Taking Care of The Carers

Being a special needs parent isn’t easy. No one prepares you for it. While your friends are off living their typical lives with their typical children, it can feel quite isolated and lonely. But you are not alone. There is a whole army of special needs parents and carers out there. We’re all in this together! Recently, we held a webinar about how to take care of ourselves as the carer and below are some of the best strategies and links we discussed.

Mind. uk has some great advice for carers:

“When you spend a lot of your time focusing on someone else, you may feel as if you have
no time for yourself. But looking after your own wellbeing is important for you and for
them.
We have listed some self-care ideas that others have said they find helpful. Even trying
one small thing might help you feel more able to cope.

Share how you feel


It’s important to have someone to talk to, especially if you’re struggling to cope. You
could:
• share your feelings with someone you trust, such as a family member, friend or
neighbour
• join a support group for carers
• contact the Carers UK helpline
• talk to others on the Carers UK forum
• talk to someone through online mental health tools.
Not all of these options may feel right for you. Or you might feel like you have nobody to
share your feelings with. If you are feeling isolated or alone, our pages on coping with
loneliness offer more information.


“Try to find someone you can be honest with about your feelings, without
judgement.”

Try to be realistic


If you take too much on, you may feel as if you never achieve anything. Try to get a clear
idea about what you can do. By accepting the things that you can’t change or do alone,
you may feel more able to cope. You could try identifying and writing down:
• a list of all the support needs of the person you are caring for
• what you can do and what you’ll need help with
• how you’ll know when you need a break.


“Respite is possible – and necessary. You can’t give your all as a carer – you
just can’t. You have to save a bit of yourself just for you.”

Take a break and make time for yourself


Try and take a break, especially if you’re worried about your own mental health. You may
not be able to take a break whenever you need one, but it’s important to have some
time that’s yours.
You may need an hour or two to clear your head, or a day to help you feel more rested.
You could go out, have a nap or turn your phone off for an agreed period of time. Try to
make time for things you enjoy.


“I love running and being able to get out for half an hour each evening
allowed me to clear my head and relax.”

Look after your physical health


It’s important to try and make time to look after your physical health as best you can.
• Try and eat as healthily as you can and do some kind of regular physical activity.
See our pages on food and mood and physical activity for ideas you can fit into a
busy daily routine.
• Try to get enough sleep, as a lack of sleep can make it harder to cope with
everyday challenges. It can also make stress and depression worse. For more
information, see our pages on sleep and mental health.
• Use relaxation techniques, as these can help your mind and body feel more
rested. You need just a few minutes a day to do most of these exercises. For
more information, see our pages on relaxation.


“I have come up with my own saying, which is ‘you have to make your own
normal’. Your life changes so much as a carer and you have to make a new

life for yourself. You do not want to feel excluded from life, so you make
your own normal.”

Parents with chronic illness

A lot of parents of children with special needs are also coping with health problems of their own. Many of the parents we speak to each week are struggling with fatigue, anxiety, fibromyalgia, migraines or CFS. One thing that can help is to make sure we are taking care of ourselves physically. Here is a list of supplements that can help support carers physically and mentally.

Sleep

Restorative sleep is so important, both as a carer and as someone with a chronic illness. Have a look at our blog post about sleep solutions and get started on the passionfruit tea!

Migraines, Fatigue and Chronic Pain

Supplements to help with migraines, fatigue and chronic pain include a combination of Riboflavin (Vitamin B2), Co Enzyme Q10, and magnesium. My neurologist (who specialises in migraines), recommends 200mg riboflavin, 300mg Co Enzyme Q10 and 300mg magnesium each day. Please be sure to check with your GP or primary care physician first though!

Hormonal Imbalances

Hormonal imbalances are really tricky to deal with. It can be hard to get a referral to endocrinology and access the help we need. This tool by Dr Tassone (an OB/GYN and specialist in women’s endocrine issues) helps to pinpoint the areas of the endocrine system which need support. He then recommends a variety of diet, lifestyle and supplements for each Hormone Archetype.

You’re not in this alone. If you are struggling with being a carer and taking care of your own health, please get in touch with Carers Trust or visit Mind UK

They can put you in touch with local support groups, online carer forums, and grant providers; as well as providing lots of resources and strategies to help you manage.

Dyslexia, Dysgraphia, Dyscalculia: what are they and how can we help children with learning differences?

Dyslexia

Have a look at this short video which explains dyslexia in greater detail:

Dysgraphia

Learn a bit more about dysgraphia in the two videos below:

For more information on how to help with handwriting, please have a look at our dyspraxia blog post; it contains lots of useful tips on how to help our children improve with their handwriting.

Dyscalculia

Ronit Bird is an expert on dyscalculia and has produced several helpful resources. Please watch her video below and have a look at her website!

Our resource recommendations:

Base 10: this equipment helps children to see the differences between the size of different numbers and it is also particularly useful to those who are following the National Curriculum. Most schools have access to Base 10 equipment which will help to consolidate your child’s learning. It uses the principles of units, tens, hundreds and thousands & is an excellent resource for kinesthetic learners.

Numicon is an amazing resource. The aim of Numicon is to make numbers real for children through them being able to see and touch them. It fits in with the Maths Mastery approach that’s used in many schools, providing a concrete object to represent each number. It also has a multi-sensory approach that’s known to help learning.

Using dominoes and dice help dyscalculic learners by helping them to recognize spot patterns instead of having to count by ones.

And finally, a great way to help children become more confident with number is by using board games. Here are our top recommendations!

Draftosaurus 2-5 players, age 6+

Your goal in Draftosaurus is to have the dino park most likely to attract visitors. To do so, you have to draft dino meeples and place them in pens that have some placement restrictions. Each turn, one of the players roll a die and this adds a constraint to which pens any other player can add their dinosaur.

Draftosaurus is a quick and light drafting game in which you don’t have a hand of cards that you pass around (after selecting one), but a bunch of dino meeples in the palm of your hand.

Catan 3-4 players (up to 6 with expansion), age 10+

Players try to be the dominant force on the island of Catan by building settlements, cities, and roads. On each turn dice are rolled to determine what resources the island produces. Players build by spending resources (sheep, wheat, wood, brick and ore) that are depicted by these resource cards; each land type, with the exception of the unproductive desert, produces a specific resource: hills produce brick, forests produce wood, mountains produce ore, fields produce wheat, and pastures produce sheep.

