Working with Reluctant Clients in Health and Social Care – an Interview with JKP author Maggie Kindred

Maggie Kindred is a retired qualified social worker and practice teacher with many years of experience. Here, she answers some questions about her new JKP book, A Practical Guide to Working with Reluctant Clients in Health and Social Care.

Who are ‘reluctant clients’ and why might they reject the help they so desperately need?

There is a sense in which everyone is a reluctant client, just as a dentist’s patient is not exactly there by choice!

However, ‘involuntary clients’ in social care are those who have become so through the will of others: the courts, relatives who have sought help on their behalf, professionals such as doctors who are worried about them, or members of the general public who have reported concerns to the police or statutory authorities. Sometimes the primary client is a child or vulnerable adult, where his or her carers are forced into receiving services on his/her behalf.

 It would be easy to define a reluctant client as someone who is unmotivated, but this judgemental idea is too simplistic. I believe that, paradoxically, one has to have a reasonably high sense of one’s own worth to be able to accept help in the psychological or social welfare spheres. Many people whose lives have gone badly wrong simply cannot face intervention because their self value is so low – hence they become involuntary clients. Also there is a huge element of fear. There are still older people who think of a care home as the workhouse, for example. Add to that the social stigma which still attaches to ‘receiving’, especially in the statutory sector, and it is hardly surprising that people who have felt undervalued all their lives are unwelcoming to someone who may have the power to remove them or their children from home, tell them what to do, and dismiss their struggles to cope.

Why did you decide to write this book? Why was it so important for you to write optimistically about an issue that is ‘far from light’?

During my years as a social worker, I became more and more aware of how hard it is for people from disadvantaged backgrounds to overcome their obstacles, be they illness, poverty, physical and emotional abuse, or learning difficulties. At the same time, I found myself challenging the attitudes I found around me, from other professionals some of the time, and from the media and general public all of the time, who, without understanding, and usually without any personal knowledge of such clients, would use words like ‘feckless’, ‘scroungers’, ‘lazy’. As the years went on, I treasured the experience of establishing a rapport with some clients enough to be able to work together. This was work satisfaction like no other!

On a personal level, a sense of my own inadequacy makes it easy for me to understand why people do bad things, and refuse to accept help – there is therapeutic value in it for me.

Tell us about your first interaction with a reluctant client. What went right? Why would it have been useful to have read your book beforehand?

This is a very good question.

Like all such important experiences, my first visit – normally you would not expect an involuntary client to come to you – is imprinted indelibly in my consciousness.

I turned up, on a cold January day, stomach churning slightly, at a house on a council estate, introduced myself and my agency and said I had come to see how I could help. The client, predictably enough, said she did not want any anything….

I truly believe, though I cannot prove it, that what went right is the fact that I found it very easy to see something of how my client saw the world: the bleakness, the comfortless, cold house, the lack of anything to look forward to, being surrounded by others in similar, if not worse situations, being hardly able to read and write, having become a parent at sixteen, being deserted by her partner. This communicated louder than any of the clumsy words I produced, and probably allowed me to stay in the house and begin a dialogue.

If I had read something specific, like my book, about working with reluctant clients, instead of only basic social work texts and counselling techniques, useful though those were, I might have started, after introducing myself, by saying that the client had told her community nurse that she was finding it difficult to manage her money. This would have made the source of the referral, and what had been said, much more explicit, a very important point for establishing honesty between worker and client. I have to admit, though, as a student, I had been given an easy situation, in that the client had offered the community nurse a small point of entry for me. It is far more difficult when you have to say that someone has made a complaint about the care of the children, but the basic point of starting honestly remains the same. My book hopefully helps the student to value the torrent of abuse which may follow their introduction of themselves, as a start of a two way process where they can acknowledge what an imposition their visit must be.

What are the most common mistakes service providers make when encountering a reluctant client for the first time?

