Is it ADHD, ASD or SLI?

The overlap of ADHD symptoms and autism symptoms have confused many families. When a child can’t sit still for homework or a meal, or stay in his chair in class, when he fidgets or talks too much and too insistently, most parents and practitioners think, “This child must be hyper-active!”

The first explanation most doctors arrive at is also attention deficit hyperactivity disorder (ADHD). The condition is familiar, it’s been around for a long time, and there are effective strategies to manage it. It is important to remember, however, that almost any psychological or developmental disorder of childhood can look like ADHD, with or without the hyperactivity. Children under stress, due to learning disabilities, anxiety, depression, communication based difficulties, specific language impairment (SLI) or sensory integration problems, may exhibit the same symptoms. It takes a skillful evaluation to tease out explanations for the behaviors.

The biggest part of our case load have had an ADHD query at some point but with time getting to know them, listening to parents and careful assessment show those who do and those who just have attention control issues.

www.private-speech-therapy.co.uk

What modifications can help CAPD in the classroom?

Last month we looked at the issue of Central Auditory Processing Disorder. The classroom can be an ordeal for a child with CAPD and often for his/her teachers! What techniques can help?

• Present directions at a slower rate, with more expression in your voice.
• Use simpler, shorter sentences.
• Ask the child to repeat the direction over and over in a low voice (or silently) until the task is finished.
• Have the child visualise the task before doing it.
• Brainstorm with the child for ideas that will help her remember directions. Some children write notes to themselves, wear clothing items or markers of some kind like stickers on a belt.
• Present directions in short, concrete segments, with visual cues.
• Be sure the child is making eye contact when you speak.
• Have the student seated up in the front of the classroom or very nearest the place of instruction where there is a good view of the chalkboard and other visual means of instruction.
• Provide “quiet” areas in the classroom where concentration may be easier to maintain.
• Have the student eliminate excess movement during instruction, chewing gum, talking to a neighbour, etc.
• When working on projects, allow children to work in small groups as opposed to large ones
• Earplugs or muffs can be worn during study time.

These are all good practise and will benefit any child who has language difficulties too. 

Does your child tick some boxes for traditional diagnoses but not others ?

Perhaps some of the following will ring bells?

Auditory Processing Disorder (APD) is defined as a deficit “in information processing of audible signals not attributed to impaired hearing sensitivity or intellectual impairment” (Roeser and Downs, 1995, p.101). Prevalence data for APD is sparse, especially for children, but in Chermak, Hall and Musiek (1999) they cited Chermak and Musiek (1997) as saying it is estimated that APD occurs in 2-3 percent of children, with a 2:1 ratio of boys and girls. Dr Tont Sinimarra from GOSH thinks it could be as high as 8%!

Common Symptoms: 

• Easily distracted by background noise.
• Doesn't follow oral directions well, especially if they are complex and have to be carried out some time later.
• Has problems recalling names, dates, times, and other information.
• Has poor memory for numbers, letters, words, and other information that is heard.
• Has difficulty with directions, especially if they are complex, lengthy, presented in a noisy background or to be carried out some time later.
• Asks for statements to be repeated.
• Is slow to respond to questions or directions.
• Gives inappropriate answers to simple questions.
• Has difficulty interpreting abstract information.
• Has poor musical abilities.
• Is slow to respond to questions or directions.
• Has difficulty with verbal math problems.
• Shows unusual reaction to sudden or loud sounds.
• Has difficulty identifying the source or location of a sound.
• Is easily distracted by noises.
• Performs better in one-to-one settings (Kelly, D.A., 1995).

If you can identify with any of these, your child may have APD. We'll look at strategies in later posts.

We can screen fro APD using Scan 3 and LiSN-S so please get in touch if you would like us to help.

www.private-speech-therapy.co.uk