Complex communication & interaction difficulties (CCI)

• Communication and Reciprocal Social Interaction (Social Affect)
• Difficulties recognising that they are part of a class, group or wider social situation.
• Social situations present challenges resulting in emotional outbursts, withdrawal, social
  vulnerability and/or isolation.
• Poor empathy, imagination and play skills which affects social understanding and impacts on learning in subjects such as English and RE
• Unusual eye gaze or eye contact. Facial expressions may be limited or reduced in range.
• May not use or understand non-verbal communication.
• Difficulties with understanding spoken language or difficulties expressing their own wishes
  and feelings (expressive and receptive needs). Speech may be delayed or unusual and may
  have an odd intonation pattern with immediate or delayed repetition (echolalia).
• Literal interpretations of language and learning with poor understanding of abstract language.
• Higher order language skills may be impaired, e.g. understanding and use of metaphor,
  inference and emotional language.
• Issues with interpreting and understanding whole class instructions and general information.
• Difficulties with the concept of time and sequencing of events significantly affect everyday
  activities.
• Difficulties with personal space. May invade others space or find close group work difficult.
  Little awareness of danger in comparison to children of their age. May ‘run’ or ‘climb’ with no regard to hazards. May be unaware of hurting others.
• May have coping strategies that enable successful social interaction with peers. At times of stress or anxiety, however, responses will be unusual and socially awkward.

Restricted and Repetitive Behaviours

• Anxiety to even small unplanned changes in the environment or learning tasks leading to
  reactions of outbursts or withdrawal.
• Unusual or different behaviours or obsessions with everyday objects, people or toys. This can lead to difficulties with finishing desired activities. May display an intense interest in a topic that is explored with a high level of frequency and/or inappropriateness to context or
  audience.
• Difficulties managing transition between different environments or tasks. Routine and visual structure supports these issues.
• Inability to maintain focus and concentration age appropriately. May be easily distracted or
  may not switch attention easily.
• Inconsistent patterns of behaviour across a spectrum from challenging or impulsive to
  extreme passivity.

Sensory Differences

• Unusual over or under responsiveness to sensory stimuli e.g. touch or noise which may affect access to everyday events or activities e.g. dining halls. May show signs of delayed hand/eye co-ordination and/or fine/gross motor skills or display unusual body movements such as
  flapping, toe walking, tics or unusual posturing. May eat inedible objects ‘pica’.
• May display unusual sensory responses to the environment at times of heightened stress.
  This may present as anxiety.

Sensory differences can affect physical milestones such as toileting and eating development. These can cause high anxiety in the child/young person and those who care for them.