inclusion in the early years for children with …...1 strategic direction : inclusion in the early...

Inclusion in the

Early Years for

Children with

Additional Needs

A Research Project for

Supported by

29/02/2012

Inclusion in the Early Years for Children with Additional Needs

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Chwefror 2012. Cedwir pob hawl.

February 2012. All rights reserved.


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Contents

Executive Summary ..............................................................................................5

1. Introduction...................................................................................................10

1.1 The Need for Research ........................................................................10

1.2 The Steering Group ..............................................................................12

1.3 Referral Schemes.................................................................................14

1.4 Welsh Context ......................................................................................15

2. Research Objectives ....................................................................................23

3. Methodology.................................................................................................24

3.1 Summary of Research..........................................................................24

3.2 Description of each element .................................................................25

3.3 Research Objectives and the Methodology ..........................................35

4. Research Findings .......................................................................................37

4.1 Steering Group Interviews ....................................................................37

4.2 Desk Research .....................................................................................39

4.3 Quantitative Survey ..............................................................................48

4.4 Interviews with Wales Pre-school Providers Association Regional

Executive Officers............................................................................................77

4.5 Focus Groups .......................................................................................78

4.6 Workshop with Referral Scheme Co-ordinators....................................95

5. Main Themes..............................................................................................100

5.1 The Meaning of Inclusion....................................................................100

5.2 Numbers .............................................................................................100


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5.3 Parents ...............................................................................................101

5.4 One to one support .............................................................................103

5.5 Geographical Considerations .............................................................103

5.6 Language issues ................................................................................105

5.7 Staff Skills, Attitudes and Training Issues...........................................106

5.8 Funding and Support ..........................................................................109

5.9 Inclusion – Barriers and Enablers.......................................................111

5.10 Ideas for improving Inclusion ..............................................................112

6. Conclusions................................................................................................116

7. Recommendations .....................................................................................120

7.1 Strategic/National ...............................................................................120

7.2 Local ...................................................................................................121

8. References.................................................................................................124

APPENDICES...................................................................................................130


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Executive Summary

This All Wales research project focuses on the provision of early years play and

educational settings for children with additional needs and their families.

The project is funded by Early Support, is led by Mudiad Meithrin and overseen by a

multi-agency Steering Group which includes representatives from Wales Pre-school

Providers Association, National Childminding Association Cymru (NCMA Cymru), Scope,

Autism Cymru, Learning Disability Wales and Contact a Family.

Methodology

The multi-agency Steering Group was responsible for overseeing the work of the project.

Research methods included consultation with partner agencies, desk research to identify

existing evidence and good practice, a large scale postal survey of 176 Cylchoedd

Meithrin, 4 telephone interviews with Wales Pre-school Providers Association Regional

Executive Officers, three focus groups with Mudiad Meithrin staff, three focus groups

with parents of children with additional needs and a workshop with Referral Scheme Co-

ordinators.

Desk Research

The Desk Research undertaken concluded that although there is a large amount of

literature in the field of children’s access to play it is nevertheless very difficult to see any

clear estimate of the level of need, the level of take up and the extent of unmet need for

provision in the community in Wales. However, the review of literature gives a figure of

between 5-10% of children having additional needs.

The references point to a range of organisations, local authority schemes, government

plans and regulations, and the legal framework within which inclusive early years’

settings and play facilities should operate, but often do not.

The Desk Research highlighted that there are competing and overlapping initiatives

which complicate the picture and make it difficult to assess the level of need. This in

itself highlighted the need for further research in this field.


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Research Findings

Inclusion can mean different things to different people but a general consensus was

given in the survey and focus groups that at its best, ensuring inclusion means planning

activities and the environment in order to enable the child with additional needs to safely

join in all activities where possible. There was a consensus that inclusion is not always

achieved for a variety of reasons .

The survey indicates that something in the region of 5% of children attending or on

waiting lists for Cylchoedd Meithrin are known to have additional needs, which is at the

lowest end of the estimated need indicated by the desk research at 5%-10%. If

aggregated, this would mean that a minimum of 3,250 children over a two-year cohort of

approximately 65,000 pre-school age children across Wales have additional needs.

It seems clear from across the methods employed by this research that children with

additional needs attend early years settings for fewer hours than other children with lack

of funding given as one of the main causes.

Communication between parents and the staff at the setting is seen as key to successful

inclusion of a child with additional needs, and although there are many examples of

good communication, this is not always the case. Many parents in our focus groups

related stories where they had encountered difficulty either in communicating with staff at

the setting, or with other parents, or with professionals. In the case of staff, it was put

down to lack of confidence, awareness and training.

Despite some negative stories, in the main, parents reported good practice and a desire

to do the best for the child at the setting.

A central issue for staff, parents and Referral Scheme Coordinators highlighted in the

research was the lack of availability of good quality, trained 1-1 Support Workers

(Helping Hands) for children with additional needs to enable them to have equal access

to play opportunities in the early years. Inadequate funding leading to poor pay and

Terms and Conditions for 1-1 Support Workers (Helping Hands) were identified as the

main causes of recruitment, retention and consequent high turnover and continuity

difficulties. According to parents, despite the fact that 1-1 Support Workers (Helping

Hands) have a crucial and challenging role in developing a trusting relationship and

enabling inclusion with very vulnerable young children, and that they are valued


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members of staff, they often only receive only a minimum wage due to the financial

restrictions under which the Referral Schemes are required to operate.

The complexity of support arrangements and mechanisms, as well as inflexibility in the

system, in the field of children with additional needs in the early years is a major theme

in this report. The set-up of Referral Schemes differs from county to county and not all

areas in Wales are covered by a Referral Scheme. There is concern also that an

increasing focus on targeting low-income families and deprived areas, with laudable

initiatives such as Flying Start and Families First, could exacerbate this geographical

inequality. Indicators of poverty are always income-based not expenditure-based, and

therefore do not acknowledge the additional financial pressure faced by parents of

children with additional needs.

The research also indicated that pressure is being exerted by health professionals and

others on Welsh-speaking parents of children with additional needs to send their children

to English-medium provision to provide language consistency, as there is little or no

provision of Speech and Language Therapy through the medium of Welsh in certain

areas.

Staff skills, training and confidence are seen as key to facilitating inclusion.

Confidence levels among staff in their ability to include children with additional needs are

lower than for other children, and this, together with the fact that slightly more than one

fifth of staff in our survey reported that they did not believe that they had the necessary

skills and knowledge to support children with additional needs, sends out a strong

message that there is a need for more training to increase skills and confidence levels

among staff. A willingness to undertake more training in inclusion and additional needs

was very marked at over 90% of respondents.

There was strong support for the Referral Schemes in our research, from staff and

parents. In cases of good practice, they provide a vital link between parents, the early

years settings and professionals and they also know how to access available funding

and support.

A strong finding in this research is that the complexity of funding and support

mechanisms together with insufficient funding leads to inequality of access to pre-school

play settings for children with additional needs.


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Conclusion

The results of this research have largely proved the perception that pre-school children

with additional needs in Wales do not have equality of access to play and educational

opportunities as other children.

The research highlights the fact that there is no Wales-wide strategic approach to

funding and support in order to ensure equality of opportunity for all pre-school children

and their parents/carers, leading to geographic inequality which exacerbates the

difficulty that parents of pre-school children with additional needs already face in

accessing inclusive play and education settings for their children.

Given that successful inclusion of children with additional needs at the pre-school stage

leads to an increased likelihood in the future of their inclusion at primary and secondary

school level, training and even employment, investment at this early stage to support

inclusion would seem to be a cost-effective method of minimizing the higher costs

involved with lack of inclusion at later stages.

Recommendations

Strategic/National

1 Strategic Direction: Inclusion in the Early Years for Children with Additional

Needs to be given strategic priority at Welsh Government level.

2 Referral Schemes to be given strategic priority (see 1 above) and adequately

funded in order to provide a consistent and comprehensive service and improve

the capacity of Coordinators to support the need.

3 Adequate funding to support equality of opportunity for early years children with

additional needs to attend pre-school settings, with flexibility in the funding

system to allow parents to access settings appropriate for their child’s condition

outside the designated area, and recognizing the additional expenditure incurred

by families of children with additional needs. Funding should follow the needs of

the child and not the constraints of geography or parental circumstances.


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4 Proving Inclusion: the onus placed upon all settings to prove inclusion of children

with additional needs with clear link to the early years inspection systems (e.g.

ESTYN and other monitoring agencies).

5 Early Support website to include an online resource centre to enable

downloading of e.g. Information Leaflets etc.

Local

6 Referral Schemes: Availability of well resourced Referral Scheme Coordinators

with the capacity to meet demand and ensure inclusion in each area

7 Practitioner-parent communication: can be improved via a Home – Setting Link

Book and use of developmentally appropriate targets set in Play Plans.

8 Practitioner Training: Training in general inclusion (which includes facilitating

communication with and between parents), training and information about the

specific conditions and visits to other settings, specialist schools or shadowing

other practitioners at other settings.

9 Practitioner Mentors: Use of experienced and trained mentors in a local/county

area who are working in early years settings with children with additional needs

to support practitioners who are less experienced.

10 An Inclusion Checklist, including self-audit activities, that can be used by

practitioners at every setting to prove inclusion. This should be monitored

regularly.

11 Networking: Regular facilitated meetings for practitioners to review progress,

share good practice and discuss concerns – at local/county level

12 Online Information Tool: Use of an online resource centre in order to share good

practice and information

13 1-1 Support Workers (Helping Hands): A trained pool of 1-1 Support Workers

(Helping Hands) covering a wide area with consistent training, monitoring and

assessment.

14 Pool of Resources: A central pool of specialist toys, equipment and other

resources in each area for children with additional needs – free to loan basis


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1. Introduction

This All Wales research project focuses on the provision of services for children

with additional needs and their families in the early years.

This project, funded by Early Support, was led by Mudiad Meithrin and overseen

by a multi-agency steering group which included representatives from Wales Pre-

school Providers Association, National Childminding Association Cymru (NCMA

Cymru), Scope, Autism Cymru, Learning Disability Wales and Contact a Family.

The research was conducted by Mabis, a research consultancy company and

part of the Menter a Busnes group.

One of the main objectives for the Steering Group was to produce clear, user

friendly guidelines to aid inclusion in all early years settings.

1.1 The Need for Research

‘’Inclusion is the process of identifying, understanding and breaking down barriers

to participation and learning’’ (Participation and Belonging in the Early

Years/Sure Start + NCB 2005)

‘’An inclusive setting is... open and reachable to all and makes positive steps to

break down barriers so that children with and without additional needs can

participate’’

The above definitions describe the ideal scenario for inclusion but there are

concerns that this is not always achieved.

The need for this research in to pre-school provision for children with additional

needs was identified by Mudiad Meithrin, in consultation with partners from the

related organisations above, because of what is seen as an inequality of

opportunity and provision for children with additional needs compared with

children without additional needs. Families of non-disabled children are able to


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access their local pre-school setting enabling the parents to live ordinary lives

e.g. a mother can meet other mothers at the local setting and enjoy a natural

progression in a child’s early life and the child can interact with other children with

all the associated developmental and social benefits.

The Welsh Government funds 10 hours per week of early years education for

children between the age of 3 years and one term and 4 years. This is provided

in nursery classes in schools in addition to settings in the non-maintained sector

which are registered with the Local Authority as education providers for children

of 3-4 years old. Non-maintained settings are often open for longer than 10 hours

per week and parents can then choose to fund any additional hours that the

children attend. Parents of children with additional needs face the additional cost

of funding the 1-1 Support Workers (Helping Hands) which would enable their

children to attend a setting.

Families who live in Flying Start areas have the right to part-time child care for

children aged 2-3 years, and although there will be some outreach work after

April 2012, this service is not available for all children who live outside the

defined Flying Start areas. Flying Start ends when the child is of an age to be

funded for part-time education at three years and one term.

In this context, parents of children with additional needs often face greater

difficulty in accessing both early years play opportunities at age 2-3 and early

years education at age 3-4, and there have been concerns that these children do

not enjoy equality of opportunity with other children. Cost is one issue as children

with additional needs may require support from an additional 1-1 Support Worker

(Helping Hands) incurring additional costs for the setting. Concern regarding the

success of achieving inclusion for children with additional needs in the wider

context highlights the need to research the causes and possible solutions in

order to enable equal opportunity for children with additional needs.


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1.2 The Steering Group

The multi-agency Steering Group ensured that the project maintained a clear

focus on the need for a coordinated approach in the early years by contributing

their individual professional perspective.

• Mudiad Meithrin is a voluntary organisation specialising in Welsh-medium

early years provision. It aims to give every young child in Wales the

opportunity to benefit from early years services and experiences through

the medium of Welsh. Sian Owen is Director for Inclusion at Mudiad

Meithrin and in addition to representing the Mudiad on the Steering Group,

is also Project Manager for this research and subsequent production of an

Inclusion Checklist by the Steering Group.

• Wales Preschool Providers Association (WPPA) is an independent

voluntary membership organisation for preschool providers throughout

Wales and a registered educational charity. It is a national charity and

membership organisation that promotes and supports bilingual pre-school

care, education and learning through play across Wales. Elaine Jones is

part of the Special Needs committee and is also Regional Executive

Officer for South West Wales

• Scope works with disabled people, of all ages, and their families, across

England and Wales offering practical, everyday support and campaigns.

They work with disabled people on the issues that are most important to

them and aim to raise awareness, change attitudes and influence

government policy. They also support disabled people and their families

through practical information and support, particularly at the time of

diagnosis and in a child’s early years. Lindsay Brewis is Head of Early

Years for Scope in England and Wales.

• Autism Cymru is Wales’ national charity for autism and is not part of an

umbrella organisation. It is strategically focussed having a Chair in Autism

at Cardiff University, and it works for change in partnership with others

(e.g. the Police – they now have individual identification cards for people


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with Autistic Spectrum Disorder). They also have a large role in training

and consultation and many publications. Maggie Bowen is Deputy Chief

Executive of Autism Cymru

• Learning Disability Wales (LDW) is a National Umbrella Organisation for

Learning Disability organisations in Wales and a registered charity working

for the rights of adults and children with learning disabilities and their

carers. It undertakes policy and lobbying work at Europe, UK, Welsh

Government and Local Authority levels. It runs an information service

which is open to members and non-members and produces good practice

manuals, updates, monthly bulletins, training and events. Zoe Richards is

the Young Person and Carers Manager for Learning Disability Wales.

• Contact a Family Wales is part of a UK charity which supports families

with disabled children and provides information and support. It organises

parent training sessions which focus on issues such as challenging

behaviour, benefits etc and family events including activities such as

circus workshops and art workshops. It maintains links with voluntary and

statutory services especially parent groups and undertakes much policy

and campaigning work. Keith Bowen is the Wales Manager for Contact a

Family

• National Childminding Association Cymru (NCMA Cymru) is the

professional membership association for childminders and nannies in

Wales. Since 1977 NCMA has worked with registered childminders and

nannies as well as other individuals and organisations such as local and

national government, to ensure families in every community in England

and Wales have access to high quality home-based childcare, play,

learning and family support. It supports its members to achieve the

highest standards of care and learning for children and works to build

recognition of their professionalism. NCMA works across England and

Wales with 1,927 members in Wales and 38,151 across England and

Wales. Claire Protheroe is the Quality and Development Manager for

NCMA Cymru.


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1.3 Referral Schemes

Referral Schemes support early years settings through advice, training, funding

of specialist equipment or if necessary funding for additional support in the form

of 1-1 Support Workers (Helping Hands) to provide inclusive play opportunities

for all children.

Each child is unique and his/her individual needs are assessed, with the consent

of the parents, by the appropriate professional e.g. Speech and Language

Therapist, Educational Psychologist, Health Visitor etc. Every setting has a

named individual who is responsible for children with additional needs within the

setting adhering to the Code of Practice (2004).

The Referral Scheme Coordinator liaises with other members of the multi-

disciplinary team and can arrange for the professionals concerned to come to a

setting to provide specific training for the staff of the setting around the individual

needs of that particular child if required. The Coordinator also provides a link

between the family and the setting/professionals ensuring that important and

relevant information is shared for the benefit of the child, adhering at all times to

the code of confidentiality, and helping to ensure inclusion.

Referral Schemes have been set up locally and their Management Committees

are led by either Mudiad Meithrin, Wales Pre-school Providers Association or the

Local Authority. Five counties are without Referral Schemes – Swansea,

Bridgend, Monmouth, Torfaen and Blaenau Gwent. In these areas support is

given directly to settings by the Local Authority. Other organizations also run their

own Referral Schemes in some areas.

At present a Referral Scheme (if one is available in the county) will have limited

funds to provide the necessary support and it is only in rare cases that they are

able to provide the full ten hours a week. This then leaves the child with

additional needs disadvantaged even further with the perception of inequity of

service in most areas in Wales.


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The Referral Schemes, if adequately funded, can redress this inequality of

opportunity and ensure that children with additional needs and their families are

enabled to live ordinary lives at the very beginning of their children’s lives.

Acceptance and inclusion into the community can have a profound and positive

effect on all concerned and can set the child with additional needs on a positive

path to inclusion going forward to primary and secondary education, and possibly

training and employment.

‘’Every child has the right to the best possible start in life. When a child has

special needs, it is vital that these needs are correctly identified as early as

possible. It is equally important that effective early intervention is available for the

child, together with emotional and practical support for the parents’’ (Welsh

Assembly Government: 2004)

1.4 Welsh Context

1.4.1 Policy in Wales

The aim of the Welsh Government is to provide a better education for all young

children in Wales so that ‘children and future generations enjoy better prospects

in life, and are not landed with a legacy of problems bequeathed by us.’ (WAG

2004). In order to achieve this, the United Nations Convention on the Rights of

the Child 1989 was adopted by the Welsh Assembly Goverment in 2004, and

later included in the Children’s Act 2004. This Act influenced policy in Wales as

outlined in the seven core aims for Children and Young People: Rights to Action

(WAG, 2004). The first of these seven aims is ‘A Flying Start in Life’ and covers

early years education.

The post of independent Children’s Commissioner for Wales was created in 2001

and was the first legislative provision put into effect by the Welsh Government.

The office has, since its establishment, sought to influence policy relating to

children and young people to ensure that policies promote and safeguard the

rights and welfare of children in Wales. Keith Towler, Children’s Comissioner, in a


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recent address stated that he ‘was committed to scoping out issues relating to

disabled children in Wales’.

The aim of the Welsh Government in investing £174 million in 2009 in Wales was

to achieve the outcomes noted in the seven aims by concentrating on the needs

of young children and their individual stages and rates of development. It was

also an opportunity to develop and implement a curriculum that enables children

to realise their full potential by minimising the barriers that can lead to failure.

A range of measures have been taken by the Welsh Government to address the

issue of inclusion of children with additional needs, including the establishment of

‘Early Support Wales’ 2009.

The provisions of the Equality Act 2010 (which replaced the Disability

Discrimination Act 1995) have force in Wales, and include the duty to make

reasonable adjustments to facilitate access and inclusion for people with

disability, and this includes children in early years play and education settings.

1.4.2 Early Support Wales

Early Support Wales is the Welsh Government mechanism to improve services

for disabled children and children with additional needs and their families.

