Handwriting and anxiety at school

[Pennygarden]

Hi everyone

 

It's been awhile since son was diagnosed with HFA (Autumn 2009 age 9) - result was his then lower school classteacher was brilliant, but he was never statemented. Headteacher resisted everything.

 

He naturally progressed to Middle School in Autumn 2010, where all the visits and chats with the Head of Year settled him and my mind and he started off reasonably well. However, problems are starting to affect his schoolwork and now in Year 6, I need to step up to get him some help. After several wobbles, he has made some "geeky" friends and that helps him during the lunch and breaks which were the worst for him in the lower school.

 

Now it's in the classroom that he has problems - one major one is his handwriting is slow - it was in lower school for the new year, but then he would settle in the January term and begin to catch up. This is now not happening and it's across the subject spectrum. His teachers comments when I say it could be part of his Aspergers are simply "well everyone has a bit of it in them" - not terribly helpful. Son is also struggling with the "less caring" attitude of the Year 6 staff too - he is finding them unpredictable and has become anxious about school with tears quite regularly outside of school.

 

I'm hoping the wonderful and experienced people here can provide some ideas as to where I go or what I do next. We had the involvement of a Home Support Officer from the Council originally - she led from observing him at school originally through to advising to see our GP to get an appointment to see the Consultant through to home visits to help his Dad and I help him (social, communication and physical were the key issues back then). But he made good progress both with her and school, so she disappeared after concluding we were managing fine and we were left to our own devices again!

 

Should I go back to see our GP to get us referred again and/or speak to his Head of Year? What would you suggest?

 

Many thanks.

[smiley1590]

when you describe and explain his handwriting as 'slow' what do you exactly mean by this statement? XKLX

[Pennygarden]

when you describe and explain his handwriting as 'slow' what do you exactly mean by this statement? XKLX

 

My son explains it as he knows what's in his head but doesn't know how to write it - so forming sentences to put onto paper, which ultimately leaves him behind the rest of the class and he almost always does not complete written work in the lesson.

 

When he does know what to write, he is also slow in terms of the speed of writing it - his hand/wrist aches very quickly. We have tried different pens within the school remit to no avail, including special grooved pencils (he is left handed).

 

It's come to a head particularly as he broke a finger in PE a couple of weeks back trying to catch a ball, which hasn't helped!

[smiley1590]

has your son got low muscle tone? i used struggle to put thoughts /ideas from my head onto paper such hard /difficult thing to do like mind fog /block so frustrating more you try and do it more it won't happen! gr! so can personally understand how your son feels! have you tried triangle pencil grips ( rubber) around pens/pencils so supports better so don't give wrist/arm ache does he seem hold pen too tight? does he struggle with PE tasks catching a ball?

 

XKLX

[Special_talent123]

penny i were like that in my english class.

[Pennygarden]

has your son got low muscle tone? i used struggle to put thoughts /ideas from my head onto paper such hard /difficult thing to do like mind fog /block so frustrating more you try and do it more it won't happen! gr! so can personally understand how your son feels! have you tried triangle pencil grips ( rubber) around pens/pencils so supports better so don't give wrist/arm ache does he seem hold pen too tight? does he struggle with PE tasks catching a ball?

 

XKLX

 

All sounds very familiar, including the physical side. He can have the facts in his head, just can't put them into a sentence and yes, he gets very frustrated at home with homework of this type.

 

He has poor balance at times - often trips over, struggles with co-ordination in PE, bumps into things easily (have had broken little toes before now) and he still cannot ride a bike. The assessment had him walking up and down the room, which didn't show anything untoward really and he does pick his feet up more than he used to which has helped. Yes, I would say he has low muscle tone and the rubber around pen/pencils sounds a good idea to try out. He does grip tight when I've watched him write at home and we've tried different ways of holding a pen, but he always goes back to the same way.

[Pennygarden]

penny i were like that in my english class.

 

That's exactly where it first started and now it's all his subject teachers. His reading is way ahead and his oral is very good with some amazing vocabulary.

 

Now I feel sure his writing issue must be part of the Aspergers, but instead of being caused by change of classroom/having to re-settle as was previously thought in his last school, it is looking like that is just how his brain works.

 

I think I will go back to my GP to get him referred to the Consultant again.

[Sally44]

It could be visual dysgraphia, dyspraxia [low muscle tone].

 

Your son is in year 6, and next year he is going to tranfer into a bigger mainstream secondary school and it sounds like the anxiety is starting now in year 6.

