A day in the life of the child Developmental Coordination Disorder
Supporting the school and home.
Professor Amanda Kirby
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Sam,9 years of age• walked at 19 months
• talked indistinctly at 2 ½ years of age
• very fidgety and hyperactive at 4 years of age.
• he usually tells his mother he can’t remember what
he has done in school
He has an older brother who is in the football team
locally and his father coaches. Sam doesn’t want to
play. He has one friend in his class, and does not get
asked to parties very often.
His writing looks like this:
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Prevalence
The ALSPAC UK based large population study more recently has shown a prevalence of 1.7%with a further 3.2% of children considered as having "probable developmental coordinationdisorder" by using broader cut-offs for coordination testing and activities of daily living
(Lingham et al,2009).
• 3:1 boys to girls
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Definitions and confusions
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Diagnostic criteria for
Developmental Coordination Disorder
(APA, 2000)
A. Performance in daily activities that require motor coordination is substantially below that expected given the person’s chronological age and measured intelligence. This may be manifested by marked delays in achieving motor milestones (e.g., walking, crawling, and sitting), dropping things, “clumsiness”, poor performance in sports, or poor handwriting.
B. The disturbance in Criterion A significantly interferes with academic achievement or activities of daily living.
C. The disturbance is not due to a general medical condition (e.g., cerebral palsy, hemiplegia, or muscular dystrophy) and does not meet criteria for a Pervasive Developmental Disorder.
D. If Mental Retardation is present, the motor difficulties are in excess of those usually associated with it.
ICD10 (WHO)- Specific Developmental Disorder of Motor Function is
also used- similar but some differences
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Dyspraxia
Developmental dyspraxia is an impairment or immaturity of the organisation of movement. It is an immaturity in the way that the brain processes information, which results in messages not being properly or fully transmitted. The term dyspraxia comes from the word praxis, which means 'doing, acting'.
Dyspraxia affects the planning of what to do and how to do it. It is associated with problems of perception, language and thought.
Dyspraxia Foundation
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Some children despite adequate teaching, a stimulating environment and
with a generally normal intellect, have difficulty with movement and
specific aspects of learning. Dyspraxia is a difficulty with thinking out,
planning and carrying out sensory / motor tasks.
Dyspraxia Association of Ireland
DCD has also been called...
“Awkward” - “in the wrong way” derived from “awke” or
wrong -from an Old Norse term “öfugr” meaning
backward
1949-MBD
1963-“minimal cerebral palsy”; “minimal cerebral
dysfunction” (Bax & MacKeith)
1965- perceptual-motor dysfunction (Ayres)
1967-visuo-motor disability in school children ( Brenner)
1968/70 -Clumsy child syndrome ( Illingworth)
1970s –Motor Morons
1975- Developmental apraxia ( Gubbay)
1982- Developmental dyspraxia ( Denckla)Dyscovery Centre copyright 2011
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What is DCD/Dyspraxia?
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A day in the life
• Take any age
• Go through what happens in a day from getting up to going to bed
• List the activities that are non motor!
The fact is that hardly anything happens without the involvement of the motor system!
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So DCD is:
A movement disorder affecting
children in more than one
setting-pervasive
Enduring
Developmental
Has multiple causes
Has more than a motor impact
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ADHD
13
ASD
7
DYSLEXIA
17
5
8
3
19
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What do we know about causes?
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Shared geneticsShared environment
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ENVIRONMENTAL
BEHAVIOURAL
NEURAL
GENETIC
“Meshes of influence”
Turvey,2006
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Genes involved in dopamine regulation (DRD4 and DAT1) receptor genes have been highlighted in ADHD- and may control attention and EF…
DAT1 and spatial attention have been associated
(Bellgrove and Mattingly,2008)
(J.M. Swanson et al. / Neuroscience and Biobehavioral Reviews 24 (2000) 21–25)
Genetic and biochemical level
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Overlap may be linked to shared genes e.g. in ADHD and DCD
1285 twin pairs aged 5 and 16 years from the volunteer Australian Twin Registry (ATR).
The DCD-fine motor and ADHD-Inattentive were most strongly linked using the DSM-IV based scale.
