'Dys'cussing a diagnosis.

I last wrote about diagnosis as labelling from the perspective of a child with undiagnosed Autistic Spectrum Conditions.   This is a common undiagnosed condition, due to the usual high-functioning nature of the condition and so questionable usefulness of such a diagnosis in a school setting; but also because of the later life implications of such a label.  It is a condition which has a predominantly social impact, rather than academic.

There are however many, many occasions when a label is, in my opinion, only a positive development in a child's life and educational experience.
Many children struggle with neurological diversity; the 'dys' group of labels.
This group describes specific learning difficulties in people with otherwise normal range intelligence.   These problems affect only one (or maybe several, they often overlap) area of educational development or communication.
This diagram illustrates the complexity and diversity of this group of very common impairments:






I think I'll write a separate post about each 'dys' as I have experienced them in the next few blog posts, but I can guarantee that every person reading this has themselves, or knows someone, with a degree of specific learning difficulty.  We read descriptions and recognise our own challenges,  or those of our children our partners and friends.  Importantly, we often recognise their strengths too as a feature of the diagnosis.

1 in 6 children have specific learning difficulties.  That's 3 children in each average primary class and often a lot more.  Therein lies the problem AND the solution simultaneously.

Teachers have come across children with these groups of difficulties before and many consequently have normalised the issues.  The children can become low attainers in far too many cases and their neuro-diversity seen as an 'excuse'. 

Children can become frustrated, perhaps bored, stuck in lower ability groups and can develop low self-esteem.  Many children 'switch-off' from their learning, not valuing their own place in the class, not understanding themselves or feeling that their contribution is being recognised. They develop a poor image of themselves as a learner and, as many adult 'dys' learners have noted, they do not begin to value their contribution to society until they reach adulthood and find their own niche, which all too often is too late and many are not able to positively contribute to society.

It paints a damning picture, which, as we become more aware as a society, is hopefully less and less likely to come to fruition.
We can now recognise neuro-diversity early and children can receive the additional support they need in order to achieve.  Once children receive recognition in the form of a written diagnosis, they can begin to better understand themselves and see their learning as different.  They can better value their individualism and identify with others.

Teachers should be able to see the child not as low ability or poorly behaved, but be able instead to see a suite of simple support techniques which can be of support to the child without necessarily impacting on the teaching of the whole class, thus maintaining inclusive teaching.  They can quickly access a wealth of information to effectively support the child rather than watch helplessly as the child fails.
Successful support of children with dyslexia, dyspraxia, dyscalculia and dysgraphia alongside autistic spectrum conditions starts with Quality First Teaching.
'Quality First teaching' starts with acceptance and understanding.  It develops through increasing class teachers knowledge and simple adjustments to teaching or resources and it results in true inclusive practise.  It can be (and I have seen this many, many times) life changing for the child at the centre of the diagnosis.
Parents can finally start to believe what they knew all along, that their child is struggling beyond that which is 'normal' during school life, that they do need help and that finally, they might actually get some.

A diagnosis does not 'cure' problems for a child.  A diagnosis does not necessarily mean anything will 'happen', such as any individual withdrawal intervention or specialist 1-1 teaching (although it will in many cases where clear 'catch-up' areas are identified) but a diagnosis can mean that a child, their family and hopefully the child's teachers, can reflect more positively on their struggle.

Together, they can begin to even the playing field.

Check out this graphic.  If ever a picture did say a thousand words, this is it:



Of course, a further solution would be to remove the barrier altogether.....

Do children need labels?

I'm having a problem.

A child I know *very* well is having problems at school.
He is an able, well adjusted, polite, well mannered child.
He speaks clearly and with confidence, and is able to express his emotions.  He is happy to approach an adult for support when he trusts them and accepts the judgement of adults when given fairly.

The problem is, he just cannot get on with other children.
Somehow, in his particular class, he is just not accepted.
It seems he feels 'different' and he behaves differently.

When there is disruption in class, he feels children are 'stealing' his 'learning time'.
When given responsibility, he appears to use it to have 'power' over other children.
He does not like playing football and avoids other team games.
He finds group or team working difficult unless he is 'leader' (as long as other children do as he asks).
He can be insensitive to the feelings of children and some of the subtleties of their language, for example when a girl said "my drawing is rubbish", obviously inviting reassurance of the opposite, Percy agreed, saying "yes, it is a bit".
He is acutely 'nosey' and always comparing himself in rights and responsibilities, to other children.
He is large and uncoordinated which makes him physically different.
He can be obsessive about interests, although he can have several obsessions at the same time.
He can become very angry and have verbal outbursts when 'wound up'.

He has set himself apart from his peers because he seems to a) feel superior to them and b) not relate to them, and c) feels his efforts fall unappreciated and so therefore it is 'not worth it'.
This child has a rich and varied social calendar and has friends outside school, he simply has not adjusted to the social 'scene' within the school he currently attends, and has attended for the last 2 years.

