4/15/2015

Creative Collaboration
To Promote Health / education interface
Success CHILD DEVELOPMENT UNIT Tertiary Assessment
CENTRE FOR EFFECTIVE READING Rural + major literacy
and www.cer.education.nsw.gov.au
Engagement CHERI CONFERENCES
CHERI mission make a difference 1995 on
in Research + Conference + online resource
Developmental Disorders http://www.cheri.com.au/presentations.html
2007 Putting evidence into practice to reach and teach ADHD
2008 Autism 2009 Mental Health
2010 Motor Difficulties And Overlaps
2011 Memory and Learning: What Works
2012 Resilience
2103 Language learning and Literacy
2014 Motivation and engagement

Leading Changes & Engaging Learners Leadership and engagement challenges

The individual strengths and vulnerabilities

SCATTER AGE LEVELS QUALITY
The parents / carers traits experience
The school class peers staff system
Practice Evidence philosophy policy funding
Culture student family peers school
Legal SEND Code of Practice Equality Act
DO DEMANDS = RESOURCE in CHILD+ SUPPORT
RESOURCES IN CHILD = Genes and Success

Special educational needs and disability

code of practice: 0 to 25 years January 2015
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/398
Mohammed age 6 years
815/SEND_Code_of_Practice_January_2015.pdf
Can read and spell but not understand or use
Communication & interaction Cognition & learning Very little language not ask a question
Smile but no eye contact Tall = 7 yrs
Social Emotional Mental health Sensory & Physical Runs around but not interact with peers
EDUCATION HEATH CARE PLAN 1to-1 aide needed for all tasks
Unassessable by ed psych Behaviour ?ASD
Forward-looking Aspirations Package Outcomes Afghan refugees but born Australia
not made expected progress with relevant purposeful actions Father: OK just speech, attention not autism
Sister (8) and Brother (7) in special schools
Remove barriers to learning reasonable accommodations
ASD and Moderate / severe LD Genetics N
Effective special education continuous review transitions Language 2-3 year AGE level IQ Borderline to Moderate
ASSESS PLAN DO REVIEW well coordinated timely Distant, poor interest and initiation = ASD
SP + OT + family support + Autism Class
USE SPECIALISTS Ed Psychol CAMHS Specialist Teacher Therapy

1
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Nicholas 10 years Nicholas action

25 week prem twin died retinopathy hear N
Neonatal Clinic follow up and some OT
speech and writing poor
very poor interaction
Inconsistent social skills anxiety
MUCH support to produce outcome
Moving public to private school then HS
Nonverbal IQ 125 socially avoidant and anxious
Language 4 years behind age very poor coherence
Motor planning + speech /sound disorder ( severe)
Speed of processing and executive function much
younger
Special English Class + Teaching Aides +
CONFERENCE
THERAPY SP + OT Computer
Methylphenidate ( cognitive effects )

Simon 10 years SIMON 10 years - LEARNING DISABILITY

Few peer friends and not happy
Able and unmotivated Literacy LD for grade(3yrs<) Severe LD for ability(5yrs<)
reading spelling PIQ 125 VIQ 103 (nb scatter)
Poor completion and application of work
Language Disorder
Reading 3 years behind age
essays off-topic not listen peer problems
Family not support homework especially reading
subtle comprehension problem solving pragmatics
If he concentrated better he would read and
auditory discrim attention working memory executive
understand
Maths
should contribute more in class
comprehension / problem / sequence / space / time
Take responsibility for own work to reach his
potential Written output narrative skills / coordination )
Organisation attention 6/7 impulsivity 3/6 DSM IV

SIMON 10 years : Action Learning Motivation Behaviour Engagement

individual student IS all perspectives; teachers bring them together
Speech Pathologist All perspectives inform strategies
comprehension word finding word narrative social Behaviour is an observation Motivation is an inference
Occupational Therapist
sequence space typing
Psychologist
structure encourage individual family
Explain success in chess science
Output modify quantity / method /time;computer
Behaviour class play home
Medication share wait targets optimise
Coghill D JCPP 55 737-740 July 2014

