Clear guidance for real family life.

Communication: understand more than spoken words

Communication includes understanding, expressing ideas, sharing attention, asking for help, refusing, connecting and repairing misunderstandings. A child may communicate through speech, facial expression, movement, behaviour, gesture, signing, pictures, typing or augmentative and alternative communication (AAC). Support should expand access, not remove an existing method or demand speech before a need is respected.

What this might look like

• A child follows familiar routines but struggles with long or unfamiliar instructions.
• They know what they want to say but cannot find words quickly under pressure.
• They repeat phrases, scripts or questions to process language, regulate or communicate meaning.
• They appear to ignore a question when they need more processing time or a clearer communication route.

Key ideas in plain English

• Receptive language is understanding words, instructions and meaning.
• Expressive language is communicating thoughts, needs and ideas.
• Processing time is the pause a child may need before understanding and responding.
• AAC includes low-tech pictures and boards as well as communication devices; using AAC does not make spoken communication less valuable.

School considerations

• Keep key information visible and check understanding without putting the child on the spot.
• Accept different response methods and give enough time to use them.
• Ensure AAC is available throughout the day, not only during a therapy session.
• Create and share a communication profile that records strengths, preferences and successful support.

When additional support may help

Discuss concerns with the child’s school, GP, health visitor or speech and language therapy service when communication differences affect safety, learning, relationships or the child’s ability to express basic needs. Sudden loss of communication or a marked change should be discussed promptly with an appropriate healthcare professional.

Autism: understand the person, not only the diagnosis

Autism is a lifelong neurodevelopmental difference. Autistic children can experience communication, sensory information, uncertainty, attention, movement, social expectations and transitions differently. There is no single autistic presentation: strengths, needs and support requirements vary between people and may change across environments and stages of life.

What this might look like

• Deep, focused interests that support joy, learning, identity and regulation.
• A strong need to know what will happen, when it will happen and how it will end.
• Difficulty noticing hunger, pain, tiredness or other internal body signals.
• Holding everything together at school and releasing distress at home.
• Preferring direct language, quieter interaction or shared activity rather than conventional small talk.

Masking, overload and burnout

Masking means consciously or unconsciously hiding autistic traits to meet expectations. A child may copy others, suppress movement, rehearse conversation or endure sensory distress. This can make needs less visible while increasing exhaustion, anxiety and delayed meltdowns. Persistent overload without adequate recovery can contribute to significant loss of capacity sometimes described as autistic burnout.

School considerations

• Reduce unnecessary sensory and social demands and provide a reliable quiet option.
• Prepare changes honestly, including what is known and what is not yet known.
• Use interests as routes into learning without turning every interest into a reward.
• Look beyond outward compliance and ask about effort, recovery and delayed distress.

Assessment and wider needs

An autism assessment considers development, communication, behaviour and functioning across settings. Families may begin with a GP, health visitor, SENCO or local referral route. Autism may occur alongside ADHD, language differences, learning disability, anxiety, sleep or eating difficulties and physical health needs; support should respond to the whole child rather than attributing every difficulty to autism.

ADHD: support attention, energy and executive function

ADHD is a neurodevelopmental condition involving differences in attention regulation, activity and impulse control. It can affect task initiation, working memory, time awareness, organisation, emotional regulation and the ability to sustain effort when a task is not immediately meaningful. A child can be highly focused on an engaging activity and still have ADHD.

What this might look like

• Knowing what to do but being unable to start without an external cue.
• Losing track of multi-step instructions, belongings or time.
• Moving, talking or seeking stimulation to stay alert and engaged.
• Strong emotions that rise quickly and take time to settle.
• Intense focus on preferred activities followed by difficulty switching away.

Executive function in plain English

Executive functions are the mental processes used to start, plan, remember, monitor and complete tasks. Difficulties in this area are not laziness or a lack of caring. Support works best when expectations are made visible and the environment carries some of the organisational load.

School considerations

• Break work into visible parts and reduce copying or memory-heavy demands.
• Build purposeful movement and short recovery into the day.
• Use neutral prompts, timers and visual deadlines.
• Review seating, distraction, workload and transitions rather than relying only on behaviour systems.

Assessment and support

Assessment usually gathers developmental information and evidence from more than one setting. Families can discuss concerns with a GP, paediatric service or school SENCO according to local pathways. Medication may be one part of clinical care for some children, alongside environmental adjustments, education and family support; decisions belong with qualified healthcare professionals and the family.

