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Catching the Children Who Fall Through The Cracks
The child who learns "differently " is one who processes information and life experiences in a unique way, and one who often also deals with confusion, distortion, uncertainty, or emotional turmoil. Many are challenged with varying abilities to regulate themselves, to soothe and comfort themselves, to remain calm in the face of what educational environments require of them.
The calls to the intake line at Children's Institute come in everyday. They are often hesitant, but always determined. The caller is usually a parent, often a school district or other referring professional, and occasionally a student himself. Each contact is a search for school placement. Each represents a child with a puzzling or complicated history, a mix of learning and emotional challenges, and a broad range of reasons why everything tried to date has had uneven results or been somehow unsuccessful. Some of the stories are about great, even heroic efforts that seem to have been made in just the right order by people with the best of intentions. Others are laden with details of frustration, despair, and disappointment. Some are loaded with clinically correct labels, while others reveal that the parent is not at all sure what to ask. They just know that school isn't going well for their child and they want to do something about it. They want support, understanding, hope, and a fresh start.
When the family comes to visit, so much is revealed in the child's reaction to a new place. Many are wide-eyed and worried. Others are impatient, edgy, and ready to leave after 15 minutes. Some want to explore everything and everyone. There may be questions about computers, the library, field trips, or sports. Some youngsters are clingy, quiet, and fearful. Older children can appear bored, disinterested, and unapproachable, or eager to change schools right away. These are the children of CHILD/Children's Institute for Learning Differences, a private, therapeutic day school in Mercer Island, Washington. Established in 1977, CHILD has a successful history of creating empowering learning environments carefully matched to the needs of anxious, distractible, untrusting, and/or disorganized children, ages 3-15. Full day school and hourly therapeutic services are provided through contracted partnership agreements with 18 surrounding school districts. Parents may also register their children as private school students.
Some come with multiple diagnoses, multiple medications, and multiple agencies or practitioners attached. Others come with no more than a concerned parent, determined to undo a year or more of being misunderstood by a teacher. Both inclusion and self-contained classrooms may have been tried. Home schooling may have been the answer for a while, so that a child's stress about learning or socialization could be lessened. There could have been lots of therapy, or almost none. There may have been a series of requests to leave daycares or small private schools. Each parent and child comes in the door with personal radar, powerfully scanning for indicators of potential discomfort or lack of a match. Each has some kind of protective armor. Each is vulnerable. CHILD is there to embrace them.
Repeatedly, there are indicators of immature or uneven neurological development that interrupts or sabotages the child's cognitive potential. Many of the children have previously "qualified" for special education services because they meet the criteria for classification as Learning Disabled, Health Impaired, Behavior Disordered, Autism Spectrum, or Communication Disordered. But how do you create the possibility of success while mixing such a diverse population? How do you create a trusting relationship with parents and students who have tasted being excluded or judged? How do you determine how much help is needed without creating dependency on an adult? How do you keep children cognitively engaged while cleaning up the debris of disorganized thinking and impulsive behaviors?
At CHILD, the staff aligns behind establishing three beliefs in the child: "I am safe," "I am acceptable," and "I can learn." Safe means physically and emotionally safe from blaming, bullying, and one's own impulses. Acceptable means that I am fine just as I am. I don't have to be more or less of something to be valued, honored, included. Confidence in learning capacity comes from taking supported risks, accumulating believable evidence of progress, and celebration of every step toward mastery.
A basic assumption is that there is more to be discovered. Teachers and specialists are taught to look beyond the diagnosis, beyond the existing learning assessment, beyond the current behavior plan. They are coached into becoming vigilant detectives. Detailed parent reporting is invited so staff can learn and borrow from the 24 hour expertise of families that live with and accommodate for the full range of a child's struggle, his aspirations, his moments of misery, his celebrations. The multidisciplinary team places immediate focus on ruling in or ruling out the possibility of a regulatory disorder of some kind. Could it be that difficulties in self-regulation accompany another, more obvious condition or hypothesis? Do such difficulties come in subtle camouflage, causing them to be overlooked? Does this more completely explain the child's difficulty understanding causal relationships, his inability to delay gratification, or his intolerance for transitions?
