Evaluation of co-production 

Blog 1 of 4 in the Insights From Researchers on Co-production blog series

EPIC blogs usually focus on parent, teacher and clinician readers. This series of blogs are the findings from a workshop for researchers entitled Overcoming barriers to co-production with children and adults with neurodevelopmental disabilities which took place during the Neurodevelopmental Disorders Annual Seminar 2022 held in Edinburgh. Following on from this series we will have the Insights from a Lived experience on Co-production blog series which will focus on getting involved in decision making about research from a parent perspective.

During the workshop, we split into groups to work on challenges associated with co-production. Attendees self-selected to one of six groups: 1) Recruitment and Partnership building, 2) Payment, Expectations, and Trust, 3) Facilitation of co-production with adults, 4) Facilitation of co-production with children and adolescents, 5) Evaluation or 6) Dissemination and public engagement. 

No one went to the Evaluation group. And so, I decided to write this blog first as there is seemingly a lack of confidence in this area with researchers. The other reason Evaluation is the first entry in this blog series, is because evaluation is something you need to think about at the beginning. 

Evaluation of co-production can be thought of in two parts: evaluating the process of co-production and evaluating the impact of the co-production on the project. Evaluating the process can be formative and summative (den Houting, 2021). Formative evaluation is evaluating the design for a given purpose and context. Collecting this formative feedback could take the form of for example, 1) checking with your project patient and public involvement co-ordinator if the structure of the workshop you’ve designed makes sense or if the questions are clear, 2) checking the activity with 1 or 2 children before doing it with ten, 3) asking a colleague who has conducted similar work if they think the design will work well. If co-production for a project is long-term e.g. over a year, formative evaluation could be collecting feedback from your  group about how the co-production process could be improved e.g. shorter meetings, sending the agenda in advance, switching to texting instead of email for communication. Recording who came to a meeting, their ages, diagnoses, ethnicities, or other relevant information like membership in charities/organisations or research experience is important for reflecting on whether other people may need to be recruited. It can be helpful if an indicator of understanding amongst the group is collected e.g. asking members to summarise the main points of the day at the end of a workshop – this point is more relevant to working with children. 

Summative evaluation of the co-production process is important as it holds the researchers accountable and provides impetus for the research team to reflect and change their processes for the next project. This can involve asking the co-production and the research team about how the co-production went. den Houting (2021) provides some examples of questionnaires and interview questions to evaluate the process of co-production. 

Finally, recording the impact of the co-production on the project. Evaluating impact of the co-production on the project can be supported by a framework like the Public Involvement Impact Assessment Framework (PiiAF) (Popay & Collins, 2017). The framework can also be used as a means of setting expectations with the co-production group at the start. When co-production is carried out well it is embedded in the research design process and gradual; it can be tricky to look back and remember exactly what the co-production group contributed to the project. The researcher might think a year later “was adding the a measure of well-being to the project my idea or their idea? Or did it arise in a discussion we had…I think it was my idea…but I think I had that idea as a result of something the co-production group said..oh I can’t remember!”. Developing a plan at the beginning of co-production to record the feedback avoids this problem. This can take the form of recording notes during each meeting and then under the notes writing a reflective piece about which parts will inform the project. When it is time to write your paper, you will be able to succinctly write how involvement impacted the project. Do not forget to record praise for the project as well. 

Patient and public involvement is a part of the research process like funding, design, data collection, analysis. I agree with Edelman and Barron (2016) when they say patient and public involvement (PPI) should not be evaluated like a sort of complex intervention on the project. They make the interesting point that PPI is a ‘contribution of expertise and advocacy, equitable to the contribution of clinicians, statisticians or others.’ Would you test the contribution of a statistician on a project? With the help of a framework like the PiiAF, thinking about the aims, desired outcomes, and indicators of those outcomes is useful for 1) designing the structure of your co-production work (how many sessions will be needed, what we need to cover in them), 2) setting expectations for the co-production group and the rest of the research team, and 3) looking ahead to decide how you will record feedback and how it informs the project. But testing co-production, like you would other variables in your research project, is not necessary in most cases. 

