When your child is struggling: observation, communication and support
Start with one everyday situation: record changes, work with your child and school, and evaluate whether support is helping.
Who this is for Parents and carers concerned about development, awaiting assessment or supporting a diagnosed child.
Key points to start with
- Understand the experience before deciding what to change.
- Set goals around safety, communication, comfort and participation.
- Discuss developmental concerns and substantial changes in functioning with qualified professionals.
“Not listening” is not a specific description
“My child never cooperates” gives a teacher or clinician little to work with. Try: “For two weeks, they have covered their ears and left when the shower turns on; pouring water from a cup is easier.” This identifies a difference to explore without proving a diagnosis.
NICE guidance asks services to consider communication, physical problems such as pain, mental health, surroundings and changes of routine. Distress should not automatically be attributed to attitude. The examples here are our own discussion tools, not individual treatment programmes.
Section sources [1]
How to make a useful observation note
Choose one recurring situation that affects life. Separate observations from interpretations: covering ears is observable; noise being the cause is a hypothesis. Note what happened before, during and after, including what adults did. Respect privacy rather than repeatedly recording distress on video.
| Field | Fictional example |
|---|---|
| Before | Ten minutes before dinner, just home from a crowded bus. |
| Observed | Said “no talking”, moved the chair and went to the bedroom; not labelled as deliberate misbehaviour. |
| Response and result | Questions paused and food remained available; later the child wrote that they wanted a quieter place to eat. |
| Still unknown | Any pain? What happened at lunch? What would the child prefer next time? |
Include the child’s communication in decisions
A child may use speech, writing, drawing, pictures or another communication method. Speech and language professionals can help select suitable supports. Start with a genuine choice such as talking here or later. No immediate response should not be treated as consent.
During significant distress, prioritise safety and basic needs; discuss events and future plans when the child is able. Understanding difficulty does not remove safety boundaries. Work together on an accessible pause signal or way to leave while protecting everyone from harm.
Section sources [2]
Agree on a workable school adjustment
Original scenarios and discussion examples · not real cases
Fictional script: “Starting lessons after lunch has become difficult. Could we explore noise, transition and task demands? Could we try a clear next-step card this week, with one teacher checking whether help is needed?” This is more actionable than a general request for attention.
Agree who will act, when to review and how the child’s experience will be heard. Reconsider an adjustment if it increases distress. Attendance or silence alone is not success. Address bullying, ongoing pain or major functional changes promptly through school and health services.
Questions to ask a support provider
These questions help compare services without endorsing a method. A provider should explain the actual difficulty addressed, how the child participates, how distress is recognised and when plans change. Verify promises of a cure, guaranteed progress or pressure to buy a long package.
Do not start diets, medicines or supplements as an autism cure. NICE does not recommend exclusion diets for the core features of autism in children. That differs from individual care for diagnosed allergies, nutritional problems or other conditions, which requires qualified advice.
- Goal: what specific part of the child’s life should improve?
- Evidence: which ages, needs and outcomes does it concern?
- Process: how can the child express willingness, refusal, fatigue or a need for a break?
- Review: who records benefits and unwanted effects, and when is continuation discussed?
Section sources [1]
Ask about developmental concerns early
Ask local child health or developmental services about concerns involving language, interaction, behaviour, daily skills, or loss of previously acquired skills. Assessment draws on multiple types of information. Confirm local referral arrangements, qualifications and costs with the service.
Parents need support too. Where possible, share appointments, school contact and daily care, and preserve your own rest and help. You do not have to become every professional your child needs. Bringing a difficulty to an appropriate person is part of caring well.
Section sources [2]
Sources & further reading
- NICE CG170 · Autism in under 19s: support and management · Recommendations ↗
UK clinical guideline: child support and contributing factors, especially sections 1.3 and 1.4; our examples are not treatment protocols.
- NIMH · Autism Spectrum Disorder ↗
Institutional overview: development, assessment and support; US service details are not universal.
Editorial note: our synthesis and educational examples have not undergone clinical review. They do not diagnose individuals or replace medical advice. Source organisations have not reviewed or endorsed these articles.
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