Parents may sense that something is wrong, but simply hope that it will sort itself out once the child starts school. Nursery or playgroup staff may also be aware that something is wrong, but be unsure - or inadequately trained - to know what to do. Too often, they may find themselves dealing with the child's "naughty" behaviour, rather than on what lies behind it, and even excluding the child when the situation gets out of hand.
In an effort to help early years staff, Oxfordshire County Council's education department has just produced a Handbook for Pre-School Provision, which, in line with the Code of Practice on special needs, aims to guide staff through assessment, so that they know what to look out for and what action to take.
At each of the five assessment stages, the handbook lists the "triggers" which should alert staff to a child experiencing learning difficultie s. At stage one, for instance, it might be that a child is having trouble processing information, or is playing at a level noticeably below other children the same age - signals that the child needs careful monitoring, and perhaps some special help from nursery staff. Most children will not go beyond stages one and two, but stage three is the point at which the nursery or playgroup needs to call formally upon external specialist support. Stages four and five provide a guide for the small number of children (about 2 per cent nationally) who will need to apply to the education authority for a statement of special needs.
The handbook is Oxfordshire's attempt to explain the Code of Practice, so that all pre-school providers know how to assess and monitor special needs cases.
Kate Schnelling, a pre-school teacher counsellor co-ordinator, who compiled the handbook with Chris Spencer, assistant principal educational psychologist, says: "We have had lots of calls in the past from playgroups not knowing how to deal with a problem of this sort. We have also had children referred to us at four, and four-and-a-h alf, who have significant problems which have been missed."
Two children, for instance, were found to be suffering from epilepsy. Another child's autism was not picked up until the age of four; his parents had thought he had some kind of language problem. Other children, Kate Schnelling says, come across as having behaviour problems and seem immature - which playgroups tend to blame on poor parenting - when in fact they are afflicted by a moderate delay in cognitive development.
Tina Dean, on the deprived Blackbird Leys estate in east Oxford, knew something was wrong with her baby son, Luke, who was late talking and walking, and had feeding problems. But it was not until he was two-and-a-half that he was recognised as having "global developmental delay", and given extra support in a special playgroup.
"It should have been picked up earlier," says his mother. "But the doctors thought I was just being stupid, and told me he would grow out of it."
Social deprivation and family trauma can play a part in children's difficulties, and Kate Schnelling runs classes to help parents find better ways of coping with their children. But there is a danger, Chris Spencer says, particularly on an estate such as Blackbird Leys, that all problems get blamed on deprivation, and specific learning difficulties are missed.
Mary Berger, who runs the Shepherds Hill Playgroup in Blackbird Leys, and has worked with pre-school children for 30 years, believes the handbook will help in setting out what to look for at each stage, what to do and what support to expect. "We might be concerned about a child, and talk to each other and to the parents about it, but you don't always know what the next step is and whose responsibility it is."
Good record-keeping is the key to good diagnosis. "Writing down what you think the child's problem is helps to focus your thinking and articulate the
problem," says Chris Spencer. He admits the Code of Practice has been something of a "bureaucratic nightmare" for schools and pre-schools, but hopes that the handbook will lighten rather than add to the burden. Half-day training sessions are now available in Oxfordshire to help staff get to grips with the demands of the handbook.
Finding the time, however, for the kind of detailed observation required is hard, points out Mary Berger, when you have children in a large group for only three or four sessions a week.
But on the whole, she is resigned to the paperwork. "It is daunting at a playgroup when you're looking after the children, as well as trying to keep up with the administration and the records. But I think, in the long run, it can only be a help to the children and their families."
Handbook for Pre-School Provision: Oxfordshire stages of assessment, guidance and record form, #163;5 from Special Division, Macclesfield House, New Road, Oxford OX1 1NA