- Cognitive/Learning delay and/or disorder
- Physical Disabilities
- Sensory Impairment
- Social, Emotional and Behavioural issues
- The Views of a Child
- Gifted and Talented Children
- Aspergers Syndrome
- Attention Deficit Disorder
- Low Self Esteem
- Emotional Difficulties/Disorders
- School Refusal, School Phobia
- Statutory Assessment
- Access Arrangements
- Learning Difficulties
Cognitive/Learning delay and/or disorder
Cognitive/Learning difficulties may be general or specific. General difficulties impact globally upon development.
Specific difficulties are commonly associated with Literacy (Dyslexia), Numeracy, (Dyscalculia), Motor Coordination/Organisation (Dyspraxia) and Language Difficulties (Dysphasia). It is not uncommon for difficulties to overlap.
Cognitive/Learning Disorders include Attention Deficit Hyperactivity Disorder, Autism and Autistic Spectrum Disorders such as Aspergers Syndrome and Pervasive Developmental Disorder.
Physical disabilities may exist from birth or may be acquired. Physical disabilities include conditions such as Cerebral Palsy, Spina Bifida, Hydrocephalus, Epilepsy and Brain Injury. Assessment of children with a physical disability is often a complex process, very particularly if speech is affected. Assessment generally requires close liaison with medical and health professionals.
Sensory impairments refer to partial or profound deafness, partial or total blindness, or in thankfully a very small minority of cases, both. Ruth has a particular interest in the assessment of children and adolescents who have a hearing impairment and she has undertaken research in this area.
Social, Emotional and Behavioural issues
It is always important to identify whether social, emotional and/or behavioural difficulties are a consequence of a learning difficulty or disorder or because of health and/or environmental and/or parenting factors. Once again assessment is often a complex process and requires skilled and detailed enquiry, collaboration and sensitivity.
Attachment is a complex concept but put briefly, refers to the relationship between a child and his or her primary care giver, usually the mother. A secure attachment serves as a protective factor for a child. Attachment is a vital area of investigation when fostering or adoption may be under consideration. Assessment of attachment also provides information which is crucial to prognosis; a securely attached child will very probably have a more optimistic prognosis than an insecurely attached child.
The Views of a Child
The views of a child form a central part of any assessment. In order to elicit the accurate views of a child, an atmosphere of trust must be generated and this may take time, particularly with an older child. Views can be explored for example through direct and indirect questioning, use of narrative, questionnaires, rating scales and pictures, through role play, sentence completion, specific writing tasks and imaginative play.
Dyslexia is an "unexpected" difficulty in the acquisition of reading, writing and/or spelling, despite appropriate opportunities for learning. A diagnosis of Dyslexia involves taking a detailed developmental history, with a particular focus on speech and language development, a detailed assessment of learning potential, memory and processing speed, together with diagnostic assessment including phonological assessment. Assessment is designed to identify the extent of the problem and to offer recommendations, which ensure that appropriate educational provision is offered.
Dyscalculia is a specific learning disability involving innate difficulty in learning or comprehending arithmetic. It is often linked with dyslexia and includes difficulty in understanding numbers, learning how to manipulate numbers and learning maths facts.
A diagnosis of Dyspraxia involves taking a detailed developmental history together with a full assessment of learning potential and of abilities requiring gross and fine motor coordinator. Assessment is designed to identify the extent of the problem and to offer recommendations, which ensure that appropriate educational provision is offered. Many children with a diagnosis of Dyspraxia also have Dyslexia.
Gifted and Talented Children
The special educational needs of children of unusually high ability are often overlooked and yet their needs are as great as the needs of those children whose ability is significantly lower than that of their peers. These children can often present as socially isolated, frustrated and even depressed. Psychological assessment which provides objective evidence of their learning potential, their individual differences and therefore their learning needs, is very important.
A child with Aspergers Syndrome has less obvious difficulties than a child with autism. It is for this reason that inappropriate behaviours, such as inflexibility and social withdrawal can so often be interpreted as oppositional behaviour, over which the child has control, rather than Aspergers Syndrome, which may require a specialist approach and sometimes specialist provision. Early identification is essential. An understanding of the child's difficulties, together with specialist help, is what is required such that the child is enabled to live a happy and fulfilled life.
Autism is a childhood disorder resulting from difficulties in the areas of language and communication, social awareness and flexibility of thought.