Common mistakes:

  • Expecting the service user to be grateful. This will not usually happen, even after a long time of relatively successful working together.
  • Taking at face value the statement ‘I don’t want you’. This does not mean the client is a liar; rather, their sense of holding themselves together is so fragile that they feel it will be shattered if they let anyone see how vulnerable they feel.
  • Offering services and other ‘goodies’ far too early. Take to heart the famous words of C. S. Lewis: ‘She spent her life helping others… you could tell the others by the hunted look’ (p. 27).
  • Underestimating the fear which people have of social workers. Even when workers are there by the client’s choice, there is always the fact that they can turn from friend to foe without much warning, if any tendency to harm one’s self or others should emerge. How much greater is this fear when your life is put under the control of others: doctors, mental health workers, child protection workers, even the innocent seeming visitor for older people.
  • Allowing empathy for client’s horrible situations to cloud your judgement, which results in making promises you cannot keep, or unconsciously condoning antisocial behaviour

The book proposes, quite simply, that awareness and acknowledgement of your motivation and sore spots are paramount. It is impossible to raise awareness yourself when under extreme pressure or where unconscious issues in yourself are being touched on. Therefore, a good supervisor is essential.

Why might it be difficult for service providers to recognise the rewards of working with reluctant clients? Why is it important that they do?

The wider society is involved here, I believe. Generally speaking, it is problems, service failures and tragedies which are publicised. So workers are encouraged, consciously or otherwise, only to write up problems. I remember being criticised for recording the positive things in a scenario. So it is hardly surprising that service managers don’t know about the rewards, because they are not told, and this rolls on to the workers themselves not recognising them.

Given that resources for helping people are so scarce, it is particularly important to correct the impression that money is simply being poured into a bottomless pit of unresponsive clients who never change. Our profession needs to educate society about the unseen rewards: the former dangerous person living successfully in the community, the parent accepting support to care for her child, the sexual abuser managing his condition.

Is the goal to turn reluctant clients into willing clients?

One of the most important messages I would want to give to a newcomer, as explained on page 38 of the book, is that your reluctant client will probably never change this aspect. Why should s/he? Compliance with you and your rules is a massive victory. If you can rejoice with your clients when they are finally getting rid of you, this is very liberating. Social work and care does not change people’s personality fundamentally, it helps them function.

On receiving this question, I thought perhaps there was a little wish inside me that I could turn a reluctant client into a willing one. On reflection, I don’t know how the change could be validly recognised.

‘What you sow tends to be what you reap … but you will never see the harvest’ (p. 127).

Providing Good Care at Night for Older People – An Interview with JKP author Diana Kerr

Diana Kerr is Research Fellow at the Centre for Research on Families and Relationships, University of Edinburgh, and has worked for many years as practitioner, educator, trainer and researcher in the field of older age, dementia and learning disability and dementia.

Here, she answers some questions about her latest JKP title, Providing Good Care at Night for Older People: Practical Approaches for Use in Nursing and Care Homes.

How did this book come about?

Care homes are charged with providing 24-hour care for their residents and yet there is almost no research about what goes on at night, about the needs of residents at night and on how to support staff at night. Additionally, homes are not inspected at night with the same rigour as they are in the day time.

We were lucky to get funding from the Joseph Rowntree Foundation to carry out an action research study. This involved us working at night in 3 different care homes, finding things that could be improved, working with staff to put things in place and seeing if things improved. We found that even some quite small changes could make a positive difference.

This made us even more determined to spread the word about what happens at night and how to better meet the needs of residents.

How do the needs of care home residents change at night?

Night time and day time are different – ‘as different as day and night!’

Night time, the hours between 10pm and 6am, is the time when the dark descends, when the world is shut away, and when ‘our nightly appointment with death’ becomes the time when fears and worries take hold. The night hours seem longer than the day hours. The night time, which can hold us in slumber and peace can also be the time of fear and turmoil as we endure the dark watches of the night. How often do we wake in the morning to find the fears of the night to be gone or at least diminished?

In the still of the night, time changes, it dislocates, it fools and extends. The anchors and cues of the day time are gone.

Many care home residents now have dementia, and for these people this stillness and emptiness can be particularly frightening and disorientating. Dementia takes people back in time. They need cues and help to orientate. Alone, at night, these cues can be missing. The person with dementia is trapped in the past, unable to understand the present. The damage to the circadian rhythm, the mechanism that regulates our body clock, telling us the difference between day time and night time, means that people with dementia will often misinterpret or mistrust such night time cues as do exist. People will often assume that if they wake it is morning and time for the tasks of the new day rather than the task of the night time, to sleep.

