When a child is finding school a challenge, there are many factors that could affect this. Before an individual program is designed for a child at Yveher, there is a process of listening which occurs. Listening to the child, the parent and the teacher will indicate some common ground. Any learning challenge is researched with certain criteria as guidelines.
Academic Assessments: There are tests available to discern a child’s reading age, mathematics ability and spelling age. These are formal assessments. These, with the child’s latest school report will provide valuable information as to where the child can be assisted.
Physical Assessments: These assessments are able to focus on different skills that can affect learning in many ways. There are gross motor skills which involve large muscle groups in the body. The areas addressed are those of muscle tone, postural control, bilateral integration, balance, ball skills and general skills such as hopping, skipping etc. Fine motor skills which are smaller muscles are areas such as finger strength, pencil grip and pencil control, in-hand manipulation skills, block building, threading, colouring and cutting skills, pre-writing skills, writing skills and of course, hand-eye coordination.
Speech: Speech and language are assessed in areas such as speech articulation, phonological errors, and childhood apraxia of speech.
Oral apraxia indicates that the child has difficulty with volitional control of nonspeech movement. For instance, perhaps the child will have difficulty sticking out and wagging their tongue when requested to do so. Or the child may have difficulty sequencing movements for the commands, “Go to the top drawer in the kitchen, open it and take out a teaspoon”/”Pick up the ball, take it to the third step and roll it down.”
Verbal apraxia shows that the child has difficulty with voluntary, spontaneous movement for the production of speech. This can be at the level of sounds, syllables, words, or phrases (in connected speech). This motor struggle is most often observed with sounds sequencing. Often oral apraxia accompanies verbal apraxia, but it is important to note that this is not always the case. (The challenges with apraxia/dyspraxia of speech are that the child is experiencing the difficulty in nonspeech and speech movement when they are quite aware of trying to make relevant movements or they are attempting movements when requested by others. Those very movements and sounds may be heard while the child is busy playing or he/she and are able to make them when they do not realise anyone is watching them. For example, a child may be playing happily and parents may hear sounds being made – “ma, ma, ba, ba,da, da”. However, when parents ask the child to use the sounds, eg. “Mama!”, the child struggles to do so. This will show on the child’s face. They may touch with their lips or silently copy the movement with their lips as if searching for the right position. When the child is not thinking about it or trying to perform, it comes naturally but when they are conscious of the request and attempt to use their mouths to make certain movements, they struggle.)
There are many intervention exercises to remediate challenges such as stuttering and stammering. Using singing is a creative way of relaxing the child and helping them to be less aware of trying to pronounce sounds.
Language Impairment: This involves difficulties in understanding and expressing language. An area that would be researched is the grammar application in speech and written work, for example, word order, tenses, pronouns and prepositions usage. Another area is language content and meaning – vocabulary, understanding concepts such as opposites, associations and categorisations etc. The use of language, known as pragmatics, where the general rules of communication are applied, is included in eye contact, initiating conversation, assessing how much information to share, and allowing people to take turns in the conversation. Different tones in the conversation can show respect for others and assertiveness in certain situations. Young children use picture forms and drawing skills to communicate and it is important not to interfere with their drawing abilities as this is their only written form of communication. There are picture boards and games available which assist children who need more communication tools.
Auditory Processing Skills: These are listening skills where concentration and focusing is built up over time. One of these skills is called whole body listening. There are various interactive skills available such as a talking and listening chair, which guides the child to know when to talk and when to listen during conflicting opinions. Listening skills are not easily acquired and need to be gently taught over a period of time. Of course, keeping content interesting when a person desires to communicate anything is as much the responsibility of a speaker as a listener.
