Helping children stay on track

How do we help children who are constantly going off task? How do we help children who don't think before they act?


Reducing distractions

One of the most important ways to help children with inhibitory control difficulties stay on task is to reduce the number of things going on in the child's environment.

- When learning: In the classroom there are many possible distractors. These can include things hung on walls, peers talking, movement around the room or outside a window. One key strategy is to have a seating arrangement that means the child is sitting away from windows, facing the front with no peers between them and the teacher and no distracting wall hangings within their direct line of site. Keep ambient noise low, paying attention to the noise coming from fans, heaters and other students.

Having clear, written rules that have been negotiated with your students will also be essential to maintain a distraction-free environment and help children with inhibitory control issues stay in their seat and on-task. You will need to have a display of these rules and frequently refer to them.

- When doing homework: It is important that a child with executive functioning difficulties not be expected to complete a task requiring concentration in a room that has many distractors. Many of these children benefit from a quiet, clear space away from TVs, toys, computers and other possible distractors.


Expect concentration on only one thing at a time

Use Pointers

Reading can be a very difficult task for children who have trouble with their "inhibitory control" because it can effect their concentration. They can lose track of where they are in the text, skipping words or even whole lines. They can be distracted by noises, and find it hard to pick up where they left off.

An effective tool is a pointer. This can be anything from a child's finger, to a laser pointer on the board, or a ruler under the line they are reading. Another tool is a little window cut out of a piece of card large enough for the child to only see one or two lines of the text at a time.

Using colour-coding can also be useful. You can highlight key words by writing or highlighting them in different colours. You can write/highlight the beginning of each paragraph, sentence or line in a different colour to help children keep track.


Break it down

Big chunks of information, or lots of steps in a task, will be hard for a child to remember if they are struggling to filter out distractions. To address this we should break tasks down so they can focus on one step at a time. The best way to do this is through checklists or graphic organisers (British Columbian Ministry of Education, 2010).

You can use visual checklists on Velcro strips where a child can remove a picture and put it in a "finished" box as each step is completed. Some places where you can get free visuals include www.visualaidsforlearning.com and www.do2learn.com

You can use a written checklists for children with good literacy skills, ensuring they can check each step once it has been completed.

It could also be beneficial to have relevant rewards for each step that has been completed. For example, a child might get 1 point each time they finish a step, and once they have gathered 10 points they are able to dip into a lucky dip of small items relevant to their interest. Other children will be motivated by merit certificates, and others by time doing a favourite activity.

Here are some charts you might be able to use:

• Desk Chart
• Step-by-step Chart
• Flow Chart
• Homework checklist (for older children)
• Chain of events
  

Stop, think, do....

To help children who are struggling to think before they act the steps involved in the Stop, Think, Do program can be used. I have discussed this previously here and here.


In conclusion...

Here is a great checklist from the British Columbian Ministry of Education that can help teachers working with children who have ADHD: www.bced.gov.bc.ca/specialed/adhd/app4.htm The strategies in this document could be helpful for any child who has executive functioning difficulties.


References

British Columbian Ministry of Education (2010) Teaching Students with Attention-Deficit/Hyperactivity Disorder: Planning for Success at School. Retrieved 31st July, 2010 from www.bced.gov.bc.ca/specialed/adhd/plan.htm

Read more...

Executive functioning and self-control

The final element of executive functioning is "inhibition." This is the function that helps us control our responses to what we see, hear and feel.


The Tigger Syndrome

Anyone who is a lover of Winnie-the-Pooh by A.A.Milne will know what I am talking about. If you aren't a fan, visit the official Disney Winnie-the-Pooh and find out a little more about Tigger. For those who don't know, his hobbies include:

"Bouncing, causing mayhem, exaggerating the truth"

For those of us who are fans, we also know that Tigger isn't a "malignant" character. He never intends to cause harm. He just gets side-tracked, is over-enthusiastic (some would say out of control :)), and has a very fertile imagination.


Perhaps Tigger has executive functioning difficulties....

Perhaps he forgets to stop and think before he acts. Perhaps his "inhibitory control" is not functioning as it should.

As Oates and Grayson (2004) state,

"If you were unable to inhibit responses to stimuli that do not relate to the task that you have planned to do, then it would probably be impossible to complete it and achieve your goal. You would be drawn from one stimulus to another, in a haphazard fashion, and it would be impossible to undertake any coherently organised action."