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Students who struggle

Students who struggle in special education/ special schools
3 main groups
COMPLEXITY OF LEARNING ABILITY and FUNCTION
LEARNING / ORGANISING/ OUTPUT / BEHAVE
Speech Language Communication Needs (SLCN)
Language / Dyslexia Motor / DCD ADHD ADHD and Autism ADDED to developmental level
Intellectual disability Anxiety and depression ( mental health 4 to 6 x normal)
Emotional and /or Psychosocial disorder GENETIC and ACQUIRED COMPLEXITY e.g. preterm
GIFTED UNDERACHIEVER MEDICAL ASSOCIATIONS HEARING VISION
Subtle language ADHD Motor Anxiety ASD Seizures MOTOR & Mobility Nutrition Sleep
POOR SOCIAL COMMUNICATION / BEHAVIOUR MEDICAL TREATMENTS Therapy needs Medication
Language ADHD Autism Spectrum Anxiety Antiepileptic methylphenidate psychotropics
Intellectual disability FAMILY Similar? Stress Stamina Finances Stigma
Emotional and /or Psychosocial disorder

Developmental Neuroscience Neuroscience and Education References

and individual success National Forum for Neuroscience and Education( UK)

http://www.naht.org.uk/welcome/news-and-media/key-topics/special-education-needs/national-forum-for-neuroscience-forum-
Describe cognitive processes in-special-education/
http://www.ssatuk.co.uk/wp-content/uploads/2012/09/NeuroSeminar-4.7.12.pdf

strengths and difficulties
developmental ages compared to demands
Describe likely impacts - success and struggle
Epidemiology overlaps evidence outcomes
Royal Society ( UK) Neuroscience Implications for education and lifelong learning
http://royalsocietypublishing.org/brainwaves2
http://blogs.royalsociety.org/in-verba/2011/02/24/neuroscience-implications-for-education-and-lifelong-learning/ Brief YouTube
intro
http://barrycarpentereducation.com/2013/06/22/the-promise-of-neuroscience/
Myths and facts for teachers about Neuroscience and Education
www.brainfacts.org
Teacher knowledge and neuromyths Bellert A and Graham L, 2013
http://barrycarpentereducation.files.wordpress.com/2013/10/abellert-graham-neurofacts-neuromyths-powerpoint.pdf

Specific causes with expected patterns Mind Brain and Education: Implications for Educators LEARNing Landscapes vol5 ,(1) Autumn 2011
http://www.learninglandscapes.ca/images/documents/ll-no9-final-lr-1.pdf#page=115
Prioritize interventions Relevance of neuroscientific data to education?
http://deevybee.blogspot.com.au/2014/01/what-is-educational-neuroscience.html Jan 25 2014
Relevance of neuroscientific data to education ? Bishop DVM 2013 JCPP 54, 247-259
http://onlinelibrary.wiley.com/doi/10.1111/jcpp.12034/pdf

Relevance of neuroscientific data to therapies? Coltheart M

http://theconversation.com/weird-neuroscience-how-education-hijacked-brain-research-10663
Taylor E (Sept 2104) Can neuroscience add to clinical practice ?
Relevance of neuroscientific data to medication? Child Adolesc Ment Health 19(3):161-2

All human qualities are a spectrum

A continuum across people and in each and all development domains
Observations and Descriptions = symptoms NOT cognitive processes NATURE OF DISORDERS -QUALITY IS THE KEY
DIAGNOSIS = IMPAIRMENT in context of demands and known abilities
LANGUAGE IMPAIRMENT 10% DEFICITS/ DYSLEXIA
Diagnoses and Disorders often overlap content context complexity
Percentage of population ADHD 8% DISORGANISATION
68% fine tuning fluency feedback
speed capacity EXECUTIVE FUNCTION
WORKING MEMORY
Number of Children

adaptability flexibility

13.5% DYSPRAXIA / DCD 5-10% PLANNING SEQUENCING

13.5%
restricted repertoire inconsistent repetition speed
2.5%
2.5% INTELLECTUAL GIFTED 3% superior 1% high superior ALL OLDER
22.5%

-2 SD - 1 SD + 1 SD +2 SD INTELLECTUAL DISABILITY 3% mild 1% moderate ALL YOUNGER

AUTISTIC SPECTRUM 1% SOCIAL INSTINCT SAMENESS

failure of social symbols poor reciprocity UNSOCIAL
Define abnormal / diagnosis / disorder
fail to generalise restricted repetitive behaviour interests