The search is for evidence of commonly connected characteristics: sleep disturbances, attention problems, early feeding problems, sensory processing problems, and/or social interaction problems. It is noted whether the child becomes overwhelmed by sensory stimuli, and whether he reacts fearfully and cautiously, or negatively and defiantly. Under-response is noted in the withdrawn or self-absorbed child. Motor disorganization can be a significant clue, often seen as a planning and implementation problem, or the inability to demonstrate in motor behavior what is understood cognitively.
Any of these conditions can be operating, regardless of the child's reported level of intelligence. They can cause testing to underestimate current functioning levels or potential. Most certainly, they interfere with children trying to do what other children do: go to school, make friends, gain resilience and independence, have full access to educational options and opportunities.
The boy who pushed people away
Jeff arrived at age 11. He was perfectly satisfied to read most of the day, wishing only to remain uninterrupted. He could write well about what he read and about the discussions he experienced peripherally in class, always appearing not to be listening. His was an isolated existence that gave him little opportunity to interact with others or learn from those interactions. People around him quickly learned to avoid irritating him or run the risk of his verbal tantrums and physical outbursts. He seemed to delight in making others uncomfortable by name-calling and heaping his critical opinions upon them. His yelling, disdain, and surly manner were easily set off in moments of even slight frustration.
No reminders or cues would stop him. No amount of talking about it seemed to help Jeff develop empathy for anyone else. He didn't "get the picture;" so drawing cartoon sequences of what happened between him and other people was provided. He responded to the visual version of what had been explained so many times in words.
Gradually he could tolerate being videotaped, as long as no one saw it but him. Eventually, enough trust with the counselor allowed mutual viewing and more cartoon sequences. Jeff learned to apply the "match-mismatch" test to his own behaviors. What did you want to achieve? What did you get? Did they match or not? He began to analyze and problem solve and predict outcomes more and more realistically.
The edgy, brittle nature of this boy began to dissolve when it was discovered that he and his dad had an edgy, criticism-laden relationship. The father was invited to volunteer for weekend construction projects at school, which gave him and Jeff a chance to work together. A trained staff person was present who could model positive communication and act as a relationship coach. Both Jeff and his dad slowly learned to converse without negative comments. When neither dished it out, neither became as defensive. Jeff gradually stopped dumping on his classmates. He went on to his home high school where he now has his own friends and willingly applies his academic skills in all classes.
The girl who hid under the desk
Teresa started mid-year, after a screaming incident in her previous school where the teacher tried to pull her out from under a table amid much kicking and scratching. She didn't want to come into a classroom until she discovered a small back room with a desk in it. If she didn't have to be with the class, could remain under the desk and turn out most of the lights, she could tolerate coming to school. She looked disheveled, depressed, and untrusting, coming out only for bathroom breaks or some drawing materials.
In counseling sessions she revealed volatile interactions with her mother and sister. Teresa didn't want anyone to know how nervous she felt or how out of control it could make her feel. She called it a "flood of super strong feelings" and said she was afraid it would happen at school. Sometimes it did, causing much embarrassment and more hiding. Other students were encouraged to share times when they felt the same way. She started to connect with her pre-teen peers.
Teresa naturally utilized metaphors from literature to explain her feelings and reactions. She also revealed a gift for architectural drawing. It provided access to her creativity and gave teachers a way to use charts, graphs, and flow charts to her advantage. After four months in the back room, with the door ajar enough to hear all classroom conversations, she appeared one day and joined the class.
The next two years saw her join, leave, and rejoin the class many times. She developed new ways to escape, without leaving her desk. Some days she disappeared into the hood of her sweatshirt, other days she would curl up on floor cushions. She always appeared to be dozing, asleep, or daydreaming. Given oral exams, she revealed that she had missed only a few of the critical concepts covered in class. Earning points as daily feedback left Teresa nervous and fearful. She remembered being humiliated in a class where the teacher posted points as motivation. They only reminded Teresa of what she could not do. Instead, time, patience, and gentle confrontation were the most effective interventions. Teresa pointed out that she "never" would have joined anyone if we had "made her" come out or if she had lost points or privileges.