 

I would suggest that you write to the LA again asking them to carry out a Statutory Assessment towards a Statement.

 

The school do not need to agree with you. The LA may refuse. In which case you Appeal to Sendist. Many LA's refuse to assess automatically and wait to see which parents Appeal. If you appeal you are more than likely going to win and the LA will be legally required to assess your child.

 

You need to start this process now because IF he needs more support, or even a different type of placement for secondary, then you don't have alot of time before the places are allocated for next year.

 

All SEN children with Statements will have their secondary placement named by no later than mid February next year. So many [if not all] of the SEN places will be taken by then.

 

A Statement takes 26 weeks from start to finish.

 

Regarding the anxiety. This needs to be taken seriously. You need to get the Autism Advisory Teacher and also the Parent Partnership involved and arrange to have a meeting in school.

 

If his anxiety grows, and he is not coping, and he is not supported, he may disengage from school. That is what happened to my son.

 

We have been very fortunate in recently winning an independent school placement for ASD children only. But my son was out of school for around 10 months, now has been diagnosed with an anxiety disorder [OCD type behaviours], with referals to Clinical Psychology and CAHMS due to serious self harm behaviours.

 

I would not have dreamt we would have found ourselves in that position 18 months ago.

 

Also go to your GP and ask for a referal to either Clinical Psychology or the Multi Disciplinary team that diagnosed your son. Make sure they have experience of ASD children. You may need them to write letters to school, or attend school meetings.

 

I would start the ball rolling now, because things can deteriorate very quickly. Christmas is approaching, with all the changes and uncertainties that involves. It was at this time that my son first refused school.

 

You will have to take the reigns and steer this process through. No-one is going to do it for you. The school and LA may try to fob you off because more support = more money.

 

I would also advise you to get the list of secondary schools from your LA. As for their maintained schools and also the list of approved, non-maintained and independent schools. Your LA WILL be funding places at these independent schools.

 

See what schools sound suitable [maintained and independent] and go and visit them.

 

He will need a small sized school, with teachers that have additional qualifications for ASD.

 

You also need to ask your GP to refer you to the NHS Occupational Therapy service to assess his low muscle tone [he may have dyspraxia].

Edited November 20, 2011 by Sally44

[Pennygarden]

Hi Sally

 

Congratulations on your tribunal outcome - I was reading many of your posts last night to glean all I could!

 

Thank you for so much guidance too and I appreciate the time of night you wrote that!

 

We have 3 tier schooling here -Lower (5-9) -Middle (9-13) -Upper (13-16) - he is in Year 6 in Middle School, so half way through and he would be due to move up again at 13. We do have a new Free School opening in September 2012 which are taking current Y6 and Y8 children - it will be a small school and son is becoming keen to change schools (he loves learning and the making friends issue seems to have subsided, but then we've spent several years working on that with phrases to use). We are going to another information evening in 2 weeks time to look at that option further and especially the SEN/ASD support.

 

Dyspraxia was ruled out by the Paediatrician at the original assessment - even though his walking gait, clumsy running and all the other things are there - they are just not there "enough" if that makes sense.

 

I've looked up Dysgraphia - this does sound closer with the handwriting issue. The other thing is when he learns his spellings - he often verbally gets letters mixed up but knows what he means, resulting in frustration as I correct him and he swears blind he said it correct anyway! Spelling on paper is good. He cannot explain how he learns the words - I've tried to understand it but apart from knowing it's not following the sounds of words, haven't got a clue!

 

Son doesn't seem to display anxiety at school - he is well behaved and whereas he used to be very quiet too, he has come out of his shell and contributes to class discussions well now. I think this is where I need to know more from the school, as we've just had one Pastoral evening meeting with his form teacher in which all seemed fine, except this slow to put pen to paper.

 

I think I am going to start with the GP for another referral and also ask for a meeting at school with the Head of Year - he can then get any problems from his subject teachers and at least I will have a start point of where they stand and know what I am up against! As he's already in the system as it were, should be easier to pick it up again than start from scratch.

 

Is it worth writing to the LEA for an assessment with a view to statementing at this stage or wait until the pro's have seen him again?

 

Many thanks.

[Sally44]

Does your son have a Statement?

 

When you visit the school ask what qualifications the teachers have got for ASD or Specific Learning Difficulties [ie. dyslexia]. Often they don't have any qualification - so if you have a Statement it could/should specifiy a specialist teacher [see the SEN Code of Practice which states a specialist teacher is an option that can be provided - and if you have any professional report stating he needs that, then it should be added to the Statement - if it isn't you can appeal to Sendist].