3

Learning Behaviour and Engagement
As a teacher, your primary job will be to encourage and ensure student
learning and adaptive behavior.
Learning is a relatively permanent change in behavior or knowledge as a
result of experience. Maturation is not learning. Changes in behavior as a
result of temporary physiological changes are not learning.
What is learned affects behavior although not all behaviors are a function
of learning.
Behavior is a different matter. It depends on learning, but it also depends
on motivation.
the learner's behavior provides the only evidence you can have of his or
her learning. (This will continue to be true until imaging of the brain can
tell us not only that there are neural connections but what is connected by
each one.) Thus, a child who refuses to answer a problem may actually
know the answer, but we have no way of knowing that he knows!
SO BEHAVIOR BECOMES OUR WINDOW ON THE NEURON.
https://www.cwu.edu/~streetl/Differences%20Between%20Learning%20and%20Beha
vior.html
Engagement
Engagement is the single best predictor of successful learning
for children with learning disabilities (Iovannone et al., 2003).
Without engagement, there is no deep learning (Hargreaves,
2006), effective teaching, meaningful outcome, real
attainment or quality progress (Carpenter, 2010).
The process of engagement is a journey which connects a
child to their environment ( including people, ideas, materials
and concepts ) to enable learning and achievement (
Carpenter 2013)
4/15/2015
Martin defines motivation and engagement as, the students
energy and drive to learn, work effectively, and achieve and
the thoughts and behaviours that reflect this
Noncognitive skills are those attitudes, behaviours, and
strategies which facilitate success in school and workplace,
such as motivation, perseverance, and self-control. These
factors are termed non-cognitive as they are considered to
be distinct from the cognitive and academic skills usually
measured by tests or teacher assessments
http://educationendowmentfoundation.org.uk/uploads/pdf/Non
-cognitive_skills_literature_review.pdf
Developmental Differences and Disorders
strategies for successfully leading
learning motivation engagement behaviour
prepare the world for the child and the child for the world Giorcelli
1. IDENTIFY Risk & RESILIENCE strengths and vulnerabilities
These coexist and Labels overlap
Early years have mixed difficulties and presentations so diagnosis may change
Gillberg C (2010) Research in Developmental Disabilities 31 1543-1551
2. EXPLAIN THE CHILD contexts collaboration continuity
3. INDIVIDUALISE priority evidence availability effectiveness
4. MATCH BETWEEN LEARNING TEACHING and OUTPUT
5. SUPPORT with EVIDENCE-BASED approaches
6. Beware Complementary and alternative approaches without evidence
WHAT WORKS? Does Will Should Might Doesn't Wont
Translate NEUROTALK to EDUTALK to LIFETALK
BRAIN PROCESS Teach / Learn Adapt Success Esteem
Collaboration
e.g. Student centred Schooling
Teacher + aide
effective instruction personalisation adjustments inclusion
Speech /language pathologist
language literacy study social feed augmented
Psychologist Social Worker
cognitive behaviour family adjustment
Occupational Physio Music Therapist
specific skills writing computer mobility response
Doctor
answers advocacy anxiety medication
PARENTS AND FAMILY
Support Groups engage individual parents and all others
4

