By Occupational Therapist - Mariza Ferreira
I have been writing a series of blogs aimed at teachers, for Potential Plus UK since 2021. They are a national charity that supports families with children who have high learning potential (HLP or gifted), including those who have dual or multiple exceptionality (DME or 2e). I thought it a good idea to also post the blogs here. I trust you will find it not just applies to teachers, but in the home environment too! This is the first blog in the series of six. Happy reading.
Let me start by saying that I do not want your job. I cannot imagine standing (or in recent years with the pandemic, sitting in front of a computer) for hours teaching a group of anywhere between 15 to 30 pupils. You need a special grace for that which I don’t have but you do. And I applaud you. I think you have one of the hardest jobs in the world and if the last few years have proven anything, it is that your job is one of the most essential to our society as a whole.
What I am good at is working with children on a one-to-one basis, to first of all identify and second of all help them overcome particular barriers they have in carrying out those tasks they need to do or want to do at home or at school. My job allows me to really get into the details of things in order to not only help a child directly, but also provide you with some bespoke management strategies in class for that particular child. I have always maintained that my role is a supportive one to yours; we combine our various professional strengths and together give that child a better chance of success.
The children I typically see are the ones who struggle severely with having the ‘correct behaviour’ in class in order to learn… They can’t keep up with writing and if they do their handwriting is illegible, they are too active, not attentive enough, too disruptive, too oppositional, very argumentative, away with the fairies, have flashes of brilliance but, if you blink, you’ll miss it – the list goes on. In most of these cases, when I look at how they function i.e. carry out a detailed occupational therapy assessment, I can almost always identify the roots, or some of the roots, for their behaviour being out of line. Some of these roots are motor coordination difficulties, sensory processing difficulties, and emotional regulation difficulties – the stuff a paediatric Occupational Therapist loves to tackle.
It is not always easy to work with these children but I more often than not get good results. Just recently a mother of a high learning potential (HLP) child, with a combination of the above mentioned difficulties that has resulted in him being homeschooled, said this after my initial assessment, “You got him to do more in the assessment than others have for years”. I am not telling you this to sing my own praises, I am telling you as I want to share with you a mindset change I made years ago which was really the turning point of my success rate in working with children. I believe it will really help you too – especially if you feel at your wits end with THAT child in your class. I realise I may be preaching to the choir here, but I am going to do it anyway. Here it is:
We need to understand and believe that children have a fundamental need to ‘fit in’ and ‘be good’. If their behaviour is off, they are trying to tell you something. They are trying to tell you they need help. They use behaviour as their words fail them.
If you really agree with me and believe this, your approach towards them will be different without you needing to anguish over exactly what you need to change. And here is the secret: Children pick up on this belief, they feel safer, and more willing to try again!
Seven Top Tips for Spotting Issues:
- THAT child who is refusing to write or who is sooo slow at it, could he be ‘telling’ you that it is physically the hardest thing he is doing at school? Every day, in every lesson?
- THAT child who is constantly on the go, could she be ‘telling’ you that she is doing it because she is in fact trying to get her body to a place where she can focus on what you are teaching instead of trying to disrupt you and the other kids?
- THAT child who is not attentive enough, could he be ‘telling’ you that he is so bothered by the scratchy feel of his clothes that all his mental energy is going into keeping it together and not exploding mid lesson, instead of not being interested in what you have to say?
- THAT child who is so disruptive, could she be ‘telling’ you that all the colourful pictures on the wall are hurting her eyes and she is trying to avoid them but wherever she looks there are even more busy walls which she is trying to get away from in order to feel calm?
- THAT child who is oppositional and argumentative, could he be ‘telling’ you that the work is actually too easy for him and that he wants you to challenge him more or allow him to work at a quicker pace, instead of trying to have a daily stand-off with you?
- THAT child who is away with the fairies, could she be ‘telling’ you that all the noise in the class is so overwhelming that she shuts down, instead of becoming exhausted with trying to figure out which noises or voices are the important ones?
