Multisensory teaching for dyscalculia and maths difficulties

Multisensory teaching for dyscalculia and maths difficulties

Multisensory teaching can help children who have difficulty with maths and/or dyscalculia. Using all of the senses when learning what numbers and symbols represent can help children to remember and use this new information. Read on for different methods to try. Click here to read more about multisensory techniques to support reading and spelling.

Building with cubes and tiles

Cubes and tiles give children a solid, visual idea of the figures they are working with. You can also use these to teach operations such as stacking cubes in groups according to a pattern, for example, 3, 6, 9, 12 - the child can then continue building. When the patterns is complete, you can use the visual of the cubes to discuss the connections between the stacks and the numbers they represent.

Using manipulatives to understand maths operations

Using simple dried pantry items like cereal or dried beans, the child can complete maths operations using these as objects which they can manipulate. For example, they could add two sets of beans together to solve an addition question, or find out how much is left after taking away some beans. Grouping the objects together can also give helpful visuals when completing multiplication and division. Physically manipulating objects can help children develop number sense and understand amounts.

Drawing to support maths

The next step, after using physical objects, would be to encourage the child to draw maths equations - this again gives them a visual of what they are doing, and is moving in the direction of using numbers and symbols to write down equations. For example, a child could solve the problem 2x4 by drawing two lots of four stars. Children can also colour in squares on squared paper and then visualise and count these up at the end.

Tapping and using poppits for numbers

Tapping out or pushing down poppit bubbles for numbers can help children connect symbols to actual amounts, and “feel” the value. This is especially useful for working with multiples. For example, if a child had to list multiples of 4, they would begin by tapping sets of 4, counting as they go. Every fourth number gets a louder tap and is written down (“1, 2, 3, 4! 5, 6, 7, 8! 9, 10, 11, 12!”). On completion, the child will have a list which they can use to answer multiplication and division problems.

Using music to support maths

There are many ways to connect math and music. Children can use songs to help memorise math rules and there are many songs already created like this on youtube. Playing musical notes can help children to learn grouping or fractional parts. You can play one note on a keyboard and hold it for a count of four. This is the “whole note.” Next, you can ask, “How many quarter notes make a whole note?” This discussion can then be linked to the writing down of fractions.

Movement to support maths

Using movement is both engaging and can help children retain what they have learnt. A child could demonstrate angles by rotating their body while standing in a hula-hoop. A nice game is to write numbers on the outside of a large ball (these could be whole numbers, fractions, or decimals.) Pass the ball around and each time someone catches it, they have to complete a maths operation with the two numbers their hands land on.

Bundling sticks for place value and regrouping

One way to introduce kids to regrouping and place value is to have them bundle lollipop sticks together in groups of 10. For example, the child could be asked to solve 45 – 9 using sticks. By collecting 4 bundles of ten and 5 single (or “ones”) sticks, they can see how each place in the number 45 holds value. Then, to subtract 9, they need to break apart one of the bundles to make 15 individual sticks. After taking 9 out, this leaves 3 bundles and 6 sticks remaining, or 36.

Building with base 10 blocks

These blocks come in different sizes that represent 1000s (a “cube”), 100s (a “flat”), 10s (a “long”), and 1s (a “unit”). Children can form numbers with them to identify place value. They can also use them to perform operations, show regrouping, and find patterns. For example, the child could be asked to “build” the number 265 using the blocks. Kids need to select two 100-blocks, six 10-blocks, and five 1-blocks. Then ask, “Which digit has the greatest value: 2, 6 or 5?

Creating a hundreds chart

A hundreds chart can help children who struggle to see number relationships. A child can be given a black-and-white 100s grid. (A grid is a large square broken into 100 smaller square units). The child can be asked to shade in 1/4 of the whole grid, and then be asked to find the number of square units they coloured in . The connection is that 1/4 is the same as 25 out of 100, or 25 percent.

Pizza slices for fractions

Cutting a pizza into slices is a useful way to help teach fractions. You can make several pizzas out of paper, then cut them into slices of different sizes. This way, children can “see” fractions like 1/8 or 1/4 by selecting slices of pizza. Using different colours for different size slices lets kids match equivalent fractions like 2/8 and 1/4. Kids can also combine slices to make a “whole” pizza.

FIND AN ASSESSOR

Speech Assessment

An assessment of speech is designed to give an idea of any diagnoses that may be indicated, such as phonological delay, dysarthria or apraxia-of-speech. A speech and language therapist would first need to make sure a child can process the sounds that they are hearing, as if a child cannot ‘hear’ a sound, they are unlikely to be able to produce it. Detailed analysis of articulation and and any phonological processes would be conducted. The following gives an indication of some measures that may be used during the assessment:

  • Initial discussion and taking of background information

  • Taking of developmental history

  • An articulation assessment for evaluating consonants and vowels in words,

  • Assessment of the stimulability of error phonemes both in isolation and in syllable contexts

  • Assessment of phonology for determining error patterns and similarities in phoneme production across single words and connected speech contexts

  • Assessment of word inconsistency for examining the variability of a child’s phonological error patterns

  • An Oral Motor Screen for identifying oral motor difficulties that may require further in-depth assessment

  • An analysis of syllable structures and how these may impact on phoneme production

Language Assessment

A language assessment will include an in-depth analysis of both receptive and expressive language. The following gives an indication of some measures that may be used during the assessment using both formal and informal assessment tools :

  • Initial discussion and taking of background information

  • Taking of developmental history

  • Assessment of ability to understand relevant concepts and follow directions

  • Assessment of word classes and vocabulary knowledge

  • Assessment of sentence structure

  • Assessment of word structure

  • Ability to recall and formulate sentences will be assessed

  • Exploring how language is used in conversation

  • Identifying how a child can build a narrative/story and how they can sequence events

