For posts on bullying, visit The Learn to be Buddies Series Blog.
All images and posts written by and copyright to Amanda Clements (nee Gray) 2009-2012 unless otherwise indicated.

Tuesday, May 26, 2009

A teacher's perspective

Tuesday 26th May 2009 (Image and text copyright Amanda Gray 2009. )

Dear Amanda.

As I read the letter on your blog Dear Teacher (May,21) my heart went out to the parent who wrote this letter. In my 13 years of teaching I have heard many similar stories from parents with children with special needs. We as teachers do need to be reminded of the importance of stepping into a parent’s shoes and seeing their child as they see them. Much research and professional writing has been undertaken in the area of understanding children with special needs and challenging behaviours and many strategies for working with these children have been put forward. However, little is heard about supporting teachers who are teaching mainstream classes with several children with ADHD and other challenging behaviours. How does a teacher with no special education training survive and continue to enjoy teaching in this situation?

After 11 years of teaching I was given a class with four children with VERY challenging behaviours. During the course of the year two were diagnosed with having ADHD and it was evident that the other two had significant sensory processing difficulties. All of these children had difficulty interpreting social cues and constantly had social difficulties in the playground. I started the year enthusiastic, having always loved teaching, I saw this class as a challenge. However, as the year progressed the unrelentless situation in my classroom wore me down. I found that I spent my days managing behaviour and despite trying many strategies suggested to me nothing seemed to work with these children. I would end each day exhausted. To survive in this situation I felt I had to water everything I taught down to maintain classroom control. I felt that instead of functioning as a teacher I regularly had to function as a therapist as the individual needs of these children were so demanding that they required more attention than actual syllabus work. In the end I finished the year wanting to leave teaching.

Fortunately I have come out of this and have a great class this year. My love for teaching has returned and I look forward to going to work each day. My question is, how does a mainstream teacher with no special education training, survive this kind of situation and continue to provide a positive learning environment for the other children in the class? How do you address the needs of these children while still maintaining a high quality of pedagogy for all children in the class?

Thank you so much for sharing this. Just as it is important to hear the perspective of parents, it is also important to hear from teachers working with children who have special needs.

This is such a complex issue and one that has no easy answer. No matter how much we talk about innovative practice and extra support, there is always the issue of limited resources, time and the need to balance the needs of all children - and our own sanity.

I have no definitive answers as every situation is different, but in my time as a teacher I found the things that helped me and my collegues included:
- Much preparation and use of student-centred, hands-on learning such as learning centres (today technology is a great resource to use)
- A strict, structured routine (visually displayed and frequently referred to in the classroom)
- A set of rules and rewards negotiated with the students (again, displayed and frequently used)
- A close partnership with executive staff in implementing consistent, supportive and immediate consequences (eg. the child does their work in the principal's office or under supervision in the library when they are having a bad day - not as a punishment, but to help them "cool down").
- A collaborative focus on preventing behaviour issues before they escalated (which can be about asking someone else to come in and observe them in your classroom so you can together identify the purpose or triggers of the behaviour).
- Wherever possible, a close partnership with parents or other family members, respite staff and/or a buddy teacher who had built a rapport with the child/children (a volunteer in the classroom at the most difficult parts of the day, with whom the child has a good relationship, can make a big difference)
- A supportive partnership with another teacher with whom you can debrief

In one particular case a teacher with whom I worked had a great partnership with her student's parent. The student had a contract negotiated between the parent, student and the teacher. This contract set out the expectations of what the child was to achieve each day, a consequence and a reward system in response to their performance. The reward system included immediate points awarded according to tasks completed, and those points went towards a trip to MacDonalds with the child's parents (the child and the family chose the award).

They also had a "crisis management plan" in place. When the child was becoming disruptive, or was distressed, a process was put in place whereby a buddy teacher and/or the assistant principal would become involved.

While these don't "solve" the issues, they provide a network of informal support if the child is not eligible for extra funding support for resources such as a teacher's aide. It may also help to regain the balance between education and behaviour management.

And, believe it or not, special education teachers don't always have the answer either. Our profession is always about collaboration, asking for help and creatively using any resources we can get our hands on.