- THAT child with the flashes of brilliance, could he be ‘telling’ you that he is physically working so hard on holding the pencil or cutting in a straight line that there’s very little energy left to consistently work at the high intellectual level you know he is capable of?
Once you start thinking about what underlying message a child’s behaviour is trying to tell you, it becomes much easier to manage the issues they are struggling with.
In my next blog we will look at how you can help THAT child who struggles significantly with handwriting.
Your specialist Paediatric Occupational Therapist
- 16 June 2022Blog postThis is the sixth and final blog in a series which I have been writing for Potential Plus UK since 2021, aimed at teachers to help them support children who have high learning potential (HLP or gifted), including those who have dual or multiple exceptionality (DME or 2e). I am posting the blogs here as well, as I think it applies not just to teachers, but in the home environment too. Happy reading. Dear Teacher, Thank you for reading my blog posts for Potential Plus UK over the last year, in which I have explored some of the sensory, motor coordination and emotional regulatory issues that could be negatively affecting children with high learning potential. I trust that I have been able to help you recognise and help those children with high learning potential who struggle with their handwriting, are constantly on the go, and overly sensitive to touch, visually busy environments and noisy environments. As you know, I firmly believe that children have a fundamental need to ‘fit in’ and ‘be good’. If their behaviour is therefore not as expected in class, such as them being aggressive, oppositional and argumentative, then you have to explore the possibility that this could be related to sensory processing difficulties. Children often use behaviour to communicate the messages they do not yet have the words for. Sometimes, however, the out of sync behaviours of children with high learning potential have nothing to do with sensory… Over the years I have worked with many children who have dual or multiple exceptionality (DME) – also known as twice exceptionality (2e) -, specifically those with high learning potential and sensory processing difficulties or disorder. I have come to realise that not all behaviour which appears to have a sensory base, is in fact sensory! For example, a child who is often on the go with lots of ‘out of seat behaviours’ could display this behaviour because he has a neurological need to move more (vestibular sensory seeking behaviour). However, it could purely be because the child is not challenged adequately enough on a cognitive level in class and therefore find themselves intellectually bored. Wandering off in all sorts of ways to get the stimulation they need, will therefore (unconsciously) seem like the most logical thing for them to do. I call these non-sensory or motor issues, the ‘non occupational therapy factors’ or ‘non OT factors’ when I speak with my own colleagues, which I think all professionals working with DME children need to be mindful of. Another example to illustrate my point is from the mother of a young child I worked with, who told me that he once swiped all the papers and writing equipment off his table whilst the teacher was explaining what the class had to do. This child had severe auditory sensitivities, and at first I thought it was because the class was perhaps too noisy on that occasion. However, once I worked with the child and we explored coping strategies together, he revealed that he swiped the materials off the table as he was highly frustrated with how easy the work was which they had to do and that he felt the teacher was wasting his time. He was 5½ at the time… It can be hard for teachers, parents and even occupational therapists to spot intellectual boredom as a core reason for a child’s unacceptable behaviours. This is especially tough when you consider that children with high learning potential and DME sometimes struggle with more mundane academic tasks such as simple adding and subtracting in class, yet at home in their spare time they like doing much more complex mathematics in their heads! At school they may sometimes show no interest in reading the age appropriate books which form part of the curriculum, leading teachers to believe that they are behind with their reading; whilst at home they have read a whole series of much more advanced material. It is understandable and quite common to hear educators say that it is impossible for a child to be “bright” or have a particular strength in a subject area when they have not seen any evidence of it in class. In fact, they may have only observed the opposite. The danger of continued misidentification of a child’s true academic potential and ability by the significant adults in their life, is that the child develops a mistrust of these people or authority figures. This can lead to the child giving up trying to prove himself and his abilities or potential to achieve, disengaging from schoolwork and in extreme cases, becoming a school refuser. What Can You Do to Help? First of all, let me say that I am not a teacher, so you probably have more ideas than I have. As a therapist I feel more comfortable highlighting the issue of intellectual boredom as a possible reason for unacceptable behaviour in class. My encouragement to you would be to be open to the idea that intellectual boredom could be a root cause for behaviour. If a child has already been identified as having high learning