A child with special needs is a child first and
foremost. As such he needs everything that has already been talked about
in this guide: warm, responsive, sensitive parenting with firm and
consistent boundaries, as well as plenty of opportunities for play,
exploration, and fun.
“A child’s special needs are as much a part of his individuality as his finger-prints.”
“My four-year-old, Joe, finds it easier to follow my instructions if I use his name first and make eye contact at his level.”
—“My four-year-old, Joe, finds it easier to follow my instructions if I use his name first and make eye contact at his level.”
“Meeting other parents with similar difficulties means we can share our ups and downs and pool our experience.”
—“Meeting other parents with similar difficulties means we can share our ups and downs and pool our experience.”
“Special needs” is
the term used to cover the requirements of children who need help and
support with particular areas of learning and development. Parenting a
child with special needs can have its own particular challenges.
Comparing your child’s progress with that of others is never to be
recommended; and this is particularly true in the case of children with
special needs. While certain patterns of development or behavior might
be expected to be linked to certain conditions, it is not inevitable.
Each child is an individual, and may therefore not fit the box society
chooses to put him into.
If you have concerns
about your child’s development, a clear diagnosis can come as a relief.
At this early stage the “special needs” label is useful: when
identifying symptoms, when contacting parents in similar circumstances,
or when approaching appropriate support and services. Beyond the
functional use, however, labels are probably best avoided. Just as no
two children with brown hair or freckles are the same, no two children
with autism or with Down syndrome are the same either. The label should
be reserved for the condition and not applied to the child. Hence, it is
usual these days to say, “Tom is a child with autism,” rather than “Tom
is autistic”; the same applies to children with hearing difficulties or
visual impairment. To be able to judge what your child can and can’t do
and identify areas where his personal skills can dominate instead, will
help others see past the special needs and see the real person.
A beautiful child
A child with special needs is a child to love, respect, and
celebrate. Give her opportunities to succeed from an early age.
Special demands
While there are
more similarities than differences between children with special needs
and the average toddler, it does help to be realistic and aware of where
the differences lie: the length of time it takes to do things; the
extra strain on finances for special equipment; the many specialist and
medical appointments; the necessary involvement of special agencies and
support, can all seem endless—to the extent that nothing about your
situation feels private or special. Don’t be afraid to seek support and
advice from specialist professionals and caregivers.
You will need to become
the expert in your child’s condition so that you can inform others how
best to help you to manage and cope. It can also be beneficial to
develop a rapport and a cooperative relationship with those who are
funded to help you. It is in your child’s best interests to work
together as a team.
All behavior is a form of communication, so if your toddler is having difficulty making himself understood he may act up. The ABC approach
to identify the causes of behavior can be particularly useful for
parents of children with special needs. It can help to identify the
progression of a behavior and focus you on its triggers (A cause), the
way your child shows the Behavior—such as a tantrum—and the Consequence,
so it can be a very useful way of changing the outcome.
Caring for a toddler
with special needs can be demanding and it is important to become
attuned to your own stress levels and triggers, and to know when you
need to take time out—for yourself. This is a very important aspect of
parenting a child with special needs, even though it can be difficult to
find caregivers that you feel confident can manage in your absence.
Equally important is to allow yourself the time to relax and enjoy your
child. Fun times will help you build a stronger bond.
Developmental delay
Most children follow
the same pattern of development and reach milestones in a similar
sequence, even if there is a difference in timing. When children are
slower to reach milestones or development plateaus across many areas
(movement, cognitive skills, language, social, and emotional
development) this is known as global developmental delay.
Not all children with
developmental delay experience global problems; for some, development
may be delayed in only one or two areas—for example, motor or language
skills may be affected by certain conditions. There are many different
causes linked to developmental delay but in around 50 percent of cases
it is not possible to identify a cause. Possible contributing factors
include genetic conditions (such as Down syndrome), brain trauma during
birth or as a young child, illness, and early environmental experiences.
The diagnosis (to see
whether the milestones are achieved within normal age ranges) can take
time. Some genetic conditions are more apparent than others and several
may be tested for during pregnancy or at birth. If you suspect something
is amiss during your child’s early months, it is important to raise
questions and concerns with your pediatrician.
Children
who are experiencing developmental delay may need extra support. You
may benefit from advice on effective ways to communicate with your child
(such as signs or pictures to compliment words to help your child
express himself). Managing behavior may present extra challenges.
Support groups can be particularly helpful in combating any sense of
isolation that you may feel. Parenting a child with a disability has
challenges and extra support is invaluable, so do seek it out.
