Let’s talk about children with learning disorders
As I’ve discussed in previous blogs, the challenging and sometimes difficult-to-manage behaviours of little ones often comes up in my clinical practice. Over the years I’ve noticed that these challenges can be even harder and more common when the minis involved have a learning disorder of some sort – whether it be formally diagnosed or not.
Learning disorders impact the way children are able to process and understand information; they are neurological disorders that might manifest themselves as difficulty listening, thinking, writing, speaking, spelling, or doing mathematical calculations. Whilst we use the word “disorder” it could be argued that these differences in perception and understanding just illustrate how much diversity there is in the human brain. However, as the world and our society tends to skew everything towards neuro-typically developed people, kids with atypical learning styles and behaviours often need a little extra help to get the best out of life.
Learning disorders exist on a spectrum from very mild to severe and at the milder end they can be hard to spot. If you have any worries about your child, it’s always worth mentioning to a doctor and asking for a referral for assessments to be done, preferably by a specialist in child development. Of course, it’s emotionally daunting to consider a learning disorder as the reason for your child’s atypical behaviours or development but identifying these disorders and getting a professional diagnosis can make a huge difference to your little one’s happiness and life outcomes, not to mention those of the whole family.
A child with dyslexia, for example, may just need a different coloured worksheet or a very clear font in order to achieve their best academically whilst a child with dyspraxia, may benefit from physical and occupational therapy. If, your child seems to have difficulty in concentrating or focusing, has more or bigger tantrums than others, is physically aggressive, has few friends or struggles to connect with peers, doesn’t follow instructions, is a really fussy eater or insists on wearing the same things every day, a few adaptations to their learning and home environment could enhance their everyday lives and help everyone involved in caring for or teaching them.
How to help a child with a learning disorder and/or very challenging behaviours.
First, we need to remember that challenging behaviour is a form of communication. Whether you’re dealing with verbally aggressive behaviours like screaming, swearing, or name calling, hostile body language like dirty looks or angry gestures or physically aggressive behaviours like throwing, hitting, biting, or kicking, it’s all an attempt to express something that’s usually rooted in fear, frustration, pain, or just an inability to make unmet needs known.
Examples of the causes of difficult, challenging, upset, and aggressive behaviours include — but are by no means limited to:
Fear, anxiety, stress
Needs not being met (for example, physical needs such as needing to go to the bathroom, or emotional needs for love, affection, recognition, understanding, etc.)
Pain
Frustration
Lack or loss of choice or personal power
Expectations that are too high or too low
Physical environment (people, space, cleanliness, noise, temperature, etc.)
Tips for understanding and managing challenging behaviours:
Triggers
A good idea to work out what’s triggering a certain behaviour, especially in pre and non-verbal little ones is for everyone involved in the child’s care to complete a behaviour diary. This should include date, time, place, what occurred before, during and after the behaviour, how the person was feeling and how people responded to the behaviour. A diary may be completed over a couple of weeks or longer if needed. Consider whether any changes, however small, have occurred in the person's routine or timetable which could affect their behaviour.
Be patient and realistic
The behaviour generally won't change overnight. Tracking the behaviour in a diary may make it easier to notice small, positive change. Be realistic and set achievable goals. Choose two behaviours to focus on at a time. Using too many new strategies at once may result in none of them working. Don't worry if things seem to get worse before they get better. It's important to continue with the strategies you are using.
Be consistent
If patterns of behaviour have emerged from the diary, a behaviour plan can be put in place. It's important that everyone involved has a consistent approach to the behaviour and regularly discusses how strategies are progressing.
Consider the sensory environment
Children with learning disorders have difficulty processing everyday sensory information. Some may find it difficult to block out background noise and what they experience as excessive visual information. Some might not be able to manage some tastes or food textures, or find that someone touching them - even lightly - is painful. Others may be drawn to sensory stimuli that they find particularly pleasing.