  • Looking at use of and understanding of questions

  • Identifying things which already help and things which don’t

Adult DCD Dyspraxia Assessment for DSA

UK DCD descriptor (2018)

Developmental Coordination Disorder (DCD), also known as Dyspraxia in the UK, is a medical disorder affecting movement and coordination in children, young people and adults with serious symptoms present since childhood. DCD is distinct from other motor disorders such as cerebral palsy and stroke and occurs across the range of intellectual abilities. This lifelong condition is recognised by international organisations including the World Health Organisation. A person’s coordination difficulties affect their functioning of everyday skills and participation in education, work, and leisure activities. Difficulties may vary in their presentation and these may also change over time depending on environmental demands, life experience, and the support given. There may be difficulties learning new skills. The movement and coordination difficulties often persist in adulthood, although non-motor difficulties may become more prominent as expectations and demands change over time. A range of co-occurring difficulties can have a substantial adverse impact on life including mental and physical health, and difficulties with time management, planning, personal organisation, and social skills. With appropriate recognition, reasonable adjustments, support, and strategies in place people with DCD can be very successful in their lives.

The professional making the DSA assessment cannot make a diagnosis of DCD Dyspraxia but can review evidence and agree that referral to an occupational therapist may be useful. it is highly unlikely that professionals such as preschool staff, trained infant teachers and PE teachers will not have noted movement and coordination difficulties in the early and later years and this information will have been recorded in school and nursery reports. it is also highly unlikely that parents haven’t noted poor movement and coordination and discussed with the family GP. Consequently there will be a paper trail.

If a student has serious concerns about movement and coordination which have persisted since childhood then then prior to the assessment:

  1. Read the description of DCD Dyspraxia above carefully and discuss with parents or other relatives.

  2. Watch these videos:
    https://youtu.be/ncnVYonMA5Y
    https://youtu.be/DKY3EAiLi3g

  3. Gather records from the GP and old school reports and any other hard copy evidence of a history of significant and serious difficulties with movement and coordination.

  4. Print and complete The Adult DCD Checklist:

    https://www.patoss-dyslexia.org/write/MediaUploads/Resources/ADC_checklist.pdf

  5. Bring your evidence to your assessment, the assessor will be able to score The Adult DCD Checklist and discuss.

International Students and Extra Time in Exams

We are often asked by international students if they can receive access arrangements in university examinations. The short answer is yes, reasonable adjustments must be applied by law (2010 Equality Act) to everyone in the UK. The best way to establish if you are entitled to Access arrangements under the Act is to opt for an assessment with a suitably qualified professional. If you are studying in a university this will be an APC registered specialist assessor or an educational psychologist. The assessment Dyslexia South offers is known as a student or DSA Assessment, the reason being that there is a substantial grant given to UK residents who have educational needs as identified by a suitably qualified professional, known as the DSA. Access arrangements can take many forms but would usually include:

  • Extra time in examinations, usually 25%

  • The use of a PC in examinations

  • Assistance with reading examination questions

  • Extensions to coursework deadlines

The DSA assessment is a highly regulated assessment and is the standard assessment report required by universities across the UK, regardless of the status of the students, UK nationals or international students, regardless if the student applies for DSA or not. The simple way to think of it is that the DSA is the assessment you need if you are a university student in the UK, regardless of your funding status.

Please contact Dyslexia South to book a student/DSA assessment.

Handwriting is painful in university examinations.

We are often asked by university students if they can use a computer in examinations. This is an example of they type of email enquiry we receive:

Dear Dana,
I am a student currently in university, and am finding writing increasingly difficult. My writing grip has always been very tight, and I write with a lot of force. I’m finding it increasingly painful to write, as my grip is so tight my hand gets sore quite quickly and this causes my handwriting speed to become very slow. I would like to use typing in my university examinations, can you help me?

Reply

Dear Student,
I am very happy to make this assessment and you are correct providing you have evidence from a suitably qualified professional then you are entitled to reasonable adjustments in examinations, in this case it is likely that the use of typing would solve the problem, but an array of adjustments are possible.  

Our student/DSA assessment would be the most suitable for you. Please let me know if you would like to book and we can arrange a date.

To book a student/DSA assessment, please see:
 

Can a 7 year old be assessed for dyslexia

This is a question that we are often asked. For instance:

Dear Specialist Assessor,
We are interested in a dyslexia assessment with you for our daughter who is 7 years old. We suspect she may have dyslexia. We have been told by her SENCo to wait until she is 8 however she fits the description of dyslexia and we don’t want to wait.

My reply:


Dear Parents,

The reason dyslexia is generally identified from 8 years old, is that there is some evidence that some children are not ready to learn to read until they are 7 years old. If that is the case, then at 8 years old we can be confident that most children have been learning to read when they are certainly ready to do so, both in and out of school, for at least a year by the time they are 8 years old.

In some cases, a 7 year old child has had much specialist literacy intervention using multisensory methods (for example they have been seeing a specialist literacy tutor outside of school). Their difficulties taking on new literacy learning are clear, and the literacy tutor notes that the child’s literacy difficulties are resistant to intervention. If this is the case, and the child has had at least 6 months of weekly specialist intervention on top of schooling and support at home, then if their profile fits with a diagnosis of dyslexia on assessment, this can be diagnosed from 7 years old. However, it is more often the case that the child has not yet accessed specialist support; if this is the case, then at 7 years old the recommendation would be to do so for a period of time before assessment. Then, when the child is 8, they can come for assessment with good evidence that they have done extra work to try to improve their literacy skills, and despite this, they are still struggling.

A specialist tutor can be found on the PATOSS and BDA websites; they contain a directory and you can search based on your location.

