Children may struggle with some, or all of the following presenting needs. Outlined are some strategies to help support. 

Attending and listening

A child may have difficulty focusing on the speaker, or the spoken word sufficiently, or long enough to learn or interact. This will have an impact on the language learning process and on learning in the classroom. They may have difficulty developing dual-channelled attention. This is where the child can carry out one activity whilst attending to someone else giving them directions.

Support Strategies:

• Always treat it as a difficulty and not as a negative behaviour.  
• Use appropriate levels of language. You will likely need to slow down your talking speed and use simple, clear language. 
• Set realistic expectations so that the child knows how long they will have to keep this effortful (for them) listening behaviour. 
• Work for short periods with regular breaks. 
• Work in small groups where successful listening and attention may become competitive. 
• Build attention to environmental sounds, clapping rhythms or responding to a keyword early on. 
• Work with the child to minimise the difficulty. 
• Reduce background noise and visual distractions. 
• Check for interfering stimuli such as tickly clothes labels and tight shoes. 
• Consider where the child is sitting and proximity to the speaker. Closer to the speaker will increase the impact and immediacy of the message. Allow direct, straight on looking at the speaker/teacher. 
• Consider what is behind the speaker and make adjustments if needed. For example; windows, light reflections and clutter). 
• Teach a whole class a 'good listening' regime with accompanying visuals and a 'caring to listen' element built-in. 
• Encourage the child to verbalise what makes a good listener by cueing them in. This can be by pointing to eyes, ears or pictures that represent each skill. 
• Use visual supports such as pictures, conceptual symbols (such as widget symbols), diagrams and mind maps. 
• Set the child's attention and call their name before speaking.
• Praise for individual skills from the good listening regime, being ready to listen and doing 'good looking'. 
• Reward for any personal success, however minimal. Examples include an 'I showed good listening' sticker or a tick on a chart. 
• Have a clear understanding of what attention skills can be expected with each age span. 
• Build listening and attention skills by adjusting tasks to the child's attention span. Ideas might include following simple instructions to find hidden objects, carrying out barrier games or putting their hand up each time a character is mentioned in a simple story.

Analyse whether a child has developed dual channelled attention. Explain and label the skill and what is required of them. Play a game and develop this skill - for example, the child draws a picture and the adult gives information verbally, then ask the child questions about what was heard. 

Support the child in the classroom to transfer attention to the teacher when oblivious. Use the child's name to break through the lack of awareness. 

By the end of primary school use an 'ask, listen and check' technique. This prompts students to listen closely to a conversation and provides a structure for continuing the conversation. The student asks a question and listens to the answer. They then ask a question to further clarify the answer or get more information. 

Recommended Resource: Book "Whole Body Listening Larry at School" and "Whole Body Listening Larry Poster".  

Difficulty maintaining attention 

This may be presented by the child looking blank, not listening, paying attention or self-distracting. This could be due to difficulty processing and understanding continuous language. 

Support Strategies:

• Understand the barriers to maintaining understanding.
• Always treat it as a difficulty and not negative behaviour. 
• Ensure the child is included in the group even if they don't appear to be listening. Give regular positive looks and attempts to make eye contact. 
• Target underlying difficulties such as vocabulary deficits. 
• Adapt your language to be understood. 
• Use simpler sentences. 
• Slow down and pause to allow for extra thinking time. 
• Repeat key points and summarise at the end. 
• Use plenty of visuals. 
• Break up continuous talking. 
• Write, draw and demonstrate when possible or applicable. 

Difficulty holding onto what has been heard

A child may present this in a variety of ways including echoing what has been said, remembering only keywords or final words of sentences they have heard. They may fail to understand the whole content or even the essence of what has been said. 

This is often described as 'short-term memory difficulties'.  

Support Strategies: 

• Help the child to understand what 'short-term memory' is. 
• Teach what factors can make short-term memory weaker. For example tiredness, hunger or distractions in their environment. 
• Develop their knowledge of memory aids that adults and children use. These can include planners, pinboards notes and calendars. 
• Encourage the use of memory aids the child finds helpful such as drawings, notebooks, pictures and lists. Monitor the use of the memory aid the child uses. 
• Teach memory strategies: 
  • Repeating strategy: Where a verbal message is kept alive in short-term memory longer, and long enough to be analysed. 
  • Visualising strategy: Where a mental image can help to keep information alive for longer. 
• Play memory activities for therapy and practice. 
• Enhance self-esteem by praising independent use of memory aids and strategies. 

Useful Resource: "Short Term Memory Difficulties in Children" - A practical resource. 

