Glossary

Avoidant/restrictive food intake disorder (ARFID) is a relatively new term, that was introduced in 2013 when it first appeared in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013). It has also previously been known as Selective Eating Disorder.

It is anticipated that it will similarly, make its debut in the World Health Organisation’s next edition of its equivalent (the ICD). Favoured by European countries, the next edition of the ICD (ICD-11) was presented at the World Health Assembly in May 2019 for adoption by Member States, and will come into effect on 1 January 2022.

The entry of ARFID into the DSM-5 was significant in that it had previously existed under an umbrella term used to encompass all ‘other infant and early childhood’ feeding disorders.

ARFID is characterised by a pattern of eating that avoids certain foods or food groups entirely and/or is restricted in quantity (eating small amounts). Avoidant and restrictive eating cannot be due to lack of available food, or cultural norms (e.g. someone who is fasting or chooses not to eat certain foods for religious or cultural reasons alone).

ARFID is different to other restrictive eating disorders in that:

​ARFID isn’t affected by a person’s beliefs about the size and shape of their body.

​Someone with ARFID doesn’t restrict their food intake for the specific purpose of losing weight.

​​ARFID doesn’t feature some of the other behaviours that can be associated with anorexia, bulimia, or OSFED, such as over-exercising. www.arfidawarenessuk.org/

Autism can also know as Autism Spectrum condition (ASC) or Autism spectrum disorder (ASD) is a lifelong developmental disability that affects how people perceive the world and interact with others.

Autistic people see, hear and feel the world differently to other people. If you are autistic, you are autistic for life; autism is not an illness or disease and cannot be ‘cured’. Often people feel being autistic is a fundamental aspect of their identity.

Autism is a spectrum condition. All autistic people share certain difficulties, but being autistic will affect them in different ways. Some autistic people also have learning disabilities mental health issues or other conditions meaning people need different levels of support. All people on the autism spectrum learn and develop. With the right sort of support, all can be helped to live a more fulfilling life of their own choosing. www.autism.org.uk

ADHD is a common condition that’s caused by differences in the brain. People with ADHD have trouble with focus. But some are also hyperactive and impulsive. That’s especially true with kids and teens. 

It’s not clear exactly how many people in the United States have ADHD. But estimates are between 5 and 11 percent.

People with ADHD have trouble with a group of key skills known as executive function. And that creates challenges in many areas of life, from school to work to everyday living. For example, people with ADHD often struggle to get organized, follow directions, and manage their emotions.

ADHD isnt a matter of laziness or willpower  —that’s one of many myths about it. In fact, people with ADHD are often trying as hard as they can to focus and keep their impulses in check.

For a long time, people thought ADHD was something only kids—boys, in particular—had. But research shows that adults also struggle with ADHD, and that women ad girls have it as often as men and boys. https://www.understood.org

Attention deficit hyperactivity disorder (ADHD) is a condition that affects people’s behaviour. People with ADHD can seem restless, may have trouble concentrating and may act on impulse.

Symptoms of ADHD tend to be noticed at an early age and may become more noticeable when a child’s circumstances change, such as when they start school.

Most cases are diagnosed when children are 3 to 7 years old, but sometimes it’s diagnosed later in childhood.

Sometimes ADHD was not recognised when someone was a child, and they are diagnosed later as an adult.

The symptoms of ADHD usually improve with age, but many adults who were diagnosed with the condition at a young age continue to experience problems.

People with ADHD may also have additional problems, such as sleep and anxiety disorders.

One of the leading charities for ADHD are the ADHD Foundation

https://www.nhs.uk/conditions/attention-deficit-hyperactivity-disorder-adhd/

Avoidant Restrictive Food Intake Disorder (ARFID) is a new diagnosis in the DSM-5, and was previously referred to as “Selective Eating Disorder.” ARFID is similar to anorexia in that both disorders involve limitations in the amount and/or types of food consumed, but unlike anorexia, ARFID does not involve any distress about body shape or size, or fears of fatness.

