SEND the Four Areas of Need

The SEND Code of Practice 2014 (updated January 2015) sets out four broad areas of special educational need that include a range of difficulties and conditions:

  1. Communication and Interaction (C&I)
  2. Cognition and Learning (C&L)
  3. Social, Emotional and Mental Health difficulties (SEMHD)
  4. Physical and/or Sensory Needs (P&SN)


These areas allow schools to gain an overview of their pupils’ range of needs. The 0-25 SEND Code (2015) emphasises:

‘The purpose of identification is to work out what action the school needs to take, not to fit a pupil into a category. In practice, individual children or young people often have needs that cut across all these areas and their needs may change over time… A detailed assessment of need should ensure that the full range of an individual’s needs is identified, not simply the primary need.’ (section 6.27)

The code also states that:

‘Many children and young people have difficulties that fit clearly into one of these areas; some have needs that span two or more areas; for others the precise nature of their need may not be clear at the outset.’

1. Communication & Interaction

Children with communication and interaction needs may struggle to communicate with others and/or struggle to understand what others are trying to communicate to them. Examples of SEND needs that fall under this category include Speech, Language, and Communication Needs and autistic spectrum disorders (ASD). Children with communication and interaction needs may struggle to say what they want or understand what is being said to them. However, it is important to remember that communication is not only about the words we use as we speak with each other, but also the way in which words are spoken. Words are used to emphasise different elements in a sentence and convey emotion, each of which adds an additional layer to verbal communication.

There are also social rules around communication; for example, what is polite and what is rude? This also varies depending on social and cultural context. Body language, emotional cues, and the social rules of language can be a particular challenge to some children, such as those with ASD. Where children have communication and interaction needs, they may become frustrated as they struggle to communicate with others or understand what others mean.

Some of the aspects of difficulty included in this area are:

  • Autistic Spectrum Disorder (ASD)
  • Speech, Language and Communication Needs (SLCN)

2. Cognition & Learning

Cognition and learning’ refers to a wide range of SEND needs. They are divided into two broad categories. The first is ‘learning difficulties’, which means that children learn at a slower pace than their peers.  The second broad category is specific learning difficulties (SpLD) which affect more specific aspects of learning. SpLD needs are more common and include examples such as dyslexia and dyscalculia. It is important to remember that each child’s SpLD profile will vary, even if they have the same identifying label (such as dyslexia). Although there are individual variations for specific types of SpLD, common difficulties also exist. These include weaker working memory (the ability to hold information temporarily for use in completing a task) and challenges with practical aspects of life, such as time management and personal organisation. Despite these difficulties, children (and adults) who have SpLD needs may also have areas of comparative strength, such as creativity.

Some of the aspects of difficulty included in this area are:

  • Attention deficit hyperactivity disorder (ADHD)
  • Moderate Learning Difficulty (MLD)
  • Profound and Multiple Learning Difficulty (PMLD)
  • Severe Learning Difficulty (SLD)
  • Specific Learning Difficulty (SpLD) that includes:
  • Dyscalculia
  • Dysgraphia
  • Dyslexia
  • Dyspraxia

3. Social, Emotional & Mental Health

Children with  Social, Emotional & Mental Health (SEMH) difficulties typically struggle with social skills and/or managing their emotions, which may affect their ability to develop and maintain healthy relationships with others. This, therefore, affects their experience of education.

There are various reasons for SEMH difficulties. Mental health problems, such as anxiety and depression may affect children’s social and emotional behaviour. Fortunately, public awareness of mental health has improved in recent years and schools are now expected to help educate children about mental health difficulties and support those affected by them. and support children with mental health difficulties.

There are also medically diagnosed conditions associated with SEMH difficulties. Attention Deficit Hyperactivity Disorder (ADHD) is perhaps the most well-known and is a lifelong condition. Children with ADHD may appear less mature than their peers and struggle with keeping still, behaving impulsively, and remaining focussed on a task. As a result, children with ADHD may find themselves getting into trouble at school due to their behaviour unless suitable support is put into place.

4. Sensory and/or Physical

Children with these needs have a sensory need or disability that means they need additional support and perhaps equipment to access education. There are five categories within this final group:

  1. Visual impairments
  2. Hearing impairments
  3. Multi-sensory impairments.
  4. Sensory processing difficulties.
  5. Physical disability.

Visual and hearing impairments occur where children have a partial or complete loss of their sight or hearing. Where these occur together, a child is said to have a multi-sensory impairment. Sensory processing difficulties are where a child is over and under-sensitive to the different senses, such as touch, sound, or smell. As a result, they can become distressed due to over or under-stimulation. Sensory processing difficulties may also occur alongside other SEND needs.

Finally, there are some children with physical disabilities, which may have occurred from birth, because of a degenerative condition or a physical injury. As with all other SEND needs, sensory and physical needs vary in their severity and the level of support required as a result.

Medical Needs

A medical diagnosis or a disability does not necessarily imply a special educational need (SEND) but would be categorised under sensory and/or physical. It may not be necessary for the child or young person with any particular diagnosis or medical condition to have any additional form or educational provision at any phase of education. It is the child’s medical needs rather than a diagnosis that must be considered. Some children may not require school-based SEND provision but they have medical conditions that, if not properly managed, could hinder their access to education. Children and young people with medical conditions will include those with Asthma, Diabetes, Arthritis, Epilepsy, severe allergies, Incontinence, Eczema, Cystic fibrosis Tracheotomy, Colostomy and Ileostomy. In such cases, school staff will take into consideration the medical guidance available.