A Guide To SPLD 2nd Ed
A Guide To SPLD 2nd Ed
A Guide To SPLD 2nd Ed
DCD/Dyspraxia
Fine and/or gross motor
coordination
Developmental
Language Disorder Dyslexia
(DLD) Common issues
Reading, writing, spelling
Speaking, understanding, Attention
communicating Organisation
Working memory
Time management
Listening skills Autism Spectrum
Sensory perception Disorder (ASD)
Dyscalculia
Speed of processing Social interaction,
Arithmetic communication, interests,
behaviour
Attention Deficit
Hyperactivity Disorder
(ADHD)
Attention, activity levels,
impulsiveness
Contents
Page
Introduction 2
Notes on Neurodiversity 3
Dyslexia 4
Dysgraphia 12
Dyscalculia 17
Trauma 28
With thanks to the following individuals and organisations for their contributions to this
Guide:
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A Guide to Specific Learning Differences
Introduction
“I’ve come to a frightening conclusion that I am the decisive element in the classroom. It’s my
personal approach that creates the climate. It’s my daily mood that makes the weather. As a
teacher, I possess a tremendous power to make a child’s life miserable or joyous. I can be a
tool of torture or an instrument of inspiration. I can humiliate or heal. In all situations, it is my
response that decides whether a crisis will be escalated or de-escalated and a child humanized
or dehumanized.”
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Notes on Neurodiversity
‘For too long, we’ve assumed that there is a single template for human nature, which is why
we diagnose most deviations as disorders. But the reality is that there are many different
kinds of minds. And that is a very good thing.’
Jonah Lehrer
Jonah Lehrer
Neurodiversity is a relatively new term, thought to have been coined in the 1990s by Judy
Singer (an autism activist).
It was originally used by the autistic community, who were keen to move away from the
medical model and dispel the belief that autism is something to be treated and cured rather
than an important and valuable part of human diversity.
The idea of neurodiversity has now been embraced by many other groups, who are using
the term as a means of empowerment and to promote the positive qualities possessed by
those with a neurological difference. It encourages people to view neurological differences
such as autism, dyslexia and dyspraxia as natural and normal variations of the human
genome. Further, it encourages them to reject the culturally entrenched negativity which
has typically surrounded those that live, learn and view the world differently.
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Dyslexia
‘The trouble was that she (the teacher) gave me too many instructions. By the time I got to
where I needed to be I had forgotten all but the last one and that didn’t make any sense on its
own. So I hid.’
Emma age 11
What it is
The British Dyslexia Association (BDA) Management Board have adopted the definition of
dyslexia published in 2009 from Sir Jim Rose’s Report on ‘Identifying and Teaching Children
and Young People with Dyslexia and Literacy Difficulties’: It is recommended that this
definition is used with the additional paragraph from BDA as shown below:
Dyslexia is a learning difficulty that primarily affects the skills involved in accurate and fluent
word reading and spelling.
A good indication of the severity and persistence of dyslexic difficulties can be gained by
examining how the individual responds, or has responded, to well-founded intervention.
In addition to these characteristics, the BDA acknowledges the visual and auditory
processing difficulties that some individuals with dyslexia can experience. It points out that
dyslexic readers can show a combination of abilities and difficulties that affect the learning
process.
What it means
Not all dyslexic children are affected in the same way. Some may have mild problems, whilst
others will have more profound difficulties across more than one area. Difficulties can be
exacerbated depending on the task and external factors. A dyslexic learner’s performance is
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often variable, as they can have good days and bad days. Their difficulties can include
phonological, visual and memory difficulties:
• Phonological difficulties
Dyslexic children with phonological difficulties can lack automaticity with sound/letter
correspondence, which is needed for decoding and pronouncing words for reading, and
encoding for spelling.
• Memory difficulties
Dyslexic individuals often have difficulty holding information in their short-term memory
and also with retrieving it from their working memory.
• Visual difficulties
Dyslexic individuals can often have difficulty with tracking accurately; they may
experience glare from reading black on white, or blur from certain fonts.
Written Work:
• A poor standard compared with oral ability;
• Poor pencil grip;
• Poor handwriting, with reversals and badly formed letters;
• Poor presentation and disregard of the margin;
• Messy appearance with many crossings out and spellings attempted several times;
• Persistent reversal confusion, e.g. b/d, p/g, p/q, n/u, m/w;
• Transposed letters, e.g. tired for tried;
• Produces phonetic and bizarre spellings which may not be age appropriate;
• Unusual letter sequencing.
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Reading:
• Slow reading progress;
• Difficulty with blending letters together;
• Difficulty with syllable division and identifying beginning, middle and end sounds;
• Difficulty with pronouncing unfamiliar words;
• Difficulty with expression;
• Lack of automaticity, especially when reading aloud;
• Unable to recognise familiar words;
• Omits words, or adds or substitutes words;
• Loses the point in stories;
• Difficulty identifying the main points;
• Difficulty with comprehension.
Strengths:
Dyslexic learners may show strengths in the following areas:
• Creativity;
• The ability to visualise things;
• Practical and problem solving skills;
• Lateral thinking skills;
• Being able to see the big picture (global thinkers) in terms of strategies and problem
solving;
• Good visual-spatial awareness;
• Good verbal communication skills;
• High levels of motivation and persistence.
Routes to identification
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Prevalence
• http://www.bdadyslexia.org.uk/educator/bda-services-educators
• http://dyslex.io
• http://www.thedyslexia-spldtrust.org.uk
• https://www.helenarkell.org.uk
• http://www.irlensyndrome.org/toolkits-for-parents-and-educators
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‘When you are perching on a high stool with no back or arms, you may be so busy trying to
keep your balance that you can’t listen to the teacher.’
Victoria Biggs. Caged in Chaos.
What it is
What it means
Dyspraxia/DCD can affect almost every part of an individual’s life and makes living and
learning more challenging. Many of the skills other people take for granted or seem to just
‘do’ have to be taught, learned and practised; they do not come naturally. This can be
difficult to understand and dyspraxic learners are often frustrated if the issues that they are
experiencing are not recognised and responded to appropriately. Dyspraxic individuals find
it difficult to copy movements demonstrated by someone else, and they may appear
inefficient or awkward in the way they carry out activities/tasks. They have an inconsistent
learning performance and weak perceptuo-motor skills.
They benefit from support and encouragement in class and other environments, which will
allow them to feel more comfortable and more likely to engage, whilst keeping their self-
esteem afloat.
Dyspraxia/DCD affects each individual differently, ranging from mild to severe. Many
learners fall somewhere between the two extremes and are dependent on appropriate
support in all environments to reach their potential. Teachers should respond to the
predominant need that the learner is exhibiting at any time (these may change with subject
area and a learner’s age). Responding to need is always more preferable to responding to
diagnosis.
Learners will present with a cluster of differences as seen in the Combined SpLD Checklist.
Most commonly these will include:
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The structure of secondary and further education may prove too difficult for the learner and
their struggles may become more evident as a result. If needs are not met they may become
disaffected and exhibit challenging behaviour.
• Challenges with physical activities such as in P.E., especially activities that involve eye-
hand and eye-foot co-ordination (i.e. ball skills), running, hopping, jumping, climbing,
skipping, learning to ride a bicycle, using equipment and working as a team.
• Poor posture, body awareness and awkward, effortful movements, hypermobility.
• Poor short term visual and verbal memory - copying from the board, dictation, following
instructions.
• Handwriting challenges both with style and speed - frequently children have an awkward
pen grip.
• Challenges organising themselves and equipment.
• Difficulty with activities which involve well developed sequencing ability.
• Problems with awareness of time, pupils need constant reminders.
• Sensory issues e.g. light, sound and heat intensity.
• Takes longer to process information.
• Extremes of emotions.
• Lack of awareness of potential danger, particularly relevant to practical and science
subjects.
• Problems with forming friendships (later in primary and in secondary school).
• Immature behaviour.
• Poor personal hygiene/self-awareness.
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Strengths:
• Tenacious;
• Creative;
• Empathetic;
• Kind;
• Polite;
• Keen to please;
• Sensitive;
• Often good at drama/singing/creative activities.
Prevalence
At least 5% of the population in varying degrees. It is probable that there is at least one child
with Dyspraxia/DCD in every classroom who will require access to a specific treatment
programme. Dyspraxia/DCD can present as a unique condition but often co-exists with other
SpLD.
Routes to identification
Medical diagnosis via a GP with referral to a Paediatrician & Occupational Therapist (OT)
and/or Physiotherapist (PT).
A cognitive assessment by an educational psychologist or specialist teacher may highlight
working memory and speed of processing weaknesses.
• http://www.dyspraxiafoundation.org.uk
• http://www.movementmattersuk.org
Dyspraxia can also affect speech and language (Developmental verbal dyspraxia).
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What it is
Developmental verbal dyspraxia is a rare condition which refers to difficulties in making and
coordinating the precise articulatory movements required in the production of clear speech.
Children with DVD find it challenging to make speech sounds correctly and to join sounds
together in words and sentences.
Oral dyspraxia, on the other hand, refers to the challenges in coordinating the movements
of the vocal tract (larynx, lips, tongue, palate) when not producing speech. Children with
oral dyspraxia have challenges carrying out oral motor tasks such as blowing and licking. It
would seem logical to think that if a child has verbal dyspraxia they must have oral dyspraxia
too, but research suggests otherwise. Although most professionals now distinguish between
the two, occasionally the terms are used interchangeably, which can be confusing.
Some children with verbal dyspraxia will also have an element of motor dyspraxia.
Early identification is crucial to success. These children need a high level of specialist speech
and language therapy over a number of years, and in some cases other professional input.
They may also exhibit differences with reading, spelling and handwriting, particularly if their
speech difficulties persist beyond the age of 5 ½ years.
Routes to identification
This is a diagnosis made by a speech and language therapist (SLT) and a teacher can refer
directly to this specialist. A health visitor may well be the first person to recognise
differences with SLCN (Speech, Language and Communication Needs). Otherwise, a GP
should be consulted and a referral to a SLT (Speech and Language Therapist) should be
made.
• http://www.afasic.org.uk
• http://www.ican.org.uk
• https://www.rcslt.org Policy Statement on Developmental Verbal Dyspraxia,
published 2011.
• http://www.dyspraxiafoundation.org.uk
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A Guide to Specific Learning Differences
Dysgraphia
‘It’s like my hand just won’t do what my brain is telling it to. Like it’s lost a connection.’
What it is
The recognition and diagnosis of dysgraphia is a rather contentious issue. Use of the term is
increasingly common, with some suggestion that dysgraphia belongs to the same family of
developmental disorders as dyspraxia and dyslexia, although it is not listed as a specific
learning difficulty in the SEND Code of Practice. Some people consider that dysgraphia goes
hand in hand with dyspraxia; however, because at the current time there is not a recognised
list of agreed core symptoms/indicators, the Dyspraxia Foundation prefers to use the term
'handwriting difficulties'.
What it means
Handwriting difficulties are more than simply 'untidy' writing; they can affect the ability to
write legibly, fluently, comfortably and effortlessly. They can limit people's ability to reach
their potential as they may struggle to express their thoughts on paper or may avoid writing
altogether.
According to Angela Webb, the Chair of the National Handwriting Association:
"In terms of a diagnosis and use of a term to label a certain condition, we go by the
Diagnostic and Statistical Manual - 5th edition (DSM V). In order for a diagnosis to be given,
there has first to be a standardised way of measuring the performance with set and agreed
cut-off points. At present, there is no consensus here. Although the term 'dysgraphia'
appeared in DSM IV, it was described as "a generalised difficulty with written expression"
and did not specify the three main types of possible handwriting deficiency: orthographic,
motor, or perceptual. Not surprisingly, given the range of components which might cause a
problem, the term dysgraphia does not appear in DSM V, despite its frequent use in the US
literature.’
It is sometimes believed that all children with dyspraxia/DCD have dysgraphia, but this is not
the case. Although a common feature of dyspraxia/DCD is difficulty with handwriting, some
diagnosed children can produce tidy and legible handwriting (although this is usually at the
expense of quantity) and others may produce writing which is fast, though poorly
controlled. Conversely, poor handwriting can exist independent of dyspraxia/DCD,
particularly if the difficulties are not motor in origin, or if poor motor control results from a
different aetiology, such as impulsivity. Poor handwriting is also frequently reported in
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children who meet the criteria for other developmental disorders, such as ADHD, Dyslexia
and mild spectrum Autism.
Handwriting is a complex skill requiring a blend of motor, perceptual and orthographic skills.
Challenges in handwriting can be caused by weakness in one or all of these areas so
meaningful interventions need to take into consideration the root of the challenge being
experienced. For example, an appropriate motor programme may address and strengthen
some of the weaknesses being experienced but may not impact on the non-motor
weaknesses.
The absence of clarity in terms can cause confusion for families seeking a diagnosis (or
indeed those who have been given the diagnosis without advice as to its impact). Currently,
it seems reasonable to stick with the DSM-V and say that until we have consensus and clear
diagnostic tools to measure the type and severity of the condition, the term 'dysgraphia' is
meaningless. Therefore, it should not be used in the way that other developmental
disorders' labels are used.
The National Handwriting Association encourages the use of the term 'an impairment in
written expression' under the category of “specific learning disorder” (DSM V) or 'a difficulty
with orthographic integration (i.e. handwriting)'.
Routes to identification
Because of the lack of consensus, the National Handwriting Association considers the
diagnosis of dysgraphia to be unsound. However, it is recognised that many people
experience handwriting difficulties. Identification of such difficulties has to be through an
educational/clinical psychologist, or an SpLD assessor in the UK, and the exact nature of the
difficulty (e. g. motor, orthographic, perceptual) should be stated. Despite it being a
relatively common condition, it is sometimes hard to find a person who feels confident to
assess it.
• http://www.nha-handwriting.org.uk
• https://www.patoss-dyslexia.org.uk
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‘Sometimes it’s like having tape on my mouth. By the time I have worked out how to say
something it is no longer relevant.’
Josh. Age 13
What it is
What it means
Children with DLD struggle to put their thoughts into words (expressive language) and
understand what is said to them (receptive language). These skills are essential for reading,
learning in school and other environments, for developing and maintaining successful
friendships and managing everyday interactions. Speech and language allow children to
express what they feel, to control and regulate their emotions, to join in and to problem
solve. Early identification and intervention has been shown to be most effective in ensuring
better outcome; without this, the consequences can be devastating for the child. Often
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described as a ‘hidden disability’, children can find extremely convincing strategies to make
it appear that they are following what is being said or is happening.
No two children with DLD are the same but they may display some or all of the following
features:
• have difficulty saying what they want to, even though they have ideas;
• struggle to find the words they want to use (word finding difficulties);
• talk in sentences but be difficult to understand;
• produce muddled speech, making it difficult to follow what they are saying. A
child with DLD won’t necessarily sound like a younger child; instead their
speech might be disorganised or unusual;
• find it difficult to understand words and long instructions;
• have difficulty remembering the words they want to say;
• find it hard to join in and follow what is going on in the playground.
Prevalence
Recent research found that 7.6% of children in reception class have DLD. This means that an
average of two children in every class of 30 experience language difficulties that are severe
enough to hinder academic progress. Further analysis, from the same study, found that
children don’t grow out of the condition, maintaining a 2-3 year gap in language skills
throughout primary school. These difficulties are known to continue throughout secondary
schooling. Considering the fundamental role that language plays in learning and in
developing social and emotional skills, this is significant.
Routes to identification
Recent discussion has centred on the importance of having a range of different types of
information to aid identification: formal assessment, informal assessment, observation, and
classroom behaviour checklists. A speech and language therapist would carry out this range
of assessments in order to profile difficulties.
Checklists are also available which school or early years’ staff can use in order to identify the
need for further investigation.
Early recognition is essential and parents, early years practitioners, or teachers can refer
directly to an SLT (Speech and Language Therapist). Parental consent must always be
obtained before a referral is made.
• http://www.talkingpoint.org.uk/
• https://www.thecommunicationtrust.org.uk/
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• http://www.afasic.org.uk/
• http://www.ican.org.uk/
You can find out more information about DLD in “The SLI Handbook”, currently being
updated and renamed available from I CAN’s online shop (icancharity.org.uk/resources/sli-
handbook).
1.2 million children in the UK struggle to communicate (Law et al., (2000). A very significant
proportion of language issues can be long-term and persistent – in other words children and
young people won’t ‘grow out of it’ (Stothard et al., 1998).
10% of all children have long term, persistent SCLN. This means 2 to 3 children in every
classroom have a significant communication difficulty.
A further group of children have SLCN associated with social deprivation. These children
have poor or immature language and have the potential to catch up with their peers.
Approximately 50% of children, particularly in areas of social deprivation, are starting school
with language skills below the expected level for their age (Law et al., 2011).
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Dyscalculia
‘I find it so hard. Numbers terrify me so I spend most of the lesson just keeping my head down
and hoping the teacher won’t notice me.’
Jill. Age 12.
What it is
The word dyscalculia is made up of “dys” = difficulty, and calculus = counting stone. Thus,
dyscalculia refers to a difficulty with arithmetic. It should be noted that there is, currently,
far less research in this area than for other SpLD. Therefore, agreed definitions of dyscalculia
are more difficult to find.
The DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th ed., American
Psychiatric Association, 2013) recommends a diagnosis of developmental dyscalculia when
“mathematical ability, as measured by individually administered standardized tests, is
substantially below that expected given the person’s chronological age, measured
intelligence and age-appropriate education.”
What it means
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People usually think of challenges with maths in terms of learning in the classroom;
however, if an individual has dyscalculia the ramifications of this extend across many other
significant areas involved in daily living. These include money and budgeting, time keeping,
organisation, and understanding weight and measurement. This can have a profound
influence on job opportunity and retention.
Prevalence
Dyscalculia is thought to affect between 3-6% of the population to varying degrees (Price
and Ansari, 2013).
This journal is available online at:
http://scholarcommons.usf.edu/cgi/viewcontent.cgi?article=1112&context=numeracy)
Routes to identification
http://www.bdadyslexia.org.uk/dyslexic/dyscalculia
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‘We’re usually very visual learners with poor short term memory, so we’ll forget much of what
you tell us almost immediately unless we read it or write it down, are shown something in the
format of picture/graphics/video, or can relate it quickly to some other long term memory we
have.’
Pixie. An autistic teenager.
What it is
Autism is a life-long developmental disability affecting social and communication skills and
the way in which people experience the world around them. It is not classified as a specific
learning difficulty.
What it means
Autism can be disabling and debilitating if it is not accepted and supported appropriately.
It is a spectrum disorder; this means that an individual may exhibit a wide range of issues.
Furthermore, these issues can vary widely from one individual to another. Challenges may
also vary for an individual person on a daily basis, meaning they may be more or less
sensitive to particular things on different days.
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and repetitively. Issues with social imagination mean that people with autism often find it
challenging to visualise what is coming next. This can lead to a reliance on structure and
routine or raised levels of anxiety when plans change unexpectedly.
Sensory needs: People with autism can be over or under sensitive to all 7 senses (touch,
taste, sight, sound, smell, vestibular and proprioception.) Also, their ability to process these
senses is not static and can change depending on levels of stress. This can mean that people
on the autism spectrum require occupational therapy adjustments.
Positive features:
• honesty;
• live in the moment;
• rarely judge others;
• are passionate;
• have terrific memories;
• not tied to social expectations;
Prevalence
The most recent editions of the DSM and ICD diagnostic manuals do not include Asperger
Syndrome as a separate diagnosis; individuals presenting with these characteristics will now
be given a diagnosis of ASD. However, many students currently have a diagnosis of Asperger
Syndrome. People with AS do not usually have the accompanying learning disabilities
associated with autism, and their language skills are highly developed. However, they still
have challenges understanding language and communication.
Routes to identification
• http://www.autism.org.uk
• http://www.autismeducationtrust.org.uk
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‘It’s like there is three of me, all wanting to do different things at the same time.’
Adam. Age 10.
What it is
This is an important issue as it is easier to spot hyperactive and impulsive symptoms and
there is a lot of evidence to support that girls with ADHD Inattentive type are missed,
especially during the primary school years. This can have serious long term consequences in
terms of their learning, behaviour and self-esteem later in life.
This is one of the major reasons why the age on onset was raised from 7 to 12 in the recent
DSM-V in terms of identification of symptoms.
What it means
Children can display behavioural differences if their needs are not understood. This may
lead to social exclusion.
Inattentiveness:
• having a short attention span and being easily distracted;
• making careless mistakes;
• appearing to be unable to listen to or carry out instructions;
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Positive features:
• engaging/charismatic personality;
• adventurous;
• creative;
• lots of interests;
• resourceful;
• willing to explore.
Prevalence
It is estimated that between 1 and 4% of children will have the disorder (1% will meet the
diagnostic criteria for a severe form).
Routes to identification
Diagnosis should be a medical one. A child should be seen by a GP in the first instance and
may be referred to a paediatrician, a clinical psychologist or psychiatrist.
• http://www.adhdfoundation.org.uk/
• http://www.addiss.co.uk/
• http://www.adders.org/
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‘When people experience sensory overload or anxiety their behaviour may seem a little
different to others, they aren't having a tantrum or being un-cooperative they are simply
overwhelmed and trying to cope best they can.’
Rosie.
One further area which cannot be classified as an SpLD but which warrants inclusion in the
Guide is anxiety and mental health. In March 2016, the Department for Education published
a booklet entitled ‘Mental health and behaviour in Schools: Departmental advice for School
Staff’. This lists low self-esteem, academic failure, neurodiversity and communication
difficulties as some of the high risk factors in the development of mental health issues. One
that is particularly relevant in the classroom is anxiety.
What it is
Anxiety is a term that has a general meaning as well as a clinical one. The dictionary
definition of anxiety is that it is a feeling of worry, nervousness, or unease about something
with an uncertain outcome. It is a normal response to a frightening or unknown situation,
such as attending a job interview or preparing for exams. For most of us anxiety is
transitory and we can find techniques to help us manage it. However, unless recognised
and managed appropriately, feelings of anxiety can escalate to something completely
debilitating and can be diagnosed as a mental disorder.
Read the Royal College of Psychiatrists leaflet on Worries and Anxieties: Information for
Young People for more detailed information -
http://www.rcpsych.ac.uk/healthadvice/parentsandyoungpeople/youngpeople/worriesand
anxieties.aspx
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Anxiety is a common and recurring theme amongst people with SpLDs – a Dyspraxia
Foundation survey in 2014 found that 40% of young people with Dyspraxia/DCD aged 13-19
years felt anxious ‘all the time’.
Many anxiety disorders begin in childhood and adolescence (Anxiety UK, 2016), and have
been reported as one of the most common forms of psychological distress for people with
learning differences (Deb et al., 2001; Emerson, 2003). Further, it is likely that individuals do
not seek help for significant levels of anxiety, meaning that many remain undiagnosed and
without treatment.
What it means
In an article published by the British Psychological Society journal in 2012, it is reported that
‘social anxiety in learning situations such as seminars and presentations can inhibit student
participation and impair the quality of student life.’
Anxiety may manifest in disruptive behaviour, inattention, throwing tantrums, panic attacks
and physical symptoms such as stomach aches or palpitations, and not engaging with the
learning process. Children with learning differences are likely to become anxious when they
realise that classmates are finding things easier than they are, which can become a block to
learning. We know that there are high levels of anxiety in children and young people who
have autism. Teachers should pay attention to the emotional climate of their classroom; it
should not be threatening or anxiety provoking. They should think about and talk to the
child to find out what is behind their behaviours or other symptoms. An awareness and
understanding of the issues faced by children and young people with neuro-divergence will
help greatly in achieving this balance.
• tiredness;
• lack of concentration;
• irritability;
• sadness/withdrawal;
• loss of self-confidence;
• a change in behaviour;
• seems worried;
• easily upset;
• complains of feeling sick;
• complains of feeling shaky/dizzy;
• hert is racing;
• short of breath;
• thinks unpleasant thoughts.
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You will have to play detective, as many of these symptoms may be related to other
conditions as well
Prevalence
About 1 in 10 young people aged 5-16 have a mental disorder (Green, 2004) and of these
young people, 3.3% will have an anxiety disorder. The prevalence of anxiety increases with
age, and teenage girls are more likely to have an anxiety disorder than boys.
• 4.4% of young people aged 11-16 have an anxiety disorder compared to 2.2% of 5-10
year olds
• 5.2% of teenage girls aged 11-16 will have an anxiety disorder compared to 3.6% of
boys.
The caveat here is that this data is from 2004 and that it only refers to symptoms of anxiety
that are severe enough to be considered a mental disorder.
There will be a new prevalence survey of children and young people’s mental health
published in 2018. Currently there are some indications that mental health problems,
especially anxiety has increased in girls and young women.
According to Anxiety UK
1. 13.3% of 16 – 19 year olds and 15.8% of 20 – 24 year olds have suffered from anxiety
(neurotic episode).
2. 1.7% of 16 – 19 year olds and 2.2% of 20 -24 year olds have suffered from a depressive
episode.
3. 0.9% of 16 – 19 year olds and 1.9% of 20 – 24 year olds have suffered from obsessive
compulsive disorder.
(www.anxietyuk.org.uk/our-services/anxiety-information/young-people-and-anxiety)
Routes to identification
There are a range of services that support children and young people’s mental health, and
treat mental ill health. The Children and Young People’s Mental Health System, is
sometimes conceptualised as a 4 tiered strategic framework, with non mental health
professionals such as teachers, GPs, school nurses, health visitors being in tier 1. This means
that teachers may be the first person to be alerted to a mental health issue. Also, we know
that young people are more likely to approach their teacher than a mental health
professional. This means they should act upon their concerns. Specific services will vary
depending on the needs of the local area, with some schools having in-house mental health
provision such as a counsellor, but can sometimes include a broader range of support.
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• The DfE suggest schools should have a clear process for identifying children in need of
further support.
• They should document evidence of the symptoms or behaviour that are causing concern
(and include this with the referral).
• They should encourage the pupil and their parents/carers to speak to their GP, where
appropriate.
• Schools should work with local specialist CAMHS to make the referral process as quick
and efficient as possible, for example by being clear who can refer, by ensuring schools
have access to the relevant forms, and by sharing information about when decisions will
be taken and fed back.
• They should understand the criteria that will be used by specialist CAMHS in determining
whether a particular pupil needs their services.
• They should have a close working relationship with local specialist CAMHS, including
knowing who to call to discuss a possible referral and allowing pupils to access CAMHS
professionals at school.
• They should consult CAMHS about the most effective methods the school can undertake
to support children whose needs aren’t severe.
Useful organisations
http://www.mind.org.uk/
https://www.anxietyuk.org.uk/
http://www.nhs.uk/conditions/cognitive-behavioural-therapy/pages/introduction.aspx
http://thinkoutsideofthecardboardbox.blogspot.co.uk/2014/01/dyspraxia-anxiety-and-
me.html
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Deb, S., Thomas, M., & Bright, C. (2001). Mental disorder in adults with intellectual
disability. 1: Prevalence of functional psychiatric illness among a community-based
population aged between 16 and 64 years. Journal of Intellectual Disability
Research, 45(6), 495-505.
Emerson, E. (2003). Prevalence of psychiatric disorders in children and adolescents with and
without intellectual disability. Journal of Intellectual Disability Research, 47(1), 51-58.
Law, J., Peacey, N., & Radford, J. (2000). Provision for children with speech and language
needs in England and Wales: Facilitating communication between education and
health services.
Law, J., McBean, K., & Rush, R. (2011). Communication skills in a population of primary
school-aged children raised in an area of pronounced social
disadvantage. International Journal of Language & Communication Disorders, 46(6),
657-664.
Price, G. R., & Ansari, D. (2013). Dyscalculia: Characteristics, causes, and
treatments. Numeracy, 6(1), 2.
Royal College of Psychiatrists
http://www.rcpsych.ac.uk/healthadvice/parentsandyoungpeople/youngpeople/worr
iesandanxieties.aspx
Stothard, S. E., Snowling, M. J., Bishop, D. V., Chipchase, B. B., & Kaplan, C. A. (1998).
Language-Impaired Preschoolers: A Follow-Up Into Adolescence. Journal of Speech,
Language, and Hearing Research, 41(2), 407-418.
Tomblin, J. B., Records, N. L., Buckwalter, P., Zhang, X., Smith, E., & O'Brien, M. (1997).
Prevalence of specific language impairment in kindergarten children. Journal of
Speech, Language, and Hearing Research,40(6), 1245-1260.
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A Guide to Specific Learning Differences
Trauma
When children struggle, misbehave, are angry, aggressive, struggle with friendships or
struggle to learn in a class environment, glaze over, seem ‘lost’, or show regressive
behaviour- the first question we should ask as adults is ‘What has happened to them?’
Trauma impacts the behaviour, relationships, learning and emotions of a child.
What it is
Trauma is an experience that renders a child terrified and powerless. The impact of a
traumatic event varies according to the intensity and frequency of the experience,
environment of the child and other factors. There is strong and growing evidence that
trauma impacts the emotions, behaviour, relationships and learning of children and young
people. Trauma symptoms can be seen in a classroom in both disruptive ‘acting out’
behaviours and less noticeable but significant in their danger, ‘acting in’ behaviours. Trauma
symptoms can be minimalized or eradicated through trauma recovery work.
Traumatic experiences, and our responses to them, vary widely and therefore it is essential
to use a trauma continuum (de Thierry, 2013) to describe how mild or severe a traumatic
experience is. Some professionals may argue that, ‘all children these days are traumatised’;
however, it is becoming known that all children know some stress, most will have
experienced a crisis, and a large percentage will have endured a traumatic experience, but
these would range in severity as shown on the trauma continuum. The trauma continuum
can help all those who work with children to use a common language, which consequently
enables a child to receive appropriate interventions that are suitable for their level of
traumatic response. The trauma continuum (de Thierry. B. 2015.) is shown below:
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different. For example, sexual abuse, trafficking, torture, organized abuse or severe neglect.
Abuse and neglect in childhood affects a child’s mind, their brain and its responses, their
spirit and the ability to have hope, and their relationships with others.
What it means
When a child or young person has experienced trauma, the impact can cause disruption to
their learning as their brain becomes focused on survival, thus hindering the ability to
reflect, learn new information and think. The brainstem and amygdala become stuck in a
threat response and primitive survival becomes the primary focus. Trauma impacts their
behaviour, which can often be seen as disruptive or irritating, can lead to adults telling the
children to ‘make better choices’ rather than understand the physiological nature of the
behaviour which is more dominant than their cognition. Sometimes the traumatised child is
compliant, fearful or withdrawn or seen to be ‘zoned out’ which indicates a response to
terror. The trauma impacts on their emotions often causing them to struggle to be self
regulated and instead causing them to be sensitive to perceived threat and impulsive and
emotionally volatile. Trauma impacts on relationships causing them to either be clingy,
nervous, anxious, controlling or avoidant which then can lead to lower self esteem and self
rejection due to loneliness. Trauma also impacts on the child’s memory and speech.
Sometimes traumatised children can struggle with memory issues due to coping
mechanisms that create ways to shut down incidents and experiences in their memory that
were too full of pain or shame. The broca’s area of the brain that is responsible for speech
becomes almost impossible to activate when a child is experiencing trauma or trying to
recall a trauma or shame filled experience. Sometimes they swear or shrug their shoulders
to protect them from the vulnerability of not being able to speak intelligently due to the
impact of trauma.
Trauma symptoms
• Aggression
• Self harming
• Agitation and restlessness
• Running away/out
• Fighting
• Wetting/ soiling
• Glazed over/ in own world
• Slow to respond
• Self loathing thoughts/ words
• Eating difficulties
• Socially withdrawn
• Anxiety
• Depression
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• Low energy
• Feeling numb
• Feeling out of control
• Memory lapse
• Distracted
• Impulsive behaviours
• Nightmares
• Flashbacks
• Substance dependency
• Panic attacks
• Suicidal Ideation
Prevalence
• 130,000 live in households where there is a known high risk case of domestic abuse and
violence.
• There is a major overlap between direct harm to children & DA. 62% of children were
also directly harmed (in plain sight CAADA 2014)
• Neglect is the main concern in 46% of CP plans. (DofE 2016)
• 69,540 are looked after by a local authority in UK (ONS 31/3 (/15)
• 46,690 are the subject of a Child Protection Plan in UK (2016)
• 1,300 are privately fostered
• 300 are in secure children’s homes
• A child is unlawfully killed in England & Wales once a week.
• 44% rise in child sex offences in the last year – 15 a day
We know that a lot of children have experienced significant trauma. This is reflected in the
rise in demand for access to mental health support. 1 in 3 diagnosed mental health
conditions in adulthood are known to directly relate to adverse childhood experiences.
Around 1 in 10 children and young people have a diagnosable mental health condition,
which translates to three students in every class. 3 in 100 children experience the death of
a parent or primary care giver before they are 14 years of age. Due to the trauma of the lack
of consistency of care from a primary care giver and the traumatic experiences (neglect,
abuse, bereavement etc.) that led to the child becoming looked after, fostered or adopted,
these children are at high risk of mental health challenges, emotional and behavioural
challenges and they are four times more likely to attempt suicide in adulthood (Young
minds Addressing Adversity 2017).
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Routes to identification
• Asking ‘what happened to them?’ ‘Is there something they are trying to say through
their behaviour?”
• Using the trauma continuum to discuss with other adults in their world the level of
trauma they may have experienced and therefore the level of impact.
References
https://youngminds.org.uk/media/1241/report_-_beyond_adversity.pdf
Websites
www.betsytraininguk.co.uk
www.trc-uk.org
www.youngminds.org.uk
Books
Bomber, L.M. (2007) Inside I’m Hurting: Practical Strategies for Supporting Children with
Attachment Difficulties in Schools. Worth Publishing.
de Thierry, B. (2015) Teaching the child on The Trauma Continuum. Grosvenor House.
de Thierry, B. (2016) The Simple Guide to Child Trauma. Jessica Kingsley Publishers.
Perry, B. and Szalavitz, M. (2007) The Boy Who Was Raised as a dog. And other stories from
a child psychiatrist’s notebook. Basic Books.
Van der Kolk, B. (2015) The Body keeps the Score: mind, brain and body in the
transformation of trauma. Penguin.
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Educational Psychologist
Assessment
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A Guide to Specific Learning Differences
The contents of this Guide and the Teaching for Neurodiversity training materials are
intended as a starting point in raising your awareness of neurodiversity and SpLD. It is
recommended that you use these materials to identify areas where further reading and/or
study is required.
Listed below are a number of recommended websites and courses providing suggestions for
further CPD. We hope that you’ll find these useful.
Dyspraxia Education
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Dyspraxia Foundation
Primary. http://dyspraxiafoundation.org.uk/wp-content/uploads/2014/12/Primary-
Classroom-Guidleines-Scanned.pdf
Secondary http://dyspraxiafoundation.org.uk/wp-content/uploads/2014/10/Secondary-
school-guidance.pdf
Post 16 http://dyspraxiafoundation.org.uk/wp-
content/uploads/2013/10/DYSP_12PP_2016.pdf
I CAN
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See http://thesendreview.com for the SEND Review Guide, a tool which can be used by all
schools to audit their SEND provision.
PATOSS
Patoss provides a range of professional development with many themes useful for schools.
Some are regularly scheduled at central locations or they can be provided in-house at your
school or institution.
A full listing of current CPD courses can be found on the Patoss website
https://www.patoss-dyslexia.org/ProfessionalServices/EventsCPD
These include:
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