Learning: July 2018

Making Sense of Children's Thinking and Behaviour

A Sep-by-Step Tool for Understanding Children with NLD, Asperger's, HFA, OD-NOS, and other Neurological Differences

by Leslie Holzhauser-Peters & Leslie True

ABSTRACT LANGUAGE

As an adult when you talk to them it seems like they understand ... because the conversation seems so normal and the child has no visible disability, it's almost impossible to believe that they have difficulty responding to simple commands or language that much younger children understand. Many of our daily interactions and instructions involve abstract language, such as; 'sit still', 'pay attention', and 'listen'. These are common and the expectation is generally understood so it makes it hard to believe that some children do not understand this. Some children do not innately recognise that to pay attention they need to look at the person speaking, they just assume that if they are 'listening' to the speaker that they are correctly following an instruction, even if they are drawing at the same time. When the teacher says put your hand up, the child may do so whilst blurting out the answer, completely unaware that they are not adhering to the general expectation.
Another example of literacy interpretation involves compound words as well as homonyms and homophones.
Children diagnosed with neurological disorders often use advance vocabulary even when they don't understand the meaning. They have just heard the words used in a certain situation.
They often don't understand the intent behind words eg. 'What did you miss when you were with your counselor today?'. They might answer 'nothing' as they didn't miss anything as they were where they were supposed to be.
It is best to ask if they understand not to just assume that they do. Abstract language understood literally leads to confusion.

Things to consider:

Think about the question you asked if you get an unusual response
Don’t assume they understand, check if they do
Think about double meanings
Consider abstract terms
Rephrase questions, directions and commands
Explain, explain, explain all abstract language you hear or read
Put yourself in their place and try to think in the way they do

MOTOR

These children often have motor deficits both fine and large. Although fine motor skills might be a problem in some areas they do not necessarily go across the board.

Things to consider:

Analysis the environment for possible safety concerns
Survey the environment with the child pointing out potentially dangerous areas
When selecting activities involving motor skills, decide what the benefit from engaging in this activity will have for the child (social, emotional & physical)
Let them participate in activities to the extent that they are able, exposing them to different activities, and discussing their interest
Don’t rule out sports altogether if team sports don’t work. Consider individual sports such as golf, archery, horseback riding etc as well as other social outlets such as chess club band etc.

SENSORY

Something as simple as closing a door can be misconstrued, because what they actually do is slam it, so if you font understand that they can't feel how hard they are closing it, you may perceive them to be angry, upset, destructive or defiant.It is necessary to believe that each child has reasons to ach in the manner that they do. It's the job of those who care to determine the why of their behaviour and consider sensory as one of the possibilities.

Things to consider:

It’s important to pick your battles
If it doesn’t impact someone else negatively, let it go
Think about how an environmental change will help the child to cope
Put yourself in the environment and think about how you would react fi you were sensory hypo or hyper
Explain to the chld how they’re sensing the world differently than others

SPATIAL ORIENTATION

The spatial orientation and motor areas often combine to make children with neurological differences appear uncoordinated and clumsy, As they walk through their environment they have a tendency to walk unawares into door frames and bump into other people. They can have trouble finding their way back to their seat as they simply forget where they have been sitting. Spatial orientation issues make it difficult for children with neurological differences to find their bodies in space.
As writing is the most common method teachers use to assess a strudent's knowledge it is an area of concern for students with spatial difficulties. Writing and colouring in the margins, lining up numbers on math worksheets, interpreting graphs and maps, and visually busy worksheets are all areas that present problems.

Things to consider:

Familiarise children with the environments they will encounter and provide as much support as needed for them to remain safe
Practice routines they will need to take in various environments
Mark routes with stickers on wall, tape on the floor, point out or list landmarks
Keep arrangement of the environment the same
Provide an organisational system at home and school - for example; label shelves, colour-code binders
Allow additional time for moving from one location to another if necessary
When analysising behaviour, consider whether it can be attributed to the child’s lack of ability to find their body in space
When accidents occur, consider their visual spatial ability to maneuver iterms

CONTROL/CONSISTENCY

As there is so little they can control they search to find what they can.If the class is scheduled to finish at 11:30 they might feel it there duty to notify the teacher by yelling it out across the room.

Things to consider:

Provide a schedule and have a routine.
Explain changes ahead of time
Pick your battles
Consider wether you want a behaviour to become routine.
Give in-depth explanations.
Tell the child what to do instead.
Considere how much support is needed to help them enter new situations.