Although many children go through phases of picky or selective eating, a person with ARFID does not consume enough calories to grow and develop properly and, in adults, to maintain basic body function. In children, this results in stalled weight gain and vertical growth; in adults, this results in weight loss. ARFID can also result in problems at school or work, due to difficulties eating with others and extended times needed to eat. www.nationaleatingdisorders.org

CAMHS stands for Children’s & Adolescent mental health service, CAMHS are responsible for the service which asseses and treats children/adolescents with emotional, behavioural or mental health difficulties. In Liverpool we have the CAMHS partnership which comprises of lots of different services coming together to support our children with a wide range of emotional, behaviour and various mental health conditions.

more information can be found here.

Disability Living Allowance (DLA) is money for people who have extra care needs or mobility needs (difficulty getting around) as a result of a disability. There are two parts called components: the care component and the mobility component. You may qualify for one or both of these.

www.turn2us.org.uk

Dyspraxia, is a form of developmental coordination disorder (DCD) is a common disorder affecting fine and/or gross motor coordination in children and adults. It may also affect speech. DCD is a lifelong condition, formally recognised by international organisations including the World Health Organisation. DCD is distinct from other motor disorders such as cerebral palsy and stroke, and occurs across the range of intellectual abilities. Individuals may vary in how their difficulties present: these may change over time depending on environmental demands and life experiences.

Children may present with difficulties with self-care, writing, typing, riding a bike and play as well as other educational and recreational activities. In adulthood many of these difficulties will continue, as well as learning new skills at home, in education and work, such as driving a car and DIY.
There may be a range of co-occurring difficulties which can also have serious negative impacts on daily life. These include social and emotional difficulties as well as problems with time management, planning and personal organisation, and these may also affect an adult’s education or employment experiences.

Many people with DCD also experience difficulties with memory, perception and processing. While DCD is often regarded as an umbrella term to cover motor coordination difficulties, dyspraxia refers to those people who have additional problems planning, organising and carrying out movements in the right order in everyday situations. Dyspraxia can also affect articulation and speech, perception and thought. https://dyspraxiafoundation.org.uk/

Dyslexia is a common learning difficulty that can cause problems with reading, writing and spelling.

It’s a specific learning difficulty, which means it causes problems with certain abilities used for learning, such as reading and writing.

Unlike a learning disability , intelligence isn’t affected.

It’s estimated up to 1 in every 10 people in the UK has some degree of dyslexia.

Dyslexia is a lifelong problem that can present challenges on a daily basis, but support is available to improve reading and writing skills and help those with the problem be successful at school and work.

Signs of dyslexia usually become apparent when a child starts school and begins to focus more on learning how to read and write.

A person with dyslexia may:

• read and write very slowly
• confuse the order of letters in words
• put letters the wrong way round (such as writing “b” instead of “d”)
• have poor or inconsistent spelling
• understand information when told verbally, but have difficulty with information that’s written down
• find it hard to carry out a sequence of directions
• struggle with planning and organisation

But people with dyslexia often have good skills in other areas, such as creative thinking and problem solving. https://www.nhs.uk/conditions/dyslexia/

Dyscalculia is a specific and persistent difficulty in understanding numbers which can lead to a diverse range of difficulties with mathematics. It will be unexpected in relation to age, level of education and experience and occurs across all ages and abilities. www.bdadyslexia.org.uk

Dysgraphia is characterized as a learning disability in the category of written expression when
one’s writing skills are below those expected given a person’s age measured through
intelligence and age appropriate education.

The word dysgraphia comes from the Greek words dys meaning “impaired” and graphia meaning
“writing by hand”.
Dysgraphia is deficiency in the ability to write, primarily in terms of handwriting, but also in terms of
coherence. Dysgraphia is a transcription disability, meaning that it is a writing disorder associated
with impaired handwriting, orthographic coding (the storing process of written words and
processing the letters in those words), and finger sequencing (the movement of muscles required
to write). It often overlaps with other learning disabilities. such as speech impairment, attention
deficit disorder (ADD), or Dyspraxia. www.dyslexia.uk.net

Early Help refers both to help in the critical early years of a child’s life, when the fundamental building blocks of future development are laid but also help throughout a child, young person’s and families life to respond, as soon as possible, when difficulties emerge in order to prevent problems from becoming entrenched or escalating.

