Blyth, Sheilagh - Boosting Learning in The Primary Classroom - Occupational Therapy Strategies That Really Work With Pupils-Routledge (2015)

Boosting Learning in the Primary Classroom
Boosting Learning in the Primary Classroom is your one-stop practical guide to understanding the physical
development of children and how it influences their ability to learn. Not only does the book explain the
reasons behind the theories, but it also provides over 75 practical tips that really work in the classroom.
The book is based on a successful five-step approach to help children acquire the skills needed to manage
at school and with daily life. It works by pinpointing a problem, assisting others in recognising the impact
that difficulty is having on the child and then providing strategies to develop that child’s specific skills. Using
the latest medical research and established occupational therapy techniques to obtain great results, this
approach provides teachers with the tools to use different knowledge and strategies to engage children in
the learning process.
Chapters include:
■ exploring the reasons for poor handwriting

■ increasing disability awareness
■ the link between body posture and concentration
■ dyspraxia in a school setting
■ how play develops learning
■ understanding sensory behaviour
By providing teachers with an understanding of a child’s physical development and the impact this has in
the classroom, this book demonstrates how educational staff can use this knowledge to boost the learning
of their primary-aged children. It encourages teachers to identify improvements in the child’s progress not
just towards educational learning targets but also in physical motor development. It uses real life case studies,
latest theory and tried and tested occupational therapy methods to help every child improve.
Sheilagh Blyth is a child development specialist, occupational therapist and independent trainer.
I was pleased to review this book as Sheilagh had kindly involved the Dyspraxia Foundation in its chapter
on dyspraxia, so I was keen to read the finished product. Sheilagh has been a children’s occupational ther-
apist for over 15 years and brings her OT know-how to the text. She is passionate about working with
SENCOs and that shines through.
The forward, written by Debra Searle MVO, MBE is inspirational and upbeat and the book continues in
a largely positive way. The message being that with the right support (by staff) and a ‘can do’ attitude (by
the child), anything can be achieved.
Whilst the book has a welcome chapter dedicated to dyspraxia, it is really a book for ALL SENCO’s and
teachers for ALL children. Whilst it sets out to address those problems related to a variety of commonly
experienced (but often not acknowledged) disabilities in the classroom, the theoretical explanations and the
practical tips would be well used for all children.
As a scholar of disability studies I was especially pleased to see a chapter devoted to the difficulties expe-
rienced by those with a disability before any support is offered i.e. the attitudes of others and the fear around
disability which can be the most disabling factor in a child’s educational progress.
The book tackles areas of development common to all children, namely play, handwriting, sensory devel-
opment, posture and concentration, and the development of play. It is good to see the inclusion of hidden
disabilities because children with these often fair badly at school if their difficulties are not acknowledged
and supported.
There are some nice checklists which are easy to complete and analyse, three practical tips for every area
covered (so the reader is not overwhelmed) and lovely summary boxes which can be read on their own for
those in a rush, equipping a teacher in the classroom with the practical solutions to some commonly
experienced issues without requiring additional, time, resources or staff. The inclusion of stories and extracts
by children brings a touch of humanity and reality to the text.
This is the kind of book one could read from cover to cover or just dip into as needed and it would be
interesting and useful either way. I found the most important message throughout was one of empathy. It
is full of great advice, backed up by firm theoretical knowledge, experience and common sense. A great
addition to any bookshelf and one that I would most definitely recommend.
Gill Dixon, PGCE, MA, BHScHons, RGN, Mum

Vice-Chair, Dispraxia Foundation
nasen is a professional membership association that supports all those who work with or care for children
and young people with special and additional educational needs. Members include teachers, teaching assis-
tants, support workers, other educationalists, students and parents.
nasen supports its members through policy documents, journals, its magazine Special!, publications, profes-
sional development courses, regional networks and newsletters. Its website contains current information
such as responses to government consultations. nasen’s published documents are held in very high regard
both in the UK and internationally.
Other titles published in association with the National Association for Special Educational Needs (nasen):
Language for Learning in the Secondary School: A practical guide for supporting students with speech,
language and communication needs
Sue Hayden and Emma Jordan
2012/pb: 978-0-415-61975-2
Assessing Children with Specific Learning Difficulties: A teacher’s practical guide

Gavin Reid, Gad Elbeheri and John Everatt
2012/pb: 978-0-415-67027-2
Using Playful Practice to Communicate with Special Children

Margaret Corke
2012/pb: 978-0-415-68767-6
The Equality Act for Educational Professionals: A simple guide to disability and inclusion in schools
Geraldine Hills
2012/pb: 978-0-415-68768-3
More Trouble with Maths: A teacher’s complete guide to identifying and diagnosing mathematical
difficulties
Steve Chinn
2012/pb: 978-0-415-67013-5
Dyslexia and Inclusion: Classroom approaches for assessment, teaching and learning, Second Edition
Gavin Reid
2012/pb: 978-0-415-60758-2
Provision Mapping: Improving outcomes in primary schools
Anne Massey
2012/pb: 978-0-415-53030-9
Beating Bureaucracy in Special Educational Needs: Helping SENCOs maintain a work/life balance,
Second Edition
Jean Gross
2012/pb 978-0-415-53374-4
Promoting and Delivering School-to-School Support for Special Educational Needs: A practical guide for
SENCOs
Rita Cheminais
2013/pb 978-0-415-63370-3
Time to Talk: Implementing outstanding practice in speech, language and communication

Jean Gross
2013/pb: 978-0-415-63334-5
Curricula for Teaching Children and Young People with Severe or Profound and Multiple Learning
Difficulties: Practical strategies for educational professionals
Peter Imray, Viv Hinchcliffe
2013/pb: 978-0-415-83847-4
Successfully Managing ADHD: A handbook for SENCOs and teachers

Fintan O’Regan
2014/pb: 978-0-415-59770-8
Brilliant Ideas for Using ICT in the Inclusive Classroom, Second Edition
Sally McKeown and Angela McGlashon
2015/pb: 978-1-138-80902-4
Boosting Learning in the Primary Classroom: Occupational therapy strategies that really work with
pupils
Sheilagh Blyth
2015/pb: 978-1-13-882678-6
Beating Bureaucracy in Special Educational Needs

Jean Gross
2015/pb: 978-1-138-89171-5
Boosting Learning in
the Primary
Classroom
Occupational therapy strategies that really work with pupils
Sheilagh Blyth
First published 2015
by Routledge
2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN
and by Routledge
711 Third Avenue, New York, NY 10017
Routledge is an imprint of the Taylor & Francis Group, an informa business
© 2015 Sheilagh Blyth
The right of Sheilagh Blyth to be identified as author of this work has been asserted by her
in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this book may be reprinted or reproduced or utilised in any
form or by any electronic, mechanical, or other means, now known or hereafter invented,
including photocopying and recording, or in any information storage or retrieval system,
without permission in writing from the publishers.
Trademark notice: Product or corporate names may be trademarks or registered

trademarks, and are used only for identification and explanation without intent to
infringe.
British Library Cataloguing in Publication Data

A catalogue record for this book is available from the British Library
Library of Congress Cataloging in Publication Data

Blyth, Sheilagh.
Boosting learning in the primary classroom : occupational therapy strategies that really
work with pupils / Sheilagh Blyth.
pages cm
1. Perceptual-motor learning. 2. Motor ability in children. 3. Occupational therapy for
children. 4. Penmanship. 5. Children with disabilities—Education. 6. Apraxia. 7. Sensory
disorders in children. 8. Early childhood education. I. Title.
LB1067.B59 2015
370.15’5—dc23
2014040957
ISBN: 978-1-138-82677-9 (hbk)

ISBN: 978-1-138-82678-6 (pbk)
ISBN: 978-1-315-73900-7 (ebk)
Typeset in Bembo
by FiSH Books Ltd, Enfield
Contents
About the author viii

Foreword ix
Acknowledgements xi
Introduction: how to get the most out of this book without it gathering dust on
your shelf 1
1 Exploring the reasons for poor handwriting 4

2 Increasing disability awareness 22
3 The link between body posture and concentration 42
4 Dyspraxia in a school setting 57
5 How play develops learning 73
6 Understanding sensory behaviour 88
Conclusion 104
Index 106
vii
About the author
Sheilagh Blyth is the founder of the Enable Me® Method (www.enablememethod.com). She
has been a children’s occupational therapist for over fifteen years and brings her OT know-how
to the primary classroom by creating training programmes and publishing ‘How to’ books.
She is passionate about working with SENCOs and other primary school staff. Three words
that encapsulate her role are: educate, entertain and inspire. She believes we need to educate
others as it is our own lack of knowledge that disables children. We need to give children
entertaining ways of mastering age expected skills rather than asking them to repeat tasks until
they are too bored to continue. Lastly she aims to inspire teaching staff by showing them how
occupational therapy knowledge and skills can help all children learn.
If you wish to contact her, email admin@enablememethod.com
viii
Foreword
As a child the only thing I ever wanted to do was to be a professional adventurer. At school,
a career advisor laughed at me saying, ‘That’s not a profession for a young lady’. Instead I
became an adventure loving PE teacher. I never lost my desire to explore and when the
opportunity arose to enter the Atlantic Rowing Challenge with my partner, Andrew, we dedi-
cated every waking moment to preparing for the race. This included building our own rowing
boat out of 6mm thick plywood.
What should have been a six-week adventure together turned in to a 111-day solo rowing
challenge across 3000 miles, as early in the race Andrew developed a crippling phobia of open
ocean and had to be rescued. I decided to go on alone, attempting to row single-handed from
Tenerife to Barbados. Every day I’d take a huge step outside my comfort zone. In those
moments I discovered the most about myself. My journey met many challenges but what I also
learnt was to take risks when they are needed, set goals and achieve them, adapt to change,
overcome obstacles, the power of teamwork and how by choosing the right attitude anything
is possible. The Atlantic Rowing Challenge pushed me further out of my comfort zone than I
ever thought would be feasible to survive but I learnt that, eventually, the comfort zone shifts.
During my three-and-a-half month adventure I thought a lot about how to choose my atti-
tude and how if you always do what you’ve always done you always get what you’ve always
got. I couldn’t choose if I got blown backwards 30 miles or if I got attacked by a shark or had
a near miss with a super tanker. But I could always choose the way I responded to those things.
When I was out there in the middle of the Atlantic, I clung to that. Choosing your attitude
works. I was not the only one to go solo but I was the only one to make it. I can’t help but think
that this is the one thing that really made a difference. I believe if we have the support and the
attitude then anything, absolutely anything, is possible.
Boost Learning in the Primary Classroom is written to give teachers their own extra support.
This book gives meaning to why if you always do what you’ve always done you always get
what you’ve always got.
The book does not boldly say choose your attitude, as I needed to do in the Atlantic, but it
does make you question whether a change in approach could help reach those children who
struggle to learn. There are six chapters looking at handwriting, disability awareness, sitting
posture, coordination, play and sensory processing skills. Cleverly it introduces you to sepa-
rate childhood difficulties but as you read on you begin to realise how the content from every
chapter can be interwoven together. For instance how handwriting is linked to sitting posture
or how sensory processing disorders limit play choices. Every chapter explains the why, what
and how a developmental delay or medical condition impacts in the classroom. It is an easy
and an enlightening read that I could have done with when I was a teacher.
When we were training for our Atlantic Rowing Challenge we made the error of training
along the River Thames. Without the right experience and knowledge we had left ourselves
open to problems. This book should become your training guide. It has over 75 tips that can
ix
Foreword
be used in any classroom and I really like this practical, hands-on approach. In particular I
found reading the children’s own explanations of what it is like to have a handwriting problem,
receive a diagnosis of autism or have dyspraxia, so powerful and motivating.
My rowing adventure taught me to seek opportunities and changes that I never saw before.
The same can happen for you too today with this book.
Debra Searle MVO MBE, professional adventurer, diversity ambassador, author and
motivational speaker. Author of The Journey: How to Achieve Against the Odds and Rowing
it Alone. www.debrasearle.com
x
Acknowledgements
I am extremely grateful to the children and the parents who contributed to this book. Without
their involvement I would not have been able to portray with such reality how their lives are
influenced on a daily basis by their conditions. I also wish to thank the Dyspraxia Foundation
which has been an amazing resource in the preparation for this book.
There have been many people along this journey who have contributed and all their support
has been invaluable. Thank you to Gary, Helen, Katie, Mary, Michelle and Sharmin for their
encouragement.
xi
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Introduction
How to get the most out of this book without it
gathering dust on your shelf
THIS BOOK HAS been written for the inquisitive teacher. The type of person who wishes to help
children learn by understanding more about the impact of physical development on education.
By choosing this book you probably work in a primary school and are a SENCO, school
teacher or teaching assistant. Every day you are involved in helping children acquire new
knowledge, skills and preparing them to be ready to encounter the new experiences of
secondary school and adult life.
It has been written by someone who knows what it is like to sit in a classroom and not have
the correct resources or feel frustrated because a child is not reaching their full potential. I
appreciate the extra time needed to teach a child with special educational needs. I am also
aware of the high expectations placed upon teachers to meet educational targets. This book
explains the reasons why particular children struggle to learn from a physical health perspec-
tive and it includes practical recommendations that really work. Boosting Learning in the
Primary Classroom provides both explanations and advice to everyday problems. With over
75 tips you will never be short of an idea to try.
The book is based on the Enable Me® Method, a successful five step approach used by the
author to help children acquire the skills needed to manage at school and daily life. It works
by being able to pinpoint a problem, assists others in recognising the impact that difficulty is
having to the child and then provides strategies to develop that child’s specific skills. The Enable
Me® Method uses the latest medical research and established occupational therapy techniques
to obtain great results. This approach does not tell a teacher how to teach, it gives them the
tools to use different knowledge and strategies to engage children in the learning process.
There are some that may say ‘I do not need occupational therapy as I have no children with
special needs in my classes’. This is where I would disagree. Occupational therapy is more than
meeting the needs of the most complex, challenging children in a special school or the ones with
a permanent physical disability. It can help a child to write, to maintain their concentration in
class and to coordinate their hands and feet together. It can prevent physical pain and avoid
future bony deformities. It can also provide medical explanations and solutions to those
children who misbehave at school.
It is human nature to want to know more. People aspire to be effective and efficient in all
that we do. There is an art and a science to being able to engage children in learning. Helping
them to perform to their best ability and reach their full potential. What I have just described
is the ethos of occupational therapy. It uses artistic creativity combined with scientific know-
ledge to help children achieve independence in every aspect of daily life. The paradigms of
education and occupational therapy are not poles apart; in fact they should become partners.
Both complement each other on helping children become successful learners. Unfortunately in
the past the two have not always combined their knowledge.
Boosting Learning in the Primary Classroom was created because I could see, as an
occupational therapist, when I visited schools for a whole morning and took part in classroom
1
activities that teachers were missing a vital component to their repertoire of expertise; that of
having occupational therapy knowledge and skills. In discussions with teachers they would
say to me that they knew there was a ‘process’ or a ‘link’ not working for the child but did not
know where the problem stemmed from. They also knew they were not able to offer the whole
class a high level of education and the learning they desired to teach because their time or the
time of their teaching assistant was being consumed by trying to help a child who appeared to
be missing a vital link in their learning. They also knew that extra help might be required but
were uncertain when to seek this support. Sometimes the reasons why a child is having a
difficulty are not the most obvious causes. For example, a child who writes using their left
hand and smudges their work could do so because they were angling the paper incorrectly.
Every chapter follows the same format where you are introduced to a problem, an
explanation of how to recognise it and you are given extra understanding as to why it is an
issue affecting learning. Then strategies are provided to solve that difficulty. It has been
designed to give you the most pertinent information to save you the time of reading
unnecessary medical facts.
There are two easy guides in every chapter. Firstly they explain how to spot a difficulty per
subject area and secondly they provide an explanation of what is considered typical
development for that specific problem.
For those that wish to understand questions relating to ‘why’ and ‘what’ should read the
sections marked ‘how that affects learning’ and ‘why we need to make changes’. This book
links each problem to the latest research from across the world.
For those that wish to know ‘what does that mean in real world?’ there is a case study where
you can reflect on what you would do if you were in that same situation. The solutions to the
case studies are supplied in the practical tips section. Throughout the book there are extracts
from five fantastic children and one mum who explain in their own words what it is like to
experience a problem that is affecting their learning. We also have two poets Sean Johnsen
and Mark Megson, who have kindly contributed their work to help us understand children’s
problems in the real world.
For those that wish to answer the question of ‘how can we help’ every chapter has over 13
tips, comprising of three in-depth solutions and 10 quick fix tips. This book I hope, ensures
that your question has been answered so that it becomes an easy and quick resource tool.
Throughout the book you will also find places where you can go to for extra information
or resources. This book will give you strategies, it will work with any child and it will even help
the ones you were not concerned about at the moment.
As an occupational therapist with over 15 years’ experience I know first-hand what works
and what does not work. You do not need to go away and study the latest medical research
because I have done that for you. My experience has been gained working with SENCOs,
teachers and teaching assistants working with them in the classroom over a number of lessons
throughout the school term. These visits did not include taking children out of class but
working with them through their year groups from Reception to Year 6 over a number of
years. I have re-learnt about Florence Nightingale, the Tudors and World War Two. I have
also learnt about number bonds and number sentences. Only by being in the classroom,
experiencing what the children need to do could I have written this book. What I have seen are
not children failing to be taught. I have seen and worked with some amazing teachers; however
what I have come to appreciate is that my skills can further help these children learn. That is
the essence of applying the Enable Me® Method in this book.
Boosting Learning in the Primary Classroom will not make you take major changes to your
lesson plans. It will achieve the following:
2
Introduction
■ Increase your knowledge
■ Give you over 75 practical tips
■ Help children achieve their educational targets
■ Help schools improve their grades.
Comments from teaching staff about this book have included ‘Fabulous reading! I’m hooked!’,
‘Well done it’s all great’, and ‘These are fantastic, so interesting to read’.
The extra bonuses with this book are the children’s own explanations. Let me introduce
you to the children. We have James Le Guerrannic, Skye Osbourne, Corey Birrell, Kathrine
Jones and Imogen McCall. We also have Corey’s Mum, Laura, who has kindly explained what
it was like to receive a diagnosis for her son. Every child has a different medical condition and
these include autism, dyspraxia, hypermobility and Asperger syndrome. Their stories and
poems are real and unaltered. Occasionally there are a few grammar and punctuation errors
but these have not been changed on purpose. Their kind permission to take part in this book
has given a written understanding that no adult could replicate.
I guarantee that by reading this book, learning will be boosted in your classroom. This is
not the type of book to be read next term or when you have a little bit more time. The content
can help all children improve their learning skills today.
3
CHAPTER
1
Exploring the reasons for
poor handwriting
Writing, to me, is simply thinking through my fingers.

Isaac Asimov
HANDWRITING IS A complex life skill and an essential requirement for school.

Teaching the skill of turning scribbles into stories can be difficult. Many children need extra
time to transform what they can see or read into the written word. Sometimes common hand-
writing errors or habits are missed. Avoidance techniques develop and frustration appears. If
not successfully taught children risk being put in the lowest set regardless of their intellectual
knowledge.
Every few years new advice on how to develop handwriting skills appears. Teaching staff
are left feeling further confused on how to teach this subject.
In the UK children start school according to their age rather than their academic ability.
However, in other parts of Europe children don’t start school until they are six or seven. If
you were born in Spain you’d start school at six years old and if you lived in Sweden you’d start
school at seven. According to research by Gharp into European school starting ages, the UK
school age limit was not based on developmental or educational reasons but on child welfare
purposes dating back to the 1870 Education Act. By starting school in the UK so early not all
children have acquired the hand skills needed to hold a pencil. So it is highly likely that chil-
dren in the UK schooling system will have handwriting difficulties at some point in their school
life.
To help you uncover and change children’s handwriting difficulties this chapter has been
broken down into five sections: identification, the effects on learning, usual development, why
we need this skill and practical tips. It will give you the skills and understanding to help a child
to form legible words.
We will start with how to spot a problem: how children physically try to show you they have
a handwriting issue. Next we will look at how handwriting difficulties affect learning. Here
there is an opportunity to read a case study of a child who swapped hands when writing and
understand how common handwriting problems are in the UK. The third section will give you
understanding of how handwriting skills develop. Followed by two pieces written by Imogen
McCall, aged eight, and Corey Birrell, aged 10, who both explain in their own words the
impact struggling to write had on their lives. Lastly, you will learn 13 different practical tips
that you can apply immediately in any classroom setting.
By the end of this chapter you will have gained greater understanding from both a medical
and a child’s perspective of this problem. You will have many different practical tips building
upon your own repertoire of skills. By applying what you know you will be helping a child with
a handwriting problem achieve future exam grades and career choices. To help you, definitions
of important terms immediately follow.
4
Exploring the reasons for poor handwriting
Before we start here are some definitions of essential terminology used in this chapter.
■ Tripod grip is the pencil grip where three fingers are placed near the nib of a pencil. Both the thumb and
index (first) finger are placed on top of the pencil shaft and the middle (second) finger has the pencil rest-
ing on top of it.
■ Handwriting problem is when a child struggles to write. It could relate to pencil grip, letter legibility, writ-
ing speed, hand skills including hand dominance, visual skills or sitting posture.
How to identify a handwriting problem
Often the first indication of a handwriting problem is when the work produced is below the
expected standard. This section explains how to identify a handwriting difficulty in a primary
school child. It will discuss why noticing a problem is essential and analyses what to look for
when thinking a child may have a handwriting problem. There is a checklist on how to spot a
child with a handwriting difficulty in your classroom.
The impact of handwriting difficulties is more than not being able to keep up academically
with peers or experiencing physical pain. Such difficulties can cause low self-esteem. Children
can become frustrated and lack the confidence to complete homework or school projects. Over
time they may even try to avoid doing handwriting activities.
Handwriting provides an indication to how a child is both physically and cognitively devel-
oping. The ability to write is not solely linked to the acquisition of one skill and often children
struggle due to its complexity.
Writing requires the combination of correct body posture, visual motor skills, motor
planning, cognition, appropriate behaviour, tactile and perceptual skills. By adulthood the use
of these seven skills becomes so automatic that sometimes it is easy to forget the intricacies
involved for a child to learn this essential activity.
In the primary classroom, handwriting remains a core activity for most subjects. The ability
to write influences reading, language and critical thinking skills. Handwriting problems can
cause a reduction in the amount of work produced and physical pain in the hand. It can result
in pupils struggling to remember letters. They might copy letters and spell words incorrectly.
Alternatively they can struggle to extract meaning from words, phrases or topic books.
Writing requires more physical energy if it is a problem area. Research has also shown that
when writing the brain gets its energy from oxygen that is transferred into glucose. The glucose
acts as fuel to help the brain. However, if a child is struggling to write they use more oxygen
meaning the body has to work harder to create the resources to think. This is why body posture
can alter from sitting up straight in a chair to appearing to be slumped over a desk as the child
no longer has the energy to remain sitting upright.
In the long term a handwriting problem can negatively affect exam grades. Studies have
concluded that examiners allocate lower marks to students whose work was poorly written.
Sweedler-Brown concluded this was regardless of the quality of the content. In turn poor exam
results impact on career choices.
Handwriting problems need to be identified to reduce the impact upon all lessons, body
fatigue and exam grades. A recent study published by Cermak and Bissell in 2014 identified
that although children may correctly identify that they have a handwriting problem, they are
unaware of the extent and severity of their problem. These children need their teachers to help
them identify that an existing handwriting problem needs to be addressed.
5
Being able to recognise a handwriting difficulty is essential. There is no one encompassing

test to state if a child is ready to write or if they have a handwriting difficulty. One of the first
words ever written by a child is their name and this is the start of a child gathering meaning
to letter formations. Asking a child to write a familiar word and a non-familiar word will help
you notice differences between practised letter formations.
When looking for a handwriting issue often both teachers and parents assess in terms of
neatness, size and pencil grip. There are two methods to analysing handwriting: either whilst
it is being completed or after it has been written. The latter is more difficult for identifying a
specific problem: observation is necessary.
If you are analysing any handwriting whilst it is being produced look at the child’s sitting
posture. They may appear to slump forward and round their shoulders when writing due to
reduced muscle stability in their trunk. Check the wrist position. Does their wrist turn inwards
towards the centre of the body as if hooking back on its self? This occurs when a child is trying
to see what they are writing but their current pencil grip restricts vision. It should be avoided
as it affects letter legibility and can cause physical pain in the wrist. To learn more about the
impact of poor sitting posture read Chapter 3.
Another area to look at is the pencil grip. Often children who hold the pencil too tightly do
so because they do not write using a three-fingered tripod grip. An awkward pencil grip causes
children to press too heavily when writing. To relieve any tension in the hand and return the
blood supply to the finger tips children will shake their hand, wiggle their fingers or say their
hand hurts. This particularly occurs if the thumb is tucked straight over the pencil shaft causing
there to be no web space between the thumb and the first (index) finger. A thumb web space
is crucial for easy formation of rounded letter shapes.
Neatness is only achieved once letter formation and size has been mastered. When looking
at any letter formations, check to see if the letters are clearly formed or reversed. Letter rever-
sals are common for younger children. This is due to them developing visual motor and
perceptual skills at the same time as learning to write. Letter size with clear ascender and
descender letters appears when a visual skill called spatial relationship is fine tuned. This is
when spaces around two-dimensional and three-dimensional shapes are noticed. Observe word
spaces and letter alignment when considering general neatness of the work.
If you are analysing writing after the work has been produced then you will only be able to
analyse neatness. Look to see if the letters are at the correct height. The straight letters may look
crooked and apart. There may be limited or no spaces between words and on turning the paper
over you can feel bumps on the page where the child has pressed their pen heavily.
Handwriting difficulties are not the easiest of the developmental difficulties to spot.
Occupational therapists use a combination of observation and standardised handwriting tests
to make their clinical judgements. They are looking at the development of hand skills, posture,
visual perceptual skills, writing formation, legibility, letter alignment and speed. Use the
checklist in Table 1.1 to help you identify a problem in relation to specific subject areas.
This list is based on combining clinical experience with educational targets for children in
Reception to Year 2 classes. These are the optimum years for identifying an issue. It is not a
definitive list. If you answered ‘no’ to more than 80 per cent of these questions then you may
have identified a child with possible handwriting difficulty.
If you have identified a child of concern continue to read on to find out how you can help.
It is also advisable to speak to their parents and request that they take their child to their GP.
The GP should then refer the child onto a local child development centre for a handwriting
assessment.
To summarise, noticing a handwriting problem is a complex skill that is multifaceted and
for this reason it can be difficult to identify the causation. If the child is heavy handed or has
poor coordination skills then writing will be affected. When looking at handwriting notice
6
TABLE 1.1 Handwriting checklist

Topic Yes No
English
■ Can they write their own name, common words and begin to write sentences?
■ Can they spell a word out aloud and write it down?
■ Can they form lower case letters all in the same size?
■ Can they write common words with no reversal of letters?
■ Can they write with even pencil pressure?
■ Does their writing appear mature or the same legibility as their peers?
■ Can they use grammar?
■ When writing do they have a preferred hand dominance?
■ Do they write using a tripod pencil grip?
■ Do they like writing activities?
Maths
■ Can they write their numbers in the correct sequence?
■ Can they write mathematical signs? (+, –, =, ÷, x)
■ Can they legibly write a number bond?
■ Can they use a ruler?
Expressive arts and design

■ Can they draw a self-portrait using a pencil?
■ Are their drawing and painting skills mature?
■ Can they use a pair of scissors to accurately cut out an object?
■ Can they make an origami shape?
■ Can they tear paper?
■ Can they make identifiable objects out of salt dough or clay?
Science
■ When growing plants, can they handle objects with a light touch?
■ When talking about seasonal change, can they carefully bring in objects without breaking
them?
■ Can they pour water without spilling it to feed plants?
Computing
■ Do they press heavily on the keys to type?
■ When writing a blog or uploading photographs, can they type letters on a keyboard at the
same speed as their peers?
Design and technology
■ Can they draw and make templates?
Geography and History

■ Can they draw maps?
Music
■ Do they have the sequential skills to beat a drum or play a tambourine in time with others?
■ Can they play a musical instrument?
General
■ Can they sit in a chair without appearing to slump forward?
■ Can they use both hands together when fastening buttons and zips?
■ Are they well behaved in class?
■ Do they seem outgoing and confident?
7
posture, pencil grip and writing neatness. The key skill to mastering handwriting is legibility.
Speed develops after legibility and is relevant particularly in exam conditions.
What are the effects of handwriting on learning?
Handwriting difficulties can affect a child’s self-esteem and can hinder them demonstrating
their academic knowledge. This second section will refer to how handwriting affects the
primary school child when learning. It will analyse the impact it can have through the use of
a case study and it will discuss the prevalence of children struggling to write.
There are many who say that handwriting is no longer needed in today’s technological
world. Within the classroom setting handwriting remains an essential skill.
Current researchers identifying why handwriting remains important are concluding that the
physical act of writing helps children learn. Learning occurs when the brain activates neural
pathways. Evidence is showing that the motion of writing automatically triggers a neural circuit
in the brain thus making learning easier.
Two studies, one by Dr James and another by Dr Berninger (see Konnikova 2014), have
concluded that writing engages parts of the brain that are not evident when typing or tracing.
Dr James’ study in 2012 identified that handwriting tasks stimulated the same three parts of
the brain as adults use when reading and writing. These were: the left fusiform gyrus which
informs semantic memory where attaching meaning to words occurs; the inferior frontal gyrus
which is part of the frontal lobe that controls emotions and lastly, the posterior parietal cortex
which processes sensory information including the understanding of language. Her study
determined that the act of writing, for instance a child’s name, helped them learn more than
visually seeing their name.
A different study by Dr Berninger in 2006 demonstrated similar results. Her study looked
at the effects of printing, writing using the cursive script and typing. All three activities
produced different brain activities. Those children who hand wrote their answers could
generate ideas and write faster than those who typed. This was achievable because these
children used their working memory to generate ideas.
Both of these studies indicate that handwriting is an essential learning tool rather than just
a method of recording work.
Developmentally, by the time a child starts school they still have not acquired all the phys-
ical hand skills needed to hold a pencil. As a result children can learn to develop avoidance
techniques, start to shake their hand when writing to relieve the pressure and struggle to
demonstrate their true knowledge as they take time to write what they know. In the case below
Jim was exhibiting these symptoms. To help further understand the impact of poor handwriting
on learning read the following case study and decide what you would do.
Handwriting case study: Mrs Thomas (Year 3) and Jim (7 years)

Mrs Thomas outlined a writing exercise for her class, the topic: Henry VIII. Surveying the room as she spoke, she
noticed a change in Jim’s body language. His shoulders tensed and he started to frown. Jim was an intelligent,
well-liked, seven–year-old boy and had no difficulty learning about the Tudors, but when it came to writing exer-
cises his attitude was noticeably different. He was the slowest writer in the class and Mrs Thomas sometimes
struggled to read what he’d written.
Everyone had opened their books to start work. However, Jim stood up and wandered around the room. When
Mrs Thomas approached and asked what he was doing he replied that he needed to sharpen his pencil. Mrs
Thomas recognised this as one of his usual avoidance strategies. Yesterday, again before a writing exercise, he
8
said he needed a drink of water and the day before that he said
he needed to use the toilet. Mrs Thomas calmly replied that it was
already sharp and asked him to go back to his desk to complete
the task.
Even when sitting, Jim still managed to fool around, using both his
hands to roll his sharpened pencil up and down the desk. The
noise was annoyingly repetitive and disturbed the other children.
This time Mrs Thomas decided to take a different approach. She
sat down next to him and started to question him about Henry
VIII. It quickly became clear that Jim remembered many facts
about where he was born, what he liked and who he married. His
verbal recall was very fast, but when he needed to write every-
thing changed.
As Jim wrote, ‘Henry VIII had six wives and enjoyed playing
music.’ Mrs Thomas noticed that he was swapping hands to do
so. The first five words were written using his right hand and the
next four using his left. She hadn’t noticed him swapping hands to write before. When she asked him why he
did this, he replied that, ‘Sometimes I write neater when I use the other hand.’ To Mrs Thomas all the letters were
of an uneven size with no obvious improvement from either hand. She noted that had she not known what Jim
was trying to write she would have struggled to read it altogether.
Reflection: If you noticed a child swapping their hands to write what would you do?
The above case study is more common than adults realise. Have you ever noticed a child
swapping hands when writing? What would you do if you were Mrs Thomas?
The prevalence of handwriting problems in UK schools remains unclear. Research in other
developmental areas such as reading difficulties are ahead of handwriting awareness and
diagnosis. Handwriting requires the acquisition of many skills. It is sometimes referred to as
dysgraphia, a medical condition specifying a child has illegible writing due to a mix of print
and cursive script, irregular spaces, an inability to keep to the line, unfinished or omitted words,
unusual pencil grip and taking time to write.
It is estimated that between 5 and 34 per cent of children experience handwriting legibility
problems. However, a definitive percentage is unknown due to its co-morbidity with other
conditions.
Any handwriting difficulty can result in the written work appearing illegible or the word
count being reduced. This impacts on a child’s ability to demonstrate their capability to use the
English language. These children can often verbalise a fantastic story demonstrating great
imagination, but struggle to transfer that story into writing.
Boys demonstrate more difficulties in handwriting than girls but the reason for this is
unknown. Some researchers say it is due to teaching styles others say it is due to a lack of free
play. A recent study from Australia identified that girls had improved accuracy with motor
coordination due to their drawing ability. It was this skill that helped them demonstrate
improved letter formation and legibility.
Poor handwriting is also associated with other developmental conditions. Children with a
motor disorder such as dyspraxia or those with ADHD, autism or learning disorders can also
present with handwriting difficulties.
To summarise, handwriting is an essential component for learning. The prevalence of
handwriting problems is unknown. Research has identified that the physical act of writing
initiates brain activity to develop working memories and reading skills.
9
How do handwriting skills usually develop?
Many people mistakenly presume that by the time a child reaches school they have acquired
all the skills needed to successfully form letters. This section refers to how handwriting skills
usually develop for children. It will address why and what the age expected writing skills for
a primary school child are.
There is much debate about whether a child is ready to start writing at the age of four when
they enter the UK schooling system or whether they should wait until they’re six like similar
countries across Europe.
New research studies indicate that the type of pencil grip used does not impede fast or
legible writing. However, one difference is in where the thumb is located. If the thumb
position does not allow an open web space but is tucked across the pencil shaft then this will
change the amount of force a child places through their hand. This in turn affects letter
legibility.
Knowing the age norms of when a child would be physically ready to hold a pencil can help
identify those children whose hand has not developed enough to use a tripod grip.
By the time a child starts school they should be holding a pencil in a dynamic tripod grip.
Avoid the three styles below as they could cause pain and clear letter legibility cannot be
formed:
1 Any grips where the hand is in a fisted position.

