Kindly designed and provided by Castlewood School in West Sussex, here are some brilliant additions to your visual timetables: they are especially designed to help us with the changes to our children’s schedules due to lockdown home learning during the Covid-19 pandemic.
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.
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.
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.
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
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
• share your feelings with someone you trust, such as a family member, friend or
• 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
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.
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 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.
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.
A lot of our children with additional needs struggles with everyday ‘demands’- requests, expectations, questions, commitments. But for some, even the most routine of expectations cause great anxiety; that’s when we see Pathological Demand Avoidance (PDA) or extreme demand avoidance.
What is PDA?
Pathological Demand Avoidance (PDA) is a condition which is part of the autism spectrum, and is characterised by an overwhelming need to avoid or resist demands.
This information sheet provides some behavioural strategies to support a person with PDA.
Key characteristics of PDA
Along with other characteristics seen on the autism spectrum, a person with PDA may show the following features:
• An obsessive resistance to ordinary demands and requests
• Use of socially manipulative or outrageous behaviour to avoid demands
• Sudden changes in mood apparently associated with a need to control
• ‘Surface’ sociability, reflected in social peculiarity, difficulties with peers and lack of social constraint
• Comfortable in role play and pretending.
Like many other people on the autism spectrum, people with PDA experience high anxiety levels and can feel that they are not in control. This leads people with PDA to avoid and refuse any requests that are made too assertively. Sometimes this is due to how the person with PDA interprets the question or instruction. This can lead them to avoid tasks and activities that they would otherwise enjoy, which can be upsetting for the person with PDA.
Core features of PDA are:
- A need to resist normal, everyday demands made by others
- This resistance appears to be a way of managing acute anxiety
- Unlike those with autism, learners with PDA may use social skills to manipulate; these skills are, however, at a functional and logical level rather than at a deeper emotional level.
What are the differences between learners with PDA and autistic spectrum disorder (ASD)?
- Passive early history in the first year
Young people with PDA tend to sit on the side lines just watching what is going on. They can be described as ‘actively passive’, letting things drop to the floor from their hands. They develop strong objections to normal requests. This is unlike young people with ASD who tend to lack social response and empathy, and tend to have poor body language and stereotypical behaviour.
- Continues to resist and avoid ordinary demands of life
Young people with PDA devote themselves to resisting ordinary demands, and as their language develops this can become worse. They may well acknowledge the demand but then can come up with a myriad of excuses as to why they cannot comply such as, “my legs won’t work”, “the teddy told me not to do that,” etc. They may crawl underneath furniture and say that they cannot do something because they are ‘stuck’ and often use fantasy to withdraw, pretending to be a cat or a super hero. This is unlike young people with ASD who may be reluctant to follow a demand, but this tends to be by ignoring or shutting out pressure in a non-social way with few direct strategies for avoidance. Their approach is more direct than devious.
- Surface sociability, but apparent lack of sense of social identity, pride or shame
Young people with PDA look more sociable but this is without depth. They have few boundaries and can display uninhibited behaviour that can be shocking. Praise, reward and punishment are likely to be ineffective. Young people with ASD are not inclined to use manipulation because of a lack of social empathy and often there is no impression of sociability.
- Lability of mood, impulsive, led by need to control
Young people with PDA can switch from passive to aggressive very quickly. They may apologise yet do the same thing again straight away, whereas young people with ASD are seldom impulsive, tending more to work to their own rules and not put an act on for anyone.
- Comfortable in role play and pretending
Young people with PDA can behave to other learners like the teacher. Some lose touch with reality, adopting a ‘video’ character. Young people with ASD tend to be inflexible with a lack of symbolic or imaginative play due to a lack of social empathy.
- Language delay, seems result of passivity
Young people with PDA tend to have an early language delay and often a sudden catch up. Their social use of language can appear normal although content may be odd. Social mimicry is more common than video mimicry. Young people with ASD have language which is both delayed and deviant. Their social language skills are poor.