This strategy is a ‘starting point’ for all Liverpool strategic partners, including voluntary partners, to consider how Early Help, delivered in partnership with children, young people and families can improve life chances, particularly for families experiencing complex and multiple difficulties. The aim is for partners to make a commitment to work differently.

This means adopting a whole systems approach to service redesign to ensure families receive Early Help as soon as difficulties emerge. https://liverpool.gov.uk/

Educational psychologists work within local authorities, in partnership with families and other professionals, to help children and young people achieve their full potential. Educational psychologists support schools and the local authority to improve all children’s experiences of learning.

They use their training in psychology and knowledge of child development to assess difficulties children may be having with their learning. They provide advice and training on how schools might help children to learn and develop. They recommend methods, or develop strategies in partnership with schools, to help a child learn more effectively. Strategies may include teaching approaches, improvements to learning environments, advice on curriculum materials and behaviour support.

Educational psychologists also keep up-to-date with best practice, policy and research relating to how children learn and make sure this informs local policy and practice.

Educational psychologists may also be involved in, and advise, local authority groups considering additional support for learning policy or provision. https://enquire.org.uk/

EHAT is a tool used for gathering information and a standard approach in assessment for the identification of Early Help needs.

The EHAT helps practitioners to gather and understand information about the needs and strengths of children and the family. This is based on discussions with children and their family and other practitioners as appropriate. 

Early Help is about: 

Identifying needs of children, young people and their family across a continuum of need (click here for LSCB’s Responding to Need Guidance and Levels of Need Framework).

Understanding and responding quickly to identified needs.

Listening to children and Families so that their views are informing what happens next.

Supporting and re-focusing resources from crisis to prevention, and helping to avoid concerns repeating over time.

Supporting families to achieve their full potential and thereby mitigate the impact of issues such as child poverty and health inequalities.

Providing the context for multi-agency working to help children and families achieve improved outcomes.

Background 

Early Help is a key part of delivering frontline services that are integrated and focused around the needs of children and young people. 

The EHAT is a standardised approach to conducting an assessment of Children’s needs and deciding how those needs should be met. It can be used by practitioners across children’s services. 

When is an EHAT needed? 

The EHAT will promote more effective, earlier identification of additional needs, particularly in universal services. It is intended to provide a simple process for a holistic assessment of a children’s needs and strengths, taking account of the role of parents, carers and environmental factors on their development. 

Practitioners will then be better placed to agree, with the child and family, about what support is appropriate. The EHAT will also help to improve integrated working by promoting co-ordinated service provision. 

The EHAT is not intended to replace or delay any concerns around child protection. If you believe a child is at risk please report it. 

An EHAT is a useful tool when reporting concerns, as this can show what is already known about the children in a family, what actions have been taken, who is involved in supporting the family, and why the level of concern needs to be reported as a risk. https://ehd.liverpool.gov.uk/

Some children with special educational needs (SEN) in England need more help than a mainstream school, college or nursery would normally provide at the level of SEN support. These pupils receive support through an Education, Health and Care (EHC) plan.

Who needs and EHC plan?

An EHC plan is a legal document that describes a child or young person’s special educational, health and social care needs, explains the extra help that will be given to meet those needs and how that help will support the child or young person to achieve what they want to in their life.

EHC plans are for children and young people whose special educational needs require more help than would normally be provided in a mainstream education setting (a college, school, nursery).

Although the plan can include health or social care needs, your child will not get a plan if they only have health or social care needs that do not affect their education.

An EHC plan can be issued to a child or young person between the ages of 0 and 25 years.

How can i get and EHCplan?

EHC plans are drawn up by the local authority after an EHC needs assessment. You, your child’s education setting or your child, if over 16, can ask your local authority to carry out an assessment.

What does and EHC plan look like?

There is no national standard format for the EHC plan. However it must have certain sections that are clearly labelled.