potential it will be easier to make the link. But if no formal testing has been done for a child who regularly has ‘flashes of brilliance’, then perhaps you could suggest this course of action to the child’s parents and / or your school? To combat intellectual boredom, you can provide work that is much more involved or at a deeper level. I am aware that most teachers already present work at various levels of difficulty, such as in maths, and that may be all the stimulation a child needs. But there is the risk that the child with high learning potential and DME does not engage with this type of work, as he does not see its relevance. Providing greater context as to why the work is important now, or linking it to a special interest of the child, could be the motivational boost the child needs. I can highly recommend that teachers and schools get in touch with organisations such as Potential Plus UK, who have many advice sheets on exactly this issue, and who also provide regular training to teachers on how to enrich lesson presentations. None of us have to go this alone, and my motto is to get good advice wherever it is available. Lastly, dare I say it, embrace the possibility that THAT child could possibly be smarter than all of us together. As a therapist working one-to-one with children with DME, I am acutely aware that the children I help are very smart, and have the potential to far succeed what I have achieved and will achieve in life. I am okay with that, and quite like the idea that I may be helping the greatest artist, surgeon, engineer, architect, code breaker, electrician or plumber the world has yet to discover, reach his or her potential. I hope you will see it this way too! Your specialist Paediatric Occupational Therapist Mariza... Read more...
- 16 March 2022Blog postThis is the fifth blog in a series of six, which I have been writing for Potential Plus UK since 2021, aimed at teachers to help them support children who have high learning potential (HLP or gifted), including those who have dual or multiple exceptionality (DME or 2e). I am posting the blogs here as well, as I think it applies not just to teachers, but in the home environment too. Happy reading. Dear Teacher, I don’t know about you, but I am desperate for spring to fully arrive. I love seeing some of the trees starting to blossom and the days getting longer. The earth seems to come more alive again with birds announcing the days earlier each morning, and people venturing outside to enjoy the sunshine days which I truly hope will be abundant this spring and summer. So, with sound and light definitely at the forefront of my mind, I think it is quite fitting that in this blog I want to write about how you can help the children in your class who struggle to cope with the physical environment which is the class! If you have been following this blog series in which I explore some of the sensory, motor coordination and emotional regulatory issues that could be affecting children with high learning potential negatively, you will know that I believe children have a fundamental need to ‘fit in’ and ‘be good’. If their behaviour is off, it is not necessarily by choice but because they are trying to tell you something. They are trying to tell you they need help. They use behaviour as their words fail them. Sometimes it is fairly easy to figure out why children’s behaviour is not as expected in class. They may be able to tell great stories but cannot adequately put it down on paper because of poor handwriting skills. They may be so “on the go” that they are constantly getting up from their desks to ask you questions that they already know the answers to. They may be so bothered by the feel of their clothes that they are constantly pulling at them. Other times it may not be that easy to figure out why children’s behaviours are not as expected. You may find it exhausting playing “detective” all the time to try and figure out why THAT child who seemed quite calm when queuing for class, becomes increasingly disruptive when IN the class. Or why THAT child who can have a highly intellectual conversation with you about a book author’s hidden message, shuts down and seems ‘away with the fairies’ when the exact same subject is discussed in group format in class. I know I am at risk of over simplifying things, which is not my intention, but I want to suggest the reason for these difficult behaviours is often right in front of us… our physical environment does not get nearly enough credit for its part in distracting children from the lessons or tasks you want them to participate in class. It may actually just be too busy, too light or too bright (or all of these) for them to feel “just right” and able to concentrate on the task at hand. Just to make matters worse, it may not be busy, light or bright enough for some children! Let me try to explain. Visual sensory processing involves the visual system but refers to a person’s ability to appropriately focus on a person or object relevant at a particular time, whilst not giving attention to other visual images, and to have an appropriate action in response. For one, it contributes to good visual perceptual abilities – which is how the brain interprets what the eyes see. Auditory sensory processing involves the auditory system but refers to a person’s ability to correctly register relevant sound waves from the environment through the ears (hearing), whilst not giving attention to background noise, and to have an appropriate action in response. Adequate auditory sensory processing is fundamental to