It is also often the case that the views of day staff about particular residents vary greatly from those of night staff. Residents, for example who are quiet during the day may be very agitated and noisy at night. People who are not seen to be troubled by incontinence may be incontinent at night or people who are mildly incontinent in the day may need very strong pads at night.

What is the core function of night staff in care homes?

Night staff have to provide the same level of person centred, individualised care as day staff. Their primary task is seen as the promotion of sleep. This can often mean that they feel compelled to get people back to bed as quickly as possible. Often, however, residents need, time, food, activity, and TLC as well as an opportunity to talk and discuss, particularly their fears and worries.

Why is night time care overlooked?

The night is overlooked because it is not a time that people generally think about and it is generally invisible in policy, training and management support.

The reasons why inspections don’t take place at night are varied. Some inspectors are concerned about disturbing residents if they visit (this does not need to be the case; where inspectors do visit they are not disturbing). There is also a general practice that inspections are only carried out at night if there is a complaint or cause for concern. With small staff groups and few visitors at night the likelihood of complaint is significantly reduced.

How does working at night affect night staff?

Working at night can be a significant health risk for staff. There is lots of evidence that too much night work can lead people to be vulnerable to a series of quite serious illnesses and conditions such as breast cancer, prostate cancer, irritable bowel syndrome, sleep disturbance, weight gain, infertility and miscarriage.

These are alarming facts but there is a lot than can and should be done to alleviate this. Employers have a duty to give night staff health checks before and during their employment. There are also optimum shift patterns that can reduce risk. The book contains lots of advice and easy things that can be out in place to help staff.

Copyright © Jessica Kingsley Publishers 2010.

‘Guerrilla Mum’ on Making Each Half-Term Count for Students with SEN

by Ellen Power, author of Guerrilla Mum: Surviving the Special Educational Needs Jungle.

It is already half term, and the end of the school year seems to be a long way off, as we plunge into a series of cold wet days. However, in terms of Individual Education Plans (IEPs) and statements of SEN the school year is approximately one sixth over. This is time we can never get back, and children with SEN need each half term to really count.

What am I getting at? To put it bluntly any help or support indicated in your children’s statements, and at any IEP or statement review that might have taken place at the beginning of term should now be in place.

I say this as a parent who had to ‘nag’ teachers to put in place the things they had promised they would do, and who waited in vain for equipment agreed under the terms of a statement to be provided. These are common experiences. It is easy to feel like a ‘nag’ when you know you have asked a teacher three times why something that has been agreed upon is not happening, and you both know that the reasons given for this inaction are wearing a bit thin. It may not be their fault, but remember why you are doing this. It’s your child’s future that is at stake and if you don’t keep on top of things nobody else will.

The reality is that in the current financial climate, all schools have been really worried about cuts and have been trying to make everything stretch further. I have heard of children being given extra teaching in ever larger groups because not so many TAs have returned to school this year. Children with statements calling for them to have individual TA support in class are ‘buddied up’ so they can be sent to lessons with one TA between more than one child, rather than the individual TA support that their statements call for. This may work fine for some children, but not for others. For example, if your child needs a TA to take notes, or to act as a scribe for them, how can they effectively do this as well as meeting the needs of another child? It can’t be done. Although we all want to be reasonable and to understand the straitened circumstances in which schools have to work this year, we must also keep in mind the bottom line: we have all negotiated so hard for our children’s IEPs and/or statements to make the provision they make and we should accept nothing less from them.

How do we ascertain that our children are still receiving the help to which they are entitled? If they are able to tell us, we can ask our children what happens in their lessons at school. I know we all ask our children ‘what happened at school today?‘ but it is worth gently probing to ask what TA was with them in a particular lesson and who else they were working with. It’s not an interrogation; it’s a useful starting point to make sure they are receiving the help they need.

