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BwD Early Years Case Study (2): Concerns around Physical Development (PD)


BwD Early Years SEND Support Service has provided details of several cases in which they have been involved.

We hope that by reading these case studies, you will gain a better understanding of

  • what we do
  • how we tailor our service to suit the individual needs of children
  • what impact and outcomes result from the work we do with individual children

Please be aware that the children's names used  are not the actual names.

For further advice and information, please contact our team on 01254 666697.

What was the concern?

Child 'Aiza' accessed nursery provision on a 2 year funded place following involvement from the Portage team.

Concerns at the time of a nursery place being allocated were  around 'Aiza's' development. She had no facial expressions,was lacking muscle tone and unable to pull to stand, she was Pre-verbal and  was unaware of adults and children.

Which professionals were involved?



Early Years SEND Support Team

Speech & Language


 Community Support Officer



What interventions and other strategies were used to help?

Initial advisory teacher oversight with strategies provided  for nursery to implement.

A targeted plan was devised by the Nursery Teacher.

Shared support from the SEND Team with a Special Support Assistant (SSA)

The SSA provided daily physiotherapy  based on set targets, daily speech & language therapy activities,Makaton,daily sensory tray using at first dry and then wet substances



What effect did these have? Impact and Outcomes

Child 'Aiza' continued to access nursery provision and received  SSA support. 

A referral has been made to Educational Psychology in preparation for an Education, Health and Care Plan.

When Child 'Aiza' started at nursery, she had limited facial expressions,unmotivated, she was pre-verbal and made few vocalisations.

Child 'Aiza' was unable to crawl any distance and unwilling to walk on different surfaces when she was on her feet,she had reduced body strength to stand and unable to pull to stand.

She was unable to tolerate foods and was tactile sensitive even towards soap and water.

 Over the past eleven months with the support received from the Special Support Assistant and the additional support given by keyworker good progress has been made.

  Child 'Aiza' is now able to bend down with hands on the table to support , walk using a sturdy pram to lean on (like a walker) able to rise from sitting on a block. She enjoys walking outside holding hands with an adult.

Can climb, pull to stand, walk unaided, squat and rise, tolerate most textures now i.e. glue/paint, unpeel and small pieces of banana, drink from an open cup.

She is now able to vocalise and sign family members and a few animal names; she has now been discharged from physio.

She now has a solid word bank of at least seventeen words and is attempting to put 2 words together.

What did the child / parents have to say?

Child ' Aiza' now use gestures and facial expressions.

She enjoys nursery and demonstrate feeling excited, happy and sad.

Mum said at a progress meeting that she was very proud of  'Aiza' and was pleased with her progress and the ongoing support she received from the SSA.