References and more resources: 

Popay, J., Collins, M., & with the PiiAF Study Group. (2014). The public involvement impact assessment framework guidance. Universities of Lancaster, Liverpool and Exeter https://piiaf.org.uk (full and short version available)

Collins, M., Long, R., Page, A., Popay, J., & Lobban, F. (2018). Using the Public Involvement Impact Assessment Framework to assess the impact of public involvement in a mental health research context: A reflective case study. Health expectations : an international journal of public participation in health care and health policy, 21(6), 950–963. https://doi.org/10.1111/hex.12688

den Houting, J. (2021). Participatory and Inclusive Autism Research Practice Guides. Brisbane. AutismCRC.https://www.autismcrc.com.au/access/sites/default/files/resources/Participatory_and_Inclusive_Autism_Research_Practice_Guides.pdf

Edelman, N., & Barron, D. (2016). Evaluation of public involvement in research: time for a major re-think?. Journal of health services research & policy, 21(3), 209–211. https://doi.org/10.1177/1355819615612510 

This workshop was funded by the University of Edinburgh College of Medicine and Veterinary Medicine Public Engagement Seed Fund through the Institutional Strategic Support Fund.

How does stimulant medication actually work on thinking skills?

We have previously posted about ‘myths around ADHD’ covering issues such as the lifespan nature of ADHD symptoms, common beliefs that ADHD is seen typically on its own and that those with ADHD are similar to each other. Another myth is that ADHD mainly affects behaviour. Our research, however, and that of many other groups has shown that thinking difficulties like memory, attentional control and planning are key difficulties for many children with ADHD.

Other myths around ADHD extend to stimulant medication, a common treatment for ADHD. So how do stimulants actually work? There is now considerable research evidence looking at how stimulants work. How do you know where to start in terms of which of these research papers should be considered? A good place to start is to look at whether there have been any reviews on the topic that have been done in a systematic way (what is called a ‘systematic review’) – this is like a study of studies. It brings together and reviews all papers on a topic and as part of the process assesses the quality of the studies and for example tries to find out if the studies are at risk of bias. It is even better if there is what is called a ‘meta-analysis’ on the topic. A meta-analysis merges the findings of individual studies and statistics are used to arrive at an overall effect across the studies.

Last year a meta-analysis was published on the topic of stimulant medication and thinking skills in children with ADHD. They found that stimulant medication improved a range of thinking skills – what are called ‘executive functions’. They include aspects of thinking such as ‘working memory’ (the mental workspace where you hold and organise information for a brief time) and ‘cognitive flexibility’ (being able to switch from thinking about different concepts or doing different parts of task). We know many children with ADHD have difficulties in these thinking skills and it is clear that the improvements we see in many children with ADHD while on medication likely reflect them being able to use their ‘executive function’ skills better. Larger doses of medication were not found to improve these particular thinking skills more than the effect of small doses.

Our own research has shown that stimulant medication improves these executive functions but has also highlighted that stimulants act on self-regulation which is a broader concept. Basically we found that despite the common understanding that this medication acts by slowing down the child so they can stop and think better actually this is too simple an explanation. We found that stimulants slowed down performance on tasks where it is good to stop and think (letting them make a plan or organise their thoughts). But stimulants also actually speeded up performance – this time on a task where the child was encouraged to perform the task as quickly as possible (doing so doesn’t usually cause more errors). So it appears that stimulants improve ‘self-regulation’ – allowing the child to act more appropriately to the requirements of the task they are doing.

While the executive function meta-analysis study looked at quite a range of thinking skills many everyday thinking skills such as planning, problem solving, time management, and self-monitoring were not examined. This reflects a lack of research studies that have examined these broader thinking skills. EPIC has been developed to help support the development of all of these thinking skills. Ideas for how to facilitate understanding of an individual child’s thinking skills and strategies to support them can be found in our free downloadable booklets. EPIC focuses on the child as a individual as children who are ‘neurodivergent’ (when someone’s thinking, learning or behaviour differs from what is considered typical) differ from one another in their thinking skills. This may be due to the presence of a second or even third co-occurring condition (e.g. having a diagnosis/symptoms of ADHD versus both ADHD + autism). Whatever the reason it is really important we understand the thinking skills of each individual neurodivergent child as an individual. EPIC materials can be used to help identify what lies behind an individual child’s difficulties whether that is with the school experience, learning, relationships with their peers and/or generally navigating everyday life situations. At the moment these booklets relate to ADHD and DCD specifically but they can be used for any child who struggles with these thinking difficulties and indeed we are currently working on booklets and videos that are tailored to all children who are neurodivergent.

Visual production credit: photographer monkeybusiness images via Getty images.

Outputs from our co-production workshop

The Neurodevelopmental Disorders Annual Seminar was held in Edinburgh this year. During the event, we held a workshop called Overcoming barriers to co-production with children and adults with neurodevelopmental disabilities.

Many researchers feel unprepared to co-produce research with people with neurodevelopmental disabilities, while still believing in the value of co-production. This workshop aimed to address this gap, by giving researchers an overview of the main challenges to co-production and how to overcome them.

