Holidays are over! The challenge for children

Returning to school can be very exciting for children. It can mean re-connecting with friends and all the social fun! It can mean a return to favourite subjects, fun activities....

But settling back into school after the holidays can also be a time of anxiety and tiredness.


Social Challenges

For some children, returning to the social life of school can bring up anxieties and challenges. After the relative freedom of the holidays, they may find it hard to re-adjust back into the routine of the classroom. As discussed in my previous series of posts on the transition to school, children with special needs may need a slow transition back into the learning routine. And there may be some social "bumps" along the way.

Some suggestions for helping children with Autism, Aspergers or developmental disabilities settle back into the social routine include:

1. Using photos of friends and staff to remind the child of who they will be seeing at school.
2. Talking about the photos to remind the child of how they interact with these people. For example, "This is Johnny. You play soccer with Johnny on the playground!"
3. Display a list of the school rules (at home and in class), with illustrations/photos, and revise, review, talk about and practice them.
4. Where possible, arrange small group, supervised activities involving the child's interest at recess and lunch breaks to minimise the sensory and social input. This is a good way to prevent behaviour difficulties that may happen due to the busy, noisy nature of the playground.
5. Establish a home/school reward system so going back to school has its extrinsic (external, "artificial") rewards, even if the child finds it hard to see anything positive about being back at school.
   

Physical Challenges

Returning to school can be a tiring business for everyone. But it is especially important to recognise that children with diverse needs may find it just that bit more tiring.

This may be because of sensory processing difficulties or impairments. For example, children with hearing impairments often have to work much harder to process and interpret sounds. Children with sensory sensitivities may be tired out due to higher levels of stress during the day as they get used to all the sights, smells and sounds of school again.

Tiredness may also be due to physical disabilities. For example, sitting for extended periods of time, moving around the school and having limited "rest periods" throughout the day could have an impact on children with Cerebral Palsy.

Concentrating and communicating is also a very tiring activity. For children with ADHD or ADD, who struggle with maintaining attention, re-training themselves back into school can be very tiring. Children with language difficulties, including children with Autism and dyspraxia or apraxia, concentrating and listening gets very tiring by the end of the day.

This may mean that, not just in the first few weeks, a child's "endurance" cracks by the final session of the school day. So having less challenging, less intense activities towards the end of the day, and minimising the amount of homework given is essential.

Children arriving home exhausted are not likely to cope with any further physical or "thinking" demands placed on them. Putting further demands on them does not allow for recovery time, and also can mean an increase in difficult behaviour as the child struggles to cope.


Academic Challenges

This links with the previous points about concentration and language. However, there may be the added factor of a child with special needs "regressing" during the holidays. Words they could read, things they could say and do, may have been "lost" during the holidays. This may simply be due to lack of practice as the words and activities of school are often quite different to those at home.

Be prepared to re-teach some old things before adding too many new concepts and activities. Revision will be important to get the child back into the swing of things.

How is the settling-in period going for you and your children?

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So this is Christmas... and what will we give

Present-giving is such a huge part of Christmas. I remember vividly the excitement that caused sleeplessness on Christmas Eve - then the joy of finding the present at the end of the bed in the morning... Much torn wrapping later, and the day was full of new toys, food and fun.

But present-giving can also cause tension. Trying to please everyone, trying to display pleasure at inappropriate gifts, arguments over money spent, offence at gifts returned.... we all want to avoid these things.


Gift-giving and children with disabilties

I recently listened to parents of children with disabilities discuss the difficulties of presents at Christmas-time. I thought it would be good to use this blog to help build awareness of the issues that we need to consider when giving gifts to children who have special needs.

Some things you need to consider:

• Narrow interests: One thing it is important to realise is that some children with disabilities have quite narrow interests. For example, a child with autism may only use items that have Thomas the Tank engine on them.
  

