Lockdown Babies: Supporting children with SEND and their parents

In the post-pandemic era, settings are experiencing pressures from many directions, not least from families who are turning to them for support.

Commentators report that many parents are worried about their children’s development, alongside experiencing their own difficulties with mental health and finances.

Josephine Burke, a parenting consultant and art psychotherapist specialising in under-fives, has gained concerning insights into this while trying to develop support plans for children, in partnership with early years settings.

Burke, who has worked for child and adolescent mental health services and in private practice in Gloucestershire and London, believes that a feeling of hopelessness and burnout is pervasive as settings try to meet this need beyond their capacity.

She says, ‘Post-Covid, the conversations with nurseries are, “We’ve got loads of kids that have behaviour that challenges, and parents struggling with their mental health, and we haven’t got the ratio of staff to manage it.”’

Burke explains that while these types of pressures existed for settings before Covid, they were less intense.

‘Now they are asking, “How can we give this child the attention they need when we have so many that need extra support?” Various settings are having to cope with a huge population of these extreme cases, whereas in the past there may have been one or two per setting.’

Burke believes parents, some of whom are traumatised themselves, are a key driver of the spike in SEND referrals that she has witnessed. This is because certain behaviours – such as a lack of social engagement – may look like a diagnosable condition even if they are not.

‘They may understandably be thought of as having some form of learning disability or autism,’ says Burke. ‘There isn’t necessarily a mental health difficulty in these children – this is a normal reaction to an adverse situation.

‘Parents may be pushing for a diagnosis and possibly medication, and they are desperate that their children are getting older and not getting support. They are on their knees wanting it to be fixed.’

DEPRIVED AREAS ARE MOST AFFECTED

Reports from across the sector echo Burke’s experience.

At this year’s Nursery World Business Summit, June O’Sullivan, chief executive of the London Early Years Foundation, said she feared taking more children with SEND could ‘tip the whole thing over’ for her social enterprise. ‘We have staff who are crying every day because they are exhausted,’ she said.

A large number of delegates also confirmed they were turning children with SEND away. And half of local authority areas are now defined as ‘childcare deserts’, with these most likely to be in deprived parts of the country, according to the New Economics Foundation.

Cross-subsidisation constraints are expected to worsen with the further expansion of the funded entitlement, according to sector leaders. Umbrella organisation Early Years Alliance, which also operates nurseries almost exclusively in areas of deprivation, has seen its number of settings drop from 132 to 41 in the past four years.

Sheffield-based early years consultant, Wendy Kettleborough, offers another case in point. She was forced to close her then-Outstanding setting, Sunshine Preschool, in April 2023 due to unsustainable costs. It had 27 children with SEND – just under a third of the total cohort accessing the funded entitlement.

Kettleborough, who has also worked as an expert in the Government’s Covid recovery programme, explains, ‘We ended up like a charity contributing to the free offer because our parents couldn’t afford to pay for extras. We were losing thousands of pounds.’

In her experience, unmanageably long waits for diagnosis and treatment are the norm, adding stress for all stakeholders. ‘You can’t get the therapy if it’s taking you 12 months to get a diagnosis,’ says Kettleborough. ‘Our S&Ls [speech and language referrals] were taking 17 months. If you’re aged two, you have to wait until you’re in school to get a diagnosis.’

IMPORTANT ROLE OF SHARED PARTNERSHIPS

Working in partnership with parents is central to the Early Years Foundation Stage.

However, Christine Wilkinson, who runs a setting in Oxfordshire and has also worked as an expert in the Government’s Covid recovery programme, is also concerned about parental circumstances.

‘There is a need for a shared partnership between settings and parents, but it can only be a shared partnership if the parents have the capacity to take part,’ says Wilkinson. ‘Parents are coming to settings saying “I need your help, I don’t know what to do”.’

A range of one-to-one needs is also commanding increased amounts of practitioner time, in her experience. ‘Anything from children that won’t sit down to eat,’ says Wilkinson. ‘They need a member of staff to walk around with them and help them eat.

‘Children that just don’t know how to play – they’re flitting around, so they need a member of staff to really get into that deep-level playing.’

Parents resorting to screen use as a coping mechanism could be a factor.

‘Children aren’t able to regulate themselves to sit and eat without a screen,’ she observes. ‘That impacts their social skills too – when you’re behind a screen, you miss the social cues.’

Parental difficulties aside, settings are duty-bound to have open lines of communication, though some practitioners may have preferred the restrictions of the pandemic.

Michael Freeston, director of quality improvements at Early Years Alliance, describes some enlightening views expressed in chat rooms by some practitioners (in sector-wide conversations during lockdown, not necessarily linked to the alliance).

‘It was pretty surprising,’ says Freeston. ‘Some openly said that it was great not having to meet with parents.

‘I don’t know if some still practise it, but if you do, notwithstanding whether it’s good or bad for families, you need other processes in place to ensure you are meeting the requirement about sharing information with parents and engaging them in guiding their child’s development at home.’

CASE STUDY: West Street in Erith, Kent

Following an Ofsted visit in January, West Street Neighbourhood Nursery in Erith, Kent, which is run by the Early Years Alliance, was upgraded to Outstanding. The report stated that staff ‘quickly identify and close any gaps in learning, including those occurring because of Covid-19’ and ‘ensure that children catch up as quickly as possible’.

Some 21 of the 72 children cared for are either in receipt of Pupil Premium, part of a SEN caseload or on an Education Health and Care Plan.

Bradley Flavien, a children’s services manager for the Alliance who oversees six settings in the South-East of England, describes how the nursery has adapted to changing demands. He says, ‘Generally children’s starting point is a lot lower than it was – mainly language delay and challenging behaviour. Intervention hasn’t happened as early. We are noticing more of a gap between the higher achievers and those who need more targeted help.

‘It does have an impact on practitioners because a lot more work goes into supporting them.

‘There’s more stress around separation, so we use an app – the photos go straight out to the parents.

‘We have more contact with families than we did before – generally parents are more open and engage staff in conversations. If they’re struggling with a child at home, they will ask a practitioner.

‘We’ve lost a lot of people, the ones that are still here are able to cope with the changes. You have to be strong-willed and the passion has to be there. We have some who have been in the field 40 years, so it’s a big change. Some practitioners still find it a struggle and they are feeling the pinch financially.’