speech and language development, communication, understanding instructions, and timing movements. When a child is therefore able to easily and consistently focus on lessons and tasks in class, without being distracted by all the pictures and visuals on the walls, how light or dark the room is, or the varying noise levels that are inherent to a class, then we can assume that they have adequate visual and / or auditory sensory processing. It is like having a free flowing traffic system in the brain. However, when a child is unable to easily and consistently focus in class, and has accompanying unexpected behaviours such as being disruptive, ‘away with the fairies’ or argumentative (the list goes on), then we need to consider whether this child may have sensory processing difficulties, or a “traffic jam” in their brain. Remember that the brain’s first priority is to look after the body’s sensory needs, so although this child may be desperate to fit in and be good, the overriding mission of their neurological system will be to get them to a “just right state” and away from the environment which it perceives as harmful. The flip side of the coin is that some children cannot focus because they actually need more visual and auditory input from the environment before they feel alert enough to do so. These children would also be considered as having sensory processing difficulties. However, they are at higher risk of not getting the appropriate support to help them reach their potential, as they tend not to cause any trouble in class and actually seem to get into the ‘zone’ the busier and noisier the classroom is. So, how do you help children who all have different sensory needs when it comes to their ability to focus in certain environments? I would suggest that you consider some general changes to benefit the class, but also some specific changes when it comes to individual children. I have written down my top two tips for each below, and hope that they will help you: General Changes Top Tip One To reduce general visual distractions, consider having no to minimal pictures and posters on the walls of your classroom, or at least on the wall where the whiteboard is. This will generally have a calming effect on all the children, and promote their ability to focus on the lessons and tasks at hand. Top Tip Two To reduce auditory distractions (which I know is probably one of the hardest things to achieve in a classroom), consider allowing the children to conduct small group discussions away from their desks and removed as far away as possible from other groups. If at all possible and feasible, allow one group to have their discussions in another room and do this on a rota basis so everyone gets a chance over the course of a term. Specific Changes Top Tip Three For children who are oversensitive to visually busy environments, consider changing the physical environment to be less busy for them. When you know a child’s individual difficulties, you may try the following: Seat the child to the front of the class within direct line of sight to the whiteboard and/or away from looking directly at the busiest walls of the classroom.Give the child a choice of which paper to do their work on – plain paper or with borders. Even though paper with beautifully designed borders are pretty, it may be just too distracting for a child.Carefully monitor how a child responds to story books with lots of pictures, as opposed to those with more text. Whilst very young children “read” through pictures, we need to consider whether lots of pictures for older children are constructive or distracting. Remember, for the child who actually needs more visual stimulation in order to focus, you may want to consider doing the opposite of the above, such as giving them paper with detailed borders or books with lots of pictures accompanying the text. Please approach each child with difficulties individually, in order to find what supports their learning best. Top Tip Four For children who are oversensitive to noisy environments, consider changing the physical environment to be less noisy for them. When you know a child’s individual difficulties, you may try the following: When giving instructions in a noisy environment, ensure that the child heard it and knows what to do. You could consider going to their desk or taking them aside – whichever you feel is appropriate so as not to embarrass the child in front of their peers.After instructions have been given and with independent work, consider offering the child ear defenders or ear plugs to help them focus on the task at hand.Similar to the above and if possible, you could offer to move the child to a quiet space to complete their individual work. Remember, for the child who actually needs more auditory stimulation in order to focus, you may want to consider doing the opposite of the above, such as allowing them to complete work whilst listening to music. Please approach each child with difficulties individually in order to find what supports their learning best. If in doubt or if these strategies do not work as effectively as you hope, then it is worth considering getting an occupational therapist involved to look more closely at the child’s particular needs. Look out for my next blog, in which I will explain how you can help THAT child whose oppositional and argumentative behaviour may have nothing to do with their sensory needs, but more with their insatiable thirst for learning. This will also be the last blog in the series. Your specialist Paediatric Occupational Therapist Mariza... Read more...