Now the question is:
As he has many of the key attributes of Aspergers symdrome as documented in many of the incidences above, should he be labelled as such?
How many of the features described above could also be attributed to adolescence?

This shows a few 'buzz phrases' often attributed to those with Aspergers syndrome:

                                                           


Many would argue it would be better for him if he saw a paediatrician and received a diagnosis of an Autistic Spectrum Condition.  It might enable him to better understand his own strengths and weaknesses and support himself.  But his family are more than capable of supporting him with this without confirmation from a paediatrician.

Will it make him more accepted at school?
Certainly, a 'circle of friends' approach, whereby a number of children are chosen and Percy's feelings are explained, along with a brief explanation of his difficulties, might help.  The children are given an opportunity to meet with an adult regularly and, it is hoped that, by becoming closely involved in supporting that child's needs, their better understanding, and that of the child with ASC, helps them to reduce incidents of isolation or outburst.
But why does he need a label to access this kind of support, and frankly, would the support be forthcoming anyway?
Supporting children with ASC is complex for schools and much less likely to happen, unless the child's behaviour becomes disruptive or their learning is affected.  There is no academic or behavioural impact in the case of young Percy, so the school has no incentive to support him other than to help him be happier, which is not a measurable outcome in  the current Ofsted schedule.

The decision is pending.

You should have started by now!

Why hasn't he started yet?

The task was introduced by a keen, vibrant teacher.  Visual prompts were used and real-life examples given to engage the class.  The children responded to their learning with enthusiasm.
So, why has Jimmy still got a blank page in his book 5 minutes later?
Why does this child, who has clear ideas when sitting on the carpet, not manage to get started on tasks of which the teacher is certain he is capable?

I am using Jimmy as an example (sorry to anyone named Jimmy reading this!) simply because most of the children I have come across with executive function problems are boys, by no means all, but certainly the majority.

Executive Functions are a suite of basic tasks which we deal with every day.  The precursors, if you will, to success in everyday life.  The building blocks upon which we build our daily lives.  Neurological diversities, in the form of Dyslexia, Dyspraxia, Dysgraphia, Dyscalculia and Autistic Spectrum Conditions often encompass an executive function deficit in one or more areas, as do, I would argue, most humans.

Executive functions are not, in this context, anything to do with corporate entertainment or company cars!

Consider a simple classroom writing task from Jimmy's perspective:  Could you follow a task if you didn't first locate the page, the line on the page, find the pencil and hold it correctly, know how much pressure to exert on the pencil in order to create a mark and know how to prevent the pencil destroying the paper from too much pressure? Do you understand how to produce shapes from the pencil, in which direction you need to move the pencil, how to form a diagonal line and how to reverse over the same line to change direction? 

Phew! All this before we even need get to understanding the alphabetic code! 
Oh, and I didn't even mention the decision to stand, sit, lean on a hard surface to support the page, or understand the purpose of a table!

Consider the working memory required to hold the instructions given by the teacher in your mind long enough for you to be able to manipulate them and carry out a task. 
Repeating daily basics like date and learning objective may help reduce the number of instructions a child needs to remember but this is why we need visual prompts.

One of the children I work with showed me how she copes with getting started:

'DUMTUMS'
Date
Underline
Miss a line
Title
Underline
Miss a line
Start

You next need to plan your work, to know what you are going to write.  I am not referring to the 'story plan' format used by many teachers to help children think about their writing.  Long before that an inner conversation takes place in your brain such; "Okay, I want to write 'cat', so what do I do first? Pick up the pencil, ok, ready, where am I going to write? Top line? Which is the top? How far away from the very top do I need to write? Where does the page start? Where does it end? Shall I stop here, or here? OK, ready. 
What was I going to write again?"

Are you starting to feel Jimmy's pain?

Now he needs to get down to the 'secretarial' skills.
He has recorded his sentence on a handy recording device such as a Talking Postcard to support his working memory, so what to write is sorted.
Press play 'The cat sat on the mat'
Right, 'cat'.  First sound, /c/ which grapheme (picture) matches that sound c or k?
How big is a c? Which direction does the pencil move? Does it touch the top line?  Does it rest on the line or drop below it?  Much easier to make it float in the middle. 
Next letter, direction, where? Does it touch the other letter? Bigger? Next to the c, where is 'next to'....

Finally, at the end of playtime, after all his friends have finished, Jimmy takes his writing to show the teacher.

"Good, now go back and check for capital letters and full stops"

Jimmy spends the rest of the day with his head on the desk.

How many?

The pride of the young mother is tangible, "Jimmy can count to ten!" she declares!
Jimmy recites the numbers beautifully, perfectly in fact, in the adorable sing-song voice only a toddler can achieve.

"Wonderful!" you respond in justifiable congratulation.  "Jimmy, how many bricks am I holding?"

Jimmy obediently chants again; "One, Two, Three, Four, Five, Six, Seven, Eight, Nine, Ten" and wanders off happily to continue bouncing Peppa Pig on the sofa, his new counting song interchanging with baa baa black sheep. Young Mum is left puzzled, staring at the three bricks you are holding.

