Special Education

Special Education

Special Education is specially designed instruction, support and services provided to students with an identified disability requiring an individually designed instructional program to meet their unique learning needs. Special education and related services are available to eligible students of ages 2 through 25 at Vikas learning centre to students with ASD and paediatric neuro cases.

The IEP provides a description and action plan of what the child with disability requires in terms of services and supports necessary to learn. It is a prerequisite to receiving special education services.

Special educator just as the general education teacher offers knowledge and expertise relative to the general education curriculum. The special education teacher has more in depth background on how to teach learners with special needs. They use that knowledge and experience to offer ideas for modifying the curriculum, individualizing instruction, suggesting behavior management techniques, and presenting progress data. In many cases, the special education teacher is also the child case manager, he or she is responsible for organizing meetings and tracking goal progress throughout the school year.

What is special education?

What do you imagine when you think about special education? You might picture children with disabilities spending the day tucked away in a different kind of classroom, separated from most of the kids their age. This may have been the norm in the past. But as the field of special education has moved forward, much has changed.
Special education today is still focused on helping children with disabilities learn. But this no longer has to mean placing kids in a special classroom all day long. In fact, federal law requires that students who receive special education services be taught alongside their non-disabled peers as much as possible.

For example, some students with dyslexia may spend most of the day in a general education classroom. They may spend just an hour or two in a resource room working with a specialist on reading and other skills. Other students with dyslexia might need more support than that. And others might need to attend a different school that specializes in teaching kids with learning disabilities.

“Special education refers to a range of services that can be provided in different ways and in different settings.”

There is no “one size fits all” approach to special education. It’s tailored to meet each student’s needs. Special education refers to a range of services that can be provided in different ways and in different settings.

If your child qualifies for special education, he’ll receive individualized teaching and other key resources at no cost to you. The child will focus on his strengths as well as his challenges. And you’ll be an important member of the team that decides what he needs to make progress in school.

What disabilities are covered by special education?

IDEA covers 13 types of disabilities. These categories include autism, hearing impairment and intellectual disability (which used to be referred to as “mental retardation”). Another category, called “specific learning disability,” applies to many kids who have learning and attention issues.

A specific learning disability most often affects skills in reading, writing, listening, speaking, reasoning and doing math. Common learning issues in this category include:

  • Dyslexia: Difficulty with reading, writing, spelling, speaking
  • Dyscalculia: Difficulty doing math problems, understanding time and money, remembering math facts
  • Dysgraphia: Difficulty with handwriting, spelling, organizing ideas
  • Dyspraxia: Difficulty with hand-eye coordination, balance, fine motor skills
  • Auditory processing disorder: Difficulty interpreting what the ear hears (which is different from having a hearing impairment)
  • Visual processing issues: Difficulty interpreting what the eye sees (which is different from having a visual impairment)

There’s a separate category called “other health impairment.” It’s defined as having limited strength or alertness, which affects educational performance. Children with attention-deficit hyperactivity disorder (ADHD) are often covered by this category.

IEP must describe, discuss, and ultimately make recommendations with respect to;
Current performance, which is frequently called “present level of performance”
    • Annual goal and objectives
    • Assessment
    • Services
    • Transition
    • The behaviour intervention plan and functional behaviour Assessment, as needed
    • Placement

The IEP is written collaboratively with the faculty and parents of Vikas learning centre. The plan is executed and continuous assessments are done and modifications to the plan as deemed necessary are done to meet the needs of the child.

What is an Individualized Education Program (IEP)?

The IEP is often described as the cornerstone of special education. That’s because this legally binding document details a student’s annual learning goals as well as the special services and supports the school will provide to help him meet those goals.

Before your child can receive special education services, you and the school must complete several steps. Here’s how the process generally works:

  1. Referral for evaluation: When your child is struggling and a learning or attention issue is suspected, you or the school can ask for an evaluation. Your request may be accepted or denied. Either way, the school must explain its decision to you. The school can’t evaluate your child unless you give written permission.
  2. Evaluation: If the school agrees to evaluate your child, the school psychologist and other specialists will give your child various tests. They also may observe him in the classroom. The evaluation will identify whether your child has one of the 13 disabilities covered by the IDEA. The evaluation will also provide information about his educational needs.
    Medical conditions such as ADHD are diagnosed by a physician or another medical professional. However, federal law doesn’t necessarily require a medical evaluation to identify a child as having ADHD.Some school districts have policies that allow school psychologists to diagnose ADHD as part of the special education evaluation. School psychologists need to have appropriate training to do this
  3. Determination of eligibility: After the evaluation, a special team from the school meets with you to discuss whether your child has a disability and if it affects his ability to learn. (If your child doesn’t meet the requirements for an IEP, he may qualify for a 504 plan, which can provide many of the same accommodations and services.)
  4. Developing the IEP: If your child is eligible for special education, his IEP team creates a plan to meet his needs. You are an equal member of this team and play a very important role. You know and understand your child better than anyone else on the team. Your insights can help ensure that your child receives the services and supports he needs to succeed in school.
    There’s a common saying in public schools: “Special education is not a place. It’s a service.” Take advantage of the resources that are available to your child. And remember that many of these resources are available to your child in a general education classroom.
    If you’re debating whether to have your child evaluated for special education, thinking through some key questions could help you make up your mind. If you decide to go for it, Understood can help you prepare for the evaluation and develop the IEP. And if you choose not to get an evaluation, or if your child is denied special education services, this site has other suggestions for how you can help your child.

Individualized Education Programs (IEPs)

An Individualized Education Program (commonly referred to as IEP) is a document, mandated by the IDEA, which clearly defines the individual goal and objectives set for a child with a disability. These programs are written documentation of the special education program and academic modifications required to meet the child’s individual needs. The two main purposes of a student’s

IEP are to:

  1. Set reasonable learning goals for the student, and
  2. State the required services that the school district needs to provide for said child.

IEPs are developed by a team including the child’s teacher(s), parents, and supporting school staff. This team meets annually (at minimum) to assess the academic and developmental progress of the student, design appropriate educational plans, and adhere any changes if necessary. The main goal these reviews are to ensure that the child is receiving appropriate and adequate services within their least restrictive environment.

While each child’s IEP is unique, IDEA mandates that all IEPs must contain the following specific information:

  • Student’s present level of academic achievement and overall performance.
  • Annual goals and/or objectives for the child (milestones that both parents and school staff feels is reasonably achievable within the next year.).
  • Special education and related services, including supplementary services such as adaptive communication devices, adequate transportation services, and appropriate school personnel
  • Portion of the day that the child will be educated apart from his or her typically-developing peers
  • Participation and/or modification to district-, state-, and nation-wide assessments
  • How child’s progress will be measured
Types of Disabilities Covered in IDEA

The umbrella term of special education broadly identifies the academic, physical, cognitive, and social-emotional instruction offered to children who are faced with one or more disabilities. Under the IDEA, these disabilities are categorized into the following areas:

Autism Spectrum Disorder (ASD)

Autism Spectrum Disorder refers to a developmental disability that significantly affects communication (both verbal and nonverbal) and social interaction. These symptoms are typically evident before the age of three and adversely affect a child’s educational performance. Other identifying characteristics of those with ASD are engagement in repetitive activities/stereotyped movements, resistance to change in environment and daily routine and unusual responses to sensory stimuli.


Deaf-blindness refers to concomitant visual and hearing impairments. This combination causes severe communication, developmental and educational needs that cannot be accommodated through special education programs solely for those children with blindness or deafness.

Deafness/Hearing Impairment

Deafness means a child’s hearing impairment is so severe that it impacts the processing of linguistic information with or without amplification and adversely affects a child’s educational performance. Hearing impairment refers to an impairment (fluctuating or permanent) that adversely affects a child’s educational performance

Developmental Delay

Developmental delay is a term designated for children birth to age nine, and is defined as a delay in one or more of the following areas: cognitive development, physical development, socio-emotional development, behavioral development or communication.