Early Support has developed a range of resources and training that are aimed at

bringing service providers together to work in partnership with the family to

ensure the child and family's requirements are met. The aim is to put parents at

the centre of the planning process. The development of the Early Support

resources and training began in England and Early Support Wales has updated

these resources, made improvements where necessary and adapted them to fit

the Welsh context.

Early Support principles and approaches underpin the use of the materials and to

help Early Support's implementation in Wales, Early Support consultants and

trainers are available for advice, training and guidance.


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A partnership of voluntary organisations was commissioned by the Welsh

Government to make sure that Early Support is introduced across Wales. With

Children in Wales leading, the other partners are Royal National Institute for Deaf

People, Royal National Institute for the Blind, Barnardos, Autism Cymru, Care

Coordination Network UK, Action for Children, Downs Syndrome Association,

Contact a Family, National Deaf Children's Society, Access for Black and

Minority Ethnic Children and Young people with Disabilities and/or chronic

illnesses, Scope, Snap Cymru, Learning Disability Wales, Mudiad Meithrin,

Wales Pre-school Providers Association, National Day Nurseries Association,

National Childminding Association and National Portage Association.

Early Support Principles are:

• Wherever possible, families are able to live ‘ordinary lives’

• The uniqueness of children and families is valued and provided for

• The care that disabled children receive is based on joint assessment,

planning and review processes that keep parents and carers at the heart of

discussion and decision-making about their child

• Children and families experience delivery as holistic, co-ordinated and

seamless, facilitated by a key worker where appropriate

• Families experience continuity of care through different phases of their

engagement with services

• Children’s learning and development is monitored and promoted

• Families are able to make informed decisions

• Families and children are involved in shaping and developing services

• Working practices and systems are integrated

• Families can be confident that the people working with them have the

training, skills and experience required to meet their children’s needs.


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1.4.3 Flying Start

Flying Start is a Welsh Government initiative targeted at 0-3 year olds in the most

disadvantaged communities in Wales. It aims to create positive outcomes in the

medium and long term. It is a prescriptive programme, based on international

evidence of what works and offers:

• free quality part-time childcare for 2-3 year olds

• an enhanced Health Visiting service

• access to Parenting Programmes

• access to Language and Play sessions.

These are universally available to all children aged 0-3 and their families in the

areas in which it operates.

Flying Start brings together education, childcare, health and social services and

combines the voluntary, private and statutory sectors to offer preventative

interventions that influence child outcomes.

The scheme builds on and complements existing valuable work done under the

Sure Start theme of the Cymorth grant scheme. The settlement also provides for

continuing capital investment within Flying Start to make sure that facilities

support the high quality required, and that the childcare settings needed are

within the disadvantaged areas targeted.

1.4.4 Families First

Families First is a Welsh Government initiative and aims to improve family

support, particularly to disadvantaged families, by working on the structure,

design and delivery of preventative and early interventions. It sits alongside the

support offered by programmes such as Flying Start.

The initiative aims to provide integrated, intensive and local family focused

services. It is aimed at the general population but is also relevant to families with

disabled children. Families First objectives are to:-


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• Reduce the number of workless households

• Improve skills levels in low income families

• Reduce inequalities in health, education and economic outcomes for

children living in poverty

The three levels of prevention, protection and remedy are also appropriate for

disabled children and their families with a range of relevant activities and support

which could be provided under each broad heading. For example:

Preventative:

• Improve information to all families with disabled children, provide a

newsletter and website on local services and activities including

information on benefits and other sources of financial support such as

grants

• Support the development and running of local parent support groups for

families with disabled children, including family activity days

• Provide training for families with disabled children on relevant subjects

such as benefits and welfare rights, sign language, challenging behaviour

etc.

Protective:

• Invest in pre-school play by supporting local authority Referral Schemes

such as those provided by Mudiad Meithrin and Wales Pre-school

Providers Association

• Invest in short breaks and after school provision for disabled children and

young people

• Develop schemes to promote inclusion into mainstream play and leisure

activities


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Remedial:

• Increase the number of families with disabled children who have a named

keyworker

• Increase the range of short break schemes available locally

• In partnership with Health Trusts increase the availability of community

children’s nurses for children with very complex needs

Since funding associated with Families First is linked to reducing workless

households, the specific needs of families with disabled children do not fit neatly

into the criteria, and for this and other reasons the services and activities

provided are not always fully accessible to families with disabled children.

Families First will work with Local Authorities, and other agencies, to ensure that

services are coordinated to meet local needs. This will be achieved through the

Families First Fund.

Families First is currently operating across 14 Welsh Local Authorities in Pioneer

areas, and is working closely with these Authorities prior to the programme being

introduced across Wales in April 2012.

1.4.5 The Disabled Children Matter Wales campaign

The DCMW campaign was launched in 2007, coinciding with the start of the One

Wales Coalition Government. At that time there had been the announcement in

England of a three year strategy to transform the lives of families with disabled

children backed by substantial investment called Aiming High for Disabled

Children.

The DCMW campaign called for a similar plan for disabled children and young

people in Wales and for the additional £21 million allocated to Wales, as a result

of Aiming High in England, to be invested in services for disabled children in

Wales. The campaign failed to secure either of these objectives but the Welsh

Assembly Government did respond with a less ambitious programme, We Are On

The Way, in 2008 which included a series of one-off investments amounting to


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approximately £10 million over three years. This included additional funding for

short breaks, changing places facilities, play and leisure, the Early Support

programme and a benefit uptake campaign.

1.4.6 Foundation Phase

The Foundation Phase is an approach to learning for children from 3-7 years of

age in Wales. It combines early years education (for 3- to 5-year-olds) and Key

Stage 1 (5- to 7-year-olds) of the National Curriculum. ’The core principle of the

Foundation Phase supports an inclusive approach by recognizing and

understanding that the curriculum and approaches need to match the

developmental level of the individual child regardless of age’ (Module 5

Foundation Phase National Training pack: Additional Learning Needs, Welsh

Assembly Government 2007)

It is the statutory curriculum for all children in Wales between the ages of 3 and 7

years of age in both maintained and non-maintained settings that are funded for

education by the Local Education Authority (LEA).

The Foundation Phase places great emphasis on children learning by doing.

Young children are given more opportunities to gain first-hand experiences

through play and active involvement. Children are given time to develop their

speaking and listening skills and to become confident in their reading and writing

abilities.

Framework for learning

This framework sets out the curriculum and outcomes under seven Areas of

Learning. These are:

• Personal and Social Well-Being and Cultural Diversity

• Physical Development

• Creative Development

• Language, Literacy and Communication Skills

• Welsh Language Development


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• Mathematical Development

• Knowledge and Understanding of the World

There is an emphasis on developing children’s knowledge, skills and

understanding through play, experiential learning (learning by doing) and by

solving real life problems in both the indoor and outdoor environments through

these areas of learning.

One of the requirements of the Special Educational Needs Code of Practice in

Wales is the formation of an Individual Play Plan for children. It should contain

three or four short term targets, the teaching strategies that are different or

additional, the proposed resources, review date, monitoring methods and steps

taken. All targets should be SMART (Specific; Measurable; Achievable; Realistic;

Time-based).

Settings which are not funded for education by the Local Education Authority can

still support children’s learning and development by understanding the philosophy

and ethos of the Foundation Phase and linking these to the activities they

provide.


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2. Research Objectives

1 Assess the current provision of play opportunities for pre-school children

with additional needs across Wales and the ease or difficulty of access to

such opportunities in different parts of Wales.

2 Collection of data regarding the numbers of children with additional needs

who are already in pre-school settings and information regarding siblings

of children who are in settings (children in settings without additional

needs but who have siblings with additional needs who are unable to

attend settings).

3 Report on the experience of parents who have children with additional

needs regarding inclusion in settings, or have negotiated the complex

route towards accessing play opportunities for their children.

4 Assess the support needs of staff and of Referral Scheme Coordinators

e.g. training, guidelines etc.

5 Identify any gaps in provision, barriers to inclusion and support needs of

parents and systemic issues.


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3. Methodology

The two main methods of research, the deductive and the inductive were utilized

for this research project. The deductive draws an objective conclusion and is

useful in answering questions of quantity, to test, confirm or compare results in a

different context.

It is, however, less useful when looking at the ‘why’ and ‘how’ questions that may

lie behind the quantitative results. Why do children with additional needs have

difficulty in being included in early years play settings in some areas? How can

we increase confidence and skills among staff? Here we need to use the

inductive method, with qualitative, more semi-structured approaches such as

talking to groups and individuals and discussing the issues in some depth while

allowing the discussion to go in perhaps unforeseen directions.

A combination of primary and secondary data and the qualitative and quantitative

approaches were utilised for the different stages of this research project.

3.1 Summary of Research

• Consultation with individual steering group members

• Establish an information base - desk research

• Design and pilot data collection questionnaire

• Quantitative survey of every Cylch Meithrin in Wales

• Develop interview discussion guides

• In-depth qualitative interviews with Wales Pre-school Providers

Association Regional Executive Officers

• Develop focus group discussion guides

• Focus groups with Cylch Meithrin staff

• Focus groups with parents of children with additional needs


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• Workshop with the Referral Scheme Coordinators

• Meetings with the project’s Steering Group – progress/interim report

• Analysis and final reporting to the Steering Group

3.2 Description of each element

3.2.1 Consultation with Individual Steering Group members.

Individual face-to-face in-depth semi-structured interviews took place with each of

the eight representatives on the Steering group, representing Contact a Family,

Scope, Autism Wales, Wales Pre-School Providers Association (Wales PPA).

Learning Disability Wales, Mudiad Meithrin and the National Childminding

Association Cymru (NCMA Cymru). A discussion guide was developed in order

to provide semi-structure to the interviews.

The Multi-Agency Steering Group was a key element in the research, both in

informing elements of the methodology with the individual agency's perspective

and experience, such as the design of research materials, and also in steering

and monitoring the research as a whole.

The aim of the individual interviews with Steering Group members was to collect

information about relevant issues to do with inclusion of children with additional

needs in order to inform other elements of the methodology and in particular the

desk research, the quantitative survey and the focus groups.

3.2.2 Establishing an Information Base

The aim of this stage was to conduct desk research which would provide a

picture of the current evidence, research the strategies and studies already in

existence in order to identify any gaps and to assess the current provision.

It was important that this research considered and built upon current knowledge.

Dr David Turner of Glamorgan University undertook the Desk Research element

during February, March and April of 2011, and we have also included other more

recent secondary research. Dr Turner assembled and reviewed secondary data


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from strategies and schemes and existing literature and early years material

which has influenced the provision of care and early education. Some examples

of similar developments in other areas of the United Kingdom and of Europe

were considered and some evidence of good practice was found. This stage also

proved the need for further research and developed a foundation on which to

build during the ensuing stages.

3.2.3 Design of Quantitative Questionnaire

The aim of this stage was to:

• Design the questionnaire for the quantitative survey

• Pilot the questionnaire

Following the Steering Group interview and the Desk Research stage, the data

collection questionnaire was designed, drawing on the information collected to

inform the questions.

The questionnaire was developed in full consultation with stakeholders and

partners during the Steering Group meeting. Their input ensured that the data

and evidence collected was as comprehensive as possible. It was decided after

the desk research and consultation with the Steering Group that a full definition of

Additional Needs should be included at the beginning of the Questionnaire.

However it was decided not to provide a definition of inclusion, but to ask

respondents to put in order of importance a number of different definitions.

The quantitative questionnaire was piloted with 5 Cylchoedd Meithrin and then

evaluated and adjusted in consultation with the Steering Group.

The main adjustments included:

• Simplifying language on the Introduction page - less jargon

• Clarifying some of the questions - particularly the numbering

• Sending an accompanying letter with further instructions


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The final questionnaire consisted of seven sections:

Section 1 - Geographical area

Section 2 - The meaning of Inclusion to the Respondent

Section 3 - Numbers of children and children with additional needs

Section 4 - Participation of parents

Section 5 - Staff Skills and Attitudes

Section 6 - Training

Section 7 - Funding and Support

Section 8 - Barriers and Enablers

The survey questionnaire has been included in the Appendix.

3.2.4 Quantitative Survey – Cylchoedd Meithrin

The aim of this stage was:

• to gather profiling information regarding staff, locations, number of children

and hours offered

• to gather data regarding numbers of children with additional needs in the

Cylchoedd

• to gather information regarding the skills and attitudes of staff to children

with additional needs

• to enquire which skills, assistance and support are available for the

Cylchoedd

• to gather data on services for children with additional needs

• to enquire which skills, assistance and support are required in order to

improve the provision for children with additional needs

• to establish the need for further financial help and additional support

• to establish the need for special equipment

• to assess training needs

• to identify barriers to inclusion


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The quantitative questionnaire and letter was sent by post to 400 Cylchoedd

Meithrin in Wales as a census survey in order to contact the greatest number of

potential responders. Freepost envelopes were included to maximise the number

of responses. Cylchoedd who had not responded by the closing date were

contacted by telephone and reminded about the questionnaire.

Statistical considerations

In order to reach a high level of confidence in the results of this survey we

needed to ensure a 65% response rate, or a return of 260 questionnaires out of

the 400. A response rate of 40% (160 returned questionnaires), was considered

be an acceptable level of confidence. Sampling was not undertaken since we

were conducting a census questionnaire to the entire sample population. In fact,

a response of 176 questionnaires was received, which is 44% of the total and

provides an acceptable confidence level with some caveats regarding numbers of

responses in different counties which makes comparison between counties

difficult, and also the danger posed by the fact that Cylchoedd are comfortable

with children with additional needs being more likely to respond to a survey such

as this than Cylchoedd which are less comfortable or confident. The methodology

addresses this by including qualitative work with Cylchoedd staff in the form of

focus groups. The findings of the survey on its own will therefore be

accompanied by a health warning (see Section 6).


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Details of responses

Figure 1 Response to survey per County

Total number of Cylchoedd in each County/Number and

Percentage of responses from each County

32

5 9 13 14

57

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1810

72

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25 23

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Number of Cylchoedd in each County Number of responses from each County

Percentage response from each County %

Caerphilly, Carmarthenshire, Gwynedd, Merthyr Tydfil, Monmouth,

Pembrokeshire, Swansea and Wrexham are the Counties which had a 50%

response rate or higher to our survey, with Rhondda Cynon Taf and Ceredigion

following closely with higher than 40%. However care needs to be taken with the

above as the higher numbers of Cylchoedd in e.g. Gwynedd and

Carmarthenshire means that responses from just these two Counties account for

27.5% of the total responses to the survey. Also the size of Cylchoedd is a

pertinent issue e.g. Gwynedd has an average 19 children per Cylch and

Carmarthenshire has an average 20 children whereas Rhondda Cynon Taf has

an average 31 children per Cylch and Cardiff has an average 32 children.


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Figure 2: Average number of children in respondents’ Cylchoedd per County

Average number of children in respondents' Cylchoedd per

County

22

54

1816

32

20

15

21 20

5

19 19 19 18 18

31

24

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Data management

All the data inputting, checking and processing were completed internally, and all

staff members working on the data inputting were carefully monitored.

Compliance with the Data Protection Acts 1984 and 1998 and the Market

Research Society Code of Conduct were achieved, and all information dealt with

confidentially in order to protect responses to the questionnaire and that

information which belonged to the responder was not seen or used by any

unauthorised persons without permission.

Data analysis

We used SNAP Survey Software exported to Excel to analyse the survey data.

SNAP offers integrated survey software which includes questionnaire design,

data collection and survey analysis.


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3.2.5 Data gathering in-depth interviews – Wales PPA

We undertook 4 in-depth qualitative interviews with Wales Pre-school Providers

Association Regional Executive Officers. We were unable to arrange interviews

with a further two officers who could have taken part.

The aim of these interviews was:

• to gather profiling information on staff, locations, number of children using

the resources etc.

• to gather data regarding the number of children with additional needs

receiving early education in playgroups

• to enquire which skills, assistance and support are available for

playgroups

• to gather data on services for children with additional needs

• to enquire which skills, assistance and support are required in order to

improve the provision for children with additional needs

• to assess the need for the provision of transport to and from the location

for children with additional needs

• to establish the need for special equipment and finance

• to assess training needs

3.2.6 Focus groups with staff and parents

Aim:

After analysing the quantitative survey and Wales Pre-school Providers

Association interviews, a series of 6 focus groups were held, in order to probe

further into the core issues which were raised in the quantitative responses. We

collected oral and first-hand evidence from practitioners working in this field and

from parents of children with additional needs receiving early education services

and care from Mudiad Meithrin and other providers.


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It was felt that talking with groups of individuals about personal experiences

would be of benefit to this project, and necessary in order to understand staff and

parents’ needs as we moved forward. In addition to reporting the aggregate

findings of the focus groups, we have also included some Case Studies in this

report which give some insight in to how the services are experienced at first

hand by parents of children with additional needs.

Three focus groups were held with Cylchoedd Meithrin staff members, that is,

one group in each of the Mudiad’s operating regions - North Wales, Mid and

South West Wales and South East Wales. We also held three focus groups with

parents of children with additional needs receiving early education and care or

who were about to move into this key early stage – once again, one in each

region.

A total of 32 staff attended the three staff focus groups - 9 in North Wales, 16 in

Mid and South West Wales and 7 in South East Wales.

A total of 21 parents of children with additional needs attended the three parents

focus groups - 5 in North Wales, 8 in Mid and South West Wales and 8 in South

East Wales.

Each of the Focus Group facilitators were bilingual and fully trained in facilitation

and in the Market Research Society Code of Conduct. This was an important

consideration as much of the parents' discussions were particularly sensitive.

The parents and staff were initially contacted by Mudiad Meithrin Development

Officers and the focus groups took place at neutral hotel / conference style

venues with the offer of reimbursement if the parents needed to make childcare

arrangements.

All the focus groups were digitally recorded with the participants' permission in

order to facilitate detailed analysis, and flip-chart and post-it exercises were used

which also fed in to the analysis (see Appendix for Focus Group Discussion

Guides). All complied with Data Protection legislation and the Market Research

Society Code of Conduct and operating standards.


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The focus groups operated in an informal and relaxed atmosphere where

individuals’ opinions could be expressed and developed within a group dynamic,

creating an original and profound discussion.

Meetings lasted from 1.5 to 2 hours each, and were held in the language of

choice - either Welsh, English or bilingually.

3.2.7 Workshop with Referral Schemes Coordinators

Aim:

To discover the main issues regarding inclusion from the point of view of the

Referral Scheme Coordinators - strengths, weaknesses, opportunities and

threats for the current system of Referral Schemes. This included capacity to

deal with the numbers of children with additional needs, training issues,

organisational and geographic considerations.

Why this Group?

Referral Schemes for children with additional needs work all over Wales

employing a Coordinator with responsibility for liaising with the child’s family, the

local Cylch Meithrin/Playgroup and other related statutory agencies.

The Mudiad Meithrin Director for Inclusion facilitates meetings each term for the

Referral Scheme Coordinators who come under the auspices of Mudiad Meithrin,

and there is an opportunity here for sharing good practice; receiving further

training, and working continuously on creating a consistent response throughout

Wales. This workshop was run as part of this regular programme of events.

The workshop allowed the responders to take part in a facilitated group

discussion which built on experiences and opinions as part of the group dynamic,

and utilised a specific method using flipcharts. The 21 Coordinators were split

into four groups and completed a SWOT analysis of the Referral Schemes using

colour coded responses per group. As a result we were able to build up a picture

of local issues and base a group-wide discussion on the findings which enabled a

consensus to emerge.