2 A pencil is being held at the top of the pencil shaft rather than near the nib.
3 A thumb is wrapped over the pencil shaft.
Table 1.2 is a list of handwriting skills based on normal physical development. Use this list to
help you identify if a child is achieving age expected skills.
Just as there are stages in development when learning to walk, such as sitting followed by
crawling and then walking, the same is true for handwriting. Key developments when acquiring
legible handwriting relate to how the body physically develops both before school and up to
the age of 10 years.
Before a child starts school they will have already begun developing the gross motor skills
needed to hold a pencil by learning to crawl. This motor movement helps develop shoulder and
wrist strength. Again before school, play will have helped a child use their hands to manipu-
late small objects, stack building blocks and feel the textures of different materials. This is the
start of developing the fine motor hand manipulation skills needed to control a pencil. The last
skill that children acquire through games is visual perceptual skills. Games similar to snap,
spot the difference and odd one out all help a child begin to recognise differences in shapes
which is an essential visual skill needed to notice letter formations.
Teaching early stages of handwriting usually follows the pattern of encouraging a child to
scribble, colour and trace with their index finger. They then learn to trace with a pencil, trace
over a broken line, trace over patterns and join the dots. Next they learn to draw prewriting
patterns which are often an overlooked essential to handwriting. All these skills should be
taught before any letter is imitated, copied and reproduced. Skipping a stage before a child has
mastered a level can cause them to have problems with letter legibility later on in life.
Before the age of eight years, handwriting development is related to letter legibility. However,
there are some letters that all children traditionally find more difficult to learn than others.
These are q, z, u, n, g, y, k, and j.
At eight years most handwriting activities are meant to be automatic to free up the brain to
concentrate on other activities such as story formation. Physically handwriting will not be fully
10
TABLE 1.2 Handwriting development

Pencil Arm Forearm Hand Drawing Writing
grip movement movement movement expectations expectation
Age Palmar Using whole Using whole Hand in a fist, Makes scribbles None.
12–18 supinate arm to move forearm to thumbs facing on a page.
months grasp. the pencil. move the downwards.
pencil.
Between Digital Using whole Using whole Fingers holding

2 and 3 Pronate arm to move forearm to pencil at top
years grasp. the pencil. move the of the shaft.
pencil. Wrist is
straight and
turned towards
the little finger.
3 years Draw a person Able to copy

showing a head V, H, T.
and 1 or 2
identifiable parts.
Age 3 ½ Static tripod Using whole Using whole Thumb index and
to 4 years grasp. arm to move forearm to middle finger
the pencil. move the placed correctly
pencil. around the pencil
but usually
positioned in the
middle of the
pencil shaft.
By 4 years Able to colour Able to copy
within 2 lines +, V, H, T, O.
and draw a
house.
By 5 years Draw a person Able to copy
showing head, a triangle and
legs, trunk and 10 letters
usually arms spontaneously.
with fingers.
Able to draw
a house with
door, windows,
roof and chimney.
Age 4 ½ Dynamic No movement. No movement. Thumb, index Some letter
to 6 years tripod grasp. and middle reversals
fingers move in e.g. 3 and R
isolation to the especially
ring and little when writing
fingers. The wrist from memory.
is slightly extended.
11
mastered until the age of 10 years. This is related to the development of the corticospinal tract:
the four columns of muscle fibre, two each side of the spinal column, that reach the fingertips.
These do not fully mature until a child is 10 years old. Therefore for some children writing
spontaneously with legible writing is not physically possible until Year 6.
To summarise, for a child to develop their handwriting skills there needs to be a number of
physical changes in their body to allow correct body posture, pencil grip and legibility. These
are developed shoulder and wrist strength, hand skills and spinal cord development to carry
the fine motor skill messages from the brain to the hand.
Why do we need to develop handwriting skills?
Good handwriting is more than being able to hold a pencil; it is a socially expected norm in
the western world. This section looks at why children need to develop and refine their
handwriting skills. It will address both the impact in the primary classroom and the long term
implications if no help is provided.
Helping a child to develop their handwriting skills provides them with an essential life skill.
Within an educational setting handwriting is rarely assessed on its own merits. Spelling, story
composition and expression of ideas are assessed by teachers. Handwriting is a complex skill
that on the surface appears to be about the ability to combine vertical, diagonal and round
pencil strokes.
During the average school day skilled handwriting is required for 30 to 60 per cent of the
day.
Failure to master writing affects a child’s ability to manage the volume of work and their
ability to write at speed. If they struggle to keep up with the pace of the work, this in turn can
affect their personal relationships in class as some children choose not to be friends with those
struggling to achieve in the classroom.
Children with dysgraphia, a term used to describe poor handwriting skills, complain about
fatigue or that their hand is in pain more than other pupils. This is related to how often they
try to cross out or erase their work. There is also a noticeable reluctance to complete
homework. Research suggests these same children can also be identified as lazy or lacking in
motivation.
Parents often place high value on the ability to write and when these expectations are not
met then judgements are often made in relation to a child’s intelligence.
There are a variety of methods, schemes and programmes designed to improve handwrit-
ing skills. With so many to choose from it can be difficult to know which ones are the best.
Recent research by Hoy et al. in 2011 indicates that the most successful interventions include
handwriting practice for a minimum of 20 sessions.
Handwriting problems can lead to personal frustration and disappointment. Children are
left feeling unable to demonstrate their intellectual abilities. Below are two different examples
of how a difficulty in forming letters impacts on classroom life.
The first is written by Imogen, aged eight, who describes her own personal experience of
having a handwriting problem associated with her dyspraxia. To learn more about dyspraxia
read Chapter 4.
12
My handwriting makes me sad

In my school I have handwriting lessons. I have to copy out writing from a book into my handwriting notebook. I only
manage to do half a page whereas the other girls managed a whole page easily. I always feel left behind. I get worried
that I won’t be a good writer when I am older. Writing is important because if you have to fill in forms, you have to
use handwriting instead of a keyboard. I do not know why my handwriting is not very good, but it is practically
unreadable. I get the letter ‘I’ mixed up with the letter ‘U’ and my hands feel achy after a few minutes of writing.
To make my handwriting better, I do ‘Write from the Start’ which is a book that teaches accuracy. Instead of doing
handwriting, I type on a keyboard as much as possible. This is a lot easier for me! I have got very lazy thumbs
and this means my grip is not very good. I use pencil grips to help me, and squeeze squishy mesh balls to
strengthen my thumbs. Squeezing helps my handwriting the most.
My advice to people with bad handwriting is don’t be sad. Think of it as a gift. I have noticed that everyone who
is dyspraxic has a good imagination, and that is fantastic!
Written by Imogen McCall, aged 8
Next, Corey has written about his experiences of writing. This 10 year old has hypermobility,
which is a medical condition where the joints have increased range of movement. Children
and adults with this condition grip the pen tightly to help control letter legibility. It affects
approximately 30 per cent of the population. Muscle strengthening around the affected joints,
hand stretching exercises, the use of pencil grips and fatter width pens can be of benefit.
Photograph of work produced by Corey Birrall
I am hypermobile. I get tired easily when I am writing my hands hurt and my wrists ache. My teachers tell me I
need to write and colour in much neater. I try really hard to do this but it is a real strain and I get so tired.
Written by Corey Birrell, aged 10
Handwriting problems do not go away with age, however, research by Caligiuri et al. in 2014
suggests the force used when writing does reduce.
Over the years, both lifestyles and daily activities have changed. Postcodes were created to
reduce the number of letters not reaching their destination saving postal workers time from
struggling to read the writing of addresses.
13
Today, due to technological advances, having a handwriting difficulty rarely affects career
options. Smart phones have enabled users to create electronic ‘to do’ lists or even photograph
what has to be visually remembered.
For some careers, being able to write and read legible writing remains an integral part.
Doctors are notorious in having poor handwriting and their lack of skill to form legible words
can have disastrous effects. A study completed by Seden et al. in 2013 identified that out of
4238 prescriptions nearly 48 per cent had a minor error, 54 per cent were significant errors,
just under 4 per cent were serious and 0.30 per cent were potentially life threatening. In this
study 21 per cent of the errors were caused by poor handwriting.
Through the use of computers many adults are finding that their writing limitations are
disappearing.
To summarise, having a handwriting problem can leave children feeling lazy, frustrated and
disappointed with not being able to write what they know. Its impact is far reaching and does
not stop once a child has left school.
How can you help a child to write?

With there being a discrepancy among researchers as to how many children have a handwriting
problem, it is essential to develop a variety of skills. This section refers to what practical tips
can be applied in the classroom. It will refer back to the case study and will provide three
in-depth and 10 practical tips.
Before we look at the practical tips we shall return to the case study to find out how Mrs
Thomas helped Jim with his handwriting. We left Mrs Thomas noticing that Jim was swapping
hands when writing.
Case study solution

Mrs Thomas took a moment to reflect. Jim was a bright boy who was a slow writer with large and sometimes
illegible handwriting. He was beginning to avoid written work, starting to disrupt others and swapped hands
when writing.
She discussed her findings with her school SENCO. It was agreed the issue with his behaviour was related to
his handwriting and his difficulty was caused by him not having a preferred hand dominance. As this was an
unusual problem for a seven year old, it was agreed, after gaining permission from Jim’s mother, that a referral
be made for an occupational therapist to assess his handwriting skills.
After the assessment it was confirmed that Jim was more right hand dominant. Therefore he needed to complete
a series of fine motor games to help him develop this dominance. While in class, it was suggested he have extra
time to complete written work and be prompted to use his right hand for any activities such as writing, using a
pair of scissors, drinking water from a bottle or catching a ball.
By the end of the Summer term Mrs Thomas had noticed several changes. Firstly, Jim’s
behaviour had improved. He was no longer disruptive in class and was happier to sit down to
complete his written work. This allowed him to show his teacher what he was truly capable
of and his grades had improved as a result. Secondly, his handwriting speed and letter legibility
had also improved. Jim could see that he wasn’t the slowest writer in class which helped
increase his self-confidence. He had become easier to teach and his work was easier to read and
14
mark. Mrs Thomas benefited from no longer having to manage a disruptive pupil making her
teaching flow more easily.
Children who have not developed a preferred hand dominance by seven years old would
benefit from an occupational therapy assessment. At this age if the brain has not established
a dominant side then precision of fine hand movements are difficult to achieve.
Practical tip 1: How to help the left handed writer
Many classrooms are set up to meet the needs of the right handed child in
terms of seat position, how handwriting is taught and using a pair of
scissors. This can leave the left handed writer confused as they try to
re-train their brain’s neural pathways to use items set up for right handed
people. Mike Megson’s poem titled ‘Lefties’ explains his own experiences
of being left handed. He uses the boxing term ‘southpaw’ to describe being
left handed.
Lefties
It isn’t easy being left handed

Everything seems the wrong way round
And back to front
And upside down
And yes it can get very confusing

When it’s the opposite to the right hand
That you are using
Opening tins is a big no-no

And non-smudged writing
Another no-go
There’s no left handed pianos

No left-handed cars
But at least there’s left-handed scissors
And left-handed guitars
When you’re a lefty the world is unfair

Because all of the righties
Really don’t care
But it’s not all bad news

For lefties it’s true
A lot of great people have been lefties too
15
Jimi Hendrix, Paul McCartney

Were left-handed stars
And many presidents too
Like Barack Obama
So take heart all you southpaws

You one out of every ten
Being left-handed isn’t all that bad
And there’s more left-handed women
Than left-handed men.
Written by Mike Megson
To avoid children feeling confused about being left handed, taking longer to complete their
work and appearing to produce messy work follow this quick and simple six point checklist:
■ Desk layout – Left handed writers need space to move their left arm. Position these children
at the left hand end of a table so that their writing hand is not knocking against another
child.
■ Paper position – Angle the paper in the opposite direction to a right handed writer. Left
hander’s need to angle the paper to the right so that it is in line with their forearm. This
avoids smudging the work by the edge of the hand.
■ Letter formation – Left handed writers often rotate their wrist inwards to write so that
they can see what they have written. To avoid straining their wrist in this way they should
be taught that the letters d, f, h, m, n and t are formed differently. For example, the letter
‘d’ usually starts with the rounded shape however instead of going up to the top of the ‘d’
and down again, a left handed writer would move their pen after drawing the rounded
shape from bottom of the line to the top. If you would like more information go to
www.enablememethod.com/resources/ to obtain a guide on how a left handed writer should
form these letters.
■ Scissors – When completing any activities that use a pair of scissors ensure that the child is
using a pair designed for a left handed person. The scissor blades are reversed and this is
what provides a clean rather than an uneven cut.
■ Rulers – In Maths use left handed rulers. They are numbered from right to left so that it is
easier to see the units.
■ Computer mouse – Many left handed people become used to using a mouse on the right side
of the keyboard. By changing the setting on the computer a left handed writer would be able
to work faster as their brain is not sending messages for motor actions along their non-
dominant side.
16
Practical tip 2: How to improve letter legibility
Letter legibility improves when a child has developed small muscle control
in the hand. There are three ways to increase this:
■ Punch picture – Increases fine motor muscle strength.

Use a mini hole punch that allows a shape or a pattern to be punched.
These can come in heart, snowflake, tree, butterfly and star shapes. Ask
the child to use their dominant hand and press out the shape on a
coloured piece of paper with their thumb, index and middle finger. The
pressing will develop the child’s finger strength. Next with the cut shapes
use them to make a bigger picture. This could be a series of stars to make
up a constellation or Christmas scene using snowflakes. The picking up
and sticking of these small pieces of paper will develop fine finger control
and in-hand manipulation skills.
■ Pencil grip – Improve how a child holds a pencil.

For younger children, use pencil grips. There are a variety of pencil grips available. It is
essential when choosing you ensure the fingers are placed on the pencil shaft allowing an
open web space between the thumb and the first finger. This space will allow rounded letter
shapes to be easily formed. It also ensures that the size of the pencil grip does not obscure
the work being written.
For older children, they are often too self-conscious to use anything on their pencils show-
ing they are different to their friends. To give a visual prompt of where to position the thumb,
index and middle finger place small stickers on the pencil shaft. Without a good pencil grip
children risk increased muscle pain when writing due to holding the pencil too tightly.
■ Letter patterns – Improve letter formation.

It is essential that all children master prewriting patterns for letter legibility. Certain letter
formations are linked to specific patterns. Identify the problem letter and locate the pattern
or patterns that need to be mastered. Some letters have two patterns to master, this is due
to the pattern teaching a specific skill e.g. to draw a letter ‘h’ a child needs to be able to draw
both vertical and round shapes. Repeat these patterns using pencil and paper, chalk and
chalkboard before using a marker pen on a whiteboard. This is due to the pen moving too
fast for accuracy when using a whiteboard. See Figure below:
Pre-writing patterns
17
If you would like free dinosaur themed worksheets to help a child practice forming their
letters go to www.enablememethod.com/resources/
Practical tip 3: Relieve pain when writing
Writing speed occurs when a child receives the correct sensory feedback
from their muscles. For younger children they need to learn not to press so
heavily otherwise their hand will hurt. Hand exercises are a great way to
help teach children to release muscle tension.
This is particularly relevant for children with hypermobility who often
hold the pencil shaft too tightly.
Seven simple stretches:
■ Shoulder shrug – Rotate each shoulder backwards similar to doing a swimming backstroke
without moving the arms.
■ Royal wave – rotate the wrists in a circular motion keeping the palm straight, as if waving.
■ Prayers – Push both palms of hands together and release.
■ Fist fight – Make both hands in a fist and pretend to punch the air. Right hand should
punch to the left and vice versa.
■ Thumbs up – Make a fist and raise both thumbs up in the air.
■ Peter pointer – Make a fist and raise both index (first) fingers in the air.
■ Hedgehog – Spread the fingers out stretched, then curl up back into a fist. Repeat three
times.
10 quick handwriting tips

1 Two Ps. Be patient and positive when practising handwriting.
2 Try different pencil thicknesses. Some children prefer a fat chunky pencil to grip while others prefer to
hold a pencil with a thin shaft.
3 Time to start scribbling. Children as young as 15 months can draw marks and scribbles on paper.
4 Use wall lining paper. Lining paper is good to use as drawing paper. It is large, continuous and encour-
ages children to make big sweeping pencil movements needed to gain pencil control.
5 Relax and observe. If you are uncertain what hand they naturally wish to write with ask them to draw a
picture of their choice. This will naturally put them at ease and they will have the motivation to draw. Observe
what hand they are using whilst they are drawing.
18
6 Do not use a whiteboard. For some children the movement of the dry ease pen on the white board goes
too fast for them to write legible letters. Consider using pencil and paper or even using chalk on a chalk-
board.
7 Develop finger strength. Children who struggle to hold a pencil may have weak hand muscles. Ask them
to pop bubble wrap with only their thumb and index finger as many times as possible in 30 seconds. Repeat
again with the aim of increasing the number popped.
8 80/20 rule. Research has identified that if a child practises handwriting for 15 minutes a day, 5 times a week.
80 per cent will improve and 20 per cent will continue to need extra help.
9 Slopes. If a child is leaning forwards to write they may have reduced upper limb strength. Consider using
a sloping board or an A4 folder as a slope to reduce muscle fatigue when writing.
10 Lines. Letter formation improves when a child is able to write on a line. If using plain paper ask a child to
draw a line with a ruler for where they need to write.
To conclude, handwriting enables children and adults to present their personalities through the
written word. When it is achieved academic knowledge can be demonstrated and learning new
information becomes easier. When it is not achieved children experience frustration, low self-
esteem and the feeling of being stupid. Rarely do these childhood feelings disappear.
Spotting a child with a handwriting difficulty can be difficult. Handwriting requires the
mastering of many physical milestones including shoulder and wrist strength, hand skills and
visual perceptual skills. Up to 60 per cent of the school day is spent writing and illegible writing
is a known factor for poor exam grades. Handwriting is a skill that is possible to teach up to
the age of 10 years. It is therefore crucial that primary aged children continue to practice and
master this life skill.
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21
CHAPTER
2
Increasing disability
awareness
My advice to other disabled people would be, concentrate on things your disability doesn’t prevent
you doing well, and don’t regret the things it interferes with. Don’t be disabled in spirit as well as
physically.
Stephen Hawking
WE ALL WANT to make a difference to a child who has a disability. Sometimes just knowing what
to say and do can be difficult. Many questions often arise such as what is the correct medical
term to use? Am I being politically correct? Often we need to learn new knowledge to help that
child. Perhaps it’s about the physical environment that a wheelchair user needs. What happens
on school trips?
To help you understand how families with a disabled child live life, this chapter will explain
what happens before, during and after school. It will also give you insights rarely discussed.
First we look at the awareness of disability across the UK. Then we will look at the impact
disabilities can have in the classroom. Here there is an opportunity to read three separate
accounts, by children, explaining in their own words their difficulties at school. The next
section will give you some understanding of different disabilities. This is followed by a mum
explaining what it is like to receive a diagnosis for her son. The importance of improving
disability awareness in children is covered in the next section. A case study refers to a teacher
planning a parents’ evening for a mum who is a wheelchair user. Lastly, you will learn 13
different practical tips that you can apply immediately to any classroom setting helping you
make life easier for everyone involved.
By the end of this chapter you will have gained greater awareness of how to help a child with
a disability. You will have many different practical tips building upon your own repertoire of
skills. By applying what you know you will be helping a child with a disability be a success
story in your school.
To help you, definitions of important terms immediately follow.
■ Disability is a physical or mental condition that limits a person’s movements, senses, or activities.
■ Developmental delay is when a child is less developed physically or mentally than is usual for their age.
22
Increasing disability awareness
Children with differing medical conditions
This section explains why we need greater awareness of disability in the classroom and it will
give insight into how different medical conditions present in your classroom.
Having a greater awareness of disability usually begins with discussions and policies about
inclusion. In reality it should begin with friendship. Social inclusion starts at school and this
is the best place for a typically developing child to understand and realise the differences
between themselves and others. Ideally inclusion offers children a chance to develop respect,
kindness and patience. School is a place to offer social acceptance. However, this is not always
achieved. Having a child with a disability in a school or within a class does not always lead to
social acceptance.
School can be a confusing place. Sometimes being inclusive and being included are two very
different terms. James Le Guerrannic had a very different experience of inclusion from how it
was initially intended to be. James attended three different primary schools and for him inclu-
sion was a word that he felt had no meaning, as it left him feeling alone. See his account below.
My mum told me about something called inclusion which is something that the government believe in which is
making sure that children with learning disabilities are included in mainstream learning.
When my mum told me this I thought it was very strange because I did not feel included at all. I felt the oppo-
site. When I was at school I felt alone and like I was the only one who didn’t understand what was happening.
Written by James Le Guerrannic, aged 11
School friendships are about sharing interests, cooperation and equality. Research by Morrison
and Burgman in 2009 looked at friendships of 10 children aged between eight and 10 years old
with mixed disabilities. These children knew that they were different in some aspects of life but
they also knew they were the same in many other ways. For them, the friendship qualities they
were seeking were someone who shared the same interests as them, who was caring, helpful,
kind and accepted their individual differences. For them their classroom experiences were
influenced by their friendships. They wanted their classmates to show them a sense of value
and acceptance. From their class teachers these children were seeking their teachers to be good
role models. This was achieved by being included in discussions and giving them a chance to
express their views.
Within every class there are likely to be children who experience a difficulty whether that
be handwriting, coordination, sensory processing or a physical disability. For the children who
have a physical disability their difficulties are usually easy to identify. Often they have extra
pieces of equipment to help them during the school day. This could be a wheelchair or a Kaye
walker for mobility. It could be a standing frame to help a child stretch their muscles in a
supported position. Some children may wear orthotics on their feet, dynamic lycra suit on their
body or hand splints on their hands. However, not all difficulties are easy to identify.
Take a few moments to read the three pieces of text below. What do you notice?
23
If I was different
If I was different, perhaps a bike I could ride,

and thoughts in my head might not hide.
If I was different, perhaps a pen I could hold,

and words on my page might unfold.
If I was different, my words I could say,

and not on my time they would stay.
If I was different, I could tie a lace,

and not have frustration upon my face.
If I was different, I could do my maths,

and not fall over are walking down paths.
If I was different, I could eat my tea,

and not have more of it, spilt on me.
If I was different, I can sleep that night,

and not wake up in a terrible fright.
If I was different, I could do these things and a whole lot more,

and not find everything such a chore.
BUT, if I was different, I wouldn’t be me,

a very loving child for all to see.
This child has Dyspraxia.
Written by Skye Osbourne, kindly provided by the Dyspraxia Foundation
Autism for me means…

1 I look the same as any other child (you can’t see autism).
2 I am very anxious all the time (mainly about vomiting, someone not picking up the phone when I call, being
left in the car on my own, getting my hair cut, shoe shops . . . these are just some of my phobias and I think
about them every day).
3 I get quite stressed about free time (school holidays and weekends).
4 I have to be moving all the time otherwise it hurts everywhere and I get very stressed.
5 My friends are mostly grown ups.
6 I get obsessed about things I like and I don’t mind having the same conversations over and over again (at
the moment the things I like talking about are vegetarianism, music and my experience in mainstream
primary school).
24
What would you like a teacher to know about you?

