Early Years: Strategies and Resources

Sensory, Physical, and Medical Needs

Sensory

What you might see

You might see a child who:

  • Does not always respond to sounds or voices
  • Does not always respond when their name is called
  • Finds it difficult to listen or join in when there is a lot of background noise
  • Takes longer to understand what is being said
  • Has unclear speech or finds it difficult to express themselves
  • Becomes frustrated or disengaged when communicating with others
  • Tires easily during listening activities
  • May not always have their hearing equipment with them
  • Wears hearing aids or cochlear implant processors

What you can try

Speak with parents/carers if you have concerns about hearing and encourage them to seek advice (e.g. via a GP)

Refer to the Hearing Support Team where hearing needs are identified

Gain the child’s attention before speaking and ensure they know you are talking to them

Face the child and do not cover your mouth when speaking

Position yourself at the child’s level and nearby, including during outdoor activities

Reduce background noise where possible (e.g. turn off unused equipment, avoid music during focused tasks)

Use quieter spaces and smaller groups for adult-led activities

Seat the child so they have a clear view of the adult and any visual materials

Repeat and rephrase what others say (e.g. peer contributions)

Check hearing equipment daily (e.g. batteries/charging, cleanliness, working order)

Seek guidance from a Teacher of the Deaf or parents/carers on equipment use where needed

Contact parents/carers if hearing equipment is not brought to the setting

Use assistive listening devices (e.g. radio aids) where provided

Support the child to develop independence in using and managing their hearing equipment

Involve the child in simple equipment checks and routines where appropriate

Use visual supports alongside speech (e.g. objects, photos, symbols, gestures, Makaton or BSL, visual timetables)

Provide picture communication resources to support understanding and expression

Model and extend the child’s language during play and routines

Follow advice and strategies from specialists (e.g. Teacher of the Deaf, Speech and Language Therapy)

Label the environment using symbols and signs to support understanding

Model turn-taking and support small group interactions to develop social communication

Explain rules of games clearly to support inclusion

Provide access to books, toys and resources that reflect hearing differences

Share positive resources about hearing differences with children and families

Recognise that listening can be tiring and provide regular listening breaks (e.g. quiet time)

Support use of equipment through encouragement, praise and practical solutions (e.g. clips, headbands)

What you might see

You might see a child who:

  • Has eyes that look different (e.g. colour, alignment or movement)
  • Seems unsteady or less coordinated when moving around
  • Moves very close to books, objects or screens to see them
  • Has difficulty seeing things clearly, especially at a distance

What you can try

Follow advice and strategies from the Vision Support Team (e.g. environmental audits for indoor, outdoor and transition spaces)

Ensure the environment is well-lit, with minimal glare and clutter, and is organised clearly

Use high-contrast colours and clear labelling to support navigation

Share the child’s individual management plan with all staff to ensure consistent support and access

Use multi-sensory approaches to support learning (e.g. combining visual, auditory and practical experiences such as real objects and demonstrations)

Check understanding regularly during activities

Engage with training from the Vision Support Team to develop staff confidence in supporting vision needs

Monitor the child’s progress and adapt support strategies as needed

Contact the Vision Support Team if there are changes in the child’s needs or further advice is required

Work in partnership with parents/carers and other professionals to support independence skills

Involve specialist services (e.g. Habilitation Team) where appropriate to support mobility and independence across home and the setting

What you might see

You might see a child who:

  • Shows signs of both hearing and vision differences (see the sections on hearing and vision)

What you can try

Use strategies from both the hearing and vision sections to support access

Ensure communication is accessible, taking into account both hearing and vision needs

Provide accessible resources, including tactile elements, to support understanding and information gathering

Support mobility and orientation by clearly defining spaces and learning areas

Follow guidance from environmental audits to adapt the setting

Work with specialist professionals (e.g. Teacher of the Deaf, Qualified Teacher of Vision Impairment) for advice and support

Seek further specialist assessment where needs go beyond ordinarily available provision