Emotional Disturbance

Emotional disturbance refers to a condition that exhibits one or more of the following characteristics both over an extended period of time and to an exceptional degree that adversely affects a child’s educational performance:

  • An inability to learn that cannot be explained by intellectual, sensory or health factors
  • An inability to build and/or maintain satisfactory interpersonal relationships with peers and teachers
  • Inappropriate types of behaviour or feelings under normal circumstances
  • A general pervasive mood of unhappiness/depression
  • A tendency to develop physical symptoms or fears associated with personal or school problems

Emotional disturbance does not apply to children who are socially maladjusted unless they are determined to have an emotional disturbance as per IDEA’s regulations.

Intellectual Disability

Intellectual disability is defined as a significantly below average functioning of overall intelligence that exists alongside deficits in adaptive behavior and is manifested during the child’s developmental period causing adverse affects on the child’s educational performance.

Multiple Disabilities

Children with multiple disabilities are those with concomitant impairments such as intellectual disability and blindness or intellectual disability and orthopedic impairment(s). This combination causes severe educational needs that cannot be met through programs designed for children with a single impairment. (Deaf-blindness is not identified as a multiple disability and is outlined separately by IDEA.)

Orthopedic Impairment

Orthopedic impairment(s) refer to severe orthopedic impairments that adversely affect a child’s academic performance. Orthopedic impairment(s) include those caused by congenital anomalies and diseases, as well impairments by other causes (i.e. Cerebral Palsy).

Other Health Impairment(s)

Other health impairments refer to a limitation in strength, vitality or alertness, resulting in limited alertness to one’s educational environment. These impairments are often due to chronic or acute health problems — including ADD/ADHD, epilepsy, and Tourette’s syndrome — and adversely affect the child’s educational performance.

Specific Learning Disability

Specific learning disability refers to a range of disorders in which one or more basic psychological processes involved in the comprehensive/usage of language — both spoken and written — establish impairment in one’s ability to listen, think, read, write, spell and/or complete mathematical calculations. Included are conditions such as perceptual disabilities, dyslexia (also dyscalculia, dysgraphia), brain injury, minimal brain dysfunction and developmental aphasia. Specific learning disabilities do not include learning problems that are the result of visual, auditory or motor disabilities, intellectual disability, emotional disturbance or those who are placed at an environmental/economic disadvantage.

Speech/Language Impairment

Speech or language impairments refer to communications disorders such as stuttering, impaired articulation or language/voice impairments that have an adverse effect on a child’s educational performance.

Traumatic Brain Injury (TBI)

Traumatic brain injury refers to an acquired injury to the brain caused by external physical forces. This injury is one that results in a partial or complete functional disability and/or psychosocial impairment and must adversely affect the child’s educational performance. TBI does not include congenital or degenerative conditions or those caused by birth-related trauma. TBI applies to injuries that result in impairments in one or more of the following areas: cognition, language, memory, attention, reasoning, abstract thinking, judgment, problem-solving, psychosocial behavior, physical functions, information processing, and speech.

Visual Impairment (Including Blindness)

Visual impairment, which includes blindness, refers to impairment in one’s vision that, even after correction, adversely affects a child’s educational performance. The term “visual impairment” is inclusive of those with partial sight and blindness.

In order to be deemed eligible for state special education services, IDEA states that a student’s disability must adversely affect his or her academic achievement and/or overall educational performance. While defining these adverse effects are dependent on a student’s categorical disability, eligibility is determined through a process of evaluations by professionals such as a child’s pediatrician/specialists, school psychologists and social workers. After a student is deemed able to receive such services, their progress is annually reviewed.

Speech Therapy

Speech Therapy

Speech, Language & Communication

In Vikas learning centre , a speech-language therapist, perform comprehensive evaluation of a student’s ability to communicate. Then design and administers appropriate training. The goal of therapy is to improve useful communication for kids with disabilities. Verbal communication is a realistic goal for others, the goal may be gestured communication, and still other may have the goal of communication by means of a symbol system such as picture boards. Therefore periodic evaluations are made to find the best approaches and to re-establish goals for each individual student. Also work is done to reduce unwanted behaviour that may interfere with the development of communication skills. Speech therapy involves much more than simply teaching a student to correctly pronounce words with the help of alphabetical chart and phonics charts.

This is a commonly used term that actually has three parts-Speech therapy, Language therapy and Communication Therapy. Speech therapy addresses motor problems involving the Oral Structures (Lips, tongue, teeth, palate, nasal cavity, breathing Mechanism), where the child is unable to produce speech sounds or cannot produce them clearly.

Language therapy addresses cognitive (thinking) problem involving listening, playing attention, understanding, memory, organizing thought etc., where the child can speak but not in sentences, make grammatical mistakes, has difficulty learning new words, and reading.

Speech and language Disorders:-

A speech disorder refers to a problem with the actual production of sounds, whereas a language disorder refers to a difficulty understanding or putting words together to communicate ideas.

Speech disorders Include:

Articulation Disorders: Difficulties producing sounds in syllables or saying words incorrectly to the point that listeners can’t understand what’s being said.

Fluency disorders: problem such us, in which the flow of speech is interrupted by abnormal stoppages, repetitions (stuttering), or prolonging sounds and syllables (stuttering).

Resonance or Voice Disorders: Problem with pitch, volume, or quality of the voice that distract listeners from what’s being said,. These types of disorders may also cause pain or discomfort for a child when speaking.

Dysphagia/Oral feeding disorders: These include difficulties with drooling, eating, and swallowing

Language Disorders can be either receptive or Expressive:

Receptive Disorders: Difficulties understanding or processing language

Expressive Disorders: difficulty putting words together, limited vocabulary, or inability to use language in a society appropriate way.

Remediation:In Speech-Language therapy, an SLP will work with a child one-on-one, in a small group, or directly in a group to overcome difficulties involved with a specific disorder.

Language Intervention activities: The SLP will interact with a child by playing and talking, using pictures, books, objects, or ongoing events to stimulate language development. The therapist may also model correct pronunciation and use repetition exercises to build speech and language skills.

Articulation Therapy: Articulation, or sound production, exercises involve having the therapist model correct sounds and syllables for a child, often during play activities. The level of play is age-appropriate and related to the child’s specific needs. The SLP will physically show the child how to make certain sounds. Such as the “r” sound and may demonstrate how to move the tongue to produce specific sounds.

Oral-Motor / feeding and swallowing therapy: The SLP will use a variety of oral exercises-including facial massage and various tongue, lip, and jaw exercises-to strengthen the muscle of the mouth. The SLP also may work with different food texture and temperatures to increase a child’s oral awareness during eating and swallowing.

Children might need Speech language therapy for a variety of reasons, including:
  • Hearing impairments.
  • Cognitive (intellectual, thinking) or other development delays
  • Weak oral muscles
  • Excessive drooling
  • Chronic hoarseness
  • Birth defects such as cleft lip or cleft palate
  • Motor planning problems
  • Respiratory problems (Breathing disorders)
  • Feeding and swallowing disorders
  • Traumatic brain Injury

Therapy should begin as soon as possible. Children enrolled in therapy early (Before they’re 5 years old) tend to have better outcomes than those who begin therapy later. This does not mean that older kids can’t make progress in therapy; they may progress at a slower rate because they often have learned patterns that need to be changed.

Individual Support Plan (ISP) describes, discusses, and ultimately make recommendations with respect to;
  • Current performance, which is frequently called “present level of performance”
  • Goal and objectives
  • Assessment
  • Services

The ISP is written collaboratively, with the parents and faculty of Vikas learning centre. Continuous monitoring of the ISP is done and required actions are done to help the child with special needs.