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Within the above structure, discussions were flexible and dynamic and allowed

group members’ responses to evolve and explore the issues raised.

3.2.8 Meetings with the Project Steering Group – progress/interim

report

Five meetings were held – one each quarter with an additional meeting at the

end of the project.

The meetings presented an opportunity for the Steering Group members to:-

• Agree the Implementation Plan

• Review and contribute to the design of data collection methods

• Report on the findings to date, including a progress report and obvious

themes

• Review of the timetable and main achievements

• Revise the techniques and implementation methods with reference to the

project developments

• Review and agree on a project Interim Report / agree any changes

• Discuss the format of the report and final presentation

• Ensure quality

• Use the report findings to inform the creation of an Inclusion Checklist for

use in all early years settings.

3.2.9 Analysis and final report

The research reports provided evidence to support the work’s main objectives;

The purpose of the reports were to draw together the interpretation of all the

information gathered during the early desk research, and from the questionnaires

and the focus groups which enabled the steering group to monitor and steer

project direction quality and deadlines.

The following reports have been produced as part of the project:-


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• Project implementation plan

• Interim Report

• Draft Final report

• Bilingual Final Report, which includes an Executive Summary, which can

be produced as a single document if required.

• A bilingual PowerPoint presentation and a presentation to the project

group.

3.3 Research Objectives and the Methodology

Research Objective Methodology

1. Assess the current provision of play

opportunities for pre-school children with

additional needs across Wales and the

ease or difficulty of access to such

opportunities in different parts of Wales

Steering group interviews, desk research,

survey, in-depth interviews, focus groups,

workshop.

2. Collection of data regarding the

numbers of children with additional needs

who are already in pre-school settings and

information regarding siblings of children

who are in settings (children in settings

without additional needs but who have

siblings with additional needs who are

unable to attend settings).

Desk Research, Survey, In-depth

interviews, Referral Scheme Coordinators

workshop

3. Report on the experience of parents

who have children with additional needs

regarding inclusion in settings, or have

negotiated the complex route towards

accessing play opportunities for their

Focus groups


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children

4. Assess the support needs of staff and of

Referral Scheme Co-ordinators e.g.

training, guidelines etc.

Survey, in-depth interviews, focus groups,

workshop.

5. Identify any gaps in provision, barriers to

inclusion and support needs of parents and

systemic issues.

Steering group interviews, desk research,

survey, in-depth interviews, focus groups,

workshop.

We believe that the above approach, utilising more than one method to look at

the same issue, provided the necessary triangulation to claim confidence in the

research results.


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4. Research Findings

4.1 Steering Group Interviews

4.1.1 Background

The Steering group included representatives of Contact a Family, Scope, Autism

Wales, Wales Pre-School Providers Association (Wales PPA). Learning Disability

Wales, Mudiad Meithrin, and the National Childminding Association Cymru

(NCMA Cymru).

The Multi-Agency Steering Group was instrumental in informing elements of the

research methodology. It also provided individual agencies’ perspective and

experience, and was also responsible for steering and monitoring the research as

a whole.

The aim of the individual interviews with Steering Group members was to collect

information about relevant issues relating to inclusion of children with additional

needs in order to inform other elements of the methodology and in particular the

desk research, the quantitative survey and the focus groups.

Therefore information was collected on:

• the area of work of the organisation they represented

• collection of relevant research and documents which would be important

to include in the desk research

• the main themes that should be included in the quantitative questionnaire

and the focus groups

• examples of good practice in the field of inclusion

• the outcomes they would like to see from the research project.


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4.1.2 Main Themes

The main themes to emerge from the interviews were:

• The need for a clear definition of ‘inclusion’ as it means different things to

different people (although it should be said that the definition varied even

among Steering Group members, underlining the point that it is difficult to

define). This was followed up as part of the Desk Research and at the

Steering Group meetings.

• The need for a clear definition of ‘additional needs’ as there is a wide

range of needs that could be included. Again this would be addressed as

part of the Desk Research.

• The need to focus on barriers to inclusion (e.g. staff confidence, skills,

over-protective parents, the complexity of the referral system, financial and

physical resources…)

• Equality issues – what are the rights of children with additional needs

compared with children generally and what is the level of take up of

services?

• How is the route to inclusion in a play setting different for children with

additional needs?

• What interventions can secure inclusion?

• The parental role from the point of view of the staff at the setting and of the

parents.

• How should the needs be assessed?

• What is the potential demand?

• What is the level of parental awareness of inclusion issues - both of

parents of children with additional needs and of other parents of children

at the setting?

• What training do staff attend at present?

• What training do they need?


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All the above themes were addressed as part of the Desk Research, discussed

at Steering Group meeting and included in either the quantitative questionnaire or

the focus group discussion guides or both. Additionally, extensive material was

collected from the Steering Group members as a result of the interviews in the

form of literature, research papers and inclusion materials, which fed in to the

Desk Research.

4.2 Desk Research

4.2.1 Introduction

Inclusion as a concept has a number of definitions, and one of the difficulties

encountered was the fact that there is no one agreed definition.

The Early Childhood Forum offered this definition of inclusion in 2003:

‘Inclusion is a process of identifying, understanding and overcoming the barriers

to participation and belonging’. (National Children’s Bureau, No Date)

‘Integration is us and them. Inclusion is us’. (Alison John 2010)

‘Inclusion is a sense of belonging: feeling respected, valued for who you are;

feeling a level of supportive energy and commitment from others so that you can

do your best work.’ Miller and Katz (2002)

‘Every child has the right to the best possible start in life. When a child has

special needs, it is vital that these needs are correctly identified as early as

possible. It is equally important that effective early intervention is available for the

child, together with emotional and practical support for the parents’’. (Welsh

Assembly Government: 2004)

All educational provision, including provision for the early years, is subject to the

terms of the Disability Discrimination Act of 1995 as subsequently amended.

The Equality Act 2010 (which replaced and incorporated the Disability

Discrimination Act (DDA) 1995) makes it unlawful to provide less favourable


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treatment as a result of a disability, and places an onus on service providers to

make necessary, reasonable adjustments to ensure that those with disabilities do

not receive unfavourable treatment. Brewis et al. (2006) provide a checklist for

inclusion which makes it clear that providers of early years settings need to be

proactive in thinking about inclusion when, for example, making strategic

decisions about future provision, or when buying equipment or designing

facilities. This means that it is helpful to think of inclusion from the start of any

provision as a way of providing the best opportunities for all children.

Children from the term following their third birthday have an entitlement to 10

hours of free early years education (Local Government Association, 2008).

Although the references to specific additional needs is fairly scarce in the

literature, the context of the DDA makes clear that providers must make

reasonable adjustments in order to include all children.

As the Early Childhood Forum definition stresses, this means that inclusion is not

merely the presence of particular facilities or equipment, but is a process that

should engage everybody involved in early years provision, so that they can

understand and overcome barriers to participation through long term planning.

The definition also stresses belonging, which involves openness for all involved

to be engaged in that process, and in associated decision-making.

We have collected and referred to a wide range of material that relates to

inclusive early years settings. This includes material that is specific to Wales, but

also includes resources from further afield when it offers good practice, or

suggestions as to how provision can be managed. Those resources are listed in

the Reference section as a resource for those who wish to consult them.

There is a good deal of information about the leisure and sports activities of

children and young people in Wales, but this provides global profiles for all

children and does not provide specific information about the participation rates of

children with additional needs (Welsh Assembly Government, 2008: 159).

Obviously, additional needs can have a major impact on participation in particular

activities, and the range of choice available to a child or young person.


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However, in terms of sensitising the staff who design and run early years settings

for children, there is a need to go beyond a commitment to inclusion for “all

children”, and recognise that different disabilities may require different, and

sometimes contradictory, provision. It is increasingly recognized that there is a

need to focus specifically on what is involved in making early years settings

available to all children. For example, although the NCMA Quality Standards

(National Childminding Association, 2004), mention both play, and support for

children with disabilities explicitly, and is a stimulus to reflection on issues for

practitioners, NCMA Cymru have recognized this as an area for further

development, and they produced a research report, Childcare for Disabled

Children and Young People: research for NCMA Wales (NCMA 2009), which

includes increased focus on additional needs in the early years. .

4.2.2 Additional Needs

Kate Wall has published two books which aim to give parents and practitioners

useful and practical guidance about including young children with special

educational needs in mainstream provision. Her first book (Wall, 2003) is called

‘Special Needs in Early Years: A Practitioner's Guide’ and makes relatively few

references to play. There is reference to “Playladders” from a paper published by

Mortimer (2000). There is also a reference to playgroups in the early pages of the

book (Wall, 2003: 10-16), mainly in the context of the development of voluntary

provision in the 1960s, and giving the historical development of the field.

The only explicit reference to play in the index relates to play therapy, and this

comes in a section about assessing children’s special needs through play (Wall,

2003: 100-105) and really stresses the need for trained play therapists. However,

since the section addresses setting "intended learning outcomes" for playing, it is

not clear that this section is about play, as opposed to project work.

References in the volume include a source for ten reasons for including all

children with special educational needs in mainstream schooling (CSIE, no date)

There is also reference to a book by Hanley, Atkinson and Howard (1997) which

reports a survey of the attitudes of teachers and parents to children with special


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needs, and in particular their sense of the need for special protection from

exposure to risk.

Kate Wall's second book (Wall, 2004), entitled ‘Autism and Early Years Practice’,

deals specifically with autism, as the title suggests. Play is discussed mainly in

the context of the absence of “imaginative” play being an indicator of autism, and

in the context of two instruments to identify autism in early childhood.

These works by Wall (2003, 2004) make reference to a range of generic

approaches for identifying disabilities and additional needs, and also stimulate

thinking about possible approaches to additional needs. However, a single

approach will not suit all children and the key is to find a supportive environment

for each child. For example, while the child with a sensory impairment or physical

disability may develop confidence through increased exposure to social play

without adult intervention, a child with autistic spectrum disorder may not be in a

position to develop social play without substantial adult intervention. Inclusion will

only be achieved if each child is provided a setting that is individually matched to

his or her needs.

4.2.3 Barriers to Inclusion

There is a clear imperative to ensure the safety of all children engaged in early

years settings. This covers both the provision of special equipment and the

management of routines. Excessive expense on special equipment does

constitute justification for less favourable treatment, but the impact on inclusion

must be considered when purchasing any new equipment. Thus it may not be

necessary to buy special equipment for an individual child, but it is a legal

requirement to consider all reasonable adjustments when planning new

provision.

Inclusion will need to take into account a range of possible additional needs, from

physical conditions that make it more likely that a child will be harmed in normal

activity (skin easily bruised / torn, brittle bones, lack of sensitivity to pain), that a

child will need special help to undertake an activity (help with actions requiring

dexterity or strength), to the routines that operate, so that unreasonable demands


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will not be made of a child. The barriers, and therefore the means of overcoming

them, must be specific to the particular disabilities.

The Equality Act 2010 makes it clear that providers must make reasonable

adjustments for those disabilities that they know about, but are not under an

obligation to make adjustments for disabilities that they cannot possibly know

about. However, if a parent has made one member of staff aware of a child’s

disability, the organisation is deemed to be aware of it. It is therefore a

responsibility of the organisation to have information handling routines that will

ensure that all members of staff coming into contact with the child are in a

position to make reasonable adjustments (Brewis et al., 2006) It is therefore

important that organisations dealing with the inclusion of children should have

appropriate means for handling information so that poor communication cannot

become a barrier to inclusion.

The institutionalisation of provision, and hence both the barriers and ways of

overcoming them, vary from Local Authority to Local Authority. A useful starting

point for examining the different organisation of play can be found at PlayWales

(no date).

As noted above, the instinctively protective attitudes of parents, carers and

teachers can, on occasion, become a barrier to inclusion, and may lead to a child

not being allowed to take part in an activity that would be beneficial.

There are three classes of barriers, as noted here, that must be overcome:

Environmental barriers – aspects of the physical environment that disadvantage

the child with additional needs, such as difficult access or small print in books;

Attitudinal barriers – attitudes that prevent children with additional needs from

taking risks that would be appropriate for other children, or that they should be

feared or pitied; and

Organisational Barriers – policies or practices that are not inclusive.


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The general concern that there is inequality of access to early years settings for

children with additional needs is reflected in the paper Equal Access to Early

Years Childcare Provision for Disabled Children (NDCS 2009), where inequality

of access to childcare provision for disabled children compared to their non

disabled peers in Wales is highlighted as a key issue.

4.2.4 Involvement of Parents and Carers

This question of attitudes leads naturally to the need to engage parents and

carers with the process of inclusion. In this respect, providers of early years

settings will need to be aware that parents/carers themselves may have

additional needs as a consequence of having a child with disabilities in the family.

Most obviously, the parents/carers may have additional physical and emotional

strains and attendance at early years settings on a regular basis may provide

respite for the parents/carers.

Nash (2010) refers to the positive benefits for fathers of accepting the limitations

of their children with learning disabilities. She also noted that fathers who accept

their children’s behaviour have a more positive view of the future, although she

did not report whether the study had gone on to examine whether this had a

positive influence on the outcomes for the children. The provision of inclusive

early years settings can therefore be the start of a virtuous cycle through which

parents can learn about the capabilities of their children, and encourage them to

attempt more.

More obviously, the engagement of family members in the process of early years

provision can provide a sense of security for the child with additional needs and

make the process of leading them into social play more productive. At the same

time the parents/carers are an invaluable source of information about the needs

of the child and the ways in which any early signs of distress can be spotted.

For all these reasons, and for the benefit of all concerned, the engagement of the

family in decisions about inclusive provision is crucially important. A range of

tools for preliminary assessment of needs, such as Playladders (Mortimer, 2000)


© Mabis. 45/130



are available for parents and play leaders to use, although these should be seen

as tools for general identification and as signalling the need for specialist

attention and diagnosis. Other methods for identifying autism for example can be

found in the references (Baron-Cohen et al., 1992; Schopler et al., 1980).

‘Early Support’ is a Welsh Assembly Government initiative that puts the needs of

families with young disabled children first and was launched in September 2009

(WAG, 2011). It is designed to ensure that all services provided for families with

young disabled children engage with families and are well coordinated and

responsive to their needs.

The principles and approach that define Early Support are reflected in a set of

materials and resources that can be used by families and professionals. The

materials have all been developed after close consultation with families and

professionals working in both the statutory and voluntary sector e.g. Family File;

Developmental Journals; Information Booklets etc. but Early Support emphasizes

that it embodies more than the resources alone.

4.2.5 Training

Training is needed at two levels; general sensitivity in observing children and

listening to family members, and specific awareness of the additional needs of

children who are using a resource at present. Given the wide range of different

specific additional needs which a professional could meet in the course of a

career, it is not reasonable to expect that all the necessary training could be

given at once. A more practicable plan would be to provide general training and

an awareness of the more common disabilities and barriers to inclusion for all

professionals, with access to more specific training as the need arises.

Scope (no date) provides useful guidance on how to conduct a needs

assessment for training in council supported centres.

General guidance on how to improve the level of inclusion can be found in a

number of the sources cited (Action for Children, no date; Bevan Foundation,

2010; CSIE; no date; and Geraghty and Sinclair, 2007a)


© Mabis. 46/130



There are also sources of information on specific needs. For example, Nash

(2010) gives a reference to the Learning Disabilities, Autism and

Neurodevelopment Research Network (LDAN):

(http://www.ldancymru.org.uk/research.php.en?menu=6&catid=8766&subid=0).

The Network has projects on “Understanding anxiety in children with Autism

Spectrum Disorders (ASD): An awareness-raising module designed to integrate

new research evidence into practice in schools”, and “Population-based

investigation of behaviour problems and parental well-being in children with

autistic spectrum disorders”, which may be relevant to the present study.

Other literature dealing with specific aspects is included in the references

(Brewis, et al., 2006; Cumine, et al., 2000; Wall, 2004).

Early Support provides training for parents and professionals e.g. Early Support

Multi-agency Planning and Improvement Tool (WAG, 2010).

Also the Foundation Phase in Wales provides information and training on

inclusion for children with additional needs (Foundation Phase National training

pack Module 5 – additional learning needs, WAG 2007)

4.2.6 Level of Need

It is difficult to be precise about the exact level of need, as the published literature

is not very precise. It is, however, possible to make some rough estimates. The

population of Wales is approximately 3,000,000, which means that in any one

year cohort there are between 30 and 35 thousand children. Rates of special

educational needs and disabilities range from 0.2% for visual impairment to 5%

for ADHD or autistic spectrum disorder, and other sources estimate that 7% of all

children are disabled (Improving the life chances of Disabled People, Cabinet

Office 2005).

If we take the estimate to be between 5% at the lower end of the estimated range

and 10% at the highest end, this means that something between 3,000 and 6,000


© Mabis. 47/130



children in any age group will have special needs when it comes to their inclusion

in mainstream early years settings or education.

This provides a baseline against which the level of provision can be considered.

Obviously one cannot simply add the percentages of all disabilities, as there will

be many children with multiple disabilities. For example, it is estimated that half of

those who are visually impaired will also have other impairments which will

require special support.

A study of toddlers with disabilities in Ohio, USA, indicates that the vast majority

of families are unaware of special provision, and instead rely on family members

for care outside the home (Niergarth and Winterman, 2010). A study in England

and Wales suggests that there are similar patterns in the UK (National Centre for

Social Research: 2011), with many parents wishing to use additional hours of

childcare if suitable provision was available. This suggests that Local Authorities

would be aware of only a tiny fraction of the needs of children with additional

needs in the community. This makes surveying the level of need of primary

importance.

The Child Care Sufficiency Assessments that each Local Authority across Wales

has a duty to undertake every three years, as outlined in the Children’s Act

(2006), provide generic data regarding childcare needs but they do not

specifically highlight the needs of parents with children with additional needs.

While there are general policies for the whole of Wales (Welsh Assembly

Government, 2006, 2008a, 2008b) there is a marked absence of detailed and

specific information about the numbers of children in the early years who would

need adjustment for specific additional needs in specific areas or regions.

Local Authorities have plans covering play provision for young children, and there

is good practice at local level (e.g. Caerphilly Children and Young People’s

Partnership, 2011), however the plans are rarely detailed enough to give a sense

of the extent of the need, even at local level.


© Mabis. 48/130



4.2.7 Desk Research Conclusion

There is a large amount of literature in the field of children’s access to play but in

one sense the findings from the research are rather negative, in the sense that it

is very difficult to see any clear estimate of the level of need, the level of take up,

and perhaps most importantly, the extent of unmet need for provision in the

community in Wales. On the other hand, those problems are clearly identified in

the literature, and a range of tools for estimating the need, and for enhancing

provision, have been found. Also much of the literature reviewed addresses the

needs of children of all ages while there is little which looks specifically at the

early years.

The references point to a range of organisations, Local Authority schemes,

government plans and regulations, and the legal framework within which

inclusive early years settings and play facilities should operate, but often do not.

Quantifying what is already described qualitatively in the literature is the

challenge for the present study.

There are competing and overlapping initiatives which complicate the picture and

make it difficult to assess the level of need. This in itself highlights the need for

further research in this field.