Sharing Information
Translate NEUROTALK to EDUTALK to LIFETALK
BRAIN PROCESS Teach / Learn Adapt Success Esteem
Student early patterns action assessments
view of difference e.g. www.adhdvoices.com ( Singh)
Family patterns strengths struggles strategy life
School comments reports (re) interpret
patterns assessments grades profiles
explain personalized adjustments
information about special educational needs
http://www.queensmead.net/sen/
Case Discussions why who when what whither
UPDATE THE ASSESSMENTS AND INTERVENTIONS
ADVOCACY FOR ALL AVOID BLAME MANAGE BULLYING
Quality inefficient ? Impairing
Relate to level scatter of abilities
Context of task expectations
Observed behaviour function
How is it interpreted
How is it supported
Impact on strengths
Impact on emotions
CONFOUNDERS of MOTIVATION ENGAGEMENT and SUCCESS
LANGUAGE COGNITIVE ORGANISATION MOTOR OUTPUT
SOCIAL INSIGHT SELF OTHERS and THE SYSTEM
EMOTIONS ANXIETY and DEPRESSION
4/15/2015
Case Conference Content
Advocacy for all
Describe developmental ages and qualities
School observations and strategies
Impact of combined abilities on performance
Strategies at school and home and therapy
Therapist and teacher collaboration
Significance of medical illnesses
Medication use targets and titration
Targets treatments and tuning over time
Engagement http://complexld.ssatrust.org.uk/
Language of different perspectives bio psycho social
Medicine and morality in interprofessional talk White S 2002,
Sociology of Health and Illness 24,409-435 DOI: 10.1111/1467-9566.00302
NEURODEVELOPMENTAL CONFOUNDERS
of LEARNING
BEHAVIOUR MOTIVATION ENGAGEMENT SUCCESS
LANGUAGE
COGNITIVE ORGANISATION SELF-REGULATION
MOTOR OUTPUT
EXTREMES OF INTELLECT Gifted Intellectual Disability
SOCIAL INSIGHT ADAPTABILITY
SELF OTHERS GROUPS and THE SYSTEM
EMOTIONS primary and secondary
ANXIETY DEPRESSION Conduct Disorder Attachment
CULTURAL AND LINGUISTIC DIVERSITY ( CALD) concepts and behaviour
Eye contact conversation achievement expectations
OPPORTUNITY ABILITY and ENVIRONMENT Chronic Illness
FAMILY / CARER / SIBLING STRESS
Illness Adversity Deprivation Abuse Trauma
Engagement evidence -based practice
Complex Learning Difficulties and Disorders
http://complexld.ssatrust.org.uk/project-information.html
96 schools special and mainstream UK + others 2009 to 2011
team + teachers+ others
Engagement profile and scale
Briefing packs information + strategies
Inquiry framework for learning
Excellent description and how to use Sally Jones (South Australia )
http://barrycarpentereducation.files.wordpress.com/2014/08/engagement-for-
learning.pptx
http://barrycarpentereducation.files.wordpress.com/2012/03/sen-magazine-the-
rules-of-engagement-sept-2011-a4page.pdf
http://www.eciaqld.org.au/images/files/Leadership%20CLDD%20-
%20by%20Barry%20Carpenter.pdf ( August 2014)
Carpenter et al ( Feb 2015 ) Engaging learners with Complex Learning
Difficulties and Disabilities Routledge www.routledge.com/9780415812740
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Student Engagement Professor Barry Carpenter, OBE

Initiation Engagement Profile Responsiveness

Barry Carpenter OBE, Project Director

Complex Learning Difficulties and Disabilities Project

http://complexld.ssatrust.org.uk/

Curiosity
Persistence Engagement
Profile
Name:
Engagement profile
Date:
Task Undertaken:
The aim of the Engagement Profile is to provide a snapshot of how the student demonstrates their engagement.
Considering when their student is highly engaged, staff should fill in each circle with how that student demonstrates Independently
each indicator of engagement, making it a very personalised document. This could be through actions, behaviour, With Prompting
With Support
expression, gesture and body language.

Engagement scale

The purpose of the scale is to charts the students journey towards meaningful engagement and sustained learning, Anticipation
through a process of staff reflecting on students' learning and their own professional practice.
Using the profile as a benchmark for high engagement, staff focus on a target in an area which the student currently
demonstrates low engagement. Staff then complete regular scales to assess the student's engagement and highlight Investigation
ideas for strategies to use next time by breaking the session down into 7 indicators of engagement. Over time,
completed scales can show the effectiveness of strategies implemented and the progress students have made, if Discovery
successful.

Staff have reported that use of the engagement tools has allowed them structured time to consider the individual
student and their learning in a more focused and creative way.

Based on the work of Barry Carpenter/ Beverley Cockbill, 2013; personalised by Sally Jones

Special educational needs and disability

code of practice: 0 to 25 years January 2015 COMPLEX LEARNING DISABILITIES -SPECIAL CONTEXTS
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/398 Specific Language and speech and motor impairments dyslexia
815/SEND_Code_of_Practice_January_2015.pdf
Specific impairments executive function working memory attention
Communication & interaction Cognition & learning Sensory impairments in Hearing and Vision
Developmental Dyspraxia / DCD Cerebral Palsy Physical Disability
Social Emotional Mental health Sensory & Physical Global Learning Disability ( Intellectual Handicap)
EDUCATION HEATH CARE PLAN Gifted
Autism
Forward-looking Aspirations Package Outcomes
CNS e.g. Tic Disorder epilepsy brain injury cerebral palsy
not made expected progress with relevant purposeful actions Severe physical illness Sleep apnoea
Remove barriers to learning reasonable accommodations Mood Anxiety Depression Conduct Disorder Bipolar
Effective special education continuous review transitions Cultural and Linguistic Diversity ( CALD)
FAMILY / CARER / SIBLING STRESS
ASSESS PLAN DO REVIEW well coordinated timely
Adversity Attachment
USE SPECIALISTS Ed Psychol CAMHS Specialist Teacher Therapy Deprivation Neglect Abuse