- 10 February 2022Blog postThis is the fourth blog in a series of six, which I have been writing for Potential Plus UK since 2021, aimed at teachers to help them support children who have high learning potential (HLP or gifted), including those who have dual or multiple exceptionality (DME or 2e). I am posting the blogs here as well, as I think it applies not just to teachers, but in the home environment too. Happy reading. Dear Teacher, A few years ago I worked with a 6 year old boy who had Dual or Multiple Exceptionality, in other words he was cognitively very bright but he also had a special educational need or disability / SEND which was stopping him from reaching his full potential. Amongst his difficulties, he struggled with tactile hypersensitivity. This means that he had a very negative reaction to being touched because, instead of perceiving everyday touch sensations in the normally expected way, his brain was telling him that it was a threat to be dealt with. So he was generally on high alert for anyone or anything touching him. I kind of forgot this one day at the start of one of his therapy sessions, and when he succeeded in an activity I naturally put out my hand and said, “High five!” Well, instead of high fiving me back, he just looked at me as if I had lost the plot. My initial reaction was that I thought he was rude, replaced straight after by my OT-hat-on-reaction of realising he didn’t want to touch my hand as he naturally avoided touch. So I adjusted and high fived my hand with my other hand! I seem to often revert to telling people about this experience when I explain tactile sensitivity, as I feel it is a simple but powerful illustration of both tactile hypersensitivity and how it can negatively impact others’ perception of a child. We rely on our tactile systems hundreds of times a day to give us information about whether the “world” we are interacting with is safe or whether it is a threat to be avoided. When our tactile sensory systems process touch (through receptors mainly located in the skin) correctly, we are able to have an appropriate reaction. So when there is something truly dangerous or threatening in our environment such as a hot plate, we will immediately pull away when we accidently touch it. Similarly, when there is something not really dangerous or threatening, such as wearing long sleeved tops, our brains will just ignore it. Furthermore, our tactile systems help us to discriminate the characteristics of the objects we are touching which of course goes hand in hand with having learnt about an object first. You can probably see how interpreting tactile sensory information correctly is crucial to a child feeling safe in his own body in order to allow him to interact with his world to learn, develop emotional resilience, bond with others and develop socially. And it will hopefully make sense that a child whose neurological system perceives everyday touch as harmful, will expend a lot of mental energy to constantly be on the ‘lookout’ for and trying to avoid touch. This in turn means that they have less mental energy available for learning in the classroom, may not appear to be listening to what you are saying, and are often prone to being misunderstood by others. Over the years of working with children with tactile hypersensitivity, I have noticed that they typically display the following behaviours: Aggressive / lashes out at other children when standing in a line;Hits other children when sitting on the carpet during circle time, or physically swings their arms in wide arches when sitting down (younger children);Flinches and/or pulls away from being touched; Meltdowns when unexpectedly touched from behind;Reluctant to participate in messy activities / using only fingertips / asks to wash hands immediately after an activity is completed; Refusing to wear long sleeved tops or jackets, trousers or even socks despite very cold weather conditions; Seems fidgety and constantly pulling on clothes. I know from working with these kids that they do not want to have these types of behaviours. They have a fundamental need to ‘fit in’ and ‘be good’ but they cannot help themselves as the “protection armies” in their brains are in control. It is our job to help them deal with tactile hypersensitivity as best we can. Doing this can be very straightforward or very difficult – depending on whether they are dealing with other sensory processing difficulties, physical