Dear Teacher,
Sometimes I get frustrated. I have Asperger’s Syndrome. I don’t like waiting in long queues because it’s a really
long wait and I don’t know when it will end.
Sometimes I like to be on my own. I can feel overwhelmed when it’s too noisy or there are too many people. I
don’t always understand whether or not what I want to say is important enough. When you ask me ‘Is it impor-
tant?’ I struggle to decide! Because my brain doesn’t filter out information. I find it really difficult to concentrate
when I’m supposed to. My mind always wanders.
Because I am very honest and I speak the truth, sometimes you might think I’m being rude. I don’t mean to be,
I just don’t always think how other people might feel.
Written by Corey Birrell, aged 10
All three conditions are commonplace in primary schools and all are lifelong developmental
conditions, however, the differences are vast. Children with dyspraxia will present primarily
with a motor difficulty. As Skye informs us, with a personal poem called ‘If I was different’,
all the problems mentioned relate to fine and gross motor coordination skills. Problems holding
a pen, answering questions, managing self-care skills exist due to this developmental condition.
Dyspraxia does not affect intelligence and these children are very aware of their differences.
Often self-confidence and self-esteem is an issue as planning and executing motor actions are
problematic.
In contrast James’ description of having autism identifies his own difficulty in terms of
communication and social interaction. Autism affects how he sees the world compared to his
peers. For him there is a level of anxiousness and he prefers to communicate with adults. James
states that he needs to ‘be moving all the time’. This is an indication that he has some sensory
processing issues, common with autistic children, where they become over or under sensitive
to the senses around them. The senses are hearing, sight, smell, taste, touch, balance and an
awareness of where the body is in relation to other objects. For him constantly moving his
body is a natural automatic movement that cannot be stopped. However, it can be reduced by
sensory processing strategies.
The last description by Corey describes similar experiences to James and that is because
Asperger’s syndrome is a form of autism. Children with this condition have normal intelli-
gence and their language development is less masked. Their key difficulty is in social
communication. This is evident when Corey says ‘his mind wanders’ and ‘my brain doesn’t
filter out information’.
Therefore within an average class it is feasible to be asked to teach a child with a physical
disability, a child with a motor coordination problem, a child with social communication
difficulties or someone with a sensory processing issue.
Due to the complex nature of identifying the differences between the needs of a pupil with
a developmental delay versus a child with a physical disability, Table 2.1 How three different
medical conditions can influence progress in class, has been created. Each column has three
different medical conditions. The comparison of their needs has been linked to an English
lesson for a Reception class to help you further identify key differences amongst these
conditions.
As you can see from above there are very few similarities in terms of how these different
medical conditions present themselves on a daily basis within the classroom. Having a disability
25
TABLE 2.1 How three different medical conditions can influence progress in class
Child A has a diagnosis Child B has a Child C has a
of cerebral palsy, diagnosis of diagnosis of
is a wheelchair user dyspraxia autism
and wears a dynamic
lycra body suit. This
child has reduced hand
function
Listening and attention
■ Expected to be able to sit Should be able to Should be able to sit May struggle to sit still
quietly and concentrate. sit still and still and concentrate and concentrate. Would
Be able to listen to what concentrate unless however may need also struggle with some
others are saying and they have reduced time to process the aspects of
anticipate events in a story. energy levels. content of the story. understanding social
communication and
events in the story, if the
content was more
fantasy than fact.
Understanding
■ Follow a story without pictures Able to follow a story, Should be able to May struggle to listen
and listen/respond appropriately however, may struggle follow a story and due to sensory
with how or why questions. to turn the pages of understand it processing difficulties
Also expected to understand a book due to reduced appropriately. May and the body’s need to
humour. upper limb function. benefit from extra time keep moving around.
Could understand to process the May not understand
questions but may information within humour.
have reduced speech the story.
skills resulting in the
articulation of what
was said being difficult
to understand.
Speaking
■ Develop vocabulary and Should be able to May take time to May struggle to use
use language to express develop vocabulary, process what they language to express
themselves. however, if there is a wish to say but should what they wish to say.
speech difficulty they be able to achieve
may struggle to this task.
articulate themselves
or find voice
projection difficult.
Reading
■ Sound out letters of the Similar to above, Should be able to do Should be able to do
alphabet and increase reading may be this task. this task.
vocabulary through reading influenced by
books. speech difficulties.
Writing
■ Write their own name and May have problems May have problems May have problems
simple sentences. due to reduced upper due to difficulty linked to sensory
limb and fine motor coordinating awareness skills but
control. movements and should be able to do
reduced fine motor task.
control.
26
or a developmental condition is complex to the child, family and teacher. Successful inclusion
strategies are about making these differences work.
To summarise, identifying the different needs of a disability and a developmental delay in a
classroom can be difficult. Often there are many variables which mean that children present
in different ways depending on the subject being taught. What all children unite in is the desire
to find meaningful friendships where other children see them as people, before seeing any
differences.
What are the effects of disability on learning?
This section refers to how a physical disability affects the primary school child when learning
during a typical day. It will address why physical disability has an impact in the classroom and
it will consider the prevalence of disabilities in the UK.
Having a physical disability impacts on learning in the classroom in a way that many do not
realise. Tiredness, endless list of medical appointments, and a general lack of time to fulfil all
the day’s needs, can impact on the school day. For some children they may also experience
pain in their muscles and/or joints.
In a study conducted in 2009 the Contact a Family charity reported that nearly 70 per cent
of families with disabled children found both understanding and acceptance within the
community was poor or unsatisfactory. In order for families to feel there is an understanding
of their situation it can be helpful to understand what happens before and after school.
Through greater appreciation of this we can then truly understand how disability affects
learning in the classroom. The following fictitious analogy has been written thinking of a child
with cerebral palsy. Many of the daily experiences occur to children with other physical
conditions including Duchenne muscular dystrophy, Down’s syndrome and spina bifida.
The typical school day often starts early. Before school many parents struggle to get every-
thing done in advance of the transport arriving. Often waking children in the morning can be
difficult due to many of them experiencing sleep problems relating to their condition. Some
children are unable to wash or dress themselves and without full parental support they could
not get dressed. Children with cerebral palsy can be prescribed a dynamic Lycra body suit,
which is like a wet suit designed to help posture. It fits as snugly as a surfer’s wet suit so getting
it on and off can be a battle. When it comes to breakfast time children with cerebral palsy may
have swallowing or chewing difficulties meaning that they either have to be fed or that extra
time is allowed for them to eat their meal in their own timescales. This all has to be achieved
before the school transport arrives which can turn up at least one hour before school starts.
Once they arrive at school a child has already been awake for three hours and used up a lot
of energy by getting ready for school. On arrival many children do not go straight into class,
they have daily muscle stretches that need to be completed and the best time to do this is at the
beginning of the day. When they arrive in your class they have now been awake for hours and
have had a full body workout. These children often benefit from extra snack breaks so that they
can replenish their energy levels. Many work with an adult who provides one-to-one support
and although the curriculum is differentiated for them there is no opportunity to drift off for
a quick day dream. Working one-to-one is an intense situation where a child needs to demon-
strate full concentration. Whilst completing their school work an occupational therapist may
request hand stretches are undertaken during a story time or a physiotherapist may ask that a
child is positioned in a standing frame during a particular lesson. Again, these children are
burning up energy whilst trying to stretch their bodies and concentrate on the lessons.
Unfortunately many medical appointments occur during the school day and apart from
needing to miss lessons to attend, their parents are also required to be present, making it
27
difficult for them to take on employed work. If a child uses a wheelchair, public transport can
be a less convenient option. Often parents leave appointments with new medical advice that
they have to apply. If a child does return back to school then it is a balancing act between
catching up time on the work missed but also having the energy to continue the rest of the day.
When returning home from school many children wish to play with friends or attend after
school clubs. Siblings may need to go to Brownies or Scouts at a time when these children have
dipped in energy.
Before bedtime, parents are preparing supper and most probably trying to help the children
learn their spellings. Bath time can take longer than with other children as transferring in and
out of the bath can be complicated without any specialist pieces of bathing equipment. Only
then at bedtime do the children get a chance to replenish their energy levels helping them to
be ready to start a new day.
As you can see from this typical day the ability to learn is influenced by many everyday life
skills.
Between 1975 and 2002 the disabled child population rose significantly by 62 per cent while
the general population increased by 7 per cent. And since 2009 the number of disabled children
has continued to rise by 30,000. In 2009 the total figure was 770,000, this equated to 1 in 20
of the UK child population.
When looking at the prevalence of disability in the UK the figures published in March 2013
reveal 7 per cent of all UK children are disabled. This equates to over 800,000 children. This
percentage may appear small, however, the number of children registered as disabled is on the
increase. In 2029 it is anticipated by the Institute for Public Policy Research that there will be
1.25 million children with a disability living in Britain. Unfortunately, research by The
Children’s Society in 2011 revealed 40 per cent of children in families with at least one disabled
member are classed as living in poverty and a disabled child is three times more likely to expe-
rience abuse or neglect than another child.
Disability affects all levels in society from celebrities to those on the poverty line. Some
celebrities are using their media appeal to raise awareness of disabilities including Boyzone’s
singer, Keith Duffy whose daughter has autism and Lewis Hamilton, the Formula One driver
whose half-brother Nicholas has cerebral palsy. However, he is also a winning racing driver
himself.
To summarise there are more disabled children living today than ever before. By the time a
child enters the school gate they have already had to work hard to get dressed, have their
breakfast and arrive on time. Often disabled children struggle to maintain concentration due
to the physical demands placed on them during the day. This can affect their learning poten-
tial. When returning home from school many have limited free time to do homework due to
the time it takes them to complete more exercises and get ready for bed. However, for many
they know no different and continue to manage their whole day with enthusiasm to be at
school.
How common medical conditions develop
This section will refer to how the Mum of a child who was given a diagnosis of autism responds
to this news. It will also look at the how common disability or developmental conditions alter
through a child’s school life.
Getting a medical diagnosis is a difficult time for everyone involved. The news can be given
during pregnancy, at birth or in later weeks, months or years. The location of this news can
vary. It may be a hospital setting, in the community, at a disability service or in the family
home.
28
Studies into how parents cope with being given a diagnosis are limited. When being told a
diagnosis emotions of depression, anger or despair are evident. During this time healthcare
professionals usually want to balance honesty with a family’s desire to hear positive messages.
Unfortunately the desire to not give ‘false hope’ sometimes leaves parents hearing of every
possible medical complication.
A study by Heiman revealed that after a diagnosis is made 28 per cent of parents have
ongoing negative emotions of anger, sorrow, guilt and frustration. Obviously every situation is
different and how every adult deals with the news differs. Interestingly in a study of parents
whose child had a traumatic brain injury, it was reported that fathers were more likely to be in
a state of denial whilst mothers were more likely to accept the situation, seeking to discuss
stages of recovery and what to do next.
The text that follows is a description written by Corey’s Mum.
What a diagnosis means to me

Receiving a diagnosis for me was a massive relief. After trying for six years finally someone agreed with me.
I was continually told he didn’t meet the criteria for autism. One teacher told me that they already had a child
with autism in the class and he wasn’t anything like that! No two people with autism are the same.
Although there is very little support after a diagnosis, knowing the reason for his difference and learning how to
help him deal with certain issues, has been a tremendous help. The school have been much more understand-
ing and helpful since receiving a diagnosis.
Written by Laura Birrell, (Mum to Corey Birrell)
This piece written by Laura especially for this book, highlights how some parents have a gut
instinct that they need to follow to seek a diagnosis. Often a diagnosis is the start of them
being able to get extra help for their child within the school setting. Similar to Laura, many
parents report that once a diagnosis is received it helps place an explanation as to why they felt
their child was not developing the same as others. However, it can also have little impact, as
the challenges in daily life rarely change the daily circumstances in which they live.
For further insight into different medical conditions and how a condition may progress, see
Table 2.2. It analyses nine common medical conditions giving you an insight into their causes
and how each condition progresses during the school years.
To summarise, receiving a diagnosis is a difficult time and it causes parents to react in many
different ways. A variety of emotions are felt. For some conditions, diagnosis provides medical
advice and input on strategies to develop physical skills. However, for other conditions
diagnosis provides sad news of a life limiting condition where therapists are involved to try and
assist the family in daily life.
Why do we need to improve disability awareness?
This section looks at why children need to develop disability awareness skills. It will address
both the impact of disability on parents and on the extended family.
Since the introduction of the policy for inclusion in schools, the 2012 Paralympics and the
2014 Invictus Games, UK society as a whole is becoming more accepting and aware of
disability. New generations are growing up with greater awareness of disability. The rise of
disability awareness can be seen across the globe. In a study by Kimberly et al. in 2013 they
29
TABLE 2.2 Medical conditions

Cerebral palsy This is a neurological condition that affects a part of the brain that controls movement and
coordination. However, other parts of the brain which control communication, hearing, vision
and the ability to learn may also be affected. Damage occurs either at birth or in the first few
months of life.
In the past it was thought to be caused by a loss of oxygen to the brain. Research in the
1980s is suggesting that asphyxiation (lack of oxygen) is only responsible for 1 in 10 cases.
Most other cases were caused by problems in brain development before birth.
There is no cure or one single treatment plan. Physiotherapists, occupational therapists,
speech and language therapists are often involved to promote independent living skills and
to reduce the risk of body changes as a child grows. These therapists are involved
throughout their school years.
Duchenne muscular This is a neuromuscular condition which causes muscle weakness that progressively gets
dystrophy worse. It occurs due to a lack of protein called dystrophin. There are various different types
of muscular dystrophy and Duchenne muscular dystrophy usually affects boys.
Symptoms are noticed when a child is one to three years old although it can also be after
they have started school. Due to changes in the muscle fibres, children lose their ability to
function. Initially the muscles around the pelvis and thighs are affected causing difficulties
when walking, running, standing up, climbing stairs. As the condition progresses it affects
arm function resulting in difficulties with writing and eating. Unfortunately by the time a child
is 8 years old they may need a wheelchair to help them mobilise around school. As adults
the life expectancy age is between 20 and 30 years.
Physiotherapists, occupational therapists, speech and language therapists are often involved
to promote independent living skills for as long as possible. These therapists are involved
throughout the child’s life.
Spina bifida This condition occurs in the first month of pregnancy. A gap in the spine develops due to the
embryo not fully forming together between the spine and the spinal cord. In most cases
surgery is performed to close the gap however damage to the nervous system has already
occurred. This can leave the child with bowel and urinary incontinence, loss of sensation and
either partial or total paralysis of the lower limbs.
to promote independent living skills throughout their school years.
Down’s syndrome This is a genetic condition. Most people with this condition will have a degree of learning
disability, however, their personalities and abilities will vary. These children have reduced
muscle tone across their whole body resulting in them becoming physically more fatigued
than other children. They may also have only one crease across the palm of their hand which
can affect fine motor control.
to promote independent living skills throughout the school years.
Dyspraxia This condition is a developmental disorder and is not usually diagnosed until a child is 5 years
old. Children experience a delay in their ability to perform coordinated movements involving
gross and fine motor control. This is not a learning disability. Half of the children, 50%,
continue to experience motor problems and difficulties with organisational skills as an adult.
Physiotherapists and occupational therapists are often involved to develop motor
coordination skills. A child may have a series of treatment sessions and may receive regular
reviews. The therapists may not be involved through all the primary school years.
Hypermobility This is a often a heredity condition where a person’s joints have a large range of movement.
It is caused by weak collagen making the ligaments and joints appear loose. It can also be
referred to as double jointed. It is estimated 30% of the population have this and it is
common in children. Usually by adulthood, children’s joints have become stiffer and it does
not impact on everyday life. Sometimes it can cause joint pain, back pain, dislocation of
joints and soft tissue injuries.
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TABLE 2.2 continued

Physiotherapists and occupational therapists are often involved to develop independent
living, hand function and self-care skills. A child may receive advice on exercises and have a
progress review. However, these therapists are not usually involved through all the primary
school years.
Sensory processing This is a condition where the exact cause is unknown. The brain has difficulty receiving and
disorder responding to information that comes from the senses. As babies these children may have
been referred to as being fussy. The effects of being unable to successfully process sensory
information become more evident as a child grows.
Occupational therapists are often involved to promote independent living skills and give
advice on sensory management strategies. A child may receive advice on managing sensory
behaviours and have a progress review. The therapists are not usually involved through all
the primary school years.
Autism This is a condition that affects social communication and interaction. It becomes more
evident during nursery and early school years. Often children have repetitive thoughts and
interests. Nearly 50% may have some form of learning issues.
to promote independent living skills for the early school years.
Dysgraphia This is a condition when a person has difficulty with writing. It is not associated with the
ability to read and there are no learning issues. It becomes evident when a child starts to
learn to write.
Occupational therapists are often involved to promote handwriting skills. A child may have a
series of treatment sessions and may receive regular reviews. However, they are not usually
involved through all the primary school years.
analysed the media coverage in Canada between 1998 and 2008. Over that period of time
they reported that there was an increase in personal stories and suggested that there was a
change in how people with disabilities were being presented in the media. Yet a study by the
Office for Disability Issues in 2011 stated 40 per cent of the respondents thought disabled
people were less productive.
Successful disability awareness has occurred due to training, where guest speakers have
entered schools to talk about their own experiences. However, some experiences are rarely
talked about. Bringing up a disabled child impacts upon the whole family. The cost of bring-
ing up a disabled child is three times more expensive than a non-disabled child. In a recent
study by Contact a Family it was reported 1 in 6 disabled families will go without food, 1 in
5 will go without heating and 1 in 4 will go without specialist adaptations.
Having a child with a disability also impacts on the role these parents have in our commu-
nities. Many parents report that they feel their position changes from that of a parent to one
of a mediator, communicator, therapist and counsellor for their disabled child. These new
responsibilities occur when speaking to both medical and educational professionals. By the
time a child starts school some parents can appear battle worn or overwhelmed as they have
repeatedly told their child’s story to so many different people.
Despite being part of our society 65 per cent of these families refer to themselves as being
isolated. Isolated when they received the diagnosis, isolated during school holidays and isolated
from not being able to work as often as they would like. Shockingly 50 per cent of families have
felt isolation due to the stigma of the disability itself.
Many Mums report struggling to return back to work and this is partly due to the various
medical appointments in the first few years of a child’s life. In one year, a Mum of a child
recently diagnosed with ADHD reported having 70 appointments. This averages out as one
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appointment every five days. With a UK government study on human rights stating 84 per
cent of Mums with a disabled child not working compared to 39 per cent of Mums with a
typically developing child who chose not to work the impact on the family is vast. Many
parents are left feeling emotionally exhausted, financially worse off and time poor.
Since the 1980s there has also been a change in how therapy is provided by the UK health
services. Today parents are expected to be co-therapists in their child’s care with greater
emphasis being placed on the family to carry out therapy at home.
Within the 24-hour day parents are expected to do muscle stretches, organise servicing of
specialist equipment, set up play opportunities as well as help a child read and do their home-
work. Sometimes it is not possible to juggle everything and unfortunately 72 per cent
experience mental ill health. Schools can become great advocates for these families.
Next we will look at how the child with a disability themselves, and different members of
their family may react to news of a disability.
Some children who are diagnosed with a medical illness at birth know no difference.
However, they certainly do know that they are different by how they may play, learn, need
extra support for lessons or by the number of medical appointments they need to attend.
Children who have a developmental delay such as dyspraxia and handwriting problems
usually become very aware of their own difficulties. This is awareness is most evident at Key
Stage 1 and can have a significant influence on a child’s self-esteem.
The impact of disability on siblings varies and studies into this relationship is growing.
Research suggests that siblings need their own coping strategies to understand and manage
the situation. They too experience stress and need help to transform feelings of embarrass-
ment to feelings of acceptance. Often an unsaid expectation is placed on siblings as adults that
they will take on the caring responsibility of their brother or sister. This is especially evident
amongst females. If you wish to read a moving story written by a Mum to the sibling of a
disabled child with Down’s syndrome go to www.enablememethod.com/resources/
Many parents experience a high level of stress which has a negative impact on marital
relationships. In a study completed by Mencap in 2012 it was reported that 7 out of 10 families
have reached ‘breaking point’ at some time. Parents of children with autism, cancer and
traumatic brain injury are said to experience the highest levels of stress. All parents use a variety
of coping strategies varying from formal support networks provided by health, social and
educational services to relying on extended family, friends, neighbours and social media. Social
media provides these families with a mechanism to feel less isolated and an opportunity to
hear from others in the same situation.
To help manage family life many families call upon the support of grandparents. Research
completed by Little in 2012 identified that it is often the maternal grandmother who provides
the most support. Research into their experiences is limited, however, many report being in a
‘state of flux’ as they too are striving for answers on how to help improve family life.
Sometimes being able to attend medical and school appointments helps them fully understand
the needs of the child as well as continuing to provide essential emotional support.
Read the case study below to further understand how we can make changes to help a
disabled Mum go to her daughter’s parents evening.
Disability case study: Miss Bell (Year 1) and Lily’s Mum

Parents’ evening is a time when expectations, and nerves, are high. For Miss Bell, a Year 1 teacher, this was her
first parents’ evening as a qualified teacher and she wanted to get everything right.
For this parents evening, Miss Bell would need to cater for Lily’s Mum, Mrs West, who had MS (multiple sclero-
sis). This wasn’t Mrs West’s first visit to the school but it would be her first visit in a wheelchair. Being a modern
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school, the building had a disabled car parking space, however the entrance posed a challenge. The automatic
doors leading into the school were followed by a set of heavy fire doors which could be difficult for a wheelchair
user to open.
As Miss Bell continued to plan she began to consider the appropriateness of offering a 10 minute appointment.
No one likes to be kept waiting and the only way for a parents’ evening to go without any delays was to have a
smooth appointment system. Miss Bell knew that Mrs West was new to using a wheelchair. Moreover, Lily had
mentioned her mother was becoming tired and was using the wheelchair to save her energy. Miss Bell consid-
ered that meant Mrs West might need extra time to get from one place to another and to process new information.
While sitting behind her desk, Miss Bell put herself in Mrs West’s
shoes and visualised her appointment. The door was definitely
wide enough for a wheelchair to go through, but now she was
questioning the classroom layout. All the desks were grouped
together in batches of three and between each desk was only a
chair’s width, providing tiny pathways around the room. For a
child there was no difficulty, but the layout would hinder Mrs
West’s movement and prevent her from seeing and reading the
work on the wall. Miss Bell knew she would want to read Lily’s
riddle about the castle on the wall. It wouldn’t be the same to
take it off the wall as she wouldn’t see her child’s work in rela-
tion to others.
The other obstacle Miss Bell considered was a large blue rug
used as a place for the children to sit during circle time. For Lily’s
mother to travel the room she would have to wheel over the rug.
While this wouldn’t pose a problem for an electric wheelchair, it
would hinder a non-motorised model.
Reflection: If you were Miss Bell how would you manage parents’ evening?
The above case study illustrates how we all need to consider access issues. If you were Miss Bell
what would you consider doing?
A child in a wheelchair will experience these difficulties every day at school. The use of
classrooms may need to be altered each year so that they remain wheelchair friendly. Sometimes
it is easier not to change class rooms every September. Adaptations will have to be considered
throughout the school and this may be difficult where old buildings are used. An occupational
therapist can undertake an assessment of the building and classroom layout to assist the school.
To summarise, the awareness of disability is increasing in the UK, however, many families
continue to experience financial shortages and not feel part of a community. Disability impacts
all parts of family life including siblings and grandparents.
How can you help a disabled child?
The final section refers to what practical tips can be applied in the classroom. It will refer back
to the case study and will continue with the story. There will also be three in-depth and 10
practical tips on how to help a disabled child.
Before we look at the practical tips we shall return to the case study to find out how Miss
Bell planned her parents’ evening. We left Miss Bell needing to make her classroom wheelchair
accessible for Lily’s Mum.
33
Case study solution

Miss Bell knew she needed to remove these obstacles to ensure a smooth appointment for Mrs West and her
daughter. Her first action was to call and ask about appointment times. It transpired Mrs West had recently been
feeling unwell and, although she said it affected her energy levels, she didn’t want to miss this appointment. A
twenty minute time slot was agreed. Next, Miss Bell organised someone to meet and greet Mrs West on arrival
so she didn’t have to tackle those heavy fire doors by herself. Then Miss Bell rearranged the classroom chairs,
and rolled up the rug, so a path throughout was clear.
With these adjustments, the parents’ evening ran smoothly for Mrs West and Lily. Mrs West was able to get
around the school and classroom without difficulty. By giving her extra appointment time there were no delays
to the other parents. Mrs West was able to hear how well her daughter was progressing at school and to see
her daughter’s work on the wall which she said made her very proud. For future parents’ evenings, Miss Bell
agreed to contact Mrs West to see if she was able to visit, or if she would prefer a telephone appointment.
Often there are many small changes that can help a wheelchair user access relevant parts of the
school. However, for some schools old building design makes this more challenging.
Practical tip 1: Creating a wheelchair accessible classroom
Identifying and preparing a classroom for a child in a wheelchair can seem

daunting if you have not done this before. Concerns including, how much
extra space is needed, changes in a classroom routine or how other children
will react are all usual fears.
To help identify a suitable classroom here is a six-point checklist:
■ Access – Door widths. The dimensions of a child’s wheelchair varies

depending on the type of chair. However access into a classroom
through a door is rarely an issue as they are not using an adult-sized
wheelchair. Often these children are still developing their visual spatial
skills and steering through door frames can be a difficult manoeuvre to
judge. Paint chipping off or scratches to the woodwork are a common
occurrence.
■ Space in the classroom – All wheelchair users need extra space to turn and this is called a
turning circle. Ideally this space should be 1700mm, although most platforms at the top of
ramps allow 1100mm space to turn, so it does vary. With space at a premium in a class-
room the ideal circle of 1700mm can be difficult to achieve. A good guide is for an adult
to stand with both arms outstretched. If they can turn 360 degrees without hitting anything
then this will provide adequate space for a child to turn around in their wheelchair.
■ Flooring – Rugs usually denote places to sit in circle time, however, for a wheelchair user
they can make the floor surface uneven to travel across. Particularly for a child using a self-
propelling wheelchair. A rug involves exerting more energy to push the tyres over the
surface. If possible remove all rugs from a classroom.
■ Desk position – A child in a wheelchair should be able to see the whiteboard without the
need to twist the spine or turn their necks. This will help them maintain a comfortable
sitting position. If work is recorded using a computer then a desk near a double socket
34
power point is required and it is good to ensure that there is no natural glare onto the
screen from sunlight. If that child has extra support assigned to them then that adult will
need room to sit and store materials. The best position for a desk is usually by the door so
that if extra one-to-one work is required outside the classroom then the act of leaving the
room does not disturb the whole class.
■ Desk height – Not all wheelchairs will be able to go under a standard classroom desk. New
pieces of furniture do not have to be bought. Consider using a desk from an older year
group if that is higher or four leg raisers can be purchased to raise the height. All children
should be sitting under a desk with 5cm clearance between the tops of their thighs and desk
top. To learn more about the importance of sitting posture read Chapter 3.
■ Group work – If you are asking a child to travel around the classroom consider the turn-
ing circle spaces at the beginning and end of their destination as well as the route they need
to travel. Often the space between desks can look wide enough for a wheelchair to travel
through when the class is empty, however, when children are sitting in their chairs the width
dramatically reduces.
Practical tip 2: Planning a school trip
When planning a school trip it is essential to undertake a risk assessment.

Site specific trips require their own planning. Here are some considerations
from an occupational therapy perspective that you might wish to include
when planning your next trip.
■ Travel arrangements – If travelling with a person who uses a wheelchair

ensure that the wheelchair is fit for purpose. For example an electric
powered wheelchair battery must be fully charged and a manual wheel-
chair should have the tyres fully inflated. Both wheelchairs will have
safety belts and these should be worn at all times. If travelling by coach,
consider how the child will gain access to the vehicle? Perhaps a wheel-
chair accessible taxi is required. Alternatively if going by train, if you
book at least 24 hours in advance you can secure a wheelchair space on
the train. This will also ensure that you gain assistance in the form of
boarding ramps to get on and off the train.
■ Toilet facilities – If needed, confirm that a disabled toilet is available. Often these toilets
have greater space than a standard cubicle and have built in grab rails by the toilet and
wash basin. Sometimes, although they have been designed for a disabled person they have
not usually been designed for more than one person and a wheelchair. By the time a wheel-
chair, the child and one, possibly two adults are in the room they can become very small
spaces in which to turn. If a child uses a special toilet seat for postural reasons or turn table
due to a difficulty in turning 180 degrees out of the wheelchair to the toilet, these may not
be available in the toilet that you are using. Consider how you are going to help the child
use the toilet. Do you need to bring any toileting equipment with you?
■ Medication – If a child usually takes medication during the school day consider how you
are going to provide this on your trip. Carry an extra bottle of water so that tablets can
be washed down with a liquid. If tablets need to be dissolved take with you a disposable
cup.
35
■ Activities – Often trips will have been linked to subject topics and have set learning
objectives. If the work is usually differentiated at school consider how this might need to
be done on the trip. For instance, if a child has a handwriting problem do they need to
write the answers or could they circle correct words to show their learning?
When looking at the activities on offer consider how the child will go from one area to
another. If they are a wheelchair user are the doors a standard width and can they propel
themselves through to the different rooms? Are the floors all on one level with no internal
steps? If there is a lift is it accessible at all times or do you need a key from a caretaker to
use it? If the activities are on a field is it level access or is there a drop kerb for the wheelchair
to gain access to the grass?
Alternatively if you are visiting a museum and have a child who has a sensory process-
ing disorder they may find activities which involve visual and auditory stimulation too over
powering. Are there activities that can be done which do not over stimulate this child?
■ Directions – For a child who has dyspraxia visiting a new place can seem overwhelming.
Children with dyspraxia have problems forming what to do, organising how to do it and
then carrying out the activity. To help them plan where they need to go and understand
what time they need to be there, consider giving them their own written instructions.
Children in wheelchairs may not be very good at steering especially in new and
unfamiliar places. Ensure that they have enough space around them and they are not close
to wheeling into the backs of other children’s legs. Sometimes it is helpful to work on the
policy similar to driving on the road, everyone heading forwards needs to be on the left
hand side of a corridor or path.
And lastly the best thing to take with you are wet wipes, you never know when they can be
useful.
Practical tip 3: No lifting policy
Since 1992 there has been a legislative policy in place in the UK that says
there should be no manual lifting. Lifting should no longer be necessary
except in exceptional circumstances. Whether it is lifting a child off a PE
mat back to a wheelchair, helping a child transfer on and off the toilet,
transferring to a bench to sit on, the advice remains there should be no
lifting involved.
Physiotherapists, occupational therapists and manual handling advisors
are all available to help give advice on the best method to transfer a child.
Often there are techniques and specialist pieces of equipment that can be
used to reduce the need to ever lift.
For a child it can be scary having different people helping manoeuvre them in different ways.
Children should be taught what the best manual handling procedure is for them. They also
should be given both the confidence and support to direct how they wish to be transferred. The
one thing that must never be done is to lift a child up by holding them under the arm pits. If
this manoeuvre is done it runs a high risk of subluxation of the shoulder. This is the medical
term used for a partial or complete dislocation of the shoulder. The reason for this is that the
child’s ligaments are still developing and they do not have the same strength as an adult to be
lifted.
36
10 quick disability awareness tips

