Early Identification: Recognizing SEN Needs in Under-5s

You know your child better than anyone. So when something doesn’t quite feel right—when your toddler isn’t talking like their peers, when your preschooler struggles with things that seem easy for other children, when development seems to be following a different path—trust those instincts.

Early identification of special educational needs doesn’t mean labeling your child or accepting limitations. It means understanding their unique profile, accessing support early, and giving them the best possible foundation for development and learning. Research consistently shows that early intervention leads to better outcomes across the board.

This guide will help you understand typical developmental milestones, recognize potential red flags, know when to seek assessment, and understand what early support looks like in the UK for under-5s.

Understanding “Normal” Variation vs Genuine Concerns

First, an important truth: children develop at different rates. Milestones are guidelines, not rigid rules. Some children walk at 10 months, others at 18 months—both can be perfectly typical. Some are chatty toddlers, others quiet observers.

However, there are patterns and timelines that, when significantly delayed or absent, may indicate a special educational need or developmental concern. The key is understanding the difference between normal variation and indicators that warrant further investigation.

When to Be Concerned (vs Normal Variation)

• Multiple areas affected: Delays across several developmental domains (communication, motor skills, social interaction) are more concerning than a single area
• Significant delay: Skills that are 6+ months behind expected milestones by age 2, or persistent gaps that widen over time
• Loss of skills: Any regression—losing skills your child previously had—should be assessed immediately
• Quality of development: It’s not just about timing but how development happens (e.g., repetitive play vs imaginative play)
• Parental instinct: Persistent gut feeling that something isn’t right, even if you can’t articulate exactly what

Key Developmental Domains to Observe

1. Communication and Language

Speech and language development is one of the most common areas where parents first notice concerns. Language delays can indicate specific speech and language needs, autism, hearing difficulties, or global developmental delay.

Red Flags for Communication (by age):

By 12 months:

• Not babbling (mama, dada, baba)
• Not responding to their name
• No gestures (pointing, waving)

By 18 months:

• Not saying any words (even approximations)
• Not following simple instructions (“get your shoes”)
• Not pointing to show you things

By 24 months:

• Fewer than 50 words
• Not combining two words (“more milk,” “daddy gone”)
• Speech is largely unintelligible to familiar adults

By 3 years:

• Not forming simple sentences
• Speech difficult for strangers to understand
• Not engaging in simple back-and-forth conversation

2. Social Interaction and Play

How children interact with others and engage in play provides crucial information about social-communication development, particularly in relation to autism spectrum conditions.

Red Flags for Social Development:

• Limited eye contact: Consistently avoids looking at faces or making eye contact during interactions
• No social smiling: Doesn’t smile back when you smile at them (by 6 months is concerning)
• Lack of joint attention: Doesn’t bring objects to show you, doesn’t look where you’re pointing (by 18 months)
• No interest in other children: Plays near peers but doesn’t engage with them (by age 3-4 is concerning)
• Repetitive play: Lines up toys rather than playing functionally or imaginatively, intense focus on spinning wheels, opening/closing doors
• Difficulty with pretend play: Not pretending by age 2-3 (feeding dolly, talking on toy phone)
• Difficulty reading social cues: Doesn’t understand when others are upset, angry, or happy

3. Motor Skills (Fine and Gross)

Physical development includes both gross motor skills (big movements like walking, running, jumping) and fine motor skills (precise movements like gripping, drawing, using utensils).

Motor Development Red Flags:

• Gross motor delays: Not sitting by 9 months, not walking by 18 months, extremely clumsy, toe-walking consistently
• Fine motor difficulties: Unable to pick up small objects with pincer grip by 12 months, can’t hold a crayon by age 2, struggles with simple puzzles age-appropriately
• Muscle tone concerns: Very floppy (hypotonia) or very stiff/rigid (hypertonia)
• Motor planning issues: Difficulty learning new physical movements, appears awkward or uncoordinated beyond typical toddler clumsiness
• Hand preference very early: Strong hand dominance before 18 months can sometimes indicate weakness on one side

4. Sensory Processing

Sensory processing differences are increasingly recognized as significant in conditions like autism, ADHD, and sensory processing disorder.

Sensory Red Flags:

• Extreme reactions to sensory input: Covering ears at normal sounds, distress at clothing tags, refusal to touch certain textures
• Sensory seeking: Constantly touching everything, seeking intense physical input, high pain threshold
• Feeding difficulties: Extreme pickiness beyond typical toddler behavior, gagging on textures, very limited diet
• Difficulty with transitions: Meltdowns when routines change, need for sameness
• Sleep problems: Consistently difficult sleep beyond normal baby/toddler patterns

When and How to Seek Assessment

If you’re concerned about your child’s development, don’t wait and see—early intervention makes a real difference. Here’s how to access assessment in the UK:

Step 1: Health Visitor and GP

Your health visitor is your first point of contact for under-5s developmental concerns. They can:

• Conduct developmental reviews (Ages and Stages Questionnaire or similar)
• Provide reassurance if development is within normal range
• Refer to appropriate services if concerns are identified
• Connect you with local early years support services

Your GP can also make referrals to specialist services and should take parental concerns seriously.

