SEND Local Offer - Communication and Behaviour

What is the concerning behaviours pathway?

The concerning behaviours pathway is a multi-agency pathway, which brings health, social care, education and voluntary sector services together to support children, young people and their families. 

Frequently referrals are made to specialist services without early support being put in place or families feeling the only option to access support is for their child to have a diagnosis. The pathway aims to shift the emphasis to support rather than diagnosis alone. It has been developed to ensure the reasons for concerning behaviour are fully explored and that the right support is available at the right time and at the right place. 

What is concerning behaviour?

There is no definition or diagnosis of concerning behaviour. Behaviour/need that is concerning can arise for many different reasons. These can be social, emotional, medical or a combination of all or any of these factors. 

Who is the pathway for?

The pathway is for all children and young people who are registered with an NHS Nottinghamshire County GP (and their families) who have behaviours that are causing concern to them, to their family, or that have been identified by someone working with them e.g. a Teacher, Nursery Nurse or Health Visitor. The pathway supports children and young people 0-19  and up to their 25th birthday where an Education and Health Care plan (EHC) is in place.

How do I access the pathway?

The pathway with your consent can be iniated by a GP or any professional working with your child such as a school teacher. You can also request to either of these that the pathway is initiated. 

What can I expect if my GP recommends this pathway?

Your GP will discuss your concerns with you and give you this information about the pathway. They will check your child's hearing and vision and assess if there are any serious medical issues, which will need a specialist medical assessment. If this is the case, they will make an appropriate referral for a specialist assessment. 

Whether or not your GP refers your child for a specialist assessment they should with your agreement contact your local school nurse or health visitor who will assist in identifying a 'key worker' to help you and your child develop a support plan. This may include simple strategies at home or school/nursery, or incliude parenting courses or other sources of support. In some cases your GP may recommend you contact the Early Help Unit.  This is a unit which offers advice, and signposts families to a wide range of support. You can also choose to access this service yourself. 

For many children and young people putting this support in place will meet their needs and they will not need to go beyond this stage of the pathway. However, if moderate concerns continue, your key worker will, with your consent, gather information about you and your child and from those working with your child. This information will help to clarify the needs of your child and your own needs, and enable a decision to be made about the next steps. It may be that advice or referral to more specialist services is required. You can see details on the different stages of the pathway below. 

The six stages in the pathway are: 

How do I find out further information?

Find out further information by reading a factsheet on the pathway or by clicking on the icon below:

What is the Early Help Unit?

The Early Help Unit provides a central contact point for families wanting to access early help services in Nottinghamshire. They can provide information and advice and will signpost to non County Council Services, as well as accepting referrals on behalf of Nottinghamshire County Council's early help services. This can include support around communication and behaviour.

What services and support can be accessed through the Early Help Unit?

Specific elements of this service include:

Children's Centre (under the age of 5):
• Universal services including play sessions and health support.
• More focused support with: challenging behaviour; communication difficulties (Home Talk Programme).
• Parenting programmes & interventions including: Strengthening Families; Incredible Years; 

Family Service provides early help support for children & young people aged 5 to 18 with needs including the following areas:
• Crime prevention via Youth Offending Teams
• Supporting Families (Troubled Families Programme)
• Missing children
• Homelessness
• Substance misuse
• Problems with attendance (including the prosecution of parents or carers)
• Defiant behaviour issues at home or school
• Emotional health difficulties that do not meet CAMHS criteria
• Support with finding work, training or re-entering education
• Young Carers

Age range

0-18 years

Who can make a referral?

Parents/carers can make a referral

Contact Details

Telephone: 0115 8041248

Email: early.help@nottscc.gov.uk

The opening hours of the Early Help Unit are 9:00am to 4:30pm Monday to Friday.

What are children's centres?

Children's Centres are located in every district of Nottinghamshire and offer a wide range of support including child development, communication and behaviour.

Age range

Any parent to be or with a child under 5 can attend their local Children’s Centre.

What support can children's centres offer?

Children's centres offer a range of activities for children under five. They can also offer one to one or group support with:

• the emotional health of you or your child
• playing with your child
• children’s behaviour
• domestic abuse
• children’s development, including listening and communication
• feeding your child
• increasing your confidence and help to get a job
• preparing for a baby

How do I contact my local children's centre? 

There are several children's centres located in each district of Nottinghamshire. You can find out contact details for your nearest children's centre on Nottinghamshire County Council's website

What does the service do?

