My point in writing many of these articles is to dispel the plethora of urban myths, which abound around kids who struggle. The sad truth is that most of what is said is without substance; and, probably the only reason these myths continue to be perpetuated, is because the actual reality of these kids performance, is not seen by most and, has yet to permeate throughout society.
Such children continue to be seen through an inappropriate lens, giving rise to speculation and a superficial understanding of their performance. Their struggle is functional, not educational or psychological and it has to do with how we perform those very tasks they struggle with; and what has gone wrong for them.
I’ve been working with kids for over 10 years now and I have yet to meet a child who has a 'learning disability.' I have also yet to meet a child who has subnormal intelligence or where ‘intelligence’ is an issue. I have, however, met a great many children who have had their struggle completely resolved, and have gone on to catch up to or surpass their peer’s performance and done so very quickly. Unlike most therapists, I do not work with these kids for months or years and I do not develop huge and unwieldly management plans. Nor do I have children practicing the very things they have already demonstrated they cannot do. I don’t do these things because they are totally and absolutely unnecessary. Life can be challenging enough, without the adults adding to the burdens of the children.
The reality is simple, if we are actually going to assist children overcome their struggles and move forward in life, we need to understand what they are struggling with. I often say that whenever a child is struggling with an everyday task, that task is not the problem; it’s only ever a symptom of something deeper, and that something is how they are processing and integrating sensory information.
Now while there is a lot of interest in this field of sensory processing and integration, and I know a lot of people tell us they are addressing these issues, mostly they are not. The most common practices and interventions used with these kids are entirely symptomatic and superficial, which typically amount to nothing more than having the child practice the very things they have already demonstrated they cannot do. In order to actually address the cause of the breakdown in the child’s performance, we have to understand how it is we process and integrate sensory information and how, in turn, we generate our task performance.
Once we understand what I have just outlined, we realise that most of the world is only ever focusing on the icing on the cake, without having any idea what that cake is actually made of and how those ingredients combine together. Developing such an understanding is the first step in leaving all that superficial stuff behind, and getting down to the reality of why kids struggle.
When I am working with kids, it’s important that we leave the nonsense behind. It serves no purpose here, other than distracting us from the truth. So, I do ask that parents make some rather rapid adjustments in perspective, because there is no point in talking about things that have nothing to do with their child or their struggle. We need to move on and start dealing with the reality of the child’s situation – we need to start looking at how the cake was made, rather than commenting on the icing.
One of the consequences of this is that I am not so interested in what others say about your child, at least not all the technical mumbo jumbo or the labels commonly used. I am, however, very interested in what your child does and how they do it, because these observations tell me a great deal about how the child’s performance has broken down and what I may find when I evaluate them. Most of the labels in use these days are devoid of any meaning. Probably the only one that has any use to me is dyslexia, because it tells me that there is a breakdown in the child’s ability to use visual cues relative to one another, and this is very much an issue of visual perceptual performance.
It’s important that we deal with the reality of what the child is doing, and we can only do this by understanding how any of us perform some rather sophisticated and refined tasks. The fact is that those tasks your child is struggling with are anything but simple. In order to perform them, anyone of us has to combine together layer upon layer of information and performance and, if any one thing within that symphony is not quite right, it affects the whole of the performance. Any fault in any of the basic skills, abilities and processes we use at the core of our performance, will be replicated throughout the entirety of performance, and the same is true for any sensory information left out of our processing and integration. The process of our visual perceptual performance and task performance magnifies what is going on at its very heart, making the child’s struggle seem far greater than it actually is.
The Visual Perceptual Therapy has evolved as an invitation to any and all clients, to show me what they do and how they do it and so that I can show them new ways of performing, which actually work. The evaluation process I utilise is incredibly revealing and it is not uncommon for parents to be shocked at the simple tasks their child is actually struggling with.
It is so common for them to remark on how obvious it is, that if the child is struggling with these tasks, it is no wonder they are struggling in the classroom or with reading, etc. It is also not uncommon for a tear or two to be shed, when it is realised the level the child is actually performing at. But I always counsel parents that they just did not know and could not have known, and that no one else they have talked to, knew either. The point is that from now onwards, we can do things differently because we do know. However, you better be on your toes, because things are never going to be the same again for your child. They will take what I show them and naturally apply this to everything in their life and, within a very short space of time, usually within 3 – 6 months; you will look back and go WOW. So often parents remark that the child that finished the therapy, is not the same as the child who began it and the transformation is so profound that we are all left unable to explain it fully.