Managing ADD/ADHD in the classroom

Teachers know what many professionals do not: that there is no one syndrome of ADD (Attention Deficit Disorder) but many; that ADD rarely occurs in "pure" form by itself, but rather it usually shows up entangled with several other problems such as learning disabilities or mood problems; that the face of ADD changes with the weather, inconstant and unpredictable; and that the treatment for ADD, despite what may be serenely elucidated in various texts, remains a task of hard work and devotion. There is no easy solution for the management of ADD in the classroom, or at home for that matter. after all is said and done, the effectiveness of any treatment for this disorder at school depends upon the knowledge and persistence of the school and the individual teacher.

Here are a few tips on the school management of the child with ADD. The following suggestions are intended for teachers in the classroom, teachers of children of all ages. Some suggestions will be obviously more appropriate for younger children, others for older, but the unifying themes of structure, education, and encouragement pertain to all.

First of all, make sure what you are dealing with really is ADD. It is definitely not up to the teacher to diagnose ADD, but you can and should raise questions. Specifically, make sure someone has tested the child's hearing and vision recently, and make sure other medical problems have been ruled out. Make sure an adequate evaluation has been done. Keep questioning the SENCo until you are convinced.

Second, build your support. Being a teacher in a classroom where there are two or three kids with ADD can be extremely tiring. Make sure you have the support of the school and the parents. Make sure there is a knowledgeable person with whom you can consult when you have a problem (learning specialist, child psychiatrist, social worker, educational psychologist, pediatrician - the person's degree doesn't really matter. What matters is that he or she knows lots about ADD, has seen lots of kids with ADD, knows their or her way around a classroom, and can speak plainly.) Make sure the parents are working with you. Make sure your colleagues can help you out.

Third, know your limits. Don't be afraid to ask for help. You, as a teacher, cannot be expected to be an expert on ADD. You should feel comfortable in asking for help when you feel you need it.

ASK THE CHILD WHAT WILL HELP. Children can often tell you how they can learn best if you ask them. They are often too embarrassed to volunteer the information because it can be rather eccentric. But try to sit down with the child individually and ask how he or she learns best. By far the best "expert" on the how the child learns best is the child himself or herself. It is amazing how often their opinions are ignored or not asked for. In addition, especially with older kids, make sure the child understands what ADD is. This will help both of you a lot.

Having taken the aboveinto account, try the following:

Remember that ADD kids need structure. They need their environment to structure externally what they can't structure internally on their own. Make lists. Children with ADD benefit greatly from having a table or list to refer back to when they get lost in what they're doing. They need reminders. They need previews. They need repetition. They need direction. They need limits. They need structure.

REMEMBER THE EMOTIONAL PART OF LEARNING. These children need special help in finding enjoyment in the classroom, mastery instead of failure and frustration, excitement instead of boredom or fear. It is essential to pay attention to the emotions involved in the learning process.

Post rules. Have them written down and in full view. The children will be reassured by knowing what is expected of them.

Repeat directions. Write down directions. Speak directions. Repeat directions. People with ADD need to hear things more than once.

Make frequent eye contact. You can "bring back" an ADD child with eye contact. Do it often. A glance can retrieve a child from a daydream or give permission to ask a question or just give silent reassurance.

Seat the ADD child near your desk or wherever you are most of the time. This helps stave off the drifting away that so bedevils these children.

Set limits, boundaries. This is containing and soothing, not punitive. Do it consistently, predictably, promptly, and plainly. DON'T get into complicated, lawyer-like discussions of fairness. These long discussions are just a diversion. Take charge.

Have as predictable a schedule as possible. Post it on the blackboard or the child's desk. Refer to it often. If you are going to vary it, as most interesting teachers do, give lots of warning and preparation. Transitions and unannounced changes are very difficult for these children. They become discombobulated around them. Take special care to prepare for transitions will in advance. Announce what is going to happen, then give repeat warnings as the time approaches.

Try to help the kids make their own schedules for after school in an effort to avoid one of the hallmarks of ADD: procrastination.

Eliminate or reduce frequency of timed tests. There is no great educational value to timed tests, and they definitely do not allow many children with ADD to show what they know.

Allow for escape valve outlets such as leaving class for a moment. If this can be built into the rules of the classroom, it will allow the child to leave the room rather than "lose it," and in so doing begin to learn important tools of self-observation and self-modulation.

Go for quality rather than quantity of homework. Children with ADD often need a reduced load. As long as they are learning the concepts, they should be allowed this. They will put in the same amount of study time, just not bet buried under more than they can handle.

Monitor progress often. Children with ADD benefit greatly from frequent feedback, it helps keep them on track, lets them know what is expected of them and if they are meeting their goals, and can be very encouraging

Break down large tasks into small tasks. This is one of the most crucial of all teaching techniques for children with ADD. Large tasks quickly overwhelm the child and he recoils with an emotional "I'll-NEVER-be-able-to-do-THAT" kind of response. By breaking the task down into manageable parts, each component looking small enough to be do-able, the child can sidestep the emotion of being overwhelmed. In general, these kids can do a lot more than they think they can. By breaking tasks down, the teacher can let the child prove this to himself or herself. With small children this can be extremely helpful in avoiding tantrums born of anticipatory frustration. And with older children it can help them avoid the defeatist attitude that so often gets in their way. And it helps in many other ways, too. You should do it all the time.

Let yourself be playful, have fun, be unconventional, be flamboyant. Introduce novelty into the day. People with ADD love novelty. They respond to it with enthusiasm. It helps keep attention - the kids' attention and yours as well. These children are full of life - they love to play. And above all they hate being bored. So much of their "treatment" involves boring stuff like structure, schedules, lists, and rules, you want to show them that those things do not have to go hand in hand with being a boring person, a boring teacher, or running a boring classroom. Every once in a while, if you can let yourself be a little bit silly, that will help a lot.

Still gain, watch out for overstimulation. Like a pot on the fire, ADD can boil over. You need to be able to reduce the heat in a hurry. The best way of dealing with chaos in the classroom is to prevent it in the first place.