Neuro Developmental Theraphy

NDT-Neurodevelopmental Treatment

Neurodevelopmental treatment (NDT) is a hands-on treatment approach used by physical therapists, occupational therapists, and speech-language pathologists. NDT was developed to enhance the function of adults and children who have difficulty controlling movement as a result of neurological challenges, such as cerebral palsy, stroke, and head injury. This therapy uses guided or facilitated movements as a treatment strategy to ensure correlation of input from tactile, vestibular, and somatosensory receptors within the body.

NDT was developed with the understanding that patients with brain injuries have a limited repertoire of movement patterns. During treatment interventions, repeated experience in movement ensures that a particular pattern is readily accessible for motor performance. The more a patient performs certain movements, the easier these movements become. Without NDT interventions, the patient likely will develop a limited set of movement patterns that he or she will apply to nearly all tasks. NDT should begin before such generalized movement synergies become hard-wired in the patient’s brain.


The NDT-Bobath neurodevelopment therapy is directed towards our youngest patients, due to its non-invasive character, this can be conducted within the first days after the child’s birth. This technique of early rehabilitation tends to give the best results during the first year of a child’s life.
NDT-Bobath therapy is directed at newborns – including prematurely born children, infants and young children, especially those with:

  • developmental problems caused by prematurity
  • motor development disorders
  • muscle tone disorders (too strongly or too weakly tensed muscles)
  • problems because of care unsuitable for a child
  • feeding, suction and swallowing disorders
  • breastfeeding disorders
  • asymmetrical body
  • children repeating the same movement pattern
  • cerebral palsy
  • myelomeningocoele
  • congenital disorder
  • children with Down’s syndrome
  • problems with sensory integration
  • Problems with feet, bowleg or knock-knee.

The therapist’s work is based on controlling the child’s activity from so called “key points,” These areas are the head, neck, shoulder girdle and other body parts, in order to create proper posture patterns of a child, along with teaching him/her how to use and control them.

What are Primitive Reflexes?

Primitive Reflexes are primal movement patterns that develop in the womb. They help us through the process of birth and to survive our early lives, and operate automatically – like the knee jerk reaction. As we mature from birth to two years of age, these reflexes become inhibited by the development of higher brain functions. As we learn to move in more complex ways – the more primitive ways fade into the background. They are still there but are no longer needed.

Shocks and traumas (sometimes ever minor ones) can prevent the natural process of inhibition and this can lead to the body retaining the primitive reflex and being somewhat ‘stuck’ in a more primitive mode. Symptoms can be seen in physical movement but also in emotional and behavioral states.

What can happen if the Primitive Reflexes are not inhibited?

If they are not inhibited at the appropriate time they are said to be retained. The Primitive Reflexes should be inhibited by 12- 18 months of age. If this does not happen, the person may have these or other symptoms:

  • Poor gross motor skills (jumping, skipping, etc)
  • Poor fine motor skills (hand- eye coordination, manual dexterity)
  • Problems with perception – at all kinds of levels
  • Poor social skills
  • Emotional issues e.g. anxiety, shyness, and aggression
What causes the Primitive Reflexes to be retained?

There can be many suggested causes but the major ones are:

  • Severe stress during the pregnancy.
  • Traumatic birth e.g. emergency caesarean.
  • Prolonged or breach birth.
  • Premature birth
  • Significant upsets that cause shock – such as operations, concussions separation from Mom.
The most significant Primitive Reflexes are;

The Fear Paralysis Reflex

This reflex is the first one we know about. It is essentially the freeze response and is designed to protect you from shock or pain. From my own clinic experience – it will very often become activated if the body / nervous system feels that is under significant threat. The person is temporarily removed from pain or the threat of pain by being ‘absent’. I’ve worked with several children and adults whose freeze response began because of a car crash.

Some of the symptoms of a retained Fear Paralysis Reflex:

  • A layer of fear that is present around most decisions or new experiences.
  • Withdrawal
  • Fear of new things
  • Insecurity/ social isolation
  • Temper tantrums- often screaming loud & long in a new situation or one they consider threatening- or May go into “freeze mode” unable to think & move at the same time
  • Selective Mutism– failure to speak in certain situations and yet be able to speak freely otherwise
  • Excessive anxiety over seemingly trivial matters
  • Very often present in children with autism
The Moro Reflex

This reflex is basically the ‘fight or flight’ response. Our most basic reaction to threat is to freeze – after that we either fight or run. And again, these actions are controlled by the primal or instinct part of the brain. As babies the Moro reflex occurs so that we can do something to announce to Mom that we are in danger – that’s the theory behind why it is there. So what does it make us do?

In tiny babies their reaction to threat is to fling their arms open, scream and go pale or red in the face. This is the early ‘flight or fight’ reaction. Later in life we will still do this action if we get enough of a fright.

When the Moro reflex is retained the person is ‘stuck’ in fight or fright and the feeling that was present when the shock occured (i.e. car crash) is being triggered.

  • The child may be hypersensitive and immature or over reactive.
  • Moro driven people dislike change and are fearful of new things.
  • A change of routine in the classroom, even for something pleasurable, may cause a child to throw a tantrum that seems a huge overreaction to the rest of us.

These children may also react in one of two ways with their peers:

  • they may shrink away and be the withdrawn wallflower, observing but not participating, or
  • they may want to be the boss of the game all the time.

Other behaviours include;

  • constantly on the alert against perceived threat.
  • The eyes are constantly wandering to the periphery of the page, the blackboard or the classroom, so that they don’t remain on task.
  • They may also have difficulty when reading with the contrast of black print on white paper. Moro driven people can be extremely sensitive in many situations
  • The constant stress involved in its frequent emergence can cause a depleted immune response.
  • Difficulty showing and receiving affection as well as problems socialising, They often prefer to play with younger children.
The Bonding Reflex

The reflex has a huge impact on feelings of safety and security. If a child doesn’t feel safe in general, then a whole host of symptoms may be present. Common symptoms include;

  • Shyness
  • The need for constant reassurance ( needing Mom’s/ Dad’ attention)
  • Over sensitive to others feelings
  • Difficulties with authority
  • The child may be inclined to reject themselves and others with hostility and aggression.
  • Learning is made difficult because the child needs constant praise from the teacher.
The Palmar Reflex (11weeks in utero-3months of age)

These symptoms may indicate a retained Palmar reflex.:

  • Poor manual dexterity
  • Making movements with mouth when drawing
  • Speech problems pencil grip
  • The Palmar reflex is the automatic grasping movement of the hand if the palm is touched. It needs to be inhibited for efficient fine motor skills such as writing and sewing movements.
Asymmetric Tonic Neck Reflex (18 weeks in utero- 6 months of age)

These symptoms may indicate a retained ATNR:

  • Difficulty copying symmetrical figures
  • Balance affected if head moves to the side
  • Awkwardness skipping
  • Homolateral marching (same leg & arm)
  • Difficulty crossing the midline of the body
  • Poor eye tracking especially across the midline
  • Difficulty writing if looking at the board
  • Difficulty getting ideas onto paper
  • Difficulty learning to ride a bike

The mother’s contractions at birth stimulates this reflex and the baby’s movements then cause another contraction to occur. Hand- eye coordination is developed through this reflex: The baby turns its head, the eyes fixate on the hand stretching out or grasping an object. This is the start of awareness of distance. This reflex needs to be inhibited for smooth cross pattern crawling and creeping to develop. Trying to focus on the body position for writing and hanging on to the pencil so that the arm does not extend and fling it away, can require huge effort so it is not surprising that these children avoid written tasks & find school assignments really stressful.

Spinal Galant (20 weeks in utero – 9months of age)

If retained you may see these:

  • Fidgetting
  • Bedwetting
  • Poor short term memory & concentration

This reflex like the ATNR plays a part in assisting in the birthing process- as the hip moves it helps the baby into the birth canal. The lower spine on either side is very sensitive to touch so stimulation such as the elastic in underpants or moving against the back of a chair can result in a squirming movement. Stimulation on both sides of the spine simultaneously can cause defecation or wetting if this reflex is strongly retained. It may also affect fluency and mobility in sporting activities.