Physical

What you might see

You might see a child who:

  • Finds some physical activities more difficult than other children of a similar age
  • Needs support to take part in some activities during the day (e.g. moving around, using equipment, joining in play)
  • Becomes tired more quickly than others
  • Needs adjustments or support to access parts of the environment or routine

What you can try

Gather information about the child’s health and medical needs in partnership with parents/carers and relevant professionals

Use available information (e.g. health records such as the red book) to understand support needs

Put appropriate risk assessments and plans in place (e.g. classroom and outdoor audits, individual profiles, physical management plans)

Provide motivating activities that support physical development and independence (e.g. cooking, painting, construction, music)

Allow additional time and support for children to develop and practise motor and independence skills

Encourage children to do as much as possible for themselves within routines (e.g. pouring drinks, serving snacks, putting on coats)

Use visual supports to guide routines (e.g. handwashing sequences) and promote independence

Provide additional support and guidance where needed (e.g. starting a fastening and supporting the child to complete it)

Use a small steps approach to develop motor, personal care and independence skills

Provide individual prompts, supervision and support within daily routines

Share strategies between home and the setting to support consistency in personal care, eating and dressing

Review approaches regularly with families

Seek advice from relevant professionals (e.g. Specialist Teaching Team for Physical Needs, Occupational Therapy, Physiotherapy, School Nurse, Health Visitor) and incorporate this into planning

What you might see

You might see a child who:

  • Finds it difficult to use their hands for small tasks (e.g. picking up small objects, using tools)
  • May not yet use a pincer grip (using thumb and finger to pick up small items)

What you can try

Provide a range of play-based activities to develop fine motor skills (e.g. manipulating objects, messy play, activities to build hand and finger strength)

Use a small steps approach to plan and deliver fine motor activities, both individually and in small groups

Include targeted fine motor activities within planning where needed

Provide a range of mark-making tools (e.g. large brushes, chalk, crayons, sticks, egg-shaped crayons, sponges) to explore patterns and shapes

Use a variety of surfaces for mark making (e.g. chalkboards, light boxes, sand, outdoor pathways)

Provide a range of adapted cutting tools and activities (e.g. easy-grip scissors, self-spring scissors, left-handed scissors, long-handled scissors)

Offer a range of construction toys with different sizes and joining methods (e.g. twisting, pushing, slotting, magnets)

Share strategies with parents/carers to support the development of fine motor skills at home and in the setting

What you might see

You might see a child who:

  • Finds it difficult to move around or take part in physical play activities
  • Has difficulty with balance during play
  • Finds it difficult to bend down to pick up objects from the floor
  • Is hesitant or unsure when trying new outdoor equipment
  • Is hesitant when moving across different levels (e.g. steps, slopes)

What you can try

Provide opportunities to practise movement across different surfaces (e.g. slopes, steps, grass, uneven ground, Forest School)

Use outdoor environments and equipment to support climbing, crawling, stepping, balancing and jumping

Plan and deliver a range of games and physical activities to develop gross motor skills

Provide a variety of equipment (e.g. trikes, scooters, balance toys, beanbags, bats, balls)

Offer adapted equipment to support access (e.g. three-wheeled scooters, balance bikes, smaller bikes, lightweight and easy-grip equipment, low-level apparatus)

Ensure indoor and outdoor environments are accessible, making reasonable adjustments to layout, organisation and resources

Maintain clear walkways and manage busy areas to support safe movement

Provide supervision and support during transitions (e.g. stairs, moving between areas, going to the toilet)

Include targeted gross motor activities within planning (e.g. individual or small group work with different levels of challenge)

Support safe movement around the setting and provide guidance where needed

Access training from the Specialist Teaching Team for Physical Needs to support inclusive practice

Incorporate physiotherapy exercises into play and daily routines where appropriate

What you might see

You might see a child who:

  • Finds it difficult to sit in a range of positions used in the early years setting
  • May not sit steadily on a chair and may need extra support
  • Finds it difficult to sit upright on the floor for short periods (e.g. during story or singing time)

What you can try

Support the child to use comfortable and stable sitting positions during activities

Ensure the child is well positioned to engage in learning

Offer a range of seating options (e.g. floor spots, chairs with arms, footrests, low tables)

Provide furniture at an appropriate height for the child

Encourage different positions for learning (e.g. sitting, standing, kneeling, tummy time)

Use adapted equipment where needed (e.g. supportive chairs, cushions)

What you might see

You might see a child who:

  • Needs support with eating and drinking
  • May not yet be able to hold a cup or beaker to drink from
  • Finds it difficult to pick up food to feed themselves
  • May not yet be able to hold or use a spoon

What you can try

Provide opportunities to explore food through play (e.g. edible messy play activities)

Use play-based activities to develop skills needed for eating (e.g. water play, playdough, role play, using spoons and scoops)

Provide appropriate equipment to support independence (e.g. easy-grip or chunky cutlery, two-handled beakers)

Ensure staff are available to support children individually or in small groups to develop independence

Allow additional time during snack and mealtimes for children to practise skills

Create a social and enjoyable mealtime experience with peers

Work with parents/carers to share consistent strategies that support independence with eating

What you might see

You might see a child who:

  • Needs support with dressing
  • May not yet be able to help with dressing (e.g. putting their arms into sleeves)
  • Is not yet be able to take off their own clothes (e.g. removing shoes)

What you can try

Provide play-based opportunities to practise dressing skills (e.g. dressing dolls, role play)

Use activities to develop the physical skills needed for dressing (e.g. fastening boards, action songs)

Provide supported opportunities to practise dressing skills individually and in small groups

Allow additional time within routines for children to develop independence

Ensure staff are available to support and prompt during dressing routines (e.g. outdoor clothing, changing for physical play, role play)

Work with parents/carers to share consistent strategies that support independence with dressing

Make reasonable adjustments to clothing and uniform (e.g. easy fastenings) to support independence

What you might see

You might see a child who:

  • Needs support with the physical aspects of toileting (e.g. managing clothing, getting on and off the toilet)
  • May not yet be able to manage toileting routines independently
  • Is unable able to sit steadily on a potty or toilet
  • May not yet be able to wipe themselves
  • May need support to pull clothing up or down for toileting

What you can try

Provide accessible toilet and changing facilities to meet the needs of all children

Provide child-accessible equipment to promote independence (e.g. toilet insert seats, handrails, lower sinks, lever taps, soap dispensers within reach)

Ensure the child’s feet are supported on a flat surface when using the toilet (e.g. use a step or a lower toilet)

Use visual prompts to support toileting and handwashing routines

Plan sufficient time within routines for children to develop independence

Ensure staff are available to prompt and support individual children where needed

Follow your setting’s intimate care policy

Work with parents/carers and signpost them to guidance and support to develop independence (see resources)

Share strategies between home and the setting to support consistent routines

Take into account family preferences and approaches to personal care and independence

Medical

What you might see

You might see a child who:

  • Has a health or medical need that affects their day-to-day experience in the setting
  • Needs support to take part in some activities
  • Requires regular medication or monitoring during the day
  • May need adjustments to routines, activities or the environment

What you can try

Ensure individual healthcare plans are in place and reviewed regularly

Teach simple health and safety routines (e.g. holding handrails, handwashing)

Plan time within the curriculum for children to develop independence in managing their own needs

Allow additional time and adult support for children to manage health needs (e.g. using inhalers, applying creams)

Store and manage medical equipment safely and accessibly (e.g. inhalers)

Use flexible approaches to support learning during absence (e.g. medical appointments or illness)

Recognise and respond to how the child shows they are uncomfortable, in pain or tired

Provide books and resources that promote understanding and celebrate differences in health and physical needs

Provide age-appropriate information about healthy eating and ensure access to water and healthy snacks