Example: Having a conversation

A conversation with a child who has difficulty with inhibitory control may go something like this...

Hi, Billy. That's a great picture you are drawing. Can you tell me about it?

Yeah. I am drawing a truck. I saw a truck the other day. It was red. I spilt red jelly all over my mum. She told me I had to clean it up. My room has lots of cupboards. I have a nintendo......

The original goal of the conversation was lost as the child followed whatever train of thought occurred. This can happen with tasks, where a child gets distracted by sights, sounds, movement and any other irrelevant stimuli. This is quite natural for very young children, but as we grow older and develop our executive functioning skills this behaviour should disappear or at least dramatically decrease.



In the next post I will explore some ways to help children with inhibitory control issues stay on task


Reference:
Oates, J. & Grayson, A. (2004). Cognitive and Language Development in Children. Blackwell Publishing: Oxford.

Read more...

Helping children self-correct and problem-solve

How do you avoid meltdowns when something changes? How do you help your child recognise that what they are doing is making others upset? How can you help a child recognise when they have said or done something that "crosses the line"? Or when someone else has done something to them that "crosses the line"?


Prepare

You are about to go to a new shopping centre. Or your child is about to go to a new school. These situations will bring up a whole range of new information that they will need to quickly process in order to behave as expected and cope.

For children with executive functioning difficulties, as mentioned previously, this will cause many difficulties (Oates & Grayson, 2004). The best thing to do is to prepare your child as much as possible for their new environment.

Talk about what is going to happen. Talk about the environment, and set relevant rules (Dodd, 2005). Further, whilst talking use video, photos, even a drive past or short preparatory visit to help them process as many things prior to the visit where possible. This will help limit the amount of new information they need to process when making choices about their behaviour.

Using repetitive patterns of language, such as if... then... statements, can also children develop an awareness of possible consequences. This means that this is one less thing that they have to think up in a difficult situation.


Rehearsal

The importance of repetition and rehearsal has been discussed previously, but it is important to recognise the significance of role play in helping children develop self-awareness and problem-solving abilities. For young children, this may be done through dress-ups and dramatic play.

For children who struggle with imaginative play, using scripts will be important. That is, teach the child to use a set phrase or set of actions in response to a situation. Older children might want to help you design a screen play and video their new skill.


Visualise


Children with executive functioning issues will need help storing the information and skills, so they need a concrete reminder to carry around with them in case of "emergencies." Ways to do this include:

• A task card
• A social story
• A comic strip
  
• A picture sequence

The bottom line is to ensure that any visuals are small enough to carry in the child's pocket or on a lanyard or key ring. They need to be immediately accessible, but hard to lose.


Teach emotions

Help children get feedback from others around them by teaching them about body language and facial expressions. You can do this through books, videos, photos and picture strips (Dodd, 2005).

Recently I borrowed a great book called Sometimes I feel....: How to Help Your Child Manage Difficult Feelings by Dr. Samantha Seymour. Apart from the great hints and tips for parents/teachers at the beginning of the book, it is full of great photos of different facial expressions and body language. It also helps build awareness of what can cause someone to feel a certain way.

For example, pages 14-19 read:

Sometimes I feel angry... like when my mummy tells me I have to eat my breakfast before I can go outside and play. Or when it's my turn and my sister won't share."

These are accompanied by relevant photos of young children. This is a great book to help children recognise what can cause others to feel angry, sad, worried and so on. Knowing this can help them self-correct more effectively.

Dodd (2005) also discusses the usefulness of video modelling. This is effective as it can be played over and over again, and can demonstrate step-by-step a process of dealing with or responding to certain emotions.

Another great strategy highlighted by Dodd (2005) on page 187 are little picture cards that include an illustration of an emotion with relevant questions (see image adapted from her examples below).


Have a crisis management plan

It is important to also anticipate difficult emotions and situations when a child may not be able to cope. Have a plan for those times.

One of the strategies that has been discussed previously is the use of a feelings thermometer. This is a visual way of helping children recognise and manage difficult emotions.



Be proactive and positive

But most importantly, we should remember to always be proactive - prepare and anticipate in order to prevent negative events as much as possible - and positive, giving praise and positive reinforcement rather than focusing on "don'ts".