Sensory processing and regulation

Regulation is not simply appearing calm. It is the ability to remain available for safety, connection, communication and participation. Sensory processing describes how the nervous system receives and responds to information from sight, sound, touch, taste, smell, movement, body position and internal body signals.

The eight sensory systems

• Sight, sound, touch, taste and smell.
• Vestibular: movement and balance.
• Proprioception: information from muscles and joints about body position and force.
• Interoception: internal signals such as hunger, thirst, pain, temperature and needing the toilet.

What this might look like

• Covering ears, avoiding busy spaces or becoming distressed by ordinary sounds.
• Seeking movement, pressure, chewing, crashing or repetitive activity.
• Difficulty noticing pain, hunger, temperature or toileting signals.
• A delayed reaction after coping with a demanding environment.

Co-regulation and recovery

• Reduce demands and sensory input before expecting discussion.
• Use fewer words and a familiar, predictable adult presence.
• Offer—not force—known supports such as movement, pressure, quiet or space.
• Allow sufficient recovery; returning to demands too quickly can trigger another crisis.

When specialist input may help

Occupational therapy or other professional assessment may be helpful when sensory differences substantially restrict daily life, learning, sleep, eating, safety or participation. Pain, hearing, vision and other health concerns should not be assumed to be sensory and may require medical assessment.

Anxiety: build safety before expecting confidence

Anxiety can appear as avoidance, repeated reassurance seeking, irritability, physical symptoms, shutdown, perfectionism, aggression, freezing, difficulty separating or a strong need to control details. SEND children may experience additional anxiety when communication, sensory or executive-function demands make the environment unpredictable or inaccessible.

What may be happening

• Uncertainty about what will happen, how long it will last or what others expect.
• Fear of failure, embarrassment, sensory pain or losing access to a safe person or place.
• Avoidance bringing short-term relief, which can unintentionally strengthen the anxiety cycle.
• Physical signs such as nausea, headaches, racing heart, shaking or urgent toileting.

School and attendance

• Explore environmental and relationship factors, not only the child’s willingness to attend.
• Agree a safe arrival, trusted adult, reduced-demand option and clear exit or pause plan.
• Record patterns by lesson, location, time, sensory demand and social context.
• Review whether support is reducing distress rather than measuring success only by physical presence.

When to seek further help

Speak with a GP, school or appropriate mental-health service when anxiety is persistent, worsening, causing significant restriction or affecting eating, sleep, health, education or family life. Seek urgent help if a child may harm themselves or others, cannot be kept safe or has a sudden serious change in mental state.

Sleep: consider routine, regulation and health

Sleep difficulties can involve falling asleep, waking repeatedly, waking very early, an irregular sleep-wake pattern or sleep that does not feel restorative. Anxiety, sensory comfort, medication, pain, breathing, reflux, constipation, movement needs, light exposure and individual circadian patterns can all contribute. Ongoing sleep difficulty is not a parenting failure.

Build a useful sleep record

• Record bedtime, estimated sleep time, waking and daytime sleep.
• Note night waking, snoring, breathing changes, unusual movement and what helped.
• Record medication, illness, pain, food, screens, activity and major changes.
• Review noise, temperature, bedding, clothing and light.

Understand the difference

A routine can improve predictability, but it cannot resolve every cause of poor sleep. A child who is exhausted but unable to settle may need a different response from a child whose body clock is shifted. Medical causes should be considered when difficulties persist.

Eating and food: reduce pressure and protect safety

Food difficulties may involve sensory processing, anxiety, predictability, oral-motor skills, swallowing, pain, allergy, reflux, constipation, gastrointestinal problems or previous distress. Some children rely on a small number of safe foods because consistency helps them feel secure. Pressure can increase fear and reduce trust around food.

What this might look like

• Eating only particular brands, textures, temperatures, colours or presentations.
• Gagging, coughing, pocketing food or tiring while chewing.
• Fear after choking, vomiting, allergy or another distressing experience.
• Not noticing hunger or thirst until distress is already high.

Selective eating and ARFID awareness

Selective eating exists on a spectrum. Avoidant/restrictive food intake disorder (ARFID) is a clinical diagnosis involving restriction that has a significant nutritional, physical or psychosocial impact and is not driven by body-image concerns. Families should not diagnose it themselves, but awareness can help them seek appropriate assessment.

When professional advice is needed

Seek healthcare advice for weight loss, poor growth, dehydration, pain, fainting, persistent constipation, suspected allergy, choking or swallowing risk, marked fatigue or a very restricted diet. Dietetic, medical, speech and language or specialist feeding input may be appropriate depending on the concern.