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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Encouraging your child to respond

This post extends on the previous one, which discussed Newman’s (2004) advice for talking to your child who has communication difficulties. I want to focus in this post on her ideas about how to react when your child responds to you to ensure more communication attempts on their part.

1- “Respond immediately and positively” (p108)

Praise any attempts, even if they are not correct. Also, use “active listening” skills to ensure your child feels rewarded for their communication attempts, and to clarify meaning if you are unsure what they mean.

Active listening, according to Friswell, involves first stopping all other activity and intently focusing your attention on your child.

Second, look at the child – make eye contact, get down to their level by kneeling beside them if necessary.

Third, listen without interruption. Children struggling with communication may need more time to produce speech. Wait patiently, without rushing them or trying to finish their words or sentences. However, you may need to make encouraging sounds (uh-huh?) or use body language such as smiles and nods to give immediate feedback and encourage your child to persist with their communication attempt.

Finally, once they have finished, respond. In responding, make sure you focus on the positives first. A good rule to go by is: praise then re-phrase.

For example:
Jilly says, “Want duce in up.”
Adult responds, “Very good, Jilly. You want juice in your cup?”

This allows your child to confirm their meaning using a nod or shake of the head.

2 – “Be over the top in your response” (p109)

To begin with, it can be important to get overly excited about communication efforts alongside providing immediate rewards for any communication attempts. This Utube video has a good illustration of this, though the communication is using the PECs system rather than words.

However, be conscious that for some older children struggling with communication over-the-top praise can be received negatively as they may feel you are drawing undue attention to their difficulties. Like with everything, be tuned in to what motivates your child or student and respond accordingly.

3 – “Don’t correct pronunciation or what she has said” – re-phrase instead.

This is a widely accepted approach.

For example:
Jilly says, “Want duce in up.”
Adult responds, “Very good, Jilly. You want juice in your cup?”
Jilly nods. Adult provides her with juice in her cup.

There are some good examples of re-phrasing in this Utube Video.

However, the Lindamood program has suggested that correction of pronunciation is important. This links in with the importance of directly teaching children with disabilities new skills, rather than expecting them to simply “pick up” these skills through indirect modelling. It is also about children experiencing communication in a multi-sensory way – feeling and seeing sounds as well as hearing them. And, further, it is about helping children break down and sequence sounds in words. The program encourages children to look at the shape of the mouth, to feel how the tongue, lips and breath create the sound alongside simply hearing sound.

So an alternate approach may be:

Jilly: “Want duce in up.”
Adult: “Very good, Jilly. You want juice in your cup?”
Jilly nods.
Adult (using the gesture system discussed previously): “You say, ‘I want JJJuice in my CCCup.’” stressing the key sounds and drawing attention to the mouth movements that go with it.
Jilly: “duce in cccup.”
Adult: “That’s great! JJJuice.”
Jilly: “Jjuice.”
Adult: “Well done!!” and rewards Jilly with juice in her cup.

This way you are rewarding both her attempt at communication, and her correct speech.


References:
Friswell, J. (nd) Active Listening with Children in the Early Years. Retrieved 22nd September, 2009 from: http://clg.coventry.gov.uk/ccm/cms-service/stream/asset/?asset_id=15186020

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 ... a student who is under three and displaying aggressive behaviour

Amanda, I have a new student who is two and a half. He is extremely impulsive, he cannot have anyone near him that he is not being aggressive to them, to the point where if I am near and pick him up, touch him or in any way try to talk to or remove him from the situation (hitting repeatedly, punching, pushing etc.) he will with one hand try to stop me while continue to strike out at the child. I think he has some form of spectrum disorder, his other behaviors are what appears to the other adults including his parents to make him 'gifted' his speech is very articulate overly complex sentencing (he is 2) but he repeats everything (very clearly) which I think is echolalia (sp?) not cognitive language use.what can I do to help him stop hurting others.

I am meeting with the parents and right now I will just ask them how he is at home types of questions. I have only had this child for 2 weeks and want to set up a good relationships with them. I have learned to approach with caution when this type of issue arises. Thanks Beth


First I just want to apologise for taking so long to answer this very tricky question. The world has been spinning very fast lately.

But now I have time to sit, think and answer your question.

I can’t suggest a quick fix

This difficulty is not something that can be addressed easily. It will take time and some investment of energy. However, I may be able to suggest some practical things you can do to help improve things over time.

I will also shy away from suggesting a diagnosis etc. That is up to the psychologist, paediatrician or other medical professional.

Step one: Formal Observation

The first thing you may need to do is take a step back and really observe what is happening. It may even be worth getting a third party in, for example another staff member who works in your centre, to watch what is happening.

The purpose of this is to get a better picture of what is going on. It will help unlock some clues to why he may be behaving this way.

Observational tools:
The observations should be written down. This written account should be factual rather than an interpretation of what is happening.

There are many forms of written observations. But you may find a couple of these useful.
Firstly, the simple anecdotal observation (click here or here for more info). That is, the observer watches for a certain time period and records everything that is happening. Not just what the child is doing, but what others around him did and in what setting it occurred.

The second example is an ABC observation.

A= Antecedent: Write down everything that happened before the child began to display the inappropriate behaviour. This includes anything that other children did, what setting they are in, what was said etc.