We had three excellent speakers:

Dr Laura Crane, co-director of Centre for Research in Autism and Education (CRAE) at University College London. In her talk, she explained her journey into participatory research methods, how research about autistic people has changed in the last few years, challenges and solutions to co-production work.

You can see her presentation on our YouTube channel here https://www.youtube.com/watch?v=qMSrhVBn4sk&t=27s

Ailbhe Mckinney talking and Sarah O’Brien on the big screen giving her views during the discussion part of the workshop

Next, we had Sarah O’Brien, a PhD researcher at Kings College London. She talked about co-production from the perspective of conducting it as a facilitator but also being involved as an autistic and dyspraxic individual. She talks about what she learnt along the way. 

See her talk here: https://www.youtube.com/watch?v=ZaBizLjR0rI&t=346s

Finally, we had Emma Pauley, who is a parent and co-production advocate. She talked about being involved in genuine co-production and then, tokenistic co-production. She spoke about how it was easy for her to see the difference and how they made her feel. 

In the afternoon of the workshop, attendees (45 researchers in the area of neurodevelopmental conditions) discussed challenges and solutions to co-production across six themes: 1) Recruitment and Partnership building, 2) Payment, Expectations, and Trust, 3) Facilitation of co-production with adults, 4) Facilitation of co-production with children and adolescents, 5) Evaluation or 6) Dissemination and public engagement. 

Over July and August we will be posting two blog series summarising the outputs from this workshop: starting this week with the: ‘Insights from Researchers on Co-production blog series. and then, later in the summer Emma Pauley’s series ‘Insights from a Lived experience on Co-production blog series’

This workshop was funded by the University of Edinburgh College of Medicine and Veterinary Medicine Public Engagement Seed Fund through the Institutional Strategic Support Fund.

Update on EPIC activities

We have been a bit quiet on the EPIC blog of late as we have been very busy with a number of activities!

We are working hard on developing new booklets! These will be added to the collection of understanding ADHD and DCD and strategy booklets we have already posted on our website. Our new booklets will be suitable for all neurodivergent children. This means they will be suitable for children who have difficulties in their thinking, learning and wellbeing who have no diagnosis or multiple diagnoses or difficulties that go beyond a current diagnosis. Many children fall into these categories as waiting lists for assessments can be long and in our work we continually hear from parents and teachers about the need for information to help these children now while they are waiting on assessment and support.         

We have also recently received funding to make a video version for parents and teachers of the EPIC booklets highlighting the ways in which these children can be supported and we hope to release that on our website in late autumn.

From next week we will be posting a series of posts again for parents and teachers that describes recent research we have published about children’s understanding of ADHD and strategy use in the classroom, understanding the relationship between thinking processes and maths learning, and an overview of how ADHD stimulant medication works on thinking processes.  

From next week we will also be posting two interlinked series of blogs that relate to the importance of children with conditions, their families and those who care for them being involved as active decision makers in the process of research studies. These series’ will involve one directed to researchers ‘Insights from Researchers on Co-production blog series’ involving 4 blog posts written by PhD researcher Ailbhe McKinney on topics from evaluating involvement of the public in research to best practices in dissemination. A second series ‘Insights from a Lived experience on Co-production blog series’ involves 3 blog posts from Emma Pauley who has lived experience. She will cover the importance of families affected by disability in being at the heart of what is researched, informing how studies are carried out and how the researcher best reaches families with the findings.  We will also be launching our YouTube ‘EPIC’ channel with videos and presentations about research and advice for parents and teachers.

Myths around ADHD

Attention Deficit Hyperactivity Disorder (ADHD) is often misunderstood. The myths that surround ADHD never seem to go away despite a huge amount of research into the causes, characteristics and treatments for ADHD. Most psychological disorders do have myths around them though – such as the image of all autistic children having amazing memories like the actor in the film ‘Rainman’. The myths surrounding ADHD may be in part have arisen by the name we have for the disorder i.e. ‘attention deficit’, and the fact that people tend to see behaviour first. In this blog post some of these myths will be addressed. Looking at these myths in relation to research evidence is important as without an accurate understanding of the difficulties children with ADHD show, it is very difficult to support these children effectively.

A common myth is that most or even all children with ADHD will grow out of their difficulties. Some children do of course show reduced symptoms with development but research has shown that the story of developmental changes in ADHD is complex. In one research study, children were followed up after a 4 year period and asked to complete a set of thinking tasks tapping memory, planning, attention flexibility and controlling responses.  On some of the tasks, such as on a long-term memory task where children had to remember patterns and later recognise them, the children caught up with their peers. On another task where children had to use a strategy to keep and update information in their ‘working memory’ they showed improvements with age but didn’t catch up to the levels of their peers. On other tasks, such as those assessing being able to keep information in memory over time there was evidence of continued difficulties. This research shows that the story of ‘growing out of ADHD’ is not a straightforward one.