Difficulty following instructions 

This may be presented by the child making errors, reliance on following what their peers are doing or looking blank/anxious. The difficulty may increase with the increase in length of the instruction, with the grammatical complexity or the inclusion of unknown words. 

Support strategies: 

• Set the child's attention before giving instructions. 
• Be aware of how many parts to an instruction the child can follow. 
• Slow down delivery and uses pauses to allow the child time to process what has been said. 
• Give individual instructions to encourage independent listening, rather than allowing the child to follow what peers do. 
• Give instructions in the correct time-ordered sequence. For example, "Put your books away before you go out to play" rather than "before you go out to play put your books away". 
• Reinforce abstract instruction with specific instructions. Such as reinforcing "it's PE time" with "this means get your PE kit and put it on so we can go outside". 
• Play games that involve giving instructions at an appropriate level. Examples include: 
  • Simon Says: Instructions are short such as "put your hands on your head" or "touch your nose". 
  • More complex instructions such as "find the clown whose hat has a feather in it" where there is an array of clowns to look at. 
• Teach language that is needed to carry out instructions successfully. 
  • Prepositions when giving instructions that involve placing objects. For example "in", "on", "under"  and "next to". 
  • Relative clauses and categories for the child to be successful in following instructions, such as "find the person who is carrying office equipment". 
• Barrier games.
  • This is where the child and adult sit on either side of a barrier and each has a set of objects. Instructions are given to position the objects in relation to each other. Remove the barrier and see if the objects are in the same place.  
  • Another game to play is to use photocopied pictures to draw crosses on based on the instructions given. Or use blank paper to draw on according to instructions. 

Difficulty responding to questions

Presenting as giving incorrect, off-topic responses, or appearing blank and unable to respond. Difficulty may be experienced with 'why'/'how' questions or questions including words such as 'might' or 'should'. For example "what might the boy do next?" or "what should he do if...?". 

Support strategies:

• Encourage active listening strategies so that the child is confident to say they have not understood. 
• Simplify questions and use simple language structures to aid comprehension. 
• Use visual supports. 
• Check understanding of basic questions words such as "who? what? where? why? or how?". Address difficulty with each one separately.
• Consider whether it is the content or the question, the form or complexity or is weak memory responsible. 
• Be aware of the level of questioning the child can manage and build on this level. 
• Adapt your language with broader comprehension difficulties.
• A lot of confusion can occur around tense. Use symbols to indicate past, present and future. 
• Evaluate what level of sentence grammar is understood in order to not oversimplify where it is not necessary. 
• Be aware of the 'Blanks Levels of Questioning' which demonstrate a hierarchy of difficulties: 
  • 1. Very basic here and now questioning (who? what? where?). 
  • 2. More detailed here and now questioning and requests to describe. (What's happening? Find something that is a fruit. How are these different?). 
  • 3. Stories, events and definitions. (Tell me how to...? What is a... [definition required]? What will happen next?). 
  • 4. Questions around analysing and reasoning. (How could he...? What will happen if...? Why?).

Difficulty understanding the grammatical structure of what's been said

A child may present with confusion or with responses that do not match what has been said or do not follow the grammatical pattern. They may also seem to have a poor understanding of the rules that govern word structure, and the rules that govern word sequence and sentence structure. 

A child may also not understand the plural forms of words, only understand part of a sentence or have difficulty extracting meaning from complex sentences. This could include sentences in the passive voice, or sentences with subordinating clauses. 

Regular lack of understanding can lead to becoming accustomed to failing to understand. This may result in passive acceptance, and a need to be taught to ask for repetition or simplification. 

Support strategies:

• Use simple language structures to aid comprehension. 
• Adapt your language as you would with broader comprehension difficulties. 
• Use visual aids. 
• A lot of confusion can occur around tense. Use symbols to indicate past, present and future. 
• Evaluate what level of sentence grammar is understood in order not to oversimplify where it is not necessary. 
• Encourage active listening strategies so that the child is confident to say when they have not understood. 

Difficulty understanding due to a combination of the above

A child may present a combination of the above difficulties. They are highly likely to seem lost, uncertain, anxious and eventually disengaged. 

Support strategies:

• Depending on the severity of the difficulty, alternative methods of understanding and communication may be needed. These can include Makaton signing, ICT and communication books/boards. 
• Symbol communication systems such as 'Widgit' will aid all children with comprehension difficulties. They are an essential tool.  

Difficulty detecting the speech sound and syllable structure of words

This may be presented as difficulty in detecting (phonological awareness) "holding onto" and storing the form of new words as they are learnt, particularly when made up of several syllables. Acquiring these skills is essential for success in 'phonics' teaching. 