- Obsessive behaviour
Young people with PDA have obsessions which tend to be social in nature. They can be over-powering in their liking for certain others. Most behaviour is obsessive, especially the demand avoidance, and can lead to low levels of achievement. Young people with ASD have obsessions which are rarely social and not focused on demand avoidance. Their obsessions are not used for manipulative purposes.
Young people with PDA are less likely to:
- have caused anxiety to their parents before 18 months of age
- show stereotypical motor mannerisms
- show echolalia or pronoun reversal
- show speech abnormalities in terms of pragmatics
- show tiptoe walking
- show compulsive adherence to routines
Young people with PDA are more likely to:
- resist demands obsessively (100%)
- be socially manipulative (100% by age of 5)
- show normal eye contact
- show excessive lability of mood and impulsivity
- show social mimicry (including gesture)
- show role play (more extended and complete than mimicry)
- show other types of symbolic play
- be female (50%)
Which strategies may help?
The PDA society provides many helpful suggestions, along with its useful PANDA mnemonic
The website goes on to explain further:
- Anxiety – the most important starting point is to understand and accept that a PDA child’s behaviours are underpinned by anxiety and a need to feel in control. Anxiety can be expressed in many different ways including avoidance, anger, shouting, crying, restlessness, boredom, fidgeting, rocking, ticks, repetitive actions, obsessing, skin picking, swearing, hiding, running off, withdrawing, throwing things and lashing out at others. The anxiety curve model is a really helpful way to understand anxiety and echoes the hierarchy of demand avoidance approaches seen in a PDA profile of autism. All the helpful approaches explained below are designed to help our children remain on the ‘lower slopes’ of the anxiety curve and avoid escalation where possible.
In addition, any or all of the following may be underlying …
- Difficulties in processing language – our children may have good expressive language but may not be able to process verbal communication quickly enough to keep up during a conversation and may be confused by non-specific questions or instructions (please listen to our webinar about PDA and speech & language for more detail).
- Difficulties with social interaction – our children may not always understand the ‘unwritten rules’ of social interaction or non-verbal communication including body language and tone of voice.
- Confusion about emotions – our children may not be able to understand or accurately ‘label’ emotions in themselves or other people, or may feel overwhelmed by their own and others’ emotions.
- Intolerance of uncertainty – our children may struggle with all the ‘what ifs’ of life, not knowing how things might ‘pan out’, what might be expected of them, where a situation might lead, when a situation might end and whether they will be able to cope with whatever may come along.
- Sensory overload – our children’s heightened sensory perception can also contribute to anxiety, overload and avoidance (please listen to our webinar about PDA & sensory processing for more detail).
Adjusting your mindset
A repeated theme in our case studies is that PDA turns “parenting norms” upside down, so our own mindset and mood are key factors in developing a toolkit of helpful approaches. Please listen to our webinar for more detail on this, but some key pointers are:
- Look beyond surface behaviours – outward behaviours are just the tip of the iceberg with many contributory factors lying below the surface as explained above.
- Re-balance your relationship – a more equal relationship between child and adult, based on collaboration and respect, builds trust. Try to aim for win:win solutions.
- Keep calm and carry on – try not to take things personally; model desired behaviours; pick your battles; treat every day as a fresh start.
- Focus on the long term objective of building a child’s ability to cope rather than short term compliance.
- Be flexible – helpful approaches require creativity and adaptability.
- See the positives – whilst supporting our children’s challenges, try not to lose sight of their many positive qualities.
- Support and self-care for you – being in touch with others who are having similar experiences can be enormously helpful and local families may have invaluable tips relevant to your area (please search our resources directory for support groups near you). It’s also important to ensure you are caring for yourself as well as possible.
Optimising the environment
Just like giant pandas, our children can thrive in the right environment – in place of firm boundaries and the use of rewards, consequences and praise, an approach based on negotiation, collaboration and flexibility tends to work better in PDA households. Top tips include:
- Balancing tolerance and demands – a child’s ability to cope with demands will vary from day to day and from hour to hour, so try to control the ‘input’ of demands accordingly (remembering that demands are many and varied) and build in plenty of ‘downtime’ to give space for anxiety to lessen and tolerance levels to replenish.