Autism ranges from severe Autism, where a child may have no speech, no desire to communicate, severely challenging behaviour and a very high sensitivity to sensory stimulation, to mild Autism, often referred to as Aspergers Syndrome.
Attention Deficit Disorder
Attention Deficit Disorder often also known as Attention Deficit Hyperactivity Disorder is particularly prevalent in children of Primary School age. There is much that can be done to modify inappropriate and inattentive behaviours through the use of consistent strategies. Children who are inattentive deny themselves opportunities for learning and invariably begin to experience failure, unless difficulties are addressed.
All schools are obliged to have an anti-bullying policy and yet, because bullying thrives on secrecy, much bullying can go unnoticed. Bullies and victims share much in common and both are in need of help. Victims invariably have a profile of vulnerable characteristics, which through appropriate help can be turned into qualities of assertiveness and resilience. Once a child is identified as a victim of bullying, it is wise to seek immediate help.
Low Self Esteem
A child or young person who fails to value him or herself will lack confidence in many or all areas of life. Low self-esteem in childhood can impact negatively upon mental health in adult life if left undressed. Low self-esteem is very often born of irrational beliefs. A Cognitive Behavioural Therapy approach, which challenges irrational beliefs and encourages a child or young person to replace such beliefs with more rational ones, is generally swift and effective.
Emotional disorders refer to a range of problems which are experienced by children and young people over a significant period of time, and which impact on learning, attitudes, behaviour, friendships and self esteem. Emotional difficulties/disorders include depression and anxiety, anorexia nervosa and bulimia nervosa, deliberate self harm, suicidal behaviour, obsessive compulsive behaviour and school phobia. Associated symptoms include reduction or loss of ability to experience pleasure, loss of energy, poor concentration and restlessness, altered appetite, altered weight and sleep pattern, helplessness, hopelessness, low self esteem, poor performance in school and feelings of guilt. Difficulties such as these require a sensitive and focussed approach, which matches the personality of the child or young person. The approaches we use in particular to address such difficulties is Solution Focused Brief Theory.
Anxiety affects how we feel and behave, and can manifest itself as 'real' physical symptoms. Mild anxiety is vague and unsettling, while severe anxiety can be extremely debilitating, having a serious impact on a young person's daily life.
It is normal to worry before confronting something challenging such as a test or exam. Anxiety needs treatment when the reaction is out of proportion with what might be normally expected in a situation and/or the symptoms interfere with a young person's ability to sleep or function.
Anger is closely linked with depression, both are barriers to social and academic learning. We offer therapeutic help to address the causes of anger and recommend practical strategies with which to manage anger.
School Refusal, School Phobia
Children who are unable to attend school generally fall into one of two categories; they either have a fear of leaving home, or a fear of going to school. Early intervention is crucial in order that the cause is identified and appropriately addressed. Pupils who refuse to go to school or are phobic about attending school are generally highly anxious children who require a sensitive and multi-pronged approach combining desensitisation and therapeutic help, alongside work with the family and school. In general, the longer a child is away from school the greater will be the task of effecting a return to school.
Pupils identified with needs over and above those normally and reasonably met within a mainstream school may qualify for a Education, Health and Care Plan (EHCP). If so, Multi-disciplinary Statutory Assessment of a pupil's needs must be undertaken by the Local Authority. Advice from all professionals involved with the child must then be submitted to the Panel for consideration. We can give Independent Advice about the appropriateness of such an assessment as well as writing Independent Psychological Advice, which must be considered by the Local Authority.
Access Arrangements, previously known as Special Examination Arrangements can be put in place for pupils entered for public examinations, but who have specific difficulties, which it is considered, need acknowledgment. Pupils diagnosed by a suitably qualified professional, as having a specific difficulty will qualify for appropriate Access Arrangements. We write reports both for Access Arrangements for GCSE's and A levels as well as for Universities and Colleges. The following list is a small selection from the many Access Arrangements that are available. Additional time, a reader, a scribe, use of a word processor, taking the examination in a separate room.
Where a child or young person is experiencing a difficulty with learning, it is important to assess whether the difficulty is general, sometimes referred to as global and means that all learning is affected; or specific, which means that only one aspect of learning is affected. It is also important to measure the extent of the difficulty. An assessment of learning potential can identify with accuracy where a problem lies and its severity, and will look at factors such as verbal ability, reasoning skills, visual, auditory and spatial memories and practical problem solving ability, as well as working memory and speed of information processing. Following an assessment of learning potential, appropriate recommendations would be offered.