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Puzzle Centre - a specialist early intervention nursery

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Introduction

''Puzzle is a very special place for special children - I wish I had found you sooner. I don’t know where I would be now if our son hadn’t come to Puzzle as I was quickly running out of ways I could help him. I can’t believe the change in our child, he is really blossoming into a lovely little boy.” (Parent)

Puzzle is a specialist early intervention centre based in Buckinghamshire, providing a specialist nursery for children on the autism spectrum aged between two and five. The centre is run by founder and director Alex Stanyer, and the nursery is managed by a specialist teacher who works in conjunction with a speech and language therapist to plan and deliver the foundation stage curriculum to meet the needs of children who are on the autism spectrum, or have other significant communication needs.

All children receive one to one support, teaching and therapy at each session, and an occupational therapist provides regular advice and guidance. Each family also receives regular home visits, and training workshops are available for parents throughout the year. Most children who attend Puzzle also attend a mainstream setting, and Puzzle staff will support this setting through visits as well as invitations for staff to spend time at Puzzle to observe the techniques and approaches used.

Puzzle is an Early Years provision and is also monitored by the local authority as an Independent Special School. It is registered with OFSTED as a day care setting and was judged to be providing outstanding care and education in every area at inspections in both 2006 and 2010.

This case study describes how Puzzle started and now operates, providing details of the approaches used for effective early intervention and transition, outreach services offered to both parents and professionals, and the challenges of funding the provision. Information and evaluation resources are also available to download.

While working for Buckinghamshire local authority in 1998, Alex Stanyer – founder of Puzzle, became involved in a working group set up by the child development team to look at the support offered to children on the autism spectrum following a positive diagnosis. At the time, there was no autism specific provision in place for families, and as such the clinical psychology service set up a six-week pilot project for pre-school children diagnosed to be on the spectrum. The project group met once a week and carried out small group intervention, working very intensively in a structured setting.

The project received very positive feedback from the families involved and it was felt that the pilot had real value. With no local authority funding available in the years to come, Alex Stanyer decided to open an independent provision in 2001. After a year of planning, Puzzle opened with places for six children, four mornings a week. There were two key staff members – a specialist teacher and a speech and language therapist. In 2004 Puzzle became a charity and moved to new premises in 2006.

“I’m so pleased we got Puzzle going – we have been able to help so many people. Puzzle’s model of working is very much a team effort. We pool expertise from specialist teachers and therapists to deliver a communication-enabling curriculum for children who find that communication and interaction present real challenges, and the process is incredibly rewarding for everyone involved.” Alex Stanyer, director of Puzzle

Puzzle is based in Buckinghamshire, but takes children from any locality. It is not far from the border with Oxfordshire, Milton Keynes, Hertfordshire, Bedfordshire and Northamptonshire, so children also come from these local authorities as well as occasionally from London boroughs.

The nursery’s main purpose is specialised and targeted intervention for pre-school children with autism or other communication difficulties. Some special education schools do take children from three years old, but many parents are not ready to make the decision to send their child to a special school so soon after diagnosis. Puzzle provides an autism specific provision for the whole family, at an age that is critical for children with autism.

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Puzzle is open Monday to Friday. It runs nine nursery sessions a week, with each session taking no more that eight children. The sessions are staffed on a one to one basis with a specialist teacher, speech and language therapist, nursery coordinator and a number of special learning assistants. An occupational therapist is also present once a week. Puzzle also runs a ‘play & say’ toddler group in conjunction with Sure Start for six weeks of the term. The group is for parents who have concerns about their toddler’s communication development and aims to model activities that they can also do at home. Some of the toddlers are referred through Sure Start, while others attend while they wait for a place to become available at Puzzle. Through the nursery sessions and toddler group, Puzzle provides for around 30 families a year, with an average of 20 to 25 children on the roll at any one time.

“We chose to send our child to Puzzle because it offered a wonderful structured environment with staff that were fully conversant with all aspects of ASD.  The fact that (our child) received one to one help and received regular speech therapy were also key factors.” The parent of a Puzzle pupil

Many of the children who attend Puzzle also attend a mainstream setting, and Puzzle staff provide support to other carers and staff in these nurseries and pre-schools, and to teachers when the children transfer on to primary education. Puzzle also provides support for parents and runs training throughout the year for both parents and professional groups.

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Our grandson went to a small, local playschool where the kind staff tried valiantly to help him, but it was quite disastrous for him, the staff assigned to him and also the other children. He then got a place at Puzzle, despite not having a Statement of Educational Need, and within weeks we saw what wonderful work they could achieve with him. (Our grandson) so wants to learn and is doing so in leaps and bounds.” The grandparent of a Puzzle pupil

When children first come to Puzzle aged two or three, their communication skills are either very limited or they are non-verbal. Puzzle’s primary objective is to help children communicate more effectively. It does this using a range of alternative forms of communication including Makaton signing; the Picture Exchange Communications System (PECS); widespread symbols in, for example, a visual timetable; and a visually structured environment using the TEACCH approach. Staff are also trained in the new SCERTS approach that has been developed in the United States, and are now beginning to implement this cutting edge framework within the nursery.

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The effectiveness of these approaches is measured each term using a detailed evaluation form to record development data, as well as information about attendance and parent training. The results vary enormously from child to child, depending where he or she is on the spectrum - a child with many additional learning difficulties requires much greater attention. Many aspects of a child’s development are also difficult to measure and quantify, even when progress is obvious.