Neurological Impairments Genetic disorders and developmental patterns

FAMILY cognitive &emotions Traits and 25 % risk disorder in close relatives
Processing of complex language , social clues, executive function and planning to
goals are the greatest cognitive demands Strengths struggles strategies spectre stamina stigma
Inherent or acquired brain problems can have wide variety of effects not only
models of local/ focal function and pathology Sex Chromosome XXY 1/500 Language ADHD ?ASD
PREMATURITY XYY
44% have >1 weak domain ; controls 16% (Roberts G et al 2011)
Fetal Alcohol Effects 1/50 to 1/100 ADHD ODD Intellect low ASD
Educational Support Needs Odds Ratio=7 , Mulder et al 2010)
to 1/1000?
particularly caused by poor Processing Speed and Working Memory
Inattention 4 x fullterm if < 32 weeks SDQ by Parent + teacher ( Brogan et al 2014) 22q11 deletion ( VCFS) 1/3000 Language ADHD Anxiety Depress
Emotional contexts Social Synapse (Champion P SSAT 2013 )
Teaching implications (Wolke D SSAT 2103 and RSM 2014 ) Fragile X 1/2000 Intellect Language ADHD ASD
Neuroscience and Special Education Forum UK ( 2013) ( carriers have anxiety; Sp LD )
http://barrycarpentereducation.files.wordpress.com/2013/05/prematurity-position-
statement.pdf Down 1/2000 Intellectual Disability
Seizures Hydrocephalus Cerebral palsy Language articulation
Brain Trauma Infection Chemotherapy Neurofibromatosis 1 1/3000 ADHD Specific LD
Tic Disorder ADHD 70% Specific LD OCD
If condition is present BE AWARE for language literacy LD ADHD DCD Williams 1/3000 Intellect language pragmatics
ADHD
Copy Number variants ??? changing interpretation &
CGH microarray relevance

6

HOW IS LANGUAGE POSSIBLE ?
"The speed and naturalness with which most
children pick up spoken and written language
can fool us into underestimating the enormity
of the intellectual task which faces them, and
thus the enormity of the task facing those
who have to solve learning problems when
they arise.
David Crystal
ADHD LANGUAGE and LEARNING
Always assess basic and higher language in ADHD
Concepts of space time and sequence; pragmatics;
output
Adolescent outcome of language disorder
Teacher not assume that in ADHD without language
or reading difficulty student does comprehend
everything
Target academic cognitive language AND behaviour
Synchronise medication to academic demands &
support
4/15/2015
Specific Learning Disability
dys*****ia
Defined by academic achievement NOT cognitive process
Reading / Maths / Spelling /ADHD all overlap
50% Overlap language and dyslexia ( McArthur 2000)
Co-occur more commonly in family (Wilcutt,; Greven CU 2014 JCPP )
Reading Difficulty Identical Twins 55% Non-identical 40%
Boy 60 % risk if Father RD; 40% if Mother RD ; girls less
(Snowling et al 2003 Torppa et al 2010)
Preschool delays identify risk ( Nash HM et al 2013)
Identify in School by poor Comprehension Phonology
Avoidance of tasks in year 1 (Eklund, KM et al 2013).
Centre for Effective Reading ( referred for major literacy problems )
100 patients 15 % Anxiety D 60 % ADHD (Hodge A et al 2013)
www.cer.education.nsw.gov.au
IF ANY OF THESE LABELS EXIST CONSIDER THEM ALL
LANGUAGE ADHD DYSLEXIA DCD / Dyspraxia
IMPACT OF LANGUAGE IMPAIRMENT
Behave play interact and learn at level of language
Examine complexity and quality not only basic level
How does it contribute to described difficulty in learning
behaviour motivation engagement
Complex written output uses and challenges many abilities
Interacting effects on literacy vocabulary learning
Adolescence Impact : complex reasoning, language of new
subjects and countries , academic and work output, social
belonging, verbal and social pragmatics, introspection,
setting future goals
talking therapy uses abstract language insight
implementation
Psychiatry Clinics & Language Clinics 40% overlap diagnoses
Juvenile Justice 45% Specific Language ADHD Intellect Disab
Language learning disorder and overlaps references
AWARENESS of Language Disorder (UK)
www.youtube.com/rallicampaign
http://www.thecommunicationtrust.org.uk/projects/what-works/
Language / Specific LD / ADHD/ DCD interwoven Rosemary Tannock
www.cas.uio.no/Publications/Seminar/Convergence_Tannock.pdf
Educating ADHD Optimally In The Schools Dorothy Hill Presentations October 2011
http://www.psych.on.ca/forum/forum_posts.asp?TID=551&get=last
"Out of the Lab and Into the Classroom
http://www.youtube.com/watch?v=Lsq5oeEunsw
Rogers, M. & Tannock, R. (in press). Are classrooms meeting the psychological needs of children
with ADHD symptoms? A Self-Determination Theory perspective.. J Atten Disord. 2013 Dec 10.
[Epub ahead of print]
Overlap with ADHD Greathead P, ADHD in Practice 2012, 4,10-13.
These impairments overlap and exist into adulthood ,www.thomasebrown.com
and even in high intellectual ability; more risk of anxiety (Brown, Reichel & Quinlan, 2007)
7