Resources

Sensory Support (Hearing, Vision and Multi-sensory Impairment)

  • Mild Hearing Loss (Local Offer Birmingham) – information, training and management guidance for children with mild hearing loss, including glue ear
  • Unilateral Hearing Loss Guidance – advice and training for supporting children with hearing loss in one ear
  • Eye Conditions (Local Offer Birmingham) – information and strategies to support children with vision needs
  • SENSE – Conditions and support – information and guidance for children with sensory and multi-sensory needs
  • SENSE: Making Play Inclusive – practical strategies to support inclusive play

Physical and Medical Needs

  • Paediatric Occupational Therapy (OT) – advice and resources to support physical development, sensory needs and functional skills
  • Birmingham School Health Support Service – support for managing health needs in education settings
  • Welcome to Startwell Birmingham – information to support health, wellbeing and early development

Sensory Support (Hearing, Vision and Multi-sensory Impairment

  • Deaf Awareness in Education – training to support understanding of hearing needs
  • Hearing Support Team Training – bespoke training for supporting children with hearing needs
  • Vision Support Training (QTVI) – training to support access for children with vision impairment
  • Assistive Listening Device (ALD) Training – training on use of radio aids and equipment

Physical and Medical Needs

  • PD Net Training (Equality Act and inclusion) – free training covering responsibilities under the Equality Act and inclusive practice
  • Physical Support Team Training – advice and training to support children with physical needs
  • Occupational Therapy Training – guidance and training to support physical and sensory development
  • Medical Needs Training – training to support conditions such as asthma and allergies

Sensory Support (Hearing, Vision and Multi-sensory Impairment)

  • Inclusive environments – adapting lighting, noise, layout, seating and positioning to support access
  • Environmental audits (SPST / Vision Support Team) – specialist advice to adapt environments
  • Management plans – personalised plans developed with specialist teachers to support access
  • Developmental Journal for Vision Impairment (0–3 years) – supports early development and monitoring

Physical and Medical needs

Physical and Medical Needs

  • ERIC (Intimate Care Guidance) – guidance to support toileting and personal care
  • Toilet Training Guidance (DfE) – advice for early years providers on toileting
  • ERIC Toilet Training Resources – practical guides for parents and settings, including how to start toilet training, and school readiness for toileting

Sensory Support (Hearing, Vision and Multi-sensory Impairment

  • Assistive Listening Devices (ALD) – e.g. radio aids to support access to sound
  • Daily equipment checks and support – ensuring effective use of hearing equipment
  • Insurance for radio aids – guidance for protecting specialist equipment
  • Specialist visual adaptations – e.g. contrast, positioning, enlarged or adapted materials

Physical and Medical Needs

  • Supporting Pupils with Medical Conditions (DfE) – statutory guidance for supporting children with medical needs in education
  • Local Offer Medical Needs Guidance – information on supporting children with health conditions

Sensory Support (Hearing, Vision and Multi-sensory Impairment

  • Sensory and Physical Support Team (SPS) – specialist support for hearing, vision and multi-sensory needs
  • Teacher of the Deaf (ToD) – specialist support for hearing needs
  • Qualified Teacher of Vision Impairment (QTVI) – specialist support for vision needs

Specialist SEND Support Services – Local Offer Birmingham

 

Sensory Support (Hearing, Vision and Multi-sensory Impairment

  • National Deaf Children’s Society (NDCS) – support and resources for children with hearing needs
  • RNIB (Royal National Institute of Blind People) – resources and family support for vision needs
  • Usher Kids UK – support for children with combined hearing and vision needs
  • Books with deaf characters / inclusive toys (#ToyLikeMe) – promotes inclusion and representation
  • Communicate and Play groups (NDCS) – supports communication and play for children with hearing loss

Physical and Medical Needs

  • OT ‘Fun with Food’ Guidance – support for developing eating skills and addressing feeding difficulties
  • Paediatric Physiotherapy Service – advice and support for physical development and movement

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