Of Knights & Ninjas 2-6 players, age 8+

Competitive, strategic card game for 2-6 players set in feudal medieval era. The first player to own 10 gems wins the game.

Corinth 2-4 players, 8 years+

In each round of Corinth, a handful of dice are rolled and players take turns selecting groups of dice to deliver goods to shops, purchase herds of goats or visit the market, recording their progress on their notepads. In this game, you will need to pay close attention to what your opponents are doing and choose between taking the best option for you or making sure your opponents don’t get theirs…

Dino World 2-12 players, age 10+

Description from the designer:

Build and manage your own dinosaur park in this strategic roll and write game for 1 or more players.

Roll dice, draw pens and try not to let any dinosaurs escape!

Each turn players share an expanding dice pool to work through three phases: add dinosaurs and buildings to the park, draw paths connecting attractions to the entrance, and control dinosaurs attempting to escape.

The game ends whenever a player runs out of space in their park, or has had too many dinosaurs escape.

The player with the most fame from dinosaurs/attractions and the fewest penalties from breakouts is the winner!

Do be sure to have a look at our blog post about dyspraxia as there are often overlaps between the various learning differences.

Dyspraxia blog post- Special Needs Village

Other Resources

British Dyslexia Association

´Childmind.org

´Importance of Early Screening

´NCDL ´

Understood.org Dysgraphia

Understood.org Educational Therapy

Ronit Bird ´

Steve Chin ´

Brainbalancecenters.com

How can we reduce problems with sleep?

Many children (and parents) struggle with establishing a regular, healthy sleep routine. This is especially true when our children have additional needs because they often have dysregulations in their neurotransmitter levels or are particularly sensitive to external stimuli. They may also be affected by circadian rhythm disorders or be genetically predisposed to certain sleep issues.

We’re going to consider the main ways we can help our children get in to a regular sleeping pattern and to make sure they are getting good quality, restorative sleep.

Environmental Factors

Behavioural Solutions

Natural & Herbal Sleep Solutions

Melatonin

Melatonin is one of the things I’m most asked about by sleep-deprived parents. Some consultants will prescribe liquid or tablet melatonin supplements. Some parents choose to order if over the internet from place such as Biovea, but others prefer to try to increase the melatonin levels naturally. Here are some of the best way to do so, according to Our Paleo Life:

There are many things one can do to naturally increase melatonin levels without supplements. The biggest one has to do with lights.

1. Take A Break From Technology

The best way to repair your circadian rhythm, experts say, is to stop using technology for a prolonged period of time. One week was found to be the perfect amount of time to normalize sleeping patterns for a group of participants who were asked to go camping for a week.

You can try to not touch any technology at home for a week but let’s face it, in today’s world it is nearly impossible to avoid technology at home. Even if you don’t want to watch TV, your spouse or your children might and that’ll tempt you to watch too.

The best solution is to plan a getaway for the whole family and turn off all the technology. If you must use it, designate only one or two hours in the middle of the day for it. Plus, leaving technology behind is a great way for the family to bond face to face.

2. Start Dimming Lights Early

Most people make the mistake of thinking melatonin starts when they turn off the lights to go to sleep, but this is not true. Melatonin levels increase when your body starts to sense there is less light.

What you can do to aid this process is by dimming the lights in your house and bedroom earlier. At least one hour before bedtime, start to turn off the lights in the house that you do not need and only leave on the ones that are crucial.

If you only have one light in your bedroom, consider getting a desk lamp or installing a light

dimmer so you can control the amount of light you can have in your room. By reducing the intensity of the light in your house way before bedtime, you’ll be signaling to your body to get ready for bed and this should help the chemicals going.

3. Reduce Exposure to Blue Lights Before Bed Time

We’re all guilty of this. Scrolling through our phones before bedtime but this is probably one of the worst sleeping habits anyone can have. The blue light emitted from your phone screen is distinctly harmful to melatonin production.

It’s not easy to put away the phone though, we know. What we suggest is for you keep the phone outside of your bedroom. Leave it charging in the kitchen or in the living room and let your friends and family know that you are trying to reduce phone usage before bedtime so they don’t call unless it’s an emergency.

Also: pro tip – blue blocking glasses at night. Check out Amazon for a bunch of options.

4. Cut Back on Social Media

Similar to point number three, social media is one of the reasons why many people are addictedto their cell phones and computers. If you find yourself scrolling through social media for hours before bedtime, stop.

5. Eat A Healthy Diet

While this seems like a generic piece of advice, a healthy diet is crucial to better sleep. In fact, did you know all plants have a certain amount of melatonin in them? That’s because plants, like us, also rely on light to grow.

Foods that have a high amount of naturally occurring melatonin are:

  • Tart cherries
  • Asparagus
  • Tomatoes
  • Sweet potato
  • Pomegranate
  • Olives
  • Nuts and seeds

Foods that are rich in tryptophan, magnesium, calcium, and B6 are also known to promote sleepiness.

6. Increase Relaxation

Another way to induce sleepiness at night is to increase relaxation and this could mean different things for different people. For example, music might relax one person but might stimulate another.

Here’s some ideas:

  • Take a bath
  • Essential oil diffuser
  • Play soothing music
  • Use a sound machine that plays white noise
  • Drink non-caffeinated herbal tea
  • Stretch
  • Search, Ponder and Pray

Anxiety & sleep

The last point on that list is very important for our children. Many of them struggle with anxiety and/or depression. Being able to process their emotions and anxieties can have a dramatic affect on the quality of their sleep.

The Therapist’s Aid website has some great worksheets, so does Twinkl.

Have a look at our previous post about anxiety workbooks and worry eaters if you feel anxiety is an issue for your child or young person.

Do you have any sleep management tips you’d like to share with other parents? Let us know in the comments!

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Creating a sensory diet for your child

It is strongly recommended that you seek the advice of an occupational therapist or other SEN advisor before implementing a sensory diet, but below are some tools to help establish your child’s needs and a variety of safe strategies and materials you can use at home while you are awaiting further assessment.

So first off, we need to establish the area our child is struggling with and which areas they are particularly hyper- or hypo- sensitive to.

Below are two tools, with links, which you can use to establish your child’s preferences.