(Martin ,Piek and Hay, 2006)
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Klinefelters (XXY)
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NF1
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NF1 and cognitive deficits
• Deficits in:– visuospatial ability,– executive function,– expressive and receptive language– attentional skills
• Abnormal MRI and Nf1= fine motor deficits
• Feldmann R, Denecke J, Grenzebach M, Schuierer G, Weglage J. Neurology. 2003 23;61(12):1725-8. Neurofibromatosis type 1: motor and cognitive function and T2-weighted MRI hyperintensities.
• Hyman SL, Shores A, North KN.,Neurology. 2005 Oct 11;65(7):1037-44.The nature and frequency of cognitive deficits in children with neurofibromatosis type 1.
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Structural or mechanical
Cerebral palsy
Epilepsy and BECTS- post rolandic epilepsy
Agenesis of the corpus callosum
Cerebellar dysfunction
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CP and DCD
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BECCTSBenign Epilepsy of Childhood with
Centrotemporal Spikes
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BECCTS
– Commonest childhood epilepsy– Motor cortex – Abnormal EEG pattern– Night time seizures… thought to not be as
significant but may have an impact on learning– Preservation of consciousness– Pooling of saliva– Speech arrest– 75% at night
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6 out of 8 with MABC <1% had BECTS
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Other reasons for co-ordination
difficulties
Degrees of freedom- Joint Hypermobility Syndrome
Visual/visual perceptual
Language –not understanding what to do
Inattention- less practice,less focus
Executive functioning- can’t plan what to do
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Joint hypermobility syndrome (JHS)
Reported to affect around 11% of the
population (Seckin et al, 2004)
• F: M = 2.5:1( Didia, Dapper and Boboye(2002)
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Impact of difficulties
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Environmental factors
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Changing lives
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Linear approach
Genes symptoms diagnosis
environment
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Dynamic systems model
Child with
additional
learning needs
Traumatic
experiences
Poor co-ordination
Hereditary factors
Low self worth
Parent with poor literacy
Poor reader
Fail exams
Poor fitness levels
overweight
Low self worth
Poor nutrition Dyscovery Centre copyright 2011
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BUT…it’s not just motor!
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DCD overlaps with:
• Dyslexia- 35%
• ADHD- 35-50%
• Autism Spectrum Disorders (ASD)
• Tourette’s Syndrome
• Specific Language impairments
• Anxiety and depression
• Joint hypermobility syndrome
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Impact of DCD
• Self esteem- Piek et al
• Anxiety and depression- Myihara
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Self esteem and DCD
• Miyihara and Piek ,2006 showed that in studies reviewed (7) there was a medium effect size on self esteem and DCD(greater than in children with CP (6 studies)
• Skinner and Piek ,2001- 8-10 yr olds had worse self perception and self worth
• Increased in 12-14 years
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Anxiety and depression
• 3.5-5 year olds - +ve correlation between motor difficulties ( MAND) and anxious /depressed scale ( using CBCL) ( Piek, Bradbury,Elsley, Tate, 2008)
• 8-10 and 12-14 years olds had increased state/trait anxiety cf td kids- Skinner and Piek, 2001
• Depressive symptoms in children (8-10 yrs) with DCD were significantly worse than td children ( Francis and Piek,2001)– Perceived athletic competency predicted depressive
symptomatology
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Cognitive functioning and DCD
• Wallin (1916) +ve correlation between motor and cognitive development ( Wassenburh et al,2005)
• Dyck,Piek et al, 2009 have shown an age differential with linkage
– 3-5 years motor and cognition linked
– 6-8 yrs motor and emotion recognition linked
– 9-11 years motor linked to perceptual organisation, receptive language and emotion recognition
– 12-14 years.. Not signifcant links
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Executive Functioning and DCD
• Roebers et al, 2009– EF and Motor linked in 7 year olds
• Murray et al, 2006– Early standing- better working memory at 33-35 years of
age!
• Piek, Dawson, Smith and Gasson (2008)– Gross motor scores at 4 yrs 4 months predicted working
memory and processing speeds at school ageEF- DCD and ADHD ( in 6-14 yr olds cf TD)– DCD worse than all groups on working memory– Showed an overall timing deficit– Poorer visuospatial ability
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Motor Development and Learning
Resources of the Child
Outcomes
Environment in which Manner of
Activity occurs presentationDyscovery Centre copyright 2011
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Presentation at different ages
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Key features of DCD..
Difficulty with:
•Self care tasks
•Writing – quality and speed
•Tool usage
•Riding a bike and balance
tasks
•Dual tasking
•Learning new tasks
•Team games
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DCD: In childhood
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John is 9 years old• John is slow getting dressed in the morning, he still needs
help with his top button and his shoe laces. Mum cleans his teeth for him. He is a messy eater and often spills things
• In school his writing is poor and he writes short stories despite telling you great stories orally. He is often on his own in the playground as he finds playing ball hard to do and the others laugh at him.
• He keeps losing his possessions and gets in trouble for it.• He has an older brother who is in the local football team
and his dad is the coach .• His mother is a musician and she wants him to play the
piano.
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Missiuna, C. et al. CMAJ 2006;175:471
Fig. 1: Concerns typically noted by parents of children with developmental coordination disorder at different ages
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Core symptoms and signs of DCD3-7 year old
• Riding a tricycle/bicycle
• Painting/jigsaws/ colouring/ cutting/drawing
• Hopping/ jumping/ball skills/balance
• Self care: Untidy eater/ spills drinks/dressing/ undressing/bottom wiping/teeth cleaning
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7-11 year olds
• Riding a bike• Poor handwriting • Poor tool usage -scissor skills, rulers
etc• Posture at the desk• Ball skills- team games• Self care tasks
• Low self esteem• Increased social isolation/difficulties
making friends• Poor organisational skills
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Secondary school
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Senior school child
• Slower learning new skills
• Handwriting remains poor
• Ball skills and team games
• Dressing / undressing slow
• Social skills / few friends
• Organisation / time management /planning
• Lowered self esteem
• Social isolation
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Persistence of motor difficulties
• 73%15-17 years continued to have difficulties (small sample- n=15)
– (Losse et al (1991) 10 year follow up study)
• 65% Finnish 17 year olds remained having some difficulties especially in visual motor integration – (Cantell et al' study,1998)
• 50%17 year olds still had difficulties – ( Van Dellen and Gueuze,1988)
• Cousins & Smyth (2003) showed a variable pattern of presentation in the index adults studied (average 38 years) but did not exclude ADHD.
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Social outcome
Cantellet al (1994) showed that those with the most severe motor difficulties as a young child seem to be the ones whose difficulties persist most and have fewer hobbies
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Overlap may predict poorer outcome
• Rasmussen et al (2000) followed children diagnosed at 7 years of age with DCD and ADHD .
• At 22 years of age, the research participants were more likely than their matched controls to be unemployed, to have had problems with breaking the law, to be alcohol or drug misusers and to have mental health difficulties.
• ADHD + DCD (not taking medication) had worse prognosis than ADHD alone respect of academic success and employment
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Interaction
Parental support
Peer interaction
DCDTypically developing
Individual
0 years 10 years 18 years 20 years
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Outcome of DCD in adulthood:
is dependent on :
a) Severity of motor difficulties
b) Level of comorbidity
c) Intervention in childhood
d) Family factors- FH of DDs as well!
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So what changes and what stays the same?
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0
5
10
15
20
25
Child
Adult
Parent concerns change over time
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Study of 16-25 year olds with DCD in FE and HE
0
10
20
30
40
50
60
70
80
90
self ca
re
writ
e ne
atly
writ
e fa
st
read
writ
ing
copy
ing
down
find
way
roun
d buildings
othe
rs re
ading
writ
ing
avoid
hobbi
es g
ood co-
ord
leisur
e tim
e alo
ne
avoid
team
spo
rts
spor
t on
own
avoid
club
bing
mon
ey m
anag
emen
t
TD %
DCD %
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Favourite Leisure Choices
Approaching significance at 0.06 level
** Significant at 0.05 level
*** Significant at 0.01 level
0
10
20
30
40
50
60
70
80
% of students
choosing
Bar Reading
*
Films/TV Club** Sport*** Other**
Leisure choices
Movement difficulties
TDA
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EF
0
10
20
30
40
50
60
70
80
Get
ting
up b
ed
orga
nising
bag
pack
ing
suitc
ase
folding
cloth
es
orga
nise
room
perfo
rming
2 th
ings
plan
ning
ahe
ad
loss
of a
ttent
ion
follo
wing in
stru
ctions
getting
ready
to le
ave th
e ho
use
com
plet
ing
task
s
arra
nging
room
and
wor
k are
as
plan
ning
to d
o so
met
hing
at a
set
tim
e
orga
nise
d to
soc
ialis
e
plan
ning
leisure
activities
orga
nise
d fo
r a class
/mee
ting
TD %
DCD %
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Handwriting• . “keeping handwriting tidy at the same time
as writing quickly”.
• “Remembering stuff, writing lecture notes whilst listening, reading to understand - have to read a difficult page 8 times”.
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Independent living skills
Parent comments
• “anything that involves sequencing, like making a cup of tea or a sandwich.” However she describes how “He can make a very simple meal, taking something out of the fridge and putting it into the microwave, or toast or a sandwich”.
• “Impulsive, lacks stability for daily living skills e.g. difficulty in pouring drink in a controlled way”.
• personal hygiene was still poor• Dental hygiene is poor
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Psychological
• “I’m just useless, I’m not very good, I’m not very bright”.
• “He is often depressed and withdrawn” and “OCD means he spends a lot of time checking/rechecking switches, doors, taps etc”.
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The importance of driving
• An important rite of passage.
• Parental perspective → one of the last times teaching their child a new skill.
• “fleeing the nest”.
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Driving: Required skills
• Accurate perception of the traffic environment.
• Ability to react to a given situation and act accordingly.
• Co-ordination of several separately related motor tasks simultaneously (e.g. looking in the mirror while continuing to steer the car) or in a sequence (e.g. mirror, gears, making a manoeuvre).
• Additionally difficult for young people in the UK:- learning in a manual car.
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0
10
20
30
40
50
60
70
80
90
Yes No
DCD (38)
Control (77)
Have you learnt/ are you learning to drive?
A chi-square test for significance indicated that this difference was significant (χ²=9.72, N=115, df =1, p<0.002).
Both groups cited lack of finances as a reason for not driving
%
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Reasons for not learning to drive: The DCD group
“Do not see things like others do. Poor sense of danger and speed. Do not feel confident enough to learn to drive”
“After 10 lessons driving instructor did not think it [was] worth me continuing - I had only been driving on trading estate”
“I would like to learn but am unsure I could do it safely”
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Reasons for not learning to drive: The DCD group
“Lack of direction ”
“*I+ Don't think I would have the ability (nervous)”
“Worried about the lessons and my Dyspraxia, will try when I leave college”
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Number of times takenPractical test
0
0.5
1
1.5
2
2.5
3
Mean SD
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Miles driven per week
•An independent samples t-test indicated that the control group reported driving
significantly more miles in an average week than DCD group (t(67)=2.75,
p<0.008).
•This may be related to social behaviour with the control group going out more.
0
50
100
150
Mean***SD
DCD (15)
Control (54)
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Day- to- day driving behaviours
DCD adults were significantly more likely to report having difficulties with distance estimation (χ²=10.38, N= 44, df=1, p<0.001) and parking (χ²=3.86, N= 27, df=1, p<0.05) than the control group
DCD Control
Driving without a valid license 0% 9.5%
License revoked/suspended 0% 3.1%
Involved in an accident 40% 48.4%
Struck a pedestrian/cyclist 0% 1.6%
Reported for reckless driving 5% 4.8%
Reported for driving intoxicated 0% 0%
Difficulties parking*** 44.4% 11.1%
Distance estimation difficulties * 63.2% 16%
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Approach to support
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M.A.T.C.H. the activity to the child
Modify the task
Alter your expectations
Teach strategies
Change the environment
Help by understanding
M.A.T.C.H. strategies available from CanChild website http://www.canchild.ca/
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M.A.T.C.H.- Organisational difficulties
Messy/disorganised desk or trayEnsure time between activities to put things awayProvide visual clues/labelling to help with effective use of
space (e.g. for pencils or notebooks)Use colour coded workbooksTimetable weekly desk/tray cleaning timeTeach child how to organise desk/trayMinimise what children keep in their desk/tray
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Towards success
C A R E
• Develop Competence
• Provide opportunity for Autonomy
• Promote positive adult peer Relationships
• Maximise Enjoyment and minimise anxiety
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Develop competence
• Optimally challenging activities– Match the activity to the child
– Modify the equipment and rules
– Frame simple goals
• Create mastery motivational climate– Focus on effort
– Learning- use ‘think aloud’ techniques
– Skill mastery
– Realistic goals
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Provide appropriate praise, encouragement and instruction
– Participation and effort
– Mastery attempts and achieving goals
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Opportunity for autonomy
Provide opportunity for a variety of activities
– Menu of structured and unstructured
– In and outside
– Allow for activity choices
– Help children help themselves- self regulation strategies e.g. think aloud
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Promote positive relationships
• Feel connected with peers/adults
• Structured after school programmes
• Promote social relationships
• Parents acting as role models
• Maximise enjoyment
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Intervention approaches
• Practicing what you can’t do
• Doing what you want to do
• Doing what you need to do
• Avoiding what is difficult and is likely to persist
• Seeking out strengths
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Approaches to support
How much time have you got
What is important for now
What is important for the future
Listen to the child
Practise enough and appropriately
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Practical strategies for home and
school
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Getting up in the morning
Challenges Responses
• Putting out clothes the night before
• Alternative fastenings-velcro etc
• Timer for teeth cleaning
• Wet wipes and practice- be explicit
• Adapted cutlery/stable position
• Verbal prompts
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Teeth cleaning
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Shoe lace tying
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Dressing
pants
T-shirts
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Organisation at home
Recordable speech bubbles
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Preparing for school
• Packing bag
• Remembering what to take
• Leaving on time
• Catching a bus
Response
• List of what to do
• Night before by the front door
• List in bag/kitchen etc
• Timer with an alarm
• Practice new journeys
• Practice sorting.. To do lists
Challenges
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Preparing for school
• Lunch box
• List of items – for the day
• Labelled clothes
• Right and left shoes
• Preparing for periods
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Arriving at junior schoolAround the school
Challenge
• Cloakroom
• Toilets
• Getting to class
• Remembering possessions
Response
• Signposting around school
• Hook on the end of the row
• Practicing process-especially when changing schools
• Practicing dressing in the holidays
• Buddy system around school
• Naming clothes
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Map of the School
Using colours, key features, reference points
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At play time
Challenge
• Being on own
• Can’t /won’t join in with play
• Bullied
Response
• Circle time
• Friendship bench
• Small clubs and planned activities
• Quiet place
• Bullying policy- explicit
• SEAL
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Friendships
• ‘Circle of Friends’
• Peer mentor
• Social groups and opportunities
• Friendship bench or stick
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Teaching
Social skills
Family
Friends
Teachers
Strangers
Social currency
Creating
Social networks
Social rules
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Amanda Kirby. Please do not copy
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Making friends
• Topics of conversation
• One to one before bigger parties
www.blacksheeppress.co.uk
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Amanda Kirby. Please do not copy
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Learn the “NON” rules
“ COOL”
“WICKED”
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Amanda Kirby. Please do not copy
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Ensure social currency
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Amanda Kirby. Please do not copy
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Lunch and break times
• Encourage lunch time clubs where there are “ formalised” opportunities for socialising
• Peer mentor schemes
• Play ‘what if’
• Play’ canteen chaos game’
• Get weekly menu from school
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Amanda Kirby. Please do not copy
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Toilets
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In the canteen
• Queuing and choosing
• Paying
• Using cutlery
• Spills
• Where to sit
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Amanda Kirby. Please do not copy
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In class
Challenge
• Recording from the board
• Listening
• Planning out tasks
• Using tools- scissors /rulers
• Maths
• Posture
• Position
• Task
• Motivation
Response
• Facing the front
• Angle board
• Adapted tools
• ICT
• Minimise writing
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Amanda Kirby. Please do not copy
without permission of the author
Handwriting
• Observe pupil writing
• Pencil grip, sitting position, letter formation
• Look at handwriting
• Letter size, spacing, on the line
• Discuss with pupil
• Do they want writing to be different, does their hand ache?
Dyscovery Centre copyright 2011
Amanda Kirby. Please do not copy
without permission of the author
Working on core stability
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Position
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Amanda Kirby. Please do not copy
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Sebel chairs and desks
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Posture- in seating
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Amanda Kirby. Please do not copy
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Angle boards
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Amanda Kirby. Please do not copy
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Pencil case
Book holder
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Amanda Kirby. Please do not copy
without permission of the author
Pencil grips
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Amanda Kirby. Please do not copy
without permission of the author
Writing tools
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Amanda Kirby. Please do not copy
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Working environment
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Amanda Kirby. Please do not copy
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Dyscovery Centre copyright 2011
Amanda Kirby. Please do not copy
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Time reminders
Handwriting practice
• Sand tray shapes
• Shaving foam and stick
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Amanda Kirby. Please do not copy
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Finger painting
Finger puppets
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Amanda Kirby. Please do not copy
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Hand strength
•Posting
•Threading
•Peg games
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Amanda Kirby. Please do not copy
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Minimise or avoid
Apples are ................
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Amanda Kirby. Please do not copy
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Mind mapping -www.ikon.com
Dyscovery Centre copyright 2011
Amanda Kirby. Please do not copy
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Use alternatives
Lower case keyboard
Dana Neo
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Amanda Kirby. Please do not copy
without permission of the author
Typing programmes
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Amanda Kirby. Please do not copy
without permission of the author
Literacy softwareFirst Keys
Clicker
WordbarDyscovery Centre copyright 2011
Amanda Kirby. Please do not copy
without permission of the author
http://www.readwritethink.org/files/resources/i
nteractives/essaymap/
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Amanda Kirby. Please do not copy
without permission of the author
Co Writer
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Amanda Kirby. Please do not copy
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www.ghotit.com
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Amanda Kirby. Please do not copy
without permission of the author
Other software
Changing colour
background Screenruler
Speech-to-text Text-to-speech
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Amanda Kirby. Please do not copy
without permission of the author
Mathematics
– Language of maths
– Visualisation of maths
– Learning times tables
– Recording in class
– Using tools
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Amanda Kirby. Please do not copy
without permission of the author
Jonny went down the street and had
£3.20, He had to buy six apples at
20p each and 4 pears at 10p. What
change did he have?
Dyscovery Centre copyright 2011
Amanda Kirby. Please do not copy
without permission of the author
Making maths real
Cookery
Weights and measures
Shape- geometry
Half and quarters
Language
Planning
Motor skillsDyscovery Centre copyright 2011
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Difficulties can impact on different
lessons
Science- weights, measures, recording, using tools
Sport- sequences of instructions, direction, timing, understanding the plan/teams
Geography- map reading, recording, orientation, graphs
History- time lines
CDT- measuring, tool usage, planning, language
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Amanda Kirby. Please do not copy
without permission of the author
Tool usage
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Rulers
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Scissors
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Inattention/fiddling
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Amanda Kirby. Please do not copy
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Movement breaks
• Running on the spot
• Shoulder shrugs
• Hand presses
• Playing the piano
• Stretch and walk
www.shelterpub.com
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Amanda Kirby. Please do not copy
without permission of the author
Homework- school approaches
• Print on labels
• ‘My Space’
• Write up at start of class
• School Intranet
• Buddy system
• Differentiate-Reduce volume- same level of work but less
• Or- easier
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Amanda Kirby. Please do not copy
without permission of the author
Literacy based difficulties
Suitable reading materials
Rising Stars
Barrington Stoke
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Amanda Kirby. Please do not copy
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In PE/Games
Challenge
• Understanding instructions
• Following sequences of instructions
• Carrying out movements
• Working together in a group of different ability
Response
• Break down tasks
• Small group work
• Stronger and weaker pairing
• Model- alongside, practice and practice-video
Dyscovery Centre copyright 2011
Amanda Kirby. Please do not copy
without permission of the author
Dyscovery Centre copyright 2011
Amanda Kirby. Please do not copy
without permission of the author
Dyscovery Centre copyright 2011
Amanda Kirby. Please do not copy
without permission of the author
Going home
Challenge
• Homework
• Tired
• Friendships
• Parties
• Hobbies
Response
• Regular processes– Time out- walk dog, chill,play
a game
• Place to study – same each time
• Eat together
• Friends around- semi-planned activities
• Not rely on sibs for friendship circle
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Amanda Kirby. Please do not copy
without permission of the author
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Amanda Kirby. Please do not copy
without permission of the author
Food
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Amanda Kirby. Please do not copy
without permission of the author
Emotional/social
• Lonely
• Frustrated
• Flare ups
• Sib stuff
• Parent stuff
• Sex stuff
• Time out
• Dedicated time
• Planning time
• Reflecting time
• Time aware
• Social opportunities
• Seeking strengths
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Amanda Kirby. Please do not copy
without permission of the author
Homework at home
• Same place
• Same time
• All equipment ready
• Home- school diary
• Create a plan
• Use an essay planner
• Parent buddy
Dyscovery Centre copyright 2011
Amanda Kirby. Please do not copy
without permission of the author
Organisational strategies
• www.mycorkboard.com
• Post-it note and alarm
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Amanda Kirby. Please do not copy
without permission of the author
Bedtime- routine
Prepare for the next day
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Amanda Kirby. Please do not copy
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Managing change and family dynamics
• Holidays- home and away
• Other sibs friends around
• Family occasions
• Times of transition
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Amanda Kirby. Please do not copy
without permission of the author
Holidays at home
• Create a time table
• Provide a framework to the week
• Opportunity for practicing skills –dressing, cutlery
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Amanda Kirby. Please do not copy
without permission of the author
Holidays away
• Calendar
• Travel time
• Smells, tastes
• Climate
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Amanda Kirby. Please do not copy
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Siblings and their roles
• As a parent/carer
• As a source of friends
• Disclosing
• Separate time for every one
Dyscovery Centre copyright 2011
Amanda Kirby. Please do not copy
without permission of the author
Family/Social occasions
• Too loud
• Too long
• Too many people
• Too higher expectations
• Highlights differences between your own child and others and raises your own anxieties... Pass these onto your children
Dyscovery Centre copyright 2011
Amanda Kirby. Please do not copy
without permission of the author
Survival guide....
• Don’t expect more than usual- expect less
• Allow time out/alone time to prevent explosions
Dyscovery Centre copyright 2011
Amanda Kirby. Please do not copy
without permission of the author
Dyscovery Centre copyright 2011
Amanda Kirby. Please do not copy
without permission of the author
CAPACITY THEORY
Moving schools- junior to secondary school
Challenge
• New school
• New teachers
• Bigger environment
• New friends
• Older children
• More subjects
• No lockers/desks
• Puberty
Response
Dyscovery Centre copyright 2011
Amanda Kirby. Please do not copy
without permission of the author
www.move627.org
Dyscovery Centre copyright 2011
Amanda Kirby. Please do not copy
without permission of the author
Create a time table
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Amanda Kirby. Please do not copy
without permission of the author
„To do‟ list
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Amanda Kirby. Please do not copy
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MATCH- IT
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Amanda Kirby. Please do not copy
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What if?
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Amanda Kirby. Please do not copy
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Guidance on each scenario
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Amanda Kirby. Please do not copy
without permission of the author
Moving on to adolescence
Challenge
• Social isolation
• Increased weight gain
• Continuing writing difficulties
• Organisation and planning difficulties
• Anxiety
Response
• Topics of interest
• Movement – walking, climbing
• Brief therapy/cognitive behaviour
Dyscovery Centre copyright 2011
Amanda Kirby. Please do not copy
without permission of the author
Seek out hobbies for success
• Swimming• Horse riding• Trampolining• Canoeing• Photography• Cookery• Rambling• Badminton• Fencing• Archery• Golf• Gym work• Orienteering• Wall climbing
Dyscovery Centre copyright 2011
Amanda Kirby. Please do not copy
without permission of the author
Dyscovery Centre copyright 2011
Amanda Kirby. Please do not copy
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Mapping SEN routes to identification
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Mapping SEN
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Amanda Kirby. Please do not copy
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www.boxofideas.org
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www.spldtransitions.co.uk
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Amanda Kirby. Please do not copy
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www.move627.org
Dyscovery Centre copyright 2011
Amanda Kirby. Please do not copy
without permission of the author
Dyscovery Centre copyright 2011
Amanda Kirby. Please do not copy
without permission of the author