Puzzle Centre
What did you do / what are you doing?
Specialist early intervention centre providing a specialist nursery for children on the autism spectrum for children aged between 2 and 5.
Puzzle is a specialist early years nursery. It is run by a specialist teacher who works in close conjunction with a speech and language therapist to plan and deliver the foundation stage curriculum – carefully differentiated to meet the needs of children who are on the autistic spectrum or have other significant communication needs. All children receive one to one adult support, teaching and therapy at each session. An occupational therapist also provides regular advice and guidance.
In addition to the nursery sessions, each family receives regular home visits and training workshops are put on for parents about 8 times each year. Most children who attend Puzzle attend a mainstream setting as well and Puzzle staff will visit and support this setting as well as inviting the staff from that setting to spend time at Puzzle to observe the techniques and approaches used.
The local authority categorise Puzzle as an Independent Special School- as well as an Early Years provision. Puzzle is registered with OFSTED as a day care setting and at its last inspection was judged to be providing outstanding care and education in every area.
Who with?
Parents / carers / teaching teams / LA teams / other professional groups (please give details)
Puzzle staff provide support to staff in other nursery/pre-school settings and to school staff when the children transfer on into primary education. In addition they run training on their approach for professional groups.
They also support parents and provide training for them.
Where are you based?
Puzzle is based in Buckinghamshire. However they do take children from any locality. They are not far from the border with Oxfordshire, Milton Keynes, Hertfordshire, Bedfordshire and Northamptonshire so do get children from those local authorities as well as occasionally from London Boroughs.
What did you want to achieve?
Alex Stanyer who set up the project was working for Buckinghamshire local authority and became involved in a working group set up by the child development team. The working group was looking at the support that was offered post diagnosis to children with autism. The County didn’t at that time have much on offer to families. As a result the clinical psychology service instituted a pilot project for 6 weeks in 1998 for pre-school children diagnosed. The pilot project met once a week and did small group intervention, working very intensively and providing a structured setting.
Feedback from families was very positive and it was felt that the pilot had real value. Unfortunately it wasn’t possible to get anything off the ground with health and education. Alex therefore decided to open up something independently. In 2001 after a year of planning time they opened with places for 6 children 4 mornings a week. There were two key people a specialist teacher and a speech and language therapist (SLT).
The main purpose was specialised and targeted intervention for children with autism or other communication difficulties. To address the problem that at an age that was critical for children with autism there was no autism specific provision. Some special schools do take from 3 years old but some parents not ready for special school decision at that point.
However, it’s also about supporting the families, working with parents as well as child. This outreach has grown as Puzzle has grown as a charity. As well as running workshops for parents Puzzle prioritises responding to the daily support requests from parents. Parents phone and email about a range of issues including the statementing process. Some of the support is emotional since many children have just received their diagnosis, and parents are going through a big emotional adjustment as well as a learning curve. Puzzle therefore set up a parent support group. There is an area where parents can sit – many of them travel from some distance so don’t go home during their child’s pre-school session. Groups of parents therefore get together when their children are there. Puzzle has made available information about a range of things, including benefits, and different approaches. Parents have also added to that information.
Puzzle has also set up a parent mentoring scheme. When a child leaves the pre-school parents are asked if they would be willing to mentor a new parent, and we match them up. 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.
Puzzle also gives support to mainstream settings. Most children attend mainstream setting as well as coming to Puzzle.
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 so the child will better integrate and access the curriculum in mainstream settings. An important aim is to enable children to integrate successfully in mainstream settings whenever this is most appropriate for an individual child.
To what extent did you meet these outcomes?
Puzzle did meet these outcomes by setting up and continuing, not only to operate successfully, but also to grow.
What is the impact on the Children / Young people?
In the short term the main thrust of Puzzle’s work is to try and help children communicate more effectively via alternative forms of communications or developing their speech communicatively. When they first come to Puzzle aged 2 or 3 their communication skills are very limited, or they are non verbal.
Puzzle measures their effectiveness and the impact is good, although of course it varies hugely because children at Puzzle range across the autism spectrum. With a child with a lot of additional learning difficulties much greater input is required.
''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 (sic), and within weeks we saw what wonderful work they could achieve with him. Every book or article you read tells you that early intervention is vital for children with ASD, and how right they are! (Our grandson) so wants to learn and is doing so in leaps and bounds. '' (Grandparent)
Longer term Puzzle know that the success of the transition to the child’s next educational placement is key if the gains made at Puzzle are not to be lost so they work closely with the schools the children are transferring to to try and ensure that the gains made are sustained and the staff are as prepared and informed as possible.
What difficulties did you need to overcome?
There have been problems with what can be a presumption about inclusion being the right way forward. This is particularly so for the early years. Setting up a specialist setting, particularly at nursery stage goes against that policy agenda. However, the staff at Puzzle feel strongly that for a lot of children with autism going into a nursery in a mainstream setting isn’t optimal. Having said that most children do also attend a mainstream setting and Puzzle helps those other nurseries to meet the child’s needs.