Get out the statement and/or IEP and check them to remind you about what should be happening. Does your child share a TA when an individual TA is called for? Are they still having speech therapy? Did they have their extra maths session? Has lunch and break time TA support been set up? Talk to your child’s teacher and ask how your child is doing and if they have made progress. How has this progress been measured? Look at their school work to see what marks they are getting and to see if their work is improving.

If when you look inside your child’s school books you see blank pages, or work that is consistently incorrect or unfinished, then things are not going as they ought, and you need to review what the school is doing with your child’s teacher and Special Educational Needs Coordinator. Remember, your child’s statement is only as good as the provision in it, and then only if that provision is delivered.

I am sad to say that unfortunately it is likely to be those children whose needs are being met under the graduated response, who are on School Action or School Action Plus, who will be most likely to be let down by the cuts. It is much more difficult to ensure that this help continues to be given within the parameters of the Graduated Response. Schools are required by law to implement the provision in a statement but those on the Graduated Response do not yet have this protection.

Please remember the Guerrilla Mum Mantra: ‘don’t take no for an answer; never give up. If in doubt, telephone, email and write letters’. When you make an enquiry about anything to do with your child’s schooling, do so in writing. It is always handy to keep the reply in case you need to forward it on up the ‘chain of command’ to get things done. So many parents of children with SEN are just grateful to get any provision for their child that they feel embarrassed about pushing school staff for answers, especially when we know that schools budgets may be reduced. However, whatever the economic state of the nation, try to remember this: our children get extra help because it is necessary to allow them to access the curriculum in the same way as other pupils. It is our job to make sure this happens.

Copyright © Jessica Kingsley Publishers 2010.

Want to hear more from ‘Guerrilla Mum’?
Tune in to hear Ellen Power on BBC Radio Four’s Women’s Hour programme on November 5th between 10 AM and 10.45 AM (GMT)!

And check out her interview series on the JKP Blog!
Part 1: My Transformation from mild mannered parent to…GUERRILLA MUM!
Part 2: Picking your battles in the fight to have your child’s special educational needs met
Part 3: Where does SEN fit into the academies and free schools models?
Part 4: How to create an educational system that fully meets the needs of children with SEN
Part 5: My Top 5 Back-to-School Tips for Parents of Children with SEN

Making mouth and tongue exercises fun for children with delayed speech – An Interview with Karina Hopper

Karina Hopper has worked as special needs support assistant and is currently studying for a creative writing diploma. Here she answers some questions about her new book, Mouth and Tongue Let’s Have Some Fun!

How did this book come about?

I chose to write this book for personal reasons because two of my children had delayed speech and I found it frustrating that there wasn’t a book of this kind available. I wanted something that was fun and child-friendly; that held their attention and made them concentrate; and something that I could pick up and use on a daily basis.

How did you come up with the exercises in the book, and the idea for ‘Timmy Tongue’?

I was advised to use mouth and tongue exercises by speech therapists. When I came up with the idea for the book I thought it would be a good idea to give the tongue a character, ideally to make it more appealing to young children. I thought Timmy Tongue had a great ring to it, and would encourage children to engage with the exercises.

How can these exercises aid speech development?

If done regularly, these exercises strengthen the tongue and facial muscles. My children had certain sound delays and these exercises – especially the tongue movements – helped a lot, making the tongue more flexible.

Who should read this book?

This book is for anyone working with children with delayed speech, including speech therapists and teachers, but especially for parents. As a parent of children who had speech delay, I would have found this book an invaluable resource and many parents I’ve spoken to have said the same. The real appeal is that it is a fun book that children will enjoy, making these exercises an exciting thing to do every day which I think is important.

How did you use these exercises with your own children? What was their favourite?

I would usually do the exercises for about 5 minutes a day with my children, repeating each exercise 2 or 3 times. All of the exercises are fun to do but I think the favourite is Timmy Tongue trying to tickle your nose. We have great fun trying to touch our noses with our tongues!

Copyright © Jessica Kingsley Publishers 2010

‘Organize Your ADD/ADHD Child’ – An interview with JKP author Cheryl Carter

Cheryl R. Carter is a former special needs teacher and the founder of Organized Kidz, an organization that assists special needs children with organization and study skills.

Here, she answers some questions about her new book, Organize Your ADD/ADHD Child: A Practical Guide for Parents.

