Monday, 27 November 2017

What to do from 0 - 2




Many people do not realise how crucial the early years are in determining a child's future development.

Professor Allan Schore of UCLA has found that eighty percent of the brain cells that a person will ever have are manufactured during the first 2 years of life. Brain scans of children who have been neglected compared to a 'typical' child show huge differences in the size of the brain. The interaction between the child and their main care givers at this time is crucial. The neuro pathways on which further learning is based are being laid down from 0 to 2, the foundations for language development, coordination, motor skills, visual skills, listening skills and focus are all being put in place.

It is not about 'hot housing' children or forcing them to do activities they are not ready for but being aware that play and interaction are important right from the start.


If you observe and interact with a group of pre-school children of 3 - 4  years of age the difference in the range of skills some children have compared to others is already huge.


Much as many people hate to say it, the advantage some children have at this stage will stay with them all throughout school.   The differences between children are partly genetic and partly due to their environment.  Of course nothing is straightforward, children all develop at different rates.  Some children are 'late bloomers' and some children have learning difficulties and developmental issues to deal with.  But stimulating and interacting with our baby and toddler will always make a difference to their later skills and ability to learn.

If you take a typical nursery or kindergarten class and ranked them in terms of language development, motor skills, focus and readiness to learn.  Then you looked at the attainment in reading and maths for the same group of children at the end of primary school at 11 years old you would find the order is pretty much the same.  It is not to say that schools and parents do not make any difference but they can only build on the foundation that is already there.

The purpose of this article is not make any one feel bad about their child or their parenting but just to raise the awareness that those first 2 years can make a real difference.  Many parents are unaware of what they can do to encourage and nurture their child at this early stage.  Many educators and parents are increasingly concerned about range and level of skills of children coming into school. But the answer is not to do more in pre-school or bring educational goals lower and lower.  The answer is in supporting parents and other caregivers and their children before pre-school.

So what can we do?

Many people still think that a quiet baby is a good baby and while we can not change a child's temperament we can encourage all children to interact and respond to their environment.

1. Talk
Talking to your baby as much as possible is important for future language development.  Some people think that because the baby can not understand you, that it is not important to talk to them. But the baby can pick up on the rhythm and sound patterns right from the beginning.  They recognise tone of voice, they recognise their care giver/s voice/s above others.  It is also not necessary to use baby talk, if you use the correct words you will find that when a child is ready to talk they will use these words too. Reading and sharing books right from the beginning is also a great way to introduce children to a whole range of vocabulary and the world beyond their own experience. Most children it love too!



2. Movement and curiosity
Encouraging your baby to reach for objects and touch things is also important. Let them have plenty of time out of their pram or cot to explore what is around them. Let them look at and touch everyday objects (as long as it is safe). We don't need fancy toys; as we all know at Christmas, when the baby or toddler plays with the box as much as the toy inside!  Encourage curiosity as much as possible, let your baby or child watch you do all the everyday things that need to be done - cooking, cleaning, shopping.  Lying on their tummy for some time each day, as well as their back helps to strengthen muscles and helps later coordination.  When they are ready to crawl let them go and explore, try not to contain them much as practical.  Babies experience to world through all their senses and we should encourage this as much as possible.



3. Play
Play, play and more play! Play is how we are meant to learn the boundaries of our environment and ourselves. It is how we learn cause and effect, how we learn to problem solve and focus.  Many of the 'traditional' toys are best - building blocks, shape sorters, jigsaws, matching games. We also want a balance between adult directed play and child directed play.  We don't always need to show a child how to do something 'properly' they can learn a lot by playing with a toy or game the 'wrong' way and then working out what to doMessy play with water, mud, sand or paint are all fun and hugely beneficial.

'Play' is currently a hot topic terms of pre-school, school curriculum and education but the point is play is important right from the beginning.

See https://www.zerotothree.org/espanol/brain-development video clips and great practical tips.

Also take a look at https://www.education.com/reference/article/infants-toddlers-ages-zero-two/  for further reading on early development.


Tuesday, 21 November 2017

Auditory Processing Difficulties


Why do some children always miss the instructions in class?

Why do some children appear not to be listening?

Why do some children never seem to know what they are meant to be doing?

Auditory Processing Disorder affects a child's ability to hear and process verbal information.
When we speak as adults we take for granted that those listening are following what we are saying. Teachers give lots of verbal information and instructions every day which they expect pupils to understand and follow. As parents we constantly give directions and pass on information verbally to our children and get frustrated when they do not respond.

Children with APD very often try to listen but are not able to 'process' or make sense of the words easily. It may take time for them to respond or they may need to ask for clarification.  They are not trying to difficult, they are simply not able to comprehend what you are saying without support.


It is not a case of focusing more or trying harder, the child is not being lazy or inattentive. It is not a physical hearing problem or a lack of attention it is to do with the way the brain is processing the sounds and language.  It is not about comprehending the words themselves it is about mishearing or muddling the sequence of sounds in a word.  Auditory discrimination is affected making it hard to distinguish similar sounds - 'chess' and 'chest' or 'back' and 'bag. ' Auditory sequencing difficulties may also mean the brain 'scrambles' the order of sounds it a words making words hard to understand.  Auditory memory is also affected making it hard to remember what has been said.