Tips for parents on listening skills: Parents set an example for children. Children copy everything they see. A wonderful way to teach children listening skills is to practise in front of them as well as with other children. Listening doesn’t always mean keeping completely silent while the other person speaks. “Active listening” is a great skill, and shows that you are involved in the conversation. Listening skills can be practised by asking follow-up questions, or asking for clarification on certain points. Simple, encouraging questions will allow the speaker to continue talking while you continue listening. Become a people watcher. Learn how other people listen, and take mental notes about the habits of people you think are good listeners as well as people you think are bad listeners. Make sure that there is no interruptions and maintain eye contact when you speak with your child. Find out what really gets your child talking passionately. Everyone has a favourite subject, or story they like to tell everyone they meet. Allow your child to tell their story and listen with empathy. Teaching a child this exercise in self control is a positive step on the way to teaching them about being a better listener. This also helps children to focus on listening more attentively in a classroom and it helps the child to stop allowing their brain to race ahead of the speaker. A child who sits and wonders about what they want to say after the speaker has finished, has allowed their brain to block out what the speaker is saying. They will not ask relevant questions. Things like television (even if it is muted) distracts from effective listening. A child raised with all these skills will naturally develop whole body listening skills (stand or sit still, have eye contact, keep hands still and relaxed, and lean towards the speaker, eager to hear what they have to say) and not be distracted. Seventy-Five percent of all communication is non-verbal. Children sense these clues as we speak, deciphering facial features, body language, and hand motions. As a parent/care giver, you may wish to pay attention to your own non-verbal motions while you speak and look for non-verbal clues from others while you listen.
Auditory memory is an area that checks rote recall (for example, counting skills), instruction recall and story recall (sequencing events in order).
Phonological awareness is developed through sound related activities such as nursery rhymes (a lovely way to teach language patterns), rhyming activities such as card games, songs and fun alliterations to mention a few. Spoonerisms are the interchange of the initial sound of two words, such as when one has a slip of the tongue, eg: “He’s a boiled sprat” instead of “He’s a spoilt brat”.
Auditory Perception skills are developed through Auditory Analysis, eg: mat = m + a + t , Auditory Synthesis, eg: m + a +t = mat(this can be assisted by singing the sounds into each other to develop the skill); Auditory Discrimination, eg: hat/mat (rhyming skills); and Auditory Closure, eg: ele_ant = elephant.
Perception Skills include activities to make sure that the following areas are developed: Body Awareness (body image, concept), Concepts (shapes, colours, numbers, size), Directionality (the concepts of left and right), Spatial Awareness (orientating the body in relation to objects/people eg: above, below, under, in front, behind, next to, inside, on top etc), Visual Figure Ground (the ability to focus visual attention on one object eg: the picture of puzzle/picture within other pictures, to increase word focus in reading), Visual Discrimination (the perception of similarities and differences between objects, shapes and symbols such as numbers/letters, words with similar letters like: hand/land), Position in Space (orientation of body and objects in space leads to differentiating between “b” and “d”), Visual Closure (the ability to complete a figure, word, sentence which is perceived to be incomplete, eg: when reading different fonts/handwriting), and Visual Motor Integration (integrating the functions of the visual system and motor skills to copy pictures or drawings; enabling pupil to copy from a blackboard).
Children with sensory integration dysfunction frequently experience problems with their sense of touch, smell, hearing, taste and/or sight. Some children also experience difficulties in movement, coordination and sensing where their body is in a given space. Individuals may be overly sensitive to certain textures, sounds, smells and tastes, while wearing certain fabrics, tasting certain foods, or normal everyday sounds may cause discomfort. The opposite is also possible – for example a child with an Autism Spectrum Disorder may feel very little pain or actually enjoy sensations that neurotypical children would dislike: strong smells, intense cold or unpleasant tastes. When the brain struggles to balance the senses appropriately and/or filter out background stimuli to ascertain what is important, a child may have to deal with overwhelming amounts of sensory input during the day and night.
Sensory integration therapy with children involves occupational therapy with the child placed in a room specifically designed to stimulate and challenge all of the senses. During the session, the therapist works closely with the child to encourage movement within the room. Some schools have a specially designed room with soft lighting and a variety of sensory activities available for a child to choose the most soothing as well as explore new experiences such as moving air from a fan, touching a furry cushion or rolling in a soft tunnel.