B= behaviour. Record exactly what the child did.

C= consequences. Record the responses of those around him. That includes the response of the other children, as well as the response of the staff.


What might be the function of his behaviour?

Read this previous post for more information on funcational behaviour assessment. However, the description of the behaviour you have given suggests to me a couple of purposes the child’s behaviour might have. However, these are only guesses as they are not based on full observations as described above.

1. A reaction to proximity
He may have sensory integration issues and subsequently have difficulty sharing space and equipment. He may not be able to endure the proximity of others, and his behaviour is his way of communicating this.

I did read somewhere else that when reprimanded he says he won’t do it again. But if it is due to sensory integration issues, and he has difficulty with social communication, he may not be able to change this behaviour without consistent and explicit support. He will continue to react impulsively in order to protect himself from the intrusion of others.

If this is the reason for his behaviour, removing him from play may seem very unfair to him as he will feel he is being punished for his anxieties or for what other children are doing. And it is unlikely that he will be able to articulate this in any other way than trying to continue lashing out whilst being removed.

What can you do in this instance?
- Set up a safe space that he can retreat to without fear of intrusion. This can be done using a mat, book shelves, cushions or a chair and table. All children should be told that this is a quiet space and only one person can be there at a time. In this space place a couple of the child’s favourite games. But this is only a starting point as you don’t want to always isolate the child from other children.
- Have a routine session every day based on a turn-taking game. This needs to be a quiet, highly structured game where only one child has a turn at a time. Start with just one or two other peers, and sit between them and the child. Let the child pick the children he wants to play with in this session. As the child gets used to this routine you may find that you can start introducing more children and less structured games. But it may take some months before your intervention is not needed.
- Use the child’s echolalic language skills to teach appropriate communication alternatives to his aggression. For example, teach him to say, “Move, please!” using an appropriate hand gesture when children get too close.

This is not a comprehensive list, but it may be a start.

2. A desire for interaction but limited social skills
I have worked with a number of children who have an intense desire to interact with others and play the same games but end up ostracising their peers because they don’t know how to get involved without aggression. There was a boy who wanted to play tips, but kept being isolated by staff because he was running around punching children. It turned out this was his invitation or his request to play tips. When he was taught how to play, and taught specific language to ask others to play, he ended up with a nice little bunch of playmates.

So if this is the case it is again not surprising that the behaviour isn’t changing. He may not be able to identify why it is wrong, or exactly what behaviour you want him to stop. He may also have a sense that is it “not fair” that he is being isolated when other children are playing together - even if he couldn't articulate this.

What can you do in this instance?
It will be about teaching specific social and language skills. Your observations will be able to tell you which skills are most relevant, but here are some ideas.
Language (teach a gesture or makaton sign language to go with this):
- Can I play?
- Can I have a turn?
- That’s mine. You can have it later.
- Can you move, please.
Social skills:
- looking at facial expressions and identifying when others are sad.
- Turn taking
- Sharing space and equipment

How could you teach these?

Social stories:
My book, Dave is Brave, is like a social story. It demonstrates a sequence of events that occur in consequence of aggressive behaviour, with pictures to illustrate facial expressions and emotions of others. It also has key phrases like, “Can I play?” demonstrated as an alternative to aggressive behaviour. (Sorry if this sounds like advertising, but I wrote the book for children with these sorts of issues so you may find it useful)

You could use this, or you could work with the student to design your own short picture sequence. You could do this by taking photos (with parent permission) of a short role play. Two photo sequences could be:
1) photo of him watching others playing
2) photo of him role playing pushing another person
3) photo of another person being sad
4) photo of him sitting by himself, not able to play with others
Second sequence
1) photo of him watching others playing
2) photo of him asking, “Can I play?” with a smile and appropriate gesture
3) photo of another person smiling back
4) photo of him sitting with others, playing together.

You could also look into using PECS such as Boardmaker and those seen on the do2learn website. This will help make language more meaningful for him if he learns well through visuals.


Responding to aggressive incidents

While he is learning these new skills, you will still need to have a way of managing or responding to aggressive incidents.

If you think that his behaviour might be due to sensory integration issues, or a difficulty with the physical proximity of others, you might want to do the following:
- Manoeuvre yourself in between him and the child he is lashing out at.
- Firmly but calmly and gently say, “Stop” with a stop hand sign
- If he doesn’t stop after 2 or 3 requests, point to his quiet space and ask him to take his toy to that space, re-assuring him that he can come back to this play space when he is ready to be settled (choose a word he can understand and use that same word all the time, you may even have a picture of the quiet space and being “settled” to help him understand what you are saying)

As much as possible, avoid physical contact. Try and shepherd him to the quiet space rather than physically move him if possible. You may also find that taking his toy to the quiet space will mean he comes with you.

If you think his behaviour is due to poor social and language skills, follow the same process. But instead of just saying, “Stop” get him to repeat a key phrase such as, “That’s mine.” with appropriate gestures so other children can understand him.


Conclusion:

The bottom line is that anything you do will take time and energy. You and anyone else working with the child will need to be consistent, repeating exactly the same process and exactly the same words every time an aggressive incident occurs. Remaining calm will be very important.

And if one thing doesn’t work after you have given it a good go (eg one month), do another observation and analyse whether you might need to think about the behaviour having a different purpose behind it.

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