- Agreeing non-negotiable boundaries – these will vary from household to household and from child to child. For some, the barest minimum of non-negotiable boundaries (such as basic health and safety requirements or those relating to their siblings) may be needed when anxiety is very high, but they may be increased over time. Sharing clear reasons for these boundaries, and agreeing on them together as a family, can help our children to adhere to them. Enforcing these boundaries without exacerbating things may require the use of other helpful approaches (please see next section on reducing the perception of demands).
- Allowing plenty of time – time is an additional demand, so it’s helpful to build in plenty of time (for instance, setting alarms earlier on a school morning). Always try to plan ahead, anticipate potential challenges and allow some flexibility to accommodate fluctuating anxiety levels.
- Having an exit strategy – knowing how to extract yourself from a situation can help with reducing anxiety (for instance, you might agree a quiet zone where a child can retreat to or provide reassurance that if something can’t be done today it can be tried again tomorrow).
Reducing the perception of demands
Re-framing demands to make them feel less ‘demandy’ is a key technique. There are lots of ways to do this – you will probably find that a ‘mix and match’ approach works best:
- Phraseology and tone: subtle adaptations to our language and tone can benefit our children greatly. Using declarative language (like a ‘commentary’) or rephrasing things to talk about an object rather than a person and even simple things like starting rather than ending requests with the word ‘please’ can all make a big difference. For instance, when getting ready for school you might say “The clothes are on the bed. I’m happy to help.” and then walk away, rather than “You need to get dressed now” or if your child hasn’t had a drink all day you might just place the drink alongside them and say “Here’s a drink”. Similarly phrases such as “I wonder whether …” and “Let’s see if …” reduce the perception of demands. Likewise it’s helpful to avoid trigger words like “no”, “don’t” or “can’t” – you can convey the same message using different terminology (e.g. “I’m afraid it’s not possible right now”) and if you can also explain the reason and offer alternatives whilst delivering the message (e.g. “I’m afraid it’s not possible to go to the park right now because there’s a storm, but we can try this afternoon when the forecast is better and in the meantime would you like to bake a cake or watch a film?”) this can help avoid escalation.
- Indirect communication: indirect communication includes physical prompts (e.g. tapping shoes instead of saying “please put your shoes on”); visual prompts (pictures or checklists (ensuring our children have an element of choice and control, for instance in the order that things are done rather than a more formal ‘first this … then that …’ approach), post-it notes or communicating via instant messenger apps can work well); telling someone else to do something whilst in our child’s earshot (e.g. telling another child or adult “Please remember the rules about not running at the side of the pool” when you know that they know the rules already); leaving leaflets/books ‘lying around’ for our children to pick up out of natural curiosity; communicating using role play or via a third party (e.g. communicate through a favourite toy or by adopting the persona of a favourite character).
- De-personalising: explain that the requirement is made by some other, higher authority than you – for instance that “the pool manager is shutting the pool at 3pm” or that a certain law dictates certain rules.
- Distracting/turning things into a game: the idea here is to focus on something else other than the demand, so you might say “let’s see who can pull the silliest face between each item of clothing” when getting dressed or “let’s list the top 10 dinosaurs” whilst getting into the bath for instance.
- Using humour/novelty: humour is a great way to make everyone feel more relaxed and to help reduce the perception of demands; and novelty (provided the change in direction feels like a bonus/benefit for the child) can also work well.
- Asking for help: saying that you don’t know or can’t remember how to do something can be a great way of making a demand more indirect.
- Offering choices: the idea here is to give a child some control without losing all control as the adult, by offering limited choices (and being willing to accept a different choice of their own that still achieves the aim) or by offering free choice within certain parameters. For instance, you might ask “would you prefer to have a bath at 6 or 7 this evening” (and accept their negotiated answer of “6.30”) or you might stock a cupboard or shelf in the fridge with a range of healthy options and allow your child free choice of any items from there.