Special needs children can be very sensitive to subtle changes in their environment. My autistic stepbrother, Jake used to hate having his bed sheets washed because he needed the familiar smell to make him feel safe. Obviously, the sheets needed to be washed but his Mum, Jo would warn him using pictures and make sure that the rest of the environment was extra soothing, to effectively minimize the meltdown. If there's a sudden change in behaviour or unexpected ‘tantrum’ think about whether there has been a recent change in the environment.
Support effective communication
Some kids with learning difficulties have problems making themselves understood, understanding what's being said to them and asked of them, understanding written words and understanding facial expressions and body language. Even those who speak quite fluently may struggle to tell you something when they are anxious or upset. This can cause considerable frustration and anxiety which may result in difficult or challenging behaviour. Using Jake as an example again, he has only just, at 25, been able to tell family members why he bit, hit and screamed sometimes when he was 7! And it was always because he felt unable to communicate his needs or to understand his environment.
Speak clearly and precisely using short sentences so that your mini is less likely to feel overloaded by information and more likely to be able to process what you say. Some children find it easier to process visual information. You can support the child to communicate their wants, needs and physical pain or discomfort by using pictures of or symbols for body parts, emotions, places, people and situations. There are apps with good pictures you can use, and these can also help prepare your child for new situations.
Help to identify emotions
Abstract concepts such as emotions are hard for all little ones to understand and even harder for children with learning disorders. Try this tip to turn emotions into more 'concrete' concepts. You can use a traffic light system, or a scale of 1-5 to present emotions as colours or numbers. For example, a green traffic light or a number 1 can mean 'I am calm'; a red traffic light or number 5, 'I am angry'. You could help the person to understand what 'angry' means. One way to do this is to refer to physical changes in the body. For example, 'When I'm angry, my tummy hurts/my face gets red/I want to cry'. Once the extremes of angry and calm are better understood, you can start addressing the emotions in between. If the child can identify that they're getting angry, they can try to do something to calm themselves down, can remove themselves from a situation, or other people can see what is happening and take action.
Praise and reward
Many special needs children don't understand the connection between their behaviour and a punishment. Punishment won't help them to understand what you do want, or help to teach any new skills.
Using rewards and motivators can help to encourage a particular behaviour or a new coping strategy. Even if the behaviour or task is very short, if it is followed by lots of praise and a reward, the person can feel positive about their behaviour, coping strategy or skill. Try to give praise and rewards immediately and in a way that is meaningful to the particular person. Some people like verbal praise, others might prefer to get another kind of reward, like a sticker or a star chart, or five minutes with their favourite activity or DVD.
Manage change and transition times
Sequencing can be difficult for children with learning difficulties - that is they struggle to put what is going to happen in a day or morning, afternoon etc. in a logical order in their mind. Abstract concepts such as time aren't easy to understand, and special needs kids may find it hard to wait. You may find that behavioural difficulties occur more in transition times between activities. Using a visual timetable can often help the child to see what will be happening throughout the day. Stick it on the fridge or on the wall in their room and cross off activities as they occur.
Offer a safe space or 'time out'
A safe space, or time out can be a way to calm down, especially if environmental factors, such as flickering lights or excessive noise, are causing distress. This could be in a familiar place, like their bedroom, or doing a calming activity. Research has shown that children on the autistic spectrum and those with ADHD prefer to be in rooms that are coloured grey or blue and have minimal distractions.
Build in relaxation
Your child might find engaging in their special interest or favourite activity relaxing, but not being able to do their favourite activity when they want to can be the cause of behavioural difficulties. Build opportunities for relaxation, and engaging in favourite activities, into the daily routine. Relaxing activities could include looking at bubble lamps, smelling essential oils, listening to music, massages, or swinging on a swing.
Difficult behaviour can often be diffused by an activity that releases energy or pent-up anger or anxiety. This might be punching a boxing bag, bouncing on a trampoline or running around the garden.