learning disorder and overlaps references
Outcome of Language Impairment
Risks in learning , attention , self-esteem, socialisation, employment
Cohen et al (2000) JCPP 41, 353-362 Beitchman et al 199
Snowling, Bishop et al JCPP 47(8), 759-765, 2006
Overlap with anxiety
e.g Selective Mutism 1/700 1/3 Lang Disorder ( Gillberg ; Keen DV, 2008)
Gifted with Learning Difficulty twice-exceptional
Model for screening GLD within response to intervention paradigm
McCallum RS et al Gifted Child Quarterly 2103 57 , 509
DOI: 10.1177/0016986213500070
Differences between Children with Dyslexia who are and are not gifted in verbal reasoning
Berninger V and Abbott RD Gifted Child Quarterly 2103 57 , 233
DOI: 10.1177/0016986213500342
Causes of ADHD
Thapar et al (2013) JCPP 54, 3-16 DOI: 10.1111/j.1469-7610.2012.02611.x
FUNCTIONAL PROFILES GUIDE SUPPORTS Professor Amanda Kirby
http://www.doitprofiler.com/resources.aspx for Employee & Employer
Educational strategies references
Literature review : Student-Centred Schools make the difference
Harris J Spina N Ehrich LC Smeed J June 2013
Australian Institute for Teaching and School Leadership
http://www.aitsl.edu.au/verve/_resources/
Lit_Review__Student_centred_Schools_Harris_et_al_2013.pdf
Student Centred Teaching Checklist http://mams.rmit.edu.au/e8unxk9vkjtp.pdf
DIVERSITY OF STUDENTS
http://cte.cornell.edu/teaching-ideas/engaging-students/index.html
http://cte.cornell.edu/teaching-ideas/engaging-students/increasing-student-
participation.html
http://cte.cornell.edu/teaching-ideas/building-inclusive-classrooms/index.html
https://www.dlsweb.rmit.edu.au/bus/public/transnational/pdf/Teaching%20practice%
20-%20Engaging%20students%20through%20learning%20activities.pdf
4/15/2015
Educational strategies and language impairments references
JULIA STARLING ADOLESCENT LANGUAGE
Recognizing language impairment in secondary school student populations
Aust J Learning Diff 2011 , 1-14 Starling et al
LINKing Language With Secondary School Learning 2014 IS EXCELLENT
www.linksresources.com.au recognition STRATEGIES Lesson Plans
Oral language interventions
http://educationendowmentfoundation.org.uk/toolkit/oral-language-interventions/
Developing Oral language in Classroom McCandlish S 2012
http://www.decd.sa.gov.au/northernadelaide/files/links/Taking_a_slice_of_Oral_Lan.pdf
UK Evidence base for Speech Language Communication Needs (SLCN )
https://www.gov.uk/government/publications/what-works-interventions-for-children-and-
young-people-with-speech-language-and-communication-needs
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/219623/DFE-RR247-
BCRP10.pdf
Educational strategies references
Education Endowment Foundation UK
Toolkit -34 topics and evidence for effects
http://educationendowmentfoundation.org.uk/toolkit
http://educationendowmentfoundation.org.uk/toolkit/behaviour/
http://educationendowmentfoundation.org.uk/toolkit/meta-cognitive-and-self-regulation-
strategies/http://educationendowmentfoundation.org.uk/toolkit/social-and-emotional-aspects-
of-learning/
How teachers evaluate their interventions
http://educationendowmentfoundation.org.uk/uploads/pdf/EEF_DIY_Evaluation_Guide_%28201
3%29.pdf
Research in schools
http://educationendowmentfoundation.org.uk/news/educating-ethics-how-and-why-and-the-
eef-trials-what-works-in-schools/
http://psychologyineducation.wordpress.com/2014/07/12/can-teachers-really-be-researchers/
TRAINING MODULES and RESOURCES and Audiovisual library UK
Speech Language ASD LD ADHD Behaviour Social Mild ID http://www.advanced-
training.org.uk/
Severe Profound Complex LLD http://www.complexneeds.org.uk/
Motor Difficulty
Developmental Coordination Disorder / Dyspraxia
Complex planning and sequencing
Inconsistency and effort = frustration = anxiety
and poor self-esteem
Writing and speech the most complex
Overlap with language / narrative from young
Overlap with ADHD and ASD
Be aware of anxiety
Strategies ( Prof Amanda Kirby)
www.boxofideas.org
www.spldtransitions.co.uk
8
 4/15/2015