How did this book come about?

When I first began organizing families with children I noticed that children who were gifted with AD/HD were a bit different. Sometimes the traditional organizing methods did not apply to them. They needed to have their attention engaged. I also saw many parents getting angry with these children thinking they were purposefully being belligerent or uncooperative simply because they could not follow the rules. Many traditional methods do not work with AD/HD children. For instance, many chore charts are too visually stimulating or overwhelming for the attention challenged child. Instead the chore chart needs to be focused with no distractions. Too many chores on a chore chart will also overwhelm the AD/HD child.

As a former special needs teacher, I pointed this out to many of the parents I worked with and most told me that there were no organizing books on the market that address AD/HD children. This is a compilation of ideas that worked with the families I have worked with over the years, and it is primarily for busy and overwhelmed parents, some who may be struggling with organization issues themselves. The methods in this book are incredibly easy and practical and I think most parents will find this book helpful. This is especially true of parents who have AD/HD themselves.

Why do children with ADD/ADHD have so much trouble getting organized?

AD/HD children are not habitually disorganized as some children may be. They are organically, albeit clinically disorganized. The approach to organizing them has to be specific and target their wandering and/or hyper-focused minds. For instance, as I said these children find it hard to focus in on one task and thus a chore chart can be meaningless to an AD/HD child because they cannot focus in on the task. Again, their focus issues need to be addressed. You can lecture, scold and bribe an AD/HD child but you will still have to deal with the deal with the fact that the child is not predispossed to organizing.

What is the F.I.R.S.T. method and why does it work so well with ADD/ADHD children?

The FIRST method employs a variety of elements that AD/HD children respond to, such as fun. Since AD/HD children struggle with boredom, this method shows the parents how to make organizing enjoyable. When organization is made fun all children, including attention-challenged children, naturally gravitate to it. Portions of these methods may be used with all children but it is especially appropriate for AD/HD children.

What is the biggest problem parents face in trying to organize their ADD/ADHD child? What about teachers?

The biggest challenge parents face is getting the child to take ownership over their own organizing and time management issues. Most parents will not say it but they worry that they’ll always have to be responsible for their AD/HD children. Teachers will also find the ideas in this book useful because given the size of their classes, they just cannot deal with all the seeming forgetfulness of AD/HD children. There are many books on the market on theory. This book offers practical solutions.

For overwhelmed parents, what is the very first step in organizing a child with ADD/ADHD?

The first step is to organize your child’s environment and then begin to organize the problem areas. Make sure the child’s environment is structured and, yes, parents will learn how to organize themselves. There is an entire chapter on organizing your home.

In teaching organization skills to a child with ADD/ADHD, is it difficult to find the line between perfection and ‘good enough’?

Great question. Our time management and organizing strategies must serve us; we should never be a master to any system or method. This book encourages parents to adopt what will work for them without expecting perfection.

Read Cheryl Carter’s article ‘ADHD’s Genetic Link: 5 Implications for Organizing ADD/ADHD Children’ – on the JKP Blog!

Visit www.ADD123.org for more information about Cheryl and her work with ADD/ADHD children.

Copyright © Jessica Kingsley Publishers 2010.

‘The One and Only Sam’ wins a 2010 Moonbeam Children’s Book Award!

JKP’s The One and Only Sam by Aileen Stalker has won a Silver Medal in the Health Issues category at the 2010 Moonbeam Children’s Book Awards!

Illustrated by Bob Spencer, The One and Only Sam provides a fresh and fun approach to exploring common idioms for all children aged 5 to 8, as well as those with Asperger Syndrome and communication difficulties.

Learn more about the book.

Aileen is thrilled and honoured that the book has been recognised, saying:

“Congratulations to all the authors who wrote the award-winning books, the artists who illustrated the books and the publishers who believed in them – it is a long journey that we all travel together to get a book published. The rewards are many – the best perhaps being that our books have encouraged children and youth to slow down, focus and develop their own personal responses to the written word – skills that will translate well into coping with a super sized, super fast world.

With 37 award categories, the Moonbeam Awards recognize the diversity found in literature for children and youth and reinforce that literacy begins at birth and provides enjoyment throughout each person’s lifetime.”