THEORY OF MIND (Thinking about others thinking)

The ability to think about someone else's thinking affects the way you react in a social situation. Someones aptitude at using developed social skills is dependent on the degree to which they have theory of mind. As you go through your day, you make judgements about the intent of others. If you think that someone else has made an honest mistake or accidentally done something, you will react differently than if you feel they have done it on purpose.

They may not be able to see the benefit of someone else winning at something.

Those of us with developed theory of mind capabilities understand others have mental states different to our own. Our discussions and conversations with others include the language that denotes these mental states, such as 'in my opinion', 'I believe' and 'I think'. when you are mindblind, however, you don't have those mental state verbs at your disposal as you do not realise that there is a mental state other than your own. No-one should, would or even could think of anything other than their idea.

Things to consider:

Only asking ‘How would you feel if it was you? is not enough
Explain, explain, explaining in different ways and in different situations
Involve the child in selecting cards and gifts for a person and discussing why it might be appropriate for that person
Discuss what other people might be thinking, as you read a book together, watch a movie and observe people when you are out in public
Look at commercials , ads and talk about what they are trying to get you to think about
Give the child small jobs that require them to think about the needs of others; feed a pet, walk the dog, water plants ...

SOCIAL COMMUNICATION

Children diagnosed with neurological differences are often unable to relate an event as it happened because they don't have the communication skills of explanation. The information they provide might be too much or too little and they also lack the ability to monitor the understanding of their communication partner. With holding break times is not a good 'consequence' for these students as they need the practice. No teacher would ever say you can't participate in reading or writing today because you were disrespectful ... reading and writing are too important.

Inability to read, understand and react to social cues, coupled with their naivety resulting from their mindblindness, makes these children potential victims for bullies, as well as predators.

Things to consider:

Tell children when they are doing something correctly and why it is corrct
Teach them social skills
Focus on imiproving one or two skills first, start with those that make the child stand out
In place of an inappropraite social skill teach them what they should do
Rehearse social situations
Wathc people, movies, videos and talk about what the characters are doing and why
When they seem rude and uncaring ask if they intended to hurt the person’s feelings
Place children in situations where they can feel success
Communicating via the computer can ofern facilitate success because the child only needs to read the message in print and not read into social cues

EMOTIONS

The way others perceive the emotions of these children is often far from the way it really is. basing reactions solely on what you see is definitely a mistake, what you see is very rarely what you get. They are unable to idenitify their emotions and as a result are unable to manage their feelings.

Things to consider:

Don’t assume that you now how the child feels based soley on their outward appearance
As situations present themselves throughout the day talk aloud about how you feel and why
When you have a good idea about what the child might be feeling, identify their feelings for them and realte it to the physical feeling they may be having
Point out both the obvious and the subtle social cues that convey certain emotions
Explain their atypical responses to those who are willing to listen
Teach them to use the 1-10 sclae to identify the intensity of their feelings
While reading or watching a video, discuss the characters’ feelings and why they might feel that way and the clues that make you think so.

MENTAL FLEXIBILTY

Children with neurological differences can look happy when they are not, look like they understand when they don't and to further complicate the matter they can't always take a learned skill in one situation and able it in another.

Inability to generalise is another result of inflexible thinking. What the child learns in one situation can not be transferred to even a similar circumstances much less one that bears no resemblance. Often this inability reinforces the thinking that their behaviour is intentional and intended in a negative way.

Their inability to use cause and effect thinking leads them to act our a situation in order to determine the outcome.

The flexible thinking as well as the inability to generalise associated wuth their disorder results in their inability to learn from past mistakes which is why consequences are ineffective. There is no question you can punish endlessly, but in the end, what is required is a logical explanation accompanied by a description of what to do instead.

Things to consider:

Use the child’s strength to teach - detail-oriented, factual, logical
If the question a child asks seems meaningless, probe further to see what the child is thinking
Explain, explain, explain the why of everything
Don’t expect the child to know how to apply acqired knowledge or skill to a new situation
As you watch television or videos, discuss the big ideas the writer is trying to communicate
Try to make abstract concepts as concrete as possibly by describing how the look and sound - when someone tells you to listen, that means to look at the person, sit quietly, don’t move etc
Help the child select the important information when they are required to summarise, explain … Provide them with graphic organisers and strategies
Help the child to work in groups to facilitate interactions and understand their role, so they don’t appear bossy and perfectionistic

IMPULSIVITY

As they are literally being asked to do something they are incapable of, children, with impulsivity issues begin to stick out when compared with their peers.

Blurting out answers is a common behaviour with children lacking impulse control, although they are unlikely to have had time to think through an answer so their response is often lacking. If you pursue their thinking with guiding questions, it becomes apparent that they know so much more that their original answer indicated.

