Child Development Network

The Short-term goals identified, and how these are achieved, clearly varies with each child. This page works through an example for an 8 year old boy, to provide some idea of the process.

James

Your boy James has Learning Disabilities in addition to an Attention Deficit type of problem that impact on his learning to read, write and spell. He is in grade 3, and his mood has changed - he is often grumpy, says he is 'dumb', and beginning to avoid doing schoolwork.

Through the assessment process you now understand these problems. You can understand

• What causes his difficulties - what ADHD and Language LD mean
• Why these are present (the presumed neurological cause)
• How 'bad' or severe his problems are (so you can tell if he is improving)
• How they impact on his life now (learning, behaviour, self-esteem)
• Whether they are going to go away (probably not)
• How they could impact on his life in the future (learning, social, mental health)

Your short term goals, to be achieved over the next 6 months are:

1. To improve James' mood and self esteem
2. To improve James' attitude to school and literacy in particular
3. That James' ability to concentrate improves so he can sit and try for a reasonable length of time
4. To ensure that James' school understands his problems, and uses that understanding to help him in the most appropriate way
5. To ensure James' school understands that the problems are likely to persist throughout primary (and secondary) education, and there are plans to continue support across the educational years.

As with other parents, once you realise that the problems are real rather than temporary, the goals change. Previously, the emphasis had been on 'fixing' the difficulty with therapy and additional learning support at school. Unfortunately James' compliance with this was not very good.

Achieving these goals

Having set these goals we meet to discuss how they might be achieved. The following are some ideas that were generated from that discussion:

To improve James' mood and self esteem

James used to be happy. He still is much of the time - especially when playing with his friends. It is clear that James is never going to feel excellent with the literacy side of schoolwork, so we can't build his self esteem just by helping him read better. How? Here are some of the strategies:

• To spend more time doing what he is good at, enjoys, and is likely to receive positive feedback from. For James this is sport and spending time with friends.
• To protect James academically. He is OK at Maths, so to make sure he is not penalised in Maths for his poor reading. In other words, to get somebody to read maths problems to him or at least make sure he has understood the written part.
• To help James understand that he does have a problem, that it isn't his fault, that it doesn't mean he is stupid, and there is a reason why literacy schoolwork is hard
• To negotiate with James around his literacy: because he has a problem he must do extra work, but he has a say how. For example, he may hate being pulled out of class (and stigmatised). The amount of homework may be cut to a fixed period of time. He may prefer an extra tutor after school.

Usually, once the goal has been set, parents and professionals can come up with many interesting and innovative strategies. These are just a few.

To improve James' attitude to school and literacy

This goal follows on from #1. To achieve this, the crucial elements are that James understands he needs extra help can co-operate, and that the demands placed on him are:

• Balanced - the hard work balances the fun part of his life
• Achievable - expectations match his abilities
• Sustainable - a slow continuous process of assistance rather than short intensive remediation.

A good way to sort this out is to imagine you were James. How would you feel about school and schoolwork? You didn't ask to do it - your parents and the school did that. You go along and it is much harder than for the other kids. How would you feel?

That James' ability to concentrate improves so he can sit and try for a reasonable length of time.

The first step to improving attention is to make sure there are no other contributing factors:

The work may be too hard (so he cannot sustain concentration). Step 1 is to make sure that the expectations match his abilities.

He may be angry, anxious or emotionally not ready to concentrate in some other way. Step 2 is to make sure his mood and attitude are appropriate for learning.

He may be tired or there may be some other medical process going on (this is not very common).

If we have ruled out all other possible reasons, and James is still having trouble concentrating, to the extent that it is hindering his learning. At this stage the possible use of medication may need to be discussed with your doctor

To ensure that James' school understands his problems, and uses that understanding to help him in the most appropriate way

A very important aspect to managing child development problems is to make sure everybody dealing with the child is doing so with the same understanding (beliefs), so that their expectations are similar wherever the child goes. Even within the same school, some may believe there is a problem, others may think James is lazy, has a bad attitude, or that the cause is problems at home.

We have found that a 'plain English' summary of the assessment can help. The first strategy would be to get a report in writing that summarises James difficulties, so that all those involved with James can read it.

Although this helps it may not be enough. A more powerful strategy is for the health professional to visit the school. For doctors, there is now a Medicare rebate that covers most of the cost for this. For psychologists and other professionals the cost will be related to the time spent.

We organise school visits with some care - who will be there, how long, what the main goal of the visit is, and what the actual 'agenda' for that visit should be. In setting the agenda, we usually invite the school to tell us what they want from us. For all school visits we expect, or strongly encourage, all parents to attend. For James, a school visit by the health professional could be very powerful in changing the schools understandings, beliefs, attitudes and what they do as a result.

To ensure James' school understands that the problems are likely to persist throughout primary (and secondary) education, and there are plans to continue support across the educational years.

This is a specific topic for discussion at the school visit. For this it is important that the School Principal (Deputy, or Head of Special Education) is actively involved because they can make sure plans are carried continuously from year to year.

Reviewing / resetting the goals

It is now 6 months later. We meet and pull out the written goals.

Have we achieved them successfully? If so, congratulations! In addition to helping your child, this is a powerful message that you can be 'in control' - you can set goals for the future and achieve them. Your own goals, not somebody else's.

If they have been achieved successfully, what are the short-term goals for the next 6 months? If they are only partially achieved, why? What can we change in the next 6 months? Do we need new goals, or the same ones with different strategies?