Fundamentally, it is my job, to identify what components of the child’s performance are not functioning as they should and to correct this. Our brains are incredibly interesting; in-as-much-as we can actually provide the means for their structure and performance to be modified, in some truly profound ways. We have to accept that the child who struggles is telling us one thing; that they just cannot perform those tasks they struggle with. So, instead of having them endlessly practice what they cannot do, we have to look at why they cannot. Visual perceptual performance allows us to do this.
The Visual Perceptual Therapy Structure
Our first contact will usually be by way of a consultation. I do most of my consultations via Skype because it is convenient to all and we don’t have to travel to do this. The child does not attend these consultations, and this allows the parent to tell me all of their concerns, without the child having to hear about them. Parents tend to be more honest and forthcoming when their child is not present and so I am able to gather a lot more information in this way.
I am only interested in the observations parents have. I am not so interested in the results of any testing you have had done and I’m not interested in the big words that are often used. It is enough to tell me that the child’s handwriting is an issue and why, without calling it dysgraphia. Practical and simple is the name of the game, because it just doesn’t have to be complex or complicated.
I do have a list of questions I run through with parents. This list is about identifying things the child does, or patterns of behaviour that are related to specific visual perceptual deficits, or about ruling some things out. I do suggest that all parents have their child’s vison and hearing tested as there can be issues here and I have seen such things before. I recall one 8 year old girl whose method of reading was highly indicative that she was not seeing the letters clearly and I recall a 12 year old girl who required two eye surgeries because of an issue she had. These two assessments are something that parents can do themselves, to rule out potential problems.
During this consultation I will be able to tell you whether or not I can help your child and I will be able to provide you with a lot of answers as to why your child is doing what they are. I can also explain why things such as handwriting, and conditions such as ‘auditory processing disorder,’ are actually caused by a visual perceptual deficit. There are also some very intimate relationships between speech and language development and visual perceptual performance.
The Visual Perceptual Therapy
The therapy is either carried out in person or via Skype. Those who live somewhere other than The Gold Coast, Australia or Christchurch, New Zealand, will need to undergo a short session of training with me, so that they can assist me at their end, with presenting tasks, etc, to the child.
The therapy sessions run for 2 hours and I will see the child only once every two weeks. The probable number of session the child will need will have been identified in the consultation, but we will need to complete the visual perceptual evaluation before we can confirm this. It is just not possible to make a full determination of the nature of the child’s visual perceptual deficit, without the evaluation.
The reason why I utilise relatively long therapy sessions is that longer sessions mean we can work at a more relaxed pace, without placing undue pressure on the child. The initial consultation would have given me a very good idea about the child and whether or not they can cope with these sessions. If they cannot, the sessions will be adapted according to their needs.
Regardless of where or how the Visual Perceptual Therapy will be conducted, the parent/s need to be present for them. There is enormous value to the parents, in observing their child and their performance. These sessions are truly revealing as to what the child is doing and why. You will also get to see the progress the child makes in session, which most parents find intensely reassuring. Some children do become upset in the therapy.
Often this is more about how others have engaged with them in the past and their sadness, anxiety or frustration bubbles up to the surface. The idea that they are less than or in some way or a failure, is an all too common a feature in these children and there is nothing better than Mum’s hug, to help heal these children’s emotional woundings in these moments.
If the sessions are conducted via Skype, they will be recorded and that recording will be made available to you, so that you can show it to other family members or the child’s teacher. I encourage parents to do this, so that the child’s circumstances can be fully appreciated by all. Too often I hear these children condemned to judgements about their behaviour, where such behaviour is telling us so much about their actual task performance, and how others are interacting with them. It is not fair to judge these children on the basis of behaviour, if we do not have the background or capacity to understand what they are actually conveying. It is far too common that I come across attitude that children get up in the morning, plotting the downfall of the empire, when nothing is further from the truth.