difficulties or emotional problems. There are various approaches that occupational therapists will use, but working with teachers to make some basic adjustments in the classroom environment is a crucial part of helping these kids. I have written down my four top tips for you as teacher, which I trust will help you: Top Tip One Allow the child to stand either at the very back or front of the line. This way she can survey her environment and feel safer in the knowledge that she won’t be bumped accidentally by one of her classmates. Similarly, during carpet time, let the child have a designated space to sit on such as her own ‘mat’, leaving enough space around her to avoid accidental touching by other children. It can also help to sit the child near you or on the edges of the circle. When you are not sure exactly where to sit the child try talking to her about the options available. You may be surprised that she knows exactly where she will feel the most comfortable. Top Tip Two It goes without saying that we should always respect a child’s personal physical boundaries. But when you do have to touch a child, approach him from the front whenever possible and give ample warning. For example, when you want to help a child to learn how to write by giving ‘hand over hand assistance’, say something like, “X, I am going to place my hand over yours to help you make this letter”. Alternatively, you could opt for offering the child to place his hand over yours as you form the letter. Top Tip Three When you are doing a messy activity in class, tell all the children at the start that they can wash their hands immediately after they have finished the activity. In addition, it is a good idea to have some disposable gloves to hand so that the child can wear this during the activity if she wants to. Top Tip Four Helping a child who struggles with wearing clothes because it hurts him, is difficult in the classroom context. However, when you notice some behaviours that you think are related to tactile hypersensitivity, it is essential that you have a conversation with the child’s parent/s or carer/s. Parents are often acutely aware of the problem, and may be able to offer some advice on the strategies that they use at home – such as buying seamless socks for their child and removing all labels from clothing. You can then make some concessions at school such as allowing the child to wear their own socks during PE lessons, instead of expecting him to wear the particular PE kit socks. If you speak to parents and they have no idea that their child may be tactile hypersensitive, then it is important that you encourage them to look into this matter further, and perhaps get the advice of an occupational therapist. Look out for my next blog, in which I will explain how you can help THAT child who is struggling with visual sensory processing. Your specialist Paediatric Occupational Therapist Mariza... Read more...
- 10 February 2022Blog postThis is the third blog in a series of six, which I have been writing for Potential Plus UK since 2021, aimed at teachers to help them support children who have high learning potential (HLP or gifted), including those who have dual or multiple exceptionality (DME or 2e). I am posting the blogs here as well, as I think it applies not just to teachers, but in the home environment too. Happy reading. Dear Teacher, I hope that what I have to say in this blog will help make your job just that little bit easier. Especially on the days when you wish you actually HAD the energy levels of the “jigglers” in your class. A few years ago I went into London to assess a Year 4 girl called *Katy in her school environment who had previously been assessed by Potential Plus UK as having high learning potential (gifted). However, she was not reaching her full potential academically and her parents were advised to look into whether this was due to sensory processing disorder. From working with her and observing her in class and on the playground with her friends, it was quite clear that she was physically much more “on the go” than her peers. When I asked her how she would describe herself, she replied with, “Well, in my friend’s words, ‘Katy is a jiggler’”! I had to go and look up the word and jiggler or jiggly means being “unsteady or moving in little, fast movements.” Yes, that seemed about right. But what you need to understand is that Katy’s need to move so much was not because