References:

Dodd, S. (2005). Understanding Autism. Sydney: Elsevier.

Oates, J. & Grayson, A. (2004). Cognitive and Language Development in Children. Blackwell Publishing: Oxford.

Read more...

To Include or not to include?

Special Education - "What's best for kids?" - as on seen on Weekend Sunrise Channel 7

And just as an additional note...

Article 23 of the UN Convention of the Rights of the Child (to which Australia is a signatory):

1. States Parties recognize that a mentally or physically disabled child [child with an intellectual or physical disability] should enjoy a full and decent life, in conditions which ensure dignity, promote self-reliance and facilitate the child's active participation in the community.

...

3. Recognizing the special needs of a disabled child, assistance extended in accordance with paragraph 2 of the present article shall be provided free of charge, whenever possible, taking into account the financial resources of the parents or others caring for the child, and shall be designed to ensure that the disabled child has effective access to and receives education, training, health care services, rehabilitation services, preparation for employment and recreation opportunities in a manner conducive to the child's achieving the fullest possible social integration and individual development, including his or her cultural and spiritual development.

And 4.2 of the Commonwealth Disability Standards for Education (2005) states:

(1)The education provider must take reasonable steps to ensure that the prospective student is able to seek admission to, or apply for enrolment in, the institution on the same basis as a prospective student without a disability, and without experiencing discrimination.

(2) The provider must ensure that, in making the decision whether or not to offer the prospective student a place in the institution, or in a particular course or program applied for by the prospective student, the prospective student is treated on the same basis as a prospective student without a disability, and without experiencing discrimination.

(3) The provider must:

(a) consult the prospective student, or an associate of the prospective student, about whether the disability affects the prospective student’s ability to seek admission to, or apply for enrolment in, the institution; and

(b) in the light of the consultation, decide whether it is necessary to make an adjustment to ensure that the prospective student is able to seek admission to, or apply for enrolment in the institution, on the same basis as a prospective student without a disability; and

(c) if:
(i) an adjustment is necessary to achieve the aim mentioned in paragraph (b); and
(ii) a reasonable adjustment can be identified in relation to that aim;
make a reasonable adjustment for the student in accordance with Part 3.

If you want to see the Facebook debate, visit http://www.facebook.com/group.php?gid=134329293268218

Read more...

Helping children adapt to change

Self-Correction:

"The ability to monitor and accurately evaluate performance and to make changes. Ability to learn from experience and feedback." (Queensland Health, 2007)

Problem-solving:

"The ability to recognise when the actions you are taking are ineffective, to stop, re-evaluate, and to formulate a plan." (Queensland Health, 2007)

Struggling with change

It would be simplifying things far too much to draw a direct link between executive functioning issues and children's difficulties adapting to change in their environment. However, it can play a significant part in this. But before I discuss the problem-solving and self-correction element of executive functioning, I want to look quickly at changes that children may find difficult to deal with, what behaviour they may display, and some other key factors that can contribute to difficulties adjusting to change.


What changes can cause difficulties?

There are many changes that can cause children with Autism Spectrum Disorders, anxiety disorders, depression, ADHD and even children who are chronically tired to feel threatened or anxious. These can include:

• New people
• Familiar people behaving differently
• Interrupted routines
• A favourite toy missing
  
• New sounds
• Moved furniture
• Complex, unpredictable interactions
  (Dodd, 2005; Oates and Grayson, 2004)
  

In fact, almost any change that a child with these difficulties is not prepared for will cause them distress.


What might you see?

Every child will have their own individual way of demonstrating that they aren't coping, or don't know what to do, when dealing with a change. Some examples:

• Meltdowns: I have talked about these in a previous post.
• Withdrawal
• "Stubborn" behaviour, or refusals. This often comes up in the context of children with Down Syndrome.
  

Executive functioning, self-correction and problem-solving

These elements of executive functioning, alongside the ability to plan and self-evaluate, help us adapt to the changes and complexities of life. As Oates and Grayson (2004) discuss, "the ability to switch flexibly between planned actions and different approaches to a task, without losing sight of the goals that are being aimed for, is a high-level cognitive function that is critically important in everyday life." (p214) That is, in order to cope with the many complexities of life - social, academic and physical - we need to be able to constantly evaluate, identify what is/is not working and adjust our behaviour accordingly.