The first was published in Raising a Sensory Smart Child by Biel & Peske

To download and print a copy please use this link: Sensory Checklist Biel & Peske

Our second resource was published by Robert Cox for Life Recovery Consulting

To view & print please use the following link: Life Recovery Consulting

Once you have established your child’s needs, you can start to implement strategies and establish a sensory diet that works for them.

Understood.org helps to explain how a sensory diet could look throughout the day and what it may involve:

“What might an example sensory diet look like?

A sensory diet is made up of a group of activities specific to your child’s needs. These depend on your child’s sensory issues. Let’s say your child is what OT’s call low arousal (meaning sluggish). Her routine might include:

  • 20 jumping jacks
  • Bouncing on a therapy ball 20 times
  • Holding a Zen bug yoga pose for 10 seconds

Your child will repeat this circuit of activities a set number of times. Each session should last 10 to 15 minutes (the effects can last for hours). Once your child’s routine is set, she’ll do it two or three times throughout the day.

What activities might be included in a sensory diet routine?

Your child’s OT will observe her to see what sensory input she seeks or avoids. The OT takes those preferences into account when coming up with a routine. Here are some standard activities they draw on to create a sensory diet:

  • Jumping jacks or lying on the ground and doing snow angels
  • Somersaults
  • Log rolling (rolling back and forth)
  • Swinging on swings
  • Climbing ladders and sliding down slides at the playground
  • Hopping up and down
  • Push-ups (which can be modified to pushing off the wall or on their knees)
  • Bouncing on a therapy ball with feet on the ground while clapping
  • Rolling on a therapy ball on their belly, forward and backward
  • Rolling a therapy ball on their back while they lie on the ground to “make a sandwich”
  • Yoga poses like downward dog or happy baby (also known as Zen bug), holding a position for at least 10 seconds
  • Facing a wall and pushing as hard as possible (variations include standing sideways and pushing against the wall with a shoulder, or pushing while sitting with the back against the wall, holding positions for at least 10 seconds)
  • Heavy work activities at home with supervision, like sweeping/dry mopping, dusting, vacuuming, lifting and carrying grocery bags from the car into the home
  • Animal walks such as crab walk (on all fours facing sky) or bear walk (on all fours facing ground)

A sensory diet may also include other activities that target specific sensory issues. One technique, the Therapressure Protocol (you may hear it referred to as brushing), can be very helpful to some kids. But it requires specific training from an OT and is not something parents can do without professional guidance.

In addition to physical activities, a sensory diet may incorporate other sensory experiences that help your child feel “just right.” These could include using fidget toys or weighted blankets, or chewing crunchy foods throughout her day.”

Here are two more examples provided by Healthline

For a child who seeks out rough play, has trouble calming themselves, and chews on objects

  • 8 a.m.: Have a chewy breakfast or snack, like a bagel or granola bar.
  • 9 a.m.: Carry a crate of books to the school library.
  • 10 a.m.: Hold the heavy library door open for the class.
  • 11 a.m: Squish with a beanbag chair.
  • 12 p.m.: Lunchtime with chewy options and water bottle with bite valve.
  • 1 p.m.: Do wall pushes.
  • 2 p.m.: Play with crash pad.
  • 3 p.m.: Walk with weighted backpack.

For a child who can’t sit still and constantly touches and fidgets with objects

  • 8 a.m.: Use fidget toy on the bus.
  • 9 a.m.: Jump on trampoline.
  • 10 a.m.: Play with tactile sensory bin.
  • 11 a.m.: Sit in rocking chair for reading time.
  • 12 p.m.: Bounce on a yoga ball.
  • 1 p.m.: Swing at recess.
  • 2 p.m.: Play-Doh time.
  • 3 p.m.: Sit on a yoga ball while doing homework.

*Have you had success in implementing a sensory diet for your child? Which strategies did you find particularly effective?

More resources:

Basic sensory diet ideas NHS

Sensory diet treatment, what you need to know

Beginners guide to a sensory diet

OT Sensory Processing Assessment for Caregivers

The impact of sensory processing issues and how to help

Sensory processing issues are a common comorbidity of neurodevelopmental disorders such as autism and ADHD. But what does the term ‘sensory processing’ actually mean and how does it manifest? How can we help our children when they are suffering from sensory overload or sensory-craving to the point of injuring themselves?

Some children receive a diagnosis of Sensory Processing Disorder (SPD). In the UK, this is usually diagnosed after an assessment with Occupational Therapy or Peadiatrics. However, in this article, we will use the more generic term of ‘sensory processing issues’ or ‘sensory processing difficulties’ because many children are affected by sensory dysregulation but don’t have a specific diagnosis of SPD.

What do these terms mean?

Hypersensitive

being overly responsive to sensory input, can lead to sensory-avoiding behaviour (see below).

Hyposensitive

being under responsive to sensory input, can lead to sensory-seeking behaviour (see below).

Sensory craving

is described as when one is “driven to obtain sensory stimulation, but getting the stimulation results in disorganization and does not satisfy the drive for more”. It can become excessive and even dangerous; such as in cases of repeated head-banging.

Hyperarousal

involves heightened baseline levels of autonomic arousal. The child is already in a heightened state of arousal so it doesn’t take much for them to become seriously overwhelmed.

Hypervigilant

involves scanning the environment for threat-relevant stimuli, and preparation for potential threat. In the case of children with sensory processing issues, they may seem to always be on the alert and extremely anxious about the possibility of sudden loud noises.

Sensory overload

this happens when you’re getting more input from your senses than your brain can sort through and process. Multiple conversations going on in one room, flashing overhead lights, or a loud party can all produce the symptoms of sensory overload. But when there’s competing sensory information, your brain can’t interpret it all at the same time. For some people, this feels like getting “stuck”; your brain can’t prioritize what sensory information it needs to focus on. Your brain then sends your body the message that you need to get away from some of the sensory input you’re experiencing. Your brain feels trapped by all the input it’s getting, and your body starts to panic in a chain reaction.

Have a look at these videos by The National Autistic Society to see how sensory overload can feel:

‘Make It Stop’

‘Can You Make It To The End?’

This causes the ‘flight or fight’ response of the sympathetic nervous system to be triggered. Have a look below at the difference between the sympathetic nervous system and the parasympathetic nervous system & the vast array of systems they can affect.