Seek out and underscore success as much as possible. These kids live with so much failure, they need all the positive handling they can get. This point cannot be overemphasized: these children need and benefit from praise. They love encouragement. They drink it up and grow from it. And without it, they shrink and wither. Often the most devastating aspect of ADD is not the ADD itself, but the secondary damage done to self-esteem. So water these children well with encouragement and praise.

Memory is often a problem with these kids. Teach them little tricks like mnemonics, flashcards, etc. They often have problems with what Mel Levine calls "active working memory", the space available on your minds table, so to speak. Any little tricks you can devise - cues, rhymes, codes and the like- can help a great deal to enhance memory.

Use outlines. Teach outlining. Teach underlining. These techniques do not come easily to children with ADD, but once they learn the techniques it can help a great deal in that they structure and shape what is being learned as it is being learned. This helps give the child a sense of mastery DURING THE LEARNING PROCESS, when he or she needs it most, rather than the dim sense of futility that is so often the defining emotion of these kids' learning process.

Announce what you are going to say before you say it. Say it. Then say what you have said. Since many ADD children learn better visually than by voice, if you can write what you're going to say as well as say it, that can be most helpful. This kind of structuring glues the ideas in place.

Simplify instructions. Simplify choices. Simplify scheduling. The simpler the verbiage the more likely it will be comprehended. And use colourful language. Like colour coding, colourful language keeps attention.

Use feedback that helps the child become self-observant. Children with ADD tend to be poor self-observers. They often have no idea how they come across or how they have been behaving. Try to give them this information in a constructive way. Ask questions like, "Do you know what you just did?" or "How do you think you might have said that differently?" or "Why do you think that other girl looked sad when you said what you said?" Ask questions that promote self-observation.

Make expectations explicit.

A point system is a possibility as part of behavioural modification or reward system for younger children. Children with ADD respond well to rewards and incentives. Many are little entrepreneurs.

If the child seems has trouble reading social cues - body language, tone of voice, timing and the like - try discreetly to offer specific and explicit advice as a sort of social coaching. For example, say, "Before I tell your story, ask to hear the other person's first," or, "Look at the other person when he's talking." Many children with ADD are viewed as indifferent or selfish, when in fact they just haven't learned how to interact. This skill does not come naturally to all children, but it can be taught or coached.

Teach test-taking skills.

Make a game out of things. Motivation improves ADD.

Separate pairs and trios, whole clusters even, that don't do well together. You might have to try many arrangements.

Pay attention to connectedness. These kids need to feel engaged, connected. As long as they are engaged, they will feel motivated and be less likely to tune out.

Try a home-to-school home notebook. This can really help with the day-to-day parent-teacher communication and avoid the crisis meetings. It also helps with the frequent feedback these kids need.

Try to use daily progress reports.

Encourage and structure for self-reporting, self-monitoring. Brief exchanges at the end of class can help with this. Consider also timers, buzzers, etc.

Prepare for unstructured time. These kids need to know in advance what is going to happen so they can prepare for it internally. If they are suddenly given unstructured time, it can be over-stimulating.

Prepare for unstructured time. These kids need to know in advance what is going to happen so they can prepare for it internally. If they suddenly are given unstructured time, it can be over-stimulating.

Praise, stroke, approve, encourage, nourish.

With older kids, have then write little notes to themselves to remind them of their questions. In essence, they take notes not only on what is being said to them, but what they are thinking as well. This will help them listen better.

Handwriting is difficult for many of these children. Consider developing alternatives. Learn how to use a keyboard. Dictate. Give tests orally.

Be like the conductor of a symphony. Get the orchestra's attention before beginning (You may use silence, or the tapping of your baton to do this.) Keep the class "in time" , pointing to different parts of the room as you need their help.

When possible, arrange for student to have a "study buddy" in each subject, with phone number (adapted from Gary Smith).

Explain and normalize the treatment the child receives to avoid stigma.

Meet with parents often. Avoid pattern of just meeting around problems or crises.

Encourage reading aloud at home. Read aloud in class as much as possible. Use story-telling. Help the child built the skill of staying on one topic.

Repeat, repeat, repeat.

Exercise. One of the best treatments for ADD in both children and adults, is exercise, preferably vigorous exercise. Exercise helps work off excess energy, it helps focus attention, it stimulates certain hormones and neurochemicals that are beneficial, and it is fun. Make sure the exercise IS fun, so the child will continue to do it for the rest of his or her life.

With older children, stress preparation prior to coming into class. The better idea the child has of what will be discussed on any given day, the more likely the material will be mastered in class.

Always be on the lookout for sparking moments. These kids are far more talented and gifted than they often seem. They are full of creativity, play, spontaneity, and good cheer. They tend to be resilient, always bouncing back. They tend to be generous of spirit, and glad to help out. They usually have a "special something" that enhances whatever setting they're in. Remember, there is a melody inside that cacophony, a symphony yet to be written.

Short Lecture on the Assessment and Diagnosis of Dyscalculia.

The following information and lecture was provided by Tim Francis in 2017 when he was working as an Educational Psychologist (Tim as now retired). Tim was asked to make a presentation to a group of senior decision makers from universities across London with respect to dyscalculia. To make the talk available to a wider audience he added a voice over to the PowerPoint presentation and published on YouTube.  Tim hopes that you find this interesting. 

https://www.youtube.com/watch?v=UNlybmlSJY4

Dyslexia South offers assessment of dyscalculia in adults and children. For adults, the assessment will be tailored to your needs, for example, it may be linked to your studies and relevant to DSA, or could be a work related assessment.

If you would like to make an appointment please contact Dyslexia South.  

