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I wonder if anyone can help

 

I have a child at my setting who I am concerned about. He only comes for 3 hours per week but I have been observing him for a few months now, and something just isn't right. I can't put my finger on it, more of a gut feeling really. I have done lots of research, but can't place him neatly in a box for any condition I've heard of - which I'm sure is true of most children with some kind of SEN. I finally raised my concerns with Mum today, and she left in a state of shock, having had no cause for concern previously, and I feel terrible for causing such worry.

 

The areas which are concerning me:

 

He needs support moving around outside, and when negotiating a change in level, seems very uncertain, his foot hovering in the air. (Reminds me of when I first got glasses and couldn't judge distance for a while.) He always asks for help. This is just normal moving around outside, in and out of the sandpit ect, not unusual activities.

 

His hands are a bit flappy at his sides at times when moving around, almost as if he is trying to get his balance.

 

His communication seems stuck at the repetitive "what's that?" stage.

 

He will not look at anything we try to draw his attention to - he looks in any direction instead. There is little (if any) eye contact either.

 

The child is only 2 1/2, and has really made progress since starting with us, but I still think there is something. His mother said today that they have noticed his ankles turn in (not visible in clothes) and were a bit concerned. Not sure if this may be why he is a little unbalanced?

 

Anyway, I have referred her to her GP or health visitor as a first step, but she was so upset, I just hope I've done the right thing.

 

Any advice would be appreciated, thanks.

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My advice would be

 

Give his mum lots of support and be available to talk lots even if it's going over the same ground repeatedly.

 

Record lots of obs to share with any professionals who come in to observe him.

 

Give him as much support as you can in the areas where you can see that he's struggling. If you think he is struggling to place his feet offer activities which support this like stepping stones or games walking along lines.

 

You don't need to identify his condition so just work on helping to develop in the areas where he needs support.

 

You have absolutely done the right thing. You've given him the opportunity of early support which is key to positive outcomes.

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Thank you Upsy Daisy that is a great relief.

 

We have been doing exactly as you have said, trying to engage him in activities to develop his confidence in the areas where he is struggling. As I say, he really has made progress, but I still think there is some extra need, just not sure exactly what.

 

I have told Mum just to phone whenever if she needs to talk, and been honest that it's just a gut feeling and I may be wrong. She was just so shocked it really threw me. She has avoided meeting with me for 4 weeks now, and I really thought she knew something was wrong, but this clearly isn't the case.

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It can take parents a long time to accept that their child might have any kind of learning delay, and one of the tactics that they might subconsciously take is to ignore all the signs so that they don't have to face up to the reality that their child might have an additional need. You mention that mum has mentioned something unusual that she has spotted, so I think it is likely that she is concerned that all might be well.

 

Sounds like mum will need lots of time and your support to come to terms with the difficulties her child is experiencing, and it looks to me as if you're doing all the right things to support her on the possible journey she might be facing in order to get support for her child. Your hunch might well be wrong but you've done the right thing in trying to find out and get the support at an early stage.

 

Good luck - let us know how things go!

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No eyesight check, although that is something I mentioned today. To be honest I don 't think it is that as he has pointed out aeroplanes in the sky before.

 

No I have not seen him without shoes and socks on as she only mentioned this today when I spoke to her and she took him straight home afterwards, but I will look next week.

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his visual fields may not be correct ...would certainly be worth a check (once mum has calmed down)...feet deff worth a look. The flapping worries me a bit...does he copy upper and lower body movements? (so if he moves left leg he also moves left arm etc)

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Devondaisy

I think you are quite right to be concerned, you have been watching carefully over a period of time and working on his weak areas. you haven't made a rushed decision. He is obviously nervous/concerned about moving about and needs help.

His mum is fortunate that you have noticed and are concerned.

 

Telling mums is the worst part of what we do, A lot of mums do not see or do not want to see. One of my colleagues own children had motor problems and despite several years experience with small children she hadn't noticed. We had some very difficult days when I suggested the child saw an OT.

 

Just a word of warning... I had problems with some children I wanted to refer for OT assessments

I needed a GP letter and the GP couldn't see the problem and were reluctant to help.

 

Do you have an inclusion team you can talk to? if you need some extra back up.

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I have a long standing parent (four years) who's attitude to me has changed since I suggested that her first-born might benefit from (another) professional's assessment. I only have the child for a couple of hours a week and is well into the school system now, but It's only recently that I felt confident enough in my experience to make the suggestion.

 

It may not be until after the child has left your setting that the mother comes to accept your opinion, but in the meantime you will have supported the child and family to the best of your ability and made observations which may be of benefit at a later date.

 

Very best of luck,

 

Honey

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I have attached a table called Early Communication and Language from the National Strategies (tried to post a link directly to the site but couldn't find it on there). You may already use this. We have recently been asked to use this after some ECAT training, for all children. The items marked with a 'x' are checkpoint statements that serve as an alert for close monitoring including discussion with the family, and perhaps further assessment or support. Do any of these checkpoint statements ring any bells with you?

ECaTchildmonitoring.doc

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Deb, your ecat statements sound of real interest, but I can't see the crosses or flags on the document. Can you check the document and re post if possible?

 

That's funny they are there when I click on this link. I've tried again to search the document on the National Strategies website to provide a direct link but cannot find it.

 

Perhaps one of our ICT experts can suggest a solution? :o

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They are there eyfs1966 - at least I can see them. Perhaps you're looking for something bigger? In this screenshot can you see the text marked in orange on your copy with a little checkbox next to it? If not something strange is going on:

flags.gif

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Thank you everyone, and Debs for the link. I have thought long and hard about how to approach the parents, so I'm sure I've done the right thing - she was just so shocked that I felt terrible.

 

Anyway, we'll see what next week brings, I'll keep you posted. :o

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Oh bless you! It's never easy to raise concerns with a parent but you've done absolutely the right thing.... if this little one needs extra help and support it really is a case of "the sooner the better"

 

Two years ago I had a little boy with similar symptoms. I even unofficially asked my daughters podiatrist about J's walking and weak ankles when he attended an appointment with us. He shared my views that further investigation was required and told me that it's often the case that children with these symptoms have delayed speech as it's the same area of the brain that controls it.

 

Mum allowed the health visitor to assess him and he was eventually diagnosed with hypotonia. With orthotics his walking has improved and he's had SLT, too.

 

Watching him running around, chattering and laughing now it's hard to recognise him as the same child and to those who didn't know he probably appears to have no problems - in fact his physio says he'll make a great gymnast with his super-flexible joints!

 

Hope your little one gets a similar happy outcome.

 

Nona

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