1 Fatigue. Children with a neuromuscular condition (e.g. muscular dystrophy and cerebral palsy) are likely to
experience fatigue. They benefit from regular breaks and food snacks for extra energy.
2 Dressing. Always dress the affected side first e.g. If a child has cerebral palsy affecting their right side, place
the right arm into the right jumper sleeve first.
3 Brushing teeth. Particularly important for children with eating difficulties as food can become easily stuck
in between teeth and gums.
4 Increased fear. Children who cannot hear, lip read or understand will have greater fear of certain move-
ments or reactions.
5 Increase time. Children with a mobility problem will need extra time to get to and from the toilet. Children
may have difficulty eating and so may take longer at lunchtimes.
6 Non slip mat. Use a non-slip mat to stop workbooks, keyboards, plates or drinks from sliding about.
7 Social media. There are many different forums on Facebook for families to join. They often allow other
members of the public. By being a member of these forums it can provide invaluable insights into daily life.
8 Understanding Down’s syndrome. Two books which can help a child understand their differences to
others are ‘Hi, I’m Ben and …I’ve got a secret’ and ‘My Friend Isabelle’. Find these books at
www.enablememethod.com/resources/
9 Understanding the sibling experience. There are some amazing parents who are sharing their experi-
ences through writing a blog. Go to www.topmommyblogs.com to hear Mums’ and Dads’ opinions from
across the world. Often they will use their blogs to post heartfelt messages to the siblings of a child with a
disability.
10 Support groups. Organisations related to specific medical conditions are a great resource tool, they often
have many incredible tips and advice relating to that one condition.
To conclude, understanding about disability and increasing disability awareness can only be
touched upon from an outside perspective. Many of the families have their own unique stories
and all the children have their own unique characteristics which makes them the wonderful
people that they are. Some children often experience disability from a different perspective as
they become carers for a disabled parent. This can impact on the amount of time spent
completing homework.
Sometimes these families need an advocate. Someone to remind them that they need to look
after themselves both physically and emotionally as well. Usually there are many health profes-
sionals who would be willing to assist you to learn more about a particular condition. They
are there to help you understand what to look out for. They will teach you how to use a piece
of equipment and they will be there to answer your questions.
37
Bringing up a disabled child is not easy. Teaching a disabled child or a child with a devel-
opmental delay does require different strategies however the rewards are just as great.
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41
CHAPTER
3
The link between body
posture and concentration
It’s tough trying to keep your feet on the ground, your head above the clouds, your nose to the grind-
stone, your shoulder to the wheel, your finger on the pulse, your eye on the ball and your ear to the
ground.
Proverb
B ODY concentration are linked. Often children’s fidgety feet or chatty mouths are
POSTURE AND
interpreted as time wasting; distracting others so that they do not listen. You may even have
asked yourself why this is happening. Perhaps they do not understand the information you
are teaching them and what has been asked. It can be soul destroying to constantly have to
repeat yourself. Have you ever stopped and looked at their actions? They may be tired because
they went to bed late or they are ready for a holiday after a long half term. Their body language
may be telling you that they are physically tired and cannot learn without a break.
To help you understand how body posture affects concentration levels in your class, this
chapter has been broken down into five sections: identification, the effects on learning, usual
development, why we need this skill and practical tips.
To start with, how to spot a child who has a posture problem. Next we will look at how
poor posture affects concentration and learning. Here there is an opportunity to read a case
study of a child who struggled to concentrate at the end of the school term and understand how
common poor posture is in the UK. The third section will give you understanding of how
posture skills develop. Followed by a poem written by Sean Johnsen explaining how the body
wishes to keep moving to be alert. Lastly, you will learn 13 different practical tips that you can
apply immediately in any classroom setting.
By the end of this chapter you will have gained greater understanding of the importance of
sitting posture for concentration. You will have many different practical tips building upon
your own repertoire of skills. Applying what you know should mean that children in your
class will no longer lack the physical energy to learn.
Before we start, here are some definitions of essential terminology used in this chapter.
■ Musculoskeletal refers to muscles, bones, joints, tendons and ligaments that help maintain the body’s
structure.
■ Body posture refers to the way you position your body or arrange your limbs.
42
The link between body posture and concentration
How to identify a child with poor body posture
This section refers to identifying a problem with posture in a primary school child. It will
discuss why noticing a problem is essential and analyse what to look for when considering
whether a child has poor posture. It also provides a checklist on how to spot a child with a
posture problem in your classroom.
Poor posture is prevalent in many classrooms. A child shows us they are fatigued through
their body language. They may hold their head in their hands when writing or if sat in a chair
listening they try to swing their chair onto the back two legs.
The skill of sitting is often under-valued. It’s something we do naturally and often don’t
think about. Correct sitting posture is vital for all children to grow into healthy adults as they
need this for every task, including to eat, write, play games, do school work and study.
Good posture allows children to work and play longer. Bad sitting posture causes muscle
fatigue, joints become stiff and blood flow can reduce around the whole body. When the body
is sat still the muscles are semi-contracted so poor posture increases the energy the body needs
to keep the muscles working; thus affecting levels of concentration and the quality of the work
produced.
Many children do not know what good posture is and how theirs differs from another child,
although some body postures may be linked to shyness, where a child tries to hide themselves
away. The reason why it is necessary to identify poor posture is that it is related to a risk of
physical deformity. Children’s bones continue to develop and grow through their whole school
life. During this time their muscles develop strength and learn how to support the body. If chil-
dren learn to adopt poor sitting posture during their primary school years, this can cause them
to experience back and neck pain. Both can lead to changes to the spine’s shape and a child
can stand with hunched shoulders.
Early identification of a poor sitting posture can help change habits and reduce future pain
as a child, teenager or adult.
With the majority of the classroom day spent sitting and the known link between body
posture and attention it is important to recognise early any warning signs that a child’s posture
is influencing their concentration. Poor body posture is actually one of the easiest difficulties
to spot because there is no way to hide or disguise it. Our bodies will reveal to anyone watching
how well we can sit.
As a teacher or teaching assistant poor body posture is most noticeable through writing and
other table top activities. Instead of using their non-writing hand to stabilise the paper, a child
will put their head in their hand. The reason for this is that the child has reduced core muscle
strength in their trunk.
A second tell-tale sign is when children try to write by leaning on the table resting the side
of their face on their elbow. Again this is a sign of low muscle tone and strength.
A third indicator is that a child is swinging their legs under the table; this is because the seat
is not at the correct height. Their feet are not flat on the floor and this chair is not giving them
the stability needed for the body to be in control. As a result their muscles have to work harder
to remain in an upright body position.
All of these signs are physical markers that a child is tired not necessarily caused by a late
night or needing a holiday but from the body being unable to maintain one specific body
posture.
Often body posture is something that is rarely noticed by parents as it has little impact on
family life except when they are around the dinner table and then children are often asked to
sit up straight. In adults rarely is posture considered until pain from arthritis or back pain
occurs.
43
Factors influencing body posture include: the time of day, type of furniture used, tiredness,
environmental temperature, reduced physical fitness especially in the core of the body, bad
habits and whether a child has a physical medical condition, e.g. cerebral palsy, Down’s
syndrome or Duchenne muscular dystrophy.
Use the checklist below in Table 3.1 to identify a posture issue in relation to specific subject
areas.
TABLE 3.1 Sitting posture checklist

Topic Yes No
English
■ When sat on the carpet listening to a story can they sit still and not fidget?
■ Can they write or read from a book without leaning on the table?
Maths
■ Can they point to and identify common shapes whilst keeping an upright sitting position?
■ When beginning to tell the time can they look up at a clock on the wall?
■ When measuring can they hold a metre ruler in a position above the ground for more than
10 seconds?
Understanding the world
■ When talking about their own environment do they sit up straight without hunched
shoulders, leaning forward?
■ When painting can they not lean in the paint?
■ When performing dance movements, can they maintain their body position?
■ When cutting can they cut with accuracy without veering off the line or cut with smooth
cutting action?
Computing
■ When using a keyboard can they sit without their shoulders hunched forwards?
■ When using a laptop can they work without moving their neck from side to side to release
any muscle tension?
■ When using a computer can they work without arching their back to relieve any muscle
tension?
Music
■ Can they listen to different music without fidgeting more than their peers?
■ When playing an instrument can they sit up straight?
General
■ Can they put their hand up in the air to answer a question and keep it straight?
■ Are they sitting on a chair with a back support?
■ Can they sit on a chair without swinging on the chair legs?
The above list is not definitive. However, if you answered ‘no’ to more than 80 per cent of
these questions then you have identified a child with possible low muscle tone which would
negatively impact on how a child is sitting during the school day, affecting their concentration.
If you have identified a child of concern continue to read the how you can help section.
To summarise, good sitting posture in children reduces overall body tiredness, helps them
learn in the classroom and increases attention levels. Good sitting posture will prevent pain,
spinal changes and avoid children developing a hunched back and shoulders.
44
What are the effects of a poor body posture on learning?
This second section will explain why poor posture has an impact in the classroom. It will
explain what physically happens to our muscles if we do not sit well and how prevalent poor
posture is in schools.
Good sitting posture helps a child increase their concentration span, helps them to work
smarter and helps them to protect their spines for their future health. Children spend 30 per
cent of their time in school and during this time a vast majority of this is spent sitting down.
Educationally there are two key effects in the classroom.
Firstly, poor posture alters the legibility of handwriting. Children require a solid base of
support when working. Even tucking one leg under another when sat on a chair can alter a
child’s base of support. It can leave them unknowingly struggling to control their upper limb
arm movements and their fine motor hand control, both of which are needed to hold a pencil.
As a result their writing appears larger, messy or illegible.
Secondly, poor posture causes a reduction in concentration. Research by Arnold et al. in
2012 has found one of the best predictors for academic success is a child’s ability to maintain
attention. Good sitting posture is often an overlooked skill when contributing to sustaining
attention. Sitting well helps children and adults work and play longer. It reduces muscle fatigue
and stops the joints from becoming stiff, both of these are vital to maintaining concentration.
Primary school children who do not sit well can experience three key problems: pain,
changes to the spine’s shape and rounding of the shoulders. Pain is often described as the body’s
alarm system. It can occur when sitting and is often identified as low back pain which is caused
by poor sitting posture.
The second problem concerns changes to the spine’s shape occurring over time when a
person is sitting awkwardly. For those children who can move about, stretching helps return
the blood flow around the body and the likelihood of postural changes in the body is minimum.
However, children who sit still for long periods can reduce the blood flow around their body
by as much as 40 per cent.
When children and adults sit slumped in a chair, this causes both the back and the shoul-
ders to be rounded forward, giving the appearance of a modern day hunchback.
Read the following case study and decide what you would do.
Mrs Kelly (Year 5) and Freddie (9 years)

It was autumn and the evenings were getting darker, coinciding with
Mrs Kelly’s Year 5 class switching off from paying attention. In truth,
even Mrs Kelly was beginning to feel fatigued. Over the term she had
introduced a merit system of awarding house points for good behav-
iour and concentration, but it was becoming clear that fewer points
would be awarded in the class’ present state.
Regardless of the season, Freddie never seemed to concentrate in

class. He was in the lower set for both English and Maths mostly
because he didn’t listen. He was one of those pupils who could
certainly do a little better if he tried. On this occasion Freddie looked
tired and he was definitely distant, daydreaming of football instead of
doing his school work.
Mrs Kelly observed the class. Although she had given them an exer-
cise they would enjoy, writing about an animal of their choice, she could
45
see most of the children were slouched over their desks and Freddie was resting his head on his hand, looking
bored.
Mrs Kelly found she had to repeat all the instructions twice and when it was time for the children to start work,
Freddie was one of five who raised their hands to ask questions. As each question was answered it became clear
that not only were the children not listening to her, they were also not listening to each others’ questions.
As Mrs Kelly walked around the class and examined the children’s work, it became clear the quality of the writ-
ing was lower than usual. Freddie was misspelling words he already knew, his handwriting was messy and the
paragraphs lacked structure and depth.
Reflection: If you were Mrs Kelly how would you help the children concentrate?
The above case study illustrates a boy who was struggling to concentrate and was not follow-
ing instructions. If you were Mrs Kelly what would be your next steps to improve the learning?
Over the last few decades school furniture design has changed. Desks with tilt tops have
disappeared and been replaced with flat desk tops. This change in furniture design, has
according to research by Mercelo et al. in 2012, increased the amount of trunk and neck flexion
when children write. This is causing postural changes to children’s spines.
Research suggests that 21 per cent of 8–12-year-old school age children report back or neck
pain. So, if we take a class of 30 children that means six of them may go home from school
saying their back or neck was hurting. This is a frightening statistic.
Poor posture in schools is a global issue. In a study published in 2003 of over 3,600 pupils
in the Czech Republic, poor posture was diagnosed in children aged between 7 and 11 years.
Poor posture was more prevalent in boys than girls with 33 per cent of seven year olds and 41
per cent of 11 year olds presenting with postural difficulties. Physically, changes were noted in
how the children’s scapular (shoulder blade) was protruding; they had increased inward
curvature of the lumbar area of the spine and a rounded back. Children were also reporting
headaches and lower back pain.
To summarise, poor posture affects handwriting skills and attention within the classroom
setting. It can leave the primary school child experiencing back pain, changes to their spine and
hunched shoulders. Poor posture is a habit that can be changed.
How do posture skills usually develop?

This third section will address why and at what age postural developments are expected. It will
also discuss how to help both children and adults sit well.
Sitting posture is an undervalued skill that can easily develop into slouching on the sofa to
watch television or hunched shoulders to message friends via mobile phones. Just as there are
stages in development to master handwriting, there is also a process of learning to sit which
leads onto crawling and walking.
By the time a child starts school, unless they have a physical medical condition, he or she
should have the skill to sit independently. It can be helpful to know how the body continues
to develop during primary school so that good posture habits are created.
The ability to start sitting upright varies due to the opportunities dictated by the culture, the
opportunity to practice and muscle strength. For example, in Africa babies are encouraged to
sit, crawl and walk before countries in the Western world. Furthermore, not every country
uses chairs to sit on. Approximately a quarter of the human race naturally take the weight off
their feet by squatting.
Babies learn to sit by using different muscle groups together. Sitting requires some muscles
46
to relax and the opposite muscles to contract. The more a baby tries to sit, the greater the
chance they have of learning the skill of timing the muscle movements together until it appears
that the ability to sit up has naturally occurred. However, it is not until Year 6, age 10, that
the human body has developed all five curvatures of the spine.
Table 3.2 is a list of how posture normally develops.
TABLE 3.2 Developmental stages of the spine

Age Physical development Spine development
New born babies No independent sitting Babies are born with one primary curve of the
spine, curving inwards towards their stomach,
like a big letter C.
5 to 13 months Starting to raise head, sit up and crawl The secondary curves in the neck and lower
back start to develop. The cervical region starts
to develop as a child lifts its head up to look at
objects whilst crawling. The lumbar region starts
to develop and this is how a child can arch their
back.
By 18 months Walking independently
3 to 8 years The lumbar region continues to develop and
strengthen, however, it is not fully developed until
8 to 10 years.
By 10 years A fully developed adult spine is an elongated S
shape. By 10 years a child should have all five
adult regions of the spine: cervical, thoracic,
lumbar, sacral and coccygeal regions.
By 16 to 18 years Children’s bones stop growing,
although some continue past this age.
Regions of the spine
47
It is important to understand how to sit well. To reduce the risk of children going home
saying they have back or neck pain it is possible to make changes to how children, and teaching
staff, are sitting without having to alter the classroom layout.
Here is ‘The good sitting guide’ to help maintain good sitting posture.
1 Seat height – Make sure the seat is the correct height for the person. Imagine you are looking
at a person who is sitting on a dining chair, instead of facing them stand to the side to see
their hips, knees, ankles and back. What you are checking for is whether their feet are
placed flat on the floor. The hips, knees and ankles should be at 90 degrees. If this does not
occur then pain and reduced concentration may develop.
2 Back support – Every school chair should have a back support as this will physically help
the spine and the trunk maintain a good posture. When sitting ensure the spinal column and
the arms are free to move about and turn.
If the back rest can be angled do not tilt the back more than 100 degrees as it provides
no benefit in reducing the pressure placed through the spine.
3 Armrests – There is some debate over whether armrests are needed. Some researchers say
that they are unnecessary and others say they release the tension placed on the spine.
If adjusting arm rests, imagine you’re looking sideways at the chair with the person in
it. They have their elbow bent at an L shape but their shoulders are not raised. The arm rest
should be positioned approximately 2.5cm (1”) below that bent elbow.
4 Neck – Many people forget about the neck, however, neck pain often occurs when typing
or looking down for long periods. Children should be encouraged to place a keyboard on
a slope of 20 degrees to reduce the risk of neck pain. Many tablet cases have a cover that
can turn into a slope for this reason.
5 Desk or table height – Imagine that you are looking at that person sitting in a chair and you
are standing at their side. The height of a desk or table should be 5cm above a child’s bent
elbow.
If the desk was too high then the shoulders would be raised. This causes muscle tired-
ness as children have to work harder to maintain their sitting position.
If the desk or table is too low then the child will be bending forwards. This puts strain
on the lower part of their spine which is in line with the hips and can cause back pain.
By following the above five steps back pain, neck pain, changes to spine shape and curving of
the shoulders can be avoided.
To summarise, sitting posture develops before the school life, however, spine development
does not end until Year 6 and bone development does not stop until a child has left secondary
school. It is therefore essential to teach good posture.
Why help a child develop a good sitting position?
This section looks at why children need to develop sitting posture. It will address both the
impact in the primary classroom and the long term implications if good sitting posture is not
maintained. For some children, sitting is a real effort as their body tires easily from the lack of
muscle strength.
Poor posture is a bad habit that can be changed.
48
A research study by Syazwan et al. in 2011 concluded that musculoskeletal pain can be
reduced and body postures can be improved by teaching 8 to 11 year olds exercises, demon-
strating good sitting posture and training them in the understanding of ergonomics i.e.
appropriate furniture and how to sit well.
There are some medical conditions that will mean good posture is essential for that child.
These include cerebral palsy, Duchenne muscular dystrophy and hypermobility. Hypermobility
is a condition that affects three in 10 UK people. Research by Tobias et al. in 2013 identified
that adolescents with hypermobility commonly reported pain in their lower back, shoulders
and upper back.
Another group of children who experience musculoskeletal pain are those who are obese.
Obese children experience a higher prevalence of pain in their lower limbs than those of a
healthy weight. Children who use a wheelchair require good sitting posture. For them sitting
is essential to protect the bones and muscles from future pain or deformity.
Within a classroom setting poor sitting posture negatively impacts on concentration levels.
The poet Sean Johnsen has written a poem especially for this book to help further highlight the
link between the body, mind and concentration.
When I sit still

My hands want to move when I have to write,
But when I sit still my back gets too tight!
My eyes want to read words inside my book

But when I sit still, it’s hard to look!
My nose wants some fresh air to have a sniff

But when I sit still, my neck gets too stiff!
My feet want to take me to walk some laps

But when I sit still, all they do is tap!
My legs leave me standing tall and proud

But when I sit still, standing’s not allowed!
My friends love playing with me at lunch

But when I sit still, my shoulders start to hunch!
My clothes fit great, and make me look bright

But when I sit still, they just don’t feel right
My teacher gives great facts to us all

But when I sit still, I just can’t recall
My brain feels much better after a rest

But when I sit still, I cannot take tests
My whole day would be best with a break or two

It is safe to say this is overdue!
Written by Sean Johnsen
49
Throughout a child’s school years their bones continue to develop until 16–18 years of age.
Only by the age of 10 years old does a child develop the adult curves of the spine. Bone growth
occurs in two ways: appositional and longitudinal growth. Appositional growth is when the
bone grows in thickness. Longitudinal growth occurs when cartilage is replaced by bone.
During the school years a child’s bones continue to grow in both formations and it is this
growth that fuses together to form the adult spinal column. Therefore for the majority of the
primary school years a child’s body is constantly developing and growing, using their muscles
in their trunk to provide body stability and to protect internal organs. Fatigue and a lack of
concentration occurs when these muscles are over used.
Although research into the link between children’s sitting posture and pain is growing it is
becoming more evident that teenagers are saying they experience back pain after doing
computer-based activities. This can be when they are playing games at home, using the inter-
net for social networking or when they are doing school work.
The World Health Organisation cites back pain as the leading cause for inactivity and work
absences across the whole world. The economic implications are more than an individual being
off sick. The WHO states back pain has a financial effect on societies, within work places and
governments. Within the UK between 60 and 80 per cent of people will report back pain at
some point in their life.
To summarise, poor posture in children is caused by carrying a heavy school bag, not
knowing how to sit or by sitting on a chair that does not meet their need. If we were to teach
children how to sit well in class we would not only help improve concentration but may also
reduce the prevalence of back pain in adults.
How can you help a child develop their posture?
The final section offers practical tips which can be applied in the classroom to help improve
concentration. It will refer back to the case study and will also provide three in-depth and 10
practical tips.
With research by Geldof et al. in 2007 suggesting that as a many as 21 per cent of children
aged between 8 and 12 report neck or back pain there is a need to establish regular movement
breaks in the classroom.
Kelly helped Freddie and his class to concentrate. We left Mrs Kelly trying to teach a class of
Year 5 students who were not paying attention and she needed to take action. Read below to
find out how she resolved the situation.
Case study solution

Mrs Kelly knew she needed to take action and decided to break away from her original lesson plan. She realised
she needed to awaken the children’s tired minds and bodies to counteract the loss in their concentration. She
asked them all to close their books, stand up and come to the front of the room. Using a concept for the younger
children to promote coordination skills, she turned on some music. Knowing that movement and dance activated
the right side of the brain’s creative powers. Mrs Kelly asked the children to move their bodies to the beat of the
music. As they waved their hands in the air, touched their toes and ‘high fived’ the person next to them, their
energy began to lift. The movement awakened those children who were previously looking distant. Before asking
everyone to sit down, Mrs Kelly requested everyone have a drink of water to re-hydrate their bodies.
As they returned to their desks, Mrs Kelly reminded the class they needed to write about their chosen animal.
The children were no longer asking questions and became more quickly engrossed in using their imaginations
50
to consider what they were going to write. Even Freddie was concentrating, producing neater handwriting as he
no longer needed to rest his head on his hand. Mrs Kelly noted she too felt more alert and decided that in future,
movement breaks and drink stops were going to be her way of keeping the class more focused.
The use of movement breaks or even opening up a window to allow fresh air into a room helps
energise the body. If you wish to give your class a movement break see Practical tip 2.
Practical tip 1: Checklist for using laptops in the classroom
In many workplaces health and safety guidelines support the concept of

changing the environment to suit a person’s needs rather than changing the
person to suit the environment. In a classroom this is not always achiev-
able. Schools do not have adjustable chairs for every child. It also not
realistic to place the laptop onto a stand on the desk so that a child is not
stooped over the screen. However, there are some changes you can make
to ensure a child does not go home saying they are in physical pain.
Help a child use a laptop appropriately:
■ Carrying the laptop to their desks – Children should not carry anything that is more than
10 per cent of their body weight. Admittedly a laptop should not weigh anything similar
to this figure, however, it is good practice to start introducing them to safe carrying
techniques, when holding heavy, bulky or expensive items. Advise them to hold all items
with two hands and keep it close to the centre of their body. By teaching this now you will
reduce a child’s risk to future back pain.
■ Seating position – Most children are unaware of the position of their bodies when they are
working. This is partly due to being engrossed in the activity but also because their brain’s
ability to judge a visual perceptual skill called ‘position in space’ is still developing.
Encourage their feet to be flat to the ground. Backs should be resting against the backrest
and elbows need to be open to a 90 degree angle.
■ Wrist position – Both wrists should be flat, resting on the laptop keyboard when typing.
■ Eye contact – Teach the children to angle the computer screen so that the top of it, is at eye
level. This will allow a child to look at the screen by moving their eyes rather than moving
their neck up and down.
■ Breaks – Encourage frequent breaks. Sitting in one position and focusing on a computer
screen can both cause muscle fatigue. This in turn affects concentration levels and the
quality of the work produced. There is a free app that can be installed to all computers
called ‘Stretch Break for Kids’. It recognises when a child has worked for more than 30
minutes and then instructs them to do one of 20 muscle stretches. If you would like more
information about this app go to www.enablememethod.com/resources/
51
Practical tip 2: Movement break
Movement breaks allow the body and the brain to become refreshed ready
to learn new information. One method to apply this is by reading an
imaginary story that includes stretching and relaxing key joints and
muscles in the body. The following story about a giant with smelly socks
has been written specifically to do this. It takes approximately seven
minutes to read and all children need to remain seated with their shoes on.
The only visible body movements are for the face, hands and arms. If you
wish to give a safety warning about not crossing rivers then please do so.
The Smelliest Giant in Town by Sheilagh Blyth

Before we start, make yourself quiet and calm . . . Sit on your chair, make sure that both feet are flat on the
ground and let your arms go floppy. . . Take quiet, deep breaths and listen to what I am saying. Follow all the
actions I tell you to do and by the end of this story your body will be awakened . . . Close your eyes and start to
relax . . .
This is a story of a giant whose feet were so smelly that even a rat would thumb its nose at him.
Imagine that you are walking down a country lane enjoying the day with the birds singing and butterflies fluttering
around on a lazy sunny afternoon. Suddenly you hear a weird noise. It sounds like a train travelling along a track,
except you live nowhere near a train station. You decide to go and investigate.
To your surprise the noise is coming from the apple orchard across the other side of the river. As you walk closer
to the sound, you see this tall giant of a man resting his body against the trunk of an apple tree. The name of
this man is Aldrich, who is well known in this area. Aldrich appears to be snoring very loudly. Whilst looking at
him, you notice that he is not wearing his usual tell-tale red and white striped socks.
Aldrich is known not only for his love of ice cream and bright socks, but mostly for his smelly feet. The whiff from
his feet is so bad, it is said that his socks could flip a small animal in the air like an acrobat on a balance beam.
Yet you still decide to help Aldrich by cleaning his socks.
To get to Aldrich, you need to cross a small flowing river covered with 3 large stones on which you can walk.
Pretend that you have taken off your shoes and are standing on the side of the river bank. To get to the first stone
you must first walk through some wet sticky mud. Yikes! The best way to do this is to spread your toes apart
and feel the mud squelch in between each toe. To avoid the mud getting all over your body, you try to wiggle
your toes some more. After you have done a reasonable amount of wiggle waggle with your toes, take a moment
to stop moving your toes and relax your wiggle free feet.
As you step out of the mud puddle you jump onto the first stone. Imagine that you are about to jump from one
stone to another. While imagining that moment, use your leg muscles to push down through your feet and as
you jump, relax. Next, you need to jump from the second to the third stone. Push down through your legs to your
feet, imagine you have made a jump, and relax. Repeat this for the third time, but this time, push down through
your legs to your feet and imagine you have jumped to the other side of the river bank, and relax. Now jump!
You are there!
Just as you are landing, Aldrich stirs from his sleep. When you see him awakening, hold your stomach in tightly,
take a deep breath, and count to three. One, two, three and relax. Luckily for you, Aldrich is in such a deep sleep
that he does not wake up. He just rolls his huge body over onto his right side and lands with a thud. K-pow!
52
After seeing that Aldrich is sleeping, imagine that you are taking small tippy-toe steps to where this giant of a
man is sleeping. You reach for one of his socks and stupidly go to sniff it. You scrunch up your face in disgust.
You ask yourself how anyone could wear clothes so smelly. As you pick up the second sock you make the same
mistake again. You smell Aldrich’s socks again, causing your nose to twitch as if you are about to sneeze. Holding
both socks in one hand, relax your face.
As you start walking to the river bed you notice a juicy red apple at the bottom of the tree. You cannot resist.
Pretend to take a bite from it, taking your time to bite down using your teeth. And you start chewing the apple
by moving your mouth. When you have finished the apple, relax your jaw.
Still holding the offensive smelling socks, you amble down to the river bank. But since you do not have any soap
with you, you submerge both socks in the water and rub them with daisies, hoping this will make them smell
nice. Pretend to rub both hands together, and relax.
Next you need to squeeze the water out of the socks. Using your imagination, pretend you have placed one sock
in one hand. With this hand, make a fist and squeeze the sock as tightly as possible and relax. Repeat the same
thing with the other hand.
The last thing you need to do is to hang the socks up to dry. As you look around, the only place you see for them
to dry is on a tall tree branch above the scary giant. Carefully you creep over to where Aldrich is sleeping. For
your own protection, raise both arms out in front of you and then above your head. Stretch up high into the sky.
You are only able to place one sock on the branch. Repeat again by raising your arms up into the sky, and relax.
As you creep away you have a big smile on your face for doing a good job today.
When Aldrich woke from his deep sleep, he found his socks were hanging on the tree above him. How weird
this is, he thought! As he put them back on, he decided to go and get his favourite ice cream.
We have now come to the end of the story. Stay as relaxed as you can, keeping your muscles relaxed and your
body floppy. When you feel ready, slowly open your eyes and move your body a little. You have now re-awakened
your muscles and are ready to concentrate again.
The story above helps children move their feet, legs, stomach, face, arms and hands. This is a
quick fix solution to muscle tiredness.
Practical tip 3: How to ask a child if they are in pain
If children are experiencing pain then it is useful to know how to ask a

child what they are experiencing. Before the age of six years the word
‘pain’ would not usually be in a child’s vocabulary so using the word ‘hurt’
is a better term.
Research has found that if a child does not understand the question
they will still try to give an answer so it is crucial to use an appropriate
pain scale. In Table 3.3 are a list of four different scales with explanations
and age norms.
If a young child is saying that they are in pain, usually they will be
unable to describe that exact location. For instance they may say it is their
stomach and make a circular sweep of their stomach using their hand but
are unable to name a body part. The use of pain scales can help determine whether a child is
in pain and would be a particularly useful tool if children were reporting they had back, neck
or shoulder pain from how they were sitting.
53
TABLE 3.3 Pain scale options

Age norms Description
Faces scale 4 to 12 years This is when a child is asked to look at 10 pictures of faces. These
are ether drawings or photographs. The faces change from happy
to sad over the series. There are no ethnicity or gender
preferences and they are good for children who struggle to
verbalise their emotions.
Visual analogue 6 years upwards This is when a child is asked to point to a part of a line that best
represents their pain levels.
Adjective scales 9 years upwards This is when a child is asked to rate their pain against an adjective
e.g. ‘mild, moderate, severe, intolerable’. Children using this scale
must have a high level of verbal communication skills.
Numerical rating scale 8 years to adult This is probably the most known, however, it should not be used
for children under 8 years old. When using you are asked ‘Please
tell me a how much it hurts using a number from 0 to 10. Zero
means no pain and 10 means the most pain.
10 quick tips to improve posture and concentration