The bottom line is don't be afraid to ask for help. If you are a teacher in this situation, you might want to ask the principal if you are eligible for a support teacher (behaviour) to come into your classroom and observe what might be triggering difficult behaviour in the child. They may be able to suggest some things (such as those discussed in my previous posts) that can be integrated into the routine of your classroom to reduce the child's difficult behaviour without disrupting your teaching. A school counsellor may also be able to do this. Or you may have a special education teacher, or a support teacher (learning assistance) in your school who may also be able to help.

And to all you teachers out there who are supporting and including children with diverse needs in your classroom, you are doing a great job (and I don't mean that in a patronising way Lol).

You are making a difference.


Monday, May 25, 2009

Ask Amanda

It is time to Ask Amanda... what do you want to know about his month's topic or any topic related to special education or inclusion?


Helping children follow your directions

Golden rule:
Give your instructions in different formats in an environment that is as quiet as possible, and reward them for their efforts.

A quiet environment
Some things to think about at home if your child is having problems hearing or focusing their attention on your instructions:

- Turn off the TV before you start talking
- Don’t try and yell over the washing machine, dishwasher or mower – or yelling kids. Turn the appliances off, and wait until your child is quiet before giving instructions.
- A room that is carpeted and has curtains will help cut down background noise
(My Dr, 2005; Neven, Anderson and Godber, 2002)

Some things to think about in the classroom if your student is having problems hearing or focusing their attention on your instructions:
- Negotiate and enforce rules about sitting quietly while the teacher is talking. Enforce the rules through praise and having a visual list of the rules on the wall (AFCEC, nd).
- Have a signal (eg. flicking the light switch for high school, clapping a rhythm which the students then have to copy in primary school) that indicates you are about to speak. Don’t try and yell them to attention (CDI, 2008).
- Wait until you have their attention before giving instructions.
- Use a noise-o-meter to keep children aware of what noise level is appropriate.
- Be aware of how any appliances, floor coverings and other features of the room may increase or decrease background noise.

Different ways of giving instructions:

“Okay, kids, collect your Maths books, sit down at your desk and start work on page 6.”

As you talk, demonstrate each step.

This can be hung on the board, or put on the child’s desk.
Give this to the child so they can tick off each step as they complete it.
(Adapted from
Motivation and rewards

"If you do your work, then you can have a sticker." This is a “bribe”.

"Remember that when you finish this you will be able to put a star on your I've Finished chart." This is a negotiated reward that is a natural consequence of task completion.

But maybe we’ll talk more about this another time.


Alabama Federation Council for Exceptional Children. (nd). Rules for Structuring the Classroom. Retrieved 25th May, 2009 from:

Child Development Institute. (2008). Suggested Classroom Interventions ForChildren With ADD & Learning Disabilities. Retrived 25th May, 2009 from:

MyDr. (2005). Hearing Impairment and School Children. Retrieved 25th May from:

Neven, R.S., Anderson, V. and Godber, T. (2002). Rethinking ADHD. Allen and Unwin: Crows Nest.


Thursday, May 21, 2009

Dear Teacher

A letter from a parent of a child with ADD, placed here with permission ....

Sometimes it is great to hear from parents so we as teachers can keep things in perspective. Thank you, parent, for sharing.

Dear Teacher,

By now you have had the chance to observe and interact with my son. You might find him to be goofy, high-strung, impulsive, reactive, or just plan irritating. But, no matter what your thoughts are about my beautiful boy, please remember what you have been hired to do. I put my child in your hands to guide him, teach him, inspire him, and help him grow. You cannot do this if you don't have an understanding of how he is made. On the days you feel like you can't take another minute of him, reach out to him. When he's interrupted you over and over again, be gentle. When he can't stay in his seat another moment, send him on an errand. When he's not really getting social cues from his peers and struggling relating to them, talk to all the children without singling him out. When he can't seem to focus, touch his shoulder gently without saying a word. When he says he hates school, don't take it personally, he just hates feeling so frustrated by the world around him that he can't turn off.

And lastly, please remember that this child is the apple of someone's eye. They bring us so much joy, even with the difficulties they have to endure every single day. You could be the one teacher that could change my child’s life forever, or you could be the one that could tear down his self-esteem for years. Watch your words. Our children never forget a negative comment. Remember why you want to teach, and realize you will see more and more children like mine. They want to do good. They want to succeed. They want to please everyone. You could be that one who could make a difference forever by reaching out to my child. I truly believe that the success you find in him will carry you on for many years. ADD parent.