- Model behaviours or apply demands to yourself (with no expectation that your child will follow suit) – for instance, you might say “I’m feeling really stressed right now so I’m going to lie down in a quiet room and listen to some whale songs to help me to calm down”.
Being cautious with rewards/praise/sanctions
It can be helpful to understand why more traditional parenting approaches – such as rewards/praise/sanctions – don’t tend to be effective in PDA households.
Rewards create an additional demand on top of the demand itself; they magnify the problem if something isn’t achieved because not only is the ‘thing’ not achieved the reward isn’t earned either; and they don’t address the underlying difficulties or lacking skills which may have prevented achievement in the first place. What can work well are surprise rewards, rewards that are bestowed immediately (rather than waiting until the end of the day/week) and rewards that are tangible (rather than stickers or tokens) or matter to the child (they may be things that are linked to their special interests or involve free time to pursue an activity of their choice).
Praise may be perceived as a demand to repeat or improve on previous performance, and encouragement can feel like a demand as it increases the sense of expectation. It can be helpful to praise indirectly – for example praising the results rather than the person (e.g. “what a wonderfully tidy room” rather than “well done for tidying your room”) or praising your child to a third party in your child’s earshot. When offering encouragement, providing choices and exit strategies can be effective (e.g. “It would be great for you to go to the cinema with your friends, but don’t worry if it feels too much once you’re there, you can call me and I’ll come and pick you up”).
Sanctions or consequences may feel unjust when behaviours are a question of “can’t” not “won’t”, and may appear controlling and arbitrary when not directly related to the behaviours in question (e.g. what connection is there between not being allowed on electronics and being mean to a friend?) – they tend to lead to confrontation and escalation. Natural consequences which flow from behaviours (e.g. a friend not wanting to play or not being able to watch TV if it got broken during a meltdown) enable lessons to be learned in a more realistic way. When everyone is calm, discussing ways to avoid difficult situations from arising in future is another way for natural consequences to unfold.
Supporting sensory needs
Our children may be hyper-sensitive (seeking to avoid the sense) or hypo-sensitive (seeking out more of the sense) to any of the senses listed below:
- Vestibular (the sense of movement and balance)
- Proprioceptive (the sense of ‘position’ of your body in space and the input from muscles and joints to the brain)
- Interoception (internal senses from your body, such as hunger, thirst, pain and needing to use the toilet)
It’s possible to be both hyper and hypo sensitive to the same sense (for instance, someone may enjoy their own noise (e.g. their voice or choice of music) but find others’ or background noises intolerable) and it’s important to remember that sensory perception and sensitivity can also vary depending on levels of anxiety, illness, the type of surroundings and so on.
Falkirk Council’s helpful guide “Making sense of sensory behaviour“, the Sensory Processing Checklist and resources on Sensational Brain are useful places to start, along with our helpful webinar on this topic. The Greater Glasgow & Clyde NHS website also has useful sensory resources and the South Australia Department for Education has resources about Ineroception. An Occupational Therapist trained in sensory integration can assess a child’s sensory needs in full and may suggest a ‘sensory diet’. There are a few suggestions to try below:
- Chewy toys for those who seek oral sensory input
- Headphones playing a child’s favourite music or audio book for those who become easily overstimulated by noise and crowded places
- Carrying an object with a favoured scent (eg. candle, soap, pillow or spraying a sleeve or handkerchief) for those who become distressed by unfamiliar or unpleasant smells
- Seamless socks, wide fitting shoes and cutting labels out of clothes for those who are hyper sensitive to touch
- Asking before touching/hugging your child as some children are sensitive to touch – or equally some children may like the comfort of deep pressure and may feel well regulated using weighted blankets or similar.
- Wearing tinted or sunglasses for those who are over sensitive to light
- Taking packed lunches with preferred food/drinks for those who are avoidant of certain foods/textures.