1 Brain fuel. Think of movement as a form of brain fuel that needs to be topped up regularly.
2 How to start the day. Stretching both arms up above the head releases any tension in the back.
3 Flat feet. Both feet need to be flat on the floor for a stable sitting position. Without this the quality of any
handwriting will be affected.
4 W sitting. W sitting is a position some children sit in on the floor. Both knees are bent and are rotating outwards.
Their feet are out either side of their hips. If you were to stand above them and look down you would see a shape
similar to a letter ‘w’. This is harmful to all the joints in the legs and should be avoided at all times.
5 Cross legged sitting. This is more stable than long sitting or side sitting. It is also easier to maintain.
6 Table height. Should be at the height of the bottom of a child’s rib cage.
7 Relax. When sitting at a desk the shoulders should be relaxed and not tense.
8 Take a photo. No one can maintain a good sitting posture for long. Moving shifts the body weight around
the body and helps reduce muscle fatigue. However, by taking a photo you can help a child visually
understand what position you wish their body to be in when you ask them to sit up straight.
9 Weak spine and trunk. If a child has weak upper limb strength then they have to use a lot of mental and
physical energy in their body to meet an adult’s expectations of them sitting upright.
10 We want children to S-L-A-N-T. Sit up, Lean forward, Ask and answer questions, Nod their heads and
Track what the person is saying to them.
54
To conclude, concentration is the combination of the brain and the body being awake and
alert. Often muscle fatigue is overlooked as a reason for inattention in the classroom. Early
identification of a postural issue can prevent bad sitting habits being formed. Leaning on the
table, children swinging their legs or fiddling with pencils may not always be a sign of bad
behaviour. Consider whether a child is moving because their body is due a movement break.
Poor sitting posture causes three problems: back and neck pain, spinal changes and the
rounding of the shoulders. Bad posture is becoming commonplace amongst eight to 12 year
olds and this is a global issue. As teaching methods change to include more technology it is
important to teach children how to sit well when using a laptop. Children’s bones continue to
develop through their school life and advice acted upon in their younger years can save them
experiencing back pain as adults. Poor posture is preventable and levels of concentration can
be increased through whole body movement.
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56
CHAPTER
4
Dyspraxia in a school
setting
Dyspraxia is like running up the down-escalator, you have to try harder to reach the same goal as the
up-escalator, lift and stairs . . . it just takes slightly longer and with it more likely to stumble or trip over.
The solution is for someone at the top to flick that switch . . . if only they could see it.
Robert Hodge
CHILDREN WITH COORDINATION difficulties struggle with more areas of learning than the obvious one
of catching a ball. How, as a teacher, do you distinguish between whether a child is clumsy or
unfocused? How are you expected to help when you do not know what is causing the problem?
With no extra resources and little spare time, many teachers feel lost as to what they can do
next.
Teaching a child with dyspraxia is challenging as their learning styles are often different
from the rest of the class. It is a myth that children with dyspraxia will grow out of their
difficulties if they do more physical exercise. For many their self-esteem is ruined in their school
years and they enter adulthood being told they are lazy and stupid.
To help you understand what it is like to have a child with dyspraxia in your class, this
chapter has been broken down into five sections: identification, how dyspraxia can affect
learning, understanding usual motor development, why we need motor skills and practical
tips. It will give you the skills and understanding to help the hard work that a child with
dyspraxia does every day, so that this child is no longer misunderstood or misjudged.
First, we will look at how to spot a problem and how these problems can present in the class-
room. Next we will look at how dyspraxia affects learning. Here there is an opportunity to read
a case study of a child with a motor coordination problem and understand how prevalent
motor difficulties are in the UK. The third section will give you understanding of how motor
skills develop. It is followed by a poem written by Kathrine Jones, a nine-year-old girl, who
explains her experiences of having dyspraxia. Lastly, you will learn 13 different practical tips
that you can apply immediately to any classroom setting without the need to buy specialist
resources.
By the end of this chapter you will have gained a greater understanding about dyspraxia and
will have new practical tips to build upon your existing repertoire of skills. By applying what
you know you will be helping a child with a motor difficulty learn.
57
■ Dyspraxia is a term used to describe someone with difficulties coordinating fine and gross motor muscles.
They also experience difficulties planning and organising those movements. It is a term often used in the UK.
■ Developmental coordination disorder is the medical name used to describe motor coordination diffi-
culties. It does not acknowledge difficulties with perception or executive functions.
■ Motor difficulty or a motor problem is when a child cannot plan and execute their whole body motor
actions.
How to identify a child with a motor difficulty
The first section refers to identifying fine and gross motor movements in a primary school
child. Here we will discuss why noticing a problem is essential and will analyse what to look
for when you think a child may be dyspraxic. In addition a checklist on how to spot a child
with a motor problem in your classroom is included.
Dyspraxia is a developmental condition affecting both big and small motor movements. It
also affects the ability to plan and organise movements. A child’s ability to coordinate their
body movements varies from person to person.
Within the UK, fine and gross motor difficulties can be referred to in as many as five differ-
ent ways: clumsiness, motor learning difficulties, motor coordination, dyspraxia and DCD –
developmental coordination disorder. Regardless of the name used, the one common denom-
inator is that children with motor problems struggle to learn.
Coordination difficulties affect more than the physical ability to move and coordinate body
parts. Children with this problem will also take longer to learn and practice new skills across
the whole educational curriculum. Whether it is in a Maths class trying to understand the
concepts of whole, half and quarters or in Science where they struggle to complete the actions
to a rhyming song about body parts; these children require extra help to learn.
The effects of being uncoordinated start in the primary school years, they continue through
the teenage years and often into adulthood. This is a medical condition not caused by bad
parenting or by a child being lazy. It is a developmental disorder that interrupts normal
development. However, what it does not affect is intelligence. The child who is clumsy,
dyspraxic, slow to coordinate their body is fully aware of their own limitations. Failures result
in low self-esteem and the risk of other children making fun of them causes unhappiness
especially when it’s time for school. This may lead to a reluctance to attend school. Frustration
with themselves and restriction over future career choices are also common.
Early identification offers these children a chance to learn coping techniques to help them
succeed both academically and socially.
All children can have good and bad days, however, for a child with a motor problem,
difficulties present themselves not at a particular time of the day but more in relation to the
activity being completed. Coordination difficulties are one of the easiest developmental
difficulties to recognise.
These children seem to attract attention, not because they have two heads or five feet but
because they seem to trip over the smallest objects. As a teacher or teaching assistant, the top
three difficulties that you will notice are in relation to PE, handwriting and social skills.
When getting changed for PE this particular child would be the last one to get dressed or
58
Dyspraxia in a school setting
when dressed they have their clothes on back to front. Difficulty with dressing is due to both
poor motor coordination and visual perceptual skills. When doing PE, a child may struggle to
catch a ball or follow instructions. The reason for this is that they have reduced eye–hand coor-
dination skills and difficulty processing information that requires an immediate motor action.
These children often have poor balance, appearing to trip over objects that others are able
to walk past without falling over. They may also not be able to catch or kick an appropriate-
sized ball. For instance they can catch a large foam ball when others around them are catching
a tennis ball.
When writing, a child with dyspraxia will often hold a pencil awkwardly. Their pencil grip
will not change depending on the type of lesson. Usually they will write with a large letter size,
struggling to keep the work on the line and often reversing letters. In an Art class they may
appear to wave a pair of scissors in the air through their lack of arm control and be unable to
cut around a shape with accuracy. These difficulties are due to reduced fine motor, eye–hand
coordination and visual perpetual skills.
The last noticeable problem area is social skills. An uncoordinated child usually lacks self-
confidence, they are less assertive and can often appear a loner or play with children younger
than their age group in the school playground. Sometimes games played with a similar age
group can be too complex in terms of the motor actions required. A recent phenomena in the
toy world, loom bands, would leave most children with dyspraxia struggling to organise and
sequence the small elastic bands around their fingers to make these bracelets. To learn more
about play read Chapter 5.
If you notice difficulties in any of these three areas: PE, handwriting and social skills, then
it would be worthwhile to complete the detailed checklist in Table 4.1.
Diagnosing a coordination difficulty can be challenging. There are no blood tests which can
identify whether someone has dyspraxia. Diagnosis is based on clinical history, home and
school observations as well as standardised motor tests completed by occupational therapists
and physiotherapists.
Often many parents state that they too have dyspraxic tendencies. Describing themselves as
someone who struggled to catch a ball as a child or now as adults remain disorganised and
frequently forgetting things. At present, science has not identified a genetic ‘gene’ to explain
this correlation. However, two studies by Lingam et al. in 2009 and Michelle Lee and Sue
Yoxall in 2007 support this theory. In the 2007 study Michele Lee and Sue Yoxall’s results
found that there was a trend of 32 per cent family history of having this developmental
condition.
Factors that influence the success of motor skills are motivation and how often someone has
practiced and refined an activity. The timescales in which children with dyspraxia achieve
developmental milestones of sitting, crawling and walking will be later than other children.
Factors that can hinder motor skills are lack of opportunity to practice and co-morbid
conditions such as dyslexia and autism.
Use the checklist in Table 4.1 to identify a motor coordination problem in relation to subject
areas.
The list is not definitive. However, if you answered ‘no’ to more than 80 per cent of these
questions then you may have identified a child with dyspraxia.
If you have identified a child of concern continue to read on how you can help them. It is
also advisable to speak to their parents and request that they take their child to a GP. The GP
should then refer the child on to a local child development centre for a coordination assessment.
To summarise, a child with a motor problem is easier to identify than any other develop-
mental condition. Early identification of dyspraxia can help a child learn how to problem solve
and manage their motor difficulties without the condition leading them to experience
unnecessary frustration and low self-esteem in later years.
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TABLE 4.1 Dyspraxia checklist

Topic Yes No
English
■ When sat on the carpet listening to a story can they sit still?
■ Again when listening to an instruction do they pay attention?
■ Can they read and understand letters of the alphabet?
■ Can they write common words with no reversal of letters?
■ Does their writing appear mature or the same legibility when compared to their peers?
■ When writing do they have a preferred hand dominance?
■ Do they write using a tripod pencil grip?
■ Do they like writing activities?
Maths
■ Can they place numbers in the correct sequence?
■ Do they understand words that describe relationships? e.g. in/on, in front of, next to,
behind.
■ Can they recognise and create patterns from shapes?
■ Can they recognise the differences between a 2d and 3d shape e.g. square vs a cube?
■ Can they tell the time?
■ Can they understand concepts of whole, half, quarter and three quarters?

■ Can they draw a self-portrait using a pencil?
■ Are their drawing and painting skills correct for their age group?
■ Can they use a pair of scissors to cut out an object and stick it on paper?
■ Can they follow and perform dance movements?
Science
■ When growing plants, can they handle objects with a light touch?
■ When naming parts of the body in a rhyming song can they complete all the actions?
Computing
■ Can they create, organise and retrieve work from a computer?
■ When writing a blog or uploading photographs, can they type letters on a keyboard at the
same speed as their peers?
Geography and History
■ Can they understand the concept of latitude and longitude?
■ Can they use a globe or map to find countries?
■ Can they remember key facts about significant individuals from the past?
Music
■ Can they listen to different music without becoming distracted?
■ Do they have the sequential skills to beat a drum or play a tambourine in time with others?
General
■ When following an instruction can they remember everything they need to do?
■ Are they organised when compared to their peers?
■ Can they concentrate the same length of time as their peers?
■ Can they maintain their balance?
■ Can they sit in a chair without appearing to slump forward?
■ Can they catch and kick a ball the same as their peers?
■ In PE are they keen to participate in the games?
■ Can they change into their PE clothes in time with their peers?
■ Can they fasten buttons and zips?
■ Are they well behaved in class?
■ Do they have friends of the same age?
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What are the effects of dyspraxia on learning?
This section refers to how dyspraxia affects the primary school child when learning. It will
examine why dyspraxia has an impact in the classroom. It will analyse the impact it can have
through the use of a case study and it will explain the prevalence of this medical condition.
At school activities such as writing stories or tying shoelaces require children to automati-
cally coordinate their eyes, their hands and to remember how to sequence actions. Difficulty
in acquiring automatic motor responses impacts on learning.
Dyspraxia, a form of developmental coordination disorder (DCD) is a common disorder affecting fine
and/or gross motor coordination, in children and adults. While DCD is often regarded as an umbrella
term to cover motor coordination difficulties, dyspraxia refers to those people who have additional
problems planning, organising and carrying out movements in the right order in everyday situations.
Dyspraxia can also affect articulation and speech, perception and thought.
Dyspraxia Foundation website, accessed 20/09/14
The impact this has on everyday life is far reaching. Specific areas of difficulty can include:
■ Motor planning – the ability to plan fine and gross motor movements.
■ Organisation skills – the ability to plan what to do next and to recall instructions.
■ Visual perceptual skills – the ability to visually recognise and interpret shapes and patterns.
■ Self-care skills – the ability to get dressed, eat without spilling food, wipe after going to the
toilet and pour drinks.
■ Fine motor skills – includes handwriting, using a pair of scissors, using both hands together
in an action e.g. stabilising the paper when writing.
■ Gross motor skills – includes balance, catching, throwing, kicking and hopping.
Without proficiency in these skills different teaching styles have to be adapted. This may mean
teachers taking extra time to plan work, using different resources or asking a teaching assistant
to work with a child to confirm they have understood what is being asked of them.
Read the following case study and decide what you would do.
Mr Adam (Year 5 PE) and Riley (8 years)

Mr Adam was a student teacher on his final placement. Miss Case, an established teacher, had set the task of
planning a PE lesson for Year 5. Not only did he have to plan to keep 28 children entertained and be physically
active, Mr Adam also needed to meet the needs of Riley, an intelligent 8-year-old boy diagnosed with dyspraxia.
For this, Mr Adam had specifically chosen the day’s activity: ‘Capture the Flag’ as it didn’t involve any catching,
kicking or using a bat.
Riley’s dyspraxia meant he could appear disorganised in class, his handwriting was messy and he wore Velcro
shoes as he struggled to tie laces. PE was Riley’s worst subject, he was aware that he was not the best partic-
ipant and this made him visibly upset. He clearly struggled with games that involved fast-paced motor movements
such as catching, kicking and hitting balls. He was a class loner and, as such, struggled with team games. Mr
Adam knew that Riley got nervous about PE. He had also noticed that Riley got picked last for team games
which had understandably dampened his self-confidence.
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The rules for this particular game were to run past and dodge the
other team while finding a flag. Anyone caught had to go to a
pretend jail. As the game began, the children ran in all directions.
Riley became confused and didn’t know which way to go. He ran
forwards straight into the opposite team and was sent to jail.
When released, he ran again, but trying to dodge someone
coming his way, he tripped over and fell onto the grass,
subsequently getting caught and sent to jail again. However hard
he tried, Riley just kept ending up in jail.
Not only was Riley getting agitated with himself, the team were
also starting to make fun of him, irritated that he was causing
them to lose. Riley was ending up in jail so often that they left him
there for lengthy periods instead of rescuing him. Every time he
was released, Mr Adam tried to give him extra support by
enthusiastically shouting, ‘Run faster, Riley you can do it.’ But
Riley was angered by this.
Reflection: If you were Mr Adam what else could you have done?
The above case study illustrates how difficult a child with dyspraxia finds PE lessons. If you
were Mr Adam would you have done anything differently?
Within the UK, the most common term to describe a difficulty to coordinate small and big
motor movements is dyspraxia. However, the medical term, first used in 1987 and now used
most by occupational therapists, physiotherapists and other medical professions, is DCD or
developmental coordination disorder.
Current research suggests that there are as many as 5 per cent of children in the UK with
coordination difficulties and that more boys than girls are affected. Within an average class-
room of 30 pupils, this would equate to every class having between 1 or 2 children who
presented with coordination difficulties.
Over the last 20 years the research and knowledge into children being uncoordinated has
grown. It has identified that 50 per cent of children with dyspraxia will remain presenting with
similar motor planning problems as teenagers and adults.
Sometimes these motor problems are also associated with other conditions including
dyslexia, autistic spectrum disorder, attention deficit hyperactivity disorder, or ADHD as it’s
more commonly known. One study completed in 1998 by Kaplan identified that 52 per cent
of dyslexic children were also showing features of dyspraxia.
To summarise, dyspraxia is a developmental disorder that impacts every stage of school life.
The case study highlighted an example of how difficult it can be to plan a lesson to meet the
needs of these children.
How motor skills usually develop
This section refers to how fine and gross motor skills usually develop in all children. It will
address why and what the age expected motor skills are for a primary school child. It will also
examine how motor skills usually develop.
All children develop and learn motor skills through trial and error. However, by the time they
enter school many of these skills are so fine-tuned that it is easy to forget how long they took
as babies and toddlers to develop what are now automatic life skills.
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The challenge for anyone identifying dyspraxia is knowing what level of clumsiness can be
expected in a child. Especially as some children can have rapid growth spurts in height and
weight which can make their body movements appear more awkward. Dyspraxia is a cluster
of persistent motor difficulties. A child who appears clumsy due to a growth spurt would be
expected to appear uncoordinated for a short period of time. This is due to them relearning
how to move with longer arms and legs. A child with dyspraxia will remain appearing clumsy.
Prior to starting school, developmental milestones of when a child sat, crawled, walked and
talked provide an indication of normal development. Once at school, age norms in relation to
everyday motor skills provide a tool for occupational therapists to measure and compare a
child’s function.
The life skills that children acquire such as getting dressed, balancing, learning to write and
tying shoelaces are obtained through the three-step process of learning.
For some children the difficulty of coordinating their body means that it takes them longer
to master school readiness skills. Table 4.2 is a list of everyday life skills based on normal phys-
ical development. Use this list to help you identify if a child is achieving age expected skills.
Motor skills usually develop through the completion of a three-step process. The steps are:
1 forming the idea and knowing what to do

2 organising the sequence of movements involved in the task
3 carrying out the planned movements in a smooth sequence
Imagine that you had a Reception pupil who was getting dressed after PE and they were strug-
gling to put their jumper on with the logo at the front. The first stage to getting dressed is that
this Reception pupil needs to know what to do i.e. form the idea. Often children have learnt
as a toddler how to put on a jumper. V neck styles or logos can be a helpful visual clue to
determining front from back. However, for a child with dyspraxia putting on a jumper can
remain confusing.
The second step is the motor movements. This Reception child must understand a sequence
of movements. For putting on a jumper a child needs to know that their arms go through the
long pieces of material and that their head goes through the large hole. However, it is not as
simple as that. Children must also understand that if a logo needs to be at the front then the
right arm has to go through the piece of material to the right of the neck hole.
The third step is the execution stage. A child’s muscles need to receive the message from the
brain to carry out the motor action. They need to move their arms, upper body and neck to
place their body parts in the respective holes whilst keeping their legs still.
Many children with dyspraxia struggle to complete motor movements in one or all three
aspects of this process. Getting dressed is an obvious indicator of a difficulty, however, the same
process is required to hold a pencil in a tripod grip or use a pair of scissors to cut out a shape.
To summarise, every human learns a new skill using the same three-step process. However,
for the dyspraxic child this three-step process of forming what to do, organising how to do it
and then executing the activity can be a struggle. This difficulty can delay the mastering of age
expected skills resulting in them being behind their peers in many school subjects.
Why we need to develop motor skills
The fourth section looks at why children need to develop and refine their motor skills. It
addresses both the impact in the primary classroom and the long term implications if no help
is provided.
Children with dyspraxia are fully aware that they find learning new skills difficult. If this
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TABLE 4.2 Stages of motor development

Handwriting skills Two handed skills Self-care skills Gross motor skills
Age 2 years Start to show a hand Start to throw a ball.
preference.
Between 2 and Snip scissors at the
3 years edges of paper.
Age 3 years Catch a large ball with
their hands out in front of
them.
Start to develop cycling
skills.
Age 4 years Hop on one foot.
Start to kick a ball.
Between 4 and Able to independently
5 years remove clothing and
be able to fasten most
buttons.
Fasten shoes with
Velcro or laces.
Age 5 years Start using a tripod Able to catch a bean
pencil grip. bag.
Able to draw a
person showing six
unmistakable body
parts or features.
Between 5 and Able to trace and Able to cut out of Able to use the toilet
6 years copy letters, although complex shapes such independently and wipe
they may continue to as a butterfly or apple. themselves thoroughly.
reverse letters or
numbers up until the
age of 6.
Age 6 years Hand skills are Able to skip alternately
not fully established
Catch a ball and throw
until they are 6½
using an under arm
years old.
action.
Ride a bike with no
stabilisers.
Age 7 to 12 years Most motor skills are learnt, now is a stage when they become mastered with greater precision as
skills become automatic.
condition is identified early, during their primary school years, new learning strategies can be
applied and a reduction in the child’s self-confidence can be minimised.
Many scientists refer to there being a ‘window of opportunity’ regarding brain develop-
ment. Research informs us that during a child’s younger years there is an optimum time for
them to learn certain skills. The ‘window of opportunity’ in terms of fine and gross motor
skills is up to the age of 12. This does not mean that after this age children cannot learn new
motor skills. It refers to the fact that it will take them longer to acquire new skills after this age.
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Therefore the primary school years are essential to helping clumsy children master fine and
gross motor skills.
Many of the difficulties children, teenagers and adults experience are hidden from others.
The phrase ‘doubly disadvantaged’ has often been linked to dyspraxia. People are disadvan-
taged by both the medical condition and by how society lacks awareness of this problem.
Hearing people’s own experiences is the best way for us all to understand how we can help.
The following poem is written by Kathrine Jones. This nine year old powerfully describes in
her own words her personal experience of dyspraxia and how to her it is a ‘pain’.
Dyspraxia is a Pain!
Dyspraxia is a pain!
It doesn’t hurt,
I don’t look different.
You can’t see it……
Until breakfast.
I can’t tie up my laces, and I always look a mess.

My shirt is buttoned wrongly –
I still find it hard to dress.
I can’t hold my knife and fork yet.
I spill my drink, my mind is all muddled.
I know I am clumsy.
I get flustered and befuddled.
It doesn’t hurt.
Until I get into class.
I can’t copy from the blackboard.

It’s hard to concentrate.
The teachers call me lazy.
Keep me in and get irate.
They say that I’m untidy –
They’re very quick to blame me and don’t care to find out why.
It doesn’t hurt.
It don’t look different.
Until I write.
I can’t write very neatly

And I can’t write very small,
I get my letters backwards –
I can barely write at all.
The others say I’m stupid
And they call me lots of names.
They say that I’m a baby.
They won’t let me share their games.
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It doesn’t hurt.
Until its art.
I can’t cut out with scissors,

I can’t rule nice straight lines.
I have never coloured neatly.
I don’t draw good designs.
The other children mock me.
They think it’s fun to tease –
They never want to play with me,
Like I’ve got some disease.
It doesn’t hurt.
Until I do PE.
I wobble when I balance.

It’s awkward when I run.
I can’t climb up a gym rope –
Sports isn’t any fun.
I can’t catch a bouncing football.
I can’t kick one in the net.
I’m always ‘it’ when we play tag.
They jeer…… I get upset.
It doesn’t hurt.
But it really hurts inside.
I want to be like other children –

Good at sport and playing games.
I really want to score a goal.
I want to be the same;
I’d love to write so neatly
And be good at colouring in.
I want my work up on display
Not rejected in the bin.
I know that I am lucky;
I can walk and talk and play.
I just do it differently
And kids prefer the normal way.
Written by Kathrine Jones, kindly provided by the Dyspraxia Foundation.
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With over 50 per cent of dyspraxic children continuing to experience problems in later life it
is important to look beyond the primary classroom. Transition from primary to secondary
school can be daunting for any child. For the child with dyspraxia where the number of school
pupils often triples in size this can be overwhelming.
Secondary schools place new demands on children. Children are expected to travel across
a school site, remember where to go, arrive on time and have the correct textbooks with them.
For lunch they may need to carry a tray of food as well as pay for their items. Friendships may
also change as peers choose different schools so new friends need to be formed.
Many teenagers wish to earn some extra money by taking on Saturday jobs. Finding suit-
able employment for a dyspraxic person is not always easy. For instance a job in a café selling
teas or coffees requires a multitude of skills. This person has to have good memory skills to
recall the order, they need good balance skills to carry the food or drink items on a tray, they
need to have good eye–hand coordination skills to pour the drinks and they may need to have
good money management skills to accept payment. All skills that a person with dyspraxia may
find challenging.
As young adults leaving school either heading off to university or entering careers many
find dyspraxia continues to impact on their life. This is most evident in the areas of organisa-
tional skills, emotions and leisure activities. Some may forget to turn up to appointments,
continuously lose items or easily become lost. If given a verbal instruction they may also forget
this. Emotionally they may become stressed, anxious and even depressed at how they continue
to struggle in life. Leisure activities are also different. They may actively seek out sports that
are not team games.
Often the last complex skill that adults learn is how to drive. However, for some the ability
to control the footplates or change gear, as well as looking forward and steering can be too
complicated. If they choose not to take their driving test, this is turn can limit their social life.
To summarise, scientists refer to there being a window of opportunity in terms of develop-
ing skills. For fine and gross motor skills research suggests this is up to the age of 12. Whilst
developing motor skills is important it is also crucial to remember the emotional experiences,
as described by Kathrine in our poem. They can turn everyday activities into an emotional
pain.
How can you help a child with dyspraxia?
This final section suggests practical tips that can be applied in the classroom. It will refer back
to the case study and will also provide three in-depth and 10 practical tips.
The average class has between one and two children showing dyspraxic tendencies. It is
essential that anyone working with a child with dyspraxia has an opportunity to develop a
repertoire of skills to help them learn.
Before we look at the practical tips we shall return to the case study to find out how Mr
Adam helped Riley in his PE lesson. We left Mr Adam needing to revise his PE lesson to help
Riley who has dyspraxia.
Case study solution

At the end of the school day, Mr Adam and Miss Case sat down to reflect on the lesson. Mr Adam revealed he
was devastated by how difficult Riley had found PE and acknowledged his words of encouragement had been
counterproductive, serving to highlight Riley’s difficulties to the whole class. Miss Case suggested that with only
two minor tweaks the lesson could have been improved. Instead of letting the children choose the teams, Mr
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Adam could have done this himself. He could also have given clearer instructions, or written down the rules the
day before, so Riley could familiarise himself with them. Miss Case said the choice of a non-ball game was
sound and acknowledged that finding the right PE activity for a dyspraxic child can be difficult.
The following week, Mr Adam planned another PE lesson. This time the class played ‘Bean Bag Scramble’. Mr
Adam chose the teams by randomly assigning them numbers: ‘1, 2, 1, 2’ and so on. Riley also had a chance to
learn the rules of the game over the weekend. The instructions were repeated clearly and the bean bag was
chosen as it was easier for him to hold than a ball and if dropped, wouldn’t roll away. Mr Adam changed his words
of encouragement to congratulate Riley whenever he did well. Riley appeared much more relaxed, did well with
catching the beanbag and at the end of that PE session was socialising with the other children. Mr Adam felt
pleased and his own self-confidence had increased.
Similar to our case study, many adaptations to lesson plans to help a child with dyspraxia
succeed at school require no extra resources, take limited time to alter and do not change the
aim of the lesson.
Practical tip 1: Helping a dyspraxic child copy from the whiteboard
Children with dyspraxia often struggle to copy from the whiteboard. This
is due to having a neurological reflex called STNR (symmetrical tonic neck
reflex) that usually disappears within the first year of life. This reflex helps
a baby look up and down. Children with dyspraxia often feel tired, lose
their place when copying from the board or misspell words. When this
reflex remains present it can influence motor movements, eye–hand
coordination, eye movements and visual perceptual skills.
Help a child with dyspraxia copy from the board by:
■ Teach in small parts – Break the activity down into small sections. Some teachers choose
to write sentences on the board using different colours. For instance line 1 in red, line 2 in
blue etc. This can help a child visually track where they are when copying from the board.
Alternatively consider teaching a child to copy 3 to 4 words at a time.
■ Exercise memory – Ask the child to repeat back what you have requested them to copy.
Verbal repetition can help them recall the motor action required to complete the activity.
■ Increase time – Allow extra time to copy from the board so that they can form, organise
and carry out what needs to be completed.
■ Provide printed sheets – Consider printing out the work on an A4 sheet of paper so that
the child has their own copy to reproduce into their work books. This will save them time
and energy by not having to keep looking up and down from the board. If a child finds they
are losing their place when copying from a sheet of paper ask them to use a ruler as a guide
line. Sometimes coloured films placed over the text can help visual tracking skills.
Alternatively, if handwriting is not the main aim of the lesson, consider asking the child to
highlight key words on the printed sheet or leave blank spaces for them to add in their
answers.
■ Encourage sitting well – Often children with dyspraxia have low muscle tone and strength.
Always ensure that when writing they are sitting using a good sitting posture.
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Having the reflex STNR as a child or adult causes no harm. The above techniques can reduce
the amount of physical tiredness experienced when copying from the board.
Practical tip 2: Using ‘Goal, Plan, Do and Check’ in the classroom
With dyspraxia being a motor learning difficulty, the best approach is to

help these children acquire new skills through the act of learning.
Traditionally it was thought that to practice an activity it was best to
take the activity back to its root and isolate the problem. For instance a
child tying shoe laces would previously practice skills in eye–hand
coordination and bilateral hand skills, this often involved threading beads.
However, today the approach is to use what is sometimes referred to as the
‘top down’ approach. The teaching of tying shoe laces thus changes to
letting a child continuously practice tying the laces instead of developing
two handed skills. When the activity is broken down into sections the child
is able to learn each section more easily as it has meaning for them to
practice. The benefit of this approach is that the child remains motivated
and can see they are working towards an end result. The double benefit is
that the child continues to also develop eye–hand coordination and two
handed skills which can be transferred into other areas of life.
Many occupational therapists use a technique called ‘Goal, Plan, Do and Check’. This is
based on a cognitive learning model, where motivation and problem solving are combined
together. The concept is that the child, usually with the help of an adult, becomes the problem
solver working out a way to help them complete the activity. Through guided discovery, prob-
lem solving and memory recall of previous successful activities, inefficient motor abilities are
changed into effective skills.
‘Goal, Plan, Do and Check’ is based on asking three questions and doing one action:
■ What am I going to do?
■ How am I going to do it?
■ Complete the action.
■ How well did my plan work?
This technique allows a child to monitor and refine their actions whilst still remaining
motivated to complete their chosen activity. The key to the success of this technique is in the
child’s understanding of what they need to do in order to achieve the goal. Often this is where
they need the most help and is best achieved by posing questions rather than telling them how
it should be done. For instance ‘how do you think the bow is tied?’ rather than ‘Tie the bow
by. . . ’
‘Goal, Plan, Do and Check’ is used for both everyday life skills and educational learning. It
is a great technique to help children stay in control of trying new motor activities. It helps
them evaluate their own motor skills and aims to reduce any loss of self-esteem.
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Practical tip 3: Giving a child with dyspraxia instructions in steps
Simplicity is the key when giving a child with dyspraxia instructions. Their
difficulty is not related to the memory of what is being asked or by being
lazy. The trouble is in the process of storing the information. Often it is
best to give two- or three-step commands.
An example of a two-step instruction could be ‘pick up your topic book
and place it on my desk’. Rather than ‘once you have finished, put down
your pencils and close your topic book. Carefully tuck your chair in under
the desk and take your book to my desk’. That last instruction would have
been classed as a five-step command.
The two- or three-step advice remains relevant if asking a child to choose between which
reading book or what aspect of a subject to write about. This technique is especially impor-
tant when teaching Maths as often mathematical sentences have a logical sequence of steps. It
may be helpful to say ‘first you do this, next you do this and lastly you do this’.
There are also four other key tips with instructions:
■ If repeating an instruction do not change the language used. Changing the language can
further confuse a child as they may perceive this as a change of instruction.
■ Keep eye contact when talking. Looking a child in the eyes helps them to concentrate.
■ Minimise distractions. Consider placing this child at a desk away from the window or door.
Near the front of class usually helps maintain concentration levels.
■ Support an instruction with visual cues. Visual reminders can be in the form of picture
cards or task planners.
The saying ‘Keep it simple’ is the best way to help a child with dyspraxia plan and coordinate
the motor movements needed to complete their class work.
10 quick motor coordination tips

1 Colour code topic materials, e.g. blue for Maths. This will help a child quickly locate the correct work book.
2 Give a child their own copy of the class rules. This will help them read and understand what is expected
of them in their own time frame.
3 School pegs. Give a child a school peg at the end of the row to hang up their coat and bag. This will save
them time when trying to find their belongings.
4 Left to right reminders. Some children with dyspraxia struggle to write from left to right. Place a green dot
in the top left corner and red dot in the top right corner. This helps them understand where to start and stop.
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5 Teach them the concept of time. Children with dyspraxia often struggle with the concept of time. Use
visual aids to help them understand the differences between 1, 5 and 10 minutes.
6 Teach basketball. This is an excellent method to help a child develop ball skills. The size of the ball helps
develop eye–hand coordination skills.
7 Suggest see through pencil cases. These are especially helpful for children who take time to locate their
handwriting pen or their pencil. Alternatively pencil cases with zipped compartments help categorise
stationery.
8 Wear school bags correctly. Rucksacks should be worn across both shoulders. Children with dyspraxia
have poor balance. By keeping the bag close to the spine it helps the body maintain its balance when carry-
ing heavy or unusual sized objects.
9 Offer praise. Children with dyspraxia are used to failure, increase their self-esteem by praising every effort
however small.
10 Observe posture. Children with dyspraxia often have reduced upper limb strength. Ensure that they are
sitting in a good position and when writing they may benefit from a sloping board to reduce them slumping
forward when writing.
To conclude, this chapter started with a quote referring to how dyspraxia can feel like running
up the down escalator and referred to how hard it is to reach the same goal as others. Having
dyspraxia affects physical movement, organisation and planning skills as well as affecting
children emotionally. The poem written by Kathrine when she referred to dyspraxia being a
pain illustrates how everyday activities had become a struggle for this nine year old.
Spotting a child with a coordination difficulty is not difficult, however, the identification of
how dyspraxia presents in the classroom is multifaceted. The acquisition of all motor skills
requires the forming, organising and the carrying out of an activity. If any one of these areas
is problematic then coordination issues can appear. With as many as two children per class of
30 presenting with this condition and the probability that one of those will continue to have
difficulties into adulthood, the need to understand this developmental disorder is crucial.
Children with dyspraxia do have different learning styles and sometimes a change in teach-
ing approach can be their light bulb moment into understanding a new concept or topic. This
chapter has contained both explanations and practical tips that can be applied in the classroom.
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72
CHAPTER
5
How play develops learning
Life should have some fun in everything you do.