Tuesday, May 19, 2009

Doing what you are told

One day, in a state of complete exhaustion, I got up to complete my final routine before crawling into bed. In my head I planned to do as follows:
Put cheese in fridge
Put rice crackers in cupboard
Clean teeth
Crawl into bed

As I discovered when I next was looking for my favourite snack, what I actually did was:
Put cheese and rice crackers in fridge
Clean teeth
Crawl into bed

This is an example of cognitive planning going wrong… and an illustration of how executive function can be affected by fatigue. Children whose executive functioning has been affected by factors such as fatigue, anxiety, ADHD or other factors/disorders may find it hard to carry out a sequence of steps even if they do remember the main points of what they have been told.

Doing what you are told

To follow instructions we need to be able to identify the important items, plan and organise the information so we can follow-through with the instructions. Then, finally, we need to be able to concentrate and monitor our actions (ie. I should have realised that the rice crackers really didn’t belong in the fridge). All this is managed by something we call executive functioning (Hagemann, Hay and Levy, 2002).

Executive Function (Hagemann, Hay and Levy, 2002):

Executive function is part of the working memory system. It is a cognitive function that helps us helps us decide what to remember, and what to discard. It helps us put the information in the right order. And it helps us stay on track.

So if a teacher says, “Well, kids, now it’s time to pack up. I want you to put your pencils in your pencil-tin, your books in your tote tray and then come and sit on the floor ready to have a story.”

A student whose “executive function” is working well might have a thought process that goes something like this… “pencils away, book in tote, sit on the mat”. They will then do this in the required order, and be sitting quietly at the front of the room ready for the teacher.

A student whose executive functioning is not operating in the same way, you may find they carry their books and pencils with them to the mat, or they get out their tote tray and put it on their desk. Alternately, they could get distracted half way through and need multiple reminders to get back on track because they aren’t monitoring their own behaviour.

For other children it may just be that they take much longer to work through the process, having to work hard at remembering each step.

Executive functioning is identified as one of the key functions that is affected in children with attention deficit disorders like ADD and ADHD. This means that the children often act impulsively, without thinking about the instructions or consequences of their actions. It also contributes to the fact that they prioritise what’s going on outside the window rather than listening to the instructions you are giving (which, of course, links back to the difficulties with paying attention).

So this is just one more thing to consider when we give instructions….

Next time I am going to post a letter from a parent who has a child with ADD. It provides some great insight. If you want to contribute a similar letter, please email it to me at

I hope this blog is helpful to you. If it is, make sure you vote on the poll on the left. I also look forward to your questions and suggestions for future topics.

If you want to find out more about me and what I am up to, you might want to visit


Hagemann, E., Hay, D.A., and Levy, F. (2002). Cognitive Aspects and Learning. In S. Sandberg (Ed), Hyperactivity and Attention Disorders of Childhood, p214-241. Cambridge University Press: Cambridge.

You might also want to visit:


Monday, May 18, 2009

What did I just say?

Tom is standing in the supermarket. He has been asked by Sal to pick up a few things on his way home from work.

He knows he needs to get bread and milk because he remembers having nothing to eat for breakfast this morning. But he knows he was asked to buy something else.

Something for the bathroom.

Toilet paper? Toothpaste? Shampoo? Soap? Razor?

He knows he needs to buy one of these things because it has nearly run out.

He closed his eyes, tried to visualise or “hear” what Sal had said… but all he could hear was Sal saying, “Make sure you write it down so you don’t forget!”

And he had said, “I’ll remember… it’s only three things!”

But that was before he had fought peak hour traffic, met an old friend, taken two phone calls and fought with a fellow-shopper for a parking spot.

He got home with bread, milk and toilet paper (because he felt that was more important than the other toiletry items).

Sal called out, “Did you get my shampoo?”


What makes us remember instructions?

When recalling things we have been told, we usually paraphrase or summarise the idea rather than repeating in our heads exactly what we have been told. That is because we usually only hold small snippets of information in our “working memory” for a short period of time.

Information in our working memory is easily accessed. Our working memory is where we put the information we are using. With our working memory we usually have to drag the information out of our long term memories so we can use it.

The capacity of our working memory

There are different theories about working memory, but Baddeley (2006) discusses this in depth. He states that working memory is for temporary storage of information. He also discusses that theorists suggest that it possibly involves four systems:
1- for processing sound and speech
2 -for processing visual information
3 – for helping us select what information we need to pay attention to
4 – to help us link what is in our working memory with our long-term memory.