4.3 Quantitative Survey

As detailed in the Methodology section (Section 3 above), a quantitative survey

was conducted with Cylchoedd Meithrin across Wales and a breakdown of

responses per county is also provided in the Methodology section (Section 3

above).

4.3.1 The Meaning of Inclusion

Following on from the desk research and the interviews with Steering Group

members, it was felt to be important not to provide a definition of inclusion but


© Mabis. 49/130



rather to ascertain what respondents meant by inclusion, as this could be an

important issue in how to achieve this in early years setting.

Figure 3: Meaning of Inclusion to Staff

What does inclusion mean to you?

70

69

40

67

43

24.22

23.88

13.84

23.18

14.88

0 10 20 30 40 50 60 70 80

1 Making sure that the child with

additional needs in the Cylch is safe and

happy even if they don't join in all

2 Making sure that the child with

additional needs is able to join in all

activities of the Cylch?

3 Making sure that the other children in

the Cylch accept and include the child

with additional needs in play?

4 Making sure that the activities are

planned so that each individual can be

included?

5 Making sure that each child with

additional needs receives one-to-one

support at all times?

Sta

tem

en

t

Percentage / Number

Number %

Of roughly equal importance to inclusion are statements 1, 2 and 4 – a

combination of safety, joining in activities and making sure all activities are

planned so that each individual can be included. One to one provision is of

slightly less importance in this response, but all the statements seemed to strike

a chord with the respondents. A selection of the comments added is given below

which reflect the main thrust of this response:

"Perhaps the child with disability cannot join in everything at Cylch but all efforts

will be made to enable this. I don’t believe that all children with additional needs

should have 1-1 support at all times, it’s important to integrate them and the other

children and not make them different, if possible”.

“It’s important that each child has the same opportunities and that there is plenty

of funding available to receive 1-1 support”


© Mabis. 50/130



"Do not have one to one support at all times due to shortage of money“.

"It isn't always physically possible for children with additional needs to join in all

the activities but we try our best to make sure that they feel part of it and make it

fun“

“Each child must be happy and enjoy in their own way in order to develop”.

4.3.2 Numbers

Numbers attending

One of the research objectives was to try to estimate the demand in terms of

children with additional needs who attend or could attend early years settings.

Figure 4: Total number of children and number of children with additional needs attending

respondents’ Cylchoedd per County.

Number of children and children with additional needs in each

County

263

54 61115 98

607

281190

122

11

691

570 38 0

164 135

311

860

50

167

13 0 2 0 1 15 18 8 5 145

3 0 1 0 19 0 13 1 0 1 40

100

200

300

400

500

600

700

800

Angle

sey

Bla

enau G

went

Bridgend

Caerp

hill

y

Card

iff

Carm

art

henshire

Cere

dig

ion

Conw

y

Denbig

hshire

Flin

tshire

Gw

ynedd

Mert

hyr

Tydfil

Monm

outh

Neat

Port

Talb

ot

New

port

Pem

bro

keshire

Pow

ys

Rhondda C

ynon

Taf

Sw

ansea

Torf

aen

Vale

of

Gla

morg

an

Wre

xham

County

Nu

mb

er

Number of Children in each county Number of children with additional needs in each county


© Mabis. 51/130



Figure 5: Average number of children in the Cylch per County

Average number of children in respondents' Cylchoedd per

County

0

10

20

30

40

50

60

Angle

sey

Bla

enau

Bridgend

Caerp

hill

y

Card

iff

Carm

art

hen

Cere

dig

ion

Conw

y

Denbig

h

Fflin

t

Gw

ynedd

Mert

hyr

Tydfil

Monm

outh

Neath

Port

New

port

Pem

bro

keshire

Pow

ys

Rhondda

Sw

ansea

Torf

aen

Vale

of

Wre

xham

County

Nu

mb

er

Average number of children in respondents' Cylchoedd per County

It is evident from the above that Gwynedd and Carmarthenshire represent the

highest numbers in the survey and have an average of 19 and 20 children per

responding Cylch respectively. However it is noteworthy that although Rhondda

Cynon Taf represent 211 children in the survey, that their Cylchoedd have an

average of 31 children. The one Cylch who responded from Blaenau Gwent

seems to have a very large number of children at 54.


© Mabis. 52/130



Figure 6: Numbers of boys and girls in the Cylchoedd and numbers of boys and girls with

additional needs.

Number of boys and girls in the Cylchoedd

16761825

110 40

0

200

400

600

800

1000

1200

1400

1600

1800

2000

Boys Girls

Nu

mb

er

Number of boys and girls in the Cylchoedd

Number of boys and girls with additional needs in the Cylchoedd

6.5% of boys in the responding Cylchoedd have additional needs and 2.1% of

girls have additional needs with a total 4.2% of all children having additional

needs, representing 150 children across Wales. In addition 22 children with

additional needs were reported to be on waiting lists to join Cylchoedd and

respondents were aware of a further 8 who could be attending but did not for

various reasons, giving a total of 180 which is 5.1%.


© Mabis. 53/130



Number of hours attended

Figure 7: Average weekly hours children attending Cylch

Hours offered by Cylchoedd

5

99.5

54

11.56

46

22

20

20

40

60

80

100

120

1-5 hours 6-10 hours 11-15 hours 16+ hours

Nu

mb

er

of

Cy

lch

oe

dd

Number of Cylchoedd

Number of Cylchoedd open for childen with additional needs

It is clear from the results in Figure 7 that significantly fewer Cylchoedd are

available for 6 hours or more per week for children with additional needs than for

children without additional needs.


© Mabis. 54/130



Who brings the children to the Cylch?

Figure 8: Adults who accompany the children to the Cylch

How many children come to Cylch with:

74.5

4.7

14.2

4.42.2

76.1

1.3

14.2

3.9 4.5

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

Parent Childminder Grand

parent

Other

family

member

Other

Perc

enta

ge

Children Children with additional needs

Most children are brought to the Cylch by their parents with similar results across

the graph for children with additional needs as for other children.


© Mabis. 55/130



Family Language of Children at Respondents’ Cylchoedd

Figure 9: Family language of children and children with additional needs at the Cylchoedd.

How many children come from:

29.025.0

43.3

2.7

17.1

30.6

47.7

4.7

0.0

10.0

20.0

30.0

40.0

50.0

60.0

Welsh-

speaking

families

Mixed

Language

families

Non-Welsh

speaking

families

Other

Language

families

Perc

en

tag

e

Children Children with additional needs

Most children (68%) across the survey come from either non-Welsh-speaking

families or mixed language families (Welsh and English), with 29% coming from

Welsh speaking families. When compared with the family language of children

with additional needs it is worth noting that significantly fewer children with

additional needs came from Welsh speaking families, although this finding must

carry a health warning as numbers are very small in this survey.

4.3.3 Participation of Parents

Parents have a key role to play in this survey as important players in the

Inclusion story. As such the survey sought to ascertain parental participation in

Cylchoedd activities.


© Mabis. 56/130



Figure 10: Parents’ Participation levels

How often do parents and carers of children

participate in playing activities within the Cylch?

26%

63%

10% 1%

Never Sometimes Quite often Very often

A relatively low percentage of parents are often or very often involved in activities at 11% although a further 63% report that they sometimes participate.

The 25% who report that parents never participate seems surprisingly high.

Participation levels by parents generally are explored further later in this report.

Figure 11: Participation level of Parents of Children with Additional Needs

How often do parents and carers of children with

additional needs participate in play activities

within the Cylch?

28%

28%1%

39%

4%

Never Sometimes Quite often Very often No response

This seems to be a low level of engagement with only 5% participating very often

or quite often.


© Mabis. 57/130



Figure 12 : Expectation of Cylch for parents to participate in Cylch activities

Are parents / carers of children expected to

participate in play activities at the Cylch?

12%

83%

5%

Yes No No response

Most respondents reported that they did not expect parents to participate in

activities, but typical comments added were:

"We don't expect them but they are always welcome to participate",

"We encourage parents to join in our language and play sessions"

“We send an invitation to parents once a term – ‘Come to play’ – for two hours

during a session”

The following comments added by respondents give an idea of the difficulty of

participation when paperwork such as CRB(Criminal Records Bureau) checks is

required, and also because many parents are working during the Cylch hours.

“We ask parents, but most think we are providing a ‘service’ that they are paying

for therefore they don’t think there is a case”’

"Some have CRB’s and help out if staff are ill"

“No – most are working”

"Only on school trips" and “Special days. Parties, outings."


© Mabis. 58/130



It is evident that parents are not required to participate, but are encouraged to do

so and that their participation is in the main appreciated.

Figure 13: Expectation of parents of children with additional needs to participate in Cylch activities

Are parents/carers of children with additional needs

expected to participate in play activities in your

Cylch? 9%

63%

28%

Yes No No response

This question had a much lower level of response with 28% of respondents not

completing the question. It is possible they felt they had included children with

additional needs in their answer to the previous question.

Clarifying comments included the following:

"As they are parents and all parents are asked to help"

“Parents are encouraged to take an interest e.g. raise money, help out as support

staff when someone is absent”

"They are not expected but we do encourage parents to participate in play

activities“.

"All parents are treated equally".

In the main respondents wished to emphasize that parents were encouraged to

participate rather than be expected to do so.


© Mabis. 59/130



4.3.4 Staff Skills and Attitudes

Experience

Figure 14: Cylch Leaders’ Experience

Cylch Leaders' Years of Experience

52

36 36

46

0

10

20

30

40

50

60

0-2 years 3-5 years 6-10 years 11+ years

Range

Nu

mb

er

of

Lead

ers

For the purpose of this research it is worth noting that almost 30% of Cylchoedd

leaders in our survey have under 2 years experience.

When asked about the skills learned by working with children at the Cylchoedd,

the main skills mentioned by staff in response were soft skills e.g.

Patience - 23 mentions

Treating children as individuals - 20 mentions

Understanding/empathy -15 mentions

Observation - 7 mentions

Managing behaviour - 6 mentions

Listening - 5 mentions

Confidence - 4 mentions


© Mabis. 60/130



Some more specific skills were mentioned e.g. Childcare, Child development,

Foundation Phase.

When asked what skills had been learned by supporting children with additional

needs, the responses also mention soft skills but also had a significantly greater

emphasis on specific skills than the responses for children generally:

Speech and language (including sign language and Makaton) - 18 mentions

Patience - 15 mentions

Understanding/empathy - 6 mentions

Treating children as individuals - 6 mentions

Listening - 2 mentions

Attitudes

Figure 15: Reaction of respondent when a child joins the Cylch

When a child joins the Cylch which of the following best

describes your reaction (you can tick more than one if

you wish)

31.8

67

80.1

9.7

8

5.7

0 20 40 60 80 100

A challenge

A chance to learn new skills

A chance for the children to mix with

and learn about other children with

The possibility of disruption to the

established routine

Anxiety on behalf of the child in terms of

health and safety

Anxiety for the other children in terms of

health and safety

Sta

tem

en

t

Percentage

%


© Mabis. 61/130



A positive response was received here regarding reactions of staff with over 80%

stating that it is a chance for children to mix with and learn about other children

with different needs, and 67% stating that is is a chance to learn new skills. Some

further comments included:

“Hope they’ll be happy and settle quickly”

“The opportunity to get to know the individual”

There were some anxieties expressed:

"How are the other parents going to react this time?”

"A bit of anxiety. Hope the child/children enjoy"

Figure 16: Reaction of respondent when a child with additional needs joins the Cylch

When a child with additional needs joins the Cylch what

best describes your reaction (tick more than one if you

wish)

33

69.3

71.6

11.9

17

10.8

0 10 20 30 40 50 60 70 80

A challenge


A chance for the children to mix with and

learn about other children with different

The possibility of disruption to the

established routine


health and safety

Anxiety for the other children in terms of

health and safety

Sta

tmen

t

Percentage

%

Responses were broadly similar to the previous question regarding children

generally but with more anxiety noted regarding health and safety of the child

with additional needs than in relation to the other children. (27.8% compared to

13.7% for the previous question).


© Mabis. 62/130



Other comments included:

"Anxiety for other children dependent on the additional needs of the child“

“Hope that 1-1 help is available for all that need it, so that everyone is safe”

“Worry more about the reaction of some of the parents (from experience)”

"There are no worries about children with additional needs

"New learning experience for everyone."

Figure 17: Reaction of other staff when a child joins the Cylch

When a child joins the Cylch, what best describes the reaction of

other staff in the Cylch (you can tick more than one)

32.4

69.3

73.9

9.7

8.5

6.8

0 10 20 30 40 50 60 70 80

A challenge


A chance for the children to mix with and learn

about other children with different needs

The possibility of disruption to the established

routine

Anxiety on behalf of the child in terms of health

and safety

Anxiety for the other children in terms of health

and safety

Sta

tmen

t

Percentage

%

Again this was broadly similar to the response regarding the respondent’s own

reaction when a child joins the Cylch.


© Mabis. 63/130



Figure 18: Reaction of other staff when a child with additional needs joins the Cylch

When a child with additional needs joins the Cylch, which of the

following best describes the reaction of other staff in the Cylch?

36.9

61.2

65.3

15.3

13.6

8.5

0 10 20 30 40 50 60 70

A challenge


A chance for the children to mix with and learn

about other children with different needs

The possibility of disruption to the established

routine


health and safety

Anxiety for the other children in terms of health

and safety

Sta

tem

en

t

Percentage

%

Respondents are less confident about the reaction of other staff when a child with

additional needs joins the Cylch with a lower percentage for the positive reactions

(chance for the children to mix with and learn about other children with different

needs, and a chance to learn new skills) and a higher percentage noting more

anxious responses such as health and safety, the chance of disruption to routine

and a challenge (which could be positive or negative of course).

"Anxiety for other children dependent on the additional needs of the child“

“Hope that 1-1 help is available for all that need it, so that everyone is safe”

“Staff also think the same as the leader – worry more about the other parents’

reaction (from experience)”

"There are no worries about children with additional needs

“We change to suit the children”


© Mabis. 64/130



Confidence

Figure 19: Confidence of respondent in their ability to include children in all activities in the Cylch

How confident are you in your ability to include

children in all activities in the Cylch?

0 0

22.7

73.9

0

10

20

30

40

50

60

70

80

Not confident

at all

Not very

confident

Fairly

confident

Very confident

Response

Perc

en

tag

e %

From this response it appears that respondents were unanimous in either stating

that they were fairly or very confident in their ability to include children in all

activities in their Cylch.

Figure 20: Confidence of respondent in their ability to include children with additional needs in all

activities in the Cylch

How confident are you in your ability to include

children with additional needs in all activities in

the Cylch?

0 1.1

39.8

51.1

0

10

20

30

40

50

60

Not confident

at all

Not very

confident

Fairly

confident

Very confident

Response

Perc

en

tag

e

%


© Mabis. 65/130



There was a shift in this response from very confident to fairly confident with a

very small response to ‘not very confident’.

Figure 21: Confidence of other staff in their ability to include children in all activities in the Cylch

In your opinion, how confident are other staff in

your Cylch in their ability to include children in all

activities in the Cylch?

0 1.7

34.7

59.7

0

10

20

30

40

50

60

70

Not confident

at all

Not very

confident

Fairly

confident

Very confident

Response

Perc

en

tag

e

%

This response indicates that there is a slightly lower confidence in the ability of

other staff being able to include children in all activities in the Cylch, compared

with confidence in the respondent’s own ability to do so.

Figure 22: Confidence of other staff in their ability to include children with additional needs in all

activities in the Cylch

In your opinion, how confident are other staff in

your Cylch in their ability to include children with

additional needs in all activities in the Cylch?

03.4

44.941.5

0

10

20

30

40

50

Not confident

at all

Not very

confident

Fairly

confident

Very confident

Response

Perc

en

tag

e

%


© Mabis. 66/130



There is a marked shift here in the confidence levels of other staff (in the

respondent’s opinion) in ensuring inclusion for children with additional needs.

Skills and Knowledge

Figure 23: Skills and Knowledge of the respondent to support children with additional needs

Do you believe that you have the necessary skills

and knowledge to support children with additional

needs in your Cylch?64.2

21

0

10

20

30

40

50

60

70

Yes No

Response

Perc

en

tag

e

%

Figure 24: Skills and knowledge of other staff to support children with additional needs

Do you believe that other staff in the Cylch have

the necessary skills and knowledge to support

children with additional needs in your Cylch? 62.5

22.2

0

10

20

30

40

50

60

70

Yes NoResponse

Perc

en

tag

e

%


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The two responses above are very similar and the percentage of negative

responses, although a minority, is nevertheless a significant minority and should

be noted.

4.3.5 Training

When asked what training the respondent had received (accredited and non-

accredited) in working with children with additional needs, the majority (82%)

either named specific courses or stated that they had attended courses run by

Mudiad Meithrin, the Referral Scheme, the local Council and others. 32

respondents (18%) either left this question blank or replied 'none' to this question.

The most frequently mentioned courses were:

• Specific conditions affecting children with additional needs e.g. Autistic

Spectrum Disorder, ADHD, Down’s Syndrome, Asthma, Allergy

Awareness and the use of an Epi-Pen, Haemophilia, Hearing difficulties,

Speech and Language difficulties, Dyslexia, Dyspraxia, Epilepsy, Braille,

Asperger's Syndrome (31%)

• Speech and language issues, including courses run by Speech and

Language Therapists e.g. sign language, language and play, Makaton,

Elklan, language and communication. (23%)

• Special Educational Needs, which includes responders who had attended

courses on the role of the Special Educational Needs Co-ordinator

(SENCO) at the Cylch (17%)

• Behaviour management 10%)

• Inclusion (7.5%)

• Other courses mentioned included First Aid, Child Safety, Child Care,

Manual Handling, Child Protection and Administration of Medicines.


© Mabis. 68/130



Figure 25: Willingness to undertake additional training to support children with additional needs

Would you be willing to undertake additional

training in order to be able to support children

with additional needs if required?

99%

1%

Yes

No

Respondents have given a resoundingly positive response to further training.

When asked what training other staff at the Cylch had received (accredited and

non-accredited) in working with children with additional needs, a smaller majority

(63%) either named specific courses or stated that they had attended courses

run by Mudiad Meithrin, the Referral Scheme, the local Council and others. 65

respondents (37%) either left this question blank or replied 'none' to this question.

The most frequently mentioned courses were:

• Specific conditions affecting children with additional needs e.g. Autistic

Spectrum Disorder, ADHD, Asthma, Cochlear Implant, Deafness,

Epilepsy, Use of an Epi-Pen in case of severe allergy and Asperger's

Syndrome ( 21%)

• Speech and language issues including courses run by Speech Therapists

e.g. sign language, language and play, Makaton, Elklan, language and

communication. (15%)

• Special Educational Needs, which includes training for Special

Educational Needs Co-ordinators (SENCO) at the Cylch (14%)

• Behaviour management (9.5%)


© Mabis. 69/130



• Inclusion (3.5%)

• Other courses mentioned included Paediatric First Aid, Child Safety, Child

Care, Manual Handling, Child Protection and Administration of Medicines.

Figure 26: Willingness of other staff to undertake additional training to support children with

additional needs

Would other staff in the Cylch be willing to undertake

additional training in order to be able to support

children with additional needs if required

99%

1%

Yes

No

Again a resoundingly positive response was received.