Phonological awareness difficulty impacts the learning of phonics which impacts literacy skill development. 

Support strategies:

• Address the underlying difficulty by analysing phonological awareness skills. Provide a phonological awareness programme before the child experiences failure in their phonics lessons and becomes de-motivated. 
• Address phonological awareness difficulty as this may also have a negative effect on vocabulary learning. 
• Develop specific awareness of individual consonants relating to how the sounds are made. 
• Use cued articulation signs to support awareness of individual speech sounds. 
• Analyse the structure of words in terms of syllable awareness, initial sound, final sound, vowel awareness and sound sequence.

Resource: "Cued Articulation" by Jane Passy. 

Difficulty detecting speech and sound patterns

This could be presented as difficulty detecting features such as rhyme. Being able to detect rhyme is important for literacy skill development. Learning speech sound patterns (rhyme) aids spelling using analogy techniques. 

A child with phonological awareness and concept learning difficulties may struggle to learn to detect rhyme. 

Strategies to support: 

• Play rhyme detection games. Start with two picture pairs to be matched such as king/wing and dog/log.
• Teach rhyme detection as something heard and not seen in letter patterns. This allows the child to understand the concept. 
• Use visual symbols (For example Widgit symbols) to show there are two parts to the word - onset and rhyme. One part is different and one part is the same. 
• Use a Talking Tin to record the onset and another to record the rhyme. Generate other initial sounds to record on Talking Tins but keep the one rhyme. Blend them together and declare "they rhyme". 
• Give lots of experience with rhyme in wordplay and storybooks. 
• Teach explicitly as this can be a difficult concept for many children to understand so they can detect rhyme independently. 

Difficulty learning, understanding and retaining new concepts and vocabulary

A child may present this by needing many more exposures to new words, how they are spoken, and how they are used to learn and retain them. 

In particular, difficulty can be experienced when learning abstract concepts. Psychological concepts, meta words (such as 'mental verbs') and time concepts are among them. 

Strategies to support: ​

• Select the level of vocabulary you feel is within the child's grasp. 
• Teach words in isolation and in context. 
• Build from concrete to abstract vocabulary. 
• Explicitly pre-teach before expecting to apply the vocabulary to a task or context. 
• Analyse the structure of words as described within the 'Difficulty detecting the speech sound and syllable structure of words' section above. 
• Analyse in terms of units of meaning such as prefixes, root words and suffixes. 
• Use conceptual pictures such as 'Widgit' symbols to help convey meaning. 
• Use visual prompts and support. 
• Relate each target word to previous world experience and to the new context it is to be used. 
• Activate using the words in games, drama and a variety of contexts and activities. 
• Review frequently to ensure the word and its meaning can be recalled. 
• Remember effortful retrieval aids further retrieval. 
• Keep logs of words learnt to aid review and only delete when sure the word is fully integrated into the child's knowledge and use. 
• Ensure class word walls include words and pictures/symbols. Create a personalised word wall.

Resources:

• "Word Aware 2" - Best used as a whole school approach to vocabulary learning. 
• "Word Aware 3" - Teaching vocabulary in groups for ages 6 to 11 years. 
• "Vocabulary Enrichment Programme" - Targeting ages 8 to 18 years. 

Difficulty understanding double or multiple word meanings

A child may present this as a lack of awareness of words that have double or multiple meanings. This is especially the case where one has a more literal meaning and one has a more psychological meaning. For example cold (temperature) and cold (emotionally). This may be presented as a revelation when this feature of our language is explained to exist.  

This can also be presented as difficulty in thinking flexibility when listening to connected speech. This could lead to the child accessing the incorrect meaning and losing understanding of what is being said. 

Strategies to support:

• Introduce explicitly the concept of double word meanings that can be readily depicted. Present picture pairs to the child, for example, bat/bat or leek/leak.
• Play matching or pairs games with the homophone pictures. 
• Give sentences where the child has to point to the correct picture/meaning of the word as used in the sentence. 
• Later move on to teaching double word meanings where one meaning is more abstract or physiological. For example, cold/cold or patient/patient. 'Widgit' symbols are good for showing many of these contrasts. 
• Support in the classroom by anticipating confusions where double word meanings arise. This will occur frequently as our language has lots of double/multiple word meanings.

Difficulty with understanding humour

A child may present this as a lack of understanding of jokes that are based on double word meanings or a play on words. They may feel socially excluded when they fail to understand the jokes their peers are telling. 