• Developmental appropriateness: You need to consider the developmental appropriateness of a toy - not just its age appropriateness. For example, some children who have vision impairments use their sense of taste to continue exploring their environment long after their peers have stopped mouthing toys. This means that toys with small detachable parts that might be age appropriate will not be developmentally appropriate for the child as they could be a choking hazard. Other aspects that need to be considered are the child's intellectual, gross motor and fine motor skills. Children with disabilities such as Down Syndrome or Autism may find it more difficult to hold pencils, pick up small items and play with things that involve threading, constructing and significant muscle control in the fingers. Others may find it difficult to balance and use the gross motor skills involved in riding bikes or climbing. And others may find the cognitive challenge of some games such as puzzles, board games, card games and craft activities, beyond their cognitive ability.
  

• Sensory sensitivities: Some children with disabilities are very sensitive to certain textures, sounds and even colours. Toys that do not align with their sensitivities will not be used, and may even cause them some distress.

So how can you make sure you purchase an appropriate gift?

The easiest way is to ask parents. They will be able to tell you about the child's abilities, interests and favourite toys. And don't be offended if they give you a list of specific things or places to shop for their children.


Here are two sites that were recommended by parents:

http://www.specialneedstoys.com.au/shop/

This Australian site provides a range of toys suitable for children with Autism Spectrum Disorders, Communiation and Sensory Processing Disorders, ADHD, Physical Disabilities and Cognitive and Learning Delays. They have toys priced from under $5 to over $100.

The toys include a whole range of things, from puzzles to computer-based games.

http://www.amazon.com

Another parent recommended this Amazon search entitled "Bestsellers in special needs multi-sensory toys."


Spectronicsinoz also has a range of games, though they are more expensive and generally educational. Here are some examples of their games:

Spot on Games
Card Games
Switch-friendly computer games for children with physical disabilities
More computer games called Play with me

All the best for your Christmas shopping :) ... and may your Christmas be full of fun.

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What is a Reasonable Adjustment?

If you are a parent, have you ever been frustrated with what has been done to support your child in an inclusive classroom? Have you ever wondered what limits there are on the types of things that can be done?

And teachers, do you feel you have been asked to do too much? Have you wondered what can be reasonably expected of you when including a student with a disability?

Part 3 of the Commonwealth Disability Standards for Education 2005

Part 3 lays down some guidelines to help learning support teams make the decision about what might be reasonable in terms of adjustments to be made for a student. The criteria centres around the concept that any adjustment made must “balance the interests of all parties affected.” (p10)

But first…. What is an adjustment?

Basically, it is anything that a school and/or teacher do to help a child with a disability to participate and access facilities. It can be anything from using visual schedules to putting in ramps for a child in a wheelchair to employing a teacher’s aide.

Parents

Part 3 states that the decision about adjustments must be made in collaboration with the student and/or their associates. It also states that the student and/or associates’ (ie. parent/caregivers) opinion must be taken into consideration as to whether the adjustments are adequate.

So as part of the learning support team, parents should have a voice in the discussion about what adjustments are appropriate. But as in any advocacy role, we need to make sure we are as well-informed as possible about our options. As stated in the previous post, parents have a right to ask for information and can bring a friend and/or advocate with them when they attend learning support meetings.

One parent I knew got much more support for her child when she brought her privately consulted speech therapist with her to the learning support team meeting. This was primarily due to the fact that the therapist knew a lot more about what the child needed and could provide evidence of that need through official reports and so on.

The student

Part 3 states that the decision about adjustments must take into account the student’s disability. This may seem superfluous, but it is important that the Learning Support Team be well informed about the characteristics of the disability, and also how that disability affects the individual student – as all students are different, even if they do have the same disability.

The adjustments need to support the student in achieving the curriculum learning outcomes, whilst also maintaining the integrity of the course or ensuring that the accreditation standards for the course are maintained. This means that some adjustments will need to be abandoned because they either water-down the content of the courses as specified in the Syllabus documents. Alternatively, they might create a false impression of the child’s capabilities.

For example, students who have intellectual disabilities who are completing the School Certificate or High School Certificate would be completing the Life Skills Certificates. The Life Skills curriculum has been specifically designed for students with intellectual disabilities as it focuses on functional skills, or skills that will help the child succeed in their future life.

It is not a “watered-down” version of the regular curriculum. It is an alternative set of criteria. But it is only accessible to children under strict guidelines as it would be inappropriate for children who can learn the skills contained in the regular Syllabus if given appropriate supports.