Autistic Spectrum Disorders (ASD)
Nearly four times more
boys than girls are diagnosed with an Autistic Spectrum Disorder (ASD),
which may first begin to show in the toddler years. Boys, it seems, are
more genetically and developmentally vulnerable than girls. The causes
of autism are still not clear, but it is now generally accepted that it
stems from the way that the neurons in the brain are connected at an
early stage of development. (This suggests that both genetic factors,
and brain trauma may be implicated.)
ASD is a generic term for a
range of conditions including classical autism and Asperger’s syndrome.
ASD is not the same as global developmental delay.
Some children with autism may have an average or above average IQ and
may develop language at an appropriate age; others may not develop
language skills at all and some will have global developmental delay or
severe learning disabilities alongside ASD. It is generally accepted
that children who are diagnosed with autism will, to some degree, have
difficulties in the following areas:
Relating to people
Children with autism lack the ability to share attention with other people and appear not to understand that someone else can think or feel
differently than themselves. This can lead to an apparent lack of
empathy, difficulty in relating to other people, or may be seen as
aloofness. These children may not want to interact with others apart
from to have their own needs met. Their social behavior may be
inappropriate or unusual. Some children fail to develop language skills,
others may echo words but use them inappropriately, or appear to use
odd turns of phrase or “set pieces.” Some children have difficulties
associated with understanding nonverbal language, such as interpreting
body language or facial expressions.
Imagination
Children who are
diagnosed with autism often lack the ability to play imaginatively or to
use symbolic play. Play with toys tends to be repetitive (see Restricted routines and interests)
or has to be learned. They may enjoy and crave sensory stimulation—so a
child may bang blocks together to make a noise rather than using them
to build something. Lack of imagination relates to language development
and those children who develop language skills may have a very literal
understanding of the words you use. The use of metaphors and sayings,
such as “Cat got your tongue?” or “I’m over the moon,” will be taken
literally and can be confusing.
Restricted routines and interests
Children with autism
often have a limited range of interests and may show repetitive
behavior. They may have an almost obsessive fascination with a single
topic, and want to talk about it all the time or repeat an action again
and again—for example, twirling string. Habits, familiar rituals, and
predictability can be very comforting to those with autism; your child
may need to have things done in a particular way, and everything put in
its place. Change, unscheduled separation, and bereavement can be very
hard for these children.
The age at which you
first notice your child is having difficulties will depend upon the
nature and extent of his problems. For example, some children appear to
manage socially until they start school. Depending upon where in the
autism spectrum your child falls, he may manage quite well in mainstream
school, perhaps with some extra support, or he may need special
education. However, even the most academically able child with autism
will struggle when it comes to interacting with his peers, and will need
some help so that he does not become isolated or anxious.
Attention Deficit Hyperactivity Disorder (ADHD)
This condition is
characterized by a difficulty in filtering out extraneous information in
order to stay focused on one thing. Children with ADD appear to be
highly distractible, and when coupled with hyperactivity, they seem to
be “bouncing off the walls.” Diagnosis under the age of five is rare
because so many indicators of ADHD are similar to typical toddler
behavior. However, it can usually be identified by the age of seven.
The causes of ADHD are not
fully understood but are likely to be a combination of genetic and
developmental factors, meaning that children with the condition find it
hard to control their responses. At home, the ADHD behavior can be hard
to manage and may lead to a worsening in behavior habits. Children find
it difficult to regulate their emotions and are likely to need ongoing
support with setting their own behaviour limits and problem-solving. At
school, children who suffer with ADHD tend to be very impulsive and may
have difficulty developing social skills and managing conflict. Children
with ADHD may have other difficulties, too, such as behavioral
disorders and specific learning difficulties. Given all this, positive
behavior reinforcements are really important for a child with ADHD.
Cuddle him often. Rewards for good behavior should be frequent and
immediate, routines should be clear and consistent, and the use of
consequences is also beneficial in making clear to your child what is
expected from him. In some cases, medication is recommended for use in
conjunction with behavioral strategies—although you are advised to
discuss this route with a specialist.
Parents need support, too,
since children with ADHD can be a challenge. Tension in the parent–child
relationship can lead to an escalation in the unwanted behavior, so
seek support and take time for yourself.
Dyslexia, dyspraxia, and other conditions
It is natural for parents to
worry if they think that their child’s development is much slower than
expected in certain areas. However, conditions such as dyslexia
(difficulty with letters and reading), dyscalculia (difficulty with
numbers and math), dyspraxia (problems with coordination), or specific
language problems such as stuttering, are very difficult to diagnose
during the toddler years, because language skills, reasoning skills,
gross and fine motor skills are not yet fully developed. Not until the age of five or six will it
be possible to detect these specific developmental problems accurately.