 

Cerebral Palsy

Some helpful sites that we have found are:

www.cerebralpalsyguidance.com

https://www.cerebralpalsyguide.com/community/

Cerebralpalsyguidance.com is a comprehensive informational website on cerebral palsy and behavioural health. The founder is someone who’s lived with cerebral palsy since infancy, he knows how critical it is for parents of a child with CP to have access to reliable and comprehensive information on this complex condition.

This site includes advice about a wide range of therapies aimed at treating and maintaining the physical and mental well being of children and adults with cerebral palsy and/or behavioural and cognitive disorders. 

https://www.cerebralpalsyguide.com/community/ is a national support organization dedicated to educating individuals and families about cerebral palsy and other birth injuries. They have put together a list of resources for parents to provide answers and help guide families to the assistance they need to help improve their overall quality of life.

 

Difficulties at Work.

Difficulties at Work.

To experience difficulties at work can be one of the most stressful life events, particularly if you have dependents and commitments.  Dyslexia South has provided assessments to those in a range of positions, such as accountants, doctors, lawyers and people in the army. Dana at Dyslexia south offers a thorough assessment for employees experiencing difficulties at work. 

If you find you:

  • Are less productive than peers

  • Find it difficult to read fast and accurately comprehend.

  • Have poor spelling skills.

  • Find it difficult to write reports.

  • Struggle to read and reply to emails.

  • Have difficultly concentrating in meetings and with minute taking.

  • Make silly mistakes.

  • Have difficulties organising your thoughts.

  • Have difficulty with number related activities.

In general clients request assessment for two main reasons, firstly confusion and secondly conflict. Clients or their employer may be confused as to why a valued employee appears to perform at a lower level than peers with respect to some occupational duties. A less frequent referral route is from solicitors and trade unions as well as individual clients as there is conflict at work about levels of performance. 

I have consistently found that the assessment process is a useful way of identifying causes behind occupational inefficiency and this has many benefits. Reasonable adjustments can be suggested which allow for focused intervention and supportive practice, that leads to good outcomes. The assessment process is also a very good opportunity for an employee to evaluate themselves against the demands of their workplace duties. 

You may find this video of interest.


If you would like to arrange for an assessment connected with difficulties at work please email or call Dyslexia South.

Stammering

Palin Parent-Child Interaction Therapy for young children (0-7) who stammer

The Michael Palin Centre is an internationally recognised centre for excellence in the field of stammering, credited with the exposition of the multifactorial model of stammering as well as Palin Parent-Child Interaction Therapy. The multifactorial model explains stammering as a phenomenon that does not have a single cause, but occurs because of several contributing factors. These include physiological, psychological, linguistic (speech and language), and environmental factors.

Comprehensive assessment of a child who stammers should explore each of these factors. The resultant formulation should aim to highlight factors contributing towards a child’s stammer that can be changed. Palin Parent-Child Interaction Therapy provides parents with the opportunity to reflect on their interaction with their child during free-play using short video recordings made during each session. Thorough discussion with the SLT parents learn to positively affect their child’s communication environment, while the young person experiences more opportunities to be fluent.

The programme involves an initial assessment, a 6 week period of direct therapy, a 6 week consolidation period where parents implement what has been learned at home, followed by a review session on the 12th week. A longitudinal study (Millard, Nicholas & Cook; 2008) has demonstrated the effectiveness of Palin Parent-Child Interaction Therapy for child who have stammered for 12 months or more.

 

References

Millard, S. K., Nicholas, A., & Cook, F. M. (2008). Is parent–child interaction therapy effective in reducing stuttering?. Journal of Speech, Language, and Hearing Research51(3), 636-650.

 

http://www.stammeringcentre.org/mpc-home

Taking Notes In Lectures

Possibly the simplest clue to dyslexia in a student is their answer to the question 'Can you take notes in a lecture?'. The answer is usually some variation on 'no'. Sometimes it is ‘Oh my word, not a chance’. Sometimes it is 'Yes, but I can't read them afterwards'. It all amounts to the same thing. What it means is that they don't leave a lecture much wiser than when they entered it.

Dyslexic people may have difficulties with processing auditory information such as language heard in a lecture. This difficulty is not only limited to the written word. They may also have a difficulty in absorbing and storing information in lectures. They are not so good at 'extracting value' from lecturers 'talking at them'.

The first suggestion is sometimes a little intimidating for the eager-to-learn-and-remember dyslexic. Try not writing at all. 'But then I won't remember any of it!', they say. 'How much of it do you remember at the moment? is the next question. 'Very little', comes the reply.

Some students are able to audio-record their lectures. They usually find, though, that they don't have time to listen to them all the way through. Imagine having to attend all your lectures twice and you'll understand why. A strategy for dealing with this is to be alert to which sections of the lecture are particularly significant – an important theorist or significant event – and mark this on the recording, perhaps by re-starting it at that point and making it easy to find. Then these sections can be reviewed later. There are various AI technologies available which can listen live and summarise information; exploring what is available and which best suits you is recommended.

Another successful technique is to spend a little time after a lecture to quietly make notes on what is immediately retained. This can be done alone or with one or two fellow students. The key is relaxation. The brain works better when it isn't trying too hard. Just sit, pen in hand, and let the lecture wash through the brain. Note what comes to mind. Don't try to actively remember, just note what the moment presents. Often most of the salient points will be 'captured'.

Reading in advance of the lecture can also be a big help. If the course is well organised, the subject of the lecture will be available in a course overview or on a VLE. Try finding the relevant chapter in a course reader or text-book and scan-read it (see Reading Tips). Read the first and last paragraph in the relevant section and anything else that grabs your attention. That's usually enough to prepare you better for the lecture and helps you follow it.

Also, you can prepare a template for the lecture. Take a single page of A4 and put headings on it from the reading. Just four or five bullet points on the main issues you'll encounter. You might then like to add to that during the lecture. Don’t try to add much, just a further four or five phrases – a date, a theorist's name, a movement or the name of a theory.