Diagnosed Attention Deficit Hyperactivity Disorder

Motor Impairments and Overlaps references
and Learning Disability: United States, 2004-2006
Language social cognition and motor broad mix of impairments
Mix of language motor and exec unction in preschoolers at risk reading disorder
http://www.cdc.gov/ncbddd/adhd/data.html
(Gooch et al ) 2015
Impact of motor development on language and social cognition Systematic review
Leonard HC Hill E Chid Adolesc Ment Health 2014 19(30 163-170
Hill, E L, 2001. Int J Lang. Comm. Dis
FM deficits in poor readers more associated with language impairment than with
literacy problems.
Brookman A et al (2013) PeerJ 1:e217 http://dx.doi.org/10.7717/peerj.217
Preschool SLI have 25% DCD and this persists to school
Gaines Missiuna 2007 Ch Care H Dv Webster R et al 2005 J Ped 146 80-85
Impact social and play success; need for routines
http://canchild.ca/en/canchildresourcesearlyidentificationspeechandmotor.asp
Assess motor ability , sequencing, planning for DCD
Kirby et al 2013 doi:10.1136/archdischild-2012-303569
Anxiety + depression non identical (DZ) twins + motor > DZ or control
Pearsall-Jones, Piek, Levy et al 2011 Res Dev Dis 32 1245-1252

CORE of ADHD
(threshold; genes + environs)
Overview of ADHD management
www.drthomasebrown.com ADJUST THE LOADS
How the brain controls thinking learning and behaviour
executive functioning planning and prioritising to a goal
Get updated comprehensive information
working memory hold in mind while processing Look for patterns of strength and difficulty
attention focus sustain switch speed Treat most obvious e.g. language and learning
inhibition monitor select regulate action and emotion
cool attention &Working Memory and hot affect significance
Is behaviour at developmental level or not
Targets for cognitive organisation
A neurodevelopmental learning difference/ disorder described/

defined/ interpreted as a behaviour disorder
Use medication clearly and collaboratively
complex language understanding and use Use medication thoroughly
motor planning visuo-spatial poor time sense (con) sequences e.g. three doses a day and give enough
are most vulnerable in complex outputs
extended writing social interactions deadlines work
Review and readjust
Castellanos FX Sonuga-Barke EJS,Milham MP Tannock R(2006) Trends in
Cognitive sciences. 10(3),117-123

School approaches to ADHD ADHD and Emotional disorder

Moore DA et al ADHD in Practice 2014/2015, 6(4) 4 -8
Systematic reviews of school strategies, teacher
and parents and pupil views
Structure time behaviour individualization
Problems in expectations child family
Pupils: learning relationships stigma
Teachers: differentiated curriculum too hard
individualised too much are strategies effective
Lack of knowledge of ADHD social family problem
Parents: conflict blame school promise more
Anxiety commonest
Effect on symptoms and their interpretation
Effect on Supports therapy medication
Efron Practice study 8% reported by paed
Anxiety survey in sleep in ADHD study group
6 different anxiety disorders
392 cases from 21 practices
No 36% 1 Anxiety D 26% >2 Anxiety D 39%
>2 AnxD Social Phobia 48% GAD 34% Separ 32%
OCD 8% PTSD 6% Panic 2%
Sciberras et al Pediatrics (2014) 133, 801-808