The sections are:

A: The views, interests and aspirations of you and your child.
B: Special educational needs (SEN).
C: Health needs related to SEN.
D: Social care needs related to SEN.
E: Outcomes – how the extra help will benefit your child
F: Special educational provision (support).
G: Health provision.
H: Social care provision.
I: Placement – type and name of school or other institution (blank in the draft plan (link to info about draft plan))
J: Personal budget arrangements.
K: Advice and information – a list of the information gathered during the EHC needs assessment.

The different sections may at first seem like a confusing alphabet soup. It can help to understand that there are three sections on needs (i.e. your child’s difficulties) that are matched by corresponding provision (the help your child will get) to meet those needs:

• “Section B: Special educational needs” are met by “Section F: special educational provision”.
• “Section C: Health care needs” are met by “Section G: health care provision”.
• “Section D: Social care needs” are met by “Section H: social care provision”.

See our page on getting an EHC draft plan for a more detailed look at each section.

The plan must be reviewed at least once a year. At the end of the review the local authority may make changes to the plan, end it or leave it unchanged. Read more about annual reviews.

The plan will remain in place until your child leaves education or the local authority decides that your child no longer needs the plan to help them in their education. If you move to another local authority the plan will be transferred. See more about a change in circumstances . www.contact.org.uk

FASD is a life-long condition that can affect a child’s brain development, behaviour and growth.⁶ It’s caused by a developing unborn baby (fetus) being exposed to alcohol in the womb.

The severity of the problems caused by FASD is wide-ranging, but there is no such thing as ‘mild’ FASD.⁹ No two children with FASD are exactly alike, either behaviourally or physically,¹⁰ but they all face serious, life-long implications for their health and wellbeing.

FASD can cause problems with:¹¹

• Movement, balance, vision and hearing
• Learning, such as problems with thinking, concentration, and memory
• Managing emotions and developing social skills
• Hyperactivity and impulse control
• Communication, such as problems with speech
• Joints, muscles, bones, and organs such as the kidneys and heart

These can create great difficulties for individuals in their childhood that persist throughout life, with a greater likelihood of facing problems at school, trouble with the law, substance misuse problems and risky or inappropriate sexual behaviours.¹²

In a minority of cases (fewer than one in 10)¹³ FASD may be associated with characteristic facial features too – small and narrow eyes, a small head, a smooth area between the nose and the lips and a thin upper lip.¹⁴

Among those children most severely affected, in addition to the problems listed above, they may have additional serious problems including:^15,16

• Epilepsy
• Hearing and ear problems
• Height and weight issues
• Hormonal disorders
• Liver damage
• Mouth, teeth and facial problems
• Weak immune system

www.drinkaware.co.uk

What is global developmental delay?

The term ‘developmental delay’ or ‘global development delay’ is used when a child takes longer to reach certain development milestones than other children their age.

This might include learning to walk or talk, movement skills, learning new things and interacting with others socially and emotionally.

Someone with another condition, like Down’s syndrome or Cerebral palsy, may also have Global developmental delay.

Global development delay and learning disability.

For some people, the delay in their development will be short ­term and can be overcome with additional support or therapy.

In other cases the delay may be more significant and the child will need ongoing support. This indicates they may also have a learning disability. 

GDD is a commonly used abbreviation of global development delay. www.mencap.org.uk

Graduated approach (sen support)

A child or young person has special educational needs if they have a learning difficulty or disability which requires special educational provision to be made.  This could be to do with behaviour or ability to play with other children, academic progress, ability to understand, ability to concentrate or perhaps their physical ability is affected in a way that makes it difficult for them to learn.   

This cycleshould not be considered a single process.  There may be more than one cycle at a time, each addressing different areas e.g. literacy, social skills, attention and/or behaviour. After the Review, a second or third cycle might start, each aiming to improve the support for the child.

Assess    

The class teacher, working with the SENCo, discusses the child’s needs and creates a baseline assessment by which progress will be measured. Schools should also take seriously any concerns raised by parents.  

The assessment should be reviewed regularly, with specific dates set for the next review.

Plan 

A plan of additional support is drawn up for a pupil, a record must be kept and the parents MUST be informed.  

The school and parents should agree what progress they hope will be made (outcomes), and by what date (deadlines).

