Does your child have complex or severe needs? Here’s how these terms are used when it comes to autism and ADHD….

Families navigating SEND often come across terms that can appear complicated or intimidating. Terms such as severe, complex, and profound are commonly used in professional reports and policy documents, whereas autism and ADHD are often described differently, even when support needs are significant.

Understanding what these terms mean can help parents tackle the SEND system with more confidence and less anxiety.

Severe Needs

Within SEND, 'severe' indicates a very high level of need and support required in specific areas, such as learning, communication, or physical abilities. In other words, their level of need is considerably higher in a specific area than for other children, including other children with SEND.

A child with severe needs may:

• Need constant or near constant adult support.

• Require significant adaptations to access learning or daily activities.

• Have severe learning, communication, physical, sensory or developmental needs.

• Need a highly structured or specialist environment.

Complex Needs

Complexity refers to the combination and interaction of multiple needs, as well as the involvement of various support systems.

A child with complex needs may:

• Have multiple SEND needs at once such as communication, physical and cognitive difficulties.

• Require education, health and social care support together.

• Need coordinated planning between professionals.

• Experience interactions that fluctuate and impact multiple areas of daily life.

A child may have complex needs without severe learning difficulties, and vice versa. These categories are related but have separate meanings.

Profound and Multiple Learning Difficulties

PMLD describes children with significant learning difficulties accompanied by other additional needs, including physical, sensory, or medical challenges.

These children may have:

• Profound cognitive/intellectual disabilities

• Multiple additional needs, such as physical disabilities, sensory impairments or medical needs

• Require highly individual lifelong support

• Communicate in very specific ways, often not using speech

Children with PMLD are typically categorised as having severe AND complex needs; however, 'profound' specifically refers to learning and development.

Autism and ADHD needs

Within SEND, autism and ADHD are often misunderstood because their needs may not be ‘severe' or 'profound,' in terms of the definitions we have described. Instead they involve specific and sometimes less visible challenges.

Many autistic and ADHD children:

• May be academically able, but struggle with regulation, communication or sensory processing.

• Have needs that are manageable at one moment and overwhelming at another

• Experience hidden challenges, where significant effort is directed toward coping rather than learning

• Require consistent and skilled support, even when difficulties are not always obvious

These children experience a different type of ‘complex’, such as:

• The interaction between environment, expectations and nervous system

• The building impact of unmet needs over time

• The need for adults to understand how and why difficulties arise, rather than focusing solely on obvious behaviours

For families, these different terms influence:

• How support is planned and funded

• Whether needs are seen as “educational only” or multi-agency

• Access to EHCPs and specialist provision

• How SEND reforms are applied.

Recent reforms recognise that children with the most complex needs, including those with profound needs, continue to require legally protected specialist support. These reforms also acknowledge that neurodivergent children may require a different approach and extra support.

It’s important to understand the differences in levels of SEND need so that parents can see why recent reforms are being suggested. Autistic and ADHD children absolutely still need support, but these adjustments need to become the norm in schools so everyone may access education equally.