Wrong box

27th February 2004 at 00:00
Labelling children is not always helpful, says Amanda Kirby

During a recent training session in dyspraxia - also known as developmental co-ordination disorder (DCD) - a session on attention-deficit hyperactivity disorder (ADHD) was in progress in an adjacent room. This compartmentalisation may be useful to provide specific skills, but confusing for teachers when a child has several labels.

Evidence has shown that many, if not most, children with a specific learning difficulty have more than one diagnostic label. One Swedish study of seven-year-olds showed that approximately half of all children with DCD had moderate-to-severe symptoms of ADHD. Other studies have shown overlap of DCD with dyslexia, and of dyslexia with ADHD. An alternative to labelling is to use a functional "inventory" of children's difficulties, which can show how the components for learning interlink with one another (see table). This avoids the situation where a child with ADHD gets one approach and one with DCD another: children need their functional difficulties to be addressed as a whole.

This approach is popular with teachers in mainstream schools as it allows them to try adjustments with children without the need to wait for a diagnosis. Suggestions for dealing with overlapping difficulties with DCD include:

* Consider the young person's difficulties and what they want to change.

* Organisational techniques such as to-do lists can help all aspects of work.

* Help with planning work on a regular basis, especially in secondary school.

* Reduce the volume of work for individuals who may get more tired than peers and have to work harder to see success.

Amanda Kirby is medical director of the Dyscovery Centre, Cardiff


Case history

John was in Year 8 at a mainstream comprehensive. Poor co-ordination affected his recording work and spelling. He found it hard to take down all the information in lessons. He sometimes took the wrong books home, missed homework or spent hours at home re-writing his work. He can swim well, but complained of headaches on rugby days. His poor co-ordination affected his ability to run, catch and listen.

The school recognised John's difficulties and put together a support plan.

He now uses an AlphaSmart portable computer in class; he has a computer at home, and has been encouraged to use this for all written work. Autocorrect in Word has helped here and photocopied sheets can minimise the need for recording. John has been taught concept mapping using an IT package to create his own essays and help him plan his time and he was given extra support for spelling. A plan for alternative PE such as swimming is being discussed.

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