When we experience sensory overload, our sympathetic nervous system is activated. To help calm a child down during sensory overload, we want to reduce the input they are receiving and try to activate the parasympathetic nervous system instead.

These activities stimulate the vagus nerve and encourage the body to calm down. It can be really effective to implement some of these strategies when our children are struggling. Try a few and see which work best for you.

How many senses do we have?

Most people with automatically respond with “Five”, but we actually have at least eight.

Let’s look at each sense in turn. We will see how to spot whether our children are under or overly responsive to various types of stimuli, and also what adjustments we can make to help them.

The Auditory System

A healthy functioning auditory system allows children to respond appropriately to what they hear. For example, they may turn their head when their name is called, or follow verbal directions given by a teacher. They would also be able to filter out irrelevant noises (such as another child tapping their pen, or the buzz of an electric light). Some children however, may be hyper or hyposensitive to the sounds that they hear and this can affect their behaviour.

The Visual System

A healthy visual system allows the child to filter out inconsequential things they can see, and also to pay attention to information that is important. Some children are overly sensitive to visual stimuli; this is particularly true of children on the autism spectrum.

They may benefit from a reduction in visual stimuli, as demonstrated below.

As seen here, the TEACHH workstation method is very effective for children who are hypersensitive to visual stimuli.

Some children are under sensitive to visual stimuli and may need bright colours and visual stimulation to keep them engaged.

The Tactile System

The tactile system is the sense of touch. A healthy tactile system allows us to process temperature, feel pain, differentiate pressure and texture. When the tactile system is well regulated, a child is able to filter out unnecessary tactile input; such as a breeze blowing in their face. They are also able to tolerate a variety of textures, such as different fabrics of clothing.

A child who is overly sensitive to tactile input may present with the following behaviours:

Children who are under responsive to tactile input may benefit from the following strategies:

The Gustatory (Oral) System

The sensory receptors in our mouths allow us to perceive temperature, texture (e.g. smooth like yogurt, hard like a crisp, or a mixture of textures like cereal with milk), and taste (e.g. sweet, salty, bitter, sour).

Our brains also receive lots of proprioceptive information from the joint of the jaw as we bite and chew different foods that provide different types of resistance (e.g. a crunchy carrot, chewing gum)

Children with a healthy oral system are able to eat a variety of foods, including a range of tastes and textures. They would also not need to seek out extra oral sensory input such as chewing on clothes, in order to regulate their behaviour.

A child with dysregulation in the gustatory system may demonstrate some of the symptoms below:

Alerting and calming activities can help to regulate the gustatory sensory system.

The Olfactory System

A child with a healthy olfactory system is able to tolerate smelling foods and other odors in his environment.  He can even tolerate unpleasant odors (within reason) without extreme reactions.  A functioning olfactory system helps a child know the difference between “good” smells – those that are safe, pleasant, or associated with positive emotions – and “bad” smells – those that are dangerous, displeasing, or reminders of negative experiences.

Children who are hypersensitive to smells may demonstrate the behaviours below:

Some children may crave olfactory input and would benefit from trying some of these activities:

The Proprioceptive system

What is the proprioceptive system?

When children move and play, their muscles stretch and contract.  Proprioception refers to the way joints and muscles send messages to the brain to help coordinate movement.

This sense also allows us to grade the force and direction of our movements – our bodies instinctively know to apply more effort when lifting a heavy box and less effort when lifting a piece of paper.  While the vestibular system tells the brain about balance and moving against gravity, the proprioceptive system helps us coordinate the movement of our arms and legs in an efficient manner to play and move without even having to look.

A functioning proprioceptive system allows a child to write with a pencil without pushing so hard that he breaks the tip or take a drink from a paper cup without crushing it in his hand. A functioning proprioceptive system allows children to move, play, and explore in a smoothly coordinated and efficient way – not too gently, not too rough.

To help regulate the proprioceptive system, sensory circuits; a sensory diet and heavy work can be very beneficial.

The Vestibular system

The vestibular system has to do with balance and movement and is centered in the inner ear.  Each of us has vestibular organs located deep inside our ears. When we move our heads, the fluid in these organs moves and shifts, constantly providing us with information about the position of our heads and bodies in space (spatial awareness).

When our vestibular sense is fully functioning, we are secure and organized enough in our bodies to be able to attend and respond to all of the other senses we encounter daily.  A child with a well-developed vestibular sense feels confident and safe during movement activities, even if his feet are off the ground.  He is able to start and stop movement activities calmly and with control.  He is comfortable with climbing, swinging, somersaulting, and jumping – knowing that his body will adapt and that he will be able to maintain his balance and keep himself from falling or getting hurt.

The Interoceptive system

So how can we help our children with sensory processing issues?

Apart from using the sense-specific strategies above, children with sensory processing disorders can be really helped by the use of sensory circuits and a specifically-tailored sensory diet.

Both programs take time to organize and implement so we will have a blog post dedicated to each one individually. Subscribe to have them delivered straight to your inbox!

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Helpful links:

Subtypes of SPD

Hypervigilence: symptoms, causes and strategies

Anxiety disorders & sensory over-responsivity in children

OT & self-regulation

Heavy work activities & sensory processing disorder

How to help our children with anxiety: The Worry Eater

Worry-eaters!
These are a fabulous resource if you have a child who struggles with anxiety and also finds it difficult to either express their worries or put them to one side. They can draw a picture of their worry, or write it down and then feed it to the worry monster!

When the child is ready, they can take the worry out and chat about it. Sometimes they prefer not to; they like to feed the worry to the monster and then forget about it.
Use your discretion as to whether it’s a big worry that needs to be talked about; or a little worry that can be mentally processed and then discarded.

It’s an effective method for visual and kinesthetic learners to process emotions and make them a little more ‘concrete’ rather than abstract.
They also come in a key ring form with a little Velcro mouth; handy for when you’re out and about or the child is away from home.

Have you used a worry monster or a worry letter box?
What methods do you find have been most useful for helping your child to cope with anxiety?

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What is Dyspraxia? And how to help children with dyspraxia

Dyspraxia used to be known as ‘Clumsy Child Syndrome’ and it some countries it is referred to as ‘Developmental Coordination Disorder’. The signs that a child is struggling with dyspraxia can be seen in various aspects of their behaviour and motor control.

There are three recognized types of dyspraxia: verbal, oral and motor.