Finally, if you don't already receive them, you can ask the lecturer for notes to the lecture. Of course, if you already do, you're probably not reading this piece. Many lecturers feel, wrongly, that writing in the lecture leads to better absorption of the material for all. That's to misunderstand what it means to be a right-brained learner (of course, not having the burden of providing notes makes the lecturer's life easier). Making learning easy for everyone should be the objective and some people learn much more easily when they have notes in advance of lectures.

You can always ask..

Written by Simon Hopper in 2016 and information on AI added by Dana in 2025.

Dysgraphia

The term dysgraphia is taken from the Greek word, (dys) meaning "bad" or "difficult" and (graphia) meaning "writing." Thus, "dygraphia" literally means "bad writing".

Dysgraphia does not appear in the DSM V, however the DSM V does include difficulties with written expression within the criteria for diagnosing specific learning disorder. For a student with no difficulties with written expression but with generally hard to read and illegible handwriting, there is no internationally recognised diagnostic criteria, such as ICD-10 or DSM V, that a clinician can refer to.

Searches of the internet reveal many definitions of dysgraphia which include difficulties with: fine motor co-ordination, organisation and presentation of written material, writing to be distorted or incorrect, letters and numbers may be backwards and out of order, expressing thoughts in writing, not understanding the spellings of words, having trouble with punctuation, more than simply “untidy” writing; it affects people’s ability to write effortlessly, a neurological condition that impairs writing and memory processing.

Using the latest DSM 5 definition of specific learning disorder most of the above would now fall within the diagnostic criteria for specific learning disorder, except for difficulties with the act of writing by hand. Because of this some practitioners now consider dysgraphia to be defunct as a diagnosis.

Dysgraphia is a very useful descriptor for handwriting that is so hard to read that it is generally illegible. Dyslexia South uses a very simple criteria: If a free writing sample is more than 25% illegible; that is more than one out of four words are illegible, or can only be read by reading around the target word to deduce what the word is, then the person’s handwriting is considered to be dysgraphic. We use a technique whereby the sample is read from the bottom in reverse, which helps to ensure that each word is read in isolation.

Dyslexia South Criteria for Dysgraphia

More than 25% of handwriting sample hard to read or illegible when the sample is read from the bottom backwards.
 

Two samples of dysgraphic handwriting:

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Employee making mistakes with reading and numbers.

The case below was reported in February 2016 and shows why an employer must pay attention to an employee in difficulty. 

Meseret Kumulchew v Starbucks

•    Meseret Kumulchew accused of falsifying paperwork at Clapham branch
•    She made errors when recording the temperatures of fridges and water
•    Her duties were reduced and she was told to retrain.
•    Starbucks faces a compensation claim after losing tribunal in December

A Starbucks supervisor with a diagnosis of dyslexia was demoted after making mistakes with paperwork, she took the case to a disability tribunal and won a disability discrimination claim against Starbucks because she struggled to read, write and tell the time.

Meseret Kumulchew, who struggles with reading, writing and telling the time, was accused of falsifying documents at the Clapham branch. Ms Kumulchew was given reduced duties and told to retrain after failing to correctly take the temperature of the water and fridges at regular intervals and record the results. Starbucks said the errors amounted to fraud, which she successfully claimed was a form of disability discrimination. Ms Kumulchew explained that she wasn't afforded the help needed to carry out her duties.  In a message to Starbucks she said: 'I'll struggle, but don't worry, help me and I'll get there in my own time."

Starbucks lost the tribunal in December 2015 and is now facing a compensation claim.
Starbucks was found to have victimised Ms Kumulchew and its 'equality' policies failed to support her dyslexia, they should have made 'reasonable adjustments' to her duties to help her continue in her job.

This case illustrates two core points:
1. If you are employee and you experience difficulties with reading, number or organisation and you suspect these difficulties  are linked to a specific learning difficulty such as dyslexia, dyspraxia, dyscalculia it is vital that you have a diagnostic assessment, Ms Kumulchew won her case because she had been diagnosed with dyslexia by an educational psychologist.

2. If you are employer and one of your employees is experiencing difficulties with reading, number or organisation and you suspect these difficulties  are linked to a specific learning difficulty such as dyslexia, dyspraxia, dyscalculia, then you have a duty to ask them to have a diagnostic assessment with an educational psychologist.

Many dyslexics are struggling in the work place with very high levels of anxiety, because employers do not have the training or the awareness to make adjustments for them. An educational psychologist will be able to make an assessment and identify any specific learning difficulties that may be causing mistakes at work and recommend reasonable adjustments. We offer a work related diagnostic assessment for £450, which includes a discussion and agreement with the employee as to reasonable adjustments. We welcome a representative from the employees company to observe the assessment and join the discussion as to reasonable adjustments at the conclusion of the assessment

 

 

Typical Ages Of Elimination For Sound Errors (Phonological Processes)

Below you will find descriptions of phonological processes (a pattern of sound error(s)) a typical child will use. This includes an example, and the approximate age (years;months) at which these processes will stop being used.

  • Pre-vocalic voicing:        pig = big        3;0
  • Word-final de-voicing:       pig = pick        3;0
  • Final consonant deletion:    comb = coe        3;3
  • Fronting:       car = tar        3;6
  • Consonant harmony:       mine = mime        3;9
  • Weak syllable deletion:        elephant = efant    4;0
  • Cluster reduction:        spoon = poon        4;0
  • Gliding of liquids:        run = one        5;0
  • Stopping /f/:            fish = tish        3;0
  • Stopping /s/ :          soap = dope        3;0
  • Stopping /v/ :           very = berry        3;6
  • Stopping /z/:            zoo = doo        3;6
  • Stopping 'sh' :           shop = dop        4;6
  • Stopping 'j':            jump = dump        4;6
  • Stopping 'ch':            chair = tare        4;6
  • Stopping voiceless 'th':        thing = ting        5;0
  • Stopping voiced 'th' :       them = dem        5;0

If you are concerned about your child’s speech or language development, please email for free advice: speech-language-therapist@outlook.com 

Alternatively, please see our fixed fee assessment which may meet your needs

References

  • Bowen, C. (2011). Table 3: Elimination of Phonological Processes. Retrieved from http://www.speech-language-therapy.com/ on 16/01/2016.
  • Bowen, C. (1998). Developmental phonological disorders. A practical guide for families and teachers. Melbourne: ACER Press.
  • Grunwell, P. (1997). Natural phonology. In M. Ball & R. Kent (Eds.), The new phonologies: Developments in clinical linguistics. San Deigo, CA: Singular Publishing Group, Inc.