Tonic Labyrinthine Reflex

If retained you may see these symptoms:

  • Poor posture / stooping or walking on toes
  • Poor sense of balance
  • Car sickness
  • Poor sequencing skills
  • Lack of organisation
  • Poor sense of time
  • Stiff jerky movements / poor muscle tone
  • Difficulty judging distance, speed and depth

Some of these may seem contradictory symptoms. It is because there are two aspects to this reflex, one related to bending the neck down with the limbs bending & the other in tilting the neck back accompanied by straightening of the limbs. The development of this reflex takes the baby from its floppy curled up foetal position to one of strong muscle tone and the ability to straighten out & walk upright.

Symmetrical Tonic Neck Reflex ( 6- 9 months age — 9- 11months age)

These symptoms may indicate a retained STNR:

  • Poor posture
  • Can’t sit still
  • Slumps when sitting at a desk
  • Slow at copying tasks
  • Poor hand –eye coordination
  • Messy eater
  • Clumsy
  • Difficulty with overarm swimming

This reflex helps the baby to defy gravity & get up on hands and knees to crawl. It enables the child to move the two halves of the body independently. If retained the child may not crawl on hands & knees but do a “ bear walk” on hands & feet or shuffle along on their bottoms. A very important reflex for training the eyes to cross the midline, looking from one hand to the other as crawling develops. In reading they need to be able to read fluently across the page without losing the words on the midline. Crawling develops interaction between the vestibular, visual & proprioceptive systems. Without this, balance, space & depth perception will be poor.

Neurodevelopmental Technique/ Bobath Approach (opposite of Brunnstrom Approach)

Therapeutic Handling:

Therapeutic handling is used to influence the quality of the motor response and is carefully matched to the patient’s abilities to use sensory information and adapt movements. It includes neuromuscular facilitation, inhibition, or frequently a combination of the two. Manual contacts are used to:

  • Direct, regulate, and organize tactile, proprioceptive and vestibular input
  • Direct the client’s initiation of movement more efficiently and with more effective muscle synergies
  • Support or change alignment of the body in relation to the BOS and with respect to the force of gravity prior to and during movement sequences
  • Decrease the amount of force the client uses to stabilize body segments
  • Guide or redirect the direction, force, speed, and timing of muscle activation for successful task completion
  • Either constrain or increase the flexibility in the degrees of freedom needed to stabilize or move body segments in a functional activity
  • Dense the response of the client to sensory input and the movement outcome and provide nonverbal feed-back for reference of correction
  • Recognize when the client can become independent of the therapist’s assistance and take over control of posture and movement
  • Direct the client’s attention to meaningful aspects of the motor task

Key Point of Control:

Key points are parts of the body that the therapist chooses as optimal to control (inhibit or facilitate) postures and movement. Proximal key points include the shoulders and pelvis, which are used to influence proximal segments and trunk. Distal key points upper and lower extremities (typically the hands and feet). Key points of control are also used to provide inhibition of abnormal tone and postures. Examples include:

  • Head and trunk flexion decreases shoulder retraction, trunk and limb extension (key points of control: head and trunk)
  • Humeral external rotation and flexion to 90 degrees decreases flexion tone of the upper extremity (key point of control: humerus)
  • Thumb abduction and extension with forearm supination decreases flexion tone of the wrist and fingers (key point of control: the thumb).
  • Femoral external rotation and abduction decreases extensor/adductor tone of the lower extremity (key point of control: hip).
  • Facilitation: Components of posture and movement that are essential for successful functional task performance are facilitated through therapeutic handling and key points.
  • Inhibition: Components of posture and movement that are atypical and prevent development of desired motor patterns are inhibited. While originally this term referred strictly to the reduction of tone and abnormal reflexes, in current NDT practice it refers to reduction of any underlying impairment that interferes with functional performance.

It can be used to:

  • “Prevent or redirect those components of a movement that are unnecessary and interfere with intentional, coordinated movement,
  • Constrain the degrees of freedom, to decrease the amount of force the client uses to stabilize posture
  • Balance antagonistic muscle groups
  • Reduce spasticity or excessive muscle stiffness that interferes with moving specific segments of the body.”

Early Intervention Therapy

Early Intervention Therapy

Children at risk of a developmental delay or disorder are routinely referred to early intervention by their physician. If a child qualifies, he or she may receive a range of services at no (or low) cost to the family. Early Intervention is designed to improve outcomes for children with disabilities by providing early, appropriate, and intensive interventions.

Early Intervention program is one designed for young children in need of therapy services. Early intervention is for children who range from birth to 4 years of age who are at risk of developing a disabling condition or have a known condition / Diagnosis, or other special needs that may affect their overall development.

Who can benefit:

Our early programme is for children with identified disorders (such as cerebral palsy, autism, down syndrome, behavioural difficulties, sensory processing disorders, etc..) for children currently under diagnostic investigations, children at risk of developmental delay and for children who are typically developing, but may be experiencing a delay in one or more aspects of development.


Standardized testing is performed at the beginning and end with every child. The emphasis of Early intervention is on prevention, developmental facilitation and enrichment in playful and supportive environment. Parent education and participation in the activities of the early intervention programme are essential components. Parental involvement will take the form of identifying target goals in conjunction with clinicians, and reporting changes to support the aims of their child’s programme.

Program Details:

Our intervention strategies follow latest research, and we use a blend of evidence based approaches known to produce beneficial effects for the child. Focus of intervention is aimed at parent and caregiver education/facilitation and allowing the individual child flexibility in terms of choice, plays companions and materials, level of challenge, etc… Thus capitalizing on the child’s intrinsic motivation.

Sensory Integration Therapy

Sensory Integration Therapy

Sensory Integration Therapy for Sensory
processing disorders and Dyslexia.

Sensory integration therapy is designed to help kids with sensory processing issues. This type of therapy aims to adjust the way children respond to physical sensations. It is based on the idea that some kids experience ‘sensory over load’ and are oversensitive to certain types of stimulation. When children have sensory overload, their brain have trouble processing or filtering many sensation at once. Meanwhile, other kids are under sensitive to some kinds of stimulation. Kids who are under sensitive don’t process sensory messages quickly or efficiently.

These children may seem disconnected from their environment. Sensory integration therapy exposes children to sensory stimulation in a structured, repetitive manner. The theory behind this treatment approach is that, over time, the brain will adapt and allow them to process and react to sensation more efficiently.

Sensory integration is a subconscious and automatic neurological process that occurs in every person at all stages of life. Our brains take in information thorough our senses and organize. It so that we are able to respond appropriately to particular situations and environmental demands. Sensory experiences include touch, movement, body position, vision, smell, taste, sound and the pull of gravity.

Sensory integration therapy uses repetitive exercise to help a child experience other sensations more accurately. An intervention study involves observing the child in the class room and while at play. Parents are interviewed and an assessment is done. Based on that, recommendations are made which best suits the child and a plan of action is charted.

Autism’s symptoms often include difficulty processing sensory information such as textures, sounds, smells, tastes, brightness and movement. These difficulties can make ordinary situations feel overwhelming. As such, they can interfere with daily function and even isolate individuals and their families.

Sensory integration therapy, as practiced by occupational therapists, uses play activities in ways designed to change how the brain reacts to touch, sound, sight and movement. While the therapy is not new, it has remained somewhat controversial. “Part of the problem has been the many different techniques that have been used under the name sensory integration.

“The rationale is that by changing how sensations are processed by the brain, we help children with autism make better sense of the information they receive and use it to better participate in everyday tasks

For most people sensory integration develops in the course of ordinary childhood activities. When a person has good sensory integration then they are able to process information automatically and efficiently. But for some people, sensory integration does not develop as efficiently as it should and can affect activities of daily living, academic achievement, behavior or social participation.