The Specialist Support Team offers bespoke, individualised packages of support for children and young people from birth to their 18th birthday, either within their own homes or local communities, supported by trained / experienced  workers. They are registered and inspected by The Care Quality Commission (CQC)

The team provides:

• Personal care needs assessment
• Support to establish positive routines
• Sleep support and advice
• Overnight support in the home/ community, after a social care assessment
• Specialist sitting (after assessment)
• Community engagement / befriending
• Group provision
• Independance support / preparing for adulthood.

Age range

0 - 18

Who can refer to the service?

Parents/carers can make a referral to the service

Contact Details

Name: Duty Point

Tel: 0115 804 1262

Email: earlysupportservices-duty@nottscc.gov.uk  

The Neurodevelopmental Behaviour Support service is based within the Family Service and provides early support to families where there are concerns that a child has neurodevelopmental behaviour support needs which may be indicative of ASC or ADHD. This includes

• Triage Assessment to identify if referral to Tier/Level 3 Services is required, and
• A range of evidence-based interventions for families of children and young people displaying behaviours that cause concern or challenge, both pre and post diagnosis.

Support will be available where there is no formal diagnosis of ASD or ADHD, but where behaviours maybe indicative or characteristic of these conditions and also for families of children and young people diagnosed with ASD and/or ADHD.

The Neurodevelopmental Behaviour Support Service does not accept self-referrals direct from Families. Referrals must be made by a professional involved with your child and/or family. For example, the Healthy Family Team or School Setting.

If a parent or professional wants to speak to a member of the Family service about a referral to the Neurodevelopmental Behaviour Support Service then please call 0300 500 80 80

The following are sources of advice and support if you are experiencing behavioural difficulties with your child or young person:

Contact school

Parents can speak with their child’s school about the concerns which they have about their child’s behaviour.  Schools have access to support through consultation with education support services or refer and/or signpost to other services.

To find the contact details for your child's schools please go to the Nottinghamshire County Council website

Other sources of advice and support

Parentline - Is a confidential texting service for parents and carers. The texting service is an easy way for parent and carers of children aged 0 – 19 years to confidentially ask for help about a range of issues, such as:

• parenting advice and support
• emotional health and wellbeing
• behaviour difficulties
• family health

Parents and carers can contact the text messaging service for advice from Monday to Friday 9.00am - 4.30pm excluding bank holidays.  Messages sent to the dedicated number are delivered to a secure website, and responded to by the Healthy Family Team. Texts are usually replied to within one working day.  Automatic replies will be sent to any messages received out of hours explaining where to get help if their question is urgent, and when they can expect a response.

Text Parentline on 07520 619919

Healthy Families Teams - An integrated service for children, young peeople and families, which brings together care provided by Health Visitors, School Nurses, the Family Nurse Partnership Programme and the National Childhood Measurement Programme. Parents/Carers can ring to access support and advice around emotional and behavioural issues.

Each Healthy Family Team works within a geographical area. These areas are based around local populations with the same boundaries as our children's centres and include the relevant 'families of schools'.

Family Lives - Providing information and support for parents on all aspects of family life, from children’s development, behavioural management, dealing with teenagers, and family breakdown. The provide support in a number of different ways including via their website and 24 hour confidential helpline.

Telephone helpline: 0808 800 2222

The Challenging Behaviour Foundation  - Specific resources for the families of children, young people and adults with severe learning disabilities who display behaviours that challenge.

What is speech and language therapy and where do they work?

The Children's Speech and Language Therapy Service supports children in Nottingham city and county. 

Children meeting the service entry criteria will receive assessment, diagnosis and support. These are delivered in different places, depending on your child's needs.

The first line of contact with Speech and Language Therapy is usually through the Community Speech and Language Therapy Teams, with access to further support as needed. The service also has Speech and Language Therapists who work across Nottinghamshire to support children with more specific and complex needs, including:

• autistic spectrum disorders
• cleft lip and palate
• dysphagia
• hearing impairment
• learning difficulties 
• physical difficulties
• pre-school complex needs 
• specific language impairment 
• stammering (dysfluency)

Age Range

0 -18 years

Who can refer to the service?

The Children's Speech and Language Therapy Service has an open referral system. Any key person in the child's life can refer, as long as the child's legal guardian has given permission. 

The Speech and Language Therapy Service receives referrals from many different people, including; parents and carers, teachers, SENCOs, GPs, paediatricians, health visitors, nursery nurses, social workers.

Service Opening Hours

8:30am – 4:30pm Monday to Friday

Contact Details

Single Point of Access:

Tel: 0300 1233387 (8:30am – 4:30pm Monday to Friday)

Bassetlaw District:

Tel: 01302 642633

Further information

You can NHS website or for Bassetlaw District on the Doncaster and Bassetlaw Hospitals NHS webpages

What is speech and language therapy and where do they work? 

