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Matthew, aged 8, has been cared for by his childminder Anne Hodgson, in Otley, Leeds since he was 6 months old.

Childminders are in an ideal position to take an objective, experienced view and notice developmental delay. Anne first became concerned when Matthew was 2½ years old. “I noticed something wasn’t quite right with his development,” says Anne. “I kept a diary before talking to his mum, and then we agreed to go the health visitor together for Matthew’s assessment.”

Childminders are skilled at observing children and this helped when a meeting with a child psychologist was planned. Anne kept notes and took photographs recording her concerns and Matthew’s achievements. She showed this evidence to the psychologist and this helped with his diagnosis. Just before he turned 5, Matthew was diagnosed with an autistic spectrum disorder.

Matthew’s autism affects his understanding of language. “He can talk and talk about things he’s interested in, like trains. But having a conversation is difficult because he repeats himself and doesn’t always listen to what the other person is saying. This affects his social skills because the other children aren’t old enough to have the patience for his repetitive language.”

To encourage Matthew’s conversation, Anne plays a lot of turn-taking games with him. She has a song box with props, and Matthew is now good at waiting his turn in games like Five Currant Buns. One of his favourite characters is Thomas the Tank Engine – Anne uses this interest to talk about emotions by looking at the expressions on the trains’ faces.

Disruption to routines can be difficult for Matthew but with Anne’s patience and strategies, he is learning to deal with this a lot better. Anne involves Matthew if there is going to be a change to a routine and talks him through it to help him prepare. “I tell all visitors to let me know beforehand if they are coming. Now he enjoys having visitors – I talk to him and let him know who’s coming, making sure I have his attention first. And then I involve him by giving him tasks like making drinks".

It is easy for Matthew to get stuck in a routine and I need to make sure that doesn’t happen to help him become independent. For example, when we’re playing shops, he always asks for the same things – cheese, oranges, and cat food – and I have to say, no Matthew, we’re not going to the supermarket today, we’re going to the toy shop, what would you like to get from the toy shop?

Anne has worked with the other children she looks after too, to help them understand Matthew. “They are really good at involving Matthew in their games,” says Anne. “But sometimes he can become agitated or even aggressive, so I’ve shared books about autism with the other children, and also I give them strategies to deal with him. For example, I tell the other children to come to me if they are upset by anything he does, and also, they all know which toys are Mathew’s favourites so they can distract him with something that he likes.”

Matthew is mainly interested in the present and has only recently started talking about the past. “I encourage this with photo albums,” Ruth explains. “We look at pictures of days out we’ve had together then talk about them which encourages his conversation skills. I know he remembers what we’ve done if he mentions something that isn’t in the photograph. He likes looking at pictures of when we went to the Eureka! Museum in Halifax, but he calls it America – he told his teacher at school that I’d taken him to America!”

“Matthew is a loveable, bright, bubbly, chatty child. You have to get to know each child as an individual,” says Anne.

“It’s great that I’ve looked after him since he was a baby – it means that I know him really well, and I cater for his individual needs. As a childminder, I also give him opportunities to interact socially with other children and become part of his community.”

The story was kindly provided by PACEY (formally NCMA).

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