Verbal dyspraxia refers to difficulty in producing clear and understandable speech; oral dyspraxia refers to difficulty in controlling the vocal tract ( lips, tongue, palate, larynx) in the absence of speech, and motor dyspraxia refers to difficulties with gross and fine motor skills.

So what causes dyspraxia?

For the majority of cases, there is no known direct cause for dyspraxia. However, it has been noted that it is a common comorbidity in people who have ASD (Autistic Spectrum Disorder) or a family history of dyspraxia.

What is very intersting is that brain scans can now show the different areas of the brain that light up when a person with dyspraxia performs the same action as someone without dyspraxia.

According to the American Academy of Peadiatrics, children with dyspraxia showed greater activation in the areas of the brain that are to do with visuospatial processing, whereas children without dyspraxia relied more on areas to do with spatial processing, motor control, and error processing.

Brain Activation of Children With Developmental Coordination Disorder is Different Than Peers

Author: Jill G. Zwicker, Cheryl Missiuna, Susan R. Harris, Lara A. Boyd

Publication: Pediatrics

Publisher: American Academy of Pediatrics

Date: Sep 1, 2010

Copyright © 2010, Copyright © 2010 by the American Academy of Pediatrics

But what does that mean for my child?

It means that there will be some things they will find tricky, or certain actions may take a lot more practice for them to master. eg. doing up a tie for school, tying their laces. But it has been seen that children with dyspraxia tend to have very good visuospatial processing, and can be creative, hard-working problems solvers; they’ve had to learn to think outside the box and this can lend itself to their becoming unique and empathetic thinkers.

Who diagnoses dyspraxia?

If you are based in the UK, then usually your GP, SENCO or health visitor will refer you to another healthcare professional for the assessment. This could be a pediatric occupational therapist, a physiotherapist, a pediatrician or an education psychologist. They will refer to the diagnostic criteria in the DSM-5 and ICD11 in order to make an official diagnosis.

How can I help my child?

These are some of the most effective ways of helping a child with dyspraxia:

  1. Encourage individual sports rather than team sports. They may feel clumsy and awkward when playing team sports and this can affect their confidence. But it’s still very important for our children to be healthy. Therefore, encouraging team sports such as swimming or Pilates can help to improve their tone and coordination.
  2. Teach one-to-one or in small groups so we can see the areas of difficulty the child has and we can tailor our approach to them.
  3. ‘How To Use’ labels on machines such as the dishwasher or washing machine. Children with dyspraxia often struggle to organize their thoughts and may get muddled up with processes.
  4. Self-esteem work. Many children with dyspraxia have low self-esteem and feel they are the ‘odd one out’. Cater to their strengths and celebrate their achievements. Just because someone has dyspraxia doesn’t mean they are stupid or incapable: it just means the messages aren’t getting from the brain to their muscles in the way they would like.
  5. Orienteering practice. Children with dyspraxia tend to have a bad sense of direction and may get overwhelmed especially when they have to learn a new route or routine. Help them by practicing it over and over again. As they get older, send them out with Google maps and a local destination- they will learn to strengthen their orienteering skills and sense of direction.
  6. Emotional expression. Due to the fact that their body sometimes won’t do what they want it to, children with dyspraxia can get really frustrated with themselves. Make sure they have an outlet for their emotions, such as a journal, sketchbook or other emotional literacy resources.
  7. Good diet, sleep and exercise. As we saw in the article on ADHD, neurotransmitters (the chemical messengers in our brain) need a good balance of vitamins and minerals in order to function correctly and to be balanced. Have a look here for a more in-depth discussion of the role of diet and neurophysiology.
  8. Task-oriented approach. This is used by occupational therapists to help children improve a specific task such as eating with cutlery (Caring cutlery helps too!), climbing stairs or tying shoes. A task-oriented approach has been found to be very effective for children with dyspraxia.
  9. Process-oriented approach. This approach is slightly different in that it encourages the all-round development of the child’s gross motor skills, which in turn leads to improvements in other areas.
  10. Prioritise. Figure out what the priority is for you and your child, then work on that. Whether it be table manners, hand writing, football practice, riding a bike…find what’s going to make the most difference to you and your child and start there. Don’t get overwhelmed with goals and tasks; just one goal at a time.

What about coordination?

Well, one of things a child with dyspraxia will struggle with, is being able to coordinate their actions and do more than one thing at a time. eg. they may struggle to hold a jar of peanut butter still while they turn the lid. There are lots of day-to-day activities that can be incorporated into their daily routine at home and can help build their confidence in coordinated actions and also build up ‘muscle memory’.

What about handwriting?

This is by far the most common question I am asked about dyspraxia. “How can I help my child to improve their handwriting? I can’t understand what they’ve written, what should I do?” Here are some tips that may help:

Start off with warm up exercises and pencil control skills, practice other fine motor skills which will strengthen the muscles and coordination in the hands and wrists. Get them to write about things they like, and in a manner that they find comfortable. Speak to the school SENCO about extra time in exams and also about the possibility of a ‘scribe’; a member of staff who can write down their answers to questions but in a far more legible manner.

There’s some videos of the warm-up exercises to follow shortly!

And over to you…

Do you or your child have dyspraxia? What techniques and strategies have helped you? I’d love to hear in the comments.

P x

Helpful Links:

Dyspraxia Foundation

Medical News Today article re: dyspraxia

NHS UK

British Dyslexia Society, post about dyspraxia

Patient. Info article about dyspraxia

What causes ADHD and how to help a child with ADHD

In this series of articles, we will discuss some of the most common questions parents ask about various additional needs. We’re going to start with ADHD.

ADHD is one of the most common neurodevelopmental disorders of childhood. It is usually first diagnosed in childhood and often lasts into adulthood. Children with ADHD may have trouble paying attention, controlling impulsive behaviors (may act without thinking about what the result will be), or be overly active.

There are three main types of ADHD…

Predominantly Inattentive Presentation: It is hard for the individual to organize or finish a task, to pay attention to details, or to follow instructions or conversations. The person is easily distracted or forgets details of daily routines.

Predominantly Hyperactive-Impulsive Presentation: The person fidgets and talks a lot. It is hard to sit still for long (e.g., for a meal or while doing homework). Smaller children may run, jump or climb constantly. The individual feels restless and has trouble with impulsivity. Someone who is impulsive may interrupt others a lot, grab things from people, or speak at inappropriate times. It is hard for the person to wait their turn or listen to directions. A person with impulsiveness may have more accidents and injuries than others.