Do  

The pupil is given extra support, undertaken under the supervision of the class teacher.  

Review  

The SEND Code of Practice (2015) is not specific about the frequency of reviews, but termly would fit in with the requirement to meet parents three times per year. Parents should be fully involved. 

Schools can bring in specialists at any time to advise them on assessing SEN, especially in the early stages, and to offer advice on what support to give.

A school should always involve a specialist when a pupil makes little or no progress, or when their work is significantly behind that of other typically developing pupils of the same age. Progress should not be compared to other pupils who may also have SEN.

The pupil’s parents should always be involved in any decision to involve specialists.

The graduated approach covers all ages and stages of education (nursery, school and post-16).

www.sen-help.org.uk

Hypermobility is the term used to describe the ability to move joints beyond the normal range of movement. Joint hypermobility is common in the general population. It may be present in just a few joints or it may be widespread. It is most common in childhood and adolescence, in females, and Asian and Afro-Caribbean races. It tends to lessen with age. In many people joint hypermobility is of no medical consequence and commonly does not give rise to symptoms. Hypermobility can even be considered an advantage, for example athletes, gymnasts, dancers and musicians might specifically be selected because of their extra range of movement. https://www.hypermobility.org/

A meltdown is an intense response to an overwhelming situation. It happens when someone becomes completely overwhelmed by their current situation and temporarily loses control of their behaviour. This loss of control can be expressed verbally (eg shouting, screaming, crying), physically (eg kicking, lashing out, biting) or in both ways. 

A meltdown is not the same as a temper tantrum. It is not bad or naughty behaviour. When a person is completely overwhelmed, and their condition means it is difficult to express that in another way, it is understandable that the result is a meltdown. 

Meltdowns are not the only way an autistic person may express feeling overwhelmed. They may also refuse to interact, withdrawing from situations they find challenging or avoiding them altogether. https://www.autism.org.uk/advice-and-guidance/topics/behaviour/meltdowns/all-audiences

PDA (Pathological Demand Avoidance) is widely understood to be a profile on the autism spectrum, though we are still at an early stage in our understanding and PDA research is in its infancy.

Whilst autism is a widely recognised term, our understanding of the full breadth and complexity of the autism spectrum is still evolving.

The National Autistic Society explains autism as “a lifelong developmental disability which affects how people communicate and interact with the world”. Many autistic advocates embrace the social model of disability and view a range of neurological differences as being part of a natural human variation (neurodiversity).

We know that autism is dimensional – it involves a complex and overlapping pattern of strengths, differences and challenges that present differently from one individual to another and in the same individual over time or in different environments.

A cluster of traits can be called a presentation or a profile – in some cases this can be quite different from what some people think autism ‘looks like’.

This can lead to presentations in some people – including autistic women and girls, and PDA individuals – being missed altogether, misunderstood or misdiagnosed, which can in turn lead to poor outcomes.

All research points to early identification and tailored support being the best predictor of positive long-term outcomes. Recognising these profiles signposts the approaches or support that will be most helpful for each individual.

A PDA profile of autism means that individuals share autistic characteristics …

• currently defined as “persistent difficulties with social communication and social interaction” and “restricted and repetitive patterns of behaviour, activities or interests” present since early childhood to the extent that these “limit and impair everyday functioning” (according to the Diagnostic and Statistical Manual Fifth Edition (DSM-5))
• often including a different sensory experience in relation to sight, smell, taste, touch, hearing, vestibular, proprioception and interoception.

… and in addition:

• have a need for control which is often anxiety related
• are driven to avoid everyday demands and expectations (including things that they want to do or enjoy) to an extreme extent
• tend to use approaches that are ‘social in nature’ in order to avoid demands
• present with many of the key features of PDA rather than just one or two
• tend not to respond to conventional parenting, teaching or support approaches

A PDA profile of autism is normally identified during an ASD assessment undertaken by an experienced multi-disciplinary diagnostic team. https://www.pdasociety.org.uk/what-is-pda-menu/about-autism-and-pda/

We have regular coffee mornings once a month, the dates are advertised on our parents support page.