68 Respondents chose to add comments regarding the type of training they felt

they and other staff at the Cylch needed. Comments were notably similar - most

requested training in the specific needs of the individual child at the Cylch who

had additional needs:

"Specialist training depending on the needs of the child.“

“Each child is different and skills and information is needed to support each

child”.

“The answer depends on the child with needs. Perhaps will need to do more

research and speak with the person who looks after the child”.

"It depends on what the child’s additional needs are"


© Mabis. 70/130



"More training on different additional needs."

"Each child is different and skills and information is needed to support each child"

"Depends on needs which arise with particular children"

4.3.6 Funding / Support

Three open questions were asked of the respondents regarding funding and

support:

Figure 27: Source of funding/support received by the Cylch for children with additional needs?

What funding or support does your Cylch receive for

children with additional needs?

55

15

20

36

0

10

20

30

40

50

60

Referral Scheme Mudiad Meithrin Other None

Support or funding type

Nu

mb

er

It would appear that the Referral Schemes and the Mudiad Meithrin centrally are

the main source of funding or support for many Cylchoedd with 70 mentioning

them in response to this question. ‘Other’ included reference to Flying Start and

the Local Authority. A significant number reported that there was no funding or

support, but it should be noted that not all Cylchoedd had a child with additional

needs and would not therefore receive any funding/support.


© Mabis. 71/130



Figure 28: Level of funding or support in 2011-12 compared with 2010-11

Is there the same level of funding in 2011-12

compared with 2010-11?

26 24

2

56

72

0

10

20

30

40

50

60

70

80

Same Less More Don't know Did not

answer

Response

Nu

mb

er

of

Resp

on

ses

It is significant that 56 respondents did not know whether the level of funding was

the same as last year or not. Of those that could answer this question, the great

majority reported that levels of funding were either the same or less than last

year.

Figure 29: Additional financial cost of providing support to children with additional needs

Is there an additional financial cost to the Cylch in

providing support for children with additional

needs? (additional hours of support in addition to

those funded by the Referral Scheme

46

58

16

56

0

10

20

30

40

50

60

70

Yes No Not applicable Did not answer

Response

Nu

mb

er

of

Resp

on

ses


© Mabis. 72/130



A significant 46 Cylchoedd reported an additional cost to themselves for

supporting a child with additional needs, over and above the additional support

provided by the Referral Scheme.

We also asked those who confirmed that there was an additional cost to give an

estimated figure for the average additional cost. Only 28 responses were

received to this question of which 9 didn’t know the extra cost and a further 9

knew that there was a further cost mainly relating to paying staff for extra hours

or topping up wages in order to attract staff. 10 responders were able to put a

cost for their Cylch in supporting children with additional needs, and they ranged

widely from £4,000 per year to £6 per week. It is therefore not possible to give an

average extra cost from these results.

4.3.7 Inclusion: Barriers and Enablers

Inclusivity

Figure 30: Inclusivity of Cylch to children with additional needs

How inclusive to children with additional needs is

your Cylch in your view?1%

3%

43%53%

Not inclusive at all Not very inclusive Fairly inclusive Very inclusive

The great majority (96%) either felt that their Cylch was very or fairly inclusive to

children with additional needs.


© Mabis. 73/130



Figure 31: Ability to offer the same level of play activity to children with additional needs

Are you able to offer the same level of play

activity to children with additional needs as to

others?

89%

11%

Yes No

Again the majority felt they were able to offer the same level of play activity but a

higher (although still small) minority felt they were unable to do so.

34 respondents (19% of the total) chose to add comments to their answers and

of these 10 (5.68%) cited a lack of specialist equipment as the reason why they

could not offer the same level of play activity to children with additional needs as

to others and 4 (2.27%) cited inadequate facilities such as toilets or lack of ramps

for wheelchair access. Only one respondent mentioned lack of training as being

the reason why the same level of play activity was not offered.

When asked for details of any specialized equipment available at their Cylch, 24

gave details of play equipment such as sensory-visual equipment, speech and

language equipment, specialist toys and games, and several mentioned that they

received resources from the Referral Scheme. 10 responders said they had

wheelchair access and disabled toilets. 82 responders said they had no

specialized equipment and 55 did not respond to this question.

49 respondents stated that they did not know where to access specialized

equipment, and 77 said that they did, with 30 citing the local Referral Scheme, or

other local organisations such as a local Children's Centre, Local Authority,


© Mabis. 74/130



Flying Start, Early Years Childcare Partnership or specialists such as Educational

Psychologist, Physiotherapist and Occupational Therapist .

Barriers

Figure 32: Barriers to Inclusion by type

Are there barriers to inclusion in your Cylch and if so what kind

of barriers are they?

35.8

1.1

0

0 5 10 15 20 25 30 35 40

Practical barriers

Negative attitudes

Organisational

barriers

Ba

rrie

r

Percentage

%

The main barriers to inclusion by far according to the staff responses were

practical barriers e.g. aspects of the physical environment that disadvantage the

child with additional needs (difficult access, no specialist play equipment etc). 31

respondents reported difficult access and 35 reported having no specialist play

equipment. No respondents felt that there were organisational barriers (e.g.

policies or practices that are not inclusive), and there was a very low perception

of any attitudinal barriers (e.g. attitudes on the part of others that children with

additional needs should not take risks that would be considered appropriate for

other children or that they should be feared or pitied).

The majority (63.1%) stated that there were no barriers to inclusion.


© Mabis. 75/130



Enablers

Figure 33: Enablers of Inclusion - order of importance by type

In your view, how important are the following in order to be able to offer

the same level of activity to children with additional needs as to other

children? 1 = not at all important; 2 = fairly important; 3 = important; 4 =

very important

4

6.8

3.4

13.1

0

4

7.4

14.2

11.4

0

12.5

23.3

20.5

23.3

0

73.9

56.8

56.3

46.6

0.6

0 10 20 30 40 50 60 70 80

Good interpersonal skills e.g. listening, empathy,

patience

Training e.g. in play skills, communication,

awareness of additional needs, manual handling

Access to support and advice

Having ways of accessing funding

Other

Sta

tem

en

t

Percentage

1 2 3 4

Again, interpersonal skills were deemed to be of the greatest importance, 'A 1-1

practitioner with good skills is the best resource you could give a child – the

problem is that the salary nor the contract of employment do not offer good

enough conditions to attract qualified staff very often'. Other comments which

were added suggest that there was also a concern that adequate and appropriate

resources should be available depending on the needs of the individual child,

and the importance of good communication with the parents, as 'they know

exactly what their child’s needs are and what they can do'.


© Mabis. 76/130



Figure 34: Support Agencies/professionals/individuals facilitating inclusion

Which agencies / professionals / individuals currently offer support to

your Cylch which facitilitate inclusion for children with additional

needs?

75.6

48.9

60.8

30.7

62.5

42

22.7

3.4

0.6

0 10 20 30 40 50 60 70 80

Mudiad Meithrin Staff

Parents

Health professionals (e.g. health visitor,

occupational therapist etc)

Educational professionals (e.g. educational

psychologists)

Referral scheme co-ordinator

Speech and language therapists

Social Services

Other voluntary organisations

Other

Su

pp

ort

Percentage%

Mudiad Meithrin staff and the Referral Scheme Coordinators and Health

professionals are the most frequently cited agencies to offer support to facilitate

inclusion. Specific professions such as Speech and Language Therapists, and

Educational Psychologists would only be called in to support children with

specific conditions.

Other voluntary / statutory organisations named include SNAP Cymru, Flying

Start and the Portage Adviser.


© Mabis. 77/130



4.4 Interviews with Wales Pre-school Providers Association

Regional Executive Officers

Four semi structured telephone interviews were conducted with Wales PPA

Regional Executive Officers. The main findings were:

• There is a lack of consistency in the operational models of the Referral

Schemes in different counties, and also in the way Wales PPA is funded

(apart from contributions from the National Children in Need scheme).

This can create inconsistency from area to area, and supports the findings

above regarding the complexity of the support system.

• A low participation level by parents of children with additional needs in

day-to-day playgroup activities is a general pattern across the country.

CRB requirements and the regulations and minimum standards for child

care can pose difficulties when involving parents. However these are not

the main difficulties, but rather the parents of children with additional

needs experience a lack of free time and see the group as an opportunity

for a break from the heavy work of caring for a child with additional needs.

This also supports the findings of the Mudiad Meithrin survey.

• Physical barriers – the nature of the building, lack of appropriate

equipment, although equipment can be shared or borrowed.

• Geographical barriers – inability to travel to a group because of lack of

money or transport particularly in the rural counties.

• Financial barriers – there is no funding to support children in all counties

on every occasion.

• Parental attitudes/fears – sometimes parents and other family members

are reluctant to give the child a label so early in their life; also there is a

lack of confidence by the parent to bring the child to the group.

• It is evident that training is an integral part of Wales PPA’s culture and

there is a relationship with other organisations to share training e.g. the

Local Authority or third sector bodies e.g. Diabetes Cymru or Autism

Cymru.


© Mabis. 78/130



• Several examples were given of close and effective co-operation with

other bodies when needs are identified e.g. Education and Social Services

Departments of Local Government, the Health Trusts, Child Development

Centres and Third Sector bodies.

• The officers believed that more funding is required for specific elements

e.g. 1 to 1 support, staff training, employing people while staff are training

and one specific comment namely funding for dedicated Early Support

Key Workers to work with families in order to lead them through the maze

of organisations and support systems.

• Some parents want their children to attend more than the two funded

sessions and the groups or the parents pay the additional costs in order to

avoid discrimination, which can put financial pressure on groups and

parents. This supports one finding of the quantitative survey where

equality and inclusion is not facilitated by the funding system.

4.5 Focus Groups

4.5.1 Parents’ Focus Groups

Three focus groups were held with parents of children with additional needs, in

North, Mid and South Wales. Most were sending their children to Cylchoedd

Meithrin, and some in the South Wales group were sending their children to

English-medium playgroups, nurseries or other settings. The children concerned

had varying additional needs e.g. deafness; complex and severe disability all of

which required a range of support and interventions.

Experience of Cylch/ Playgroup

Parents were in the main happy with the experience they had had with their

Cylch Meithrin. In fact one parent reported that it was Cylch staff who had noticed

that their child might have Autistic Spectrum Disorder and suggested making an

application for support. Many parents wanted to express that from their


© Mabis. 79/130



experience their children were and are being included well within the Cylch and

were very thankful to the Cylch for incorporating their child into the activities and

for ‘designing games to suit their childs needs’. Sending their child to the Cylch

was described by some as a ‘worry free task’ as the children had enjoyed or

were presently enjoying this period in their lives.

However some criticism was expressed of certain aspects of early years settings.

Some parents in one area were critical of the difficulty of finding a suitable setting

for their children, some having tried several before finding a suitable setting. The

words ‘prejudice’ and ‘insensitivity’ were used more than once and one parent

described her perception thus: “A lot of early years settings don’t really want

children like ours”.

The mother of one child at a day nursery said there was hyper-sensitivity

regarding the child’s multiple disability, although the main issue was

developmental not physical: ‘We can’t cope with **** – she needs more help than

we can give her’. She kept dropping toys on the floor and the staff wouldn’t put a

table in front of her as there had been no risk assessment, and after the risk

assessment was done, the reason given was that no staff had been trained to

use the table. This again points both to a lack of confidence on behalf of the staff,

and a lack of awareness of their responsibility in ensuring inclusion for children

with additional needs.

Some parents felt there was an over-reliance on the part of some setting staff on

outside professionals (e.g. Portage) to help with ideas for play and equipment.

They felt this again was a lack of confidence on the part of the staff to cope on

their own.

Some parents felt that staff were too quick to telephone them to say there is a

problem and to ask them to take the child home. Again they felt this was a

confidence issue and also points to a lack of consistent and ongoing

communication regarding the child’s needs and the best way to deal with them.


© Mabis. 80/130



One parent reported the upset experienced by their child when the child was

taken to another part of the building when the other children were singing and

therefore excluded from the activity.

One to one support

The main issue highlighted in all three focus groups was the quality and

availability of 1-1 Support Workers (Helping Hands) for the children who needed

it. Some parents also felt that there were occasions when the setting relied

heavily on the 1-1 Support Worker (Helping Hands) so that if one was not

available to support the child during all sessions they were requested not to bring

their child to the setting. They questioned whether the setting could have

supported the child with the existing staff ratio at the setting.

In one case, three afternoons of 1-1 support were funded but the setting could

only provide a 1-1 Support Worker (Helping Hands) on two afternoons. Although

they initially said they could cope without a 1-1 Support Worker (Helping Hands)

on the third afternoon, they rang to say that the child could not attend any more

on the third day. This was not a funding issue, but a combination of not being

able to find a 1-1 Support Worker (Helping Hands) and a lack of confidence to

cope on their own in a setting where there were three staff to ten children.

Another setting refused to make up the shortfall in funding for a 1-1 Support

Worker (Helping Hands), so the parents found another setting where their

experience has been much more positive and they report that the quality of the 1-

1 Support Worker (Helping Hands) has been excellent.

Several parents identified a problem with the quality of the 1-1 support. They felt

the role of the 1-1 Support Worker (Helping Hands) was a key factor in facilitating

inclusion but they felt that often they were young, inexperienced and untrained. A

major problem is the fact that the wage is low and no payment is made if the child

is absent (which occurs frequently because of the nature of the additional needs).

In addition the basic wage for the 1-1 Support Worker (Helping Hands) can be

set at the minimum wage level.


© Mabis. 81/130



Staff turnover is also an issue – lack of continuity affects children with additional

needs disproportionally as they lose contact with a familiar person. One parent

with a great deal of experience of the system owing to having an older child with

additional needs as well, stated that the only time she worried about her child

was when the member of staff who looked after her child at the setting, who was

experienced with children with additional needs and had been in the profession

for years, was replaced with a newly qualified member of staff with no experience

of working with children with additional needs. She felt uneasy with her lack of

training, knowledge of the child and generally felt that she was out of her depth.

Generally, she did note that the member of staff tried her best but needed and

should have had more training.

Experience of Other Support/Services

A consistent theme in the focus groups was that parents have to do a lot of

groundwork themselves in finding a suitable setting for their children where there

is adequate support. They are used to this because of having to negotiate a

range of medical and other specialist services as part of the diagnosis and

treatment of their child’s condition/s. Some examples of this include having to

battle for Welsh-medium services particularly for such specialisms as Speech

and Language Therapy. Parents felt they were being pushed in to English

medium services and made to feel a nuisance because of asking for Welsh-

medium services and sometimes told they were not available when in fact they

were. Examples were given of professionals advising parents to put their children

in English medium pre-school provision as the lack of other specialist services in

Welsh would mean a lack of consistency for them. Parental confidence in

insisting on fair and equal treatment is crucial in many cases in accessing

inclusion in early years setting.

One theme was the frustration of parents that professionals don’t listen to them

regarding day-to-day development / tendencies and any changes in behaviour /or

their child’s condition. “They should realise that our input is a very important part

in moving forwards”.


© Mabis. 82/130



One family who moved from Cheshire to Flint found a deterioration in support

and that there was a constant battle to ensure that her son was given the best

possible support in their language of choice (Welsh as they are passionate Welsh

learners).

Funding

Funding is more of an issue in some areas than others and the perception is that

of unfairness when provision is there in one Local Authority but not in the next.

The setting or the parents themselves sometimes have to make up the shortfall in

funding but if this is not forthcoming, the child does not get an equal opportunity

for play with other children in a setting. The system has recently changed

according to one parent, with funding available if the parents work but not if they

do not work. As some parents have to give up working because of the additional

needs of the child, this was perceived as unfair.

Training

Parents felt that training was extremely important and the 1-1 Support Workers

(Helping Hands) were often untrained or required further training in relation to

their child’s needs. New staff in the setting could also lack training and

experience in dealing with children with additional needs.

Some parents expressed concern that training takes a long time and in the

meantime the child’s needs are not fully met. “By the time the staff member is

fully trained it’s time for the child to go up to the Primary School”.

Communication

Progress sheets with targets are often unsuitable for children with additional

needs such as developmental delay but some staff continue to give them to

parents month after month. Parents felt this showed insensitivity on the part of

staff. Others felt that well-completed Individual Education Plans were crucial if the

child was to make a successful transition to school.


© Mabis. 83/130



Communication between staff and parents can be poor. One child was not

settling in, but this was not reported to the parents and therefore the child’s

needs were not being met.

A positive suggestion was to make a Home-Setting Link book an integral part of

the communication process. The parents would complete a section on progress

at home and tips on how to deal with the child, and staff would complete a

section on progress and activities at the setting, any concerns etc. Patterns of

behaviour could be monitored more effectively this way. A booklet ‘All About Me’

is available but not in Welsh, which was a concern for some parents. Staff will

gain in confidence and experience as they deal with the child with parental

support. However, some parents are naturally very protective and do not give

staff a chance, so parents also need support in order to be able to trust the staff

to deal with the child.

Parents appreciated the discussion and suggested that discussion groups of

parents of children with additional needs would be a good support network. This

was available in some areas but not others.

Benefits to children with additional needs of attending early years settings

Parents felt that children with additional needs and other children benefit equally

when a child with additional needs joins a setting. The child with additional needs

gains in confidence and learns to socialise, play and share. Other children get the

chance to become used to children who are different from themselves and learn

to be accepting. Acceptance is the most important thing for the child – not to be

treated differently from the other children.

One of the main benefits is that the early years experience provides a stepping

stone to school, as separation anxiety (for both parent and child) is dealt with

gradually, and this helps them to settle in to school more quickly. The child also

learns independence and makes educational and developmental gains. One

parent described her child learning to put things in a box by copying the other

children, where she had been unable to teach her child to do this at home.


© Mabis. 84/130



However it was also suggested that there should be more time spent in preparing

both the child and the school for the transition to take place successfully.

Parents also felt that attending an early years setting increases the tolerance of

the child of other people, children and other stimuli. Pushing the boundaries and

daily challenges of what the child can tolerate is seen as hugely beneficial. This

again emphasises that inclusion is key, and that the child is not left to sit on his or

her own with a 1-1 Support Worker (Helping Hands), although they may be

perfectly happy doing so but encouraged by the 1-1 Support Worker (Helping

Hands) to take part in the activities.

Benefits to parents of their children attending early years settings

Most parents felt that the main benefit was having a break from the relentless

burden of all the therapy and to have some time to themselves and peace of

mind for a short period. This helped them to cope better and in some cases to

return to work. It also helped the parent to trust someone else to do things for

their child, as they are naturally very protective. Separation anxiety is a very real

experience for the parent also and the early years setting can help with this in a

gradual way.

Building links with other parents is a benefit too, as they can feel quite isolated.

One parent reported that she felt very proud that her child had been invited to a

party. ‘You feel you have allowed them to be a child’.

Other Parents

Although many parents are very accommodating, not all focus group participants

had good experiences to report of other parents. In many cases other parents

don’t know how to react when they find out there is a child with additional need in

the setting. Some parents in the focus groups reported getting ‘looks from other

parents’ because they perceive that they get favourable treatment such as being

able to enter the setting first in the queue out of the rain. There was a great deal

of sensitivity to the perception that they were being blamed for the child’s


© Mabis. 85/130



condition – that they were badly behaved rather than having a condition such as

Autistic Spectrum Disorder. However, some other parents in the groups felt that

this was understandable, “If my child was on the receiving end of what he dishes

out, I’d be protective too. When you are in the ‘special needs’ world, you’re more

tolerant of other children”. Good communication was suggested as the way to

overcome anxieties and the perhaps misguided perceptions of other parents.