Strategies to support: 

• Target homophone jokes for analysis, targeting jokes where both meanings are known. For example, " What month do soldiers like best?". "March". 
• Explore the double word meanings on which the joke is based. 
• Provide visuals. 
• Retell the joke and give an explicit explanation. 
• Introduce further homophone jokes in a hierarchical way relating to the difficulty. 

Difficulty with reasoning skills

Presenting as confusion over cause, effect and involved 'reasoning sequences'. A child may have difficulty assigning meaning to visual information and identifying similarities and differences. They may also struggle to solve problems that require understanding concepts. 

A child might have difficulty interpreting verbal information and have difficulty understanding word problems in maths while having the ability to calculate using numbers. 

They may present with slowed information presenting and a lack of logic, have difficulty in using meta-cognition (thinking about thinking) and struggle taking/understanding another person's perspective. 

Social communication with peers could be difficult including having an altercation with someone else as they cannot follow their reasoning. A child could also have difficulty with a wide range of more advanced skills too, for example, making rational decisions based on evidence rather than prejudice.  

Strategies to support:

• Build reasoning skills from a low base, asking whether the child can match the concept (things that go together). Can they detect similarities/differences or classify objects. These skills should be developed as a first step. 
• Support with the identification of cause and effect. Use picture descriptions of what happened and the outcome as a result of this. The child can show this by ordering two picture sequences. 
• Support with the reasoning to interpret individual and sequential pictures. 
• Provide extended thinking time when giving reasoning tasks. 
• Provide thought bubbles accompanying pictures for the child to draw what the person is thinking relevant to the situation in the picture. 

Difficulty following non-explicit and changing rules 

This could be presented by the child showing an inability to follow a set of rules or instructions. This is especially difficult when trying to follow the rules of a playground game where there is no explicit explanation available. This can lead to social exclusion. 

Strategies to support:

• Play simple rule-based table-top games. Build this up gradually to more complex games. 
• Ensure all materials and actions in the game can be named. 
• Work on any difficult concepts using visuals to support your explanations. 
• Make each step of the game as explicit as possible. 
• Plan out step by step with visuals. 
• Test out understanding with "What if...?" tasks and scenarios.

Difficulty with inferential understanding

A child could present this by being unable to work out the underlying meaning or draw conclusions from pieces of information given. They may fail to understand the 'bigger picture' in situations like understanding the moral of a story. 

They may tend to take a literal understanding of what is being said, misunderstanding what is being said or misinterpreting the intention of what is being said. A child might present confusion or uncertainty as the child is aware they don't understand it. 

Strategies to support:

• Remember to work in all three mediums - visual, auditory and through reading.
• Give pictures and ask inferential questions. For example: Where are the people? How do you know? Or "What in the picture tells us that...?". 
• Give sentences using the word 'it'. The child will have to identify the 'it' from other information in the sentence. For example, "It escaped when my sister left the hutch door open". Make explicit the keywords that allowed us to infer the answer. 
• Give short written texts and ask inferential questions. Use highlighters to help make explicit the keywords that will lead to drawing the inference as a stepping stone to independent success. 
• Ensure the task is within the child's capability. 

Difficulty understanding non-literal language

A child may show this as a revelation. They could be completely unaware of idioms and may not make sense of idioms such as "caught red-handed" and "pull your socks up". 

Strategies to support:

• Draw attention to idioms and teach about the literal and hidden meaning. Create a picture of the literal meaning, this helps to remember the idiom and introduces humour. For example, "raining cats and dogs" and "pie in the sky". 
• Explain that groups of words can have different meanings, the same as individual words can. 
• Teach some contexts that idioms may be used in and give scenarios for the child to match to idioms they have learnt. 
• Support to spot new idioms seen in writing, or heard being used in conversations. 
• Remind the child of their active listening skills and encourage them to ask what it means. See if there are any other context clues. 
• Make a log of what idioms were used, who used them and the context in which they were used. 

Difficulty following taught routines

A child may present this difficulty as struggling to remember what has been asked of them, struggling with organisation and appearing vague and/or helpless. They may have difficulties organising their thoughts, managing their time and planning/knowing how to get things done. 

Strategies to support: 

• Be tolerant. Don't show exasperation at the child's failure to carry out the simplest of routines, even when they are carried out on a daily basis. 
• Support with visual/picture step-by-step planners. 
• Support by listening to the child verbalising the steps required on the planner. 
• When this is going well challenge the child to follow the routine by imagining the steps, with the planner turned over. 
• Give materials for the next step in a lesson. See if the child can infer what is to be done with them. 
• Lead and let the child complete a routine. 
• Praise for any degree of success.