DOWNLOADS:
Initial assessments

Child development assessments

The success of the transition to the child’s next educational placement is vital if the gains made at Puzzle are not to be lost, and it can be very upsetting if it goes badly. Puzzle works closely with the schools to which the children are transferring to ensure that the gains made are sustained and that staff are as prepared and informed as possible through reciprocal staff visits and observation.

It is presumed by many that inclusion is the right way forward for children on the autism spectrum, particularly so for the early years, and Puzzle’s specialist setting does go against this policy agenda. However, Puzzle feels strongly that for a lot of children with autism, solely going into a mainstream nursery isn’t the optimal solution. While most children do also attend a mainstream setting, the results of Puzzle’s work supports the notion that specialist pre-school support can help children on the autism spectrum maximise their achievements.

“As regards his educational placement, it is my opinion that the specialist provision at Puzzle has been crucial to help (child) develop his social and communication skills.” Consultant Paediatrician in Buckinghamshire.

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It is not just the child who goes to Puzzle – it is the whole family. Being able to draw on the experience of the staff is a great source of strength… and being guided on how best to deal with a situation certainly made family life easier for us.” The parent of a Puzzle pupil

Puzzle works hard to support the families of the children who attend, working with the parents as well as the child, and this outreach service has grown significantly over the years.

Puzzle visits each family at home once a term to offer support for the child’s home life. It also responds to parents’ daily requests for support as a priority. Parents call and email about a range of issues such as the statementing process, their school placement choice or their child’s behaviour at home. For parents of children who have just received a diagnosis, support is often required to help them through the huge emotional adjustment that they are going through as well as the steep learning curve they face.

In addition to this, Puzzle runs around eight workshops a year for parents. Workshop topics include PECS, play, managing behaviour, visual structure at home, understanding the statementing process, sensory difficulties, and communication. And parents are asked to contribute ideas for future workshop topics that they would find useful.

To complement the support provided by staff, Puzzle set up a parent support group, providing an area where parents can sit and meet during their child’s session. Puzzle has made information available about a wide range of issues, including benefits, other useful organisations, and the various approaches used to help the children. Parents have also added to this information. An excellent source of information is the Department for Education Early Support materials and resources which are free to download or your can order free hard copies. The National Autistic Society also offers an invaluable and extensive range of resources for parents and professionals.

Puzzle has also set up a mentoring scheme for parents. When a child leaves the pre-school parents are asked if they would be willing to mentor a new parent, and they are matched with a suitable partner. It can be incredibly helpful for a parent to have access to support from someone who has been through similar experiences or decisions such as which school to choose or how to cope with sleep difficulties.

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Most children who attend Puzzle also spend time in a mainstream setting. One of the principles behind Puzzle’s approach is that if everyone working with the child uses the same strategies, then appropriate behaviour will be better maintained and the child will better integrate and access the curriculum in mainstream settings. Enabling children to integrate successfully in mainstream settings, whenever this is most appropriate for an individual child, is a key goal for Puzzle.

Puzzle provides crucial support to mainstream staff to ensure that this continuity is achieved. Puzzle staff visit and support staff in the mainstream settings, and also invite the staff to spend time at Puzzle to observe the techniques and approaches used.

Alex Stanyer carries out a number of training courses for Early Years practitioners and professionals throughout the year and also gives University and school lectures on autism, widening the footprint of Puzzle’s impact. Puzzle held its first national conference specifically for professionals working with under 5s on the autism spectrum in July 2010 and hopes to repeat this event in 2012. Puzzle also works hard to publicise its learning model and encourages people to come and see what they’re doing.

DOWNLOAD: Puzzle training brochure

Puzzle receives consistently positive feedback from the courses it offers both in-house and across the county, as well as from the 100+ visitors that come to the nursery each year. It has also forged strong links with the wider autism education professional group and has received affirmation of its work from the research community.

“The structure at Puzzle is exactly what (child) needs to reduce her anxiety, and enable her to learn new skills in a predictable, safe environment.” Specialist Speech and Language Therapist, Buckinghamshire

Puzzle continues to build relationships with authorities that aren’t familiar with its approaches, with the aim of helping them to better understand the benefits of this early intervention.

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The success of Puzzle arises from its holistic nature and outreach into mainstream settings and the home. The placement costs received for children with a statement do not meet this additional input, and often do not even meet the total placement costs due to the high level of expertise required. As such, funding is an issue.

Furthermore, many children have a diagnosis but not a statement, and even when parents do manage to get a statement, it won’t necessarily state that Puzzle is where the local authority wants the child to be educated. The whole purpose and vision of Puzzle is to offer specialist help as early as possible, and the statementing process can unfortunately work against this.

Puzzle needs charitable funding to fund children before they get a statement or where the statement doesn’t name Puzzle as the education setting. Even with funded places, Puzzle still needs to fundraise for two thirds of the running costs and now employs a part-time fundraiser to ensure its fundraising strategy is fully implemented. Having someone on board with knowledge of fundraising has been crucial to its success in this area. However, Alex Stanyer feels strongly that there should be more government funds available for specialist nursery provision, and that the issue of sustaining these vital resources should be addressed on a national level.

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For more information about Puzzle, please contact:

Contact  Alex Stanyer, director
Address  The Old School, Middle Claydon, Buckingham, MK18 2ET
Email   alexstanyer@puzzlecentre.org.uk
Web http://www.puzzlecentre.org.uk/index.html
Telephone  01296 733900

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