Along with offering direct support to children, their nursery workers and parents, our team also offers a consultation service to colleagues.
Consultation is the term used to describe a session where the practitioner requests support without referring to a child by name. These anonymous sessions can be helpful in situations where:
* a parent is reluctant to give permission for a referral to an outside agency
* a setting is unsure whether a child and their difficulties are an appropriate referral
* there are already many agencies involved who are focused on the child and their family, leaving the nursery practitioners feeling unclear or unsupported in their role with a complex child or situation.
We are keen to use this approach because:
* we feel it supports the practitioner in their professional development
* the Code of Practice recommends that we should use a 'graduated approach'
to the identification and assessment of a child's needs. A consultation can explore areas of difficulty though still lead on to a referral if necessary
* where a child and adult have 'got stuck' in a way of relating which repeats a negative pattern, this can stimulate a change that can lead to other developments.
Direct support
Where possible we can offer a structured session. This session offers a time-limited 'conversation' about a child and a situation. It begins with an outline of the child, the nature of the concerns and the reason for consulting with us. Here our role is to listen to the practitioner's observations.
We then have a period of elaboration where the team member, or consultant, asks questions that illuminate the situation, before moving to a period of looking at alternative courses of action that the practitioner could take.
When the practitioner has thought about these alternatives they are encouraged to plan some actions to take the situation forward.
Such a consultation was offered when Jane, Fred's keyworker, contacted one of the team's area special educational needs co-ordinators (SENCO) by telephone. Jane was keen to talk through her concerns about Fred's difficulties, to explore how she might then approach the parents and what advice she could then offer them.
The area SENCO began by gathering a profile of the child, including age, gender, his time at nursery, how he had settled and how the parents felt.
This is pertinent information and helps the team member to ask further questions that will add insight.
Jane went on to describe how her observations of Fred at nursery led to her concerns about his lack of language and limited play and social interaction skills. She was able to refer to clear records of what he was able to do and on what date.
However, she was unsure of herself, and embarrassed at the thought of making a mistake. It became apparent that one of the things Jane needed most from this consultation was reassurance and validation of her own knowledge and skills.
The SENCO needed to facilitate a dialogue that would boost Jane's confidence in her own professional skills so that she felt able to raise these concerns with the parent.
Jane and the SENCO went on to explore together possible phrases that could open a discussion with the parent. For example, 'I've noticed that Fred enjoys playing with the bricks, but gets upset if they are arranged in a different way. I wonder how you get him to play with them at home?'
They talked about the importance of expressing concerns in observable terms, as well as commenting on Fred's strengths. The team has found that it is important to begin and end any discussion with something positive about the child, 'sandwiching' the concerns in the centre.
The telephone consultation ended with Jane being in a position to move the situation on. First, she would set up a meeting with the parents. It was then agreed that this initial consultation would be followed by a training session for all the staff on language and communication difficulties. The particular focus would be the possible indicators of language and communication difficulties and the range of strategies the nursery could use for encouraging language.
It was important to include all the staff since this reinforced the notion that the responsibility was a shared one and not only the domain of the keyworker. This, in turn, supported Jane, in consultation with Fred's parents, to set clear targets, devise appropriate strategies and to monitor his individual progress.
Group work
In one of our nurseries we ran a training session on group consultations.
This process is based on the work of Gerda Hanko. She has outlined a structure within which staff can be trained and supported in running small group consultations.
We spent the first session with them, to build their levels of self-confidence in the groups. The structure is similar to that outlined above. Ms Hanko reports that these groups are most likely to succeed and be sustained when:
* they are recognised and validated by the nursery management and systems.
For example, that taking a child to a group consultation system should count as one strategy for their Individual Education Programme (IEP)
* writing up the outcomes of the consultation could be considered as an IEP at Early Years Action
* membership of the groups is consistent, and all attend whether 'their'
child is to be discussed or not
* the group and the children are reviewed after a period of time to see if there are implications for training. For example, one nursery realised that staff often discussed children who were quiet and timid but referred children who were noisy and domineering. So they organised a training day in which they looked at the different ways in which children may be expressing similar difficulties.
In one of our small nurseries Sam's parents were refusing a referral to our team for direct work. The staff were concerned that they could not cope with the child's hitting and his keyworker, Sue, was afraid that the managers would blame her for other parents' complaints. We were able to lead a staffroom discussion about Sam.
Group work
At first the staff needed to express their frustration. When their feelings had been acknowledged they were able to move on to talk through their concerns, but also instances of good behaviour and things that had worked a bit better. They were then able to generate ideas based on each staff member's contribution. The following points are taken from their IEP:
* Sam would arrive earlier, so as to have a settling-in time before the other children arrived.
* Rushing in and talking 'at' Sam made him more agitated, so it was decided that all staff would use the phrase 'Use your words' when they could see him getting agitated. They would then ensure they were listening clearly to his words.
* Sam's 'clumsiness' meant he sometimes found delicate movements hard. For this reason all staff introduced the phrase 'Be gentle' to all children, starting with delicate objects, modelling and careful handling, then applying it to pets and each other.
Reference: Hanko, G Special Needs in Ordinary Classrooms: From Staff Support to Staff Development David Fulton Publishers (1995)