Steve Wozniak
PLAY IS WHERE and how children learn to be smart. It is how they learn to be a scientist by search-
ing for insects or pretending to taste food to become a chef. Play is essential to children: it is
their work. Play provides them with an opportunity to develop, absorb new information, think,
increase creativity and socialise with others. It also provides an opportunity to develop personal
identities.
Teaching a child to understand Maths, comprehend the English language or discover science
are reliant on a child having the ability to be flexible in their thoughts, open to opportunities,
to be able to problem solve and to be able to share with others. The act of playing develops
all these skills.
To help you understand how play impacts learning, this chapter has been broken down into
five sections: identification, how play can effect learning, understanding usual play develop-
ment, why we need play and practical tips. You will acquire the skills and understanding to help
a child learn essential school readiness skills through play.
First, we will look at how to spot a problem and how these problems can present in the class-
room. Then: how play affects learning. Here there is an opportunity to read a case study of a
child with autism and understand how prevalent play issues are in the UK. The third section
will give you understanding of how play skills develop; followed by a poem written by Sean
Johnsen explaining how play develops interests and career options. Lastly, 13 different practical
tips that you can apply immediately in any classroom setting without the need to have to buy
specialist equipment.
By the end of this chapter you will have gained greater understanding about play and will
have additional practical tips to build upon your own existing repertoire of skills. By applying
what you know you will be helping a child use play to learn.
■ Play is a developmental process that starts the moment we are born, it assists children to learn and to
socialise. It is a child’s work.
■ Pretend play can also be referred to as imaginative, make believe, fantasy or symbolic play.
73
How to identify a child with a play issue
Play is a process and not an end result. Often we see children at school who have low self-
esteem, reduced self-awareness and an inflexible attitude. These could be indicators that a
child is struggling to play. In this section we will discuss why noticing a problem is essential
and we will analyse what to look for when you think a child struggling to play appropriately
for his or her age. There is also a checklist on how to spot a child with a play problem.
Play is more than allowing children to burn off excess energy. In terms of developing
children’s thinking both outside and inside the classroom, play is a powerful and often under-
valued educational tool. It provides an indication of a child’s development, particularly in their
ability to imagine.
Research has identified that there is a link between social interaction, pretend play and
managing well at school. If pretend play is restricted then it has an impact on social interaction
and on the development of pre-literacy skills. Pretend playing allows children to suspend
reality, giving them the opportunity to develop the skills needed to problem solve, plan and
negotiate.
Socially, children who struggle to play imaginary games are found to be more disruptive
during playtimes. Their refusal to share toys leads them to being rejected by their classmates.
In a study by Cosbey et al. in 2012 of how children played at school they identified that a
typically developing child will spend over 50 per cent of their time playing cooperatively with
other children and 12 per cent of their time playing alone. A child with a sensory processing
disorder (SPD) was seen to play 33 per cent with others and 20 per cent alone.
Children who manage well at school have been found to demonstrate good problem-solving
skills and an ability to be flexible in their thinking, both of which come from play. For them
friendships are easily formed as their play is more interesting for others to join in with. Children
who struggle to socialise have been found to be more disruptive in class.
There are ten different characteristics of play that all children demonstrate regardless of
age. These play types are: active, adventurous and risky, communicative, enjoyable, involved,
meaningful, sociable and interactive, symbolic, therapeutic and voluntary. Identifying a play
problem is initially about being aware of these ten types and what activities a child may not
be doing to demonstrate those play components.
In the playground it is easier to notice a child playing alone or the one who appears an
outsider, wanting to join in but struggling to be included. Often break time provides adults with
a small window of opportunity to see into the child’s imagination. Those children who like
active, adventurous play will be the ones who are kicking a ball around, climbing on balance
beams, playing ball games and generally running around. This type of play helps a child
develop gross and fine motor activities to be coordinated. If a child is not doing this then they
are not engaging both their mind and body.
Some children can be observed standing in groups, communicating with each other and
sharing stories. These children are often heard laughing, having fun and showing commu-
nicative play. Some are bystanders to this activity as they struggle to pick up on the social cues
needed to socialise.
Particularly when children are engrossed in an activity, perhaps it is searching for insects,
this is when you can see ‘involved’ play. Here they need both concentration and thought. For
those who struggle to plan, problem solve and remain on the task, ‘involved’ play can be chal-
lenging.
Symbolic play is mostly seen when props are involved. Perhaps they are in the home corner
pretending to cook or someone is playing being the teacher and others pretend to write.
Children with autism often struggle with symbolic and spontaneous play as they struggle to
74
imagine how a change in use of an object applies in a play setting e.g. imagining turning a
plastic plate into a flying saucer. Other types of spontaneous play include making up songs
using sounds and words or creating dance moves.
Research has identified that certain medical conditions and children with developmental
delay lend themselves to more sedate, solitary and informal play. Some of these conditions
include dyspraxia, ADHD, autism and physical disability. These children will often be seen
playing alone, watching others, being next to another child but not interacting or being unable
to take turns.
Within the class setting spotting a play problem is more about noticing the by-product that
play produces, children who: have flexible attitudes, are able to express their feelings and
thoughts, show understanding and ability to follow instructions and problem solve. Use the
checklist below in Table 5.1 to help you identify a problem with learning in relation to play skills.
TABLE 5.1 Play checklist

Topic Yes No
English
■ Can they listen and respond to ideas expressed by others?
■ Can they respond appropriately to what others are saying?
■ Do they understand humour?
■ Can they clarify their thinking and ideas?
■ Can they say who their favourite characters are and explain why?
■ Do they share information, knowledge and communicate to others either verbally or
nonverbally?
Maths
■ Can they identify common shapes?
■ Can they create patterns?
■ Can they problem solve mathematical sentences involving adding, subtracting,
multiplication and division?
Understanding the world
■ Can they appreciate that other children do not always enjoy the same things?
■ Can they understand similarities between themselves and their friends/family/community?
■ Can they make observations about animals and plants?

■ Can they use different media imaginatively?
Music
■ Can they experiment and create music?
General
■ Are they using both their minds and body in their play?
■ Do they explore the unknown in playtime?
■ Do you notice the child having fun, laughing and being excitable?
■ Are they focused on what they are playing?
■ Do they play using what they know, hear or see?
■ Do they play with others?
■ Do they play spontaneously?
■ Do they have friends of the same age?
■ Do they have a flexible attitude?
75
This list is based on combining clinical experience with educational targets from Reception
to Year 2. These are the optimum years for identifying an issue. It is not a definitive list.
However, if you answered ‘no’ to more than 80 per cent of these questions then you may have
identified a child with possible difficulty when playing.
It is advisable to monitor the child’s progress and if learning concerns continue, then liaise
with an educational psychologist. If there are concerns regarding hand function or if a child is
presenting with a dislike to sensory stimuli then it is best to liaise with an occupational therapist.
To summarise, a problem with how a child plays is usually noticed in the playground
especially if they are playing alone. Play is important and if left unchecked difficulties can lead
to intense frustration and can have long term implications for the child as they struggle to gain
the skills needed to learn.
What are the effects of a play problem on learning?
This section refers to how play affects the primary school child when learning. It will discuss
why play has an impact in the classroom and will analyse the impact it can have through the
use of a case study. It will also refer to the prevalence of play difficulties.
Play is more than just about having fun. It helps develop the hand skills needed to hold a
pencil. It helps develop the coordination skills needed to kick a ball. It develops the muscle
strength needed to sit up on a chair.
Play provides children with a chance to express their feelings, thoughts and fears. When
reality is suspended and play takes over, it allows children to develop thinking skills. For
example deciding which toy to play with develops problem solving skills. These thinking skills
are crucial to how a child develops and educationally progresses.
Research informs us that play offers children three benefits to achieving success at school.
Although these benefits are not surprising, it is important to recognise them.
■ Firstly play provides an opportunity to practice new skills.
■ Secondly, it gives children an opportunity to explore and gain control over their environ-
ment as well as an opportunity to experience joy and pleasure from interacting with others.
■ And thirdly, it enables children to socialise. Play helps children learn social cues and teaches
them how to make friends. It also teaches them about sharing, taking turns and how to
verbally interact with others.
Two groups of children who find play difficult are those with a diagnosis of autism and those
who have a physical disability. Research into how autistic children play has revealed that they
use pretend play less than other children. This attributed to their communication skills.
Pretend play requires imagination, spontaneity and understanding. Autistic children often
have reduced problem solving and lateral thinking skills which can affect how they learn and
play. The type of teaching style used should consider these points.
Children with a physical disability also demonstrate less imaginative and symbolic play.
For them often an adult is involved or has been supervising their play opportunities through-
out their life. These children can become used to others directing them. This is usually due
to their own physical limitations and environmental restrictions. For instance a child in a
wheelchair cannot play on the floor without being lifted in and out which can cause manual
handling concerns when in the school setting. Again, having an adult assisting in play can
have a negative impact on learning as their ability to problem solve independently becomes
reduced.
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Play should develop friendships, problem solving techniques and enable learning about topics
such as nature or science. To be able to resolve differences play has to have meaning to that child.
Play should be able to answer the following three questions, in order, for it to be a success:
1 Is the play experience, safe, stimulating and fun?

2 Does the activity reflect the child’s interests, strengths and abilities?
3 Does the activity help develop the child’s current learning?
In the case study below Mrs Sandals uses play to assess how Noah is developing. Read the
following case study and decide what you would do.
Play case study: Mrs Sandals (SENCO) and Noah (5 years)

Mrs Sandals’ knowledge of helping children who have difficulties at school was wideranging. As a SENCO she
had a brilliant quality of being able to join and observe a class without the pupils feeling they were being studied.
On this particular day, Mrs Sandals was following up on Noah, a new boy to the school who had been identified
as having difficulty settling in. As she observed Noah she noticed he didn’t look at people when they were talk-
ing to him. In fact, he wasn’t playing with any of the groups of children. Instead, he was building a Lego tower
by himself while the others were using their imagination to build a castle together.
Mrs Sandals sat next to Noah, introduced herself and reached into
the tub of Lego. Initially, without talking, she copied him by building
a tower. Then when she felt he was more comfortable, she started
to do something different by building a pyramid which captured his
attention. Mrs Sandals asked Noah if he would like to be shown how
to do this and he nodded in agreement. However, as Mrs Sandals
gave instructions, Noah did his own thing appearing not to follow.
She changed approach and announced that they should make the
pyramid together. With each brick she encouraged him to take his
turn. However, the more this happened, the more defensive his body
language appeared to become.
Based on what Mrs Sandals had seen during their interactions, she
had concerns. At break time she discussed the situation with Noah’s
class teacher, Miss Greene. Miss Greene was an experienced Year
1 teacher who had also noticed some of these behaviours. For her,
Noah was standing out in the class as someone who was struggling
to communicate and learn. She explained Noah didn’t like team
games and in the playground she had noticed he didn’t seem to understand social cues. She gave an example
of one child passing Noah a toy car. Instead of taking the car and pretending to drive along an imaginary road,
he held the toy in his hand and looked on blankly. Miss Greene had also noticed that Noah preferred to play alone.
In class he would do his own thing and didn’t follow instructions so it was difficult to engage him in learning exer-
cises. She also said that if he was to try to solve a problem, perhaps by spelling out a word phonetically, he
struggled.
Reflection: If you were Mrs Sandals’ what would you do to help Noah?
The above case study illustrates a boy who prefers to play next to rather than with others. If
you were Mrs Sandals, what next steps would you take?
77
Occupational therapists view play as a form of work for children, essential for their devel-
opment and a crucial requirement of life. Techniques to evaluate play by OTs include
observation and evaluation. These usually relate to looking at hand function and how it
compares to age expected hand development.
Research studies on play as a whole are limited. They usually categorise play into its
component parts e.g. pretend play or sensory motor play. Studies will also look at particular
groups of children and how they play e.g. those attending a special school, children identified
with a diagnosis of autism or cerebral palsy. Studies also exist on gender preferences for toys.
However, the prevalence of play difficulties for a typically developing child and their impact
on learning is not really known.
Bundy in 2005 concluded that there were no formal measures in which to determine a child’s
ability to play. A new parental questionnaire called ‘My Child’s Play’ for three to nine years
olds may be about to change our information about play. Published in 2014 by Schneider and
Rosenblum research findings suggest that this tool, comprising of 50 questions, is culturally
sensitive. It provided parents with greater insight into the importance of play and would be
appropriate for occupational therapists to assess how a child’s playing skills are developing.
The questions include asking a parent if their child can initiate play, can they adapt their
behaviour for the setting and can they vary their play with the toys available. It then scores the
answers in relation to four categories: executive function, interpersonal relationships, play
choices and opportunities in the environment. Of particular interest would be the answers to
the executive function and interpersonal relationship questions. Perhaps a child struggling with
the mental process of play where they have to plan and organise their actions would also be
experiencing difficulty with learning. In future, the prevalence of play difficulties and their
effects on learning may become more readily available.
To summarise, we know that play has many benefits. We know that it has to have meaning
to a child and we know that the school readiness skills needed to learn initially develop from
children having opportunities to play. It is possible to learn about component parts of play
and the difficulties children with specific medical conditions have when playing. However, the
prevalence of children struggling to play is unknown.
How play skills usually develop

This section refers to why it is helpful to know about play skills and will address what are age
expected play skills and then how play skills usually develop. Play has a five-step develop-
mental process that begins from birth and it is helpful to know about how play develops as it
offers an insight into a child’s physical, educational and social development.
Physically, when a child is born, their nervous system is naturally immature. For a child to
grow and develop, they need opportunities to expand and challenge their ability to control
their body’s motor movements. However, exploring by movement alone is not enough, they
need to feel the movement through running, jumping, climbing and touching in order to make
sense of their environment. This is why using finger painting or drawing in sand helps a child
develop handwriting skills. By providing young children with opportunities for sensory play
and older children with opportunities for recreational play you are helping them remain healthy
and tolerant of others. To learn more about sensory processing skills read Chapter 6.
Educationally, research states that make-believe games are essential to helping children think
and to problem solve. These skills are used in Literacy, Maths and other school subjects and
help develop good behaviour. By facilitating ‘make believe’ games you will be helping a child
develop the skills needed to succeed academically at school.
Socially, research informs us that as a child becomes more socially confident they may
78
initiate play with other children and begin to understand the meaning of friendships. Games
with rules help children form friendships and this type of play develops socialising skills needed
both at home and at school. These social skills are needed in adulthood.
Play has five stages of development. Each one runs in a sequence and no step is ever missed
out. However, some children may take longer to move from one stage to another, or they may
never move onto the later stages of play development due to learning difficulties.
Table 5.2 is a list of play skills based on normal development. Use this list to help you
identify if a child is achieving age expected skills.
TABLE 5.2 Developmental stages of play

Birth to 2 years Sensorimotor play. These activities develop both motor and sensory awareness skills.
This is the start of muscles being able to interpret sensations needed later in life to hold a
pencil or ride a bicycle.
Between 2 and 4 years Symbolic and constructive play. These activities include objects that have meaning or
objects created to make an end result. Both continue to develop motor skills.
Between 4 and 7 years Dramatic, complex construction and pregame play. These activities involve
imagination and fantasy. ‘Make-believe’ games are essential to help children think and to
problem solve. This is also the start of children developing self-control and flexibility.
Between 7 and 12 years Game stage. These activities start to involve rules and the acceptance of these rules
develops social behaviour. Games that have rules help friendships to be formed.
Between 12 and 16 years Recreational stage. These activities incorporate teamwork. Games that challenge and
involve competitive sports appear. This type of activity helps teenagers lead a healthy and
fit lifestyle.
All play stages are influenced by parental and carer stimulation.

Before a child starts primary school they should have already developed the first play stage,
sensorimotor. This is the ability to link sensation and movement. For instance a child will enjoy
playing ‘peek-a-boo’ or will enjoy dropping objects into a container because of the sound it
makes. They also enjoy exploring different textures such as foam, sand and cotton wool.
Children will also start to explore shapes using both hands, an essential skill for being able to
hold a pencil. Although children start the process of learning to feel an object at this young age,
it’s not until they are six years old that they have learnt how much force is needed to accurately
lift an object.
The second stage is ‘symbolic and constructive play’. Here children will begin to play ‘make-
believe’ games and pretend play. Pretend play allows creativity and imagination to develop. A
scary monster could be created in play dough or a dressing up game could lead to the use of
different materials such as corduroy, felt or velvet, or a child could pretend to be an animal by
walking on all fours, which is also a good way to develop muscle strength. Children will start
to build objects using large blocks. At this time they will start to explore more complex shapes
with their hands and understand about spatial concepts. At this stage they will also fine tune
their running and climbing ability.
Dramatic, complex construction and pre-game play develops during the first few years of
being at school. Play becomes more socially interactive and role play can be seen. Examples
could include enacting a daily experience, like making dinner; taking on roles such as playing
a shopkeeper; or more fantastical roles such as becoming a fairy with magical powers. Here
play becomes more developed in terms of hand use and these skilled hand movements allow
greater precision needed for handwriting. Activities involving strength and playing outdoors
79
emerge, including some daredevil games. Construction games become more realistic and
complex.
In the later part of primary school life ‘game’ stage play emerges. Friendships in these games
are important, interests in sports groups and in how things work starts to develop. Children
may begin to show an interest in attending Scout or Brownie groups. They may also be curious
about nature.
Post primary school ‘recreational’ play occurs. At this age, peer groups may become more
important than the family. Teenagers may become self-conscious and parents can experience
a period of conflict.
To summarise, the development of play has five stages and each one provides a child with
the skills needed to be ready for school. As play develops through the primary school years it
helps children meet physical, educational and social expectations placed upon them. It prepares
them for role play in later school life when putting on a school production.
Why do we need to develop play skills?

Play is a process that provides children with an opportunity to develop, learn, think and
socialise with others. This section looks at why children need to develop and refine their play
skills. It will address both the impact in the primary classroom and the long term implications
if no help is provided.
Time given by parents for free play is decreasing due to hurried lifestyles and the same is true
in schools where the demands of meeting the national curriculum leave some schools reduc-
ing the amount of time children play. The United Nations High Commission for Human Rights
recognises the importance of play referring to it as being the right of every child.
Playing helps healthy brain development. It opens opportunities for a child to discover
interests, explore the world at their own place and learn how to share and negotiate. Play helps
children become ready to learn and to behave in the school setting. It engages both the mind
and the body.
Knowing about play provides an indicator of how well a child may be physically develop-
ing their muscles and senses. It also gives us a clue to how they are managing at school and how
well they can socially interact with their peers. Play lets an adult know how self-aware a child
is, how high or low their self-esteem is and whether they have developed a flexible attitude to
life and learning.
By enacting their play, a child can show us whether they are ready for the daily challenges
we ask them to complete. Observations of play can also reveal issues of physical, emotional
and sexual abuse. Once we know about play and how well a child is playing, we can then spot
a child who may need extra play opportunites or help socialising with others.
In the past many games were devised to challenge both the mind and the body. Some popular
games still played today started in the 1900s. They required no money and could be played in
the street, for example hopscotch, playing with hoops and leapfrog. In the 1960s popular
games and toys included Simon says, Twister and Barbie dolls. Changes in technology in the
1980s brought about the first computer games. Games played today still involve imagination,
exploration and problem solving. It is these games that can help forge career interests later in
life.
The poet Sean Johnsen has written a poem specifically for this book to help further highlight
the link between interests explored as a child through play and jobs undertaken as adults.
80
Because I played
If I make it as a writer, it would be from all I touch
Fine motor skills from textures that I find from play and such
If I become a detective, it’s because of hide-and-seek

Being careful with decisions as I select where to peek
If I get involved in fashion, it’s because of arts and crafts

With the perfect cut, I could replicate anything I draft
If I end up as a bank manager, it’s from playing with fake bills

Sorting it out with my friends helped with my problem solving skills
If I make it as a politician, it’s ‘cause of how I speak

Conversations with my friends as I play with them every week
If I become a pro athlete it’s because of playing sports

Playing them increases motor skills of every single sort
If I make it as a parent, it’s because mine let me play

I know what’s necessary, and should be the only way
Anything my future holds in store, I know that it was paved

From the freedom I was granted, and the way that I behaved
Influencing my development with all forms of advices

Anything else can be valuable, but I know play is priceless!
Written by Sean Johnsen
Over the last 20 years play has changed to become more technologically based and this is having
an impact in the classroom. Research into the long term implications in the use of computers is
limited. In a survey of 2000 UK parents completed in 2013, 40 per cent of parents said their
children used a tablet or smartphone at home and 17 per cent said their child had their own
device. Electronic gadgets are not going away and today they are very much part of our society.
Some recent studies suggest that computers are a contributing factor to the levels of obesity
in America and the rise in South Korea of children developing what is called ‘digital dementia’.
This is when children are struggling to concentrate as they have not fully developed the
attention and memory skills acquired from the right side of the brain as they have over devel-
oped the left side of the brain when playing computer games. It is therefore possible to conceive
that technology is reducing children’s attention spans which in turn is affecting learning.
From an occupational therapy perspective the use of computers can help with therapy
treatment programmes aimed at improving balance and coordination. However, the swiping
of the fingers on a tablet or the tapping on a screen to play a game does not develop the hand
skills needed to hold a pencil in a three fingered tripod grip or teach a child how to use both
hands together to use a pair of scissors. Some of the traditional games such as posting pennies
into a money box or pressing a cutter into dough are the only real way that a child can learn
how much muscle force to use in their hand or learn the fine motor intricacies needed for table
top activities. An interesting development will be to see how the use of tablets and the reduction
of gross motor play impacts on learning in the classroom.
Psychologists are also reporting concerns that children are struggling to develop social skills.
Children would usually learn to take turns, make eye contact and share, by playing with others.
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As playing on a computer is an insular activity this is another set of skills that children may
not be developing in order to help them achieve top grades at school.
To summarise play opens up opportunities to the world both as a child and as an adult.
The impact of technology remains relatively unknown, however, the use of tablets where chil-
dren swipe or tap changes how usual hand function develops in play. It remains to be seen the
impact this may have on a generation learning to hold a pencil and write legibly.
How can you help a child play?
It is the role of parents to create play opportunities such as play dates and provide children with
toys that are of interest. However, there are changes that schools can make when promoting
play and learning. This section presents practical tips that can be applied in the classroom. It
will refer back to the case study and will also provide three in-depth and 10 practical tips.
Sandals helped Noah. We left Mrs Sandals discussing with his class teacher how Noah had
reduced social skills.
Case study solution

Assembling together all the information, Mrs Sandals felt that Noah was displaying autistic tendencies. Namely,
he was socially awkward and liked systems, puzzles and building block games. His strengths were not in turn-
taking and problem solving.
While waiting for a referral to be actioned by the local child development centre, Mrs Sandals wondered whether
a lunchtime Lego club might be helpful. She had heard about the concept of Lego® therapy a while ago and
knew that, more recently, schools were using it. She knew that the idea of building something out of Lego would
be of interest to many children in the school.
With an adult overseeing the activities, the Lego club requires the children to adopt specific roles. Engineers read
the plans of what needed to be built. Suppliers find and distribute the Lego bricks and lastly builders who
construct what was described. Mrs Sandals was confident this type of group would help Noah follow instruc-
tions, take turns and build his confidence.
The setting up of Lego clubs for primary aged children happens across the whole world. This
international phenomena occurs in schools but also in libraries, shopping centres and toy
shops. Often the sessions have themes and people donate unwanted Lego pieces resulting in
minimal financial outlay to create a club.
Practical tip 1: Bring a cardboard box to the playground

A necessary component of play is playfulness. In the school playground
equipment and time limitations can restrict this. In a study by Bundy in
2008 a playground was transformed by having ‘loose part’ materials added.
These were non expensive items that had no meaning. Loose materials
included cardboard boxes, bicycle tyres, plastic barrels, crates, wooden
planks, fabric, lengths of tubing and hay bales. In a play environment loose
materials required children to use their imagination if they were to be
included in the play.
82
The concept of this research was based on the premise that years ago children were allowed
to go out and play outside making their own entertainment. At these times children would
often discover pieces of wood or dens and let their imaginations amuse them.
Interestingly, Steve Wozniak, co-founder of Apple Macintosh, said in a recent speech given
in 2014 that he considers himself a builder. Outside school he learnt to use electronic parts and
build computers. For him, he chose do to this as a form of play. His daily motivation and
enjoyment came from creating and exploring the unknown.
Unfortunately, as adults became more fearful for children’s safety, youngsters were
encouraged to only play in playgrounds with swings and slides where play is less imaginative
and more predictable.
In the past schools have used the ‘greening’ approach to keep children entertained. Positively,
whole playgrounds were turned into natural play spaces where bark chippings, willow
structures and sensory gardens occurred. Negatively, they can be expensive to install and take
years to mature.
The results of Bundy’s research identified that placing of ‘loose part’ materials, as mentioned
above, on the playground increased children’s creativity. Children transformed into becoming
creators and inventors. They started looking at the mechanics of properties by rolling balls
down planks of wood. They also were using more physical skills and imagination in their play.
Observations by teachers included that they heard the children talking and explaining their play
more. There was increased cooperation in the playground and children were playing together
regardless of age. Another positive result was that children who were not as physically capable
as others were using their creative and imaginative skills to become leaders of play. Usually their
physical limitations would not have led them to take on this leadership role.
The research results suggest that children can become more active, creative and social when
non expensive items that have no meaning are placed in the playground.
Practical tip 2: Moderate screen time for a child
Screen time is a phrase that refers to television, computers, video games

and mobile devices. In today’s technological age one big question is how
long is too long when watching a screen? In 2014 a systematic review by
Hale and Guan identified that between 1999 and 2014, 90 per cent of the
studies looking at screen time of school children reported that children were
either going to bed late or having fewer hours sleep due to the amount of
screen time they had.
In America the advice for every child is that they undertake 60 minutes
moderate to vigorous physical activity a day and have no more than 2
hours at a screen. This same advice on screen time is being given by the
Australian government who stated watching TV does not help a child under
two years old to develop language skills. It can also have a negative effect
in terms of the development of their eyes. In Australia, for children aged between two and five
years old the guidelines suggest up to one hour of screen time per day. As the child increases
in age so does the limit but not as much as you would think. For children aged between six and
18 years the guidance suggests up to two hours each day.
In a study by Jago et al. in 2014 of 1078 children aged five to 6 years old the researchers
discovered that on a weekday 12 per cent of boys and 8 per cent of girls watched more than
2 hours of television per day. On a weekend these figures increased to 45 per cent of boys and
43 per cent of girls. These figures are only based on what a child sees at home and excludes
any screen time at school using a laptop.
83
The two-hour-a day rule remains the guideline across the world and without staying true to
this there is a concern children will lead sedentary lifestyles, and have an increased risk of
obesity and postural changes to the spine.
Practical tip 3: Traditional play is still useful
Many of the ‘old’ play games remain as relevant today as when they were
first created. Here are five top favourites that can be completed in any
primary school.
Hopscotch
This is an excellent game to promote balance and eye–foot coordination.
It dates back to the seventeenth century. Hopscotch can be played either
alone or in a group. The concept is that a pattern of squares are created on
the ground. They follow the formation of 1 single square, 2 squares, 1
single square etc. The squares are then numbered 1 to 10. A small object is thrown into a
numbered space. A child must then hop or jump on every number to the small object. They hop
by using an alternate action of hopping on one leg on a single square. Then land on both legs,
one foot in each square. To collect the small object they must balance and pick up without
landing on that square.
Kim’s game
This game helps to develop visual memory games as it strengthens a child’s ability to observe
and remember. This is a very traditional game dating back to 1901 when Rudyard Kipling’s
hero Kim played this game to improve his spy skills. Kim’s game cannot be played with fewer
than two people. The concept is that a child is shown a series of everyday objects. These are
then covered over and one object is removed. The child must recall what the object was. The
same visual memory skills can be developed using a set of cards and by playing pairs. Both
games will help increase concentration skills.
I Spy
Apart from the ability to develop social and language skills this is also a good game to develop
essential visual skills needed for reading and writing. Instead of the usual way to play this
game it is possible to develop visual perceptual skills by asking the child to find a shape. E.g.
I spy with my little eye a shape that is round. The answer could be clock, plate or button. The
more imaginative you can be can really help a child notice visual differences in the environment
around them. This game is not suitable for children with visual impairments unless they are
asked to think of an object made from a particular shape.
Treasure hunt
This game is great for helping sensory motor skills and helps to develop skills needed for hand-
writing. The concept is to hide everyday objects inside a material. This can be sand, soil, water,
polystyrene. It can also be played by hiding objects loose within a cloth bag. Items can include:
key, pen, comb. The material can be alternated so that the child learns to identify objects
through touch alone.
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Hula hoop
This is a good game for developing a child’s core body stability and concentration skills. It is
also a game where children can build upon their self-esteem as there are new moves which can
often be mastered with ease. Many often think of this game as being one that mainly girls
enjoy, however, boys can enjoy this too. To add complexity a child can decide to hula hoop
with more than one hoop. To work the core of the body the hoop needs to be kept circling
around the child’s waist by moving the hips forwards and backwards. By moving the hips in
this push–pull movement rather than a circular direction it helps children have an extra body
workout.
10 quick play tips