Combined Presentation: Symptoms of the above two types are equally present in the person.

Usually a child will be diagnosed with one of these three types, according to the diagnostic criteria in the ICD-10 or DSM-5. However, the latest research shows that there are actually seven different types of ADHD and they all manifest in slightly different ways. To learn more about this, have a look at Dr Amen’s work with SPECT scans: a special kind of scan to see areas of brain activity.

what causes ADHD?

ADHD is caused by a variety of factors including genetics, neurotransmitter levels in the brain and the ‘wiring’ of the brain itself. It is not caused by bad parenting!

Usually a parent or close (male) relative has ADHD. Identical twins 90% chance of both having ADHD; this shows us that there is definitely a strong hereditary cause.

What about the neurotransmitters? What are they?

Neurotransmitters are the body’s ‘chemical messengers’; they pass information from one neuron to another. Two neurotransmitters are either imbalanced or reduced in children who have ADHD. These are noradrenaline and dopamine.

Noradrenaline affects behaviors including our levels of vigilance, arousal, attention, motivation, reward, and also learning and memory.

Dopamine is  involved in reward, motivation, memory, attention and even regulating body movements.

When these two brain chemicals are unbalanced, or not being produced in the right amounts, it causes a lack of concentration, hyperactive behaviour and difficulties controlling impulses.

This is compacted by the way the ‘wiring’ is in the brain of a child with ADHD. On PET and SPECT scans, scientists can see that there is dysfunction in the frontal lobes-the part of the brain that says “hmm, is this a good idea?”- so the children can’t put the brakes on their behaviour

In addition, other areas such as the limbic area are under functioning which means the children are taking in lots more unnecessary information through their eyes and ears but they can’t filter the information. 70% of children with ADHD show ‘markers’ on brain MRIs which show their internal system is dysregulated: they are underactive when they should be busy, but hyper when they should be quiet. They also really struggle to monitor and regulate their behaviour.

All of these things added together obviously make a huge impact on their behaviour and emotions. Imagine how you would feel if you were in your car and had a near-miss. You’d likely have an adrenaline rush- the ‘flight-or-fight’ response- and would feel shaken up. Now imagine feeling like that for most of the day and being asked to sit down and write an essay or do some maths: it’s practically impossible.

Behaviours that parents find most difficult to deal with

What about girls with ADHD?

Girls with ADHD do tend to demonstrate slightly different behaviours and there is still a long way to go in researching why this is the case. However, some of the most commons signs of ADHD in girls are shown in the diagram below:

So how can I help my child?

As in the infographic above, the most effective behavioural treatments for ADHD involve living by routine, rewarding the good and taking a step back from confrontation.

Approximatly 50% of children with ADHD also have a Specific Learning Difficulty such as dyslexia, dyspraxia, slow processing speed or poor working memory. They need routine and structure in order to thrive. Children with ADHD often have mood swings and emotional variability so they need help regulating and expressing their emotions. Additionally, they can be very sensitive and suffer from cripplingly low self-esteem: they are ‘out of kilter’ with their peers, misread social cues and tend be treated as the annoying outcast who won’t calm down and keep up with the group. They put a lot of effort into their school work but achieve little because they are unable to focus and channel their attention. To help them we need to tackle the issues of emotional regulation, sensory processing problems and brain chemistry.

But how do i do that?

We need to make sure they eat and sleep well. Sugar crashes are far more severe in our children and they get ‘hangry’ quickly. They need a diet that helps to balance their noradrenaline and dopamine levels. This includes a protein heavy breakfast- turkey burgers are particularly good, but baked beans, boiled eggs and other sources of protein are excellent choices. Choose brown carbs over white carbs- they have a grounding affect and take longer to break down which means our children don’t suffer such extreme energy crashes. Iron, zinc and magnesium are essential in the production of neurotransmitters so a multivitamin is essential, along with green leafy veg (maybe in a smoothie with some orange juice to aid the iron absorption). Fortified bread and cereal are excellent choices too, along with bananas (which are an excellent source of B6- a vitamin that helps in neurotransmitter function). Zinc can be found in meat products, beans, chickpeas and nuts. A breakfast of baked beans or peanut butter on whole-wheat toast is an ideal way to get the day off to a good start!

Make sure the children are surrounded by positive social support. They may be left out at school, with friends pushing them to the side when they’ve had enough of the mood swings or inattentiveness. This really impacts our children’s mental health so we need to give them plenty of positive social interaction and specific praise from family and friends. They may find it easier to be friends with younger children who are at a similar developmental age.

Children with ADHD are very sensitive to stress and become overwhelmed very quickly. We need to find out what their triggers are, think ahead and plan ahead. Choose which aspect of their behaviour you’d like to work on and stick with just that to begin with. Don’t overwhelm them with lots of changes and punishments. Use a behaviour system such as ‘1,2,3…Magic’. It’s one of the most popular programs and really works well for children with ADHD because it gives them the chance to stop, think and make the right choice. We need to make sure we don’t ask too much of them; don’t expect the impossible. Keep distraction to a minimum as far as possible and have structures in place to help the child. This could be things such as having a place for everything in the home, getting them to count what they need in their school bag, repeating requests back to you. As they get older, organization and note apps are really helpful for them to keep track of their thoughts and their day.

Their body, mind and brain are all sending and receiving mixed signals due to their systemic dysregulation and sensory issues. We need to help their body and mind ‘tune in’ to each other and balance their neurophysiology as far as we are able to. This can be done by using grounding activities, mindfulness, and helping them to recognize what they are feeling. For a younger child, we might ask them to colour in on a picture of a body and point to “where they feel cross” or “where they feel sad”. We could then do some mindful breathing exercises and grounding techniques. Even just 15 minutes of mindfulness per day has been shown phenomenal improvements in attention, working memory, compassion and anxiety reduction. Apps such as Positive Penguins and Molehill Mountain are very effective. Another useful habit to start is journaling and using a diary to monitor their emotions. The one I recommend is the Happy Self Journal; it asks different questions every day and helps the children to process their feelings and events of the day. This is also so useful to us as parents because sometimes our children struggle to express themselves verbally and using the journal allows them the opportunity to share their feelings through writing or drawing.