Phonological Processes In Typical Development

As children learn to speak, they tend to use some different sound errors or patterns as they are not yet able to use all the sounds in all the different word positions that most adults can use. These are called phonological processes. As they get older, these typically disappear as they become more able to pronounce all the words they need to use correctly. For the typical ages that phonological processes are gone by, please click here.

Below, the name of the phonological process is given, along with an example and a description of what is happening to create the process. 

  • Pre-vocalic voicing:    car = gar    A voiceless sound preceding a vowel is replaced by a voiced sound.
  • Word final devoicing:    red = ret    A final voiced consonant is replaced by a voiceless consonant
  • Final consonant deletion:    boat = bo    A final consonant is omitted (deleted) from a word.
  • Velar fronting:    car = tar    A back sound is replaced by a front sound.
  • Palatal fronting:    ship = sip    sh or zh are replaced b y s or z respectively
  • Consonant harmony:    cup = pup    The pronunciation of a word is influenced by one of the sounds it 'should' contain.
  • Weak syllable deletion:    telephone = teffone    Weak (unstressed) syllables are deleted from words of more than one syllable.
  • Cluster reduction:    try = ty    A cluster element is deleted or replaced.
  • Gliding of liquids:    ladder = wadder    Liquids are replaced by glides.
  • Stopping:    ship = tip    A stop consonant replaces a fricative or affricate.

If you are concerned about your child’s speech or language development, please email for free advice: speech-language-therapist@outlook.com 

Alternatively, please see our fixed fee assessment which may meet your needs

References

  • Bowen, C. (2011). Table 2: Phonological Processess. Retrieved from http://www.speech-language-therapy.com/ on 16/01/2016.

Typical Stages Of Language Development

January 26, 2016

Receptive Language
Receptive language development refers to how children develop listening skills and an understanding of the language they are hearing. 

Birth
Language learning starts at birth. Even new babies are aware of the sounds in the environment. They listen to the speech of those close to them, and startle or cry if there is an unexpected noise. Loud noises wake them, and they become "still" in response to new sounds.

0-3 months
Between 0-3 months babies learn to turn to you when you speak, and smile when they hear your voice. In fact, they seem to recognise your familiar voice, and will quieten at the sound of it if they are crying. Tiny babies under three months will also stop their activity and listen closely to the sound of an unfamiliar voice. They will often respond to comforting tones whether the voice is familiar or not.
 
4-6 months
Between 4 to 6 months babies respond to the word "no". They are also responsive to changes in your tone of voice, and to sounds other than speech. For example, they can be fascinated by toys and other objects that make sounds, enjoy music and rhythm, and look in an interested or apprehensive way for the source of all sorts of new sounds such as the toaster, birdsong and the whirr of machines.

7-12 months
During the 7 to 12 month timeframe, the baby will listen when spoken to, turns and looks at your face when called by name, and discovers the fun of games like "peep-oh" and "pat-a-cake". They will begin to recognise the names of familiar objects ("Daddy", "car", "eyes", "phone", "key") and begin to respond to requests ("Give it to Granny") and questions ("More juice?").
 
1-2 years
Now your child points to pictures in a book when you name them, and can point to a few body parts when asked (nose, eyes, tummy). He or she can also follow simple commands ("Push the bus!", "Don't touch; it's hot!") and understand simple questions ("Where's the toy?" "Who likes chocolate?", "What's in your bag?"). Your toddler now likes listening to simple stories and enjoys it when you sing songs or say rhymes. This is a stage in which he or she will want the same story, rhyme or game repeated many times.

2-3 years
By now your toddler will understand two stage commands ("Get your coat and put your shoes on") and understand contrasting concepts or meanings like hot / cold / stop / go / in / on and nice. He or she notices sounds like the telephone or doorbell ringing and may point or become excited, get you to answer, or attempt to answer themselves.

3-4 years
Your three or four year old understands simple "Who?", "What?" and "Where?" questions, and can hear you when you call from another room. This is an age where hearing difficulties may become evident. If you are in doubt about your child's hearing, speak to your GP who will refer you to a clinical audiologist.

4-5 years
Children in this age range enjoy stories and can answer simple questions about them. He or she hears and understands nearly everything that is said (within reason) at home or at pre-school or day care. 
 
Expressive Language
Expressive language refers to how children learn to speak and use Language

Birth
Newborn babies make sounds that let others know that they are experiencing pleasure or pain.

0-3 months
Your baby smiles at you when you come into view. He or she repeats the same sound a lot and "coos and goos" when content. The baby uses a different cry for different situations to help you differentiate between what they need. For example, one cry says "I'm hungry" and another says "I have a pain".

4-6 months
Gurgling sounds or "vocal play" occur while you are playing with your baby or when they are occupying themselves happily. Babbling really gets going in this age range, and your baby will sometimes sound as though he or she is talking. This speech-like babbling includes many sounds, often these are bilabial (two-lip) sounds e.g. 'p', 'b' and 'm'. They also use different pitches. Your baby can tell you, using sounds or gestures that they want something, or want you to do something. He or she can use very "urgent" noises and facial expressions to spur you into action.