Step 2: Specialist Assessments

Depending on the area of concern, your child may be referred to:

Early Years Assessment Pathways:

• Speech and Language Therapy (SALT): For communication delays or feeding difficulties
• Paediatrician: For global developmental delay, medical concerns, or autism assessment
• Audiology: For hearing tests if language delay or lack of response to sounds
• Occupational Therapy (OT): For sensory processing issues, fine motor delays, feeding concerns
• Physiotherapy: For gross motor delays or muscle tone concerns
• Early Years SEN team: If your child attends nursery, the setting’s SENCO can coordinate support
• Portage: Home visiting service for under-5s with developmental delays (not available in all areas)

Step 3: EHC Needs Assessment for Under-5s

EHCPs aren’t just for school-age children. If your under-5 has significant, complex needs, you can request an EHC needs assessment. This can be particularly important if:

• Your child has complex needs requiring coordinated multi-agency support
• They need specialist nursery placement
• You’re planning ahead for school and know they’ll need significant support
• Early intervention services recommend it

The Benefits of Early Identification

Early identification isn’t about labeling—it’s about intervention. Research overwhelmingly shows that early support leads to better outcomes:

Why Early Intervention Matters:

• Brain plasticity: Young children’s brains are incredibly adaptable. Early intervention takes advantage of critical developmental windows.
• Prevents secondary difficulties: Addressing language delay early can prevent later literacy difficulties; supporting social communication can prevent mental health challenges.
• Parent confidence: Understanding your child’s needs and having strategies helps you support them effectively.
• School readiness: Early support means children start school with foundations in place, rather than struggling from day one.
• Access to resources: Formal identification opens doors to specialist support, therapy, and funding.

Common Early Years SEN Conditions

Autism Spectrum Condition (ASC)

Early signs of autism can be present from the first year of life, though diagnosis typically occurs around age 2-3 or later. Early indicators include:

• Limited eye contact and social smiling
• Not responding to name by 12 months
• Delayed speech or unusual speech patterns (echolalia, scripting)
• Repetitive behaviors or intense interests
• Difficulty with changes to routine
• Sensory sensitivities or seeking
• Limited pretend play or imaginative play

Speech and Language Delay

Very common in early years. Can be isolated or indicate broader developmental concerns. May resolve with therapy or persist as a specific language impairment (DLD—Developmental Language Disorder).

Global Developmental Delay

When a child shows delays across multiple developmental areas. May indicate chromosomal conditions, brain injury, genetic syndromes, or unknown causes. Requires comprehensive assessment.

Sensory Processing Disorder

Difficulty processing sensory information, leading to over-responsiveness, under-responsiveness, or sensory seeking. Often co-occurs with autism and ADHD but can be standalone.

What to Do While Waiting for Assessment

NHS waiting lists for specialist assessments can be long—often 6-18 months or more. Don’t just wait. Here’s what you can do:

Proactive Steps During Waiting Periods:

• Access universal services: Most areas have early years support services that don’t require diagnosis
• Nursery/childcare support: Speak to your setting’s SENCO about strategies and support
• Charity resources: Organizations like ICAN (speech), NAS (autism), Contact (general SEN) offer free resources and helplines
• Parent training: Many areas offer courses like Early Bird (for autism), PEEP (Parents Early Education Programme), etc.
• Document everything: Keep records of concerns, developmental observations, and what strategies help or don’t help
• Consider private assessment if possible: Can speed up diagnosis and access to some therapies, though this isn’t accessible for all families financially

Trusting Your Instincts

Parents often report knowing something was different from very early on, even when professionals said “wait and see” or “all children develop at their own pace.” While it’s true that development is variable, persistent parental concern should be taken seriously.

If you’re worried:

• Don’t let anyone dismiss your concerns with “boys talk later” or “Einstein didn’t talk until age 4” (apocryphal and unhelpful)
• Seek a second opinion if your GP or health visitor isn’t taking you seriously
• Document specific concerns with examples to make your case clearer
• Know that early assessment doesn’t harm and can rule out concerns or identify needs—both are useful
• Remember that you know your child best and advocating for them is part of being their parent

Final Thoughts: Early Doesn’t Mean Limiting

Some parents worry that seeking early assessment will label their child or limit expectations. The opposite is true. Early identification and support give children the best chance to reach their potential by addressing needs during the most formative developmental period.

A diagnosis or identification of SEN doesn’t define who your child is or will become. It simply describes their current profile and helps professionals provide appropriate support. Many neurodivergent individuals and people with disabilities lead fulfilling, successful lives—early support helps set that foundation.

Trust your instincts, seek assessment when you’re concerned, and remember that advocating for your child—at any age—is one of the most important things you can do.

Related Resources

• Sensory Processing Disorder: The Hidden Barrier to Learning
• Occupational Therapy for SEN: Accessing Support in the UK
• EHCP Application Guide: Complete UK Process
• Building Your Child’s SEN Support Team