What about medication?

There are quite a few options for medication in treating ADHD, and all are working towards the same end goal: adjusting the levels of brain chemistry and compensating for the brain wiring problems so that the child can focus. According to Childmind.org, “Stimulants are the best and most common type of medication used to treat ADHD. There are only two stimulant medications, methylphenidate (the active ingredient in Ritalin, Concerta and other formulations) and amphetamine (the active ingredient in Adderall, Vyvanse and other formulations). Both medications are available as short-acting medications and in longer acting preparations.

The two types of medications (methylphenidate and amphetamine) are equally effective and have the same benefits and the same risks. While most people will respond equally well to either medication, there are a few people who respond better to one versus the other. Typically, if you start treatment with one of these medications and it doesn’t work well or is not tolerated, you should probably try the other medication.”

Which books do you recommend?

Always a favourite point to end on, here are some of my favourite books for children with ADHD & their parents.

The Survival Guide for Kids with ADHD

All dogs have ADHD

Thriving with ADHD: Workbook for Kids

Self-Regulation Interventions and Strategies

CBT Toolbox for Children & Adolescents

Understanding ADHD

Understanding Girls with ADHD

The Explosive Child

What do you find most challenging about being a parent of a child with ADHD? Have you noticed if you have ADHD traits yourself, or a diagnosis even? How do you manage your child’s behaviour? I’d love to hear your feedback.

P x

Questions parents ask…about ADHD

In this series of articles, we will discuss some of the most common questions parents ask about various additional needs. We’re going to start with ADHD.

ADHD is one of the most common neurodevelopmental disorders of childhood. It is usually first diagnosed in childhood and often lasts into adulthood. Children with ADHD may have trouble paying attention, controlling impulsive behaviors (may act without thinking about what the result will be), or be overly active.

There are three main types of ADHD…

Predominantly Inattentive Presentation: It is hard for the individual to organize or finish a task, to pay attention to details, or to follow instructions or conversations. The person is easily distracted or forgets details of daily routines.

Predominantly Hyperactive-Impulsive Presentation: The person fidgets and talks a lot. It is hard to sit still for long (e.g., for a meal or while doing homework). Smaller children may run, jump or climb constantly. The individual feels restless and has trouble with impulsivity. Someone who is impulsive may interrupt others a lot, grab things from people, or speak at inappropriate times. It is hard for the person to wait their turn or listen to directions. A person with impulsiveness may have more accidents and injuries than others.

Combined Presentation: Symptoms of the above two types are equally present in the person.

Usually a child will be diagnosed with one of these three types, according to the diagnostic criteria in the ICD-10 or DSM-5. However, the latest research shows that there are actually seven different types of ADHD and they all manifest in slightly different ways. To learn more about this, have a look at Dr Amen’s work with SPECT scans: a special kind of scan to see areas of brain activity.

what causes ADHD?

ADHD is caused by a variety of factors including genetics, neurotransmitter levels in the brain and the ‘wiring’ of the brain itself. It is not caused by bad parenting!

Usually a parent or close (male) relative has ADHD. Identical twins 90% chance of both having ADHD; this shows us that there is definitely a strong hereditary cause.

What about the neurotransmitters? What are they?

Neurotransmitters are the body’s ‘chemical messengers’; they pass information from one neuron to another. Two neurotransmitters are either imbalanced or reduced in children who have ADHD. These are noradrenaline and dopamine.

Noradrenaline affects behaviors including our levels of vigilance, arousal, attention, motivation, reward, and also learning and memory.

Dopamine is  involved in reward, motivation, memory, attention and even regulating body movements.

When these two brain chemicals are unbalanced, or not being produced in the right amounts, it causes a lack of concentration, hyperactive behaviour and difficulties controlling impulses.

This is compacted by the way the ‘wiring’ is in the brain of a child with ADHD. On PET and SPECT scans, scientists can see that there is dysfunction in the frontal lobes-the part of the brain that says “hmm, is this a good idea?”- so the children can’t put the brakes on their behaviour

In addition, other areas such as the limbic area are under functioning which means the children are taking in lots more unnecessary information through their eyes and ears but they can’t filter the information. 70% of children with ADHD show ‘markers’ on brain MRIs which show their internal system is dysregulated: they are underactive when they should be busy, but hyper when they should be quiet. They also really struggle to monitor and regulate their behaviour.

All of these things added together obviously make a huge impact on their behaviour and emotions. Imagine how you would feel if you were in your car and had a near-miss. You’d likely have an adrenaline rush- the ‘flight-or-fight’ response- and would feel shaken up. Now imagine feeling like that for most of the day and being asked to sit down and write an essay or do some maths: it’s practically impossible.

Behaviours that parents find most difficult to deal with

What about girls with ADHD?

Girls with ADHD do tend to demonstrate slightly different behaviours and there is still a long way to go in researching why this is the case. However, some of the most commons signs of ADHD in girls are shown in the diagram below:

So how can I help my child?

As in the infographic above, the most effective behavioural treatments for ADHD involve living by routine, rewarding the good and taking a step back from confrontation.

Approximatly 50% of children with ADHD also have a Specific Learning Difficulty such as dyslexia, dyspraxia, slow processing speed or poor working memory. They need routine and structure in order to thrive. Children with ADHD often have mood swings and emotional variability so they need help regulating and expressing their emotions. Additionally, they can be very sensitive and suffer from cripplingly low self-esteem: they are ‘out of kilter’ with their peers, misread social cues and tend be treated as the annoying outcast who won’t calm down and keep up with the group. They put a lot of effort into their school work but achieve little because they are unable to focus and channel their attention. To help them we need to tackle the issues of emotional regulation, sensory processing problems and brain chemistry.

But how do i do that?

We need to make sure they eat and sleep well. Sugar crashes are far more severe in our children and they get ‘hangry’ quickly. They need a diet that helps to balance their noradrenaline and dopamine levels. This includes a protein heavy breakfast- turkey burgers are particularly good, but baked beans, boiled eggs and other sources of protein are excellent choices. Choose brown carbs over white carbs- they have a grounding affect and take longer to break down which means our children don’t suffer such extreme energy crashes. Iron, zinc and magnesium are essential in the production of neurotransmitters so a multivitamin is essential, along with green leafy veg (maybe in a smoothie with some orange juice to aid the iron absorption). Fortified bread and cereal are excellent choices too, along with bananas (which are an excellent source of B6- a vitamin that helps in neurotransmitter function). Zinc can be found in meat products, beans, chickpeas and nuts. A breakfast of baked beans or peanut butter on whole-wheat toast is an ideal way to get the day off to a good start!

