QUIRKY KIDS: UNDERSTANDING AND SUPPORTING THE UNIQUE STUDENT

Dr. Roby Marcou , MD, FAAP, FSDBP Developmental Pediatrician, Singapore

The mind set that will be adopted in this presentation which is neither educational nor deficit-oriented at the core.

Rationale

Iliana- Age 16

  Spoke well at an early age and developed an encyclopedic vocabulary related to crustaceans

  Flourished in a small oil-field camp school from ages 6-11

  Always had one best friend   Disliked ‘camps’, assemblies and massages (!)   ‘Collapsed’ in a US public school 7th grade and

relocated with the family to your school at age 14   Anxious, interesting, interested, targeted, adult-oriented

Today: two major themes

  WHY: what is the neurodevelopmental and neuropsychological basis of quirkiness (and why does it matter!)

  WHAT: what is in the realm of feasible for accommodating these students, and helping them thrive in an inclusive international school setting

Why Quirky?

  Changing incidences   Changing definitions   The labeled child, the

eccentric child, the quirky child

  The unique challenges of the international quirky child

Core Values of a Neuro-Developmental Approach

  The difference between lumping and splitting

  ‘Michael is ADHD’   The critical nature of

an evidence base   Leitmotifs and details

  We all have imperfect minds

  Children are inherently no more resilient than adults

  Child perfection and the era of well roundedness

inspect respect

What or Why- of any of these

  Auditory processing   Processing   Attention deficit   Immature   Non-verbal learning D.   Sensory processing D.   Social communicative D.

  Asperger syndrome   Twice exceptional   Executive function D.   Dyspraxia   Specific language

impairment   Autism Spectrum D.   Pervasive

Developmental D.   Tic Disorders

The appearance of order Amidst actual Disorder

OR: I SEE IT WHEN I KNOW IT

I KNOW IT WHEN I SEE IT

MY ASSUMPTIONS

  If a student can, they will.   No one is intentionally bad at their own

development.   A label is sometimes right, sometimes

wrong, sometimes useful, sometimes limiting, sometimes understood, sometimes assuages guilt.

  Variation is not the same as Deviation.   Expectations, and thus the significance of

variations, changes over time.

Differential Thinking Meets Curriculum

  Hoof beats usually mean horses, not zebras.

  BUT: students do not study pedagogy.

  Quirky children will do things differently and be consistently inconsistent.

What We Will Achieve …..

  Goodness of fit   Realistic adult

expectations   A commitment to

salient instruction for a given student

  A reduction in secondary issues

  Change the underlying nature of the student

  Be sufficient to mitigate all curricular mismatch

  Prevent ultimate vulnerabilities

Understanding Creates Understanding May Not

Common patterns and some theories for understanding why.

Themes and Schemes

Recurrent Themes

  Extreme developmental unevenness

  Behaviors and patterns which are atypical, not just delayed

  Awkwardness-physical   Unique, well

developed, narrow interests

Often seen from early childhood

  Sensory variations   Rigidity and cognitive

inflexibility   Social peculiarities   Emotional reactivity

Neuropsychological and hence sometimes genetic variations. Environmental overlay in cases (ad).

Why.

Theory Of Mind:

The ‘Sally Anne’ Test. Baron Cohen 1985.

TOM: thinking about thinking of others

  Others have mental states, intentions, needs, desires and beliefs which may be different than our own

  Reading the mind of and being aware of the thinking of others

  Developmental norms

Theory of Mind: Real Impacts

School Level What you might see Preschool Lack of interactive play

Idiosyncratic references Elementary Playground confusion- when to ‘stop’

Apparent lack of empathy Inappropriate social responses

Middle School Inability to ‘write for a reader’ Marked difficulty with social nuances

High School Poor interpretation of higher level language Inability to read between the lines in studies, preparation for examinations

Central Coherence- Frith 1989

CC: pulling together parts to make sense of a whole in context

  Making sense of situations according to their context

  Focusing on the correct level of detail to allow for cohesive rather than fragmentary processing

  Focusing on wholes, as well as details

Central Coherence: Real Impacts School Level What you might see Preschool That’s my green chair!