While it seems that nobody is exactly sure of the capacity of each system, it is estimated that if we don’t link it to our long term memory in a few seconds, it can be lost. The only way we can save that information for later is if we file it carefully in a way that makes it easy to access later.

A good filing system

One way for us to have more success in storing instructions is through rehearsal. For example, if Tom had spent time chanting “Milk, bread, shampoo. Milk, bread, shampoo” to himself he could possibly have had more success in remembering what he needed. This is because the information would have been in his working memory for longer, with more time to process and link it to ideas and patterns in his long term memory.

Another way is to chunk information together. One good example is when we remember sets of three numbers in a nine digit phone number, instead of trying to remember the whole number at once. Again, this is because we are putting short chunks of information into our working memory, instead of overloading it with a large, unwieldy amount of information.

Linking with what we know:
But one of the most important ways of remembering what we have been told is by quickly making links between the instructions and what we already know, or what is important to us. That is why Tom remembered the milk and bread but not the shampoo.

Poor filing systems:

If you have trouble paying attention, controlling your thoughts, or have a small working memory capacity, then you will struggle to focus on information long enough to be able to retrieve all the information later. Their working memory may be overloaded (Hagermann, Hay and Levy, 2002; Gathercole, Lamont, & Alloway, 2006).

So that may be why you find a child with ADHD or ADD, when given instructions to get their books, sit at their desk and get out their pencil, wandering around the room with their book.

Anxiety can also cause difficulties with the working memory processes (Terry, 2006).

Children with developmental delays (intellectual disabilities), including children with Down Syndrome, will also have trouble with the processing systems of working memory. However, it is possible that most of their difficulties come with not being able to generalise or link new information with what they already know. They may also struggle to develop good memory strategies (Terry, 2006).

Again, this may mean that they cannot retrieve what they have been told… and this is in addition to possibly struggling with language patterns and vocabulary.

It is also important to remember that we all have different working memory capacities. Part of that is about the strategies we use, but there are many other reasons that we don’t fully understand (Terry, 2006).

So when you give some instructions, make sure you think about how you are catering to your child/children’s working memory.

Next time we will think about what it takes to act on instructions you have been given.


Baddeley, A. (2006). Working Memory: An Overview. In S.Pickering (Ed) Working Memory and Education, p3-33. Academic Press: London.

Gathercole, S.E., Lamont, E., and Alloway, T.P. (2006). Working Memory in the Classroom. In S.Pickering (Ed) Working Memory and Education, 219-240. Academic Press: London.

Hagemann, E., Hay, D.A., and Levy, F. (2002). Cognitive Aspects and Learning. In S. Sandberg (Ed), Hyperactivity and Attention Disorders of Childhood, p214-241. Cambridge University Press: Cambridge.

Terry, W.S. (2006). Learing and Memory: Basic Principles, Processes and Procedures. Pearson Education: USA.

If you have any good websites that address this issue, please share them. I ran out of time to do some searching... maybe I will add some later.


Saturday, May 16, 2009

Do you understand what I'm saying?

Image from "Dave is Brave" . Copyright Amanda Gray and Daniel East.

Jenny has just arrived home from the gym feeling stiff and sore. Tom has just come inside as the coldness of the evening has made it too uncomfortable to work any longer in his garden.

Jenny rubs her lower back. “Uhhh! I feel old!”

“Brrr. I’m freezing, too! I’m going to have a shower.”

Jenny watches him go with a perplexed look on her face. “What?”

Image from


Even if we hear what a person is saying, and are paying attention, sometimes we don’t correctly interpret what they are saying.

To interpret or work out what a person is saying you have to be able to make sense of the sounds you hear. You need to change the isolated sounds into words, then put those words together based on their sequence and how they are said to get the full meaning of what you have been told (Anderson, 2000).

Minor misunderstandings like that between Jenny and Tom can occur because of trouble hearing. But they also often occur because we all bring our own ideas or context to communication.

Jenny’s context was that she was sore and tired. Tom’s was that he was cold. So he interpreted the word “old” to mean “cold”.

What makes it hard to interpret sounds?

The size of your vocabulary
You need to share the same vocabulary with the person to whom you are talking (Anderson, 2001). Children can have a smaller vocabulary for a wide range of reasons. Children with developmental delays such as that associated with Down Syndrome may take longer to learn words in a way that means they can “retrieve” them easily. This means that they may have a smaller vocabulary (Buckley, 1993; Chapman, 2006).