Aileeen StalkerAileen Stalker is an experienced Occupational Therapist with a Masters degree in Special Education. She has over 30 years’ experience of assessing and treating children with a wide variety of diagnoses and has presented papers at numerous conferences, developed handbooks and manuals for clinical therapeutic use and worked at a senior level in several Occupational Therapy departments.

Read an interview with Aileen about The One and Only Sam.

Inclusion or Specially-Designed Community Programs? How to Choose.

By Lisa Jo Rudy, author of Get out, Explore, and Have Fun! How Families of Children with Autism or Asperger Syndrome Can Get the Most out of Community Activities

So you’re ready to get out and have fun with your child with autism – but you’re having understandable qualms.

Perhaps you’re worried that your child with autism will be overwhelmed by sights, sounds or smells…or that his odd behaviors will be misunderstood by other kids (or, worse, by other parents). Maybe you’re concerned that your child’s developmental differences will make it impossible for her to keep up with the other kids.

It could even be that, like many other people, you’re embarrassed by the idea that your child with autism will be the “special case,” in need of extra support and encouragement.

Whatever your reasons, you may be absolutely correct. You and/or your child may not be ready for full-scale community inclusion.

If, after thinking it through carefully, you’re more comfortable with “special needs” options for your child with autism, you’ll certainly be in good company. And for many children and families, the special needs programs are a terrific jumping off place for full inclusion down the line.

So how do you know if special needs sports, arts, or other activities are best for your child? Ask yourself:

• Is my child asking to be involved with the community, or is this my idea as a parent?

• Does my child have most of the physical skills needed to take part in the activity (if sports, can he kick, throw, and run as appropriate for his age and for the sport? If art, can he draw, cut, glue, etc.?)

• Does my child have the ability to understand and attend to spoken direction with just a little extra support?

• Does my child have the maturity to engage with any activity for an hour on end?

• Does my child have the emotional maturity to manage interaction with a group without outbursts, meltdowns or other troubling behaviors?

• Will my child require special caregiving skills such as toileting/diapering when he is beyond the usual age for such needs?

• Can I or an aide be present to support my child if he needs it?

• Can I, as a parent, handle the potential fallout if my child is asked to leave a community program?

If, after honestly answering these questions, you feel your child ready for full inclusion, wonderful! If you’re not quite sure, it’s important to spend some time investigating the programs you’re considering for your child. If you’re realizing now that a special needs program might be best for your child, start researching the options.

Before making a final decision about which type of activity is likely to be best for your child and for you, I highly recommend actually visiting and observing the program(s) you have in mind. Often, it’s the instructor and not the program that makes the difference – and wonderful (or terrible) instructors may be found anywhere, at any time!

Lastly, if you’re not sure your child is ready for a typical program – but you think she may be – I recommend giving it a trial run. Explain your situation, and ask if your child can visit and try out the program for a session or two. If the answer is “no,” move on. If the answer is “yes,” give it a try. You may be pleasantly surprised at how well your child with autism can adapt to a new situation if the activity, the instructor and the group just happen to fit your child’s needs.

Lisa Jo Rudy is a professional writer, researcher and consultant, and the mother of a 13-year-old boy with an autism spectrum disorder. She has more than twenty years of experience in developing hands-on exhibits, interactive games, books and activities for kids with every learning style. Since 2006, Lisa has been the About.com Guide to Autism.

Pick up Lisa’s book, Get out, Explore, and Have Fun!, for more guidance about how to get your child with Autism or Asperger Syndrom involved in community activities.

Copyright © Jessica Kingsley Publishers 2010.

Working with Asperger Syndrome in the Classroom – An Interview with former Teaching Assistant and JKP author, Gill D. Ansell

Gill D. Ansell has over 14 years’ experience of ASDs, and previously worked as a teaching assistant, both at schools for children with Autism and Asperger Syndrome, and in a mainstream primary school.

Here, she answers some questions about her new book, Working with Asperger Syndrome in the Classroom: An Insider’s Guide.

Tell us about you, your background and your role in the day-to-day life of students with ASD in mainstream education.