When the executive functions aren't developed appropriately, then children will have difficulties adapting to change unexpected behaviour.

For example, imagine you are a child who loves playing in the sandpit with your two close friends. Ever since you have been at school the three of you have gone directly to the sandpit as soon as the recess bell has rung. Then one day you are heading out to the sandpit and one of your friends decides they want to join the hand-ball games instead.

You want your friend keep to your routine, so you say, "Come on! Aren't you coming to the sandpit?"

Your friend replies, "Nah. Today I feel like playing in the sandpit."

You say, "Aww. Come on! Let's play in the sand pit. We always do!"

Now, if you have a well-developed ability to self-analyse, self-correct and problem-solve, once you start noticing that your friend is becoming annoyed, you think about previous experiences, what you have been taught, how your behaviour is effecting them. You then correct your behaviour and problem-solve based on your goal of maintaining friendships ... which could mean you join the hand-ball game or go to the sandpit with your other friend.

If you have executive functioning difficulties, you would probably keep insisting that your friend maintain the routine. You may become aggressive in your attempts to maintain the routine (eg. pulling the child towards the sandpit) or have a meltdown as you are unable to work out what to do next since your routine has been broken.


Other reasons why children may struggle with change

• Theory of mind or social imagination (as discussed in a previous post) ... Not being able to interpret and respond appropriately to your social context will lead to difficulties with problem-solving and self-correction, or the ability to be flexible and adapt to your environment.
• Intellectual Disability ... a person's IQ is only one element of diagnosing an intellectual or developmental disability. The other element is an assessment of adaptive behaviour. As the American Association of Intellectual and Developmental Disabilities states, adaptive behaviour is about the ability to use language, social, conceptual and practical skills to live independently and according to the social expectations of our culture. It is therefore recognised that a person's cognitive development influences their ability to problem-solve and self-correct.
  

Next time....

Next time I will talk about ways to help children self-correct and problem-solve.



References:

Dodd, S. (2005). Understanding Autism. Sydney: Elsevier.

Oates, J. & Grayson, A. (2004). Cognitive and Language Development in Children. Blackwell Publishing: Oxford.

Queensland Health. (2007). Executive Function and Capacity. Retrieved 8th May, 2010 from http://www.health.qld.gov.au/abios/documents/behaviour_mgt/exec_functn_capacity.pdf.

Read more...

A-way with visuals

The heading is a slight (perhaps a poor) play on words... I am painfully aware that I have been neglecting this blog (ie. "away") for the last month. Here are my excuses (plus a few resources and a bit of useful information for you).

Playgroups for children with Autism

In Australia, the government and Playgroup Australia have teamed up to fund playgroups for families of children with Autism Spectrum Disorders or Autism-like symptoms. These are called PlayConnect Playgroups.

So while I have been neglecting you, I have been investing time in connecting with some special people helping children with Autism in my area, and with a few families whose children have Autism Spectrum Disorders or language delays.

Medowie PlayConnect

Medowie PlayConnect started on the 18th of June. We run on Fridays from 10am until 12noon. I am the facilitator of the group and have really enjoyed getting to know the parents and children who have come along for the last few weeks.

Our Schedule

While we are pretty flexible because we are all just getting used to each other, this is our little schedule which helps us keep track of what is going on. If you want to use these pictures, you can access it here...

This website has a whole variety of visuals that can be used for both pre-school and school aged children, at home and at school.

Our Hello and Good-bye Song

At Medowie PlayConnect we also have a "hello" and "good-bye" song. You can find it here (in pdf format) ...

We are using a little AUSLAN sign language with the song, and you can click on the links in the document above to watch short clips of the key signs for our song. Feel free to use it if you need a short greeting and farewell song.

And another thing....

I have also been busy marking assignments, all of which were about finding ways a child with ADHD can be included in a wide range of different lessons and classrooms... there are some great ideas and great teachers coming your way :)

I am also preparing for my presentation at the Autism and Aspergers Support Group in Richmond on the 12th of July. We will be having some discussions about bullying and inclusion. To find out more, visit http://www.autismsupport.org.au/

Hopefully I will see you there.

And I promise more posts this month - to finish off the series on executive functioning.

Read more...