepted by the Inclusion and Intervention Team. NB: Girls with social communication difficulties may present differently to boys with social communication difficulties. Please consider the following points before profiling girls using the FACT Plus.
Girls are especially likely to fall under the radar at school and often social communication difficulties are missed.
Girls are more likely than boys to mimic others in social situations and to want to ‘fit in’. They often develop ways to camouflage their difficulties.
Girls tend to obsess over friendships and can develop one or two close and likeminded allies although they are often led by their peers rather than initiate social interaction.
Girls have more active imagination and more pretend play than boys. Many girls escape into a fictional world such as fairies and witches.
Irritability and lethargy affect girls with social communication difficulties more than boys.
Girls tend to control their emotions better than boys; girls tend to withdraw and boys are generally more disruptive in the classroom. Girls act far differently at home where they release the pressure built up in the day, pretending to be someone else.
Girls are more likely to control their behaviour in public; they are less likely than boys to have public meltdowns, make socially inappropriate comments or speak too loudly.
Boys and girls have similar difficulties reading social situations but girls have a better understanding and use of gesture and ability to maintain a conversation.
Young girls are less likely to line up toys and play repetitively with them. However play is markedly different from other children’s play.
Topic interest is less unusual than boys but it is pursued with intensity and obsession.
Girls find social hierarchy and how one communicates with people of different status problematic and leads to difficulties with teachers in school.
Older girls appear to suffer from anxiety and depression more often than boys or typically developing girls.