Wandering and apparent disregard for norms of circle time.

Elementary Focus on a limited element of a task. Strong preference for routine.

Middle School Difficulty incorporating new organizational skills. Poor ability to prioritize.

High School Limited interest in new ideas. Discrete and poorly generalized skills.

Executive Functioning Deficits

Seen in multiple ‘diagnoses’ . Applied first to this population by Ozonoff 1995.

EF: the ability to maintain an appropriate problem solving set for attainment of a future goal

  Planning   Self monitoring   Inhibition of responses   Behavioral regulation

and flexibility   Organized search   Set maintenance and

change- seeing alternatives

Executive Function: Real Impacts

School Level What you might see Preschool Impulsive behavior

Poor pretend play- cannot suspend images

Elementary Poor ability to use organizational schemes Low frustration tolerance

Middle School Difficulty with processes Can’t get started or prioritize

High School Overwhelmed by task planning Poor time use and allocation

Question?

  How does an understanding of the impact of Theory of Mind change the way you might work with a student in your class who:  Talks on and on about topics that others are not

interested in.  Seems unable to analyze the intent of a writer in spite

of excellent vocabulary.   ‘Runs over’ his peers on the way to get a toy he wants

during play time.

Question? Is one size fits all ‘fair’?

Of course not.. Goals for the Quirky Student therefore:

  Accessing curriculum   Social functioning   Affiliation   Mastery leading to self efficacy   Niche exploration   Mood and motivation maintenance   Progression   Fostering optimism

What are the characteristics of Quirky students? What does this look like in my classroom?

Attributes: Social

The Core Issues are Often Social

  The idiosyncrasies of a young child are often seen as precociousness  Nicholas’ ileum

  The first environment in the family is not reflective of the real world  Rachel in Bontang

  ‘Relative’ skills are different  Relatives may also be different

  Hence> teacher as the first ‘informant’……………

The plight of the socially challenged..

  imagine that you have to be explicitly taught many/most of the social skills and awareness that other people intrinsically have developed

  any taught skill needs much, much more reinforcement for generalization

social realities of school life

  Constant scrutiny   Lack of privacy   Humiliation avoidance   Constantly social   Status maintenance   Being popular VS

having friends   Quirky kids are often

‘clueless’   Pressures over time   International schools!

All Learning is Social   social cognition binds

factual learning   tasks such as reading

comprehension- socially abstract concepts; thinking about the audience in writing; interpreting non-literal directions; participating in groups; functioning in unstructured times

  learning from others experiences

Social Need: self marketing

  Being interested in and legitimately adopting the style of peers to fit in

  the fierce individualist: chooses no affiliation, would see this as a sell out

  To help:  Discuss the up and

downsides of group adherence

 Make aware of the choices of others

 Mentoring  Foster acceptance in

the classroom for difference

Andrea is a new student to your classroom. Is there a concern?   She has just moved

from a highly restrictive all-girls’ parochial school in a small village in Canada. She is first language French speaking, but fluent in English. Her mother has only told you that she is a ‘delightfully quirky child’

Social Need: collaboration Degree to which the child succeeds in cooperative learning by understanding their role and compromising within a group to move the task along   The challenged child

feels frustrated and bull dozed, resentful or fearful>> aggressive and rude or passive behavior

  To help:   reduced emphasis on

competition   encourage material sharing,

cooperative work   provide class activities

contingent on positive interactions

  shared interest in thematic content as meeting point

  communication of positive, genuine statements about contributions during activities- allow students to develop their own

  Be Selective.