- Access to messy play or a fidget toy for those who seek tactile input
- Plenty of opportunity for movement e.g. scooter, trampoline, running and bike rides for those who seek plenty of movement
- Rough and tumble play, playing in ball pits and sensory toys (such as a body sock) can be helpful for those with proprioception needs.
Supporting social communication & interaction
Our children often need support in relation to processing language and social interaction. A speech and language therapist can assess a child’s communication and interaction skills and make detailed recommendations. Our helpful webinar on this topic is useful place to start – a few top tips are shared below:
- Allow extra processing time so that your child can make sense of what you have said and have time to think about how to respond – it can be helpful to count to 5 in your head following a statement or request.
- Chunk questions or requests (space them out one at a time) rather than saying or asking many things in one go. Allow time for your child to answer your first question or respond to your first request before adding any follow-ups.
- Be clear and precise whilst being indirect – for example “I wonder if you could help me. I need four blue cups, from that cupboard, to be put on the table in the kitchen”.
- Role play can help our children understand other people’s perspectives, how someone’s actions can make another person feel and how this can affect relationships.
- TV/books can be a good way to learn about emotions, relationships and social dynamics, and enable our children to develop understanding and skills, in a more indirect way.
- Be inventive by linking activities to your child’s special interests or by using role play (e.g. your child could be the teacher for the day and teach her/his toys a social story or how to act in certain social situations) or by making a poster together that will tell other children how to behave.
Approaching behaviour that challenges
The helpful approaches outlined above are often very effective, and the frequency or intensity of meltdowns usually subside. However, meltdowns (best seen as panic attacks) are still likely to occur – please see our detailed page on meltdowns for more on this. It’s really useful to understand the triggers and/or possible purpose behind any behaviour that challenges – please see understanding behaviours for a structured approach to building up a picture of what can lead to these episodes that also points us towards the approaches that may be helpful.
Following a situation that has been tricky to handle, it can be helpful to reflect back and think about how a re-occurrence might be avoided in future. Try to approach this with a detective’s hat on, take the learning points on board but try not to dwell too much on things.
Working together with our children collaboratively and proactively to find solutions can also be really beneficial – many families find Dr Ross Greene’s approach in this area extremely helpful, it is explained in detail on his website and in his books ‘The Explosive Child’ and ‘Lost at School’. Ross Greene’s approach is also particularly useful when there may be doubt or disagreement about diagnosis as his approach is diagnosis ‘agnostic’.
Recognising and regulating emotions is something most of our children find very difficult. Whilst our children are young, the adults around them will need to be very vigilant in spotting the signs that anxiety is escalating. As our children grow older and their emotional intelligence develops, they may be able to recognise their emotions and deploy their own coping skills more effectively. Books can be a good way to learn about emotions, and enable our children to develop understanding and skills, in a more indirect way. There are some general book ideas that may be helpful with this in the resources section.
Supporting emotional well-being
It is important to remember to try and support our children’s emotional well-being by
- focusing on their many positive qualities as well as trying to support them with areas that they find difficult
- regularly reminding them that they’re valued for who they are and that it’s ok to be different
- regularly reminding them that they’re loved through whichever medium works best for them
- supporting them with the things that they’re interested in rather than trying to impose on them what you feel they should be doing
- speaking about them in positive terms to other people e.g. “Millie has an amazing imagination, she always thinks of really good games to play” or “Luke really makes me laugh, he’s such good fun to be with.”
For more information and support, please have a look at these useful resources and websites:
Have a look at this short video which explains dyslexia in greater detail:
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.
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.
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.
Natural & Herbal Sleep Solutions
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
- Sweet potato
- 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
- 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.
Do you have any sleep management tips you’d like to share with other parents? Let us know in the comments!
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
- 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?