Children can present with different types of sensory integration difficulties (also known as sensory processing processing difficulties).

These include:

Hyper (over) sensitive
  • Fear of heights
  • Dislike of touch experiences eg nail cutting, messy play, hair cutting
  • Dislike of loud and sudden sounds
  • Avoidance of playground equipment (swing and slides)
Hypo (under) sensitive
  • appears to have no fear or doesn’t feel pain
  • Seeks movement or touch opportunities’ (fidgets, rocks, run about, leans on peers)
  • mouth or chew things
  • poor attention to the environment or people around
Motor Planning (praxis)
  • Appears clumsy
  • Difficulty creating movements ideas
  • Difficulty planning and executing new movements
Poor posture
  • Slouches at desk
  • Fidgets/difficulty sitting in one position for extend period of time
  • Impact on fine motor coordination & ball skills
  • Impact on fine motor coordination & ball skills
  • Poor Balance

Sensory integration provides occupational therapists with a frame work for assessing and treating children who present with difficulties outlined above.

Different ways an occupational therapist may use an sensory integration approach:
  • Direct 1:1 therapy using specialized equipment
  • Provision of a sensory diet and sensory based therapeutic activities for home and school (see “calming and altering activities activity ideas” information sheet-coming soon)
  • Environmental adaptations at home and school (see ‘coping with classroom environment strategies’ information sheet – coming soon).
  • Consultation & education with careers and school.
Some areas of involvement are:
  • Balance and posture
  • Muscle tone and strength
  • Environmental adaptations at home and school (see ‘coping with classroom environment strategies’ information sheet – coming soon).
  • Body awareness
  • Fine motor abilities (pinching and grasping, manipulative skills, pencil and scissors use, hand writing)
  • Gross motor abilities (running, jumping, climbing)
  • Motor planning (ability to plan, initiate and execute a motor act)
  • Visual perception (shape recognition, visual memory)
  • Visual motor integration (copying shapes, copying block design)
  • Sensory integration (response to sensory stimuli, discrimination of sensory input)
  • Behaviour Modification (arousal level, attention, problem solving skills)
  • Self-care skills (eating , toilet habits, bathing)
  • Community living skills (management of money, shopping)
  • Pre academic skills (identify letters, sounds, shapes, colours and numbers)
  • Play skills are used as a tool to enhance life skills.
  • Social skills.

Standardized Assessments are conducted on a regular basis. These Assessments are for motor proficiency, visual perception, hand writing skills and sensory processing. These skills are evaluated and progress reports are sent to the parents along with their academic reports. Parents are trained at school so that they can continue the therapy at home to maintain continuity and regularity.

Some areas of involvement are:

Sensory process (or sensory integration) is the way in which the central nervous system of the body receives messages from the senses of the body and uses that information to act in appropriate motor or behavioral responses. Sensory processing disorder (SPD, also known as sensory integration dysfunction) is a condition in which the sensory signals received by the central nervous system do not become organized into an appropriate response. A child who has SPD may find it challenging to process and act appropriately his or her central nervous system receives sensory information which causes problems with carrying out activities of daily living. SPD can cause tremendous challenges for a child if it is not treated or managed appropriately.

Sensory processing disorder may affect only one sense – such as sight or hearing – or it can impact multiple senses and impacts each child in a different way. One child may react strongly to different textures of clothing while another may over-respond to loud sounds. Children with SPD may also have impairments of the joints and muscles, impacting posture and motor skills. Many children who have SPD are not immediately diagnosed with the condition as the disorder can be mistaken for ADHD. While this disorder is commonly diagnosed in childhood, many people reach adulthood without a proper diagnosis and may struggle with the symptoms of the disorder.

Children who have sensory processing disorder are effectively treated by a combination of physical and occupational therapy that focuses upon activities that strengthen a child’s ability to handle sensory stimuli appropriately. Over time, a child will learn to appropriately respond to sensory stimuli so that they are able to behave in a more positive manner in therapy, in school, and at home.

Types of Sensory Processing Disorders

There are certain subtypes of sensory processing disorder that may alter the course of treatment and diagnosis. The subtypes of SPD include:

Sensory Modulation Disorder: Children who have sensory modulation disorder have problems regulating the intensity and nature of responses to sensory input. The responses may be emotional or behavioral, negative responses to stimuli not averse to others, and the problems are exacerbated by stress. Common symptoms include:

  • Withdrawing from light and unexpected touch
  • Gagging and refusal to eat textured foods
  • Dislike of teeth-brushing, hair washing, or nail cutting
  • Avoidance of messy textures such as dirt or lotion
  • Avoidance of messy textures such as dirt or lotion
  • Strong preferences to certain types of clothing, including textures and fit
  • Over sensitivity to sounds or visual stimuli

Sensory Discrimination Disorder: Children who have sensory discrimination disorder have problems discerning and assigning proper meaning to qualities of particular sensory stimuli. These children may struggle with recognition and interpretation of characteristics of sensory stimuli, have poor detection of difference or similarities in the stimuli, and often occurs with dyspraxia and poor skill performance. Symptoms may include:

  • Difficulty manipulating an object when out of sight
  • Difficulties following directions
  • Challenges distinguishing between similar sounds
  • Problems finding an image in a cluttered background
  • Uses too much or too little force
  • Poor balance
  • Poor sense of movement speed

Postural-Ocular Disorder: Children with postural-ocular disorder have problems controlling or stabilizing the body during movements or at rest. Muscles may be hypo or hypertonic and joints may be unstable. Poor usage of vision and coulomotor control. Symptoms may include:

  • Poor posture control or strength
  • Poor equilibrium and balance
  • Difficulty isolating head-eye movements
  • Poor tracking of visual stimuli
  • Avoidance of upper extremity weight bearing
  • Discomfort climbing or fear of heights
  • Tires easily
  • Challenges establishing dominant hand (right or left handedness)

Dyspraxia: Children with dyspraxia have a deficit in their abilities to plan, sequence, or execute unfamiliar actions. Motor skills and movement may be awkward; these children may have poor ability to generalize learned skills to apply to other tasks, and may have poor timing, sequencing, and action of motor skills. Symptoms may include:

    • Trouble performing activities of daily living
    • Accident-prone and clumsiness
    • Resists new activities
    • Poor playing skills
    • Poor fine motor coordination
    • Poor articulation
Co-Occurring Disorders

Sensory processing disorder may occur with other types of disorders. The most common co-occurring disorders include:

      • Autism
      • Asperger syndrome
      • Attention-deficit hyperactivity disorder
      • Language disorders
      • Learning disabilities
      • Post-traumatic stress disorder
      • Fragile X syndrome
Causes of Sensory Processing Disorder

The precise cause for SPD is still unknown, although researchers are spending much time learning more about the condition. Some of the potential causes for SPD may include:

Genetic: Children born to adults who have autism spectrum disorders may be at higher risk for developing sensory processing disorder. Additionally, children with Asperger syndrome or autism are at a higher risk for developing SPD. Boys are more likely than girls to have SPD.