 

The EP is the person who would assess things like learning style, whether he had dyspraxia or Dyslexia etc and whether the placement can meet need.

 

Dyspraxia is not JUST motor co-ordination problems. It can be low muscle tone, problems with sequencing and organisation, problems with planning [known as executive functions].

 

If your son is not learning by 'sound', that would indicate an auditory processing problem [and you also say he misprounces words?]. Learning to read/write is based on phonics ie. 'hearing the sound and relating it to the written equivalent of that sound'. A problem with auditory processing [and other sensory integration and processing problems] and/or dysgraphia is going to impact on his reading and writing and wording finding skills. If he does not listen or hear correctly he may find it hard/impossible to retrieve the written equivalent of any given sound or combination of sounds.

 

This is the SALT remit [as is social interaction/communication].

 

You may find it useful at some stage to have thorough independent reports completed. But the timing of these is very important. IMO it is worth doing when everything else has failed, and his needs are not being identified or being met in school and he is not making progress and may also becoming anxious about school.

 

From your posts I would suggest he needs properly assessing for:

 

Dysgraphia

Auditory Processing Disorder

Dyspraxia

Dyslexia [and other SpLD such as poor working or short term memory]

Sensory Processing Difficulties/disorder

 

Any, or a combination of the above is going to impact on learning and therefore an educational need.

 

For a long time my son appeared to cope by memorising. But as things become more complex that strategy began to fail. He could learn his spelling list, and then not recognise it a few days later.

 

Can your son ride a bike, climb trees, tie his shoelaces?

Edited November 20, 2011 by Sally44

[Sally44]

It is hard to get LA or NHS professionals to further diagnose difficulties [ie. SEN needs]. Because diagnosis = support = costs more money.

 

Our community OT would not state 'dyspraxia', however she provided me with some exercises for home for "low muscle tone, lack of core muscle strength and poor co-ordination."

 

It was actually the CAHMS psychiatrist who said he had dyspraxia, which my independent EP fully assessed. The CAHMS psychiatrist asked him to open and close a door as quietly as possible. Because he was trying to hard to be quiet, he could also monitor his body and move accordingly. He also could not walk a straight line with one foot repeatedly going over the midline. He could not heel to toe walk or balance.

 

I then wrote to the OT and said that CAHMS and an independent EP said Dyspraxia, and a week later I got a letter confirming Dyspraxia in writing - but she said that their service did not provide therapy for Dyspraxia.

 

That means that IF a child has Dyspraxia they will not get an OT programme delivered by an OT. There maybe some advice to home or school.

 

At an SEN Tribunal the Panel will not be happy with that. It is an educational need. If the NHS don't fund it, the LA has to buy it in.

 

But without any report stating he has dyspraxia and identifying that, and any other needs your child may have, you cannot argue for it to be put in. That is often why independent reports are essential.

 

The same for sensory processing disorder. The NHS does not fund sensory integration therapy. It is too costly. But if your child has a diagnosis of SPD [as mine had since 2006], and has no input, again the SEN Tribunal will state that they need a Sensory Integration Programme [if you have a report that states that, and also have a letter from the NHS OT saying they don't fund it].

 

My GP tried for several years to get OT therapy for my son. He wrote to their department a number of times. He was told it was not commissioned because it was too costsly. So he tried to refer me to GOSH which would assess for these difficulties [including auditory processing disorder], and the referal was turned down on the grounds that his case was not "exceptional" and that other children may seek a similar referal if they had similar difficulties.

 

So my GP asked that as the NHS Trust and OT department had identified that there were a population of children with these severe difficulties, why were they not providing therapy. Again it boiled down to cost.

 

But he challenged whether there were any other children with similar difficulties, and we were told that actually there were not. My son was an exceptional case - so we could have pursued a referal to GOSH. But in the end i've won the tribunal place and now he will get all the therapy we've been trying to secure for years.

 

For auditory processing problems have a look at APDUK website. GOSH does assess for this disorder, but it all depends on whether your GP would support such a referal and your NHS Trust agrees to refer him.

 

There maybe other hospitals that can assess his hearing. That is what we did. And after they have ruled out everything else, and if the child meets a number of criteria, the hospital will say that he "probably" has an APD, but that they are unable to assess that or provide any treatment.

 

Listening Therapies can help. The OT service typically uses something called "listening with the whole body", but we only managed to get one session of that due to lack of resources. You can go private.

