Taking an individualised approach when helping a child with developmental difficulties

The EPIC intervention and use of associated materials aims to facilitate optimal thinking, learning, and wellbeing in children and young people. Today we are going to cover a further aspect of EPIC: taking what is called an ‘individualised transdiagnostic’ approach.

The EPIC approach is individualised. It is important that psychoeducation and strategies are based on a child’s strengths and difficulties and not assumptions about their diagnosis. As we have mentioned before research has shown that not all children with ‘Attention’ Deficit Hyperactivity Disorder actually have an attention difficulty. They may act distracted because of a difficulty in memory for example. We need to look beyond the diagnosis because as the saying goes ‘if you have met one child with ADHD you have met just one child with ADHD’. We know from decades of research that children with the same diagnosis can ‘look’ very different to one another. An example is ’executive functions’ – which are thinking processes we engage to organise ourselves and to help us to achieve goals. There are different types of executive functions. Memory – especially using strategies or organising your memory is one example. Another example is being able to use your attention flexibly – for example in moving easily and flexibly from one part of a task or an activity to another. These seem very different – but both are part of the concept of executive functions. Some children with ADHD have a difficulty in one of those processes, some the other, some both, and some actually neither of them. This means we need to be careful about making assumptions of what a child’s thinking difficulties will be, based on the label a child has. The label is a guide but we need to ask further questions about what it is for that child that distracts them – attention, memory, sensory processing or something else? See our booklets for more information on this.      

Many children with a particular developmental condition show difficulties associated with another. Even if a second condition has not been diagnosed, a child may still show difficulties associated with a different disorder that are making life difficult for them. A common example is a child with ADHD showing sensory processing difficulties we normally associate with autism or dyspraxia/DCD symptoms or diagnosis. A child with ADHD may act distracted and can’t focus and of course it would look very much like an ‘attention’ difficulty. Actually though the child may have sensory processing difficulties and they are distracted by particular noises that occur in the classroom or at home. It is important we take an individualised approach and assess what the specific difficulties are that an individual child is experiencing. Our booklets detail lots of ideas and activities as to how to identify what the underlying difficulty might be. Our strategy book describes ways then that these difficulties can be helped.  

We hope you find our booklets useful. Do please contact us with any feedback you have! 

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Personalisation

We have published free downloadable materials for parents and teachers to help with thinking and learning in children and young people especially for children with developmental difficulties. Yesterday we blogged about a key feature of EPIC – multiple areas of difficulty and we wrote about our play, game and activity based focus.   Today we are going to cover personalisation and will also write about active learning.

At the heart of EPIC is personalisation. How can we best engage children to improve their thinking learning and wellbeing? We advocate using the items that are personal to a child such as toys they play with or items they collect. We have for example used nerf guns to help children learn high frequency words! A parent or teacher could write out a series of words for example ‘th’words – the, they, there, them – put them up on a door and ask the child shoot at them on calling each word out! Children who love lego can be easily engaged in maths by using lego to represent numbers with coloured pieces used to represent ‘chunks’ or groups of information. We include many more examples in the Strategy booklet.   

A child’s active participation in their learning is critical for all children but especially important for children with developmental difficulties. It is important the child ‘does’ the activity in addition to listening to information. In our strategy booklets we detail examples like this that many teachers routinely use in this way such as ‘rainbow writing’ and ‘stepped writing’. When we conducted interviews and workshops with teachers as part of the development of EPIC, teachers described the range of strategies they use and we found lots were being commonly used by all but some teachers used strategies that others weren’t using. We were able to document them in our booklets to ensure that teachers can learn from other teachers’ effective use of strategies.  Of course parents can also use these strategies to help with their child’s thinking and learning.    

We hope you find our booklets useful. Do please contact us with any feedback you have! 

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Multiple areas of difficulty and neurodevelopmental conditions

The EPIC intervention and use of associated materials aims to facilitate optimal learning, behaviour, wellbeing and mental health in children and young people. We recently blogged about strategies paired to areas of difficulty.   Today we are going to cover a further key aspect of our approach: targeting multiple areas of difficulty.