Another recurring problem at school for children with control problems is their need to rush through classroom assignments.

Things to consider:

Keep in mind that the child can’t help it.

Being patient will lessen the effect.

At anxiety-provoking times, try to decrease demands and expectations.

For persistent, recurrent impulse-related problems, such as blurting out answers, consider strategies to deter impulsive reactions, such as a reminder card.

Consider phrasing sentences carefully - instead of ‘ Who knows the answer to …’ say ‘If you know the answer, raise your hand’.

EXECUTIVE FUNCTIONS

Executive functions are the skills that allow one to plan, sequence, organise, prioritise and problem-solve in order to complete tasks. They are unable to find a solution to a problem and often not identify that one exists. Children with executive function deficits need someone to provide that consistency in order to give them the best chance to succeed. The executive function involved in completing homework, planning, organising, sequencing, prioritising, and actually finishing work, make the tasks surrounding the actual homework impossible to complete independently for someone with a deficit in this area. Deficits in the areas of organisation, planning, sequencing and prioritising all combine to make problem to make problem-solving difficult. Executive function skills allow us to operate in an organised manner, giving life order.

Things to consider:

Make necessary accommodations. Determine if the child’s ability to show what they know is being compromised.
Constantly monitor tasks providing scaffolded support. You model the task, do it together, and then they try it by themsleves
Help them to priortise tasks and long-term projects, providing a reasonable time for completion
Chunk information into smaller bits.
Provide strategy and supports in the way of graphic orgnanisers, lists etc
Think aloud as you problem solve situations so the child can her the process of your thinking
Visually display the steps of problem solving in an easily accessible place, so that as problems arise you can use them to look at options or alternatives
Remember that the inability to problem-solve can be impacted or have impact on other deficit areas.

ANXIETY

So often the worries of children with neurological differences are dismissed as insignificant, which only serves to compound the problem.The bottom line is that if you don;t address their anxiety, the problem you judged to be insignificant will be yours shortly. They live in a world that is confusing and frightening because they can never be sure how to respond to the world around them. When you face a world each day where each action has the potential for disaster, how could you not feel anxiety? These children have great difficulty identifying their emotions, as well as expressing their worries.

When you are unaware of a problems, your odds of fixing it are greatly increased. These students often use phrases like, 'Am I in trouble?', 'Am I ok?' and 'Are you mad at me?' These aphrases are requests made to adults to obtain an expression of reassurance. If you are unsure of when you've made a mistake, it makes sense to regularly check to see if you have,

Knowing that someone doesn't like them makes them anxious, causing them to try to fix the damage even though they're not sure what the damage is.

Sometimes test situations might be less stressful than a typical school day.

Unless anxiety is addressed and at least minimized, the child will be unable to deal cognitively with any other areas. What may seem insignificant to you is real to them. Minimising is a high mistake.

Things to consider:

Do whatever it takes to make the child feel safe and protected in their environment
Provide a safe person at school
Ask them frequently if they feel safe
Teach them what to do in different situations
Help the identify their anxiety ad the physological changes that occur as a result
Provide them with techniques to control their anxiety, such as relaxation exercises and cognative behaviour therapy
Let them know everyone feels anxious at times
Talk out about their anxiety - tell them how you feel and why
Don’s dismiss their anxiety. It doesn’t matter if the anxiety seems real to you or not. If it’s real to them you need to address it

BELIEVE
The most frustrating aspect of having a child with neurological differences surprisingly, is having to try to convince others to believe the enormity of the deficit areas faced by these chilldren. The most important step you can take in improving the life of these children is believing. With believing comes a willingness to think about the world through their eyes. Parents of children with neurological differences spend enormous amounts of time and energy thinking about their child and their needs.They know what works for their child and what doesn't.

ALL BEHAVIOUR IS MEANINGFUL

Once you begin to ask 'why?' things get better for everyone because you are not just reacting to a behaviour. It's important to remember you have a better chance of achieving your desired goal by asking why and getting to the root of the problem, as opposed to punishing the result of their behaviour.

Parents of children with neurological differences spend enormous amounts of time and energy thinking about their child and their needs. They know what works and doesn't work for their child. Believe the parent.

Guidelines:

Believe the parent
Reduce anxiety
Be kind
Check often for deep understanding
Explain everything
Don’t automatically assume that negative behaviour is intentional; try to determine the cause
Tell them what to do instead
Don’t engage them in a power struggle
Try to see the world through their eyes
Enjoy them and laugh with them