If your child seems to
have continuing difficulties in specific areas after he starts school,
speak to his teachers and to your pediatrician about whether an
assessment might be needed. In the meantime, bear in mind that it will
take time for your child’s skills to develop and for him to feel
confident in using them. Try not to trigger anxiety by putting him under
undue pressure to improve.
Sensory impairment
Children with sensory
impairment include those with sight and hearing difficulties. Children
with multiple sensory difficulties can have very complex needs and
specialist support is vital for both them and their parents. Behavior
difficulties shown by children with sensory problems may be due to a
variety of reasons, including personal frustration when trying to make
themselves understood, difficulty in understanding what is going on
around them, and as a response to parents who find it hard to set and
enforce behavioral guidelines.
Whatever your concern,
if you believe your child suffers from sensory impairment, talk to your
pediatrician, who may advise referral to a specialist.
Reduced vision also impacts
his self-awareness (of his own body, for example) and may delay general
development. He will also find it harder than a visually able child to
learn by imitation; and his ability to explore and to learn through play
will be restricted. Try to adapt his environment to encourage
exploration.
If your child has a
hearing difficulty, concentrate on building communication via the other
senses instead, such as his vision. Visual props and picture cues can be
used to remind him of a routine or to back up your behavior guidelines.
Sight
Visual
problems can vary from blindness to being cross-eyed or wearing glasses.
A child with impaired sight may not be able to pick up on visual clues
such as facial expressions, and will need you to be verbally clear and
to use noise cues to help him. He may turn his head to hear better
rather than look in the direction of a noise. Find ways to interact
using other senses (through touch, or using noises to indicate
turn-taking).
Hearing
Signs of
deafness may first show when your young toddler’s babbling comes to an
early halt. He stops responding because he cannot hear your verbal
feedback. Children are good at compensating for a missing sense (and of
course have never known life to be any different), so it is not uncommon
for less severe hearing difficulties to be overlooked until your child
begins school.
A parent’s needs
A child with special needs
is vulnerable and so should be given every opportunity to develop a
strong sense of self and self-esteem. However, families can struggle to
cope and there can be tensions that stem from parents feeling anxious or
sometimes guilty about their child’s difficulties. Don’t be afraid to
ask for support—you deserve it. It will enable you to relax and enjoy
your child, and give him the kind of family environment that will
provide the best start and so the best chance in life.
Communication challenges
Learning to communicate with
a young child with learning difficulties can be particularly
challenging. As early as the baby stage, parents may feel there is
something “wrong” and this can have a major impact on the early
parent/baby relationship. If a baby seems unresponsive, this can set up a
vicious cycle where the parents interact less with their baby and he
therefore receives even less stimulation. It is particularly hard if the
special needs have been difficult to diagnose, in which case the parent
may have felt isolated with their concerns in the early days (or may
later feel guilty that they didn’t notice the delayed development). If
you are having difficulties, your pediatrician can point you in the
right direction to get support.
What you can do
Here are a few ways in which you can help your toddler overcome some of the difficulties he may have:
Meet him at his level—for
example, if your two-year-old is finding language skills a challenge,
play games and activities appropriate for his own level. Echoing back
his early sounds and using word and action games will give meaning to
his communication. Find toys appropriate to his developmental stage
rather than his chronological age.
Encourage his social skills—help
your toddler to develop social skills and interact with other people.
Some children with developmental disabilities may be less responsive to
adults than others. Try to notice your child’s communication cues and
respond to him sensitively.
Set clear behavior limits—use
behavior management strategies that are appropriate to your child’s
developmental level. For example, if your child is three years old, but
is developmentally on a par with a toddler of 18 months, use ignoring
and distraction techniques rather than “time out”
and start to introduce simple consequences. Behavioral strategies, and
the reasons for using them, are important for all ages and developmental
levels.
Promote self-esteem—find things that your child is good at and is able to do well and encourage him to develop them further.
Early warning signs
Retrospectively,
parents can usually identify some differences in the timing or style of
their child’s social development. For example, learning to point may
happen very late or not at all; there may be problems making eye
contact; unusual behaviors; delayed language or play skills; a lack of
interest in people generally; and extra sensitivity to noise, textures,
movement, light, or change. Early diagnosis and parental support can
make a positive difference to a child with autism. A pediatrician’s
support is vital, too.
Identifying key issues for a child with ADHD
A child with ADHD will have three main difficulties:
Inattention
He will
find it difficult to sustain attention for any length of time, be easily
bored, lack persistence, and be easily distracted by what is going on
around him.
Hyperactivity
He will always be on the go, fidget, have lots of energy, and be unable to sit still.
Impulsiveness
He will
show signs of risky behavior, and say and do things without thinking so
can appear to be insensitive to those around him.