The therapy is driven by four main principles: 1. Just Right Challenge (the child must be able to meet the challenges through playful activities) 2. Adaptive Response (the child adapts behaviour to meet the challenges presented) 3.Active Engagement (the child will want to participate because the activities are fun) 4.Child-directed (the child’s preferred activities are used in the session).
Sensory Integration therapy is careful to not provide children with more sensory stimulation than they can cope with. Children with lower sensitivity (hyposensitivity) may be exposed to strong sensations, while children with heightened sensitivity (hypersensitivity) may be exposed to quieter activities. Appropriate rewards may be used to encourage children to tolerate activities they would normally avoid.
Guidelines for children with heightened sensitivity
Parents can find it very distressing if their child rejects hugs, cuddles and other demonstrations of affection. This can be misinterpreted as a personal rejection when it is felt as a discomfort with unpleasant touch by the child.
These suggestions may assist in more appropriate touch with autistic children who have hypersensitivity: the child finds it easier to initiate hugging than receive it; touch is more tolerable when the child anticipates it; a consistent, firm touch is better than a light or moving touch; light touch may be tolerable after a firm, constant touch; initial stimulation may be unpleasant at first but tolerated later. It is important to approach each case as a unique set of parameters. As you will know, no two children present with the same sensory challenges.
The sense of touch varies widely between children experiencing sensory integration dysfunction. When children enjoy the feel of sticky textures, materials such as glue, play dough, stickers, rubber toys and sticky tape can be utilised. Other materials that can be useful for tactile sensation include water, rice, beans and sand. Many children on the autism spectrum enjoy a sense of firm overall pressure. This can be achieved by wrapping them up in blankets, squashing them between pillows and firm hugs. These activities can form a basis for play, interaction and showing affection. Many experiences that may be claustrophobic for neurotypical children may be enjoyed, such as being squashed between mattresses, and making tunnels or tents from blankets over furniture. Parents may be aware of a child’s response to the smell of substances, and may experiment with putting different fragrances in play dough or rice. If a child actively likes strong odours, specific toys with this feature can be used positively in therapy. Sound can be focused on by experimenting with talking toys, games on computers, musical instruments, squeaky toys and all sorts of music, especially classical. Rhythmic sounds like clapping together, rhymes, repeating phrases and tongue twisters are good activities. If a child on the autism spectrum responds more to music than voices, a melodic or “sing-song” voice may be preferred. By trying different tones of voice and pitches, one can assess a child’s response.
The Proprioceptive System helps children (and adults) to locate their bodies in space. Autistic children often have poor proprioceptive skills and need help developing their coordination. Playing with weights, bouncing on a trampoline or a large ball, skipping or pushing heavy objects can be used to improve this.
The Vestibular System is located in the inner ear and responds to movement and gravity. It is involved with the sense of balance, coordination and eye movements. Hanging upside down, rocking on rocking chairs, swinging, spinning, rolling, somersaulting, dancing and doing cartwheels helps. Activities that involve the head moving in different ways stimulate the vestibular system. Watch the child carefully to make sure that the movement is not over stimulating. Back and forth movement is regarded as often less stimulating than side-to-side movement. Rotational or spinning movements are the most stimulating and should be used carefully. A rocking motion will usually calm a child while vigorous motions like spinning will stimulate them. Some popular activities include going on merry-go-rounds, being tossed on to cushions or jumping trampolines.
Learning new skills involving movement such as tying shoe laces or riding a bike can be difficult as they involve sequences of movements. To help in this area, parents may use swimming, mazes, obstacle courses, constructional toys and building blocks. Difficulty with using both sides of the body together can occur in some cases of sensory integration dysfunction. Children can be encouraged to play games with crawling, hopscotch, skipping, playing musical instruments, playing catch and bouncing balls with both hands to help with bilateral integration. Hand and eye coordination can be improved with activities such as hitting a ball with a bat, popping bubbles, and throwing and catching balls, beanbags and balloons.
Yveher has included many of these activities in specially tailored programs in The Brain Train which is enjoyed by all the children who participate. They leave each session with a sense of wellbeing and increased self esteem. To receive advice or make a booking, please email yvette@yveher.com and we will send you a booking form.