She needed assignments broken down into small segments in order to imagine herself completing them. She needed teacher support to write out her ideas, not because of fine motor fatigue, but because of fear that she would never write it the way she thought it. She learned to use "post it" notes to construct her ideas until they "looked" right. Each new assignment began with reference to a previous one that contained similar or identical elements. Gradually, she built a repertoire of successful performance strategies. Two years ago Teresa transferred back to her home school. She wanted to attend the same school her sister had because there was a "really good art teacher" there. She has immersed herself in computer graphics and attends school every day.
The boy who just had to sit upside down
Jerry was a seven-year-old wiggler. He could barely stay in one position for 3 minutes. He created multiple ways to sit without ever facing the front of the classroom. Walking in line meant bolting ahead of everyone else. If anyone in the room talked, Jerry talked too. When the other person stopped, Jerry did not. Once he got onto a subject, he could not get off of it until some novel interruption occurred. Even though the daily schedule and all transitions were clearly posted and discussed, Jerry could not seem to apply the structure of the day to himself. He spent the bulk of his time being a distracting disrupter of others, not noticing their growing intolerance.
Jerry quickly labeled teachers who intervened as "mean", "cruel", and "abusive". In class his voice and activity were poorly modulated, the assignments he started would grind to a halt midstream, and his tendency to grab for whatever interested him generated many heated arguments with peers. Jerry clearly needed help finding some 'brakes" for this overflow of output and a way to corral his thought patterns.
Work began with a sensory menu from the occupational therapist. Jerry was given small toys that he could hold, twist, and squeeze while sitting at his desk. A textured cushion was attached to the chair seat so Jerry could get lots of feedback where he was in space without having to go through constant contortions. A weighted blanket was provided for the times he wanted to roll up in a quiet place. And since Jerry seemed to be triggered by talk, staff learned to talk less to Jerry. Reference to the schedule was done by pointing, rather than explaining. Gestures for "ready", "stop", and "new directions" were incorporated into the classroom cueing system. If Jerry became agitated, he was escorted to his quiet place and given time to de-escalate without any discussion of what happened or should have happened.
Jerry was able to spend more time holding the class pet, a rat named "Digger," which was particularly calming for him. Jerry is preparing for transition back to his home school next semester. All the accommodations and supports that work for him can be transferred to the new environment. Jerry now earns taking Digger home for holidays and vacations. Maybe they will graduate together.
The girl who touched too much
Anna arrived with arms crossed, lower lip protruding in a furious pout, and remained hidden behind her mother for the entire first interview. She had been in an excellent early intervention program in her elementary years, but had aged out. A medication change had caused a sudden weight gain, even though it had effectively addressed some ups and downs of agitation and aggression. "You'd better be nice to me!" Anna announced during her first few minutes in class. Within seconds she had head butted the teacher in the chest, lunged across the room to pull a student's hair, then ran from the room. This turned out to be Anna's version of first day jitters, her way of saying, "I feel new and I don't know what to do here".
Without extra clear structure and boundaries, Anna's anxiety took over. Even though Anna could read, a picture/word schedule was put into use to assure her understanding of when each transition would take place. Each assignment was introduced with a review of what Anna already knew about it. Not only did Anna have trouble with anxiety about what was coming next, she also had worries about who would come close to her. Anyone coming close to her desk was pushed away. A taped boundary was put on the floor around her desk and classmates were taught not to cross the tape without Anna's permission. Then she learned to honor the space around the desks of others as well.
She had a high need to track the mistakes made by teachers and each of her classmates, announcing them loudly whenever they occurred. Anna learned to make a book of her observations, rather than blurt them out. When things went wrong for Anna, she would put her hands over her ears and make loud noises to avoid hearing any bad news about herself. She could not tolerate circles around mistakes, red ink, percentages or grades on her work, or a daily report sheet going home to her parents. Teachers created a different kind of daily report called "Anna's Good News". Nothing went on it unless it was an achievement in positive terms, i.e. "I finished my math with three minutes to go", "I went to cooking even though it felt like an interruption", or "Jimmy and I figured out how to agree about lunch". Her tolerance for reporting increased dramatically.