At the completion of the first therapy session, you will be advised that for the next 2 weeks, everyone just needs to back off and give the child some space. I am modifying the way they perceive the world, which allows their engagement with, and performance in, the world to change. They need space to do this on their own terms. These children typically have a history of having been ‘hunted down and corralled’ into engaging in the tasks they struggle with and these tasks have no enjoyment of them. From now on everyone needs to ‘pave the way’ for these kids. That means we engage with the child in a way that challenges them to consider life and all that is in it in different ways, asking questions, exploring, considering different perspectives, and what will work and what will not.
It has been my consistent experience that children who receive the Visual Perceptual Therapy will be asking to engage in and perform tasks they previously avoided, in a very short period of time. For example, most children who have historically avoided reading will be asking to read within 10-14 days of our first therapy session.
During the course of the therapy, if issues do come up, we address them. I’m currently working with a 10 year old boy on our advanced visual perceptual performance program. He had a virus as a toddler, which left him having to learn to walk again but never fully regaining his co-ordination – he could not use scissors and had a history of falling over and injuring himself. He struggled enough in school to receive additional assistance in the classroom.
All this boy's historical issues have resolved, his behaviour has improved considerably, because he can now fully engage in the parent/child relationship. This boy completed the Visual Perceptual Therapy and then came back for the advanced sessions, in order to tidy up on some remaining issues – early intervention is still the gold standard and the longer these issues are left untreated, the more time and effort it takes to resolve them. One of his remaining issues was skipping words when reading. This was purely habitual where he was simply overlooking the words. We were able to target this issue in the therapy session and, over the ensuing 2 weeks his mother engaged with him as advised and the problem immediately resolved. There are typically very practical things we can do, to help the child apply new found abilities to everyday tasks; for example, how to teach a child to read functionally, and all parents are given access to such information.
I will see most children only 3 or 4 times. Some children will need 6-8 sessions, depending upon what is found in their evaluation. Unfortunately, it is not possible to predict this until the child is evaluated. Some of these children will require some follow up sessions down the line. These are usually children whose development has been impacted in some critical ways. My advice is usually that these children need to be left to make use of what they have already gained in the Visual Perceptual Therapy. When the time is right - and parents invariably know when this is, so I leave it up to them to make this call, knowing they can always contact me if they need to discuss this – we will get the child back, and run through the therapy again if necessary; or we will run through some of the tasks they have already completed in the previous session, as a precursor to engaging in the advanced visual perceptual performance program. The advanced program refines performance, and it is the program I use with elite athletes and other high achievers, wanting to refine their performance. It essentially allows the participant to process vast amounts of sensory information, and do so whilst remaining calm and focused. This leads to spontaneous and instantaneous performance in the moment, without having to ever work out what one is going to do or how to do it. It’s a great tool for kids to have access to, because it produces the ability to perform at a very high level, in a harmonious and relaxed way.
At the end of all of this I can offer one other guarantee; that the parent/s will be the experts in their child’s performance, by the time the child has completed the Visual Perceptual Therapy program. You will know the level your child is performing at and you will know what they are capable of; you will also know how to work with them in a truly effective way; you will also know why they struggled in the first instance and you will have seen that rapidly disappear; and finally, you will have had access to the latest science in understanding and refining human performance and that will be informing your every step from now on.
As you can see, there is no real way to predict what a child will need, prior to them engaging in the Visual Perceptual Therapy, and undergoing a formal evaluation. However, the fact remains that it is possible to improve upon any child’s performance in some truly profound ways. It is simply unnecessary, for any child struggle to perform everyday tasks, regardless of any diagnosis they may or may not have. Most of these struggles are relatively easy to resolve, quickly and effectively.
If you would like to find out more about the Visual Perceptual Therapy, please feel free to arrange a Skype consultation, in which you can talk to someone and see if you would like to move forward, into the Visual Perceptual Therapy. You can make an appointment here and you will find we are very easy to talk to. If you would like to do some more preparation before you make an appointment, you can use our free VisualPerceptual Screening Tool as a checklist on your child's performance. This will give you a very good idea on what we will be talking about in that consultation. You will find that most of this discussion is around what you have observed and what this means about your child's performance.
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Natoya Rose is an Occupational Therapist and developer of the clinically based programs, used to refine visual perceptual performance
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