Some statements you may have come across about ADHD might include ‘ADHD mainly affects behaviour’, ‘ADHD is a childhood condition’, and ‘attention difficulties explain the thinking (‘inattentive’) part of ADHD’. In fact these are myths in the specific sense. While many children with ADHD do have behavioural difficulties, thinking and learning difficulties are very common and often underlie behavioural difficulties that are seen. Obviously the name ‘attention deficit’ suggests that difficulties in attention explains the thinking part but in reality this accounts for only a small part of the difficulties. Research has shown that many of these children do not have a specific attention difficulty at all – at least in terms of how psychologists measure attention.

Children with ADHD often show difficulties in thinking strategically – what we refer to as ’executive functions’. The thinking difficulties associated with ADHD are much broader than executive functions too though. Children with ADHD often show memory difficulties including basic memory processes and not just the more strategic kind of memory associated with executive functions. Other difficulties or differences can include perception of time (and a range of aspects of timing), being able to self-regulate, having an aversion to delay, and being variable in responding.  

An important issue to emphasise is that children with ADHD differ from one another. We now know that many children with ADHD show difficulties in executive functions for example but not all do, and those that do can differ in the areas they have difficulty in. Some may have difficulties in ‘working memory’ (a mental workspace where we hold and organise information in our mind) and others with planning. Other children may have a difficulty in using their attention flexibly and/or being able to control their responses. Children with ADHD have different strengths and difficulties and it is important we understand these children on an individual basis for that reason. In our ‘Understanding ADHD’ booklet, we describe a range of these strengths and difficulties and in our linked Strategy booklet we outline ideas for how to support children with their particular set of difficulties.   

ADHD is often spoken about as a condition that occurs on its own. Most children with ADHD show difficulties in other areas. Often these will relate to a second or even third diagnosed condition but children with ADHD often show symptoms of another condition but do not meet criteria for a diagnosis. These symptoms may still impact their thinking, learning, behaviour and wellbeing though. These difficulties may include the sensory difficulties we would associate with autism, or fine or gross motor difficulties we would associate with dyspraxia/DCD. Children with ADHD are also more likely than their peers to show specific learning difficulties such as dyslexia. Understanding these common co-occurrences is critical to fully support a child with ADHD.

A few years back members of our team were involved in a large scale research priority exercise (called a James Lind Alliance exercise) with young people, their families and health and education practitioners across a range of areas of learning difficulty including ADHD. Several of the top questions families and professionals felt were a top priority for research focused on how do we optimally support these children for best outcomes. A huge part of tackling this question involves the need to dispel these common myths and to understand children with ADHD based on research evidence. This research, which shows that ADHD is associated with a wide range of difficulties and that children differ from one another in their specific profile of difficulties, highlights the importance of taking an individualised approach to supporting children with ADHD.

Visual photo credit: Photographer valentinrussanov via Getty images.

Thinking skills and literacy in children with ADHD

We have recently published systematic reviews about thinking skills and their relationship to difficulties in maths and literacy in children with ADHD. Today we will summarise the findings of the review that focused on literacy. So first of all, what is a ‘systematic review’? A systematic review is a summary of all of the literature that has been published on a specific topic. The authors make decisions before hand about criteria that the research studies must meet such as for example that the review will include children in primary school only or who have a confirmed diagnosis. The authors then comprehensively search all of the available literature with those criteria and arrive at a final set of studies to be included. In our literacy review, we also did what is called a ‘meta-analysis’ – this involves doing a statistical analysis on the data produced by the studies in the review that combines them. Both a systematic review and a meta-analysis are therefore important ways of putting together and understanding a research area that draws on as much robust studies as possible. The conclusions made then reflect the studies across that field rather than a conclusion that comes from a single study result.

The review we are going to focus on today was on the topic of thinking skills and literacy. We chose to examine studies that focused on literacy broadly and not just reading as we know that young people with ADHD, their parents and teachers often make comments that difficulties lie beyond reading. This makes sense if you think about writing for example and the importance of planning in creating a story that has a beginning, middle and an end.

So what did our review and meta-analysis find? Using our criteria we ended up with a review that included 6 studies. The age of participants in the studies ranged from 6 to 16 years with an average age of 9. We found there was a fairly small set of studies conducted that met our criteria and had looked beyond reading to other aspects of literacy. Researchers mainly focused on ‘working memory’ (the mental workspace where you hold and organise information for a brief time), but some also looked at ‘inhibitory control’ (difficulty with avoiding distractors and generally controlling responses). Attention was also examined and several included measures of ‘processing speed’ (how long it takes to get something done). Surprisingly given our example above none of the studies had included a measurement of planning or broader organisation skills.