Non-Compliance- For Discussion

  why might a quirky child be perceived as avoidant/ oppositional   theory of mind  central coherence  executive functioning

  NON compliance as a lack of skills learned to behave otherwise.. Not seen as a CHOICE per se.  Drs. Ross Greene and Stuart Ablon: Collaborative

Problem Solving

Social need: initiation technique

  Skills are needed for appropriately meeting new people and joining in with those you know

  Quirky kids respond to lack of skills by avoidance, barging in, inappropriate social proximity or levels of intimacy

  the culture of social initiation and the international school quirky kid

Learning to meet and greet

  guidelines for greeting informed by:  pattern recognition   response inhibition  working memory issues

and greetings!

 SOCIAL THINKING is more than a social skill.

 Michelle Garcia Winner.

  Teach explicit greeting techniques

  Work on ‘social currency’- shared interests

  Develop skills through board game play, etc.

Social Need: social control regulation

  strong: nice level of give and take; are not always the boss, not always the follower; select peers as friends; share well with others

  weak: may be too assertive and insist on control in relationships; may be too passive and allow others to make all the decisions; may select older or younger children as friends

will and grace: social control

  talk about the signs that others are feeling over controlled, not listened to

  provide guiding questions: “Do they not want to be around me because I act too bossy?” “How can I help in this situation?”

  provide rules for guests and hosts

  encourage ‘I’ statements and self advocacy

  Parent screening ??  Whom does your child

play/associate with  What do you need to do

to facilitate this  What social rules do you

enforce for your child at home?

Social need: timing and staging relationships   strong: know when a

relationship is ready for intimate sharing, good natured teasing or asking a favor; move a friendship along at the right speed

  weak: use humor, ask for favors or tell secrets before trust is established

  To help!   discuss indicators that

relationships are proceeding too quickly- what others might do if they feel that way

  use models in stories or film to help portray the timely development of relationships

  prepare for friendship transitions   the excitement of that first

friend for the quirky child, the sadness of loss

Social Need: social conceptualization

  Distinguish different types of relationships: friendships, acquaintances, adult relationships

  Ability to judge parameters and understand what constitutes a ‘friend’

concepts of social life

  teach social concepts: friendship, teamwork, compromise, fair play, sharing, sportsmanship

  use case vignettes- use models in stories and film to illustrate different relationship levels

  conduct role plays of appropriate responses to similar topics in different relationships

Social Need: Political Acumen

  Relates to ability to appeal to and be seen positively by adults and peer leaders- use of diplomacy and positive interest to facilitate relationships

  Ability to ‘get’ the social architecture and hidden curriculum   Mentorship for the less aware… reflection time.

conflict resolution   strong: perceive successful resolution of conflict as

gratifying; more interested in finding satisfactory solution to conflict than ‘winning’; describe problems mindful of the perspective of another; compromise to eliminate conflict

  weak: may be passive or aggressive when conflict arises; conflicts left unresolved so continued pouting or punching

THEORY OF MIND

CENTRAL COHERENCE

EXECUTIVE FUNCTIONS

No Bullying: No Fighting

  teach students to recognize signs the precede conflict   help students identify events that frustrate or anger

them- teach alternative ways to handle them- give practice

  seat and maintain environment to reduce chances for aggression

  examine triggers and confrontational interactions   define what they are doing wrong   and what the alternative is

SOCIAL COGNITIVE HEALTH-

  building ability to recuperate from social problems

  have issues delineated in advance, use advance organizers to plan, response formats in many forms, appreciate the fluidity of the solving of social problems, plan for sustained effort

  EMPOWER EVERYONE

lack of engagement: a choice?

  not everyone needs to be or wants to be popular   the path towards rugged individualism   enjoy being loners/own person   reject values or culture of classmates   don’t want to emulate a popular sib

  even when engagement is not chosen, possessing the skills is likely to be both useful and healthful in the future

SOCIAL COGNITION: TAKE AWAY

  Most quirky students have areas where they are ‘okay’ but often have lacked practice which exacerbates the issues

  International life- new coding, new norms, new peers is an inherent challenge for many quirky kids

  There is a tremendous upside learning opportunity for peers…….

WHAT DO DEFICITS IN USING LANGUAGE FOR SOCIAL/ACADEMIC ENGAGEMENT DO TO A CHILD’S LEARNING AND SENSE OF SELF?