They aim to deliver a high quality service to adults in Nottinghamshire County with swallowing, voice and other communication problems.

They work with patients, carers, other healthcare professionals and agencies to help people recover their communication skills as much as possible. They also help people to manage their own long term problems.

The service also supports people who are being cared for at the end of their lives.

They see patients at a number of places across Nottinghamshire. They can also see patients in their own homes if they can't travel.

Group therapy is also provided, when appropriate. The staff work across four areas:

• stroke
• long term conditions
• specialist medicine and dementia
• voice/head and neck cancer

Age Range

18 +

Service Opening Hours

8:30 am – 4:30pm, Monday to Friday

Who can make a referral?

The adult needing support, family/friends (with consent) and health professionals.

Contact Details

South Community SLT Team:

Adult Speech and Language Therapy Service
Stapleford Care Centre
Church Street
Nottingham
NG9 8GA
Tel: 0115 8760117

Mid Nottinghamshire SLT Community Team:

Adult Speech and Language Therapy Service
Mansfield Community Hospital
Stockwell Gate
Mansfield
NG18 5QJ
Tel: 01623 785166

Email: SLTAdultsNottinghamshire@nottshc.nhs.uk

Bassetlaw District:

Adult Speech & Language
Doncaster Royal Infirmary
Armthorpe Road
Doncaster, DN2 5LT
Tel: 01302 644218

Further information

You can find out further information on the NHS website  or for Bassetlaw District on the Doncaster and Bassetlaw Hospitals NHS webpages

SPEECH AND LANGUAGE THERAPY SERVICE (ADULT INTELLECTUAL DISABILITIES)

What does the service do?

They provide specialist assessment, formulation, therapy, support and advice for people with speech, language, communication needs or dysphagia (swallowing difficulties). We also work with their carers, support staff and other teams.

This also includes specialist learning and development to enable others around safe eating and drinking and communication techniques.

Specialist assessments include comprehension of language, especially in relation to capacity to understand information and Autistic Spectrum Disorder diagnostic assessments. This also includes specialist communication aid service for people with developmental disabilities.

They are accessible to adults with intellectual disabilities and provide a communication aid service for adults with developmental disabilities.

Where are they based?

They are based with Community Learning Disability Teams and Intensive Community Assessment and Treatment Teams across Nottinghamshire County and in Nottingham City, as well as providing some inpatient support.

Age range

18+

Service opening hours

Monday to Friday, 9.00 - 17.00

Who can make a referral?

The adult needing support, family/friends and health professionals.

Contact details

Byron House

Newark Hospital

Boundary Road

Newark-on-Trent

Nottinghamshire

NG24 4DE

Tel: 0115 876 0150

Further information

You can find out further information on the NHS website

Some children, including those who are autistic or have communication and interaction differences, may experience sensory sensitivities; such as finding everyday environments difficult to cope with; becoming overwhelmed in noisy or busy places; finding the sensation of some clothing unbearable.

Early identification of sensory differences can support your child.  If you are concerned that your child may be experiencing some sensory sensitivities you can contact your local Healthy Family Team  or the special education needs coordinator (SENCO) at school, to discuss.  They will be able to provide advice and support or signpost you to resources, which can help you and your child to manage these needs.

If concerns remain education settings can request advice and support from the Communication and Interaction Team within Schools and Families Specialist Services.  This may include undertaking a sensory audit / profile to identify the sensory differences your child may be experiencing and suggest ways in which reasonable adjustments can be made to meet these differences.  Examples of such adjustments could include access to a quiet area for lunchtimes when overwhelmed, amendments to uniform policy or wearing ear defenders in noisy environments.

Where children are experiencing severe difficulties, you may wish to explore a specialist assessment.  As Sensory Integrated Assessments are not currently commissioned by the Integrated Care Board, a health professional supporting you would need to agree that an assessment would be clinically beneficial and make a request via an Individual Funding Request (IFR) for non-core commissioning panel to consider.  The policy for this can be found on the Nottingham and Nottinghamshire ICB website.  This provides guidance to the professional on how to make that request. 

Alternatively, a parent /carer can commission their own independent qualified professional to do an assessment to determine needs, if required.

Click here for Individual funding requests for specialised services – a guide for patients (icb.nhs.uk)

You can find details of organisations who offer support around communication and behaviour on the SEND Local Offer website

PLEASE NOTE: You can narrow down the results, if you are specifically looking for services that support with communication, by clicking on the filter option 'supporting people with' and then 'communication difficulties'

Stories with Symbols

Bringing books to life.

Videos for children with speech, language and communication needs. These videos are designed to stimulate interest in books, support comprehension and help children learn new words and ideas.

Click here to start watching the stories or on the image below: