Thursday, 28 October 2010
If your child has been diagnosed with 'behavioural problems' choose their secondary school carefully, warns Rebecca Harvey.
Exclusion from school is something every parent dreads. Hearing the words, “We would like you to remove your son at the end of this term”, was certainly one of the worst moments of my life.
Dan was starting his second year at an exclusive independent boys’ school and had behavioural problems. In fact, he had Attention Deficit Hyperactivity Disorder (ADHD) although this had not been formally diagnosed at the time. We knew all along that there was more to his behaviour than simply being “bad”. The school chose to ignore this. They were, in my opinion, prepared to let him destroy himself simply to protect their position in the league tables.
With the independent schools’ open-day season now under way, I would advise the parents of prospective pupils who fall into the same category as my son, or who have already been diagnosed with ADHD, to choose carefully. As we were to discover, the consequences of not doing so can be damaging for both the child and their family.
ADHD is a recognised medical condition affecting up to 5 per cent of all school-age children, with more boys affected than girls. Scientists believe that it is caused by an imbalance in brain neurotransmitters – chemicals that allow the cells of the central nervous system to communicate – and those afflicted find it hard to concentrate, stay still for long, or restrain their impulses. Recent research showing, for the first time, direct evidence of a genetic link, is helping to disprove assumptions that this condition is merely “naughtiness”.
Dan had sailed through his entrance exam and the interview, and arrived at the school in September 2007. We were proud and excited, thinking a big sporty school perfect for him. There had been some behavioural problems at his state-funded primary school – he could be over-boisterous and sometimes aggressive in the playground – but there was no question about his intellectual ability. He was also an exceptional athlete, and soon in the rugby first team at his new school.
His half-term reports were worrying, however. While some teachers clearly enjoyed teaching Dan, others complained about his behaviour. He would call out impulsively during lessons and fidget in class. His homework was often incomplete and messy. In spite of this, he did well in tests and had a wide group of friends.
He was difficult at home, too: he couldn’t settle to homework and had trouble getting to sleep. Yet there was no deliberate mischief in Dan’s activities; he often apologised for letting us down.
A few weeks into the start of Dan’s second year, we were called to a meeting with the deputy head, shortly after our son had been given a one-day suspension for fighting with another boy. I said that my husband and I were convinced that there were underlying reasons for his behaviour, and the deputy head promised to recommend an educational psychologist who could see Dan.
By now, we were wondering if ADHD could be causing Dan’s problems. I wrote a letter to the deputy head the following day, asking for details of the psychologist. A reply never came. When I tried to follow this up, the head of year suggested Dan should visit the school’s counsellor. We agreed to this, though he had tried this previously at the school’s request but it had not helped. We trusted the school, believed it wanted to help our son, and felt we should co-operate.
From this point, things spiralled quickly downward. Dan’s meetings with the school counsellor had no impact. He had twice been suspended for fighting, which officially meant that he was on his last chance. Over the next few weeks, there were increasingly frequent small incidents: detentions for missed homework and minor complaints about his behaviour. Dan himself withdrew and appeared frightened. We could not get through to him.
Looking back, I feel this large, highly regarded school was surely well equipped to tell the difference between children who maliciously disrupt school life, and those, like Dan, who cannot help themselves. But the school was not prepared to recognise ADHD, even though it qualifies for Special Educational Needs (SEN), which its terms and conditions promise to provide for. Instead, the school let Dan down – badly: a talented, exuberant child on arrival in school, had become an unhappy, failing student.
We were invited to another meeting in early December 2008. “It’s nothing to worry about,” the head of year reassured me over the phone. Two days later, as we sat in his office, the deputy head asked us to remove Dan at the end of term. “If he does one more thing, I will expel him,” he threatened.
We took him out two days later, not daring to leave him there a moment longer. On his last day, he played in a rugby match, scored a try and the team won. It was expulsion, by another name. The boys in his year group launched a “Save Dan” campaign on Facebook; Dan himself kept apologising to us.
As soon as he left, we sought medical help. Within weeks, Dan was formally diagnosed with ADHD by a consultant paediatrician at our local hospital, and examined by a neurologist.
Contrary to recent media opinion, a child does not easily qualify for this diagnosis. Dan’s personal and medical history was meticulously investigated, and detailed questionnaires on all aspects of his behaviour completed by us and three teachers from the school. He ranked high on the scale, with eight out of nine behaviours classic in ADHD. He was assigned a specialist ADHD nurse and prescribed the drug, Ritalin, to help his concentration and control impulsivity. He has also had a course of therapy with a psychologist from our local authority’s Child and Adolescent Mental Health Service.
The school dismissed our appeal against Dan’s removal in January 2009, even though, by that stage, we had a preliminary diagnosis. We tried local state schools for Dan, but the good ones were full. Private specialist schools, mostly for boarders, were too expensive.
For a long time, Dan’s self-esteem was low, his bubbling confidence gone. It was distressing to see a child you love in such despair; by now, he had lost months at school, as well as more than a stone-and-a-half in weight. He looked gaunt and sad: it broke my heart. Finally, in September 2009, Dan obtained a place at a private school, with smaller classes and an SEN department with full-time staff. The school was well aware of his condition.
Nearly two years after being excluded, Dan’s behaviour is not perfect but it has greatly improved. He gets on well with the staff, and has learnt to trust them. His teachers take simple steps to help him, checking his notes taken in class and keeping in touch with us by email. I feel Dan is finally getting the education he deserves.
Many parents choosing a private school are reluctant to burden their child with a diagnosis of ADHD because of the stigma attached, but if the condition is identified and treated early, a child can be helped to achieve his or her potential. In the state sector, ADHD is recognised although getting the right help can be a slow process. Private schools, however, which deny its existence do untold damage to vulnerable youngsters.
All names have been changed
Dressing up to go trick or treating is very exciting for children and it creates lasting memories for both children and parents. Help children prepare for trick or treating with these five strategies.
1. Select a Costume – Help children select a costume that fits properly and is safe. Children may be uncomfortable with anything on their face especially make up. Some children may not like masks because of sensory issues or limited vision. Keep these factors in mind when selecting an outfit. For children who have difficulties with masks, holding a mask rather than wearing it or not using one at all may make the evening more enjoyable.
2. Set Costume Guidelines – Children often want to wear their costume other times than trick or treating. Let them know if/when they can wear it besides trick or treating. Be sure to tell them this before they buy the costume and after it is purchased. Explain why they can wear the costume only at certain times. For example, “You can put it on in the evening for a few minutes to see how you look, but you can only wear it for a little while so it doesn’t get dirty before Halloween.”
3. Practice Going to People’s Doors – Role play going to someone’s door, saying “Trick or treat,” holding a bag out, and saying “Thank you.” Remind children to be polite, wait their turn, and take only one piece of candy when they are asked to
select something. It is tempting to rush to a door and take a handful of things when offered a basket or bowl to select from so multiple opportunities for review are important. Be sure to practice other things that may happen such as someone not
being home or someone complimenting them on their costume.
4. Establish Guidelines in Advance – Prepare children for factors such as: What time trick or treating starts and ends; How they know when it ends; Where they can trick or treat (e.g. only houses with lights on, only people the child knows, only homes in a four street radius, etc.); and What the rules are such as staying with a sibling or parent. Be sure to review these guidelines days in advance with a story, visual cards, or written rules. Before trick or treating, review them again so children clearly understand expectations.
5. Set sweet Guidelines– Children become very excited about getting sweets and other treats while trick or treating. Set rules in advance about eating candy. Let children know before trick or treating that they need to bring all of the sweets back for you to check before they can eat it. Make sure children have dinner before trick or treating so they are not hungry. Have guidelines about the number of pieces they can eat per day and create a schedule for when they can eat their sweets.
Display the sweet plan where they can easily look if they have questions.
Recognizing your own feelings and identifying the feelings of others are foundation skills for developing more involved social skills such as learning to cope with feelings and responding appropriately to the feelings of others.
1. Provide Multiple Examples: Feelings can be difficult to teach because they are expressed in a variety of settings, have many synonyms, and involve understanding subtle clues. In order to teach identification of emotions, provide examples in different settings through stories, pictures, videos, reallife experiences, and role play.
2. Show Feelings are Important: Children need to understand that it is okay to talk about and express feelings. Demonstrate this by asking children how they feel, sharing your feelings, and discussing how you cope with your feelings and respond to the feelings of others.
3. Use Natural Opportunities: When reading, watching movies, or in real-world situations, look for opportunities to discuss feelings. If the child is upset, use this as an opportunity to teach appropriate responses and coping strategies. For example, “Josh, I know you are angry that you have to leave the playground. Take 3 deep breaths to calm your body then join the class in line.” If another child is upset demonstrate how to handle the situation. For example, “Alex is upset. Let’s see if we can help him.”
4. Set Time Aside to Practice: Just as math and reading require practice so do social skills. Take a few minutes during the day to work on social skills. Since children may be overwhelmed by feelings it is important to practice expressing and responding to feelings when they are calm.
Role Play: Below are a few games that include role play of emotions.
• Have children select a feelings word or emotions card and act out the feeling on the card.
• Have children select a feelings word or card and role play when they felt this way.
• Put children in pairs. Have one child pick a feeling and act it out. The other child responds to the first child’s feelings.
Discuss Feelings: Show children pictures or drawings of facial expressions or scenes demonstrating feelings. Ask the following questions:
• How does the character feel?
• How do you know how the character feels? For example, they are smiling/frowning.
• When have you felt this way?
• What would you do if a friend felt this way?
• What do you do when you feel this way?
Use Art and Literacy: The arts provide a different way to think about feelings. They allow children to see the details of specific emotions and experience the look and feel of the emotion through a different medium. Art activities include:
• Have children draw a facial expression or scene showing a feeling.
• Have children write a story about a time they felt a certain way and what they did about it.
• Create a feelings book. On each page have a drawing of a feeling and a short sentence, “I feel sad/happy/scared when….” Keep each child’s book in the literacy center.
• Focus on a feeling by having a book specifically about the feeling that includes when the child feels this way and what coping strategies to use for managing the emotion.
Conversational skills build a foundation for developing friendships, cooperating with other people, and communicating effectively with people in every aspect of life. Although the art of conversation is difficult to address, below are some strategies for teaching basic conversational skills.
1. Model Skills – Children learn from watching other people and then practicing skills. Role play is a fun and extremely effective way to teach skills because it lets children learn from examples. During role play model an appropriate greeting or conversation. Let children see how questions are asked and answered and how people remain on topic. Keep the ‘skits’ short and simple at first to establish the basic skills then expand on them later.
2. Practice Small Steps - Just like any other skill, social skills need to be broken into smaller steps and practiced repeatedly. Role play greetings by teaching the child to say, “Hello” and then expand to, “Hello, how are you?”
3. Multiple Phrases, Settings, and People – Conversational skills should be developed with a variety of people, phrases, and novel settings. To promote generalization of skills, introduce different questions and wording when role playing such as: “Good morning,” “Hello,” and “Hi there!” By doing this, children learn there are various greetings and responses. Since conversations occur throughout the day with
different people, recruit people in the school or community to help the child practice. Ask the crossing guard or librarian to engage the child in a conversation that incorporates the skills being practiced.
4. Remember Body Language – When practicing conversational skills, be sure to include key skills such as personal space (approximately an arm’s length is considered appropriate in the United States), body language, and facial cues. These unspoken aspects of conversation are often extremely difficult for children to grasp and should be included in role play and instruction.
5. Ways to Reduce Repetition – Children frequently learn saying hello or asking someone their name is part of a conversation, so they may repeatedly incorporate these phrases in the same conversation. One way to practice saying something only once is to hold up a finger as a visual cue during role play. For example, if there is a question or phrase that should only be used once, hold up a finger during
conversational practice time. After the child asks the question put your finger down. This is a cue that the child already has asked the question. After the child has used this cue successfully a number of times, practice without the visual cue and then praise them for remembering to ask the question only once.
Another strategy is to have the child keep a hand (preferably the left hand if you are teaching them to shake hands) in their pocket with one finger pointed. After they ask their favorite question, have them stop pointing or stop pointing and remove their hand from their pocket. This allows the child to remind themselves they used this phrase or question and other people are not able to see this personal cue.
6. Praise and Review - Praise children for greeting people, using a phrase once, or ending a conversation appropriately. Often it is best to praise children during role play or after the child is away from other people to avoid embarrassing them. To reinforce the skill, be sure to review what they did correctly. For example, “I like the way you asked Mr. James if he was having a nice day only once.” If a novel situation occurs naturally, role play it later and use it as a learning experience.