Funding is also a huge issue. This would be the case even if the service had been set up by the local authority. This is because the success of the provision arises from its holistic nature – the read across to other settings and home. The placement costs received for children with a statement doesn’t meet this additional input but also actually doesn’t always meet all placement costs because of the high level of expertise.
Furthermore many children have a diagnosis but not a Statement and even when parents get a Statement it won’t necessarily state that Puzzle is where the local authority want to educate the child. The whole purpose and vision of the setting is to offer specialist help as early as possible. The Statementing process can work against this.
Puzzle therefore needs charitable funding to fund children before they get a statement or where the statement doesn’t name Puzzle. Even with funded places staff have to fundraise for two thirds of the running costs.
Is the impact/outcome sustainable?
Children
In terms of the impact on children more research is needed on the efficacy of early intervention. In terms of the sustainability of that impact that is very dependent on the success of next placement. It can be really upsetting when this goes badly and gains are lost which is why Puzzle puts so much effort put into transition.
Funding
All Puzzle can do is address its own sustainability but Alex Stanyer feels strongly that there should be more money specialist nursery provision to address the sustainability issue nationally.
Puzzle are trying to address this by organising a conference which they hope will kickstart a lobbying group to push for more specialist placements.
Scale of work
Puzzle has taught 100 children since starting. At present the setting is able to provide places or support for 20-30 families including the toddler group.
However within their local area they do try and encourage other settings to look at what they’re doing and spread the learning from their model. Alex Stanyer has also done a lot of training across Buckinghamshire to widen the footprint of their impact.
Puzzle has decided against setting up other centres, but is publicising its model and encouraging people to come and see what they’re doing.
What are you most proud of?
‘I’m really pleased we got it going because of all the people we’ve helped. That I had the vision of setting it up which came out of work with families and have therefore been able to help families. Also the fact that Puzzle’s model of working is very much a team effort: the importance of pooling expertise from specialist teachers and therapists to deliver a communication-enabling curriculum for children who find communication and interaction present real challenges.’
Alex Stanyer is also proud of the links that Puzzle has forged with the wider autism education world and the affirmation that they’ve received from the research community. Finally, that the project has not stood still but has developed and is still developing.
Were all of the stake holders views of the outcomes positive?
Puzzle has been inspected by Buckinghamshire’s monitoring officer and got very favourable reports.
Puzzle also gets consistently positive feedback (from evaluation forms) from the courses it offers both in-house and across the county. It also gets good feedback (via questionnaires) from about 100 visitors each year to the centre,
A sample of parental comments can be seen below.
There is work to do around relationship building and working in partnership with authorities who don’t know the project and its work as well. This tends to be with those authorities who do not understand the benefits of this type of early intervention.
What would you like to improve?
There is more work to be done on relationships with other local authorities to encourage them to consider setting up something similar or support what Puzzle is doing. There is also more work to be done around people understanding the benefits of early intervention and the efficacy of this particular model.
What aspects of what you achieved can be passed on to others?
What aspects of what you did could be effective learning points for others?
The way in which the setting is structured – it does work. Puzzle would very much like to encourage others to look at their model and which elements might be transferable to other localities or settings.
Supporting quotes
''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.'' (Parent)
''We are thrilled that our son has thrived in this environment and is more vocal, saying more words and generally interacting more. The fact that he has developed while at Puzzle really gives us hope for the future.'' (Parent)
''During my child’s time at Puzzle they improved their communication and social skills thus making family life much easier and calmer.'' (Parent)
''Our child’s use of PECS enables him to communicate his needs to others and enables him to make his own choices. It also helps to ease his frustration.(Parent)
“You are a great oasis in life’s desert and I would recommend you to anyone in the same circumstances.''(Parent)
''Through Puzzle and the structure there we have learned to organise our lives differently so that our son has the best chance in life we can give him.''(Parent)
''What a very special place for special children…I wish I had found you sooner. I don’t know where I would have been 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)
''We were so incredibly lucky to have found Puzzle. We’ve been thrilled in the changes we’ve seen in our son’s confidence over the months, not to mention the help and advice you’ve given me. You’ve given our son a wonderful start.'' (Parent)
Consultant Paediatrician in Buckinghamshire:
''As regard to 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.''
Educational Psychologist in Buckinghamshire:
''The environment at Puzzle pre-school seems to be optimising his development in all areas.''
Consultant Paediatrician in Northamptonshire:
''It is clear that the child is doing well there and that he has made great improvements since I last saw him.….clearly the support he is having (at Puzzle), I believe, has been most helpful for him.''
Specialist Speech and Language Therapist – Buckinghamshire:
''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 ''
''I feel that it is not only 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.'' (Parent)