For example, a child who is deaf can meet the requirements for accreditation under the Curriculum guidelines if they are provided with adjustments such as an interpreter. Click here for guidelines (Word doc) on who can complete the Life Skills Curriculum.

This brings us to the next point Part 3 makes: That the adjustments must provide adequate support so the child can participate in the educational activities.

The adjustments should also promote the independence of the child. I previously discussed this in the context of teachers aides.

Part 3 mentions that the adjustments should be the “least intrusive” option. The least intrusive adjustments are subtle. They don’t take away a child’s independence or choice. They have minimal effect on the child’s social belonging and status in the classroom. In short, they don’t “intrude” on the child – or their friends - socially or academically as they learn together in the classroom.

For example, let’s say a child is struggling to sit still in the classroom for long periods of time. The most intrusive approach would be to continually correct and re-direct the child. “Johnny, sit down.” “Have you finished your work yet, Johnny?” and so on. This will affect the child’s self-esteem, it could be disruptive to others (perhaps even more so than the actual getting out of the seat), and can lead to a labelling of the child as “naughty.”

A less intrusive approach would be to know the child’s limits, as well as their strengths and work with them. Have clear, visual guidelines like a picture that you put on the board/Smartboard to indicate when it is time to stay in their seat. Use eye contact and pointing to the picture to prompt the behaviour. But also know how long the child is able to sit still. For some children who have ADHD, or cerebral palsy, sitting still for long periods of time can be physically impossible. So occasionally have fun physical breaks, or options for movements like running errands, getting children to bring their work to you for checking or having a one minute “stretch break” every 10 to 15 minutes.

But as the child gets older and has more practice at sitting still, the time they can “last” is likely to increase. Then, as Part 3 states, the adjustments need to be reviewed and changed with the child’s changing needs. This should be the case for all adjustments.

Teacher and students

When making adjustments, we also need to balance the interests of the teacher and students in the classroom.

The concerns of teachers often revolve around their ability to equitably cater for all children in their classrooms in terms of the amount of time they may need to spend with a student who has a disability, answering their questions or managing their behaviour. They may be concerned about the disruption caused by some of the more difficult behaviour, and doubt their ability to deal with that behaviour without extra training. They may also be concerned about extra time and expertise required to plan inclusive lessons and design appropriate materials.

All these factors need to be taken into consideration when planning for inclusion. But it is important to note that we cannot expect zero disruption in inclusive classrooms. Inclusion does come with its challenges, and for some children placement in specialist classes may turn out to be the best option in the context of the resources currently available in our education systems.

However, as reported by Foreman (2008), research does indicate that children without disabilities who learn in inclusive classrooms may develop extra-curricular skills such as respect, value for diversity and social values associated with inclusion that they may not have developed in other classrooms. It also indicates that students not diagnosed with a disability may feel an advantage from the adjustments made for fellow students with disabilities.

So, when choosing adjustments, Part 3 states that not only should we look for the least intrusive option, but we also need to look for the least disruptive option.

So, some examples of what we cannot expect from teachers are:

• To spend chunks of time one on one with a single student
• To spend all their time planning adjustments that will only cater to one child

But we can expect teachers:

• To participate in learning support meetings or collaborate with support staff
• To spend a reasonable amount of time planning adjustments that are essential to the child’s completion of class tasks

And, teachers, you can get support from specialist staff such as Support Teachers to help you access ready-made resources, or for help in designing appropriate resources for students with disabilities.

When it comes to the challenge of behaviour, you might also want to read this post to hear the perspective of a teacher.

School and Education Departments

In making sure that adjustments are reasonable, school and education departments will also need to look at the available funding and resources. Part 3 highlights that the costs and benefits of every adjustment need to be weighed up. It is important to make all effort to implement the best adjustments, but these need to be realistic in the context of the funding rules and other regulations governing what can be implemented in schools. You can get more information about this from the disability consultant in your local education office.

Finally, whenever a learning support team has decided on a specific adjustment, it is important that it be implemented as soon as possible. As Part 3 indicates, the adjustments should be made available as soon as possible so as not to disadvantage the student in their learning.

So if you are heading off to negotiate adjustments for your child or your student, make sure you keep these things in mind.