According to the focus groups, other parents at the settings were generally less

forthcoming than their children and tended not to ask anything about the child

with additional needs for fear of causing offence or upset. A suggestion to tackle

this issue was for the parents of the child with additional needs to seek the early

years setting’s permission to share printed information about the child’s condition

with the other parents. They suggested that doing this could overcome the barrier

of not having a relationship with other parents.

Parental Fears

The greatest fears of parents are:

• That the child would not make a successful transition to school owing to a

lack of continuity in the 1-1 Support Worker (Helping Hands) and lack of

understanding of the child’s needs at school.

• The child being laughed at and excluded

• Whether the child would continue to be accepted as they grew older and

other children became more aware of difference, and that their child would

not understand the change in attitude.

• The child feeling frightened

• The child not reaching his/her potential because his/her individual needs

are not being met by the play/education setting

• Lack of funding

• The child wanting a voice and not being able to communicate

• Fears for older siblings of children with additional needs – they need

support too.


© Mabis. 86/130



Parents’ View of how to achieve inclusion

• Funding – adequate and consistent funding without geographical

boundaries to enable equal opportunities for children with additional needs

to attend early years settings

• Consistency of best practice and support throughout Wales. It should be

looked at from the point of view of the child – they should have the best

care and not be dependent on a postcode lottery.

• A trained pool of staff. It was suggested at more than one focus group that

a trained pool of staff for the area should be established. This would give

the parents confidence in leaving their child and address worries whether

nursery staff were administering therapies correctly. The pool of staff could

then raise awareness of the other staff in the setting, and train them to

cope with children with additional needs.

• A central pool of resources for children with additional needs. This

happens in some areas but not all

• Greater monitoring to ensure staff employed in the setting are meeting the

child’s needs.

• 1-1 Support Workers (Helping Hands) should be trained, monitored and

assessed more often (one example was given of a 1-1 Support Worker

(Helping Hands) at a school-based early years setting being taken out half

way through the session to be a dinner lady). They should also keep pace

with the child’s developmental needs

• Flexibility to go outside of area to access good early years settings

• Increase awareness of staff members both of the particular needs of

individual children and of how to achieve inclusion.

• Ensure that all children are taking part in all activities wherever possible

and that they are treated the same as other children

• Empower and involve parents more, e.g. via discussion after a session

and via a link book which staff and parents share.


© Mabis. 87/130



• Staff to take the initiative in sharing information about the child with

additional needs with other parents, in order to break down barriers (with

the parents’ permission).

• Consistency of funding

• Appropriate targets should be set for children with additional needs taking

into account any developmental issues and progress reported to the

Primary School in the Individual Education Plan

• Greater use of Referral Scheme Coordinators

• A reactive and quick system for accessing support

• All settings should have to prove inclusion of children with additional

needs, and this would include how they react when approached by

parents with a child wanting to join the setting. A checklist proving

inclusion is needed and should be monitored.

• All the above should be done with a smile and not treated as a burden.

4.5.2 Staff Focus Groups

Three focus groups were held with early years settings staff, in North, Mid and

South Wales. Around half of the attendees currently had children with additional

needs in their settings.

The Meaning of Inclusion

Staff felt that inclusion meant being able to give the child the opportunity to reach

their full potential, and that they are treated as far as possible in the same way as

other children. They felt that it involved hard work to achieve this and to adapt

everything they do to enable inclusion. They felt that all children needed to be

treated as individuals and support tailored to their needs, and not for the children

to have to fit in to the support that was available.

However, different children have different needs. This can sometimes mean

having to understand that they’re not going to be able to do certain activities. A


© Mabis. 88/130



balance is necessary between encouraging and developing a child’s potential

through challenging them constructively but being mindful of not setting them up

to fail.

Inclusion is also as much a learning curve for the other children in the Cylch and

for the staff as it is for the child with additional needs. When children with

additional needs are included, everybody benefits because staff and other

children do not see the child with additional needs as being different but rather

embrace that child for his/her individuality. Inclusion means everyone is

accepted for who they are, and not defined merely by their disability.

The belief was expressed that every setting should be inclusive and that no child

should be turned away. Staff felt that children should be given the opportunity to

find themselves, to be themselves and to have their needs identified and met.

Some staff noted that they did not believe that this was being achieved on every

occasion within their area.

Sometimes staff found that they had to identify the problem themselves,

communicate this to the parents and also get external agencies involved.

External agencies Working with the Cylch

Cylchoedd staff can work with a variety of external agencies, e.g. the Referral

Scheme Coordinator, the Portage Worker, the Speech and Language Therapists,

Special Needs Health Visitors, Physiotherapists, Psychologists, county SENCO

(Special Educational Needs Co-ordinator), Specialist Teacher for Deaf Children,

Occupational Therapists.

Staff seemed to be aware of the support available from Referral Schemes and

felt it was valuable although some felt that the Referral Scheme Coordinator did

not have enough capacity to offer all the support that was needed.

The complexity and slowness of the referral and support mechanism in some

areas was a cause of concern for staff. Some Referral Schemes are unable to

receive direct referrals from parents or settings and in these situations a referral

could only be received from a Health Professional e.g. a Health Visitor, who in


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some areas is unable to refer the child to the Referral Scheme until they have

received a referral from the Educational Psychologist. Staff felt that this process

caused unacceptable delays in ensuring the child with additional needs receives

the support they require in the setting.

One member of staff noted concerns regarding the long delay in arranging

support for a child with a severe sensory impairment. Another noted the

difficulties in their area of ensuring that the child receives Welsh medium speech

and language therapy.

The difficulty in finding a Welsh speaking Speech Therapist was again

mentioned.

Parental Involvement

Staff reported that parents who have already had their child referred and have

accepted that their child has additional needs before he/she starts attending the

setting, are usually supportive and helpful.

However, much concern was expressed at all three focus groups that some

parents, particularly of children who have not yet been identified as having

additional needs, can on occasion be indignant, defensive and unable to accept

that their child has difficulties. Staff further noted that another problem was that

some parents of children with additional needs, who have not accepted that their

child has difficulties, avoid engaging with them, for example avoiding eye contact.

This difficulty in engaging with parents was described by some staff as one of the

main barriers to inclusion for the child. In one case it resulted in the child being

withdrawn from the Cylch because the parents would not accept that their child

was experiencing difficulties. Staff suggested that in such cases, someone from

outside the Cylch e.g. from Mudiad Meithrin or a health professional, should

come to the Cylch to talk to the parents, and that the staff require more support in

these difficult situations.

Parents can view the child’s time in the Cylch as a chance for a break and it can

sometimes be difficult to involve them in activities.


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When the child is first introduced to the Cylch – the parents are encouraged to

share information about their child’s development so that the staffhave a baseline

of the child’s development which assists the staff to monitor the child’s progress.

Staff believed that there should be a better partnership between staff and

parents. This is not always possible as not all pertinent information is able to be

disclosed to staff for confidentiality reasons. ”Some partnerships fail –for example

32% of our children are on the child protection register, and quite a few of them

are with additional needs also, but because of the confidentiality issue services

are not allowed to disclose that information to nurseries, and it’s our main

barrier”.

Another example was given of a child who had severe communication difficulties.

The parent did not inform the staff that his child was already receiving treatment

before joining the Cylch. As a result the child was at the Cylch for some weeks

before an educational professional contacted the Cylch to ask how the child was

getting on. Once the staff realised this, they were able to provide enhanced

support for the child; the parent and the family.

An example of good practice was described where a specific form was completed

as soon as a child is registered. It noted any areas of concern and explanation

and advice by parents and by the Cylch. This is used as a communication tool

between Cylch staff and parents and this monitoring strengthens the relationship

between the Cylch and parents and gives the staff confidence.

Staff Training

Some staff at the focus groups reported that they had Personal Development

Plans which are reviewed each term, with related targets such as developing

resources for a specific child that they are currently working with. However other

staff felt that they had not received enough training, and that this made them feel

anxious and overwhelmed.

Staff felt that a major problem was a lack of consistency between counties and in

particular between different Cylchoedd. Funding is another key factor where


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several of the smaller Cylchoedd do not have access to funding and therefore are

unable to attend different courses or further training.

There is also a significant difference between self-funding Cylchoedd and Flying

Start Cylchoedd. Self funding Cylchoedd can struggle to pay staff salaries and

do not have enough resources to fund training for all staff. Sometimes they are

only able to send one staff member for training.

One suggestion was that a key member of staff should go to the relevant training

to increase knowledge and understanding of a child’s specific condition and

practical ways in which to support and engage with the child, and then cascade

the knowledge to the other staff at the setting. This increases the confidence of

staff at the setting to be able to be pro-active in ensuring inclusion and doing their

best for the child.

As a setting approach, all staff should be aware of the needs of all children in the

setting so that if one member of staff is absent the other staff members are able

to support and include the child with additional needs. Children with additional

needs should always be included in the setting in every way possible and not be

solely dependent on the 1-1 Support Worker (Helping Hands).

Training in how to deal with the behaviour associated with certain conditions, as

well as the condition itself, was viewed as crucial to ensuring inclusion. Also

training to increase confidence among staff is seen as necessary, not only in

working with the children but also in order to work in partnership with parents.

Developing the necessary interpersonal skills to deal with sensitive and difficult

situations with parents was seen as vitally important.

The point was made that staff should receive regular training to further best

practice and to ensure their knowledge is current and up to date. It was felt that

training should be organised at a time when it does not clash with the setting

opening hours as this could create a staffing problem at the setting.

Enhanced input from Development Officers, and the use of an Area Mentor were

suggested who would be able to go to a setting when a child with additional


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needs joins the setting. This could help the staff help to identify what they need in

terms of skills and knowledge, policies, equipment etc, and how to go about

accessing these. This should preferably be done at the setting so that practical

and specific suggestions could be discussed.

A forum for sharing best practice between setting staff was suggested either at

county or national level. This would also be an opportunity to learn more about

funding sources and how to access these. Staff made the point that they had

really appreciated the opportunity to take part in the focus group as it had allowed

them to network, to discuss the issues and learn from others. They would like to

have facilitated meetings as a regular event in order to share best practice.

Another suggestion was maximising the use of the online resource centre (WIKI).

Other Issues

Some staff felt that paperwork was onerous, as was the background work of

finding out all they need to know about a child’s specific condition and trying to

source the right support. This was especially the case with staff who were

inexperienced with children with additional needs, and this caused anxiety.

During discussions, some staff noticed that other settings had better resources

and funding than their own. This, they felt made a significant difference to the

level and quality of the service they could offer children with additional needs.

A member of staff stated that children with additional needs, funded through

Flying Start have an abundance of support compared to other children outside

Flying Start areas, noting in particular the difficulties in ensuring a child receives

input from the Speech and Language Therapist outside Flying Start areas.

Staff also made the point quite forcefully that the quality of 1-1 support is crucial.

‘I feel strongly that the 1-1 or the helper needs to have knowledge….they have all

this responsibility to nurture the child but they haven’t always got the background

or the knowledge’’. They all felt that this was absolutely necessary in order to

provide the best possible service for each individual child.


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Barriers to Inclusion

• Lack of consistency from area to area leading to inequality

• Inadequate funding

• Complexity of funding and support mechanisms leading to inequality

• Inadequate training/information/support for staff

• Lack of confidence of Cylch staff

• Lack of good communication with parents

• Poor pay and conditions of 1-1 Support Workers (Helping Hands) causing

difficulty in recruitment and retention

Facilitating Inclusion for children with Additional Needs

• Good background information about the child and his/her needs is vital if

staff are to meet those needs. Staff felt that there is currently not enough

sharing of information by agencies because of confidentiality issues.

• The right specialist equipment was considered to be of great importance

e.g. ‘’a hydraulic chair which the child could make lower or higher to give

him more access to things and become more involved – he could sit at the

table and it made him feel that he was the same as everybody else and at

the same level.’’ Also mentioned was a special cover for a balloon so that

children with additional needs could catch it. Specialist equipment is

expensive however and staff suggested that a bank of such resources

could be built up so that all settings could access them on a free to loan

basis.

• Adjustment of the setting space e.g. thinking through the colour options on

walls, noise etc because that has an impact on some of the children,

particularly children who have autistic spectrum disorder., ‘They don’t like

bright colours so having a bright orange Sali Mali in the corner isn’t

something that would suit them, so we have a dark den as well, so they

can calm themselves down’.


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• Support Pack put in place for the child with additional needs which

includes all pertinent information, e.g. the development plan, suitable

activities, and information about the condition.

• Specific skills such as sign language e.g. Makaton for the hard of hearing

or PECS (Picture Exchange Communication System) for children who

have difficulty speaking.

• Include the other children in specific activities with the additional needs

child. Other children are always interested and want to see what’s going

on.

• Availability and input of specialists such as Speech and Language

Therapists and health professionals

• Constant monitoring and observation and assessments to measure

developmental progress

• Good communication with parents. Working with parents to learn more

about techniques to use with the child and to prepare the child’s Special

Educational Needs plan. Also a Home-Cylch Link book which would be

completed regularly by staff and parents was suggested.

• Review progress – an opportunity to reflect and discuss

• Staff skills training. This should be about more than showing DVDs

explaining about e.g. autistic children, but training on what they should be

doing to nurture children with additional needs and seeing techniques in

practice would also be useful.

• Visits to specialist schools, shadowing, funding to allow them to see hands

on how to work with the child practically.

• Sharing best practice

• The right 1-1 support. It can be very difficult to find a good 1-1 Support

Worker (Helping Hands) owing to the pay and conditions.


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4.6 Workshop with Referral Scheme Co-ordinators

Referral Schemes support the early years settings through advice, training,

funding of specialist equipment or if necessary funding for additional support in

the form of 1-1 Support Workers (Helping Hands) to provide inclusive play

opportunities for all children.

Operational models for Referral Schemes differ from county to county, with

Mudiad Meithrin leading on many, Wales Pre-school Providers Association

leading on others, Mudiad Meithrin and Wales Pre-school Providers Association

either working in partnership in some areas or leading their own Referral Scheme

in the same area, with yet others led by the Local Authority. Five counties do not

operate a Referral Scheme at all, but directly fund settings to facilitate inclusion.

Some organisations, such as NCMA Cymru, operate their own referral system.

Figure 35: Number of Children receiving support from Referral Schemes and reporting figures to

Mudiad Meithrin

Number of children received support from Referral Scheme

3344

59

10491

2311 13

105

35

129

11 9

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20

40

60

80

100

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A facilitated workshop was carried out with 21 Mudiad Meithrin or MM/WalesPPA

partnership Referral Scheme Coordinators from across Wales, which produced a

SWOT analysis of the current Referral Scheme situation.

Strengths

• There is a dedicated team of Referral Scheme Coordinators

• Mudiad Meithrin is efficient in managing/running the schemes

• Referral Scheme Coordinators can identify additional needs

• Cooperation between Mudiad Meithrin and Wales PPA

• A bilingual service is offered

• Many successful results in terms of inclusion

• Regular team meetings

• The Referral Scheme Committee includes a variety of professional

agencies

• Cooperation between Development Officer and Cylchoedd Special

Educational Needs Coordinators

• Children able to attend cylchoedd with support

• Support/help for Cylch staff

• Regular training/ meetings for Coordinators hosted by Mudiad Meithrin

Weaknesses

• Funding – not enough money for the children who meet the criteria in

many areas

• Cooperation between other agencies could be improved

• Speech Therapists not always able to work through the medium of Welsh

• Children not always able to be placed immediately after they have been

referred

• Not enough courses and training for Cylchoedd and parents

• Geographical constraints – should be able to work more widely


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• No flexibility or consistency in service across Wales

• Different set-up/funding/lead in different areas.

• Lack of fairness – depends on start date of child whether the money is

available

• Illogical and inflexible rules for funding leading to children missing out and

too much funding left in other pots.

• Flying Start – 12.5 hours until 3 years of age and then nothing if there is

no place at the school.

• The scheme offers 10 hours support only – Cylchoedd are open for longer.

Inequality issue

• The Local Authority offers 10 hours of education to children who are three

years and one term, but not always with extra support for children with

additional needs

• Lack of funding

• Have to prioritise who receives support

• If the child is absent the 1-1 Support Worker (Helping Hands) does not get

paid – this leads to recruitment and retention issues and lower quality of

one-to-one support

• Level 2 qualification – more 1-1 Support Workers find this very difficult

because of the limited hours of the job

• Criminal Records Bureau checks take a long time to come through

• Slowness of early intervention by Educational Psychologists in some

areas

• Difficulty of getting support for children with behavioural or language

difficulties

• Delays in paperwork for the school/unit

• Lack of funding for training

• Need for national consistency – financial/strategic. Equal opportunity for

all.


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Opportunities

• Equal opportunities

• Integration

• Prepare for school

• Develop skills

• Respite for the family

• Independence

• Confidence for the child and the family

• Early intervention

• Co-operate with other agencies

• Offer information to Cylchoedd and families

• Training

• Contact with other children – playing together

• Opportunity for parents to discuss their anxieties with agencies

• Individual attention for the child – ensure they receive the best possible

experiences by attending the Cylch

• Individual Play Plans are pre-school evidence of where the child has

received support

• Preparation for further integration – structure/community provision for the

child and the family in a natural way

• Professional – facilitating the child’s progress

• Cooperation with Education on courses.

Threats

• Shortage of funding

• Difficulties in recruiting 1-1 Support Workers (Helping Hands) because of

low wages, irregular and minimum hours e.g. no payment if the child is ill

• Lack of status for a 1-1 Support Worker (Helping Hands) post


© Mabis. 99/130



• Employment terms and conditions for the 1-1 Support Workers (Helping

Hands)

• Lack of awareness of the Referral Scheme

• Lack of consistency across geographical areas (funding and also how the

Scheme is run)

• Some Management Committees are more effective than others – lack of

consistency

• Lack of working hours for Referral Scheme Coordinators – loss of skills

• Lack of SENCO funding

• Attitude of staff at some settings


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5. Main Themes

5.1 The Meaning of Inclusion

Inclusion can mean different things to different people but a general consensus

was given in the survey and focus groups that at its best, ensuring inclusion

means planning activities and the environment in order to enable the child with

additional needs to safely join in all activities where possible. This will sometimes

involve the support of a 1-1 Support Worker (Helping Hands), but this is not

always necessary if the staff have the right training and experience. Inclusion

also means including the other children in activities planned for the child with

additional needs.

There was a consensus that inclusion is not always achieved for a variety of

reasons and these are given below.

5.2 Numbers

5.2.1 Numbers of Children with Additional Needs

Numbers of children with additional needs are very difficult to ascertain

accurately owing to the varied nature of additional needs and the young age of

the children, many of whom either have additional needs which have not so far

been identified or are not attending play settings for some reason. However the

survey indicates that something in the region of 5% of children attending or on

waiting lists for Cylchoedd Meithrin are known to have additional needs, which is

at the lowest end of the estimate indicated by the desk research at 5%-10%. A

significant difference was seen in the percentage of boys and girls with additional

needs with 6.5% of boys and 2.1% of girls already in Cylchoedd, having

additional needs, and this reflects the fact that in general, boys are more prone to

having additional needs e.g. autism, than girls. An indicative percentage figure for


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Wales PPA provision would appear to be between 2% - 4% based on responses

during interviews with their Regional Executive Officers. Figures obtained from

Referral Schemes regarding children with additional needs supported in

Cylchoedd indicate a 6% level. The nature of the methodology of this research

would make the survey figure of 5% the most accurate in terms of comparing

numbers of children with additional needs with total numbers of children.