What did the review and analysis find then? We found a series of relationships between different aspects of literacy and thinking skills. Poorer working memory skills were linked to a wide range of aspects of literacy difficulties including word reading, reading comprehension (being able to understand what is being read), writing and spelling. What this means is that if a child has difficulties in working memory they are likely to need supports and strategies in place when doing tasks that involve literacy. Having difficulties in inhibitory control, which we know is a key characteristic of many children with ADHD, was related to poorer spelling. Attention was only examined in one study and was found to be associated with reading. Processing speed, or how long it takes to get something done, was not consistently linked to literacy, although may be relevant for writing. We concluded that much more research needs to be done on this important topic.

Understanding thinking difficulties and their relationship to literacy is really important in arriving at suitable supports and strategies for optimising literacy learning for children with ADHD. In our Strategy booklet we describe a range of techniques to encourage children to practice these thinking skills and strategies that can be used to help children engage optimally with their academic learning.

The full paper can be found here: https://bpspsychub.onlinelibrary.wiley.com/doi/epdf/10.1111/bjdp.12395

Visual production credit: photographer monkeybusiness images via Getty images.

Helping children with their thinking skills across settings

We have been blogging about EPIC over the last few weeks introducing the ideas behind our approach.  

Last time we blogged about two of the central foundations of EPIC –our approach being individualised and taking what is called a ‘transdiagnostic’ apporach. Today we are going to discuss the importance of embedding change across contexts.  

In order for activities to be most effective for children, it is best that they are carried out across the settings they spend time in. Using and practicing the strategies we have described in our Strategy booklet at home and at school can help to make them routine and a child’s go to.

An example is encouraging children to practice planning. Most children as they develop begin to naturally use methods to help them plan out tasks or activities. Some children with developmental difficulties forget to do this and it makes starting, staying on, and completing a task or activity difficult. In our ‘understanding’ booklets, we describe how parents and teachers caring for children with developmental difficulties can be aware of this thinking difficulty so they know they must encourage the child to put steps in place to help them complete tasks. They can also use external strategies like planners, diaries and mind-maps to help them think about and practice planning.

In the home, everyday toys like Lego and craft activities are excellent ways to promote planning. In our strategy booklet (e.g. page 38) we describe steps that can be taken to promote the use of planning like drawing out what you plan to make with Lego pieces and working out what pieces you will need before you start. Games like ‘Connect 4’ and ‘Guess Who’ can be used to remind children about the importance of planning by chatting through about how you plan your moves before you make them. Many craft activities are also useful. Children can be encouraged to think about the final goal, plan out their use of materials before starting, and break the tasks into steps or stages to help them stay on task and complete the goal. Baking, and cooking in general, with children is also an excellent way to model planning – ‘what are all the ingredients we need before we start?’. When we bake we can engage the child in breaking the task into steps and encourage them to work towards an end goal – the cupcakes coming out of the oven!

In school, there are many routine activities that lend themselves to planning. Doing a book or chapter review is a great way to encourage children to reflect and to break a story into parts.  Mind-maps are a visual way to organise thoughts and ideas. They have a focus in the middle with ideas or themes branching out from it. The branches can be used to represent relationships between ideas.  A mind-map can be used to plan out the writing of a story – in the middle could be ‘my story’ with the branches indicating ideas for the beginning, middle and end and of course this could be words or it could be pictures depending on the age and ability of the child.      

The knowledge and strategies children gain from these activities can upskill them in new scenarios they encounter where planning skills and aids can be beneficial. Although our posts are often especially useful for children with developmental difficulties these skills are important for all children and we encourage a whole class or family approach when using them at school or at home.

In the next few weeks, we are going to blog about research evidence on children with developmental difficulties starting with a piece on ‘myths around ADHD’ and then a post about stimulant medication and ADHD. Academics write about their research in journals that are often not accessible to the very people who would gain most from hearing about the research. Over the next few weeks we will blog about some of this research in a style that is suitable for all people. It is very important to us that parents, teachers and all those caring and working for children with developmental difficulties have information to hand that can help them understand a child’s condition or difficulties but also that helps them to offer opportunities and strategies for the children they care for.  

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

Visual credit: Image by photographer damircudic via Getty Images

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! 

Visual production credit: Photographer Ekaterina79 via Getty Images

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! 

Visual production credit: Photographer damircudic via Getty Images

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! 

Visual production credit: Photo by T L Furrer via Getty Images