she was trying to be obnoxious or deliberately distracting to others. It was in response to her neurological system’s need to get as much movement as possible in order to feel “just right” for the tasks she had to do every day. I firmly believe that children have a fundamental need to ‘fit in’ and ‘be good’, and in this case that meant that Katy knew that her jack-in-the-box behaviours were ‘out of line’ so, she found ways to mask it. One of these masking behaviours was that Katy got up constantly from her seat to ask questions at the teacher’s desk, although she knew the answers. The sense of movement and balance is one of the hidden internal senses, and it involves the vestibular sensory system. It is the ability to correctly perceive head movements in relation to gravity through receptors that are located in the inner ear, and to have an appropriate action in response. It tells you whether or not you are moving, how quickly, and in what direction. It plays an important role in head control and eye gaze, and regulating muscle tone, posture, balance, bilateral integration and alertness levels. (Some children need less vestibular sensory stimulation to feel alert, and some a lot more). By processing vestibular information correctly a child feels secure during movement, which helps him to develop both physical and emotional core stability. So, for the “jigglers” in your class who need a lot more vestibular stimulation, here are my top tips to help not just them, but you: Top Tip One Trying to get children like Katy to sit still, will just aggravate the problem and may result in aggressive behaviours. Therefore, give them the opportunity to move as much as is possible and practical during the day. Katy’s class was on the top level of the school building, so Katy’s teacher allowed her to run up and down the flights of stairs during the day when she asked permission. Other ways to get kids to move is to send them on errands for you or to get the whole class to do 10 jumping jacks on the spot before a lesson. In one school I worked with, the early years teacher placed a tunnel at the front door for kids to crawl through in order to get into class. It worked a treat! Top Tip Two Speak to the child’s parents to find out whether they have a good mix of physical activities to participate in outside of school time. If not, suggest some easy and (where possible) low cost activities that will give the child the daily dose of physical movement his body craves. I like suggesting walking or biking to school instead of driving, and going to parks that have zip wires and climbing frames. Sports are also great, such as rock climbing, running or playing tennis. Top Tip Three You may recognise this tip from my previous blog about helping children with handwriting difficulties, but it is also a really important one to help the jigglers. Remember, the vestibular sensory system has a lot to do with regulating a person’s posture, so we need to give it all the help we can. Make sure that the table and chair a child sits at is suitable for his height, in order for him to obtain and maintain a stable seated posture for writing. Postural stability, in other words the ability to ‘control your body against gravity’, is the body’s second highest priority after breathing. As a guide, when seated at a table, a child should be positioned with his or her feet flat on the floor, and with the chair being of the correct height to allow 90-degree angles at the child’s ankles, knees and hips. Furthermore, the table surface should be approximately 5cm higher than the child’s forearm, when the child’s arm is bent 90 degrees at the elbow. I am fully aware that when it comes to school furniture, it is a ‘one size fits all’ scenario. But you can be very creative with old books under a child’s feet or using an adjustable bath step (https://www.completecareshop.co.uk/bathroom-aids/bath-steps/adjustable-bath-step) for the shorter children, or raising the writing surface with a writing slope or similar (https://www.sensorydirect.com/writing-slope) for the taller children. In my next blog we will look at how you can help THAT child who is not attentive enough, because he is so bothered by the scratchy feeling of his clothes that all his mental energy is going into keeping it together and not exploding mid lesson… Your specialist Paediatric Occupational Therapist Mariza *Katy is not the jiggler’s real name... Read more...