ATTRIBUTES: PRAGMATIC LANGUAGE

Getting Pragmatic

  Many quirky kids have very elaborate technical vocabularies and completely intact language structure

  Nonetheless there is very little communication in reality- pragmatics/social use of language

  OFTEN, the expressive skills can be more well developed than receptive ability, which is not apparent- and is not at all ‘typical’ of language disorders

the basic questions?

  Does the student have the interest?

  Does the student have the skills?

  Does the child want to communicate or inform?

  What is the underpinning?

  How do you increase the motivation?

challenge: communication and interpretation of feelings

  Using words and tone consistent with the situation and feelings

  Appear empathetic and are good listeners

  Understand and reflect non-verbal elements

  To help:   realize that the

‘aloofness’ is not ‘deliberate’

  Load with emotional vocabulary and phrases that convey understanding

  Use role play and pictorial approaches to increase awareness and experience

  Emphasize a stop/think/recognize approach

  Model and ‘Translate’

Challenge: code switching

  Using the right form of language for the audience, time and place

  Using humor when it is acceptable

  Using colloquialisms and slang appropriately

  Avoiding the ‘little professor 'mode

using the right code:

  model and reinforce ways that students can switch codes

  identify ‘classroom language’ versus ‘playground/social language’ role plays demonstrating the consequences of inappropriate switching

  Do-say // Don’t- say charts

challenge:

topic selection and maintenance

  Being able to choose topics of interest to others

  Knowing when a topic is ‘getting old’

  Reading the audience   Keeping references relevant

and being mindful of partner’s knowledge

  Responding to topical interest of others

  Interested and interesting!

  How to help

 be mindful of the possible reasons for off the cuff remarks (unable to read situation, trying to change the subject c/o feel left out, impatient with peers)

  script writing, role playing  advanced organizers

challenge: humor regulation

  create and describe anecdotes that listeners find amusing

  engage in developmentally appropriate word play and hyperbole

  see the humor in irony   laugh appropriately during a

presentation   enjoy good natured teasing

from peers or teachers

challenge:

conversational technique:

  listen attentively to speaker and then produce responses related to what they hear

  contribute to conversation and invite input of others

  How to help!   demonstrated methodology and

reinforce the idea of ‘social repair’ when miscommunications are made right– teach repair statements “let me say that another way”....

  dinner time conversation   teach the lingo, even to a student

who may never use it!

conversationally speaking:

  identify/model phrases for asking for things   Why is the quirky child likely to interrupt, likely to

disrupt, likely to run away rather than ask for help  core elements  every behavior meets a need  skills to seek clarification or assistance as an

alternative to escape/ avoidance/ disruption need to be taught

 imagine not thinking someone else could help you?

How about Social Skills Training?

  undermined by:   challenging groupings

of students   timing   lack of student buy-in   impulsivity   difficulty finding

means to assist in generalization

  enhanced by:   lawyer’s children   using the natural flow

of school events   students helping to

define the issues   global awareness on

the part of teachers and aides to assist in generalization

  home support

Teaching Social Thinking

  considering the perspective of others..how to make this happen>>the importance of helping the child understand why social skills are used

  use instruction to teach about social cognition– increase mindfulness

  based upon a ‘desire’ to relate or an understanding of why/how they should be thinking about the other person (RDI, Jarvis Clutch, Michelle Winner)

  not having the skills is not the same as not having the interest....

Example: Blurting Out

  Behavioral Approach: ‘don’t yell’

  Social Thinking approach: focus your eyes on the student, hold up the palm of the hand in the direction of the ‘blurter’ and say, “I was looking at ..., I was talking to ...., I am not talking to you right now.” COGNITIVE information that helps the student learn to understand how to not blurt out...and why they would not want to.

Classmates and Friends   Thoughtful seating   Educate peers   Create cooperative

learning situations in which the students academic skills will be viewed positively by peers.

  Peer buddy as social translator

  Foster involvement with others by limiting time spent in isolated pursuits and structuring conversations