We pick up most of our vocabulary through experiences with language and conversations (Cross, 2001). Children who have difficulties hearing will have smaller vocabularies due to limitations placed on their language experiences. Children for whom English is their second language will also have a smaller vocabulary.

Some conditions like dyslexia can influence how we process sounds (Stein, 2001). So while children with these conditions may be able to hear the sounds, it might take them longer to work out what these mean. These children may also have a smaller vocabulary, or mix up sounds more often. They may also struggle to hear changes in tone of voice, which will be discussed below.

Children who have Autism Spectrum Disorders may also have a smaller vocabulary. This is mainly due their limitations in social and emotional reciprocity, or empathy (Scott, Clark, Brady, 2000). This means that the motivation for their communication will come from their own interests, not based on an understanding of how communication influences their relationships with others (Autism Association of South Australia, 2009).

For example, a child with Aspergers may have a special interest in Maths and logical problems. This child may then have a big vocabulary relating to this subject. But in the context of other subjects, including language related to everyday tasks and social interactions, their vocabulary might be quite small.

These difficulties can also lead to problems with the other things you need to know in order to correctly interpret what people are saying (discussed below).

Your knowledge of the patterns of language
To understand what people are saying you need to have a good knowledge of how words fit together in a sentence. You also need to know how tone of voice can change what they mean. As discussed in a previous post , this can be difficult if you have trouble paying attention to and interpreting others’ facial expressions and body language.

Your knowledge of the subject being discussed
As mentioned previously, knowing the context of a discussion is important in helping us interpret what is being said (Anderson, 2001). It helps us put the sounds together and chose the right words to fit the context. It also speeds up the process of changing the sounds into meaningful sentences.

So if you have a child who is tired, or bored, or struggling to pay attention they are more likely to misinterpret what you are telling them to do.

The process of interpreting sounds and words relies on our skills in remembering and retrieving information we have learnt (Hick, Botting & Conti-Ramsden, 2005). I will talk more about memory in the next post.


Anderson, C. (2001). Pragmatic Communication Difficulties. In R. MacKay and C. Anderson (Eds), Teaching Children with Pragmatic Difficulties of Communication, p24-38. David Fulton Publishers: Hampshire.

Autism Association of South Australia. (2009). What is Autism? Retrieved 16th May, 2009 from:

Buckley SJ. (1993) Language development in children with Down syndrome - Reasons for optimism. Down Syndrome Research and Practice,1(1), p3-9. Retrieved from

Chapman RS. (2006). Language learning in Down syndrome: The speech and language profile compared to adolescents with cognitive impairment of unknown origin. Down Syndrome Research and Practice, 10(2), p61-66. Retrieved from

Cross, L. (2001). Early Communication Development. In M.S. Lue (Ed.) A Survey of Communication Disorders for the Classroom Teacher, p35-54. Allyn and Bacon: Boston.

Hick, R.F, Botting, N., and Conti-Ramsden, G. (2005) Short-term memory and vocabulary development in children with Down syndrome and children with specific language impairment. Developmental Medicine & Child Neurology, 47, p532–538. Retrieved

Scott, J., Clark, C., and Brady, M. (2000). Students with Autism: Characteristics and Instruction Programming. Singular Publishing Group: San Diego.

Stein, J. (2001). The Neurobiology of Reading Difficulties. In M. Wolf (Ed) Dyslexia, Fluency and the Brain, p 3-22. York Press: USA.


Friday, May 15, 2009


John is boring on, once again, about the latest movie he has seen. He is retailing, in the greatest unnecessary detail (including quotes), the most exciting parts – all of which mean that your intention to see the movie next week is, well, redundant.

But all the sudden there is an ominous silence. It dawns on you that John has asked you a question… and while you heard what he said, you weren’t actually listening.

You frantically search in your memory… but, no, it’s not there.

You may have to admit it…but, instead, you tell a little white lie.

“Sorry, John, I didn’t hear you.”

Unfortunately John knows that is not strictly true. He walks away in a huff, knowing that the reason you didn’t “hear” is because you mentally tuned out.

Picture copyright Daniel East and Amanda Gray. From picture book, "Dave is Brave"
To listen, you have to pay attention

To be able to do what someone asks, you have to be paying attention. You have to not only hear what the person said, you also have to concentrate and focus on the relevant information (Hagemann, Hay & Levy, 2002; Moore, 1997).