Reference:

Foreman, P. (2008). Setting the Scene: Teachers and Inclusion. In P.Foreman (Ed), Inclusion in Action, p2-36. Thomson: Australia.

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Games and fun stuff to promote communication

Children get sick of being asked to talk or “perform” and may refuse, especially if your request for language seems purposeless to them. Games are a fun way for children to learn without even knowing they are learning. Newton (2004) discusses some key things to think about when deciding on what games to play. I discuss some of these below. But the key thing to remember is that, while learning to label things is important:
“Action words are more important than nouns or names because they are far more useful. Names can only be used for labelling.” p113

Sounds or words?

Words will be meaningless sounds to our children if we don’t help them understand those sounds. Some fun ways to help children recognise the meaning include:

* Sorting games – to help children recognise colours and understand descriptive words such as big and small, wet and dry, play sorting games. This could be a simple as getting them to find all the blue pegs while you are hanging the clothes on the line. Or sorting counters during Maths activities at school.

* Nonsense words – one of the things I use to prompt reluctant talkers to get involved is use nonsense or incorrect words to label or describe things that you are pretty sure the child is able to identify. For example, when reading a book identifying a dog as an elephant. Or if the child is requesting something, make wildly incorrect, humorous guesses until they correct you. And, from my experience, it usually brings laughter as well as the desired communication.

Which comes first? The request or the manners?

Newton (2004) suggests that it is much more important that your child learn to request something (eg. drink, biscuit) than learning “please” and “thank you”. However, once they have mastered the requesting, then you might want to teach these words. Some fun ways to expand on your child’s ability to request items:

* Hide and seek using an object – This will give you an opportunity to model and prompt requests.

* Sharing toys – play games where you limit the number of toys available so that you and your child, or the child and other children, have to request items and take turns. Or put toys just out of reach so that your child needs to ask for them.

Dramatic play, puppets and soft toys

Acting out every day activities in dramatic play can really help expand children’s language. Puppets, dolls and soft toys can also be a front behind which a child can “hide” if they are reluctant talkers. A child who will not talk with others may sit for hours “chatting” to or through their dolls, puppets and soft toys.

* Shopping – just like with many of us adults, shopping can be a favourite with children. Set up a sales counter, use picnic sets, toys, empty cartons and play money and you will have many opportunities for speech. In this game children will need to request things. You can also help them with counting and other phrases that might be used in real life shopping experiences. Also, take every opportunity to describe what you, other children or the child is doing.


* The sandpit – playing in a sandpit will also product a lot of opportunities for communication. Building roads, castles, villages, cakes…. So many different opportunities for requesting and describing activities will be made.

* Cubby houses – cubby houses also seem to be one of those things that hold their appeal across the ages. And some of the most exciting, communication producing cubbies are the ones built out of mum’s bedspread, pillows, chairs, the dining table etc. Again, requesting, describing and using useful “real life” language in a pretend setting can help increase children’s communication abilities.

Cooking together

There are some household or life activities that lend themselves to helping children communicate. Cooking is one of these. It provides you with opportunities to describe what you are doing, talk about the ingredients, request items and so on.

Drawing and craft

Drawing, painting and craft projects are also productive of similar opportunities as described for the cooking activities. Here are some tips:

* Rather than guess what your child has drawn, try saying “Tell me about your picture.” Write down what the child says, either on the back or on the picture itself, so you can read it together and talk about it again another time.

* As you do these activities, talk about what you are doing. Eg, “Snip, snip! We are cutting in a straight line!”

Giving instructions

Play games where children provide instructions verbally. For example, Simon says (replacing “Simon” with the child’s name), treasure hunts, obstacle courses. But make sure you have pictures and gestures lined up for the child to use as well as language if they are struggling with their words.


… But most of all, have fun LoL

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Shared reading can help with language development

Newman (2004) also discusses how books can be used to help with language development. Based on her recommendations, here are some guidelines to help you with choosing and using appropriate books. I will use my book, Dave is Brave, to illustrate these as it was written and illustrated with these guidelines in mind.

1- Start with books that have clear and expressive pictures.