Sensory Modulation Disorder: Children who have sensory modulation disorder have problems regulating the intensity and nature of responses to sensory input. The responses may be emotional or behavioral, negative responses to stimuli not averse to others, and the problems are exacerbated by stress. Common symptoms include:

Symptoms of Sensory Processing Disorder

Children who have sensory processing disorder cannot properly process the sensory stimuli from the outside world and may have trouble interpreting information from one or more senses. As no two children with SPD have the same type of sensory dysfunction, the symptoms will vary tremendously from child to child and may include:

Behavioral Symptoms:

      • Withdraw when touched
      • Behavioural problems
      • Difficulties calming oneself after exercise or being upset
      • Refuse to eat certain foods due to the textures of the foods
      • Be hypersensitive to certain fabrics
      • Only wear soft clothes or clothes without tags
      • Dislike dirtying his or her hands
      • Do not engage in creative play
      • Lack variety in play – may watch the same television program over and over
      • Oversensitivity to sounds, especially hair dryers, washing machines, or sirens
      • Be oversensitive to odours – strong or mild
      • Have challenges with certain movements, such as swinging, sliding, or going down stairs
      • Notice or hear background noises that others cannot
      • May harm others during play accidentally

Physical Symptoms:

      • Have odd posture
      • Clumsiness
      • Poor balance
      • Delayed fine motor control, such as handwriting challenges
      • Delayed gross motor development
      • Impairments in sleep, eating, and elimination patterns
      • Be in constant motion
      • Jump, swing, spin excessively
      • Fatigue easily
      • Alternate between constant motion and fatigue
      • Poor coordination
      • May fall often
      • High tolerance to pain

Psycho social Symptoms:

      • Decreased ability to interact with peers
      • May stand too closely to others
      • Social isolation
      • Depression
      • Anxiety
      • Aggression
      • Fearful of crowds
      • Avoidance of standing in large groups
      • Fearful of surprise touch
Effects of Sensory Processing Disorder

As SPD may be undiagnosed, especially in older people, and left untreated for years, the long-term effects of living with SPD can cause significant impairment in their daily lives. Many healthcare professionals are not trained to recognize the symptoms of this disorder and as a result, diagnosis may be delayed for years.

The long-term effects of SPD may include:

    • Trouble maintaining a mainstream job
    • Challenges with interpersonal relationships
    • Inability to find pleasure in recreational activities that over stimulate the senses
    • Depression
    • Underachievement
    • Social isolation
    • Poor self-confidence
    • Decreased friendships
    • Low self-esteem
What is dyslexia?

In a person with dyslexia, the brain processes written material differently. This makes it hard to recognize, spell, and decode words.
People with dyslexia have problems understanding what they read. Dyslexia is a neurological and often genetic condition, and not the result of poor teaching, instruction, or upbringing. Between 5 and 15 percent of people in the United States have dyslexia.

  • Dyslexia commonly causes difficulties in word recognition, spelling, and decoding.
  • Dyslexia is different from delayed reading development, which may reflect mental disability or cultural deprivation.
  • The most common signs and symptoms associated with dyslexia can be displayed at any age, but they normally present in childhood.
Childhood symptoms of dyslexia include:

Difficulty in learning to read
Many children with dyslexia have normal intelligence and receive proper teaching and parental support, but they have difficulty learning to read.

Milestones reached later
Children with dyslexia may learn to crawl, walk, talk, and ride a bicycle later than the majority of others.

Delayed speech development
A child with dyslexia may take longer to learn to speak, and they may mispronounce words, find rhyming challenging, and appear not to distinguish between different word sounds.

Slow at learning sets of data
At school, children with dyslexia may take longer to learn the letters of the alphabet and how they are pronounced. There may be problems remembering the days of the week, months of the year, colors, and some arithmetic tables.

The child may seem clumsier than their peers. Catching a ball may be difficult. Poorer eye-hand coordination may be a symptom of other similar neurological conditions, including dyspraxia

Left and right
The child may confuse “left” and “right.”

They may reverse numbers and letters without realizing.

Some children with dyslexia might not follow a pattern of progression seen in other children. They may learn how to spell a word and completely forget the next day.

Speech problems
If a word has more than two syllables, phonological processing becomes much more challenging. For example, with the word “unfortunately” a person with dyslexia may be able to process the sounds “un” and “ly,” but not the ones in between.

Concentration span
Children with dyslexia commonly find it hard to concentrate. Many adults with dyslexia say this is because, after a few minutes of non-stop struggling, the child is mentally exhausted. A higher number of children with dyslexia also have attention deficit hyperactivity disorder (ADHD), compared with the rest of the population.

Sequencing ideas
When a person with dyslexia expresses a sequence of ideas, they may seem illogical or unconnected.


Dyslexia can be broken down into different subtypes, but there is no official list of dyslexia types because they can be classified in different ways.
However, the following categories are sometimes used:

Phonological dyslexia:
The person has difficulty breaking down words into smaller units, making it hard to match sounds with their written form. This is also known as dysphonetic dyslexia or auditory dyslexia.

Surface dyslexia:
The person cannot recognize a word by sight, making words hard to remember and learn. This is sometimes called dyseidectic dyslexia or visual dyslexia.

Rapid naming deficit:
The person cannot quickly name a letter or number when they see it.

Double deficit dyslexia:
The person finds it hard to isolate sounds also to name letters and numbers.

Visual dyslexia:
The person has an unusual visual experience when looking at words, although this can overlap with surface dyslexia. Sometimes people refer to “directional dyslexia,” meaning it is difficult to tell left from right. This is a common feature of dyslexia, but it is not a type.
If a person has difficulty with math learning, the correct term for this is dyscalculia. It is not dyslexia.

Phonological Deficit:
Difficulty decoding or assembling words based on their sounds. Note that phonemic awareness is not a reading deficit per se since it involves only sounds and not letters.

Speed Naming Deficit:
Slow reading: poor use of sight. A sight word is a word that is instantly recognized by the reader: is not sounded out, and requires almost no effort to understand.

Comprehension Deficit
Poor understanding of what was just read.

By Sensory System

Auditory Dyslexia
Auditory Dyslexia involves difficulty processing sounds of letters or groups of letters. Multiple sounds may be fused as a singular sound. For Examples the word ‘back’ will be heard as a single sound rather than something made up of the sounds /b/ – /aa/ – /ck/. Single syllable words are especially prone to this problem.

Visual Dyslexia
Visual dyslexia is defined as reading difficulty resulting from vision related problems. Though the term is a misnomer, visual problems can definitely lead to reading and learning problems.

Attentional Dyslexia
Attentional Dyslexia in which children identify letters correctly, but the letters jump between words on the page. “kind wing” would be read as “wind king”. The substitutions are not caused by an inability letters or convert them to sounds, but instead result from the migration of letters between words-the first letters of one word switches place with the first letter of another word.

By Deficit

Phonological Dyslexia
Phonological dyslexia is extreme difficulty reading that is a result of phonological impairment, meaning the ability to manipulate the basic sounds of language. The individual sounds of language become ‘sticky’, unable to be broken apart and manipulated easily.

Surface Dyslexia
A type of dyslexia characterized by difficulty with whole word recognition and spelling, especially when the words have irregular spelling sound correspondences”.

Deep Dyslexia
Deep dyslexia is an acquired form of dyslexia, meaning it does not typically result from genetic, hereditary (developmental) cause. It represents a loss of existing capacity to read, often because of head trauma or stroke that affects the left side of the brain. It is distinguished by two things: semantic errors and difficulty reading non-words.

By Time of Onset:

Developmental Dyslexia
Developmental dyslexia is not so much a type of dyslexia, it is dyslexia. In fact our definition of it would be the same as our definition of dyslexia generally: Extreme difficulty reading caused by a hereditary, brain based, Phonologic disability. So why do people use the term instead of just saying dyslexia? The simple answer is they are trying to be more specific, distinguishing ‘regular’ dyslexia from the other types of dyslexia. In particular, distinguishing it from acquired forms of dyslexia that result from stroke or head trauma for example, which often present very differently. For more on developmental dyslexia.

Acquired Dyslexia
This type results from trauma or injury to that part of the brain that controls reading and writing. Late in life this can be the result of a tumor or stroke.

Other Dyslexia Types:

Directional Dyslexia
Directional dyslexia is distinguished by left-right confusion and tendency to become disoriented or lost. The term is also occasionally used to mean confusion with letters such as P and b or d and b, where there is confusion over the ‘direction’ of the letter. Generally, problems with direction are a symptom of dyslexia more than a sub type. Not all dyslexics have this problem.