9

Autism and ADHD
DSM IV <7y; NOT coexist DSM -5 <12y; coexist
www.dsm5.org/Documents/ADHD%20Fact%20Sheet.pdf
In ASD Anxiety ADHD and ODD all about 28%
Simonoff 2008 JAACAP , 2008, 47,921-929
Overlap genetically 6771 twin families at 8 y
ASD criteria 41% suspect ADHD; ADHD 22% susp ASD
Ronald et al JCPP 2008, 49,535-542
Severe ID +/- ASD 122 7-15y IQ 30-69
Methylphenidate up to 1.5mg/kg/D effective 50%
Simonoff et al JCPP 2013 54, 527-535
ADHD/ TICS/ TOURETTE
Comorbidity
ADHD 5% Conduct disorders 3%
Tics 4 - 24% TS 1% - 0.1%
Stimulant prescribing 1% of 5-19 yrs
Predisposition
genetics / natural history / fluctuating
Pre existing / Appearance/ Persistence
stimulants and tic onset 1%
stimulants and tic exacerbation 13% - 50%
NSW Stimulant Committee experience
MEDICATIONS FOR ADHD-
Improve efficiency of information Processing
Methylphenidate Dexamphetamine Atomoxetine
MPH DEX - Dopamine / Noradrenaline balance
Onset 30-40 min
last 3 to 4 hours
MPH DEX first line
70 to 90% success
5 to 20% adverse effects
INDIVIDUAL RESPONSES
Controlled prescribing
Long acting have different release profiles
Morning dose RITALIN LA 50% CONCERTA 25% of total VYVANSE
Long acting preparations European review Banaschewski et al (2008)
Atomoxetine build up over 6 weeks
?tics substance use ?Long term ? Mood
4/15/2015
Intellectual disability ( ID )
ADHD when inappropriate for developmental age
ID neurogenetic complexity / syndromes
Complexity of function and management
Mental health disorders 4 X N IQ<70 6xN <50 epilepsy
Comprehensive support baseline and targets
ADHD / ANXIETY / DEPRESSION
Simonoff et al JCPP 2013 54 186-194
Dose manipulation complex, side effects more
MPH EFFECTIVE 50 % IN IQ 30-65 1/3 WITH ASD
Simonoff E et al 2013 JCPP 54, 527-535
Multiple medications more likely (international)
Hsia et al 2014 Psychopharmacology 231 999-1009
Collaboration and Medications for ADHD
expectations experience extrapolation
Rigorous knowledge science safety success
Individual patterns of symptoms and response heterogeneity
Responsible collaborative use share target symptoms
Effect on other interventions Which medication / alternatives?
Misconceptions and media
Over reliance be realistic PLAN & SHARE TRIAL & REVIEW
Should all children with special education needs be considered for
methylphenidate trial to mitigate their disability and enhance effectiveness
of supports ? How would we know?
(Professor Dame Uta Frith UK Neurosciences Forum 2012)
Bolea-Almanac J Psychopharmacology 2014 ,1-25
LONG-ACTING Coghill et al ( European )
http://www.biomedcentral.com/1471-244X/13/237
Using methylphenidate
( each doctor will differ )
Increase to steady best dose over 2 to 3 weeks
Up to 3 doses per day of immediate release
Before school 7.30 ( more organised going to and start school )
MID-MORNING ( cover late morning class and lunch playground)
after school 4 p.m. for play and home work
teacher observe gains wear off and different doses
Trial adequate doses before say it is not effective
Start during sequence of therapy and during term
Change dose mid-week
Continue at weekends and in holidays ( parents evaluate )
Work through minor side effects
Work through choices MPH to DEX at same dose, then ? ATX
Extended release preparations have different release profiles
Complex brains respond more / less or more frequent
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 4/15/2015

Tuning Medication to Teaching and Life Other Medications

less science more side effects ?once daily
ADHD SYMPTOMS
Clonidine sedative for sleep H/A
Melatonin for sleep
STIMULANT Anti-anxiety
DOSE SSRI s Fluoxetine Sertraline
DOSE TIMING Obsessive , stereotyped , anxiety
Group/hard work Risperidone BUT adverse weight motor
SCHOOL HOURS Homework
Aggression high activity agiataion sterotyped
7 am
RECESS
11 am
LUNCH
1 p.m. 4 p.m. 9 p.m.
Valproate
ALL TITRATE SLOWER
DOSE TIMING
GIVE WITH GREAT CARE and COLLABORATION
ADHD SYMPTOMS

Leading Changes
Engaging Learners
Match abilities and demands and supports
Updated information of realistic abilities
Relate to observed performance and behaviour
Language cognitive organisation & regulation
What works what doesnt what might
Relative targets for medication
Review and refine priorities
Sharing and collaboration
ADVOCACY FOR ALL

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