Many of our children struggle with anxiety; especially if they have SEN or disabilities. The anxiety has only been heightened by the Covid-19 pandemic and the many disruptions to their lives. I’m often asked for recommendations of emotional literacy resources and workbooks to help with anxiety. Here are a few of the favourites- let me know if you’ve used them or there’s any others you have found particularly helpful.
No Worries! Mindful Kids: An activity book for children who sometimes feel anxious or stressed
No Worries! is an interactive self-care activity book for children aged 7+ to colour and doodle their way to happiness, calm and confidence.
The encouraging and simple activities and exercises tackle anxiety, sadness and stress; children will enjoy using their creativity to combat negative feelings, work out why they feel worried and how to put stress back in its place through writing, colouring, doodling and drawing.
Featuring the charming and quirky illustrations of Katie Abey, a UK-based illustrator. Her quirky pictures will keep the reader entertained and focused as they work through the book, or simply dip into the pages for ten minutes of calm colouring.
CBT strategies to help kids ages 6 to 10 stand up to anxiety and feel calm
Worrying all the time can stop kids from having fun with friends, hobbies, sports, or school. The CBT Workbook for Kids helps them get back to doing the things they love. The ideas and activities inside use proven, up-to-date cognitive behavioral therapy (CBT) strategies to help manage―or even change―worried thoughts and feelings.
This CBT workbook is an emotional toolbox for any anxious child, full of methods to help lower anxiety. First it helps them figure out what’s going on in their heads, and then it gives them tools to change it. Fun quizzes, drawing challenges, and fill-in-the-blank exercises show them new ways to look at each worry.
The CBT Workbook for Kids includes:
- Helpful skills―Learn techniques for expressing feelings, dealing with anger, staying focused, and making smart decisions.
- Relaxation strategies―Discover everyday calming methods, like creating a morning routine, asking for help, and facing fears a tiny bit at a time.
- Experiences from other kids―Each chapter in this CBT workbook has stories about how other kids might experience anxiety, too.
Helps kids take a deep breath, face their fears, and win with this CBT workbook!
Conquer anxiety and calm your body and mind–a workbook for teens ages 13 and up
Anxiety is a difficult emotion to manage, and the added stressors of teenage life can make it feel impossible to overcome. But you have the power to handle it–you just need the right tools. Unlock your ability to conquer anxiety with this therapeutic workbook. The exercises teach you practical, effective techniques to tackle worrying in the moment―so it doesn’t ruin your day and run your life.
You’ll find out how to identify the types of anxiety you’re experiencing–general anxiety, social anxiety, panic attacks, or phobias. Using strategies from cognitive behavioral therapy and mindfulness practices, you’ll learn how to manage your thoughts, emotions, and behaviors. With helpful examples of real scenarios teenagers face at school, home, or with friends, this book is your secret weapon against anxiety in any situation.
The Conquer Anxiety Workbook for Teens lets you:
- Soothe your mind―Learn how anxiety plays tricks on your mind, and find out how to be more realistic and confident while correcting “thinking errors” and old beliefs.
- Understand your body―Discover immediate calming strategies like body scanning, taking charge of your anxious alter-ego, creating a self-care routine, and more.
- Write in the book―This workbook has lined space to invite you to answer questions, try thoughtful exercises, and take quizzes right on the page.
Release stress and worry while you nurture your mental health with the Conquer Anxiety Workbook for Teens.
Big Life Journal (ages 7-10)
Big Life Journal helps children develop strong Social-Emotional Learning (SEL) and growth mindset skills through inspiring stories, colourful illustrations, and engaging guided activities.
In this illustrated journal, children discover:
- how to believe in themselves
- how to face challenges with confidence
- mistakes are opportunities to grow
- they can achieve anything when they’re persistent
Are there any others that are your particular favourites? Let me know in the comments 🙂
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.
being overly responsive to sensory input, can lead to sensory-avoiding behaviour (see below).
being under responsive to sensory input, can lead to sensory-seeking behaviour (see below).
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.
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.
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.
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:
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.
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!
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?
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
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:
- 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.
- 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.
- ‘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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.