Make sure the children are surrounded by positive social support. They may be left out at school, with friends pushing them to the side when they’ve had enough of the mood swings or inattentiveness. This really impacts our children’s mental health so we need to give them plenty of positive social interaction and specific praise from family and friends. They may find it easier to be friends with younger children who are at a similar developmental age.

Children with ADHD are very sensitive to stress and become overwhelmed very quickly. We need to find out what their triggers are, think ahead and plan ahead. Choose which aspect of their behaviour you’d like to work on and stick with just that to begin with. Don’t overwhelm them with lots of changes and punishments. Use a behaviour system such as ‘1,2,3…Magic’. It’s one of the most popular programs and really works well for children with ADHD because it gives them the chance to stop, think and make the right choice. We need to make sure we don’t ask too much of them; don’t expect the impossible. Keep distraction to a minimum as far as possible and have structures in place to help the child. This could be things such as having a place for everything in the home, getting them to count what they need in their school bag, repeating requests back to you. As they get older, organization and note apps are really helpful for them to keep track of their thoughts and their day.

Their body, mind and brain are all sending and receiving mixed signals due to their systemic dysregulation and sensory issues. We need to help their body and mind ‘tune in’ to each other and balance their neurophysiology as far as we are able to. This can be done by using grounding activities, mindfulness, and helping them to recognize what they are feeling. For a younger child, we might ask them to colour in on a picture of a body and point to “where they feel cross” or “where they feel sad”. We could then do some mindful breathing exercises and grounding techniques. Even just 15 minutes of mindfulness per day has been shown phenomenal improvements in attention, working memory, compassion and anxiety reduction. Apps such as Positive Penguins and Molehill Mountain are very effective. Another useful habit to start is journaling and using a diary to monitor their emotions. The one I recommend is the Happy Self Journal; it asks different questions every day and helps the children to process their feelings and events of the day. This is also so useful to us as parents because sometimes our children struggle to express themselves verbally and using the journal allows them the opportunity to share their feelings through writing or drawing.

What about medication?

There are quite a few options for medication in treating ADHD, and all are working towards the same end goal: adjusting the levels of brain chemistry and compensating for the brain wiring problems so that the child can focus. According to Childmind.org, “Stimulants are the best and most common type of medication used to treat ADHD. There are only two stimulant medications, methylphenidate (the active ingredient in Ritalin, Concerta and other formulations) and amphetamine (the active ingredient in Adderall, Vyvanse and other formulations). Both medications are available as short-acting medications and in longer acting preparations.

The two types of medications (methylphenidate and amphetamine) are equally effective and have the same benefits and the same risks. While most people will respond equally well to either medication, there are a few people who respond better to one versus the other. Typically, if you start treatment with one of these medications and it doesn’t work well or is not tolerated, you should probably try the other medication.”

Which books do you recommend?

Always a favourite point to end on, here are some of my favourite books for children with ADHD & their parents.

The Survival Guide for Kids with ADHD

All dogs have ADHD

Thriving with ADHD: Workbook for Kids

Self-Regulation Interventions and Strategies

CBT Toolbox for Children & Adolescents

Understanding ADHD

Understanding Girls with ADHD

The Explosive Child

What do you find most challenging about being a parent of a child with ADHD? Have you noticed if you have ADHD traits yourself, or a diagnosis even? How do you manage your child’s behaviour? I’d love to hear your feedback.

P x

SEN Resources: Visual Aids

Visual aids are a marvelous way to help children with additional needs. Many children are visual learners, and children who struggle with sensory overload find verbal prompts or reminders difficult to understand when they already have so much information being processed. A visual aid helps them to focus, to understand what is happening next, which behaviours are required of them and also allows them the opportunity to express what they are feeling or to ask for something they need.

This blog post is going to discuss various forms of visual aids which can be used to support learning, to help with routines and to aid children in expressing themselves.

Now, Next & Then Boards

These are particularly useful in supporting children who have autism or learning difficulties. The boards explain clearly what is happening now and in the near future. This can help to settle anxiety and help the child to understand that they need to, for example, wash their hands before having their lunch.

Visual Timetable

Visual timetables are an effective way for children to see exactly what is happening that day, or to help them develop independence in their daily routines (such as getting dressed). These can be used in class and also at home. They are particularly useful for days out or when there is a change in routine. Some visual timetables have each activity attached with Velcro so once the activity is finished, it is removed from the timetable. This helps to keep things simple and gives the child a visual reminder of how many activities are left to be completed.

As a child gets older, they may prefer not to use pictures or symbols as part of their timetable. Checklists are a useful transition tool and way for them to become more independent with appropriate support tools.

Emotional regulation & expression

Some children (particularly those on the autistic spectrum) may find it hard to express or recognize the feelings they are having. Most children with autism also struggle to understand facial expressions so visual aids are an important way for them to learn what other people are feeling and also for them to demonstrate what emotions they are experiencing.

Behaviour reminders

These are useful to have when out and about or in the classroom. The reminders can be kept on a keychain or lanyard, or in a pocket; anywhere easily accessable. They can be used to remind the child of which behaviours are ‘expected’ (such as standing nicely in a queue at the supermarket) and also contain other communication cards for the child to use when they are too overwhelmed to use verbal communication.

PECS (Picture Exchange Communication System)

PECS is a widely used communication system.

“The Picture Exchange Communication System, or PECS, allows people with little or no communication abilities to communicate using pictures. People using PECS are taught to approach another person and give them a picture of a desired item in exchange for that item. By doing so, the person is able to initiate communication. A child or adult with autism can use PECS to communicate a request, a thought, or anything that can reasonably be displayed or symbolized on a picture card. PECS works well in the home or in the classroom.  PECS was developed in 1984 by Lori Frost, MS, CCC/SLP and Dr. Andrew Bondy. It was first used at the Delaware Autistic Program. The goal of (PECS) is to teach children with autism a fast, self-initiating, functional communication system. PECS begins with the exchange of simple icons but rapidly builds “sentence” structure.” The National Autism Resources.com website