If we take this conservative percentage estimate, which does not include children

who could attend but are not or children whose additional needs have not yet

been identified, and which is at the lowest end of the estimated level of demand

suggested by the desk research of between 5% and 10%, we are still looking at

3,250 children over a two-year cohort of approximately 65,000 pre-school age

children across Wales.

5.2.2 Number of Hours attended at Cylch

It seems clear from across the methods employed by this research that children

with additional needs attend Cylchoedd and other settings for fewer hours than

other children. Funding is given as the root cause of this, as children with

additional needs often need support either from a 1-1 Support Worker (Helping

Hands) who is not funded for sufficient hours per week to enable the child with

additional needs to attend for the full hours. This can be qualified by the fact that

staff can sometimes tend to have an over-reliance on one-to-one assistance

when it is perhaps not always necessary, but it is still a significant factor and has

highlighted one of the main findings of this report – that children with additional

needs do not currently have equality of access to pre-school play settings with

other children.

5.3 Parents

Parental participation in Cylchoedd activities is lower for parents of children with

additional needs than it is for parents of other children, although both figures are

low. Reasons include parents working (it should be remembered that funding

may be linked to parents returning to work, education or training), not having


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CRB checks and the fact that parents are in general not expected by the setting

to participate in day-to-day activities. Another factor was that the few hours that

their children were at the setting provided a respite from the caring

responsibilities for parents, which many parents at the focus groups felt was one

of the main benefits for parents of their children attending a play setting, as this

helped them to cope better and in some cases to return to work.

Parents are in general not expected to participate in Cylchoedd activities but are

encouraged to do so in most cases, and many do sometimes participate.

Staff at the focus groups identified a reluctance by some parents to acknowledge

that their child had additional needs, and this on occasion caused them to

become disengaged from involvement with activities in the settings.

Communication between parents and the setting is seen as key to successful

inclusion of a child with additional needs, and although there are examples of

good communication, this is not always the case. Many parents in our focus

groups related examples where they had encountered difficulty either in

communicating with staff at the setting, or with other parents, or with

professionals. In the case of staff, it was put down to lack of confidence, lack of

awareness and training, and a fear of causing offence in other parents.

Parental confidence in overcoming communication problems and other barriers

was seen as key in gaining successful inclusion. There was a strong desire

among parents and staff at the focus groups to have good two-way

communication between parents and staff at the setting.

Staff confidence in approaching parents is also seen as crucial in facilitating good

two-way communication.

In the main, parents reported good practice and a desire to do the best for the

child at the setting. However there were some more negative examples

particularly when trying to find a suitable setting for the child.


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5.4 One to one support

A central issue for staff, parents and Referral Scheme Coordinators highlighted in

the research was the lack of availability of good quality, trained 1-1 Support

Workers (Helping Hands) to enable children with additional needs to have equal

access to play opportunities in the early years. Inadequate funding leading to

poor pay and Terms and Conditions for 1-1 Support Workers (Helping Hands)

were identified as the main causes of difficulty in recruiting, retention and

consequent high turnover and lack of continuity in personnel. Owing to the

perceived lack of value of the job reflected in the poor pay and terms and

conditions, good experienced and trained 1-1 Support Workers (Helping Hands)

are difficult to obtain, and this is at the root of many of the inclusion problems

discussed. Parents also wished to express their view that some staff at early

years settings tended to rely too much on one-to-one help for children with

additional needs, although this was not always necessary.

The qualities noted as being of value in a 1-1 Support Worker by parents were

experience, training and continuity. According to parents, 1-1 Support Workers

have a crucial and challenging role in developing a trusting relationship with very

vulnerable young children and in enabling inclusion and they should be valued

and paid accordingly.

Parents agreed that a pool of trained staff who could cover an area would be a

good way of beginning to address the problem but felt that this needed to be

backed up by adequate funding and a review of Terms and Conditions.

5.5 Geographical Considerations

The complexity of support arrangements and mechanisms, as well as inflexibility

in the system, in the field of children with additional needs in the early years is a

major theme in this report. It appeared in the desk research, and is reflected in all

aspects of the methodology. Funding is led by Local Authorities and can lead to

many examples of people who live near each other but in different counties


© Mabis. 104/130



having different levels of funding and support for their children, and this causes a

strong perception of unfairness. In one case a mother who lives in one county

and works in a neighbouring county could not get funding for her child to attend a

nursery near where she works, which makes it extremely difficult in practical

terms for the child to attend nursery. The structure of Referral Schemes differs

from county to county and not all areas in Wales is covered by a Referral

Scheme. Even where there is a Referral Scheme, such as Powys, the fact that

the two Coordinators supporting Cylchoedd Meithrin are trying to cover a very

large area in only 2 hours each per week. This makes it virtually impossible to

offer the kind of support necessary, given that it can take almost two hours to

drive from one end of the county to another. There is concern also that an

increasing focus on targeting low-income families and deprived areas, with

laudable initiatives such as Flying Start and Families First, could exacerbate this

geographical inequality. Parents are faced with having to make up for shortfalls in

funding themselves, or relying on the setting to make up the difference from their

funds. Funding which is available for working parents can be seen to discriminate

against parents who are forced to give up work owing to the complex, severe and

profound nature of their child’s additional needs. Indicators of poverty are always

income-based not expenditure-based and therefore do not acknowledge the

additional financial pressure faced by parents of children with additional needs.

The complexity and limited criteria of the funding and support infrastructure are

seen as inflexible to the point of militating against the rights of children with

additional needs to access play and education opportunities as stated in the

Children’s Act 2004.

The concerns regarding geographical complexity and difference in funding levels

can be summed up as a lack of national strategic coherence in the field of

inclusion for children with additional needs.


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5.6 Language issues

Most children attending Cylchoedd Meithrin come from either non-Welsh

speaking homes or mixed language (Welsh and English) homes with a minority

from Welsh speaking homes. However a significantly smaller percentage of

children with additional needs come from Welsh speaking homes. This could

need further investigation – why are there fewer children with additional needs

from Welsh speaking homes presenting in this research? Given that the overall

percentage of children from Welsh speaking homes who have additional needs

should be similar to the general population, are these pre-school children

attending English medium settings, bearing in mind the fact that the survey was

done exclusively at Welsh-medium Cylchoedd Meithrin settings? Even with the

health warning of working with very small numbers, this is an interesting finding

although one which unfortunately cannot be explored further within the remit of

this research.

Parents and staff alike reported a difficulty in obtaining Welsh-medium specialist

support e.g. Speech Therapy. Parents felt they were being pushed in to English

medium services and made to feel a nuisance because of asking for Welsh-

medium services and sometimes told they were not available when in fact they

were. Examples were given of professionals advising parents to place their

children in English medium pre-school provision as the lack of other specialist

services in Welsh would mean a lack of consistency for the child. Parental and

staff confidence in insisting on fair and equal treatment is crucial in many cases

in accessing inclusion in early years setting. In fact there is a responsibility on all

public services to offer those services to citizens in Wales in their language of

choice, under the Welsh Language Act 1993

LUKE’S STORY

Luke and Sarah are four year old twins and Luke has bi-lateral profound hearing loss

and Crouzon’s Syndrome. The family moved to North Wales recently from England and

Luke’s parents are learning Welsh. They are also very keen that Luke and Sarah should

be able to speak Welsh and saw the Cylch Meithrin as the natural first step on the path


© Mabis. 106/130



to Welsh medium education for the twins. Luke was accepted and integrated well with

other children and also received 1-1 support at the Cylch.

Luke’s father feels that Luke benefitted greatly from attending Cylch Meithrin, as it was

through the medium of Welsh and meant that Luke was able to attend the same setting

as his twin sister who does not have additional needs. It also enabled Luke’s parents to

forewarn the primary school that their intention was to send him there, so the school had

time to make adequate provision.

The main barrier for the family has been from some support services which are either not

available in Welsh or they have not been given the option of having them in Welsh e.g.

Speech Therapy and Teacher of the Deaf (although the latter is now through the

medium of Welsh). Luke’s parents have had to battle with the support services who

pressured them to put Luke through English medium education that would ensure

consistency with the language of the support services. Also, it is much harder to access

support in Wales than it was when the family lived in England – they noticed a big

difference.

However their experience of the Cylch has been very positive and having won their

battles to date, they are now getting the support that Luke needs.

Names have been changed to protect confidentiality

5.7 Staff Skills, Attitudes and Training Issues

There is slightly more concern for health and safety among staff when children

with additional needs join the Cylch and this can sometimes lead to an over-

reliance on 1-1 Support Worker (Helping Hands) and specialist staff. This is seen

by parents as a confidence issue, which could be addressed by training.

However the majority feel that this gave them a chance to learn new skills, and

was also a chance for all the children to mix with other children with different

needs.

Confidence levels among staff in their ability to include children with additional

needs are lower than for other children, and this, together with the fact that

slightly more than one fifth of staff in our survey reported that they did not believe


© Mabis. 107/130



that they had the necessary skills and knowledge to support children with

additional needs sends out a strong message that there is a need for more

training to increase skills and confidence levels among staff. A willingness to

undertake more training in inclusion and additional needs was very marked at

over 90% of respondents. Training needs to be responsive and needs to happen

in a timely fashion – parents had experience of staff undertaking training which

they had not completed by the time the child was ready to move up to school.

Staff expressed a desire for training in the specific disorders that affected

children in their Cylch, and to have that training provided at the setting in order to

help with practical application, while the research as a whole also points to the

need for more general training in how to facilitate inclusion, and how to improve

communication with parents and professionals.

BETHAN’S STORY

Bethan, now aged three and a half, was starved of oxygen at birth suffering severe brain

damage. This has left her with global developmental delay and cerebral palsy and she

can not walk or talk.

Bethan’s mum, Wendy, works part time in the neighbouring county – she could not

return to work full time when Bethan was 14 months as she could not access suitable

childcare and the Referral Scheme funding does not start until the child is two and a half,

and is only available during term time. Although there is funding available for working

parents, when Wendy first returned to work, this funding was not available..

The family’s first experience of trying to access a suitable setting for Bethan was not a

positive one. Wendy managed to get a day nursery to take Bethan for one day a week

on a trial period but they were unhappy about taking her without any additional support.

Even though she was fourteen months old at the time, Bethan was developmentally like

a 6 month old. She had no complex medical needs - she was eating mashed and

chopped foods and drinking from a beaker with some thickener added to the liquid.

However, she could not sit unaided and could not crawl. Although normal 6 month old

babies at the nursery had the same needs and only needed a 1 to 3 staff to child ratio,

the nursery kept saying that Bethan needed additional help. They seemed unable to


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treat her according to her developmental age rather than her actual age.

The staff would sit her in a baby seat and give her toys to play with but as soon as she

dropped them out of reach she would get frustrated. Wendy arranged for Bethan’s

Occupational Therapist to visit to see if she could help and she gave the nursery a little

table that had built up sides to be used with the baby seat. This meant that toys would

stay on the table within Bethan’s reach. The Occupational Therapist phoned Wendy after

leaving Bethan to say how much happier she was with the table. She was able to play

better and it allowed her to use her left hand (which is a bit weak). When Wendy went to

collect Bethan the table was nowhere to be seen but the staff said they had put it away

while the children were having their snacks. The following week when Wendy dropped

Bethan off there was still no table. Wendy was told that it needed to have risk

assessment completed on it before it could be used. The following week there was still

no table. Wendy asked whether the risk assessment had been completed and was told

that it had but that the staff had not yet been trained in how to use the table!!

Then, when Bethan reached two and a half years of age, she joined the local playgroup

who are very supportive and eager to be doing the best for Bethan in whatever way they

can. It was a relief for Wendy to be able to hand the responsibility of some of Bethan’s

therapies over to someone else and she seems to respond better to input from

professionals.

Bethan also attends a new day nursery one day a week with a 1-1 Support Worker

Helping Hands) funded by the Referral Scheme. Wendy is very pleased with the day

nursery - they have had previous experience of supporting children with additional needs

and are also receptive to new therapy ideas. Bethan benefits enormously from attending

playgroup. She loves having normal social interaction with other children her own age

and she is able to model her learning on the other children.

For a whole year as part of her therapy Wendy had been trying to get Bethan to put

objects in a box, with no success. On her first morning at playgroup when in a group with

other children, all of whom were taking it in turns to put toy figures into a ship, Bethan put

her figure in the ship!

Bethan built her first tower of bricks at playgroup. They have helped enormously with her

sensitivity to certain textures because she watches other children painting or playing with

plasticine and she does it too.


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The other children also help with Bethan’s therapies. One part of Bethan’s physio

involves trying to get her to lay on her tummy over a “V” shaped pillow. This is a huge

struggle at home but in playgroup the other children lay next to her and they all look at

books together.

The first day nursery where Bethan was taken on a trial basis and her new day nursery

are near to Wendy’s work. It was sometimes difficult to get Bethan’s professionals to visit

the nurseries because they live in a town in the next county and the nursery is not within

their working boundaries. Since Bethan started school for three days per week, the

professionals are unwilling to visit her at the day nursery or the playgroup on the other

days.

Bethan is much more vocal since attending playgroup, her fine motor skills are improving

and she is making friends.


There are obviously great benefits to Bethan and to her mother from attending a

good inclusive setting and interacting with other children of her own age, but this

story also highlights some of the difficulties in accessing the right setting - both

the organisational barriers of bureaucracy and geographical inflexibility, and the

barrier of staff skills and attitudes leading to lack of confidence. Luckily, Bethan’s

mum has the confidence to take on and overcome these barriers with the help of

her Referral Scheme, but this is not always the case with other children

5.8 Funding and Support

There was strong support for the Referral Schemes in our research, from staff

and parents. In cases of good practice, they provide a vital link between parents,

the Cylch/setting and professionals and know how to access the available

funding and support.

A strong finding in this research is that the complexity of funding and support

mechanisms together with insufficient funding for children with additional needs

leads to inequality of access to pre-school play settings. Funding has generally


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either stayed the same or decreased in the current financial year (2011-12)

compared with last year according to the staff survey.

Both staff and parents believe that there is inadequate funding to support

inclusion for children with additional needs in early years settings.

The low awareness of Cylchoedd staff of funding levels and sources was another

interesting finding and could perhaps be explained by the complexity described

above. However there is often an additional cost to the Cylch in accepting a child

with additional needs as they have to or decide to make up the funding shortfall.

Unfortunately it was not possible to give an estimate for this additional cost from

the survey because of the low response to this question indicating a low

awareness of the funding issues.

MASON’S STORY

Mason and Lily are two and a half year old twins. Mason has cerebral palsy which

means that although he needs help with the physical side of things such as being lifted

and going to the toilet, he is perfectly able mentally.

The Cylch were very supportive and a Health Visitor referred Mason to the Referral

Scheme in the county in order to ensure that a 1-1 Support Worker (Helping Hands) was

provided for Mason while he was at the Cylch. A meeting took place between Mason’s

father, the Cylch leader, the Referral Scheme Coordinator and the Health Visitor to

discuss Mason’s needs, hours of attendance at Cylch and any training or resources that

might be needed to make the setting as suitable as possible for the child.

Mason now attends the Cylch and enjoys playing with Lily and the other children his own

age. He is not overly dependent on the 1-1 Support Worker (Helping Hands) but is

allowed to try to join in as many activities as possible on his own, with facilitation.

Mason’s father, the 1-1 Support Worker (Helping Hands) and the Cylch staff have a

good relationship and Mason enjoys his experience at the Cylch.

However, because of the lack of adequate funding for the Referral Scheme in the county

where Mason lives, he only receives funding for six hours per week of one-to-one

support, and this means that he can only attend for this period, while his twin sister Lily


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and the other children attend for 10 hours. Mason’s father believes that he would benefit

greatly from having equal access to the Cylch as his sister, but owing to the

unavailability of funding, Mason has to stay at home while his sister attends the Cylch for

the additional hours.


5.9 Inclusion – Barriers and Enablers

Barriers

Most of the staff in our survey reported that their Cylch is either very or fairly

inclusive to children with additional needs and a similar number thought they

could offer the same level of play activity to all children.

According to the survey, the main barriers to inclusion are practical barriers such

as difficulty of access or no specialist play equipment.

However, taking the research as a whole, including the survey, interviews, focus

groups with staff and parents, and the workshop with Referral Scheme

Coordinators, other barriers were identified and included:

• Inadequate funding

• Complexity of funding and support mechanisms

• Inconsistency of support and funding from area to area

• Slowness and complexity of referral mechanisms

• Lack of confidence among some staff

• Inadequate/inappropriate training

• Lack of communication between staff and parents

• Lack of skill/experience and difficulty of recruitment of 1-1 Support

Workers (Helping Hands)

Some parents also felt that they had faced barriers in finding a suitable setting for

their child, with some staff reluctant to take on a child with additional needs.


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Enablers

Great emphasis was placed on good interpersonal skills of staff as an enabler to

inclusion and there was a general consensus that good two-way communication

between staff and parents was the best way to successful inclusion of the child in

the setting.

Other enablers are:

• Good background information about the child and his/her needs is vital if

staff are to meet those needs

• A Home-Setting Link book completed regularly by staff and parents.

• Good planning including a development plan and play plan

• Good resources and specialist equipment – although there are good

resources available such as the Early Support Information Booklets, they

do not always find their way into the settings.

• Good one-to-one support where appropriate

• Training of staff

• Supportive parents

• Staff confidence

• Sharing best practice

• Availability and input of specialists such as Speech and Language

Therapists and health professionals

• Monitoring and observation to measure developmental progress

5.10 Ideas for improving Inclusion

Some suggestions were made as to how to facilitate inclusion, including a Link

Book for the Cylch and the Home and area-wide facilitated discussion groups

which include parents and staff.


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Strategic/National

• Funding – adequate, simple, consistent and reactive funding mechanisms

without geographical boundaries to enable equal opportunities for children

with additional needs to attend Cylch/Nursery/Playgroup

• Referral Schemes to be adequately funded in order to improve capacity to

support the need

• Consistency of best practice and support throughout Wales.

• Flexibility to go outside of area to access good early years settings

• Greater monitoring to ensure staff employed in the setting are meeting the

child’s needs.

• Appropriate targets should be set for children with additional needs taking

into account the stage of development rather than age of the child and

progress reported to the Primary School in the Individual Education Plan

• All settings should have to prove inclusion of children with additional

needs, and this would include how they react when approached by

parents who are requesting that their child joins an early years setting. A

checklist proving inclusion is needed and should be monitored.

Regional/County level

• The role of Referral Scheme Coordinators to be strengthened and

adequately funded

• A trained pool of staff.

• Area mentors to go to the early years setting as necessary to support staff

with information, best practice regarding inclusion and practical and

relevant methods to use with the child with additional needs

• A central pool of resources for children with additional needs.