Children with neurodevelopmental difficulties most often show multiple thinking difficulties. It is a myth for example that children with ADHD just have a difficulty with attention. Indeed research has shown that many children with ADHD do not have an ‘attention’ difficulty at all. Many children with neurodevelopmental conditions show difficulties in being able to hold and organise information in memory, in automatically using strategies when they are needed, and in other areas like organisation and planning. Some children act distracted not because of a thinking difficulty but because they have sensory processing difficulties and of course classrooms can be noisy places. We emphasise identifying as many of the areas of difficulty a child has and undertaking psychoeducation and using strategies across these components.

How best can we engage children to understand their difficulties and to practice ways to overcome them? EPIC takes a play, game and activity based approach to achieve this. Games that are available routinely in homes like connect 4, snakes and ladders and guess who can be used to identify a child’s thinking difficulties and to practice ways of overcoming them – see our Strategy booklet for examples.  Routine household items can also be used as featured in our ‘tea towel’ memory game and ideas around baking and crafting.  See the booklets for more information on these strategies.

We will post about more of the EPIC underlying principles over the next few weeks. We hope you find our booklets useful. Do please contact us with any feedback you have! 

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Strategies to help with thinking skills

A central part of the EPIC approach is the use of psychoeducation and pairing of that knowledge with suitable strategies for facilitating optimal thinking, learning and wellbeing.

Once the child, parent and/or teacher are aware of a child’s difficulties, strategies can then be paired to difficulties to meet an individual child’s needs. In our Strategy booklet, we detail many examples of games and activities that can help with a child’s awareness of their thinking difficulties and easy tips and tools they can use to overcome them. Our current booklet has been developed for teachers but is also suitable for at home use by parents. In our next phase of EPIC we plan to co-produce a strategy booklet specifically for parents working with parents to do so. All of our work has evolved from what is called a ‘co-production’ model – working with children and young people, parents, teachers and clinicians to ensure our research priorities, practices, language use and materials are directed by those that will use them.

The strategies we detail include those that involve internal thinking strategies and external aids. Internal thinking strategies include for example ‘chunking’ which involves grouping or listing things based on similarity. If a child has to hold in mind a series of numbers they could chunk them into something meaningful – 1045 – my brother is 10 and my Dad is 45. Chunking in reading can help to not overwhelm a child with a long piece of text. Seeing the text as broken up into meaningful parts can also help with understanding.

Another technique to help memory is use of ‘mental imagery’. This is when a child creates an image in their mind to make things more vivid. It can also be used to remember to connect different bits of information. If a child for example is writing a paragraph that has to include a child, a dog and an ice-cream they could picture themselves holding an ice-cream and the dog takes a lick!

External strategies can also be useful such as the use of diaries or planners. These can help to reduce information that has to be remembered but also to plan out tasks and divide into steps. A mini-whiteboard can be a particularly useful tool for children with thinking difficulties. The use of ‘mind-maps’ can also help with planning and organising information meaningfully. A mind-map is a diagram or picture where information can be grouped and it can be linked. Colour and images can be used to help organise and display information.

Please see our booklets for more information on these strategies. We will post about more of the EPIC underlying principles over the next few weeks. We hope you find our booklets useful. Do please contact us with any feedback you have! 

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Psychoeducation

The EPIC intervention and use of associated materials aims to facilitate optimal thinking, learning, and wellbeing in children and young people.

A central part of the EPIC approach is the use of psychoeducation.   What is psychoeducation and what does it involve?

Psychoeducation involves gaining knowledge to help with understanding of a condition. The aim of psychoeducation within the EPIC approach is to ensure that everyone caring for a child understands the strengths and difficulties of the individual child. Our booklets ‘Understanding ADHD’ and ‘Understanding DCD’ can be used at home and at school to help with understanding a child’s difficulties.  

Within the EPIC approach, psychoeducation is not about learning about a diagnosed condition such as DCD and assuming every child with DCD has the same set of difficulties. Children with the same diagnosis label differ from each other. These differences mean it is important that everyone caring for a child understands the strengths and difficulties of that individual child and not what they assume would be their difficulties from their label.

A really good example concerns Attention Deficit Hyperactivity Disorder (ADHD). Of course it will be assumed that a child with this label has an ‘attention’ difficulty – it is in the name after all. But actually our research shows that if you ask children with ADHD to complete a range of tasks tapping areas like attention, memory, planning and similar skills, the fewest amount of children have a difficulty in ‘attention’. A lack of concentration can reflect a whole wide range of thinking or other difficulties. It could reflect a memory difficulty – we know that for many children with ADHD information disappears more quickly from their short-term memory than it does for other children. Many of these children have sensory processing difficulties and are hyper sensitive to noises or other sensory information around them. Classes are noisy busy places. It is likely that many children with developmental difficulties are distracted by aspects of their environment they are sensitive to, rather than by an internal ‘attention’ difficulty.  For other children there will be a thinking related attention difficulty. Each child is different. The EPIC approach takes a ‘strengths and difficulties’ perspective where each child is understood as an individual.       

