Thursday 30 May 2019

My child is smart, but why aren’t they making expected progress at school?

The answer may be a Working Memory difficulty!

But, how can my child have a memory problem? He can remember the names of over 50 dinosaurs!

To answer this it’s best if we first take a look at a simple model showing some of the different types of memory.

 Input is all the information we collect from our different senses. It first goes through our ‘Short Term Memory (STM). STM only lasts a matter of seconds and simply has to store the information without needing to process it in anyway e.g. remembering a phone number / recalling a sentence we have just heard.

Working Memory refers to the ability to hold, manipulate and process information in our brain over a short period of time; it can be known as our mental workspace or notepad (Sue Gathercole 2008). On average, an adult cannot hold more than six or seven units of information in working memory at a time; and this all depends on whether or not the material to be remembered is organised in a meaningful way or not. Difficulties with memory performance do not appear to be due to more general factors such as language difficulties or a low IQ, but are very closely linked to dyslexia; as it affects the pupil’s ability to retain and recall phonological information.

Working Memory is one of the most important indicators of academic success across the curriculum, specifically in terms of maths and reading. Children may have very good 'Long Term Memory' (LTM) for things they are interested in, places they have been etc, but still find it incredibly difficult to remember what they have learned or to follow instructions.

Working Memory is a significant difficulty and affects an estimated 1 in 10 children.

That’s on average of 3 children in every classroom! And typically affects more boys than girls.

However, it is surprising how often this problem is overlooked and not fully understood by teaching staff or healthcare professionals. The impact of a working memory deficit can have a huge impact across the child’s entire school and personal life.
Below is a list of possible signs that your child may have a Working Memory problem:
 In general:

-       Holding and manipulating instructions in the brain is difficult

-       They can usually be the last to carry out an instruction

-       They miss whole steps out of the instruction

-       Long discussions may result in inappropriate / disruptive behaviour

-       Can get easily distracted by people talking around them

In the classroom:

-       After getting off to a good start in the task:

o   the child may start ‘zoning out’

o   Not finish at the same standard

o   Work can be rushed and finished early

o   May abandon task half-way through

o   If the teacher interrupts in middle to do a ‘check-in’, may not remember where to start again

o   Teacher more likely to call their name to ‘hurry up’

-       There may be differences in the level of work depending on the amount of support / environment / time of day

-       May have to shout out the answer before they forget it

-       Struggle to learn new vocabulary

-       May struggle to do mental maths

-       Fail to check work for careless errors

-       May work better in a smaller group than whole-class learning

-       They may watch others around them a lot to work out what to do

-       Struggle to copy notes from the board

-       Often get in trouble with peers for ‘getting the rules of the game wrong’

-       Difficulties navigating around the school

-       Can read the words, but not able to tell you what they have read

o   But when the word is read to them, they understand it better

Classroom tasks that place heavy demands on Working Memory:

-       Following multi-step instructions

o   “after you have put your pencil case in your tray with your spelling book, go and line up at the door”

-       Remembering sequences

o   Multi-step math questions e.g. long multiplication

o   Timetables, days of the week, months of the year

o   Remembering all measurements of ingredients when you cannot see the recipe

-       Problem solving activities

-       Coursework

-       Collecting the equipment needed for an activity

-       Writing the date, title and learning objective before starting the work

Information can be lost from Working Memory when we are distracted by the environment around us, noise and movement or when its limited capacity is overloaded. When demands on the child’s Working Memory are too high, they may appear to be distractible and have limited concentration.

It is important to remember that children are often acutely aware of their memory difficulties – even from a young age, so it is vital to support them as much as possible and to reduce any anxiety they may have about forgetting things. If you are concerned about your child's memory difficulties please contact a Speech and Language Therapist or Psychologist. 

Strategies on how to support Working Memory are coming up in the next blog! So stay tuned!

Tuesday 14 May 2019

It must be the parent: why unconscious incompetence is dangerous!

I feel so angry my head could explode! I'm supposed to be off today but I've written a report. A report on a boy who social workers, CAHMS and school feel is 'fine' but I know is not.

I had a call from the social worker who told me that they suspect the parent of making up their child's issues and that he's 'fine in school'. In fact even the head teacher says he's quite 'normal'. Yet the parent talked about her 7 year old wanting to die, having awful melt-downs, not understanding the world etc The boy himself confided in me that he doesn't want to be here in the world and it's just too scary. He has tried to run in front of a car, jump out of  an upstairs window and hold his head under the bath water...he's 7 for Gods sake!!!

The social worker feels that as I'm 'private' the parent has shopped around to find someone who will agree with her and as I'm 'private' I would, because I will have been paid.

I'm not angry that she has, in effect, called me unprofessional, I'm angry because the rest of the people involved don't know what they don't know. George and Miriam, two brilliant parents I know, discuss this as 'unconscious incompetence' which sums it nicely.

The boy has significant language issues which he doesn't want people to know about, he wants to please, to do his best and not be seen as different but the cost of keeping this up, is enormous; so he has to let it out when he's at home, where he can be himself. The toll on his mental health is rising.

This is a phenomenon known as masking which many parents of children with ASD know all to well. However, its not just confined to the autistic population, children with any type of issue may do it. This particular boy needs assessing for ASD but ones with developmental language disorder can also display this.

Please, please let's just listen; listen to the parents who are at their wits end, listen to the child who is struggling, listen to your instinct!

Saturday 11 May 2019

Practical PDA training

Every week see children who have demand avoidance, some will be very anxious so need to control, others will have PDA (Pathological Demand Avoidance). We don't need to get into the debate of whether this exists or not but we do need to understand why children are demand-avoidant, so we can better help them.

We are running an informative and practical training day on Saturday June 15th at Cannock Fire Station 9.30-3.30 where I will go through what PDA is and is not, in the morning, and Rachel Tenacious will deliver a workshop on low-arousal approaches in the afternoon. These approaches work with all anxious children.

This is great CPD for any professional (we are registered UK training providers so you will receive a credible certificate for your CPD file):

Teachers: you will receive information to help you understand children in your school, what it means to have PDA and learn strategies which work for those children

Speech and language Therapists/Educational Psychologists: you will be able to understand sufficiently to be able to assess new clients and then understand how you need to tailor therapy in order for it to work.

Parents: When we understand our children, we can better help them, you will also learn strategies to help at home.

£90 including lunch.

So book today, as spaces are limited to allow for better participation.

Libby Hill is a multi-award winning speech and language therapist who appeared in Channel 4s Born Naughty. She sees children with PDA from all over the UK and occasionally abroad. She is part of the PDA professional's group and the PDA Research group. She supports PDA action and the PDA Society. She is co-writing a book about Parental Perspectives of PDA

Rachel  Tenacious is a late diagnosed autistic parent with three children aged between 30 and 16. H is her youngest child who was diagnosed with autism at age 9 and selective mutism at 15. She removed H from the education system in 2015 after she had what we now know as an autistic burn-out. The school system didn’t suit H at all but home ed was  amazing. She shares her experience at support groups.