The reason for this is that children are engaged or their attention is grabbed by things that interest or attract them. Colourful and clear pictures mean that the child does not have to be concentrating on the book to have their eye attracted to it. Colour and clarity catch the “corner of their eye”, so to speak.

Pictures will also give you the opportunity to label items and ask questions to prompt language attempts. If the child is interested and engaged by the pictures, they are more likely to attempt to communicate about the book, whether it be through gesture or speech.

2- Use books that show characters doing everyday, familiar things.

Books about unfamiliar topics will mean that the child is not able to use their prior knowledge or experiences to identify appropriate words that they might be able to use. If the content is familiar, through the reading process the child will learn words that will help them function or participate in their everyday life activities.

You can also develop your own books by taking a sequence of photos of everyday routines. These books can be a great resource to help expand your child’s vocabulary.

Talk about the pictures, suggest things that the people in the pictures might be saying, ask your child to label objects or identify what the person is doing. If your child’s language is developing, start asking them less obvious questions such as how they think the people in the photo might be feeling.

The activity plans that are sold in the Dave is Brave pack provide you with questions that will not only help develop your child’s language, but also their emotional intelligence. That is, it will help them understand what is going on socially and emotionally, and will prompt them to use language that will help them express this in everyday, real life.

3- Simple stories with few words and lots of repetition are especially good.

As mentioned in a previous post, repetition is a great tool for helping children develop language through imitation and modelling. A book with rhythm and rhyme can also help prompt memory of sounds and phrases.

Dave is Brave is written with this in mind. For example, the text is written with the frequent repetition of the phrase, “Golly was a bully, but Dave was brave.” The text is also rhythmical:
“Golly was a bully when he didn’t act like a friend.”


When interacting with the book, Newman (2004) suggests firstly that you read the book normally, with natural expression in your voice.

Next, ask questions of increasing difficulty depending on the child’s level of language development. Educators often talk about the different levels of questioning as “here, hidden and in the head.”

For example, looking at this picture from Dave is Brave:
“here”: What did Dave say?
“hidden”: How do you think Dave is feeling?
“head”: Is Dave a boy or a girl?

Thirdly, there may be times whey you will need to paraphrase books to make sure that your child understands the language. This relates to your family or classroom language culture – the words you use to describe something may be quite different to those used in another family/classroom.

Finally, get the child to anticipate or guess what words comes next. And example of this is the cloze activity that is part of the listening games on the Dave is Brave music CD. What I do is pause to encourage the listener to say some of the repeated words for me. The rhyme also helps with this.

For example, “This is Dave. He is …..”


My final recommendations?

Read often.

Read about things your child is interested in.

Have fun with it.

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Talking to your child

Based on Newman (2004) pages 107 – 108

Newman discusses a series of things you need to consider when talking to your child who has communication difficulties. Here is my summary of her advice, and some hints about how you can achieve these:

1- Get your child’s attention – which usually means eye contact.
For children with sensory integration issues, pointing their ear towards you may be there way of paying attention. Or you may want to hold their hand and wait until they are still before you speak.

2- “Speak clearly and simply using natural intonation.” p107
Exaggerating expression or speaking/yelling loudly will not help your child to understand, even if they have a hearing impairment. It will only distort the sounds. Using inappropriate volume will also mean that your child will not learn about the different use of intonation and volume for different contexts. Eg. you might talk loudly outside, but use what teachers may call an “inside voice” indoors. You yell when you are angry or warning others, but speak calmly or with a smile in your voice in play situations.

3- “Repetition and consistency is very important.” I addressed this in the previous post.

4- Talk about everyday events and experiences, such as favourite games, videos, dinner, bathing and so on. Newman (2004) states, “Give her the language for what she is doing: ‘You are having a bath.’” (p107). If you repeat this regularly, your child will learn to connect the language with the experience.

5- Talk about the things your child is interested in. Watch what your child is looking at and label it, describe it. We have probably all done this with our very young children – “Look at that cow! Mooo! Moooooo! It is eating grass!”

6- Make sure your child can use the context to help them understand what you are saying. So if you are at the dinner table and you want to talk about what has happened during the day, make sure you have some cues such as photos.

7- Use body language to support your words. Use natural gestures to reinforce words, such as waving to reinforce the words “Bye-bye.” Makaton signs were designed for this purpose.