- 10 February 2022Blog postThis is the second blog in a series of six, which I have been writing for Potential Plus UK since 2021, aimed at teachers to help them support children who have high learning potential (HLP or gifted), including those who have dual or multiple exceptionality (DME or 2e). I am posting the blogs here as well, as I think it applies not just to teachers, but in the home environment too. Happy reading. Dear Teacher, I am excited to be writing to you again, this time about how you can help THAT child who struggles significantly with handwriting. In my occupational therapy practice, probably half of the children I treat at any one time, have handwriting difficulties. Two characteristic they almost all share, are noticeably low confidence and self-esteem because their handwriting is ‘poor’, and an intense desire and motivation to improve their handwriting to the point where: Their teachers can read their writingThey can keep up with their peersThey can start getting their thoughts on paper and…They can stop being the only child in their class who does not yet have a pen licence! No child I have ever come across chooses to have poor or bad handwriting on purpose, and it is important to understand that their handwriting is not the way it is because of a lack of trying. In fact, by the time these children reach me, they have often had lots of extra handwriting tutoring and additional practice with little to show for it. These children have a fundamental need to ‘fit in’ and ‘be good’, i.e. to have legible and fast handwriting. So if you come across a child who is refusing to write, who is writing too slow, or keeping up but whose work looks like a dog’s dinner, then you need to hear the figurative alarm bells that they are actually asking for help. Handwriting is probably one of the most difficult tasks a child has to engage in at school. It is the end product of various abilities and relies on good motor processing such as postural control, eye movement and hand strength; good sensory processing such as correctly judging how hard to grip a pencil and press down on paper; good visual perceptual skills such as recognising a letter regardless of its size; and good motor planning (praxis) to cope with the different small hand movements needed to form different letters. Compositional writing, as opposed to copying text such as from the whiteboard, places even higher demands on a child. This is because the working memory available for compositional writing has to be ‘shared’ among a child’s ability to use words, sentences and paragraphs (translation), the ability to plan and review the writing (executive functioning), and the child’s ability to spell words and physically write it down (transcription). You can imagine, if a child struggles with one or more of the “background” and “actual” handwriting skills I have mentioned above, that handwriting will suffer in some way or form. While recognising and treating any of these difficulties are often the job of an Occupational Therapist, there are a lot of things teachers CAN do to help, especially those of you who are teaching our little ones how to write. For the sake of being succinct in this blog, I will share my top two tips. I realise the first one may seem insignificant, and the second one controversial. However, after years of helping children, I am fully convinced of their importance as proactive measures to reduce the severity of the handwriting difficulties children experience. Top Tip One Make sure that the table and chair are suitable for the child’s height, in order for them to obtain and maintain a stable seated posture for writing. Postural stability, in other words the ability to ‘control your body against gravity’, is the body’s second highest priority after breathing. Whilst most children can cope with tables and chairs which do not fit them ideally, this can be a real problem for children with handwriting difficulties. They are working so hard to stay upright that there is little energy left for actual handwriting! As a guide, when seated at a table, a child should be positioned with his or her feet flat on the floor, and with the chair being of the correct height to allow 90-degree angles at the child’s ankles, knees and hips. Furthermore, the table surface should be approximately 5cm higher than the child’s forearm, when the child’s arm is bent 90 degrees at the elbow. I am fully aware that when it comes to school furniture, it is a ‘one size fits all’ scenario. But you can be very creative with old books under a child’s feet or using an adjustable bath step (https://www.completecareshop.co.uk/bathroom-aids/bath-steps/adjustable-bath-step) for the shorter children, or raising the writing surface with a writing slope or similar (https://www.sensorydirect.com/writing-slope) for the taller children. Top Tip Two When teaching children to write, it is crucial that you teach letter formation in its purest or most basic form (print), and not by starting all the letters from the writing line (cursive). This is because of the immense impact letter formation has on letter joining. For example, a child who is asked to write the word ‘dog’, and who has learnt to start a ‘g’ at the top right corner (purest form), should easily be able to join the ‘d’ diagonally to ‘o’, and the ‘o’ horizontally to ‘g’. In contrast, when a child has been taught to start all letters on the writing line with a diagonal stroke (cursive), he will be able to easily join the ‘d’ diagonally to ‘o’, but he will likely want to return to the writing line after ending the letter ‘o’, in preparation for forming the ‘g’ with its introductory diagonal stroke. Although some children have minimal difficulty in relearning the motor patterns of letters when starting to do joined up handwriting, many children, especially children with motor planning difficulties and or Developmental Coordination Disorder (DCD), will have marked difficulty in relearning the new motor patterns. Writing, first and foremost, is a motor skill and not a visual skill. To prove my point, close your eyes and write your name on a piece of paper… In my next blog we will look at how you can help THAT child who is constantly on the go. Your specialist Paediatric Occupational Therapist Mariza... Read more...