Pica is an eating disorder that involves eating items that are not typically thought of as food and that do not contain significant nutritional value, such as hair, dirt, and paint chips. 

Typical substances ingested tend to vary with age and availability. They may include paper, soap, cloth, hair, string, wool, soil, chalk, talcum powder, paint, gum, metal, pebbles, charcoal, ash, clay, starch, or ice. 

The eating of these substances must be developmentally inappropriate. In children under two years of age, mouthing objects—or putting small objects in their mouth—is a normal part of development, allowing the child to explore their senses. Mouthing may sometimes result in ingestion. In order to exclude developmentally normal mouthing, children under two years of age should not be diagnosed with pica. https://www.nationaleatingdisorders.org/

Selective mutism is a severe anxiety disorder that affects both children and adults. It is believed that one in 150* children are affected and it is more common in girls that in boys. In this specially commissioned blog, Carl Sutton from iSpeak discusses growing up with this misunderstood disorder.

From the age of 14 until I was 23, I was unable to speak at home. I could speak outside of it, with select friends at school, college and later university. But not at home. This was not ordinary teenage reticence. Regardless of the distress it caused me, the humiliating situations I found myself in, or the punishment I received, there was absolutely no way that I could speak, even when I desperately wanted to. I was suffering from an uncommon pattern of selective mutism.

Selective mutism is a situational anxiety disorder, which can be likened to a phobia of speech. It almost always develops in early childhood – as it did for me. And for me it became much worse at around 14 years old. However having met an older adult with selective mutism I can state that it can potentially be lifelong.

While selective mutism may seem like something people choose to do (the old name for this condition used to be aphasia voluntaria) this is absolutely not the case. Muteness is triggered by the proximity of given specific individuals or groups of people. It becomes instinctive. Triggers may be generalized: other students, teachers, shopkeepers, or even work colleagues. Or triggers may be much more specific: your aunt, uncle, siblings or parents. Most people with selective mutism have a mixture of generalized and specific triggers. During the worst of my own selective mutism, my primary triggers were my stepfather, mother, stepsister, stepbrother, sister-in-law and so on. As this started in early childhood, none of my grandparents ever heard my voice. They died long before I was able to speak freely. https://www.rethink.org/

SEN means special educational needs, IPSEA define SEN as:

Special educational needs (“SEN”) can affect a child or young person’s ability to learn. For example, someone’s SEN might affect their:

• reading and writing, for example because they have dyslexia
• ability to understand things
• behaviour or ability to socialise, for example they struggle to make friends
• concentration levels, for example because they have ADHD
• physical ability to do things such as writing.

More in depth information can be found on the IPSEA website here.

A SENCo, or special educational needs co-ordinator, is the school teacher who is responsible for assessing, planning and monitoring the progress of children with special needs / SEN.

n some people, the brain has trouble organizing and responding to information from the senses. Certain sounds, sights, smells, textures, and tastes can create a feeling of “sensory overload.” Bright or flickering lights, loud noises, certain textures of food, and scratchy clothing are just some of the triggers that can make kids feel overwhelmed and upset.

There are two types of sensory processing challenges, and many kids experience a mix of the two. One is oversensitivity (hypersensitivity). This leads to sensory avoiding—kids avoid sensory input because it’s too overwhelming. The other is undersensitivity (hyposensitivity). This causes kids to be sensory seeking—they look for more sensory stimulation.

Often, kids with sensory processing issues are oversensitive. They try to avoid sensations they find intolerable.

But some kids seek more sensory input, not less. They may want to touch things and feel physical contact and pressure. They may also be undersensitive to pain and have an unusually high tolerance for it. That’s why they may prefer playing rough and not understand if they’re hurting someone.

Some kids may be both sensory avoiding and sensory seeking. They may be oversensitive to some sensations, and undersensitive to others. A child’s reactions can also change from one day to the next, or even throughout the day, depending on the environment or situation.

Sensory processing issues aren’t a specific learning disability. But they can still have a large impact on learning. www.contact.org.uk

Speech and language is often associated with those who are non verbal or preverbal, but Speech and language therapy can help our children with any form of communication difficulties. To find out more