8- Pause and maintain eye-contact to encourage your child to respond. It may take longer for your child to process what you have said, and produce a response.

… I will talk more about helping promote children’s responses in my next post.


Reference:
Newman, S. (2004). Stepping Out: Using Games and Activities to Help Your Child with Special Needs. London: Jessica Kingsley Publishers.

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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?

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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 amandag7@optusnet.com.au

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 www.learn2bebuddies.com.au


References

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:
http://www.ldinfo.com/executive_functioning.htm
http://www.ncld.org/content/view/1200/480
http://www.ldonline.org/article/Executive_Function_Fact_Sheet

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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?”

Doh!


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

Repetition:
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.

Chunking:
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.

References:

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.

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Do you understand what I'm saying?

Image from "Dave is Brave" www.learn2bebuddies.com.au . 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

Interpreting

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.


References:

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:http://www.autismsa.org.au/html/disorders/autism.html


Buckley SJ. (1993) Language development in children with Down syndrome - Reasons for optimism. Down Syndrome Research and Practice,1(1), p3-9. Retrieved from http://www.down-syndrome.org/reviews/5/

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 http://www.down-syndrome.org/reports/306/

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 http://journals.cambridge.org/download.php?file=%2FDMC%2FDMC47_08%2FS0012162205001040a.pdf&code=7abb5653813d8fc667d2aaa56a4c8e16

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.

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Why aren’t you listening? Disobedient or Distracted?

Picture copyright Daniel East - from "Dave is Brave" www.learn2bebuddies.com.au

“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.

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.

References
Australian Hearing (2008) Types of Hearing Loss. Retrieved 10th May, 2009 from: http://www.hearing.com.au/types-of-hearing-loss

American Speech-Language-Hearing Association. (2009). Type, Degree and Configuration of Hearing Loss. Retrieved 10th May, 2009 from: http://www.asha.org/public/hearing/disorders/types.htm

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: http://www.mja.com.au/public/issues/177_04_190802/coa10271_fm.html

Mayo Clinic (2009). How do we Hear? Retrieved 10th May, 2009 from: http://www.mayoclinic.org/hearing-disorders/how.html

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: http://www.deafblind.com/downmoss.html

My Dr (2008). Otitis Media in Children. Retrieved 10th May, 2009 from: http://www.mydr.com.au/kids-teens-health/otitis-media-in-children

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Modelling and rewards

Chris is sitting eating lunch with her peers. They are chatting away. Suddenly, without warning, Chris gets up and leaves. Her peers look very surprised and a little offended.

Applied behaviour Analysis

Pictures and social stories are often used in the process of Applied Behaviour Analysis (ABA). This approach is about analysing what we can see, breaking down behaviour into small steps, and changing it through encouraging, modelling, prompting, and praising changed behaviour

Using ABA for Chris

If we applied this approach to Chris’ situation, we would have to start by looking at what is actually happening. We might start with writing a more detailed observation of what is happening.

Antecedent:
Before Chris walked away, she had been intermittently involved in a discussion with her peers. They were talking about their favourite foods.
Jenny looks at her sandwich then smiles at her two buddies: I love vegemite sandwiches! They are great.
Chris continues looking at and eating her sandwich. Tom smiles back at Jenny: Yeah, I like them, too. But I like cheese better.
Chris (still looking at her sandwich, which is almost finished): I like cheese.
Tom smiles at Chris: Mmmm. It is so good, especially with some tomato. Have you ever had it with tomato?

Behaviour:
Chris has finished her sandwich and walks away.

Consequence:
Chris puts her rubbish in the bin and puts her lunchbox away in her bag.
Tom looks surprised and a little offended.
Jenny looks at Tom: Maybe she didn’t hear you.
Tom and Jenny sit silently until they finish their sandwiches, then quietly pack up.

So what next?

This observation gives some ideas about what is going on. For example, while Chris was listening to Tom and Jenny, she was not paying attention to them. That is, she is not making eye contact. This meant that she missed the body language, facial expressions and social rules that would have told her about whether the conversation was finished or not.

Modelling, prompting, praising

To start teaching Chris the skill of eye contact we may need to draw attention to the importance of eye contact.

