Monday, 21 May 2012

Notes from Integrated Therapy: Auditory Processing Disorder

What is Auditory Processing Disorder (APD)?
I’ve noticed many parents coming to me concerned over their child’s auditory processing abilities and its effect on learning. For instance, a common concern sounds like this – “My child’s teacher told me that my son can’t hear properly in class. He is starting to fall behind in reading and spelling. The school counsellor said that I should have him assessed for auditory processing disorder. How do you assess an auditory processing disorder, and if he has APD, can you do anything to help him?”

APD is defined as a deficit in the auditory pathways of the brain that results in the inability to listen (Richard, 2001). As such, a multi-disciplinary screening process conducted by educational psychologists, audiologists and speech therapists is recommended to eliminate the influence of other factors such as IQ, attention, language disorders, peripheral hearing losses and memory on a reported listening and learning dysfunction. Once these factors have been ruled out, a comprehensive diagnostic audiological assessment can be conducted to determine which aspects of the auditory pathways are affected.

Management
These are generic management options, therefore it is strongly recommended that you consult your speech therapist regarding managing your child’s APD. Every child’s APD profile is different.

  • Phonological awareness training
  • Same/different training for the identification of non-speech sounds
  • Prosody training (i.e., therapy for interpreting tone-of-voice cues)
  • Exercises which require child to multi-task (e.g., sing and draw at the same time; processing of heard information in the presence of noise)
  • Modifying the classroom and home environment
  • Speech therapy for APD

References
Richard, G.J. (2001) The source for processing disorders. East Moline, IL: LinguiSystems, Inc
Cameron, S and Dillon, H (2005) Auditory Processing Disorder – from Screening to Diagnosis and Management – A Step-by-Step Guide.Audiology Now (Winter, 47-55)

Friday, 17 February 2012

When being called “Special” has its irony in Society.

“Is this a special needs school?” is the question many of us encounter when “Learn Different” is mentioned.

It seems there is not full agreement of the term “Special Needs Education” simply because we all have our own understanding of it. It’s a case of different strokes for different folks. For some, if not most, the traditional definition Special Needs stands firm; physical disabilities that require varied attention, a cognitive impairment that is severe enough to prevent opportunities in a mainstream environment, or being visually impaired, hearing impaired or mute. Google “special needs and Singapore” for the Ministry of Education’s (MOE) definition (www.moe.gov.sg/education/special-education/) and all roads lead to anything but mainstream education – special schools for special people. Life skills, vocational skills and opportunities serve the special needs community through special needs education. That’s it?
In 2007, the Organisation of Economic Co-Operation and Development (“OECD”) published a paper on “Students with Disabilities, Learning Difficulties and Disadvantages” together with policies, statistics and indicators for the common good. Rich in data, it makes good fodder for policy makers and educators. But what got me hooked was the admission that special needs education lacks a single, unifying definition. The International Standard Classification of Education (ISCED) set the record straight with the term “Special Needs Education”. It now covers “those who are failing in school for a wide variety of other reasons that are known to be likely to impede a child’s optimal progress.”
It sounds harsh to say “failing in school” because a large population are not necessarily “failing” but are just getting by albeit with some challenges that are obvious enough to raise concerns amongst the classroom teacher, the school head and parents. It is not about passing a test or an exam, it is more about the journey. The biggest hurdle has to do with the individual challenges themselves, and for every minute of intellectual demand placed on the learner to deliver like the norm, think of multiplying a hundred times for its emotional equivalent. Note that recent local research indicates at least 10% of Singaporeans have some form of learning difficulty; Asperger’s Syndrome, Dyspraxia, Attention Deficit Disorder (ADD), Attention Deficit Hyperactivity Disorder (ADHD), Central Auditory Processing Disorder (CAPD) and Dyslexia. From a numbers perspective that is nothing to shy away from – we’re not all that “gifted” as purported to be.
The OECD paper proposed a straightforward classification scheme for students on special needs education. A tripartite system was drawn up with three categories, one of which is the cross-national category “B/Difficulties” whose focus is on the student with a behavioural or emotional disorder or, a learning difficulty.
When you visit the MOE website and key in “special needs education”, (www.moe.gov.sg/education/programmes/support-for-children-special-needs/) you are now witness to a government that has made leaps and bounds in special needs education and is proactive in addressing the concerns of those with “mild special needs” “including Dyslexia, Autism Spectrum Disorder (ASD) and ADHD”, the latter being nothing “mild” to say the least unless the student is on a good dose of medication.
Schools adopt an inclusive approach for this group of learners who are in desperate need of additional support. This translates to engaging Allied Educators (Learning and Behavioural Support) for literacy or other skills. But does the curriculum change? Sadly, not at all. The difficulty is in the number of learners and large classroom sizes. Not all schools have the luxury to adapt the curriculum to meet the needs of the diverse learner. So students with ASD, dyslexia, dyspraxia, Asperger’s, ADHD are going to have to adapt and change to meet the demands of the curriculum. We have an additional 3,200 teachers who have been trained in special needs to assist students with mild special needs to date, according the MOE website, but are we really able to include these learners when inclusion means a form of accountability to deliver and, that means remodelling the achievement tests marking system? This automatically translates into a conflict between the student and the educational context. These diverse learners sit for the same tests as everyone else. A dyslexic learner for example, is going to make noticeable blunders unintentionally because that is how his/her brain works. Yet, the marking criteria remains the same for everyone. The question of real learning then arises. Truth is, the actual aptitude of a diverse group of learners is being masked by testing that does not accommodate their needs and ultimately short changes them, denying equal opportunity to excel.
One parent put it in a painfully graphic way, “It’s like failing a wheelchair-bound individual for not being able to run”. Do we make that differentiated learner work for the system or should the system work for the individual? Parents, you decide; are we a special needs school or a school that provides special needs education? 
- Sharon Sophie Solomon, Director

1Learn Different Academy strives for inclusion but we adopt a pragmatic approach.

Thursday, 9 February 2012

Gross Motor Skills


Gross motor skills are important to develop during childhood.  A lot of our gross motor skills are learned through play.  Gross motor skills are defined as the amount of control and coordination we have over the large muscle movements that our bodies make.  These muscular movements include activities such as running, walking, jumping and maintaining balance. 

There are many ways to help improve gross motor skill development:

  • Playing “Simon Says” and doing movements like jumping jacks, hopping on one leg at a time and jumping with both feet.  This will get the child moving and using their muscles.
  • Ask your child to shadow or mimic your actions.  This will not only be fun for the child, but it also gets them moving around while having fun!  
  • Imitate different animals with your child: Jump like a kangaroo, waddle like a penguin, crawl like a mouse, creep like a tiger, gallop like a horse.  Activities like this encourage children to move their muscles in different ways from the way they normally move when doing activities such as running or walking.  
  • Activities like swimming, riding a bike or tricycle, skipping or hopscotch help to increase muscle endurance and strength.
  • Playing catch! The larger the ball the easier it is so start with something big like a beach ball. Also, try rolling a ball or kicking it. 
  • Walking on curbs and low barriers (sometimes found in parks) improves balance and coordination. However, if your child is walking on curbs, ensure that it is in a safe environment!  

Gross motor skill development is a fundamental part of growing up.  By developing gross motor skills, children are able to increase their strength, endurance, coordination and balance.  This in turn helps children with their self-care, social skills, handwriting, postural stability, navigating through their environment safely, and their daily routines and activities.

- By Sirida Johnston (Occupational Therapy Student & LD )