You have to be able to shut out all the unimportant things happening around you… like the person mowing the lawn just outside the window. Or the pretty, colourful bird that just flew past. Or the music playing, or people talking, or the TV going in the background (Neven, Anderson & Godber, 2002).

This takes effort. It is also a skill that is more difficult under certain conditions.

When is it hard to pay attention?

There are many reasons why a child may be struggling to pay attention. For example, a child with a hearing impairment or any other language difficulty can miss any words or sounds that cue other children into the fact that you are about to give them a list of instructions.

For example, you might call a child’s name, or say to a class, “NOW (pause to wait for all eyes to turn to you)… what you have to do is…” This is a verbal cue to get your student’s attention. This will only work if the child is “tuned in” to your voice.

It is not only children with hearing impairments who might find it hard to be tuned in to your voice. Children with attention deficit disorders such as ADD or ADHD may find it difficult to focus on one thing if there are lots of other things to look at or listen to (Kewley, 2005; Neven, Anderson & Godber, 2002).

Children who are tired, hungry, anxious, or simply not interested in what you are saying will also find it hard to pay attention to what you are saying.

I will talk about strategies later in another post, but it is important to remember that triggering the child’s attention through more than one sense (touching their shoulder or standing close to them as well as calling their name) may be the answer.

And always, always, make sure you have their attention first before you start asking them to do things (Educational Psychology Service, 2008).

How can you tell if they are paying attention?

Eye contact is one of the most important things to gain before giving instructions. This will tell you that the child is focusing their attention where you want it. It will also help those who struggle with storing the words or hearing the sounds as they can get clues about what you are saying through your body language, gestures, lips and facial expressions (Queensland Health, 2008).

For children with Autism for whom eye contact may be difficult, do not demand eye contact (Austism SA, 2004). Looking in your direction or tilting their ear towards you may be their way of paying attention.

In the next post I will talk about difficulties children might have in interpreting what we are saying.

Reference list:

Autism South Australia. (2004) Information Sheet 17 Classroom Issues. Retrieved 15th May, 2009 from:

Queensland Health (2008). Communication with vision or hearing impaired clients. Retrieved 15th May, 2009 from:

Kewley, G. (2005). Attention Deficit Hyperactivity Disorder: What can Teachers Do? David Fulton Publishers:London.

Neven, R.S., Anderson, V. and Godber, T. (2002). Rethinking ADHD. Allen and Unwin: Crows Nest.

Hagemann, E., Hay, D.A., and Levy, F. (2002). Cognitive Aspects and Learning. In S. Sandberg (Ed), Hyperactivity and Attention Disorders of Childhood, p214-241. Cambridge University Press: Cambridge.

Moore, B.C.J. (1997). And Introduction to the Psychology of Hearing. Academic Press: San Diego.

Educational Psychology Service. (2008). Managing Attention Deficit Hyperactivity
Disorder (ADHD) in the Classroom. Retrieved 15th May, 2009 from:

You might also want to check out the following links:


Sunday, May 10, 2009

Why aren’t you listening? Disobedient or Distracted?

Picture copyright Daniel East - from "Dave is Brave"
“I’ve told him what to do a dozen times, but it goes in one ear and out the other!”

Have you ever heard that said? Well, it might be very near the truth.

But, despite what you might feel, a “good kick up the backside” is not the solution. We need to understand why our words have not stuck with the child.

What is involved in doing what you are told?

When you are told to do something you have to be able to hear, listen, interpret, remember and act on the instructions. If you have difficulties doing any one of these things you can seem “disobedient”.

In this post I want to talk about hearing.


I won’t give you a biology lesson on hearing here. You might want to visit the Mayo Clinic if you are interested in how the ear works. For now, I just want to point out some reasons why a child might not be able to hear you.

Conductive hearing loss (ASHA, 2009; Australian Hearing, 2009; Moore, 1997)

Children who have recurring ear infections such as Otitis media, or even a build up of wax in the ear will find it hard to hear clearly. For others the bone and cartilage structure may interfere with the movement of sound through the ear to the nervous system that processes the sounds.

Children with Down Syndrome are shown to be at increased risk of ear infections and conductive hearing loss because of their susceptibility to infections and the smaller ear canal (Moss, nd).

Indigenous Australians have also been shown to be at increased risk of conductive hearing loss (Coates et al).