1 Keep moving. Through movement children learn how to explore and interact with the world. This helps
them to develop problem solving skills.
2 Make believe. Turn everyday objects into treasure. Make believe games help the imagination to grow.
3 Get children working. Play is a child’s work, dedicate time to play so that they can develop thinking and
motor skills.
4 Get physical. Physical activities stimulate the connection between the mind and the body. Plan an obsta-
cle course to help the mind develop thinking skills. Complete the obstacle course for the body to learn about
movement.
5 Wet play ideas. Consider making origami, drawing pictures, designing a new board game, and building
jigsaws when it is raining.
6 Lie on the floor. Games that involve children lying on their stomachs with their arms propped on their fore-
arms helps develop shoulder, arm and wrist muscle strength needed to write.
7 Post money. Posting coins into a piggy bank remains one of the best methods to develop hand skills requir-
ing manipulation of small objects in the palm of the hand. These in-hand manipulation skills help a child hold
a pencil in a three fingered tripod grip.
8 Simon says. Remains a great game for developing body awareness, postural body strength and the abil-
ity to follow instructions.
9 Snap. This game develops eye–hand coordination, manual dexterity and speed of hand movement skills.
10 Become part of a group. Group activities help develop social skills e.g. Lego groups or after school clubs
like Brownies.
85
To conclude, play is crucial and should be undirected fun as this will allow a child’s imagina-
tion to flow. While playing children learn about their environment, how they interact with
that environment, how to solve problems, plan and negotiate. These are all skills needed to
excel in school and later life. Play is a child’s work. They need dedicated time to master their
play skills so that they can successfully progress through the five developmental stages of play
aiming to reach recreational play whilst they are in secondary school.
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CHAPTER
6
Understanding sensory
behaviour
Some children may need a behavioural approach, whereas other children may need a sensory
approach.
Temple Grandin
CHALLENGING BEHAVIOUR CANbe difficult to manage in any situation. It can leave teachers feeling their
lesson plans have been interrupted and it can also affect the learning of other children. It can
leave any adult feeling their patience has been tried and tested. Not all behaviour is bad
behaviour.
Often a child with a sensory processing disorder will feel overwhelmed, helpless and out of
control. As a result their behaviour becomes noticeable for all to see. Finding the balance
between helping a child with a sensory processing disorder and meeting their learning needs
within a mainstream setting can be difficult. These children do not make a decision to
misbehave; their difficulty is in the interpretation of the senses around them.
To help you understand sensory behaviour, this chapter has been broken down into five
sections: identification, how this can effect learning, understanding usual sensory awareness,
why we need sensory awareness and practical tips. It will give you the skills and understand-
ing to manage a child with a sensory processing difficulty in your class.
First we look at how to spot a problem and how it could present per subject area. Next we
will look at how sensory processing affects learning. Here, there is an opportunity to read a
case study of a child with ADHD and understand how common this condition is in the UK.
The third section will give you an understanding of how sensory skills develop. This is followed
by a piece written by James Le Guerrannic, an 11-year-old boy who explains his experiences
of having a sensory difficulty in school. Lastly, you will learn 13 different practical tips that
you can apply immediately into any classroom setting without the need of having to buy any
specialist equipment.
By the end of this chapter you will have gained greater understanding from both a medical
and a child’s perspective of this condition. You will have many different practical tips to build
upon your own repertoire of skills. By applying what you know you will be helping a child with
a sensory processing disorder to learn, and to find the school a less frightening and bewilder-
ing place to be.
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Understanding sensory behaviour
■ A sensory child refers to a child who responds to events in a way that is out of proportion compared to
their peers. They consistently show behaviours that can’t be ignored.
■ Sensory information is a neurological process of understanding and organising information from the envi-
ronment to our own body. What an observer sees is how a person behaves and reacts to that information.
■ A sensory processing disorder (SPD), formerly known as sensory integration, SI or sensory integration
disorder, is ‘a condition that exists when sensory signals do not get organised into appropriate responses’
(this definition is from the SPD Foundation website).
How to identify a child with sensory issues
Before we can look at how to help we need to know how to identify a sensory processing
problem. Here we will discuss why noticing a problem is essential and will analyse what to look
for when you think a child may be sensory seeking or sensory avoiding. This chapter includes
a checklist on how to spot a child with a sensory problem in your classroom.
Children with sensory processing difficulties find a typical day very challenging. Often these
children don’t feel safe. They find the sensations they experience frightening, unpredictable
and bewildering. It can affect all aspects of life including play, friendships, behaviour, learning,
communication and a child’s development. As a result their behaviour can be different to other
children and they struggle to function.
Many children with a sensory issue describe a typical day as challenging. They may find
it difficult to get dressed due to the feeling of the clothes against their skin. They may only
want to eat certain foods due to the texture the food makes within their mouths. They may
also appear to play too roughly with friends during playtime as they do not know how much
force they are using through their muscles. In class they may be unable to sit still and appear
never to listen to instructions. For some, being at school and managing the school day is too
overwhelming. These are the children who need sensory strategies applied within the
classroom.
Being able to notice the difference between usual behaviour and sensory related behaviour
is essential. Often individuals describe behaviour as being either good and bad or knowing
right from wrong. In reality, children’s behaviour is defined by the adult and how that adult
views the world. What is acceptable for one adult may not be acceptable for another.
Sometimes the challenge can be in knowing how to respond appropriately to something that
you perceive to be ‘naughty’.
Sensory related behaviour is easy to spot but usually difficult to understand. Sensory process-
ing behaviours are about opposites, what calms one child can over-stimulate another causing
them to appear hyperactive.
Children who appear to become very hyperactive for no apparent reason are over-reacting
to a sensory feeling. Children who appear switched off and not engaged are under-reacting to
the senses around them. Both over- and under-reacting behaviours are often thought by adults
to be possible to stop or altered when asked. Some older children have learnt to control or hold
in their feelings at school, however, this usually results in them having a ‘meltdown’ after school
in the safety of their own homes.
Many parents are aware of their child’s sensory behaviours. Some children may enjoy
89
making whole body movements such as flicking their hands, spinning their bodies, making a
rocking movement or twirling around. In play parks their parents may have become used to
their child seeking out swings or disliking how certain materials feel against the skin. This
child may give firm hugs or dislike being hugged. If they have fallen over the child may not
respond to pain by crying.
In class these same children could have average intelligence or have dyslexia. They become
noticeable to teaching staff often because they might fidget, appear to always be unable to sit
still or to constantly want to tap their fingers on a desk or tap their feet on the floor. This is
due to an over stimulation of the sense called proprioception, knowing where their body is.
Children with a sensory disorder can also be easily distracted when sitting on a carpet during
circle time, due to the amount of visual stimulation around them. This can be caused by other
children or looking at what is happening outside the window or who is walking past the
corridor. Although this is common to all children for those with a proprioception difficulty
their distraction is more frequent.
In the school playground a sensory child may dislike loud noises and actively seek out the
quiet areas. When playing these children can lack an awareness of others’ feelings due to not
understanding that the way they feel when playing a rough and tumble game, or running fast
around the playground, is not the same as their friends.
Apart from the physical behaviour as described above some children will present with
different sensory behaviour in some lessons. Sensory processing difficulties are individual to the
person. For this reason factors that influence or hinder sensory skills are specific to that
individual.
Use the checklist in Table 6.1 to help you further identify a sensory processing problem.
This list is based on combining clinical experience with educational targets from Reception
to Year 2. These are the optimum years for identifying an issue. It is not a definitive list.
However, if you answered ‘no’ to more than 80 per cent of these questions then you may have
identified a child with possible sensory issues.
It is advisable to speak to their parents and request that they take their child to their GP. The
GP should then refer the child onto a local child development centre for a sensory processing
assessment.
To summarise how to identify a child with these problems, sensory processing difficulties are
one of the easiest to recognise but are also one of the most difficult to understand. This is due
to the complexity of the condition and no two children present or react in the same way.
What are the effects of a sensory processing disorder on learning?
Sensory processing disorders cause a child to display a variety of behaviours which affect learn-
ing. This section will explain why sensory issues have an impact in the classroom and will
analyse the impact they have through the use of a case study. It will also discuss the prevalence
of this medical condition.
The classroom for a child with a sensory issue is a complex place to be. A study carried out
in 2011 by Paterson and Peck identified that out of 20 children with an autistic spectrum disor-
der, 83 per cent could not filter out noises (auditory processing) and 68 per cent were tactile
defensive, a reaction to tactile stimuli e.g. a child touching another’s arm.
Classrooms can also restrict learning by being too visually appealing and over stimulating,
resulting in a child behaving excitedly or being hyperactive. A classroom also offers many
different tactile experiences. For example a Year 2 Science lesson identifying and discussing
familiar materials could leave a child who is tactile defensive struggling to touch different
materials such as metals and wood, making them unable to discuss these properties. The hum
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TABLE 6.1 Sensory processing checklist

Topic Yes No
English
■ When sat on the carpet listening to a story can they sit still?
■ Again when listening to an instruction do they pay attention?
■ Can they listen to what others are saying and respond fittingly?
■ Can they write with an even pencil touch that is not too light or too heavy?
■ Can they read out aloud?
Maths
■ When exploring characteristics of everyday objects and shapes using mathematical
concepts can they manage to touch items that are made from different textures e.g. brick,
feather?
Science
■ When growing plants, can they place their hands in soil?
■ When learning about the difference between objects and materials can they touch the
items identified e.g. glass, wood, metal, plastic, rock?
Art
■ Can they draw, paint and sculpt using different materials e.g. paint, chalk, clay?
Music
■ Can they listen and react appropriately to different tempos of music?
■ Can they experiment and create different musical sounds?
General
■ Can they sit in a chair or on the floor without appearing to fidget?
■ Can they wear different clothing materials without becoming agitated?
■ Can they concentrate without being distracted?
■ Do they pick up new activities easily?
■ At lunch, can they eat or drink any texture of food?
■ Can they cope with loud noises?
■ Are they happy to get dirty or wet?
■ Do they have a lot of friends?
■ When playing do they play appropriately e.g. not too roughly/aggressively?
■ When playing do they avoid the swing?
■ If they fell over in the playground do they react the same way to pain as other children?
of children working can be distracting for a child sensitive to auditory difficulties. They will find
it difficult to differentiate and follow the teacher’s verbal instructions if others are talking.
For those children who are sensory seeking and over respond to the sensations around them
you may notice they often present in class using excess body movements. They may rock their
chair, fidget, try to manipulate things in their hands and tap or shake their feet. Children who
appear hyperactive struggle to sit still, disturb other pupils, struggle to concentrate on the task
and find it difficult to join in a group exercise.
Sensory processing has a huge impact upon lessons. Children with a sensory processing
disorder find it difficult to learn in a classroom setting and struggle predominantly with
communication, behaviour and social relationships.
91
Their struggle to manage behaviour is due to them battling with an automatic flight or fight
response to what they are experiencing around them. Research has shown that this group of
children will encounter more conflict in their school lives than others. They are unaware of
social cues and as such any instructions with complex play become too difficult to carry out.
To help understand conflict and behaviour experienced by a person with sensory difficul-
ties read the following case study and decide what you would do.
Sensory case study: Mr Lewis (Deputy Head/Year 2) and Emily (7 years)

Emily was one of Mr Lewis’ Year 2 pupils and she was giving him great concern. She liked action and if things
were too slow for her she would quickly become bored and move on. Her ADHD (attention deficit hyperactivity
disorder) diagnosis helped explain some of her personality traits, but as the school year progressed; her inability
to sit still and maintain focus was becoming a problem. Emily would even become distracted when receiving
simple instructions. However, if the focus was a subject she liked she could concentrate for double the length
of time.
Emily seemed perplexed by her own behaviour on several occasions and couldn’t explain why she got up to move
about the room when everyone else was quietly sitting doing their work. If there was a group activity sometimes
she would choose not to join in. If she needed to remember to do one thing, she would forget and she always
appeared disorganised.
Mr Lewis found Emily’s impulsiveness the hardest element of

her behaviour to manage. He couldn’t predict what she would
do next. She could be impulsive in the classroom, in the play-
ground or even just walking down the corridor to assembly. Mr
Lewis was also concerned about her safety as she never
followed the rules and instructions he outlined. Subsequently
he found himself tensing every time she held a pair of scissors
wondering what she would do next.
Other times Emily would do things without thinking about the

consequences. For instance she had an angry outburst over
not finding her water bottle. It transpired another child had
placed it in a different bottle tray, but Emily couldn’t control her
emotions and became angry to the point of needing to be
calmed down. Her impulsiveness was also affecting her learn-
ing. She would guess an answer rather than think it through or
problem solve. Mr Lewis knew she had the knowledge to
answer correctly, but her guessing was making her lose marks
in tests.
Emily’s behaviour was also disrupting the rest of the class. If others were trying to write on their own, she would
talk to them. Some of the children subsequently told Emily to go away as she was disturbing them and this was
affecting her self-esteem, particularly because she was struggling to control what others felt was unacceptable
behaviour. At playtime Emily was becoming more of a loner as some of her usual friends were beginning to
distance themselves from her.
Reflection: If you were Mr Lewis, how would you help Emily?
The above case study is an example of what happens in classrooms on a daily basis. If you were
Mr Lewis what would you do to assist Emily?
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In order to help these children it is important to understand the prevalence of the condition.
Sensory processing disorder (SPD) is a multifaceted problem and the cause of SPD is unknown.
It is often evident in children who have been diagnosed with an autistic spectrum disorder and
attention deficit hyperactivity disorder (ADHD). In the UK over the last 10 years there has
been a rise in autism of 1 per cent. In many cases children with autism incorrectly process the
sensory information of balance, touch and knowing where their body is. Individuals who are
autistic often describe the senses they feel as being different to those described by others.
It is reported that as many as one in six children experience sensory symptoms affecting
their daily lives. Within an average classroom of 30 pupils, as a many as five children could
struggle to process sensory information.
Medical research continues to investigate this condition, particularly as not all children react
in the same way. Some under react and others may over react. At present the best thing any
parent or teacher can do is to pinpoint specific triggers and teach methods to manage sensory
behaviour.
To summarise the effects on learning, this is a complex problem where research is continuing.
How do sensory skills usually develop?
This section explains what sensory skills are and how we become sensory aware. Over the
years the terminology used to describe behavioural issues and treatment approaches for sensory
difficulties has changed. Terms such as sensory information, sensory integration and sensory
processing have been used. The most common term used to be sensory integration however the
correct medical term is sensory processing disorder which can be abbreviated to SPD.
All humans process information about touch, taste, feeling, hearing, sight, balance and a
sense of body position every moment that they are awake. To have sensory awareness, we all
use our senses to handle and manage the information around us. However, by the time we are
adults often this practice is so routine that we become unaware of it.
With a sensory processing disorder children may react in a variety of ways and this is what
adds to the complexity of this medical condition. Unlike a coordination difficulty where most
children struggle to balance, sensory processing difficulties can be complex to understand.
Only by understanding the child’s unique responses to their senses can we truly understand
their personal experiences of the world.
When describing the senses, many people know about five: seeing, hearing, smelling, touch-
ing and tasting. However, there are actually seven in total. The two that most people do not
know are the sense of balance (vestibular) and knowing where their body is in relation to other
objects or people (proprioception).
Every child up to the age of four years seeks some form of sensory input. This could be a
baby visually looking for their Mum, a child recognising the smell of their teddy or a toddler
learning to use their muscles to balance and learn how to walk.
As a child grows they learn about their environment through their senses. They learn by
their body sending impulses to and from the brain about what they see, hear, taste, feel and
smell. For some children these neurological messages become stuck and are difficult to inter-
pret, causing a blockage. This reaction can cause a neurological traffic jam known as sensory
processing disorder.
Children with a sensory processing difficulty cannot help but react to the sensory messages
that their body is telling them. This is not them displaying bad behaviour. It is behaviour that
they cannot stop. These sensory reactions are powerful and as automatic as the human fight
or flight response.
A sensory processing disorder is not a developmental delay. Every child acts and reacts
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differently to the senses around them. Occupational therapists complete a sensory profile to
help them assess and understand the specific areas a child has sensory difficulty with. For a
child aged between three and 10 years old this comprises of 125 questions asked to their
parents to help the OT understand how that child processes information, behaves emotionally
and how they control their reactions.
As an adult it can be difficult to understand how children become aware of and process the
information from their senses.
To fully understand what is sensory processing we can use an analogy of a butterfly landing
on your arm. Take a moment to think how you would react. Would you brush it aside or perhaps
try to blow it off? There are five steps everyone takes in order to respond to this occurrence.
■ Firstly, you need to know something is touching you.
■ Secondly you need to pay attention to that feeling on your arm.
■ Next you need to know what type of touch it is. Is it light, heavy, cold or hot, rough or
smooth?
■ Then you then need to organise your response. Do you hit what it is that is touching you?
Do you become anxious because something is touching you? Or do you ignore the feeling
altogether?
■ Lastly you need to ‘execute’ your response. Perhaps you decided to brush the butterfly away
whereas another person may have screamed and tried to run away from it. The execution,
as it is called, would be the motor movement of brushing your hand or moving your legs
to run.
This five-step process requires the brain to recognise a sensation, process the information and
execute a motor response.
Imagine the same scenario again, however, this time with a child who has a sensory process-
ing disorder. The sensation of the butterfly landing on their skin could feel heavy. Alternatively
they could become visually scared of the butterfly’s wings on their arm. For them, they need
to decide to how to react to the whole experience.
To summarise, there are a number of terms used to describe a sensory problem. All terms
refer to the processing of the seven senses and it is this skill which is crucial for managing
everyday life.
Why do we need to have sensory awareness?
Sensory processing affects all aspects of life including friendships, behaviour and learning. This
next section looks at why children need to refine their response to sensory feedback. It will
address both the impact in the primary classroom and the long term implications if no help is
provided.
A sensory processing disorder significantly impacts on a child’s school day and teaching
these children can be more complicated than teaching their fellow classmates. Some children
find any sensory information too over stimulating and can appear ‘too excited’, others are left
feeling under stimulated as if ‘switched off’ from the day’s activities.
For a child with a sensory problem it can be a confusing time especially if they notice others
are not reacting in the same way. A sensory processing disorder can be described as similar to
being stuck in a traffic jam. Information is coming from all directions, however nothing is
moving forward. This is due to the neurological impulses from the senses becoming stuck
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because they are too difficult for the child to interpret. Children can describe themselves with
this medical condition as not always feeling safe, they find sensations frightening, unpredictable
and bewildering.
For other children in the class, a child who has a sensory processing disorder can be diffi-
cult to understand. Peers may be uncertain how a child is going to react. For this reason
classmates may choose to be friends with other children who they understand better and who
are more predictable. This can leave the child with SPD socially isolated, struggling to play, not
able to control their behaviour, finding it difficult to learn and communicate with others.
A sensory processing disorder has a huge impact on the child’s classroom activities.
Sometimes children with sensory processing problems can feel misunderstood by those around
them and as stated above they can feel different. James Le Guerrannic, an 11-year-old boy,
has used his experience of primary school life to talk about inclusion explaining why he felt it
did not work for him. James has a diagnosis of autism and below he uses his own words to
mention some sensory processing behaviours that caused him to struggle in the classroom.
I went to three different primary schools. I found all of my primary schools really hard. I did not like being there.
These are the main reasons I did not like being at school:
1 Most of the time I did not understand what was happening in the lessons.
2 I was always being told off unfairly. The main reasons were: fidgeting, laughing inappropriately, singing
during lessons, forgetting the rules, not putting my hand up, not following instructions.
3 I was getting into fights most days with other children which I didn’t like but it always happened anyway and
it wasn’t my fault.
4 Every day I was told I was not listening when I was listening.
5 I was never once star of the week.
6 The other children in my class weren’t very nice to me.
What sensory behaviours did you spot? Fidgeting, laughing inappropriately, singing, forgetting
rules, not following or listening to instructions and fighting with children are all typical
behaviours of a child with a sensory issue.
Many parents seek occupational therapy help for their child so that these children can learn
at a young age how to manage their reactions, improve their self-confidence, learn how to
interact with others and learn how to participate in motor activities.
Studies into adults with sensory processing issues are limited and therefore less is known
about the true impact of this medical condition. As adults we have all learnt to adapt to
routines which support how we like to process sensory information. Take a moment to consider
what you do in the morning. Are you someone who likes to get up and exercise? If so, then
you are meeting your body’s need for movement. Alternatively are you a person who when
getting up likes to listen to music? This would be one method to meet the auditory (listening)
needs of your body. Perhaps you rely on your visual sense to wake you up needing the bright
sunshine to stop you from hiding under the duvet. We all use our senses unknowingly. How
would you feel if you couldn’t exercise, there was no music or it was a rainy dull day? Would
you feel slightly unsettled and frustrated? These feelings are often what children describe when
living with a sensory processing disorder.
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As adults we choose activities to meet our preferences. Researchers have identified that three
main areas of adult life influenced by a sensory processing disorder are: activity choices, coping
strategies and general quality of life. In 2011 researchers Kinnealey, Koenig and Smith
identified that there was a link between sensory processing and mental ill-health. Symptoms
of anxiety and depression were evident; this was compounded by this group of people having
fewer social support networks.
Children need to be taught different coping skills by an occupational therapist so that their
sensory issues do not leave them avoiding certain aspects of life.
To summarise, both children and adults can feel affected by misunderstanding the world
around them, making good sensory awareness essential.
How you can help a child with a sensory problem
When a child grows they learn about their environment through their senses. Messages are
sent to and from the brain about what a child sees, hears, tastes, feels and smells. For some
children these messages become stuck and are difficult to interpret. This section suggests
practical tips that can be applied in the classroom. It will refer back to the case study and will
also provide three in-depth and 10 practical tips.
Before we look at the practical tips we shall return to the case study to find out how Mr
Lewis helped Emily. We left Mr Lewis needing to help Emily manage her impulsive behaviour.
Case study solution

Mr Lewis decided to make changes to increase Emily’s attention levels, reduce her restlessness and minimise
her impulsive behaviour.
Every day, instead of just writing the plan of the day on the whiteboard, he used picture cards as visual reminders
of what was going to happen next. He introduced a variety of visual timers both sand and digital to be a guide
as to when subjects would start and stop. He also introduced an incentive scheme with an instant reward. In addi-
tion, Mr Lewis changed the seating around the class, preferring Emily to sit away from any distractions she
could see through the windows. He also allowed regular movement breaks in between activities. If sitting at a
desk was not required to complete the work then all the children could stand. This helped Emily not to feel she
was receiving special treatment when she stood up. Lastly, Mr Lewis introduced the concept of a fidget bag. When
needing to sit quietly in circle time or assembly, Emily could choose a ‘fidget toy’ to help her concentrate.
The changes that Mr Lewis made helped Emily immensely, both socially and educationally. By being allowed to
move her body she was getting the sensory input she craved when sitting still. This also helped her concentrate
for longer. Emily could sit for almost double the time when she had a ‘fidget toy’ in her hand. This helped both
her and the other children learn and disruptive ‘walkabouts’ were reduced. There were still good and bad days,
but the visual timers really helped Emily know when a new change of activity was about to happen. Instead of
feeling overwhelmed by how to manage Emily, Mr Lewis felt he was able to teach her, and the rest of the class,
to the best of his ability.
Many classrooms now use visual cue cards, timers and fidget toys. Providing these small
changes can help a child meet both their sensory needs and educational expectations.
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Practical tip 1: Making a sensory friendly classroom
Problem behaviour in the classroom can be the greatest challenge to the

school day for any teacher. One moment can alter the learning of many.
Lesson plans go awry. Nerves can become frazzled and patience can be
tested to its limits. Children with a sensory processing disorder use the
senses around them to interpret information. This heightened ability can
result in their behaviour being reactionary or they may actively seek out
attention to receive a certain sensation.
Use these six points to see how sensory friendly your classroom is:
■ Quiet Area –A quiet area can provide a place of safety for a child with a sensory process-
ing disorder. Often having the opportunity for some time out helps prevent any major
meltdowns in behaviour. In small classrooms a quiet area can be difficult to accommodate.
Consider using two bookcases to create a corner or have an area which can be partitioned
off with bean bags to sit on to help those children who are finding the classroom too visually
stimulating or to loud to be part of.
■ Colours – Bright vibrant multi-coloured classrooms can look appealing to a visitor.

However, for a child with a sensory disorder the use of too many colours on a wall can
provide a visual overload to their senses causing their behaviour to change and a reduction
in the quality of their work. Instead consider using two or three colours. For instance this
could be the same background wall colour with two different border colours to distinguish
separate content.
■ Lighting – Often the ceiling lights can be too bright and over stimulating. The ideal is to
have subdued lighting or to use daylight bulbs. If this is not possible consider only turning
on half of the lights in the room.
■ De-clutter – Being organised and having a place for everything to go into helps a child
locate classroom essentials that they need. Sometimes it is helpful to pull a curtain across
any named drawers or to hide items away in a cupboard so that it is not visually too
distracting.
■ Time out – As a child with sensory processing difficulties develops they start to recognise
and understand more about their senses and sensory overload. Consider placing laminated
cards in the centre of their desk which say ‘Time out’. This will allow the child an
opportunity to explain to staff that they need a sensory break.
■ Seating – Does everything have to be done whilst sitting at a table? Some children need to
have regular movement breaks. Consider allowing children to stand, lie on the floor or sit
on a large therapy ball to complete some subjects. Sometimes sitting on an air cushion,
called a wobble cushion or disco sit, helps a fidgety child concentrate. This is because their
natural sense of movement is being stimulated from the air moving around when they are
sitting.
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Practical tip 2: How does your engine run?
The question ‘How does your engine run?’ is used in a sensory treatment
programme called the Alert Programme however it is also suitable for
children with no sensory issues. The Alert Programme is a form of
treatment called a ‘Sensory diet’. The diet is not food-based but sensory.
Certain senses are either added or removed to help a child manage the
school day. A child who is not being bombarded by sensory information
will be in the right mood to engage, interact and ready to learn.
The correct ‘diet’ can help a child feel less anxious. Sensory diets can be
a powerful behavioural tool for helping children respond appropriately to
their senses. They help reduce the overacting or under reacting to sensory
information helping the children to feel ‘just right’. If a child can start to
understand what makes them feel ‘just right’ then this is the start of self-regulation. Self-
regulation is important as it provides a child with optimum learning opportunities.
The Alert programme is a self-regulatory tool, combining knowledge from the areas of
neuroscience and occupational therapy. Usually it is used in relation to a car engine. Alternative
rating scales include referring to animals (cheetah for too fast, turtle for too slow and a bear
for just right) or by sounds (wooo for too high, ughh for too low, humming for just right)
(William and Shellenberger 2006, pp. 9 and 10).
When using an engine analogy a low geared engine would be when the body is sluggish,
body posture is drooped and a child does not appear engaged. An engine running on high
would be when a child is unable to sit still, constantly on the move, looking around and their
breathing may be irregular. The programme aims for children to be ‘just right’, with good body
posture, appearing attentive and have regular breathing.
Although this concept was created for a child with a sensory processing disorder it is useful
with every primary school child. Often there is an adult who is the ‘leader’ who poses the
question of ‘How does your engine feel?’ If a child has a problem answering the ‘leader’ may
say ‘Hey you might want to do something for your engine. Looks like you are running on high
gear right now. Maybe you could try a fidget toy or a stretch break.’ (William and Shellenberger
2006, p. 14.)
There are three stages to helping a child understand how their body is feeling and behaving:
■ Stage 1 – Children learn to identify and name how they are feeling.
■ Stage 2 – Children learn to try different activities to see if that helps them e.g. doodling
when listening can help those children who need to be constantly on the move. (If a child
has a sensory processing disorder then it is important that an occupational therapist
determines what senses over and under stimulate them before they try different activities
at school.)
■ Stage 3 – Children learn to recognise their own ‘engine’ and make changes to how they feel
without adult support.
It can be helpful to explain to a child ‘your body is like a car engine, sometimes it runs on
high, sometimes it runs on low and sometimes it runs just right’ (William and Shellenberger
2006, p. 9). Ask a child ‘How does your engine feel today?’ Lastly, help a child choose an
activity that makes them feel ‘just right’.
Activities can include fidget toys, taking slow deep breaths, sucking or chewing on some-
thing, stretching the body, twisting their hair, dimming the lights or listening to music. Noticing
98
what time of the day the child’s engine is becoming too high or low can help pre-empt future
times when they are not ready to learn.
Practical tip 3: Build a sensory garden at school
The concept of building sensory gardens is not new. When first created in
the 1970s they initially only met the needs of people with a visual impair-
ment. Today sensory gardens and reminiscence gardens are becoming
increasingly popular to help people with dementia. Both types of gardens,
either sensory or reminiscence, are based on the concept of providing an
outdoor sensory experience and research has identified that these gardens
can improve a person’s behaviour and overall well-being.
Building a sensory garden at a school does not require a large space. It
can be of any shape or size and sometimes it does not even have to be a
garden, it can be a sensory trail. Three key areas to consider in the design
stage are to have a clear goal of what you wish to achieve, make it
accessible and consider how it is going to be maintained. Maintenance will be crucial
particularly as most horticultural growth occurs during the summer months when the schools
are closed. However, with careful choice of plants, using raised planters and having trellis work
for plants to climb along, maintenance can be reduced.
Help at the design stage can come from local garden designers, artists and sculptors; they
may even be able create a piece of work to go into the garden. Alternatively there are companies
that can provide sensory specific garden toys.
Here are some suggestions of what might be included in your sensory garden:
■ Sight – Use an array of flowers, plants and shrubs. Sunflowers are usually great fun for
children to plant and grow. For more information about types of plants to use go to
www.enablememethod.com/resources/ Garden blackboards and wall art can be used to add
visual interest.
■ Touch – Mosaics and pebbles in a pattern on a wall can help children feel the difference
between surface textures. Plant leaves and flowers create an opportunity for children to
feel oval and round shapes as well as feeling hairy or smooth textures. A good plant for
texture is lamb’s ears (Stachys byzantina), it is a silvery-grey in colour and is a low
maintenance plant. This can help a child develop an understanding about muscle pressure
e.g. light vs heavy force, so as not to damage the foliage of a plant.
■ Smell – Flowers and herbs provide this sense. The most commonly used are lavender and
rosemary, however, hyacinths and jasmine will also provide a good scent. Consider placing
fragrant plants near seating areas.
■ Hearing – Often people think of wind chimes or water features to create sound in the
garden. Sound can also be created from the wind moving bamboo or the rustling of leaves.
Alternatively consider specialist garden drums or chimes that children can touch to play a
specific musical note.
■ Taste – This sensory need is often achieved with edible fruit, vegetables and herbs. Easy to
grow plants include lettuce, tomatoes, strawberries and mint.
The forgotten senses of balance and knowing where the body is in space can be encouraged
through individual swings, trampolines or a sitting bench that sways.
99
When looking at accessibility requirements floor surfaces such as bark chippings and pea
shingle can make it difficult for a wheelchair user, or a child using a frame or crutches to
mobilise. Consider providing a place of shelter for children to gather to socialise or to go to
when it is too sunny.
A sensory garden is aimed at promoting interaction and stimulation. Within schools many
gardens become a place of interest, a calming place to be and help all children develop creative
play. Financially they do not need to be expensive and in some schools older classes take on
the maintenance as a project. Lastly, if you wish to add extra interest the garden could include
cause and effect buttons with levers and press switches.
10 quick sensory processing tips