Math Dyslexia (Dyscalculia)
Math dyslexia or dyscalculia is not, in fact, a type of dyslexia, but we included it here because the term is frequently used. According to the U.S National Center for Learning Disabilities, math dyslexia, or dyscalculia, refers to wide range of lifelong learning disabilities involving math, varies from person to person and affects people differently at different stages of life

As with reading, when basic math skills are not mastered early, more advanced math becomes extremely difficult. Approximately half of people with dyslexia also have dyscalculia, though far less research has been conducted regarding testing, assessment and remediation.

Language Disorder group, Articulary and Dyscoordination Group and a Visual spatial Perceptual Disorder group

They divided the children into three groups: (I) those with brain damage who could read, (II) those with brain damage who were dyslexic and (III) those without brain damage who were dyslexic. Interestingly enough they found a similarity between those with developmental dyslexia and those with brain-damage dyslexia. On the basis of these results and a battery of neuropsychological examinations, they divided dyslexia into three syndromes.

  • Syndrome I Language Disorder- This syndrome is characterized with anomia, comprehension deficits, confused imitative speech and speech- sound discrimination. Vision and motor coordination is normal.
  • Syndrome II Articulatory and Graphomotor Dyscoordination- Children with this syndrome have gross and fine motor coordination disorders. They have poor speech and graphomotor coordination.
  • Syndrome III: Visuospatial Perceptual Disorder- These children score 10 points more on verbal IQ than performance IQ. Their visuospatial perception is very poor, as is their ability to store and retrieve visual stimuli.
What is dyspraxia?

Dyspraxia is a neurological disorder that impacts an individual’s ability to plan and process motor tasks.

Individuals with dyspraxia often have language problems, and sometimes a degree of difficulty with thought and perception. Dyspraxia, however, does not affect the person’s intelligence, although it can cause learning problems in children.

Developmental dyspraxia is an immaturity of the organization of movement. The brain does not process information in a way that allows for a full transmission of neural messages.<br.
A person with dyspraxia finds it difficult to plan what to do, and how to do it.

The National Institute of Neurological Disorders and Stroke (NINDS) describes people with dyspraxia as being “out of sync” with their environment.

Experts say that about 10 percent of people have some degree of dyspraxia, while approximately 2 percent have it severely. Four out of every 5 children with evident dyspraxia are boys, although there is some debate as to whether dyspraxia might be under-diagnosed in girls.

According to the National Health Service, United Kingdom, many children with dyspraxia also have attention deficit hyperactivity disorder (ADHD).

Symptoms of dyspraxia

Symptoms tend to vary depending on the age of the individual. Later, we will look at each age group in more detail. Some of the general symptoms of dyspraxia include:

  • poor balance
  • poor posture
  • fatigue
  • clumsiness
  • differences in speech
  • perception problems
  • poor hand-eye coordination
Diagnosis of dyspraxia

A diagnosis of dyspraxia can be made by a clinical psychologist, an educational psychologist, a pediatrician, or an occupational therapist. Any parent who suspects their child may have dyspraxia should see their doctor.

When carrying out an assessment, details will be required regarding the child’s developmental history, intellectual ability, and gross and fine motor skills:

  • Gross motor skills – how well the child uses large muscles that coordinate body movement, including jumping, throwing, walking, running, and maintaining balance.
  • Fine motor skills – how well the child can use smaller muscles, including tying shoelaces, doing up buttons, cutting out shapes with a pair of scissors, and writing.
    The evaluator will need to know when and how developmental milestones, such as walking, crawling, and speaking were reached. The child will be evaluated for balance, touch sensitivity, and variations on walking activities.

Dyspraxia in children
Dyspraxia symptoms may vary depending on age. With that in mind, we will look at each age individually. Not every individual will have all of the symptoms outlined below:

Very early childhood
The child may take longer than other children to:

  • Sit.
  • Crawl –the Dyspraxia Foundation says that many never go through the crawling stage.
  • Walk.
  • Speak –according to the Children’s Hospital at West mead, Australia, the child may be slower in answering questions, find it hard to make sounds, or repeat sequences of sounds or words; they may also have difficulty in sustaining normal intonation patterns, have a very limited automatic vocabulary, speak more slowly than other children, and use fewer words with more pauses
  • Stand.
  • Become potty trained (get out of diapers).
  • Build up vocabulary.
  • Early childhood
Tying shoelaces can be a difficult task for children suffering with dyspraxia.

Later on, the following difficulties may become apparent:

  • Problems performing subtle movements, such as tying shoelaces, doing up buttons and zips, using cutlery, and handwriting.
  • Many will have difficulties getting dressed.
  • Problems carrying out playground movements, such as jumping, playing hopscotch, catching a ball, kicking a ball, hopping, and skipping.
  • Problems with classroom movements, such as using scissors, coloring, drawing, playing jigsaw games.
  • Problems processing thoughts.
  • Difficulties with concentration. Children with dyspraxia commonly find it hard to focus on one thing for long.
  • The child finds it harder than other kids to join in playground games.
  • The child will fidget more than other children.
  • Some find it hard to go up and down stairs.
  • A higher tendency to bump into things, to fall over, and to drop things.
  • Difficulty in learning new skills – while other children may do this automatically, a child with dyspraxia takes longer. Encouragement and practice help enormously.
  • Writing stories can be much more challenging for a child with dyspraxia, as can copying from a blackboard.

The following are also common at pre-school age:

  • Finds it hard to keep friends
  • Behaviour when in the company of others may seem unusual.
  • Hesitates in most actions, seems slow.
  • Does not hold a pencil with a good grip.
  • Such concepts as ‘in’, ‘out’, ‘in front of’ are hard to handle automatically.

Later on in childhood

  • Many of the challenges listed above do not improve or only improve slightly.
  • Tries to avoid sports.
  • Learns well on a one-on-one basis, but nowhere near as well in class with other children around.
  • Reacts to all stimuli equally (not filtering out irrelevant stimuli automatically)
  • Mathematics and writing are difficult.
  • Spends a long time getting writing done.
  • Does not follow instructions.
  • Does not remember instructions.
  • Is badly organized.

Dyspraxia in adults , symptoms include:

  • Poor posture and fatigue.
  • Trouble completing normal chores.
  • Less close control – writing and drawing are difficult.
  • Difficulty coordinating both sides of the body.
  • Unclear speech, often word order can be jumbled.
  • Clumsy movement and tendency to trip over.
  • Grooming and dressing more challenging – shaving, applying makeup, fastening clothes, tying shoelaces.
  • Poor hand-eye coordination.
  • Difficulty planning and organizing thoughts and tasks.
  • Easily frustrated.
  • Less sensitive to non-verbal signals.
  • Low self-esteem.
  • Difficulty sleeping.
  • Difficulty distinguishing sounds from background noise.
  • Notable lack of rhythm when dancing or exercising.

Social and sensory – individuals with dyspraxia may be extremely sensitive to taste, light, touch, and/or noise. There may also be a lack of awareness of potential dangers. Many experience moods swings and display erratic behavior.

How does one determine which sensory perception areas should be trained?