7-12 months
The sound of your baby's babbling changes. This is because it now includes more consonants, as well as long and short vowels. He or she uses speech and/or sounds other than crying to get your attention and hold on to it. Your baby's first words may be spoken (they may not be very clear yet). Examples of typical first words are: "MaMa", "Doggie", "Night Night", "Bye Bye", "No")

1-2 years
Now your baby is accumulating more words as each month passes. He or she will even ask 2-word questions like "Where ball?" "What's that?" "More choc", and combine two words in other ways to make other sentence types ("Birdie go", "No doggie", "More push"). Words are becoming clearer as more initial consonants are used.

2-3 years
Your two or three year old's vocabulary is increasing quickly. He or she seems to have a word for almost everything. Utterances are usually one, two or three words long and family members can usually understand them. Your toddler may ask for, or draw your attention to something by naming it ("Dog") or one of its attributes ("Red!") or by commenting ("Wow!").
 
3-4 years
Sentences are becoming longer as your child can combine four or more words. He or she talks about things that have happened away from home, and is interested in talking about pre-school, friends, outings and interesting experiences. Speech is usually fluent and clear and people outside of the family can understand what your child is saying most of the time. 

4-5 years
Your child speaks clearly and fluently in an easy-to-listen-to voice. He or she can construct long and detailed sentences ("We went to the zoo but we had to come home early because Sally wasn't feeling well". He or she can tell a long, involved imaginative story sticking to the topic, and using "adult-like" grammar. Most sounds are pronounced correctly, though he or she may be lisping as a four year old, or, at five, still have difficulty with "r", "v" and "th".
Your child can communicate easily with familiar adults and with other children. Your child may tell fantastic, dramatic, inventive, "tall stories" and engage strangers in conversation when you are out together.
 
If you are concerned about your child’s speech or language development, please email for free advice: speech-language-therapist@outlook.com

Alternatively, please see our fixed fee assessment which may meet your needs

References

  • Bowen, C. (1998). Ages and Stages Summary: Language Development 0-5 years. Retrieved from http://www.speech-language-therapy.com/ on

The Difference Between 'Speech' And 'Language' Impairments

Speech
‘Speech’ refers to the sounds we make when we are talking. We put strings of sounds together to create words. For example, ‘Cat’ is made up of 3 sounds – C, A and T. The number of sounds in a word does not necessarily correspond to the number of letters when spelling the word. For example, ‘Fright’ is made up of the sounds F, R, I and T (the ‘I’ would be pronounced like ‘eye’).


Different sounds develop at different ages, for example, ‘m’ is typically acquired at around 3 years old, whereas ‘v’ is not typically acquired until 6 years, and ‘th’ until 8 years (Kilminster & Laird, 1978). Children initially will not be able to produce certain sounds, or produce all the sounds in a longer word and so employ phonological processes e.g. saying ‘lectic’ for ‘electric’ or always producing ‘k’ as ‘t’. For more information on phonological processes used in typical development, see here: LINK. All children employ phonological processes up to a certain age. Norms for elimination of phonological processes can be found here: LINK.


Speech Sound Disorder (SSD) is an umbrella term referring to slow development of, or a difficulty with, speech development. An SSD could include articulation disorder, phonological disorder, childhood apraxia of speech and motor-speech disorders. If a child has a speech sound disorder, they may have difficulty producing certain sounds past the age at which those sounds would typically have been acquired. They may use a pattern of sound errors (phonolocial processes) past the age at which this may be typical. A child may be unable to coordinate the sounds needed to make up words, or have a structural or neurological reason that they cannot produce all of the sounds we use when we are talking.


A child may also have difficulty processing certain sounds; this will inevitably lead to difficulty producing that sound. This could have different causes e.g. glue ear, or an Auditory Processing Disorder. 


A Speech and Language Therapist will assess your child’s ability to process and produce a full range of speech sounds to identify how to best target any difficulties in therapy. They may use a formal assessment such as the Diagnostic Evaluation of Articulation and Phonology (DEAP) (Dodd et. al., 2002). For further information on the DEAP, see here: LINK.

Language
Language refers to the meaning of the words we use. When we talk, we string words together into sentences to convey meaning. We also listen to other people’s sentences to understand what they are telling us. Children move through language development milestones, however there will of course be some variation between them. Norms for language development can be found here: LINK


Children may have a language delay if they do not achieve language norms within the expected time-frame. Children may also be diagnosed with ‘Specific Language Impairment’; this is where language is below the expected level in relation to a child’s academic abilities in the absence of general learning difficulty, hearing impairment, autism spectrum condition or anything else that could explain their language difficulty.


A Speech and Language Therapist will assess your child for language impairment. They may use a formal assessment such as the Clinical Evaluation of Language Fundamentals (CELF) (Semel et. al., 2006), along with speaking to the child’s parents and teachers. They may also observe the child in different settings. They will use the information gained in assessment to inform their therapy plan.


If you are concerned about your child’s speech or language development, please email for free advice: speech-language-therapist@outlook.com
 

Alternatively, please see our fixed fee assessment which may meet your needs.

References

  • Bowen, C. (1998). Ages and Stages Summary: Language Development 0-5 years. Retrieved from http://www.speech-language-therapy.com/ on[insert the date that you retrieved the file here].
  • CELF
  • Kilminster, M.G.E., & Laird, E.M. (1978) Articulation development in children aged three to nine years. Australian Journal of Human Communication Disorders, 6, 1, 23-30.
  • Bowen, C. (2011). Table 2: Phonological Processess. Retrieved from http://www.speech-language-therapy.com/ on [insert the date that you retrieved the file here].
  • Bowen, C. (2011). Table 3: Elimination of Phonological Processes. Retrieved from http://www.speech-language-therapy.com/ on [insert the date that you retrieved the file here].
  • DEAP

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