Children sometimes find it easier to talk to puppets than adults, says Pat Kelly, a member of the London Borough of Camden's early years intervention team.
"They might talk to a puppet about how they feel or talk about the puppet's feelings. Then the adult controlling the puppet can lead the conversation," she says.
It is one strategy the team - Ms Kelly, Bernice Shamplin, Deirdra Leahy and Shelagh Alletson - employs to communicate with children who have emotional, social or behavioural difficulties.
"We are quite innovative and like to use things we know are going to work, but use them in creative ways," she says.
The team works with two- to five-years-olds who might have problems participating in nursery activities or accessing the curriculum or be at risk of developing more long-term special needs. They work directly with individuals or small groups of children for agreed periods of time and they also work indirectly, offering support and advice to the children's parents or carers and staff in under-fives provision, developing programmes and strategies which enable children with specific difficulties to access the curriculum more easily.
"We work with children who are having difficulties learning how to behave in a nursery," explains Ms Kelly, "and we are particularly interested if there's a language or communication aspect to the difficulties.
"A large factor of exclusion is if a child has a language or communication difficulty that hasn't been identified."
More than one million children in the UK - that's almost one in 10 - have some kind of speech, language or communication difficulty, according to the UK charity ICAN, which helps children with speech and language difficulties. These children struggle to understand what people are saying to them and have difficulty conveying their thoughts and feelings, which may have a significant impact on their development.
Ms Kelly is the team manager and an educational psychologist. Her colleagues are a speech therapist and two special needs teachers who specialise in children with challenging behaviour. They adopt a multi-disciplinary approach which has been effective in identifying children's needs and helping them to achieve positive results, she says.
"With small groups of children we model and rehearse appropriate behaviours. The interventions are carefully structured to ensure that the child is successful and feels good about learning.
"We use proactive approaches which may modify the environment or the curriculum. We plan with the key worker, so that successful strategies transfer immediately to the large group situation," says Ms Kelly.
"An important thing is to think about how you can teach children to play together, share and make friends. Some early years practitioners think all children can do this automatically.
"If a child has problems engaging with the staff, it might be that the staff would benefit from a resource or approach we could offer, such as structured turn-taking or we might teach staff a few Makaton signs."
(Makaton is a signing system that supports communication.) "What we advise is to look at the range of strategies that could be tried with a child," explains Ms Kelly.
"We encourage early years staff to look beyond the child's behaviour and treat it as a barometer of what's going on with the child. If the child is having difficulty with communication, we want practitioners to look at ways they can try to help.
"It's about giving the practitioners a chance to stand back for a moment and reflect on what they do," she continues. "We make sure the strategies we suggest are manageable and try to involve them as much as we can.
Support from colleagues and good supervision is vital," she adds.
Training is an important service and can be offered in a variety of topics, from positive behaviour management to writing individual education plans to looking at effective use of space.
"It's so important that these kids get a positive start. If they are excluded at this age they will face greater difficulties later on."
Camden's early years intervention team talk about Working with Pre-school Children at Risk of Exclusion as part of the NASEN conference at 1.30pm, November 15www.makaton.org