For example, when Chris wants something we might wait until she responds to the prompt, “Chris, look at me” before we respond to her. We may also use a physical cue like putting our hand into the line of her gaze, then bringing the hand to our cheek or chin.

Any attempt to make eye contact should be praised. This can be a combination of specific praise (eg. “Thanks for looking at me” said with a beaming smile) and giving Chris what she wants.

And all the time we are doing this, we need to be modelling good eye contact.


Functional behaviour analysis, or behaviour support

Another way of looking at this behaviour is to ask why Chris walked away in the first place. What was the function, or purpose of her behaviour?

Why did Chris walk away?

It wasn’t just that Chris wasn’t paying attention, it was that she was paying attention to something else.

The observation suggests that she was following a routine, and she was focused on this. She had finished eating. And, according to routine, when you finish eating you put your rubbish in the bin and put your lunchbox away.

So what next?

We need to help Chris to balance the routine with her friendships. So, first, we need to help her make eye contact with her peers. We need to help her apply what she has learnt with an adult prompt (“Look at me, Chris”) to her discussions with her peers.
So we may teach her peers to say, “Chris” and wait for Chris to look at them before speaking.

Then we need to teach Chris to use a signal to let her peers know she is going to leave the conversation. So we could teach Chris to say, “I am going to…. now.” before she walks away.

Modelling, prompting, praising

To start with, we might have to practice this skill in the classroom. Or a teacher may need to sit alongside Chris and her peers in the playground.

In the beginning, the teacher may need to encourage Tom and Jenny to say Chris’ name and wait until she looks at them before speaking. The teacher may need to give some immediate praise to encourage Chris to use eye contact. The teacher may also need to use a picture, social story or modelling the sentence “I am going to…. now.” to prompt Chris to use this sentence.

To make sure that this is making a difference, we would need to keep a record of Chris’ successes.

But the end product should go something like this:

Antecedent:
Chris is chatting with Tom and Jenny. They were talking about their favourite foods.
Jenny looks at her sandwich then smiles at her two buddies: I love vegemite sandwiches! They are great. Aren’t they, Chris.
Chris continues looking at and eating her sandwich. Jenny waits for a moment, then says: Chris?
Chris looks at Jenny.
Jenny: Do you like vegemite sandwiches?
Chris shakes her head.
Tom smiles at Jenny and Chris: I like vegemite sandwiches. But I like cheese better.
Chris (still looking at Jenny): I like cheese sandwiches. See! (she holds out her cheese sandwich.)
Tom smiles at Chris: Mmmm. It is so good, especially with some tomato. Have you ever had it with tomato?
Chris has finished her sandwich and is packing up her rubbish.

Behaviour:
Tom: Chris?
Chris looks at Tom.
Tom: Do you like tomato?
Chris: No. (short pause) I am going to put my rubbish in the bin now.

Consequence:
Chris puts her rubbish in the bin and puts her lunchbox away in her bag.
Tom and Jenny continue talking until they finish their lunch. Then they put their rubbish away and join Chris. They all go and play together.


If you want to know more:

Conway, R. (2008). Encouraging Positive Interactions. In Forman, P. (Ed) Inclusion in Action, p198. Thomson: Australia

Moyes, R.A. (2002). Addressing the Challenging Beahviour of Children with High-Functioning Autism/Aspereger Syndrome in the Classroom: A Guide for Teachers and Parents. Jessica Kingsley Publishers: London.

Repp, A.C, and Horner, R.H. (1999). Functional Analysis of Problem Behavior: From effective assessment to effective support. Wadsworth: Canada

Weiss, M.J, Harris, S.L. (2001). Reaching out, Joining in: Teaching Social Skills to Young Children with Autism. Woodbine House: Bethesda


You may also want to visit these links:

http://www.autismsa.org.au/html/strategies/therapies/aba.html

http://www.learningplace.com.au/deliver/content.asp?pid=7498

http://www.txautism.net/docs/Guide/Interventions/ABA.pdf

http://www.usu.edu/teachall/text/behavior/LRBIpdfs/Functional.pdf

At the end of every month I want to anwer any questions you might have relevant to the topics discussed in this blog. If you have any questions, post them here as a comment. I will answer them next week....