For some children, the treatment might be through antibiotics or grommets (MyDr, 2008). For others, hearing aids may be used.

Sensorineural hearing loss (ASHA, 2009; Australian Hearing, 2009; Moore, 1997):

This is when the cochlea or the nerves that carry sound to the brain might be affected. The levels of hearing loss may differ, but generally sensorineural loss cannot be fully addressed even if the child is using hearing aids. For children whose cochlea is damaged, cochlea implants can be used. For others, communication will be through the use of sign language.

The levels of hearing loss are described as mild, moderate, severe and profound. If you want to know what a child might hear depending on the level of hearing loss they have been diagnosed with, visit ASHA and the Medical College of Wisconsin (they have a great picture that is easy to understand). The Warren Centre also has a good diagram of what sounds equate to different decibel levels (as seen in the ASHA description).

Disobedience or Distraction?

If a child has an ear infection such as Otitis Media they will struggle to hear you call their name in a noisy room or if their back is turned to you. So if they don’t respond, it is that they haven’t been able to pick out your voice from all the other noises going on around them.

If a child has a hearing aid or a cochlea implant, it doesn’t mean that they have perfect hearing. They will struggle to hear you in noisy rooms, or if there is something or someone making a noise closer to them than you.

You also need to remember that children with hearing impairments may have smaller vocabularies and may struggle with understanding how sentences are put together. This is because their learning of language is interrupted by what they can and can’t hear. This may mean they find it hard to pick out the important bits in your instruction.

For example, if you say "Julie, can you put your book away in your book tray, please?" the child
may know you have mentioned a book and a tray, but not make the connection between the two. So the child may be confused about what exactly you want them to do with the two objects.

Next Time

In the next post I will talk about the difference between listening and hearing. Later I will also talk about some strategies and things to think about when giving instructions to a child who has a hearing impairment.

Australian Hearing (2008) Types of Hearing Loss. Retrieved 10th May, 2009 from:

American Speech-Language-Hearing Association. (2009). Type, Degree and Configuration of Hearing Loss. Retrieved 10th May, 2009 from:

Coates, H.L., Morris, P.S., Leach. A.J., and Couzos, S. (2002). Otitis media in Aboriginal children: tackling a major health problem. Medical Journal of Australia 177 (4): 177-178 Retrieved from:

Mayo Clinic (2009). How do we Hear? Retrieved 10th May, 2009 from:

Moore, B.C.J. (1997). An Introduction to the Psychology of Hearing. SanDiego: Academic Press.

Moss, K. (nd). Hearing and Vision Loss Associated with Down Syndrome. Retrieved 10th May, 2009 from:

My Dr (2008). Otitis Media in Children. Retrieved 10th May, 2009 from:


Thursday, May 7, 2009

Ask Amanda - Which school is best for my child??

Shelley's question: Hi I just found this blog via your comment on DSA Keeping up with DS. I have a blog - would love your opinion on 'which school' dilemma - I know there is no one way to decide which school gets the privilege of teching my twins - but looking at the 3 options - which one would you choose based on the infornation available toyou? Is the nain thing that the school WANT the child with DS?

Hmmm, this is always a tough one. But I suppose the best thing is to look at what makes transition to school a success.

A number of years ago I wrote a literature review for a study called Experiences of parents of children with special needs transitioning from early childhood to school. I also helped analyse some of the information that came from parents.

This study and the research that I did for the literature review suggested that a smooth and successful transition to school involved the following:
- There was regular and positive communication between the families and the school.
- There was a good understanding of the child's needs during the transition process.

Some research also suggests that a child's adjustment to school is made much easier and successful if the school, teacher and early intervention or preschool staff work together and support each other as well as the child.

I also remember that there were quite a number of parents who felt that the school wanting or at least being willing to make adjustments for the child was a significant factor in which school they chose.

So I suppose the short answer is... go to the school where you as well as your child will be supported in the process of adjusting to school. It might be said that the attitudes and supportiveness of the school staff and culture outweighs in importance the school's available finances and facilities.

I hope that helps in your decision-making.

If any other parent has suggestions or experiences to share on this, please do so....


Wednesday, May 6, 2009

I will be back soon... I promise

Things have been very hectic lately. I write a monthly newsletter for my Learn to be Buddies series so have been very focused on that in the last week. But I will be writing a blog called Disobedience or Confusion? on the weekend. In the meantime, you can see my newsletter at


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Copyright Amanda Gray 2009-11

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