I started working in pre-schools when my own children were young and got the most satisfaction working with the children with challenging behaviours. However, it wasn’t until I moved back to Hampshire (UK) and worked in another pre-school that I worked with a child on the autism spectrum who also exhibited challenging behaviours. Finding it an interesting condition, I visited a local school which was autism specific and, soon afterwards, started working there as a Special Support Assistant and within months transferred to a school which was Asperger Syndrome specific. I spent five years there and got a good understanding of the condition and how students with it can be affected before moving to a mainstream school working as a Teaching Assistant with children with special needs, including Asperger Syndrome (AS).

I wrote this book because I realised that over the years I had accumulated a lot of knowledge about working with students with AS and wanted to share what I had learned. It was also because I realised that, although there are many books out there with vast amounts of valuable information in about AS, there were limited books that were written in simple English which could be accessed and read quickly. I know that many teachers and TA’s do not have the time to read lengthy non-fiction books with technical jargon in – I get so frustrated when I start to read a book and need a dictionary next to me to translate as I go along. It doesn’t flow and I find it harder to digest what I’m reading. Therefore, I wanted to produce a book that could be read and understood easily and the strategies put into place as soon after reading it as possible. Another reason I wrote the book was because I wanted to show that with a few simple strategies a child with AS has a better chance of accessing mainstream education successfully.

How did your position as a Teaching Assistant enable you to find the most effective strategies for communicating with students with AS?

As a Teaching Assistant (TA) I felt able to work closely with the students with AS; to get to know them as a person; to get to see the world the way they see it and from there develop strategies to help individuals. Sometimes, I tried new strategies which in reality were just ideas I had which I thought could work with a particular individual – that’s why it is important to know the student as an individual.

I’m a firm believer that just because I know a student with AS it doesn’t mean that I know every student with AS. They are all individuals and deserve to be treated as such and what works with one student won’t necessarily work with another. I think what has helped me develop strategies has been that I have changed the schools where I have worked and, as well as doing in-house training, I made sure I went out and did external training and discovered new ideas and methods used by others which I could take back and use in the school I was at, at the time. Personal development is important to me and that’s why I felt it was important to work in different places and do external training – I would never have learnt all that I did if I had stayed in the same place.

Why is consistency in the classroom so important for students with ASD?

It’s important to work as a team, so the child understands that everyone is working together. If you’re not working as a team the child’s anxieties can rise and result in negative behaviours. These negative behaviours could be reduced with staff working together in the best interest of the child. That’s not to say you can’t be an individual because you can and you can also work independently but the fact is, you are still part of a bigger team. Any team not working together will be unlikely to achieve successful results and it will be their own doing. Working in a team means you may have to compromise sometimes, but if you’re all working together for the benefit for the child then it will be worth it. Also, when you’re working as part of a team you can share ideas and continue your own learning, developing ideas together.

Which of the strategies in the book are your favourite or most effective?

I have a couple of favourite strategies which I made up on the spur of the moment. The first one is the ‘Strategy Book’. A child I was working with kept using the ‘f’ word in the playground when he got upset with peers and he really didn’t know any other thing he could do instead. Well, that’s not entirely true – when I asked him what he could do instead he said ‘I could punch him instead!’

So, we found a new exercise book and I explained that we were going to teach him some new strategies which wouldn’t get him into trouble. I drew a cloud shape on a clean page and in the centre of it I wrote ‘Instead of swearing I could …’ then gave 3 things he could do instead. I talked him through the strategies and then we role played them. We would then read through the strategy book each morning, to reinforce his learning. Over several years we built up a bank of strategies for him to use for different problems. Eventually he was able to use the strategies without looking at the book each day.

Another favourite is the ‘Good Book’. Again, it was a spur of the moment idea and was so easy to implement. It would take me only a few minutes at the end of the day to write something positive in the book. If I’d had a particularly bad day with the student, I would ask another staff member if they had noticed something positive the student had done, and there was always something to write in the book. It is such a simple but useful tool, not only for the student but for parents and staff to look at as well.

What advice would you give to teachers and TAs who might be having trouble with a student they suspect is on the autism spectrum?