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Ask Amanda

At the end of every month I want to anwer any questions you might have relevant to the topics discussed in this blog. If you have any questions, post them here as a comment. I will answer them next week....

But in the meantime, I want to talk about another way to teach pragmatics... I'll get back to you with this shortly.

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Using pictures

Are you Angry or Not?

(pictures from www.learn2bebuddies.com.au)

Tommy asks Jenny if he can play with the truck she is using. She says, calmly and politely, “No. I am playing with it. There’s another one over there.”

Tommy begins to cry and comes rushing up to you. “Jenny won’t let me use the truck! She is being mean! Waaaaa!”

How do you explain that Jenny wasn’t being mean, or angry? She just wanted to play uninterrupted. There are other toys she wanted to share with you...


Using pictures to teach pragmatics (following on from the previous posts)

Tom needs to learn the difference between the facial expression and body language that makes the word “No” represent bullying or “meanness” as opposed to the pragmatics that reflect a reasonable refusal. This is a complex concept for all young children to learn.

For some children you may be able to talk to them and use words to help them understand this. But talking about it assumes several important things. Firstly, if you reason with Tom you are expecting that he is able to hear the words and understand what they mean. If he has a hearing impairment, developmental delay or a language disorder, this may be a difficulty for him.

Second, you are expecting that he can imagine and relate to the actions and emotions reflected in the words you are using. Again, children with developmental delays, Autism, Aspergers Syndrome and other social or behaviour difficulties may struggle with this process.

So what can we do?

One way to approach the issue is to use pictures. There are a number of benefits to using visuals (Bondy & Frost, 2002; MacKay, 2000; Marion, 2007).

1 - They can attract attention
For example, children with autism will find it hard to make eye-contact with others. It may be difficult for them to process sights, sounds and movement all at once. Making eye contact may mean they struggle to actually “hear” what the speaker is saying. Other children may have difficulties concentrating, paying attention or directing their gaze to something when asked.

When you use a picture, you can help a child focus on a representation of the facial expressions and body language without having to process movement and sound as well. The child can also be given the picture to hold, or it can be held in their eye-line.

2 - They are permanent
You can allow the child to study the picture for as long as needed. The expression won’t disappear in a moment as it would from another child’s face.

3 - They can be carried around
You can use the picture in a range of situations. You can get the child to use it to communicate their own emotions. Or you can point to the picture to communicate what another child may be feeling. By doing this you are helping the child generalise the information, or apply it to different situations and different people. This, in turn, will help them develop empathy.

4 - They are concrete
You don’t have to use language and imagination. The picture is a concrete representation of an abstract concept. You are providing them with the “image” for their imagination. This is especially important if the child thinks in pictures rather than in words.

5 - They can be adapted to any age
You can use photos, pictures or line drawings. You can adapt the pictures to any age and to any child’s interest.


So, in Tom’s case, you may use two pictures such as those seen below (free download from http://www.do2learn.com/).

You may get him to chose which one he thinks reflects Jenny’s response. Then you may get Jenny to choose the one that reflects what she really meant. Then you help correct the miscommunication in a very concrete way.

Don’t expect immediate results. You may have to use this process many times depending on the child’s difficulty. The first step may be just getting the child to look at the picture.

But with repetition, patience, praise and reinforcement (such as getting the truck after he has played with another toy for a short while), Tom will learn the difference between a calm and friendly, “No.” and an angry, mean “NO!”

References:

Bondy, A., Frost, L. (2002). A Picture’s Worth: PECS and Other Visual Communication Strategies in Autism. Woodbine House: USA

MacKay, G. (2000). Primary-age Pupils with Pragmatic Difficulties. In R. MacKay and C. Anderson (Eds), Teaching Children with Pragmatic Difficulties of Communication, pp55-71. David Fulton Publishes: London.

Marion, K. (2007). Visual Supports for People with Autism: A Guide for Parents and Professionals. The Canadian Journal of Occupational Therapy, 75(5) p281.

Line drawings retrieved from:

http://www.do2learn.com/picturecards/printcards/2inch/imagegridsnowords/emotionsnoword.htm

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