How can the EPIC materials help with identifying what is the underlying difficulty affecting a child? The ‘Understanding’ booklets detail areas of strengths and difficulties to think about and focus on. In our strategy booklet (designed for teachers but it is also suitable for parents) we describe everyday games that can be used to think about what underlies a child’s difficulties. Every day games like connect 4 and snakes and ladders can be useful with this. With connect 4 you can play and see whether a child plans out their moves and whether they have difficulty in taking turns. Being able to think flexibly can also be observed when playing connect 4 by switching the players colour disks between games. Snakes and ladders is also useful for this – play normally and then switch to going down the ladders and up the snakes.

In our booklets we emphasise the importance of talking to a child about their thinking processes. Many children with developmental difficulties don’t have the neurotypical child’s automatic tendency to plan and to use strategies to aid memory.  Psychoeducation can help a child to recognise they need to put strategies in place to help them complete tasks and activities. Parents and teachers can also put strategies in place to aid thinking difficulties and ensure a child can approach and complete a task as best as they can.            

We are currently designing a more general booklet that will be useful for children without a diagnosis. Many children do not have a diagnosis as they are on a waiting list. Others are without a diagnosis as they may not have quite met criteria during assessment. Other children have similar thinking and wellbeing difficulties to those with a diagnosed developmental condition but their difficulties have arisen from a different reason such as having been born premature.  Our approach of taking each child as an individual means that these games and activities are likely useful for children without a diagnostic label.

Of course all children have strengths and difficulties so these booklets can also be used more generally with children. We very much encourage that a whole class approach is taken when learning about thinking processes in school. This can help foster children’s awareness and insight into the limitations inherent in aspects of our thinking like our memory and successful planning and organisation.        

Tomorrow we will blog about pairing knowledge of a child’s difficulties with suitable strategies for facilitating optimal thinking, learning and wellbeing.

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Welcome to the EPIC blog!

We are really pleased to launch our blog ‘Edinburgh Psychoeducation Intervention for Children and Young People’ (EPIC) today!  Our website can be found here with downloadable resources to facilitate thinking, learning and wellbeing in children.

EPIC takes an individualised approach to child development with the aim of facilitating optimal learning, behaviour, well-being and mental health in children and young people. At the heart of the EPIC approach is understanding the individual child’s strengths and difficulties regardless of age, sex, or clinical diagnosis. There is a common saying ‘if you meet one autistic person you have met one autistic person’ – the same applies to other diagnoses such as ADHD and DCD.   We have developed resources for parents and teachers that are available on our website. These resources are suitable for all children and young people, but may be particularly helpful for children with neurodevelopmental difficulties (e.g. ADHD, ASD, DCD/Dyspraxia) and children born prematurely.

During the last few years we have been developing an intervention with children, their parents and teachers. We are currently working with children undergoing ADHD assessment and autistic children. The intervention we have been developing is an 8 week 16 session school and home based intervention. EPIC is focused on psychoeducation involving the child, parent and teacher developing an understanding of the individual child’s strengths and difficulties. We then pair strategies with these difficulties and practice thinking skills using a range of games and activities. In early 2022, we will be extending this work out to children with DCD. In the meantime our resources highlight a lot of our activities with children and young people and can be used by parents and teachers outwith being involved in an intervention.

The booklets contain ideas for how to identify what the individual child’s strengths and difficulties are.  Is there an attention difficulty? Or is the difficulty actually a memory or sensory processing problem that looks like a loss of concentration? Once this understanding is built up, the parent or teacher can use it to inform two key practices – psychoeducation and pairing of strategies to target areas. 

The EPIC blog will include regular posts about child development particularly focusing on thinking and learning skills and wellbeing. Our work is evidence based but importantly posts will be written in a non-academic style to be useful to everyone. Please follow our blog http://www.epic-information.com and us on twitter @InformEpic to keep an eye out for our posts.

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