Last was Anna's tendency to offer effusive hugs or repeated stroking on the face, hand, or arm of anyone she thought needed her support. She seemed to have an uncanny ability to read the sadness, upset, or hurt feelings of another person. Her empathy could easily become an imposition or go on far too long. Knowing when to stop was what Anna could not discern. Staff and students learned to be direct with her. "It's time to stop stroking now. I'm feeling better. Thank you for caring about me."
In time Anna became desensitized to her fears of being evaluated. Receiving assignments did not cause panic, and she learned to attend differently to social signals from others. Her mother wisely enrolled Anna in a teen girls group at their church. They became the practice ground Anna needed to generalize her newfound skills and bridge to a special needs classroom in public school. That was three years ago. Anna calls several times a year just to let us know how well she is doing and to share the latest news of other alumni students. She's still keeping track of other people's lives, now as their friend.
How Does Focus on Self-Regulation Help Children Succeed?
The child who increases his capacity to self-regulate becomes easier to parent, more accessible to instruction, and more available for meaningful relationships. Children's Institute for Learning Differences dedicates itself to this task, knowing that developing a capacity for self-regulation is the underpinning for social acceptance, independent functioning, and inclusion.
Resources
Galanos, Carol. Words That Work, Language Cueing for Teachers, . Reprints are available through CHILD at www.childrensinstitute.com .
Greene, Ross W. ( 2001) The Explosive Child: a New Approach for Understanding and Parenting Easily Frustrated, "Chronically Inflexible" Children. NY: Harper Collins.
Kovalik, Susan and Karen D. Olsen. (2001) Exceeding Expectations: A User's Guide to Implementing Brain Research in the Classroom. Covington, WA: Books for Educators, Inc.
Levine, Melvin D. (1992) All Kinds of Minds. Cambridge, MA: Educators Pub Service.
Nowicki, Jr., Stephen and Marshall P. Duke. (1992) Helping the Child Who Doesn't Fit In. Atlanta: Peachtree Publishers.
Osman, Betty S. with Henriette Blinder. (1996) No One To Play With: Revised, Social Problems of LD and ADD Children, Novato, CA: Academic Therapy Publications.
Simons, Laurie. Coping With Challenging Behaviors, Foundations for Classroom Success Reprints are available through CHILD at www.childrensinstitute.com.
Trott, Maryann Colby. (1993) SenseAbilities: Understanding Sensory Integration. San Antonio, TX: Communication Skill Builders.
Trina Westerlund, MA Special Education, is the founder and Executive Director of Children's Institute for Learning Differences/CHILD, located in Mercer Island, WA. Her 43-year career of immersion in special education issues includes serving as an Intervention Specialist at the Seattle Crisis Clinic, Head Teacher at Ryther Child Center in Seattle, WA. Teacher/Therapist at League School for Seriously Disturbed Children in Brooklyn, N.Y., Special Education teacher in three New York City specialty schools: The Reece School, Manhattan School for Autistic Children, and Floyd Patterson House School. She was the In-service Trainer at Instituto Para Ninos Excepcionales and Head of Assessment Services at Colegio Leon Pinelo, both in Lima, Peru. As a private advocate, therapeutic tutor, and referral specialist, Trina joined the local and State Board of Directors of Learning Disability Association (LDA) of Washington, then served five years on the National Board of Directors of LDA. A popular trainer, she specializes in empowering parents of special needs children and in generating sensitive accommodations and strategies among Montessori interns, teachers new to Special Education, and paraprofessionals.
Trina Westerlund can be reached at trina@childrensinstitute.com, by FAX at (206) 232-9377, or by phone at (206) 232-8680. Additional information about Children's Institute for Learning Differences/CHILD can be found at www.childrensinstitute.com
© December 2003 New Horizons for Learning
This information is provided by:
Office of State Superintendent of Public Instruction
Special Education
P O Box 47200
Olympia, WA 98504-7200
(360) 725-6088
Fax (360)586-1631
E-mail: dgill@ospi.wednet.edu
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