If the child displays more than one deficiency in the following areas, then these areas of sensory perception should be trained:

Visual recognition
  • Basic essentials cannot be understood from what is seen
  • Visually similar things are not recognized as different
  • Distinguishing important information from a multitude of stimuli is unsuccessful
  • The ability to filter something out of the background is lacking
  • The child must touch/handle everything in order to understand it
  • Difficulties with distinguishing between colours and shapes
  • Writing and recognition of letters is difficult
  • Handwriting is untidy and difficult to read
  • Lack of uniformity in the size of the letters
  • Uneven reproduction of letters and numbers
  • Confusion between letters which are different in placement (d/b, u/n)
  • The ability to distinguish between visually similar letters, arithmetical symbols, and numbers (h-k, a-o, 7-4, 6-5) is severely lacking
  • Inverted (left to right or right to left) reading or writing of numbers, for example 6 and 9
  • Increasingly occurring copy errors
  • Difficulties grasping amounts
  • Omission of letters or numbers
  • Difficulties with quantities over ten
  • Difficulties with compound arithmetic problems
  • Difficulties with structuring text exercises
Visual memory
  • Visual information is not retrained
  • Difficulties in recognizing colours, shapes, images, patterns, and objects
  • Memorization of word images does not succeed: words are often written properly ten times, then incorrectly again
  • Difficulties with drawing patterns from memory
  • Transposition of letters a-e-o, h-k, f-t, m-n
  • The child cannot find his place in the text when reading
  • Frequently checking the pattern while copying
  • The writing is angular, curvatures and lengths are different
  • The letters a-e-o appear the same
Visual sequencing
  • Visual sequences cannot be perceived properly
  • Difficulties with grasping the succession of letters when reading together
  • Reversing the sequence of letters when reading and writing
  • Letters or syllables are missing, they are transposed or added
  • Halting, slow reading
  • Assistance articulating, prompting of a given text
  • Switching the word order when writing
  • Omission of letters, endings or words when writing
  • Duplication of letters
  • Frequent subsequent additions of missing letters in a word
  • Uneven line spacing and spaces of the letters within a word as well as between the words
  • Reversal of the sequence of a story (for instance, while writing compositions)
  • Distraction by small details and losing the place in the story
  • Incorrect sequencing of numbers, omission of digits
  • Difficulties counting and counting off
  • Difficulties grasping amounts
  • Slow learning of basic arithmetic skills
  • Omission of intermediate steps when doing arithmetic
Acoustical recognition
  • The basics of the sounds heard cannot be grasped
  • The ability to distinguish whether sounds are the same or not is severely lacking
  • A sound is matched with the wrong letter
  • Removing a letter from a word does not work
  • Inability to distinguish between or transposition of similarly sounding noises, words or numbers
  • Ability to distinguish between vocalized and non-vocalized consonants is severely lacking: g-k, b-p, d-t, s-z, f-v
  • Ability to distinguish between diphthongs is severely lacking: ei-eu, eu-au
  • Transposition of elongation and sharpening
  • Difficulties distinguishing between m and n, for example between 3. and 4. case
  • Difficulties repeating the same or similar words
  • Difficulties repeating unfamiliar words
  • Difficulties transcribing a series of spoken words
Acoustical memory
  • Cannot remember and repeat what was heard
  • Frequent questions when reciting
  • Omissions or additions of letters, syllables or words
  • Failure to complete recitations
  • Severe difficulty understanding what was heard
  • Errors with b/p, d/t, g/k
  • Poor vocabulary, frequent repetitions of words
  • Short compositions with poor content
  • Prompting of sentences
  • Omission of parts of verbally assigned arithmetic problems
  • Assistance articulating, prompting of a given text or arithmetic problem
Acoustical sequencing
  • Acoustical sequences are not perceived correctly
  • Muddled explanations, loses the thread easily
  • Difficulties with verbally presenting sentences with the correct word order and placed correctly in the thought process
  • Difficulties avoiding becoming distracted by minor details when telling a story
  • Halting, broken speech with inharmonious breathing
Spatial orientation
  • Spatial perception is not judged correctly
  • Ability to judge spatial and temporal measures (distances, amounts, and units) is severely lacking
  • Difficulties orienting oneself in an unfamiliar environment
  • Memorizing a specified route is tiring
  • Building to a pattern or blueprint (building games) is unsuccessful
  • Difficulties learning to tell time
  • Very slow learning to dress oneself
  • Riding a bicycle and swimming are learned much later
  • Ability to imitate rhythmic movements is severely lacking
  • Problems with singing and movement games
  • Ignoring given spatial instructions
  • Uneven line spacing
  • Cannot arrange the lines properly, writing outside the margins
  • Losing the line when reading
  • Inverted writing (right to left instead of left to right)
  • Transposition of letters when distinguishing their position: b-d, b-p
  • Numbers are transposed: 6-9, 36-63
Body perception
  • Difficulties orienting oneself to one’s own body
  • Confusion between right-left, above-below, behind-before (in back of-in front of)

Occupational Therapy

Occupational Therapy

Occupational Therapy enables students to improve their development and prevents disability from impacting their functioning in daily life. It also focuses on the promotion, restoration and mainstreaming of productivity in people with wide range of abilities and disabilities.

Occupational Therapy may include adaptations of task or environment to achieve maximum independence to enhance the quality of life. Occupational therapy has a definite role in helping / treating children with sensory processing deficits.

Occupational Therapists aim at enabling the child to be as physically, psychologically and socially independent as possible. Occupational therapists work with children who have inadequate motor coordination and planning (praxis), sensory processing dysfunction, social-emotional imbalance, impaired cognitive functions, poor academic performance and limited play skills.

Occupational Therapists use a knowledge base of neurology, anatomy, physiology, kinesiology, child development and child psychology, psycho social development, activity analysis, and therapeutic techniques. They are trained to treat clients holistically, addressing their cognitive, emotional, and physical needs through functional, activity-based treatment. When working in paediatrics, occupational therapists select activities that are of interest and have meaning for children, and that also meet therapeutic goals.

What is Occupational Therapy?

Many people think the word “Occupation” is a work related term: however, an occupation can be anything someone does to occupy his or her time in everyday life. Groups of activities constitute an occupatio9n. For Example, work, leisure / play and self-care are general occupation. Within each of these are components of one or more activities. Self-care includes many activities of daily living such as brushing your teeth, bathing, eating, and dressing. Leisure / play. Can involve reading, writing, teaching, or typing. Activities are the building blocks or components of human occupation.

“Occupational therapy is an allied health profession concerned with improving a person’s occupational performance. In a pediatric setting, the occupational therapist deals with children whose occupations are usually play, preschoolers, or students.

Visual Motor Skills:

Difficulty coordinating hand movements / skills using the eyes. Copying shapes, connecting dots, drawing through mazes, difficulty cutting on a line, or writing and drawing.

Visual Perceptual Skills:

Difficulty labelling letters / numbers / shapes, discriminating difference between forms, difficulty putting puzzles together, difficulty remembering forms, difficulty locating objects in a distracting background, matching similar objects / forms, and trouble copying when writing or drawing.

Postural Control:

Sits in a slouched manner at a table or desk, props head up with hand while sitting, fidgets constantly in chair, falls out of chair or falls down while navigating the environment, relies on railing to climb stairs, frequently bumps into people or objects, props self up against people or objects, has poor endurance and poor balance.

General Gross Motor Skills:

Difficulty maintaining balance when standing on one foot, difficulty negotiating playground equipment, unable to hop, jump, skip, gallop, or walk on a line, appears awkward when running, avoids physical education or sports activities.

In-hand Manipulation / Fine Motor Skills:

Drops or has poor control of small objects ( pegs, beads, coins ), difficulty using both hands at the same time or always uses one hand, has hand dominance confusion, difficulty grasping pencil, marker, crayon, hand muscle appear weak and movements seem awkward.

Psychosocial Skills:

Problem with transitions (stop and starts tasks with an adverse reaction), becomes frustrated or upset easily, has difficulty making friends, has low self-esteem.

Attention / Arousal:

Doesn’t respond to his/her name, looks “space out”, becomes easily distracted, fidgets often, misses verbal directions or needs directions repeated, impulsive, seems lethargic or over-active and cannot adjust arousal level for a task.

Play Skills:

Difficulty with sharing, becomes upset when losing a game, difficulty following rules, tends to play alone rather than with peers, doesn’t understand how to join peers in play or how to initiate play.

Sensory processing and / or Modulation:

The child could be under/over-responsive to ordinary sensations from the body or environment (sounds feel too loud or the person cannot tune into what is said, unexpected touch might feel uncomfortable or the person touches everything/everyone constantly) or sensory information is not processing accurately causing poor coordination and/or body in space awareness.

Literacy Class

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Dance Class

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Art Class

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Yoga Class

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