It's the one to one correspondence, you see.  A missing link, if you will, for many children who can 'count' by rote and all too often, simply miss the bit where the number is associated with an object.

Later, many children find themselves caught out when they are adding and taking away, calculating using a number line and using concrete material in maths.  Their work is simply incorrect, they are not able to count accurately.  They do not understand the 'oneness' of one.

Maybe they were in the top group in pre-school and reception and moved on to using numbers to calculate BEFORE they were ready.  Heaven forfend.

Don't get me started about moving children on too quickly in order to meet targets!

To help: Count in number sequences from different starting points.  Count in every day life. Leave the counting in 2s, 5s and 10s for a bit and simply find out how many shoes there are on the shoe rack today.  Estimate first, is that reasonable?  Who has the biggest pile of coins, Let's find out by counting, How many more do I have? Can you give me 12 cake cases/18 screws for this project/24 red lego bricks?

Stages: 1. Label each object as you count (one-to-one correspondence); 2. Remember to stop at the last object (this can take a while!) and declare 'How many?' 3. Count accurately without missing numbers, recounting objects by moving objects as you count. 4. Count larger groups of objects by grouping. Here come the 2s, 5s and 10s beloved of the national curriculum.

Another common misconception is found when children begin to 'count on'. In addition, we say "Put the biggest number in your head and count on from there".  Lets say the calculation is 12+4 -not enough fingers to count the whole thing.  The child obediently chants "put 12 in my head" and counts on "12, 13, 14, 15" The answer is 15.

How confusing is that?!!!

To the child, the counting from 12 is the same as counting from 1.

Now, if these children had had enough time to get to know these early numbers, perhaps been able to recognise the link between 12+4 and 2+4, see that both numbers were even perhaps, they may have been able to know more reliably if their answer was reasonable.  But for now "count on from the next number" has to suffice as we try to make sure little Julie learns this process correctly.

My favourite: 

How many squares?

Playing with early number is absolutely vital to successful calculation later.  Recognise odds and evens by making rectangles with objects. Share play coins or counters between the teddies, who has the most? Are the piles the same? Is that fair? Count, count, and count again!

A wonderful website to introduce a fun, creative approach to maths at all levels is nrich. Teachers can use this to help them teach at the new desired 'mastery' level.  Home schoolers have the joy of being able to use this approach without restriction, deepening that understanding of number and the relationships within and throughout.

Enjoy!

What is a sentence, anyway?

So many children get caught trying to run before they can walk. Or, under pressure to meet increasingly ambitious developmental goals, trying to write in sentences before they can speak in sentences.

What is a sentence anyway?

"Make sure you have a capital letter at the beginning of your sentence, and a full stop at the end".  We've all been there, we've probably all either said it or had it said to us.

I think most people who have ever paid any attention to a child's early composition will have seen a neat row of dots at the end of every line of writing, regardless of it's grammatical position.

Those educated in the dim and distant 1980's, like myself, will remember very little formal grammar. It simply wasn't taught beyond nouns, verbs and adjectives.

It's not that I don't use grammar, it is just very difficult to understand the terminology. I know when it's there and can spot when it isn't, but I couldn't explain a past participle if my life depended upon it.
My understanding of grammar is implicit.  It has never been explicit.

With the new curriculum focus on SPAG, grammar is hot again.  It is even tested in year 6.  Eek!

To clarify: In order to be a sentence, a group of words must have a subject and a predicate (which could be an action).   'The dog is sitting' is a simple sentence.  It can be made more complex with the addition of adjectives or subordinate clauses, but the subject and the predicate must remain.

So, how on Earth can we make grammar accessible to children in the early stages of formal language acquisition or with language impairment, for those children for whom grammar is not being picked up naturally?
In practise, these are the children who find it difficult to answer simple questions with more than a single word, or use basic statements to express wants and needs.
"Miss, need toilet."

I was lucky enough to spend some time with a very talented Speech and Language Therapist who was supporting a child in my class. She introduced me to Shape Coding, designed and introduced by Susan Ebbels, which you can learn about here. 

As a teacher, I need to help children speak in sentences in order for them to write in sentences.

Shape coding makes this possible in a simple, visual format.

What is learned naturally for most people, has to be taught explicitly to children with Language Disorders.
What I have found is that the large majority of children in our current world of moving on very quickly from skill to skill, also benefit from a bit of explicit teaching.  I have seen that taking Shape Coding a little farther and using it to support children's writing, can have dramatic positive effects.  Importantly, children can see their own success and begin to self-assess.
A shape for each part of the sentence means we can help children to see how to improve their sentence composition and consequently, their writing.  I have seen children write a relevant string of sentences with nouns, verbs, adjectives  and conjunctions correctly, wheras they may have previously struggled to write a few words or indeed form a complete sentence verbally.

I love it when something works.