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Local

Good background information about the child and his/her needs when he/she

joins the setting

• Support Pack put in place for the child with additional needs which

includes all pertinent information, e.g. the development plan, suitable

activities, and information about the condition

• 1-1 Support Worker (Helping Hands) trained, monitored and assessed

more often

• Communication between staff and parents – increase parental

involvement e.g. via discussion after a session and via a link book which

staff and parents share.

• Communication between parents of children with additional needs and

other parents - staff to take the initiative in sharing information about the

child with additional needs with other parents (with the parents’

permission), in order to break down barriers.

• Appropriate specialist equipment

• Adjustment of the setting space e.g. colour options, noise etc

• Training for staff in specific skills e.g. Makaton for the hard of hearing or

PECS (Picture Exchange Communication System) for children who have

difficulty speaking

• Training in general confidence and inclusion and what setting staff should

be doing to nurture the children’s development

• Monitoring, observation and assessment to measure developmental

progress

• Review progress – an opportunity to reflect and discuss

• Visits to specialists schools; funding for shadowing experienced members

of staff.

• Sharing best practice – a regular facilitated discussion forum


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• Ensure that all staff use appropriate interpersonal skills at all times –

everything done with a smile!


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6. Conclusions

The results of this research have largely proved the perception that pre-school

children with additional needs in Wales do not have equality of access to play

and educational opportunities as other children.

The research highlights the fact that there is no Wales-wide strategic approach to

funding and support in order to ensure equality of opportunity for all pre-school

children and their parents/carers. This leads to geographic inequality which

exacerbates the difficulty that parents of pre-school children with additional needs

already face in accessing inclusive play and education settings for their children.

In addition to the geographical inequalities, staff, parents and Referral Scheme

Coordinators who took part in this research believe that the funding is inadequate

to support inclusion for children with additional needs in early years’ settings. As

a result, children with additional needs are not able to attend a pre-school setting

for as many hours as other children. However, despite the lack of consistency in

operational models at county level, there is much good practice which could be

disseminated and adopted in many parts of Wales, and this is detailed in the

report.

In terms of demand, the survey indicates that somewhere in the region of 5% of

children attending or on waiting lists for Cylchoedd Meithrin are known to have

additional needs, which is at the lowest end of the estimate indicated by the desk

research at 5%-10%. The research therefore estimates that we are still looking at

a minimum of 3,250 children with additional needs over a two-year cohort of

approximately 65,000 pre-school age children across Wales. This is a significant

number of children, and given that successful inclusion of children with additional

needs at the pre-school stage leads to an increased likelihood of inclusion at

primary and secondary school level, training and even employment, investment

at this early stage to support inclusion would seem to be a cost-effective method

of minimising the higher costs involved with lack of inclusion at later stages.


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This research has sought to consult with parents of children with additional needs

via focus groups and the author wishes to thank all those who participated in

North, Mid and South Wales. The honesty and integrity of mostly young parents

who are facing and dealing with the sometimes heartbreaking conditions of their

children were profoundly impressive, and this research benefits from the first-

hand accounts of their experiences in trying to achieve inclusion for their children

at a pre-school setting. Whilst being realistic in their expectations for their

children, nevertheless their insights and suggestions on improvements which can

be made both at strategic and at a local level are invaluable.

Communication between parents and the setting is seen as key to successful

inclusion of a child with additional needs, and although there are examples of

good communication, there is room for improvement and this is addressed in the

Recommendations of this report (Section 7).

Staff have resoundingly confirmed their willingness to attend additional training

and are keen to improve confidence and skills in working with children with

additional needs.

A coherent and consistent funding system would enable more training to take

place which would in turn increase the confidence of staff to work with children

who have additional needs. The positive attitude and dedication of most staff

came through strongly, but again there is a lack of consistency which would

benefit from a mechanism to prove inclusion at any particular setting, with regular

monitoring. Also good quality, trained 1-1 Support Workers (Helping Hands) are

essential to enable children with additional needs to have equal access to play

opportunities in the early years and the difficulties involved with achieving this is

seen as a major barrier to inclusion as detailed in Section 5.4.

An interesting finding in this research, and a cause for some concern, is the

reported pressure by health professionals and others on Welsh-speaking parents

of children with additional needs to send their children to English-medium

provision to provide language consistency, as there is little or no provision of


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specialisms such as Speech and Language Therapy through the medium of

Welsh in some areas.

A child’s right to play should not be affected by family, geographic or bureaucratic

considerations. The complexity of support arrangements and mechanisms, as

well as inflexibility in the system and inconsistency in Local Authority prioritisation

of their Equality duty in the field of children with additional needs in the early

years is a major theme in this report, and points to a lack of strategic coherence

on a Welsh national level. This is evidenced by the Referral Schemes which at

the moment receive funding from a variety of different sources such as Flying

Start, Social Services, Health Trusts etc, all with their own criteria. The Referral

Schemes in the main provide excellent support with often scarce resources, but

would benefit greatly from having a reliable and simpler source of funding and a

consistent organisational model across Wales.

Given that achieving successful inclusion in early years settings increases the

likelihood of inclusion at later stages in primary school, secondary school, training

and employment, there is an urgent need to address the inequality currently

being experienced by the families of over 3,500 children in Wales and the

recommendations in section 7 set out the necessary actions if this is to be

realized.

IFAN’S STORY

Ifan’s mum, Leanne, had noticed by the time that he was a year old that Ifan was slow in

sitting and walking, but at the time thought that his muscles had just not developed

enough yet. He had been born with an extra thumb and at fourteen months, had an

operation to have this removed as it was stopping him from gripping properly. During the

physiotherapy after the operation, the physio noticed that he was not walking and

referred him to a consultant who diagnosed Cerebral Palsy. He has recently been further

diagnosed with Spastic Diplegia Cerebral Palsy

Ifan then received physiotherapy to address the problems caused by his condition and

when he started at Cylch Meithrin, his physio visited regularly and gave him a

programme to follow.


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‘The staff at the Cylch have been fantastic’ says Leanne. The Cylch Leader in particular

noticed that I was nervous about leaving Ifan at the Cylch, and told me to come and talk

to them at any time and to let them know if there was anything I or Ifan needed. After

about a week I was totally relaxed about Ifan going to Cylch’.

As Ifan’s speech is also delayed, he received speech therapy. This was originally in

English but as the family are Welsh-speaking they asked for Welsh language speech

therapy to provide consistency for Ifan, and this was then provided.

Ifan was given a 1-1 Support Worker (Helping Hands) at the Cylch which was funded for

four days per week, so Ifan was able to attend equally with the other children (apart from

one day when he goes to the hydrotherapy pool). The 1-1 Support Worker (Helping

Hands) is great according to Leanne, ‘’sitting with Ifan at the beginning but gradually

standing back more and allowing Ifan to do things for himself and join in the activities

with the other children’’.

Ifan now attends primary school and Leanne says that the fact that he had such a good

experience at the Cylch Meithrin ensured that Ifan’s transition to school was smooth,

with no separation anxiety for Ifan or Leanne. He knows many of the other children at

school as they were at the Cylch with him, and they know him and accept him and even

help out, as do their parents. Ifan has settled in well at school and his speech in

particular is now developing quickly. The family are however anxious that when Ifan has

to go through the assessment for statementing at school, that he will continue to receive

the level of support that he has experienced during his pre-school education.



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7. Recommendations

Based on the findings of this report the following indicative recommendations are

made, to be discussed and developed in detail by the relevant organisations.

7.1 Strategic/National

Recommendation 1

Strategic Direction

Inclusion in the early years for children with additional needs given strategic priority at

Welsh Government level in order to provide simplicity and consistency to the funding and

support mechanisms across Wales, and above all to ensure equality of opportunity to

children with additional needs to access and experience inclusion in early years settings.

Recommendation 2

Referral Schemes

Referral Schemes to be given strategic priority (see 1 above), a consistent organisational

model across Wales, and adequately funded in order to provide a consistent and

comprehensive service and to improve the capacity of Coordinators to support the need.

Recommendation 3

Funding

Adequate funding to support equality of opportunity for early years children with

additional needs to attend pre-school settings, with flexibility in the funding system to

allow parents to access settings appropriate for their child’s condition outside the

designated area, and recognising the additional expenditure incurred by families of

children with additional needs. Funding should follow the needs of the child and not the

constraints of geography or parental circumstances.


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Recommendation 4

Proving Inclusion

All settings to have to prove inclusion of children with additional needs via the inspection

and regulatory systems e.g. Estyn (Inspectorate for Education and Training in

Wales).and CSSIW (Care and Social Services Inspectorate Wales).

Recommendation 5

Early Support Website

Raise awareness of the resources available on the Early Support website ensuring

increased use.

7.2 Local

Recommendation 6

Referral Scheme Co-ordinators

Availability of well resourced Referral Scheme Co-ordinators with the capacity to meet

demand and to ensure inclusion in each area.

Recommendation 7

Improve staff-parents communication

7.1 A Home – Setting Link Book

This would begin with completing relevant sections about the child by the parents when

the child first joins the setting. This would include information regarding the child’s

condition, advice from the parent about techniques that work with the child etc.

Subsequently the setting practitioners and the parents would complete a weekly diary of

the child’s activities/development/behaviour/any incidents etc in the Link Book which

could be shared. This would lead to better sharing of information and improved


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communication. There are many good examples of this which could be emulated in other

areas.

7.2. Appropriate targets should be set for children with additional needs in their

Individual Education Plan/Individual Play Plan taking into account their stage of

development. This vital information regarding the child’s progress should be shared

during the transition process to the Primary School.

Recommendation 8

Practitioner Training

Reactive training to take place at a time not clashing with setting hours. Training in

general inclusion (which involves facilitating communication with and between parents),

training and information about specific conditions and visits to other settings, specialist

schools or shadowing other practitioners at other settings.

Recommendation 9

Practitioner Mentors

Use of experienced and trained Mentors in a local/county area who are working in early

years settings with children with additional needs to support other setting practitioners

who are less experienced. Area Mentors to go to settings as necessary to support

practitioners with information, best practice regarding inclusion and practical and

relevant methods to use with the child with additional needs.

Recommendation 10

Inclusion Checklist

An Inclusion Checklist, including self-audit activities, to be used at every setting. This

can be used by the setting practitioners to prove inclusion. This should be monitored

regularly.


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Recommendation 11

Networking

Regular facilitated meetings for setting practitioners to review progress, share good

practice and discuss concerns – at local/county level

Recommendation 12

Online Information Tool

Use of Online Resource Centres in order to share good practice and information.

Recommendation 13

1-1 Support Workers (Helping Hands)

A trained pool of 1-1 Support Workers (Helping Hands) covering a wider area.

Consistent training monitoring and assessment of 1-1 Support Workers (Helping Hands).

Recommendation 14

Pool of Resources

A central pool of specialist toys, equipment and other resources in each area for children

with additional needs – free to loan basis. This could either be organised by the Referral

Scheme Co-ordinators or by the Umbrella Organisations involved e.g. Mudiad Meithrin,

Wales PPA, NCMA Cymru etc


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8. References

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peoples-plan-2008-11.pdf accessed 16 March 2011 Caerphilly Children and Young People’s Partnership (2011) Draft Caerphilly Children and Young People's Plan 2011-2014 (Caerphilly: Caerphilly Borough


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Council) available at http://www.caerphilly.gov.uk/pdf/Education_Learning/cypp_2011_14(draft).pdf accessed 17 March 2011 Centre for Studies on Inclusive Education (CSIE) (no date) “CSIE's Inclusion Charter relaunched” http://inclusion.uwe.ac.uk accessed 17 March 2011 Children’s Commissioner for Wales (2008) A Happy Talent: Disabled children and young people’s access to play in Wales 2007: a review of local authority strategies (Swansea: Children’s Commissioner for Wales) available at http://www.childcomwales.org.uk/uploads/publications/54.pdf accessed 11 March 2011 Cumine, V., Leach, J. and Stevenson, G. (2000) Autism in the Early Years (London: David Fulton) Disabled Children Matter Wales (No Date) Reading List Disabled Children Matter Wales (2008a) Funding Proposal: Referral Schemes in Wales unpublished paper Disabled Children Matter Wales (2008b) Access to play, leisure, sporting and cultural activities: Task Group paper Disabled Children Matter Wales (2009) “Equal Access to Early Years Childcare Provision for Disabled Children”, unpublished paper, produced for Rights into Action for Disabled Children and Young People Task Group Geraghty, T. and Sinclair, R. (2007a) The daycare needs of disabled young children in Northern Ireland (London: National Children’s Bureau) Geraghty, T. and Sinclair, R. (2007b) The daycare needs of disabled young children in Northern Ireland: Research Summary (London: National Children’s Bureau) Gwent Association of Voluntary Organisations (no date) How Can We Help You Play? (Newport: Gwent Association of Voluntary Organisations) available at http://www.gavowales.org.uk/Children_and_Families/Play/Report%20-

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Hornby, G., Atkinson, M. and Howard, J. (1997) Controversial Issues in Special Education (London: David Fulton) Local Government Association (2008) Making the free early years entitlement work: Good practice case studies of partnership working (London: Local Government Association and National Day Nurseries Association) Miller, Frederick A. and Katz, Judith H. 2002. The Inclusion Breakthrough: Unleashing the Real Power of Diversity. San Francisco: Berrett-Koehler Publishers Mortimer, H. (2000) Playladders (Lichfield, Q.Ed) on sale at http://www.qed.uk.com/nurseries_and_early_years.htm#Playladders accessed 17 March 2011 Mortimer, H. (2001) Special Needs and Early Years Provision (London: Continuum) Nash, Susie (2010) “Research: What’s going on in Wales?” in Llais, No.97, pp.14-15 National Centre for Social Research (2011) Take-up of formal childcare is high, but disadvantaged families are still missing out (London: National Centre for Social Research) available at http://www.scotcen.org.uk/media/686114/nc438_findings-

childcare%20challenge%20web.pdf accessed 27 April 2011 National Childminding Association (2004) NCMA’s Quality Standards: A workbook for childminders (Bromley: National Childminding Association) National Childminding Association (2009) Childcare for Disabled Children and Young People: research for NCMA Wales (Bromley: National Childminding Association) available at http://www.ncma.org.uk/news_and_events/news/july_to_december_2009/care_for_disabled_children.aspx accessed 11 March 2011-03-11 National Children’s Bureau (No Date) Participation and Belonging in Early Years Settings - Inclusion: Working towards equality (London: National Children’s Bureau and Early Childhood Forum) NDCS (2009) Early Years Childcare Provision for Disabled Children


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Niergarth, L. M. and Winterman, K. G. (2010) “Out of Home Care for Infants and Toddlers with Medical Handicaps”, in International Journal of Applied Educational Studies, Vol. 9, No.1, pp.41-51 PlayWales (no date) “Overview of Regional Infrastructure Projects” available at http://www.playwales.org.uk/page.asp?id=466 accessed 17 March 2011 - a useful resource for organisation at the public service level for Wales PlayWales (2007) “Inclusive Play and Disability” available at http://www.playwales.org.uk/downloaddoc.asp?id=233&page=256&skin=0 accessed 22 March 2011 Schopler, E., Reichler, R.J., DeVellis, R.F. and Daly, K. (1980) "Toward objective classification of childhood autism: Childhood Autism Rating Scale (CARS)"in Journal of Autism Development Disorders Vol.10, No.1, pp.91–103 Scope (no date) Liverpool City Council Children’s Centres (London: Scope) Scope (2010) Moving Up (London: Scope) Wall, Kate (2003) Special Needs and Early Years: A Practitioner’s Guide (London: Sage) Wall, Kate (2004) Autism and Early Years Practice: A Guide for Early Years Professionals, Teachers and Parents (London: Sage) Wall, Kate (2007) Education and Care for Adolescents and Adults with Autism: A Guide for Professionals and Carers (London: Sage) Welsh Assembly Government (2004) Children and Young People: Rights to Action (Cardiff: Welsh Assembly Government) available at http://wales.gov.uk/topics/childrenyoungpeople/publications/rightstoaction/?lang=en

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wales/playpolicy/implementationplane.pdf?lang=en accessed 17 March 2011 Welsh Assembly Government (2007). Foundation Phase National Training Pack Module 5 Handbook - Additional Learning Needs. Play Learn Grow Foundation Phase 3-7 (Cardiff: Welsh Assembly Government)


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Welsh Assembly Government (2008a) Children and Young People's Well-being Monitor for Wales (Cardiff: Welsh Assembly Government) available at http://wales.gov.uk/about/aboutresearch/social/ocsropage/2008monitor?lang=en accessed 17 March 2011 Welsh Assembly Government (2008b) Play/Active Learning Overview for 3 to 7-year-olds (Cardiff: Welsh Assembly Government) available at http://new.wales.gov.uk/dcells/publications/policy_strategy_and_planning/early-wales/whatisfoundation/foundationphase/playactivelearning/playactivee.pdf?lang=en

accessed 17 March 2011 Welsh Assembly Government (2010) Early Support Multiagency Planning and Improvement Tool: Background mapping document (Cardiff: Welsh Assembly Government) available at http://www.earlysupportwales.org.uk/materials/ma-materials accessed 17 May 2011 Welsh Assembly Government (2011) Early Support in Wales (Cardiff: Welsh Assembly Government) is the website of Early Support in Wales and can be found at http://www.earlysupportwales.org.uk/ accessed 17 May 2011 Resources cited in PlayWales (2007) above: Children's Commissioner's Office in Wales adopted play as one of its themes for 2007 and is focussing attention on inclusive play. Find out more at http://www.childcom.org.uk Children’s Play Information Service (2006) Inclusive Play Factsheet Douch, P (2006) The Busker’s Guide to Inclusion. Eastleigh: Common Threads Children and Families Directorate, Welsh Assembly Government (2004) National Service Framework for Children in Wales. Cardiff: Welsh Assembly Government http://www.wales.nhs.uk/sites3/home.cfm?OrgID=441 Contact a Family (2002) Everybody Here? Play and leisure for disabled children and young people. London: Contact a Family available at http://www.cafamily.org.uk/leisure.pdf Department for Education and Skills and Disability Rights Commission (2006) Implementing the DDA in Schools and Early Years Settings. London: DfES Douch, P (2006) It Doesn’t Just happen – Inclusive Management for Inclusive Play. London: Kids. Ward, F, Elliott, C and Day, C (2004) I Want to Play Too. London: Barnardos


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Dunn, K, Moore, M and Murrary, P (2003) Developing Accessible Play Space. A good practice guide. London: Office of the Deputy Prime Minister John, A and Wheway, R (2004) Can Play, Will Play: disabled children and access to outdoor playgrounds. London: National Playing Fields Association Kids (2004) All of Us - inclusion checklist for settings. London: Kids http://www.kids.org.uk Kids (2006) Planning for Inclusion - making your play strategy inclusive. London: Kids http://www.kids.org.uk Lenehan, C, Morrison, J and Stanley, J (2004) The Dignity of Risk: A practical handbook for professionals working with disabled children and their families. London: National Children’s Bureau The Playwork Principles can be found at http://www.playwales.org.uk Welsh Assembly Government (2002) Play Policy Welsh Assembly Government (2006) Play Policy Implementation Plan http://www.learning.wales.gov.uk/pdfs/play-policyimplementation-plan-e.pdf

inclusion in the early years for children with …...1 strategic direction : inclusion in the early...

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