I’m no longer a TA and now work a lot with parents so I know that they often know their child is different long before the school do. I feel it’s important to work with the family, find out what strategies work at home and try to understand that many children with AS can manage to contain their anxieties at school for a number of reasons, but then when they get home they release these anxieties often in an aggressive and disruptive manner. It is important to understand that this is not down to bad parenting – the child needs to be understood at school and given opportunities to speak, in confidence, with staff about what they are anxious about. Many of these students are academically able and their needs are not always recognised by school staff. Transition times can be traumatic for many of these children, as can breaks and lunchtimes as they are unstructured times.

If staff suspect a child has an Autistic Spectrum Disorder (ASD) observation is crucial, not just in lessons but in unstructured times. Learn about ASDs, limit language and check the student’s understanding. If staff can make a diary of behaviours which are giving them cause for concern it can help build a better picture of the child and this could involve speaking with other staff that work with the child, including the dinner staff, maintenance and playground staff views are important. The sooner these children’s needs and difficulties are recognised the sooner the strategies can be put in place and the more chance the child has of learning more positive behaviours before negative behaviours become entrenched. It can also be helpful to have written evidence to support the parent if they take their child for a diagnosis.

Read Gill’s article: ‘How Educators Can Help Students with Asperger Syndrome Relieve Anxieties at School (and Avoid Meltdowns at Home!)’

Copyright © Jessica Kingsley Publishers 2010.

ADHD’s Genetic Link: 5 Implications for Organizing ADD/ADHD Children – by Cheryl Carter

The Lancet medical journal *recently revealed that ADHD children have a gene that predisposes them to ADHD.

Their “findings provide genetic evidence of an increased rate of large CNVs in individuals with ADHD and suggest that ADHD is not purely a social construct.” In a nutshell, the presence of CNV proves that ADHD is not the result of poor parenting, unstructured environment, too much sugar or a myriad of other reasons. This research proves what many have known all along — that ADHD may run in families. This has far reaching implications for families with ADHD. Given the genetic link, chances are either one or both parents may have ADHD. This has at least five interesting implications for most families, particularly in regard to organization and time management:

1. Parent and child may likely be learning organizing skills together. This means that parents and children may be concurrently trying to organize themselves and better manage their time. This can be encouraging to the child but it does mean the parent should have a definite plan of action for themselves and the children. The parent should have a definite plan to guide the child in the organizing process so that the child feels secure. This plan could be in the form of a book or therapist plan.

2. ADHD parents may have already developed some coping mechanisms that have worked over time. Some of these may be quite positive but some may not. These coping mechanisms are likely to be mimicked by the child. It is imperative that a parent stop and ask him/herself are they being effective. Again, the parent needs a blueprint to work from that the child can reproduce. For instance, if the parent remembers by putting post-it notes around the home, is this a method the parent really wants the child to duplicate? The parent really needs a solid plan.

3. If a child in the family is not ADHD they may assume a parental-like role in the organizing/time management issues of the home. Unconsciously, ADHD family members may lean on other family members who are not attention-challenged. This can cause major breakdowns in the parent-child relationship, especially if a young child takes the lead in the organizing process. It is essential that the parent guide the plan with all their children.

4. A parent who seems to be hopelessly disorganized may not represent a proven authority for the child to go to for organizing guidance. It is essential that the child see the parent putting organization skills to practical use with the entire family.

5. Finally, little everyday activities like doing homework can become a major issue and foster stress in the parent/child relationship. Parents of children with ADHD need to accept that organization issues are real and need to be addressed early.

Cheryl R. Carter is the author of Organize Your ADD/ADHD Child; the book offers practical solutions for parents and is useful for anyone working with ADD/ADHD children and families. Visit www.add123.org for more info.

*The Lancet’s recent report on the genetic link in ADHD: 
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)61109-9/fulltext

Copyright © Jessica Kingsley Publishers 2010.

New & Bestselling Titles for World Mental Health Day 2010 – from Jessica Kingsley Publishers

In support of World Mental Health Day on Sunday, 10th October, we’ve pulled together a range of new and bestselling JKP titles for mental health practitioners, support workers, and anyone affected by or concerned with mental health issues.

Browse our full catalogue for more related titles.