 

However IF over the following year/s you begin to find more and more difficulties that your son has, that begins to make it more complex, requiring more 1:1, small group professional input with professionals working as a team, and that cannot be achieved except in a specialist placement where all the professionals are on site.

Edited November 20, 2011 by Sally44

[Pennygarden]

Sally - you are wonderful giving your guidance so freely.

 

I feel like I took the initiative originally, then dropped the ball as things seem to improve...but then new areas seem to have popped out of the woodwork!

 

He doesn't have a statement, no. We had help from a Parent Support Adviser originally - this led to seeing the Paediatrician who gave an Aspergers diagnosis, but there was no follow up action here. The PSA and I met with his school on the back of this - the Head would not accept there was a problem but his teacher did, however signing the minutes meant she reluctantly agreed to the actions/support in class. His class teacher helped him, as well as the class TA, but there was nothing else, ie. no statement.

 

Moving to Middle School, they were very ASD aware and talked a good talk on how he would be looked out for, helped, etc. To which in reality, there has been nothing. It's now that it is becoming an issue again and I can only see it getting worse as the work gets more complex.

 

He cannot tie shoelaces..he struggles with buttons and zips at times, he cannot ride a bike and he can't climb a tree. He pronounces words correctly, but it's when he spells them out he seems to confuse letters out loud, but his mind has them correctly (more like dyslexia but generally his spelling on paper is ok). I too think he has learnt by memorising, hence the problems coming to the fore in this area now.

 

Time to push for the assessments!

[puffin]

Do you feel that this is a psychological issue of how to formulate what he wants to write or is it a physical issue of how to hold the pen aand write efficiently? Or is it both

 

My DD1 had the latter problem - she had a physio and OT assessment and the found poor coordination and the tendency to press very hard when writing which led to writing become and exhaustingf and slow process for her as she was using much more effort.

 

We had difficulty getting the first school to take the issue seriously but when she moved to an SEN unit they developed a special hand-training programme for her in conjuction with the OT - the programme had many different elements:

- a letter formulation programme to improve her letters

- a general programme to improve dexterity which included

~ computer programmes

~ colouring in using mandalas - highly complex patterns

~ craft activities including sewing, crochet and baking

~ physio exercises for her hands and wrists

 

 

It worked really well - nowadays she writes for fun and carries her story notebooks everywhere she goes

[Sally44]

I think you've described some pretty common motor co-ordination problems which any professional should recognise and assess and address.

 

Ask your GP for a referal to OT, and then find out who the GP has referred to and phone them up and then follow that up with a letter.

 

There is a very long waiting list for OT [we waited 2 years], but if you have tried to get him assessed and his needs met, and nothing happens, then that is further evidence for any appeal you go to.

 

You can write to the OT and ask them "how" they assess, diagnose and meet the SEN of children with dyspraxia. Ask them what amount of "time" would be allocated to your son, and would they include any 1:1 direct therapy in school.

 

If they write back, I am guessing they will say they just give advice to parents. If he has Dyspraxia, it is an "educational need" because it will impact on his learning. Dyspraxia is not JUST about muscles and co-ordination. If you read about Dyspraxia you will see that many skills essential for learning are affected by dyspraxia.

 

At a Tribunal Hearing, if there is a need ie. dyspraxia in part 2, they will want provision quantifying and specifying in part 3. And you would be arguing that although you would definately want to reinforce and carry out exercises at home - that the home environment, and you as "mum", should not be the sole person delivering OT or SALT programmes. There are degrees of difficulty and for our children they need those professionals to be working with your child 1:1 with maybe a trained TA carrying out the programme on a daily basis, but with the qualified professional monitoring the programme and adjusting it on a weekly/monthly/termly basis [an independent report would be very specific].

 

I would start the process now because as our children go through school the demands placed on them do become greater. And although our children do make progress, they can find the gap between them and their peers widening in all areas [academic, social and emotional], and that can be scary for them and make them very anxious, especially if they recognise that they are different and not performing or being as successful as their peers.

 

If they find themselves not very good academically, not good physically at sports or team games, not good socially and have no friends - then they can quickly start to feel negatively about themselves and their confidence and self esteem plummets.

Edited November 20, 2011 by Sally44

[Special_talent123]

I have dyspraxia. my hand writing couldn't be understood a while ago and i had something done in clas that helped me. But still when i were in my english class i get frustrated writing and prefer a use of a computer. I can't even think what to even write in the class even prompts and have trouble understanding what tutor saying to me.

Edited November 27, 2011 by Special_talent123