LINDSEY FOSTER, ANGELA MAAYUF AND TAZMIN RAHMAN, SHERINGHAM NURSERY SCHOOL AND CHILDREN’S CENTRE, UK
JULIAN GRENIER, EDUCATION ENDOWMENT FOUNDATION, UK; MEMBER OF DEPARTMENT FOR EDUCATION’S SEND INCLUSION IN EDUCATION EXPERT GROUP
Mainstream early years settings often include children with complex needs, as there is little specialist provision for children under five. This case study is about Zayd, who joined us at Sheringham Nursery School in October 2025.
Zayd (pseudonym) is a playful four-year-old with complex needs, including septo-optic dysplasia. Medically, he is described as a child with global developmental delay and neurological signs of motor disorder. His disabilities affect communication, vision, mobility, eating, social interaction and emotional regulation. Several nurseries had turned Zayd away because they felt unable to meet his needs.
When Zayd’s parents applied for a place at Sheringham, we read the paperwork about his needs and team members said that it felt ‘scary’. But carrying out a home visit and meeting Zayd was quite different. His key person, Tazmin, commented:
I noticed he had a lot of strengths and was keen to interact with me. I felt that once I understood his areas of difficulty, and by working in partnership with his family, we would be able to support him and help him to make progress.
When he started at Sheringham, we noticed that he really liked coming to an adult for cuddles and would initiate interactions. He would often throw toys at adults, which we thought was his way of saying that he wanted to interact and play. However, if other children approached him and wanted to play, he would usually cry and swipe toys out of the way. He had limited experience of being around other children.
Our priority was to help Zayd to communicate with others. Communication is fundamental to all aspects of learning. However, as Drager et al. explain, children with complex communication needs (CCN) can ‘fall further and further behind their peers and have limited opportunities for communication, language, literacy learning, and socialization’ (2010, p. 304).
To avoid this downward spiral, we used a range of strategies to build on Zayd’s drive to communicate.
Augmentative communication
The team at Sheringham use ‘core boards’ as part of everyday provision, with support from Newham’s speech and language therapy team. Core boards are laminated sheets featuring high-frequency words and their associated symbols – for example, ‘yes’, ‘no’, ‘want’, ‘stop’ and ‘help’. The team had already embedded the core board, so we could teach this to Zayd from his first day and give his parents a copy of the board to use at home.
The core board supports a wide group of children to express their needs and choices, including children who feel shy and those learning English as an additional language. It also acts as an emotional regulation tool for children who struggle to express their feelings verbally. As a result of this whole-class approach, Zayd could communicate with his peers, and they with him.
The ShREC approach
Sharing attention and developing back-and-forth interactions are crucial to children’s early development. We therefore wanted to make sure that we were not solely focusing on Zayd’s functional communication, based on single symbols on the core board. Sheringham Nursery School developed the ShREC approach (Ang et al., 2025), which the Education Endowment Foundation has disseminated widely (James, 2025). ShREC is a mnemonic to prompt educators to develop back-and-forth conversation with children:
- Share attention: Be at the child’s level; pay attention to what they are focused on
- Respond: Follow the child’s lead; respond to their non-verbal or verbal communication
- Expand: Repeat what the child says and build on it by adding more words
- Conversation: Have extended back-and-forth interactions; give children time to listen, process and reply.
The team had to be responsive to Zayd’s style of communication and adapt the ShREC approach accordingly. For example, once he was engaged with an adult, Zayd found it difficult to share that attention with another child. Staff needed to give him lots of reassurance that they had not ‘forgotten’ him, while also introducing him to a manageable amount of frustration by responding to other children so that he had to take his turn. Staff also introduced pauses, to encourage Zayd to take a lead and give him more time for processing and deciding what he wanted to communicate. As a result, Zayd increased his use of vocalisation, clapping and signs, to keep interactions going.
Rethinking the environment
At first, Zayd needed educators to move him from one area of the room to another. He would sit on the floor, with the support of an educator, as he played. He could not see other areas of the room clearly or move independently.
While most of our actions were based on adapting the approaches to care and teaching that we use with all children, we also needed to make further changes based on our observations of Zayd. This required time for team discussion, as everyone had important insights to share. It also required specialist input from the external health teams – for example, occupational therapy.
We noticed that staff would sometimes walk towards Zayd and then bend down to interact with him. We felt that this might feel off-putting. We also noticed that Zayd was starting to ‘scoot’ on his knees, but there would often be equipment (like wooden blocks) that barred his way.
We therefore reordered the room to make more space between large items of furniture, and set out more items at a lower level for Zayd to reach. We explained to the children that we needed their help with keeping routes tidy and clear. We bought some low, wheeled stools so that adults could move around with Zayd without looming over him.
Supporting progress
After a term and a half in nursery, Zayd was smiling at peers, accepting them sitting beside him and confidently signalling his needs to adults. He was able to see items at his eye level and move towards them on his knees. He was developing a sense of ‘belonging’ in the group – something hugely important to Zayd and his parents, but difficult to quantify.
As Drager et al. comment, ‘the earlier intervention begins, the better the outcome may be, resulting in increased quality of life’ (2010, p. 305). Zayd’s greater independence and ability to communicate were enabling him to make choices and decisions – skills that will give him greater self-determination at primary school.
Rather than centring our planning around Zayd’s medical diagnosis and perceived deficits, we adopted a strengths-based model, identifying and extending his capabilities to play and learn alongside his peers. While the paperwork around children’s medical diagnoses might seem overwhelming, our experience of including Zayd in the nursery did not require as many individualised approaches or stretches of one-to-one support as anticipated. Instead, we used high-quality, evidence-informed approaches, like ShREC and augmentative communication, in a way that is inclusive and beneficial to all children. Florian and Black-Hawkins helpfully describe this process as ‘seeing difficulties in learning as professional challenges for teachers, rather than deficits in learners, that encourage the development of new ways of working’ (2011, p. 819).
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