Background noise can make a huge difference to a child's ability to listen and understand what is being said. As so many environments can be noisy many people learn to 'tune out' the noise, but this is not possible if you have auditory processing disorder. Other noises compete for your attention making it difficult to follow what was being said.

What can done to help?

Children need to be specifically assessed by an audiologist, a child may have normal hearing but have auditory processing difficulties.  The tests can not normally be administered until the age of 7.  Assisted listening devices may be recommended that reduce background noise and enhance that speaker's voice.  Speech therapy may also help to address some of the auditory difficulties.

When a parent is aware of these difficulties they can try to ensure there is no background noise when giving instructions or discussing something important.   They need to be patient when the child doesn't follow what is being said first time.  Keep important information short and clear.  Encourage eye contact. It is not always easy not to get frustrated, when what you said seems straightforward.  Use routine, checklists and visuals to help reduce that amount of listening required for day to day things.

Teachers need to create an environment where it is acceptable to ask for instructions to be repeated rather than getting cross and telling a child off for not listening.  They should also be conscious about using visuals and concrete materials to support what they are saying.  Allowing children to have printed versions of what is being explained or at least bullet points can be very helpful for many children. Rephrasing what is said can be helpful as sometimes it is the complexity of language or the sound combinations that make something hard to understand.

For more information see www.understood.org and read the excellent book by Terri James Bellis


Wednesday, 8 November 2017

Have you heard of Non Verbal Learning Disorder?


Does your child have excellent verbal skills ? Learns facts easily? Asks lots of questions?

But misunderstands social situations, takes things literally, is reluctant to explore things for themselves, is clumsy?

These could be signs of Non Verbal Learning Disorder.  Many people have not heard of this difficulty.  As its name suggests it is a difficulty with understanding and processing information that is presented visually rather than verbally.  Typically there is a big discrepancy between verbal skills which are age appropriate or even advanced and their visual perceptual skills.

The difficulty affects a number of areas including social skills as the child (or adult) can not read facial expressions or body language. They may misunderstand social situations leading to friendship issues particularly as they get older.  They may 'talk at' people and may want to share facts they are interested in but not notice when the other person has lost interest. For this reason it can easily be confused with Asperger's syndrome.

While the child can seem very knowledgeable or even precocious when they are speaking, they may miss the subtleties of language.  They may take things very literally and not understand sarcasm or figurative language.  This can then affect their reading comprehension as they may focus on the factual detail and miss the bigger picture and a character's feelings and motives.  It can also be mistaken for language disorders, like social pragmatic communication disorder.

 Motor and visual spatial skills are affected making the child seem clumsy and uncoordinated.  Their handwriting and drawings will be messy.  Their lack of focus and careless work can lead to a diagnosis of ADHD.


At the heart of Non Verbal Learning Disorder is the difficulty in noticing and understanding patterns, particularly visual patterns.  They can also have difficulties with abstract reasoning, maths concepts and organisational skills.  It is like having the building blocks but not being able to put them together to make a building.  Children can have good decoding and spelling skills, have difficulties with reading comprehension.  They may be able to learn maths facts and some methods by rote but not understand maths concepts or be able to solve problems. Verbally they can seem very able to but this is not translated into their school work.  This can be puzzling for both teachers and parents and frustrating for the child.



While Non Verbal Learning Disorder is not longer listed in the Diagnostic and Statistical Manual of Mental Disorder (DSM-5), there is still a lot information available about this difficulty. Prior the changes diagnosis, as a lot of work had been done to raise awareness of Non Verbal Learning Disorders as a Specific Learning Difficulty.  As an Inclusion Coordinator, I recognise many of the signs in the children I work with and still consider it to be important in understanding and supporting children effectively.

With all this confusion why bother labeling?
Understanding what is really causing the difficulties a child is experiencing both helps the child understand themselves and will unlock the right interventions. Interventions for children with ADHD or Asperger's syndrome may not be effective in helping children with Non Verbal Learning Disorder.
Winston Preparatory School in New York specialises in teaching children with Non Verbal Learning disorder and is working on specific interventions for these children. Recent articles by Caroline Miller discuss some of the strategies that are proving helpful at the school (see childmind.org).

Parents and teachers need to focus on clear communication.  Patterns and connections between concepts need to be taught explicitly, children need to be told the main idea or concept directly. Adults need to verbalise what is represented visually to help the child to make sense of the visual material. Talking through the steps needed to solve a problem can help children know how to approach a problem solving task.  Support needs to be given for transitions between activities or for new situations.  Social skills groups and interventions which help the children to understand and practice social skills in a safe environment are important.  They need adult support to analyse situations and understand what is really happening and how they misunderstood or misread the situation.  Occupational therapy can also be beneficial in addressing the visual spatial difficulties, poor motor skills.

As a parent of a child with Nonverbal Learning Disorder, Rondalyn Varney Whitney has written an excellent book documenting the journey she took in understanding her son and gives practical advice to support parents and teachers.


In addition lots of useful information can be found at www.understood.org