1 Do not banish breaks. Children who need to move in class need their break times. If a child has been
naughty do not consider taking away their break time as a form of punishment as this will result in their
behaviour becoming worse.
2 Classroom culture. Create a culture where it is not ‘odd’ or ‘strange’ to get a fidget toy or go to a calm
area for a sensory break.
3 Break cards. To help a child who is over stimulated by the senses around them have a card with the word
break written on it. Place this always on the desk and ask the child to use this card if they feel they need
some time out because they are feeling overwhelmed.
4 Fire alarms. Warn children who have an auditory processing difficulty of any planned fire alarms. This will
help them manage their behaviour and be able to follow the escape plan without becoming distressed.
5 Use sensory stories. This is where a child hears a story various times. The messages in the story provide
clues to the child on how they should act. These stories may include phrases such as ‘I sit down on the floor.
Then, I like to give myself three big hugs. This helps me to calm down’. The reason a child may be asked to
self-hug is that they may struggle to sit on the floor without fidgeting because their body struggles to know
its own body position. This type of treatment was found to be most effective for children aged between three
and 10 years old (Marr et al. 2007).
6 Avoid distractions. Create a cubicle out of cardboard for those children who become too visually distracted
by others around them.
7 Create a tactile box. Create a box of different items that a child can get to help them concentrate when
sitting still. This could be stress balls, koosh balls, small fidget toys or various different materials e.g. velvet,
fur, cotton.
8 Drinks. Some children become more alert after drinking a sour taste. Use a diluted lemon cordial drink
instead of water to see if this helps a child concentrate.
100
9 Pop up. If a child is feeling too overwhelmed? Use a pop up tent for them to go to. This will provide them
with a feeling of safety as it only has one entrance.
10 Relax. Use music, dim or turn off the lights to calm over excited children down.
To conclude, sensory processing disorders are complex in their presentation as no two children
act or react to sensory stimuli in the same way.
For the sensory child the world can appear bewildering and frightening. To them their
behavioural responses are a natural human fight or flight response. All occupational thera-
pists will advise strategies for a particular child. Some of these techniques such as making a
classroom sensory friendly and asking a child ‘How does their engine run?’ can be applied to
the whole class.
The understanding of sensory processing disorders is still continuing and by being able to
help a child self-regulate their behaviours in school you are reducing their risk of mental ill-
health in adulthood.
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103
Conclusion
Boosting Learning in the Primary Classroom was written and created for the primary school
SENCO, school teacher or teaching assistant to build upon their own repertoire of expertise.
It uses occupational therapy knowledge to explain and provide solutions to the daily difficulties
children experience in the classroom.
In Debra Searle’s foreword she wrote, ‘if you always do what you’ve always done you always
get what you’ve always got’. In essence the same is true when helping children with a devel-
opmental delay or physical disability to learn. Sometimes the touchpaper to lighting the fire to
a child’s learning is by approaching things differently. That difference has been brought to you
by using the Enable Me® Method where a problem has been identified, its impact has been
recognised and strategies to develop that child’s specific skills have been recommended.
This book has brought you real experiences and stories from the child’s perspective. Their
unaltered words are powerful reminders that sometimes the simple act of handwriting can
make a child feel sad. Or by being unable to coordinate their body a child can feel they have
a pain. To a child, school life can be both frustrating and confusing. However, the same can
be true for the teacher when a child they are teaching is failing to meet educational targets.
Hopefully, through reading this book, you have now gained the answers to why a child may
not be reaching their full potential. You will also have gained over 75 tips to help you teach
children differently without needing to spend extra time on lesson preparation.
As the chapters progressed I am sure that you also began to appreciate how no one difficulty
stands in isolation. A child with a handwriting difficulty may improve their hand skills by
playing with different games as well as practising writing skills. A child with a coordination
problem may also have a sensory processing disorder. Children without a physical disability
need to learn how to maintain a good sitting posture as much as those children who use a
wheelchair to mobilise.
The following is a summary of the key messages to take away from the six difficulties
described in the book chapters:
Handwriting is a complex life skill that some children struggle to complete due to how the
hand physically develops. The key to being able to hold a pencil using a three fingered tripod
grip is through the act of play where fine motor skills are developed and refined. The key to
legible handwriting is the ability to accurately copy pre-writing patterns. Speed in handwrit-
ing only occurs once legibility is achieved.
Disability impacts the whole family and the number of disabled children in the UK is rising.
A diagnosis process evokes many emotions and these feelings stay with parents, grandparents
and siblings. Sometimes the physical act of getting to school can be a struggle and for these
children to be ready to learn they may need extra breaks to recharge their energy levels. A
child with a disability seeks acceptance, a sense of value and the same friendship opportuni-
ties as any other child.
There is a link between body posture and concentration, when the body is tired it cannot
104
Conclusion
concentrate. If a child adopts poor posture habits perhaps by leaning on the table to write they
risk experiencing physical pain in their back and neck, bony changes to their spine and hunched
shoulders. Throughout the whole of the school years a child’s bones continue to develop and
being taught how to sit well when using a computer or laptop is as essential as teaching digital
literacy.
Dyspraxia is a motor disorder that does not affect cognition. A child can have difficulty in
processing one or all three of the following: forming an idea, organising a sequence of
movements or completing the required movements.
Play provides an opportunity for children to develop problem solving, imagination and
social skills. Play has a five-stage developmental process. It is a child’s work. If a child has a
difficulty in any one of these stages then essential school skills are not learnt and disruption in
the class can occur.
A sensory processing disorder is a difficulty interpreting sensory information. If a fly lands
on an arm, the brain needs to process this information through the receiving of sensory
messages and physically reacts using muscle movements. The body has to learn to react to the
body’s seven senses: sight, touch, hearing, taste, smell, balance (vestibular) and knowing where
the body is in space (proprioception). Most often people recognise an overreaction however
people can also under react to the sensory information.
This book introduced you to the most prevalent medical conditions seen in the primary
classroom. There are many more that are not included. The practical tips that have been
supplied are designed to meet the generic needs of most children. For specific help it is recom-
mended that you liaise directly with the health care professionals involved with an individual
child.
Many UK class sizes have around 30 children and based on statistics already discussed
throughout the book it is likely that during your teaching you will meet a child who is
dyspraxic or has a handwriting problem or has a sensory processing disorder or struggles to
play. They may have a physical disability or report pain due to a poor sitting posture. The aim
of this book is to bridge a gap between education and occupational therapy that I saw when
visiting schools. I want to give teachers the opportunity to access and use a variety of skills to
help children learn.
The use of case studies throughout the book has shown how these techniques can realisti-
cally be applied in the classroom. I know through my own investigation to supply the latest
medical research and having over 15 years’ experience as a children’s occupational therapist
that these strategies work in the primary classroom. They can be applied to the whole class or
to an individual child.
My hope is that you will use this book as a practical resource in your teaching life and that
it gives you answers and explanations at a time when you most need it. I hope it is accessible
and shared with your colleagues. It will aid your creativity when teaching children to learn, to
develop new knowledge and to be ready to encounter new experiences in life.
105
Index
80/20 rule 19 through school life 43, 48, 50; growth stops 47;
1870 Education Act 4 longitudinal growth 50
brain: activation of neural pathways 8; energy from
active play 74 oxygen when writing 5; fuel 54; importance of play to
ADHD (attention deficit hyperactivity disorder) 62; and development of 80; stimulation by writing 8; window
play 75; and sensory processing disorder (SPD) 93 of opportunity for development 64
adjective scales for pain 54 break cards 100
adventurous play 74 breakfast time: and cerebral palsy 27
Alert Programme 98 breaks: classroom 100; laptop use 52
appositional growth of bones 50 Brownie groups 80
armrests 48 brushing teeth 37
art: sensory processing checklist 91 Bundy, A. 78, 82, 83
Asimov, Isaac 4 Burgman, I. 23
Asperger’s syndrome 25
attention deficit hyperactivity disorder (ADHD) see cardboard boxes 83
ADHD careers: and handwriting 14
attention spans 81 cerebral palsy: breakfast time 27; importance of good
autism 62; difficulties of play 76; disability awareness posture 49; listening and attention 26; progression
24, 25, 26, 31; listening and attention 26; and play during school years 30; reading 26; speaking 26;
74–5; progression during school years 31; and reading understanding 26; writing 26
26; and sensory processing disorder (SPD) 93; Cermak, S. 5
speaking 26; struggles with symbolic and spontaneous chairs: back support 48; height for good posture 48
play 74–5; understanding 26; writing 26 Children’s Society 28
avoidance techniques 8–9 classroom culture 100
class rules 70
babies: learning sitting skills 46–7 clumsiness 58, 63
back ache: school age children 46 colour coding 70
back support: for good posture 48 colours: sensory friendly 97
balance: and dyspraxia 59; motor difficulties 59; sense communication skills 76
of 93, 99 communicative play 74
Barbie dolls 80 complex construction play 79, 79–80
basketball 71 computer games 80; digital dementia 81
bicycle tyres 83 computer mouse 16
Birrell, Corey 13, 25 computers: contribution to obesity levels 81; dyspraxia
Birrell, Laura 29 school checklist 60; handwriting checklist 7; help with
Bissell, J. 5 therapy treatment programs 81; hindering
body posture: 10 quick tips to improve 54; back and development of social skills 81–2; reduction of
neck ache 46; changing shape of spine 45; definition attention spans 81; sitting posture checklist 44; see
42; developmental stages of the spine 47; effects of also laptops
poor posture on learning 45–6; factors influencing 44; concentration: 10 quick tips 54; classroom breaks 51;
and flat desk tops 46; good sitting posture 44, 48–50, lacking, signs of 42; link with body posture 42;
68, 71; helping children develop their posture 50–1; muscle fatigue 50, 55; poor posture and 43, 45, 49;
identification of poor posture 43–4; impact of poor sitting posture and 44, 45, 49; see also body posture;
posture on handwriting legibility 45; impact on sitting
concentration 42; low muscle tone 44; movement conflict 92–3
breaks 50–1, 52–3; Mrs Kelly and Freddie (case constructive play 79
study) 45–6, 50–1; and pain 45; physical risk of Contact a Family 27, 31
deformity 43; postural development 46–8; reduction coordination difficulties 58, 63
in concentration by poor posture 45; sitting posture coping strategies 32, 96
checklist 44; skill of sitting 43, 46–7; tip for crates 83
movement break 52–3; tip to ask if a child is in pain crossed-legged sitting 54
53–4; typically for using laptops in the classroom 52 culture, classroom 100
bones: appositional growth 50; growth and development Czech Republic: poor posture 46
106
Index
DCD (developmental coordination disorder) 61, 62; school checklist 60; secondary schools 67; self-care
definition 58 skills 61; speaking 26; teaching children with 57;
decluttering 97 terms of reference 58; tip for giving instructions 70–1;
design and technology: handwriting checklist 7 tip to help children copy from whiteboards 68–9;
desks: flat tops 46; height for wheelchair access 35; tying shoe laces 69; understanding 26; visual
layout 16; position for wheelchair access 34–5; tilt perceptual skills 61; writing 26
tops 46 Dyspraxia Foundation 24, 61
developmental coordination disorder (DCD) 61, 62;
definition 58 educational development 78
developmental delay: definition 22 electronic gadgets 81
diagnosis: medical 28–9 Enable Me® Method 1
diets, sensory 98 English: dyspraxia school checklist 60; handwriting
digital dementia 81 checklist 7; play checklist 75; sensory processing
disability awareness: 10 quick tips 37; Asperger’s checklist 91; sitting posture checklist 44
syndrome 25; autism 24, 25, 26, 31; burning energy enjoyable play 74
at school 27; cerebral palsy 26, 30; changing role of ergonomics 49
parents of disabled children 31; children with exam grades 5
differing medical conditions 23–7; cost of raising a expressive arts and design: dyspraxia school checklist
disabled child 31; definition of disability 22; 60; handwriting checklist 7; play checklist 75; sitting
developmental delay 22; development of common posture checklist 44
medical conditions 28–9; Down’s syndrome 30; eye contact: and dyspraxic children 70; for laptop use 52
Duchenne muscular dystrophy 30; dysgraphia 31; eye-hand coordination skills 59
dyspraxia 26, 30; effects of disability on learning
27–8; hypermobility 30–1; impact on siblings 32; fabric 83
improving 29–33; inclusion 23, 29; influence of faces scale for pain 54
medical conditions on progress in classroom 26; fatigue 37
isolation of families 31; media coverage in Canada fear: and disability awareness 37
31; medical appointments 27–8, 31–2; medical fidgeting 95
diagnosis 28–9; Miss Bell and Lily’s mum (case study) fidget toys 96
32–3, 33–4; physical disabilities 23; pre-bedtime fighting 95
routine 28; pre-school day routine 27; rising numbers fight or flight responses 93, 101
of children with disabilities 28; school friendships 23; fine motor skills 61, 74; window of opportunity 64
sensory processing disorder (SPD) 31; snack breaks finger strength 19
27; social acceptance 23; spina bifida 30; stress fire alarms 100
experienced by parents 32; therapy 32; tip on no fist fight, stretching exercise 18
lifting policy 36; tip to create a wheelchair accessible flat feet: improving posture 54
classroom 33–5; tip to plan a school trip 35–6; flooring: wheelchair access 34
wheelchair access 32–3, 33–5 fusiform gyrus 8
distractions 70, 100
door width: wheelchair access 34 game stage 79, 80
doubly disadvantaged 65 gardens, sensory: hearing 99; maintenance 99; places of
Down’s syndrome: progression during school years 30; shelter 100; sight 99; smell 99; taste 99; touch 99
understanding 37 geography: dyspraxia school checklist 60; handwriting
dramatic play 79, 79–80 checklist 7
dressing 37 ‘Goal, Plan, Do and Check’ technique 69
drink stops 50–1 Grandin, Temple 88
driving: adults learning 67 grandparents: helping families cope with disability 32
Duchenne muscular dystrophy: importance of good greening approach 83
posture 49; progression during school years 30 gross motor skills 10, 61, 74; stages of motor
Duffy, Keith 28 development 64; window of opportunity 64
dynamic lycra body suits 23, 26, 27 group work: and wheelchair access 35
dysgraphia: progression during school years 31
dyslexia 62 Hamilton, Lewis 28
dyspraxia: 10 quick tips 70–1; account of 24, 65–6; hand dominance 14, 15
awkward pencil grip 59; clumsiness 63; coordination handwriting: 10 quick tips 18–19; analysis 6; avoidance
difficulties 58; definition 58, 61; development of techniques 8–9; and careers 14; case studies 8–9, 13,
motor skills 62–7; diagnosing 59; directions on school 14–15; checklist 7; comparison of boys and girls 9;
trips 36; doubly disadvantaged 65; effects on learning consequences of problems 5; development of skills for
61–2; family history 59; fine motor skills 61; ‘Goal, 10–12; doctors’ prescriptions 14; and dyspraxia 59;
Plan, Do and Check’ technique 69; good body posture effects on learning 8–9; essential learning tool 8; hand
71; identifying a child with motor difficulty 58–60; dominance 14, 15; helping children 14–15; identifying
and intelligence 25, 58; ‘keep it simple’ rule 70; a problem 5–8; impact on legibility through poor
lacking social skills 59; learning to drive 67; leaving posture 45; learning 104; legibility problems 9; letter
school 67; listening and attention 26; misjudgement legibility 10; Mrs Thomas and Jim (case study) 8–9,
of children with 57; motor difficulties 25; Mr Adam 14–15; neatness 6; need for skills 12; negative impact
and Riley (case study) 61–2, 67–8; organisation skills of poor handwriting on exam grades 5; pencil grip 6,
61; and play 75; poor balance 59; progression during 10, 11, 17; physical bodily development required for
school years 30; reading 26; reduced eye-hand 10–12; physical energy required for 5; skills required
coordination skills 59; Saturday jobs for children 67; for 5; stages of motor development 64; stimulating
107
the brain 8; swapping hands 9; teaching 4; teaching influence on progress in classroom 26; progression
early stages of 10; tip for left-handed writers 15–16; during school years 30–1
tip for relieving pain when writing 18; tip to improve medical diagnosis 28–9; emotions experienced 29
letter legibility 17–18; tracing 10; tripod grip 10, 11; medication 35
see also dysgraphia Megson, Mike 15–16
Hawkins, Stephen 22 memory exercises 68
hay bales 83 Mencap 32
hearing: and sensory gardens 99 mental ill-health 96
hedgehog, stretching exercise 18 Morrison, R. 23
Heiman, T. 29 motor difficulties: awkward pencil grip 59; definition
history: dyspraxia school checklist 60; handwriting 58; diagnosing 59; family history 59; fine motor skills
checklist 7 61; gross motor skills 61; identifying a child with
Hodge, Robert 57 58–60; and intelligence 58; lacking social skills 59;
hoops, playing with 80 planning movements 61; poor balance 59; reduced
hopscotch 80, 84 eye-hand coordination skills 59; terms of reference 58
how does your engine run? 98–9 motor skills: development of 62–7; difficulties see
hula hoop 85 dyspraxia; motor difficulties; gross 10, 61, 64, 74;
hyperactivity 89 how skills develop 62–3; stages of development 64;
hypermobility 13, 18; importance of good posture 49; three-step process of development 63; trial and error
progression during school years 30–1 development 62
movement breaks 50–1, 52–3
inclusion 23, 29 muscles: core strength in the trunk 43; daily stretches
Institute for Public Policy Research 28 27, 32; Duchenne muscular dystrophy 30; fatigue 19,
instructions: giving a child 70–1 43, 50, 55; fine motor muscle strength 17; low muscle
intelligence: and Asperger’s syndrome 25; and dyspraxia tone 43, 44; overuse of 50; pain 17; releasing tension
25, 58; and motor difficulties 58 18; and sitting 43
interactive play 74 muscular dystrophy, Duchenne: progression during
interior frontal gyrus 8 school years 30
involved play 74 musculoskeletal: definition 42; pain from obesity 49
I Spy 84 music: dyspraxia school checklist 60; handwriting
checklist 7; play checklist 75; sensory processing
Johnsen, Sean 49, 80–1 checklist 91; sitting posture checklist 44
Jones, Katherine 65–6
neatness: handwriting 6
keyboards 48 neck ache: prevention by good posture 48; school age
Kim’s game 84 children 46
Kipling, Rudyard 84 non-slip mats 37
numerical rating scale for pain 54
laptops: carrying to the desk 52; eye contact 52; seating
position 52; taking breaks from 52; wrist position 52; obesity: and computers 81; and musculoskeletal pain 49
see also computers; computing occupational therapy: benefits 1; play as a form of work
leapfrog 80 78; tests to identify writing problems 6
Lee, Michele 59 Office for Disability Issues 31
left-handed writers 15–16 organisation skills 61
‘Lefties’ (Megson) 15–16 Osbourne, Skye 24
left to right reminders 70 over-reacting behaviour 89
Lego® therapy 82
Le Guerrannic, James 23, 24, 25, 95 pain: adjective scales 54; asking a child about 53–4;
letter formation 16 body posture and 45, 53–4; faces scale 54; from
letter legibility 10, 17–18 obesity 49; from poor body posture 45; muscle 17;
letter patterns 17 numerical rating scale 54; tip for relieving 18; visual
lifting: UK policy on 36 analogue 54
lighting: sensory friendly 97 paper position 16
Little, M. 32 parents: stress 32
longitudinal growth of bones 50 parents’ evening 32–3
loose part materials 82–3 Paterson, H. 90
low muscle tone 43, 44 Peck, K. 90
pencil cases: see-through 71
make-believe games 78, 79, 85 pencil grip 6, 10, 11, 17, 59; see also tripod grip
manual handling procedures 36 pencils: thickness 18
marital relationships 32 PE (physical education): and dyspraxia 59, 62
maths: dyspraxia school checklist 60; handwriting Peter pointer, stretching exercise 18
checklist 7; instructions for dyspraxic children 70; physical activities: and play 85
play checklist 75; sensory processing checklist 91; physical development 78
sitting posture checklist 44 physical disabilities 23; and play 75, 76
McCall, Imogen 13 physical energy: required for handwriting problems 5
meaningful play 74 plastic barrels 83
medical appointments 27–8, 31–2 play: 10 quick tips 85; benefits to achieving success in
medical conditions: common 28–9; differing 23–7; school 76; characteristics of 74; checklist 75; and
108
Index
children with autism 74–5; creating opportunities for self-esteem: lack of 5

82; definition 73; development of play skills 78–82; sense of balance 93, 99
difficulties experienced by autistic and physically senses 93, 94; and autism 25
disabled children 76; and disruption in class 74; sensorimotor play 79
educational tool 74; effects of play problems on sensory behaviour: 10 quick tips 100; building a sensory
learning 76–8; encouraging children to use garden 99–100; developing sensory skills 93–4; effects
imagination 82–3; essential to development of of SPD on learning 90–3; how does your engine run?
children 73; form of work 78; greening approach 83; 98–9; identifying sensory issues 89–90; sensory
hopscotch 80, 84; hula hoop 85; identifying children awareness 94–5; sensory friendly classrooms 97;
with issues 74–6; importance of developing play skills sensory stories 100; stages for helping children
80–2; I Spy 84; Kim’s game 84; loose part materials understand bodily feelings 98
82–3; make-believe games 78, 79, 85; moderation of sensory child 89
screen time 83–4; Mrs Sandals (SENCO) and Noah sensory diets 98
(case study) 77, 82; ‘My Child’s Play’ questionnaire sensory gardens: hearing 99; maintenance 99; places of
78; physical development 78; playing cooperatively shelter 100; sight 99; smell 99; taste 99; touch 99
with other children 74; pretend 73, 74, 79; reduction sensory information 89
in time available for 80; requires meaning for children sensory play 78
77; social skills 78–9; stages of development 79; sensory processing disorder (SPD) 74, 89; and ADHD
technology based 80–1; traditional 84–5; treasure 93; and autism 93; causes of 93, 94–5; challenges of
hunt 84 typical days 89; coping strategies 96; difficulties for
pop up tents 101 other children 95; easily distracted 90; effects on
posterior parietal cortex 8 learning 90–3; excessive movements 91; experiencing
post money play 85 conflict 92–3; helping children with problems 96;
posture see body posture hyperactivity 89, 91; and mental ill-health 96; Mr
praise: offering children with dyspraxia 71 Lewis and Emily (case study) 92, 96; over-stimulation
prayers, stretching exercise 18 of proprioception 90; progression during school years
pre-game play 79, 79–80 31; social isolation 95
prescriptions, doctors’ 14 sensory processing strategies 25
pretend play: definition 73; development of creativity shoe laces: teaching how to tie 69
and imagination 79; importance to social interaction shoulder: subluxation of 36
74 shoulder shrug 18
printed sheets 68 siblings: impact of disability on 32; understanding
proprioception 93, 99; over-stimulation 90 experience of 37
punch picture 17 sight: and sensory gardens 99
Simon says 80, 85
quiet areas 97 singing 95
sitting: armrests 48; babies 46–7; back support 48;
reading: and autism 26; and cerebral palsy 26; and cross-legged 54; desk/table height 48; good posture
dyspraxia 26 44, 48–50, 68, 71; neck 48; posture checklist 44; seat
recreational play 78 height 48; skill of 43, 46–7; squatting 46; still 49; W
recreational stage 79 sitting 54; see also concentration
relaxation techniques 101 S-L-A-N-T 54
reminiscence gardens 99 slopes 19
risk assessment: school trips 35–6 smell: and sensory gardens 99
risky play 74 snack breaks 27
Rosenblum, S. 78 snap 85
royal wave stretch 18 sociable play 74
rucksacks 71 social acceptance 23
rulers 16 social development 78–9
social interaction: and pretend play 74
safe carrying techniques 52 social media: and disability awareness 37
Saturday jobs 67 social skills: development hindered by computers 81–2;
Schneider, E. 78 and dyspraxia 59; and motor difficulties 58; and play
school bags 71 78–9
school friendships 23 socialisation skills 76
school furniture 46 Spain: school starting age 4
school pegs 70 spatial relationship 6
school trips: activities 36; directions 36; medication 35; speaking: and dyspraxia 26
toilet facilities 35; travel arrangements 35 spina bifida: progression during school years 30
science: dyspraxia school checklist 60; handwriting spine: changing shape through poor body posture 45,
checklist 7; sensory processing checklist 91 46; developmental stages 47; regions of 47; weak 54
scissors 16 spontaneous play 74–5
Scouts 80 squatting 46
screen time: moderation of 83–4 STNR (symmetrical tonic neck reflex) 68, 69
seating: back support 48; height for good posture 48; for stretching: fist fight 18; hedgehog 18; Peter pointer 18;
laptop use 52 prayers 18; royal wave 18; starting the day 54;
secondary schools: and dyspraxic pupils 67 thumbs up 18
see-through pencil cases 71 subluxation of the shoulder 36
self-care skills 61; stages of motor development 64 support groups 37
109
Sweden: school starting age 4 vestibular 93, 99

symbolic play 74, 74–5, 76, 79 visual analogue for pain 54
visual cues 70
tactile: boxes 100; defensive 90–1 visual perceptual skills 10, 61
taste: and sensory gardens 99 voluntary play 74
teeth brushing 37
television: hours spent watching 83 wall lining paper 18
therapeutic play 74 wet play ideas 85
therapy 32 wet wipes 36
thinking skills 76 wheelchair access 32–3, 33–5; activities on school trips
thumbs up, stretching exercise 18 36; classroom space 34; desk height 35; desk position
time: teaching concept of 71 34–5; door widths 34; flooring 34; group work 35;
time outs 97 travel arrangements on school trips 35
toilets 35 whiteboards 19; tips for helping dyspraxic children 68–9
top down approach 69 window of opportunity 64
touch: and sensory gardens 99 wooden planks 83
tracing 10 World Health Organization (WHO) 50
treasure hunt 84 Wozniak, Steve 73, 83
tripod grip 10, 11; definition 5; see also pencil grip wrist position: laptop use 52
tubing 83 W sitting 54
Twister 80
two-handed skills: stages of motor development 64 Yoxall, Sue 59
UK (United Kingdom): school starting age 4, 10

under-reacting behaviour 89
United Nations High Commission for Human Rights 80
110

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Boosting Learning in the Primary Classroom

■ exploring the reasons for poor handwriting

Gill Dixon, PGCE, MA, BHScHons, RGN, Mum

Assessing Children with Specific Learning Difficulties: A teacher’s practical guide

Using Playful Practice to Communicate with Special Children

Time to Talk: Implementing outstanding practice in speech, language and communication

Successfully Managing ADHD: A handbook for SENCOs and teachers

Beating Bureaucracy in Special Educational Needs

Routledge is an imprint of the Taylor & Francis Group, an informa business

© 2015 Sheilagh Blyth

Trademark notice: Product or corporate names may be trademarks or registered

British Library Cataloguing in Publication Data

Library of Congress Cataloging in Publication Data

ISBN: 978-1-138-82677-9 (hbk)

About the author viii

1 Exploring the reasons for poor handwriting 4

■ Increase your knowledge

■ Give you over 75 practical tips

■ Help children achieve their educational targets

■ Help schools improve their grades.

Writing, to me, is simply thinking through my fingers.

HANDWRITING IS A complex life skill and an essential requirement for school.

How to identify a handwriting problem

Being able to recognise a handwriting difficulty is essential. There is no one encompassing

TABLE 1.1 Handwriting checklist

Expressive arts and design

Geography and History

What are the effects of handwriting on learning?

Handwriting case study: Mrs Thomas (Year 3) and Jim (7 years)

How do handwriting skills usually develop?

1 Any grips where the hand is in a fisted position.

TABLE 1.2 Handwriting development

Between Digital Using whole Using whole Fingers holding

3 years Draw a person Able to copy

Why do we need to develop handwriting skills?

My handwriting makes me sad

Written by Imogen McCall, aged 8

Photograph of work produced by Corey Birrall

Written by Corey Birrell, aged 10

How can you help a child to write?

Case study solution

Practical tip 1: How to help the left handed writer

It isn’t easy being left handed

And yes it can get very confusing

Opening tins is a big no-no

There’s no left handed pianos

When you’re a lefty the world is unfair

But it’s not all bad news

Jimi Hendrix, Paul McCartney

So take heart all you southpaws

Written by Mike Megson

Practical tip 2: How to improve letter legibility

■ Punch picture – Increases fine motor muscle strength.

■ Pencil grip – Improve how a child holds a pencil.

■ Letter patterns – Improve letter formation.

Practical tip 3: Relieve pain when writing

Seven simple stretches:

10 quick handwriting tips

Megson, M. (date unknown) Lefties. Available at: www.readingjuice.co.uk/index.php/news/365/204/Lefties.htm

Children with differing medical conditions

Written by James Le Guerrannic, aged 11

If I was different, perhaps a bike I could ride,

If I was different, perhaps a pen I could hold,