A Practical SEN Guide for Teachers, Doctors and Carers: Real Tips From 7 Years of Support Work
The plastic waiting room chair squeaked under 8-year-old Leo as he spun it for the twelfth time in five minutes. Our GP appointment to update his education health and care plan was already running 17 minutes late, and the crinkle of the cherry lollipop wrapper in his pocket wasn’t enough to hold his focus anymore. The receptionist glanced over from the front desk, her mouth tightening, and I saw Leo’s shoulders hunch. He knew he was being “too much” — he’d heard it enough from substitute teachers, birthday party hosts, even distant relatives. I’ve worked as a primary school SEN co-ordinator for seven years, and I’ve lost count of how many well-meaning professionals and carers fumble these small, everyday moments. No one gets formal training for the little things that make all the difference, and the official 50-page guidance documents are full of jargon that doesn’t help when a kid is dysregulated in your waiting room or disrupting your lesson. That day with Leo drove home how much a simple, practical guide would help people who don’t work with SEN kids every single day.
A few months before that appointment, Leo’s new class teacher, Sarah, had called me in frustrated after three straight days of sending him out of the classroom for disruptive behavior. He was tapping his pen nonstop, spinning in his chair, getting up to walk around mid-lesson when he was supposed to be doing his math work. Sarah told me she’d reminded him a dozen times to sit still and focus, and he just wouldn’t listen. I sat in the back of her class for 20 minutes that morning, and what I saw was pretty simple: Leo couldn’t sit still. His brain needs constant small movement to focus, and every time he moved, he got told off, which made him anxious, which made him move more, which led to him being sent out.
I suggested two small changes that took less than five minutes to arrange. First, let Leo stand up to work whenever he wanted, no need to ask permission. Second, put a cheap rubber stability disc under his desk, so he could wiggle his feet without moving the whole chair. Sarah was skeptical at first — she said it would set a bad example for the other kids. But she tried it anyway. Within two weeks, Leo had only been sent out once, and he’d finished three full pieces of writing that he’d refused to even start before. That’s the thing no one tells you: most SEN adjustments are low-effort, low-cost, and they don’t disadvantage other kids. They just give the kid who needs it space to work.
When we finally got called in for Leo’s appointment that day, the new GP turned straight to me and started asking, “When did his stomach aches start?” Leo was standing right there, twisting the hem of his hoodie. I stopped her and said, “Can you ask him first? He’s the one who feels the pain.” She looked a little surprised, but she turned to Leo and said, “When do your tummies hurt most, Leo?” He immediately said “after lunch, when we all have to sit on the carpet for story time, it’s too crowded and loud.” That’s something I’ve seen over and over, across doctors and teachers and even social workers: people talk over the kid, like their experience doesn’t count until an adult confirms it. For non-verbal kids, it’s just as important — talk to them, explain what you’re doing, don’t just treat them like an object to be examined. It builds trust faster than any form you can fill out.
I give this tip to every GP surgery I do training for: keep a small fidget box by your waiting room. It doesn’t need to be fancy — a few rubber bands, some textured keychains, a small bottle of bubble solution, a couple of printed maze sheets. It costs less than ten pounds, and it gives a dysregulated kid something to do while they wait, instead of spinning chairs and getting side-eyed. One surgery told me they’ve had half as many issues with anxious kids since they put the box out, and neurotypical kids use it too, no one notices.
I worked with a family carer a while back who was at her wits’ end with her 12-year-old, who has autism and only eats beige food: toast, chicken nuggets, chips, crackers. She’d been told by multiple people she was being too permissive, that she had to force him to try new foods to expand his diet. She’d tried bribes, she’d tried forcing bites, and it ended in screaming matches every meal. I suggested she try one small thing: put one bite of a new food on his plate every meal, no pressure, no comments, no demands to try it. If he doesn’t touch it, just throw it away when he’s done. That’s it, nothing more. She thought it was too simple, but she tried it. Three months later, he picked up a piece of broccoli off his plate and ate it, just because it was there and no one was making a big deal out of it. He still eats mostly beige food, but mealtimes are calm now, which is way more important for everyone’s mental health.
A common pushback I get is that people don’t have time for all this. Teachers have 30 kids in a class, doctors have 10 minutes per appointment, carers are already stretched thin. But the things that matter don’t take extra time. Turning down an overhead light that’s too bright takes two seconds. Telling a kid “I see that you’re upset, that change in plan surprised you” instead of “calm down” takes the same amount of time as telling them to calm down. Letting them sit by the door instead of the middle of the waiting room takes five seconds.
I still get it wrong, more often than I’d like. Last week, Leo had a meltdown in class when the class hamster got out of its cage unexpectedly, and the first thing I said was “just breathe, Leo” — which I know is one of the worst things you can say to a dysregulated kid. He ran straight to the quiet room and slammed the door. I waited ten minutes, grabbed his favorite lemon candy from the supply cupboard, and went in. I sat down on the other end of the couch, didn’t say anything for five minutes, just let him suck on the candy and rock. That worked. SEN support isn’t about being perfect, or following a thick manual, or changing the kid. It’s about adjusting your space, your words, your expectations to meet them where they are. Some days it works, some days it doesn’t. Every kid is different, so what works for Leo won’t work for the 10-year-old I support who hates fidget toys and needs total silence to work. But these small, simple tricks I’ve picked up over the years work more often than not, for anyone who just wants to get it right more often than they get it wrong.
Please indicate: Thinking In Educating » A Practical SEN Guide for Teachers, Doctors and Carers: Real Tips From 7 Years of Support Work