Assistant Psychologist, Wong Kwan Wei, from Oasis Place Sdn Bhd, describes the three common hidden disabilities among children.
Are you concerned that your child has trouble keeping up with school, maintaining friendships or completing daily tasks? Is he or she noticeably slow to process, overtly shy or unmotivated? Besides the more commonly known Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD), there are also lesser known conditions in children that can affect learning and behaviour.
Executive functioning is the key to a set of mental processes that help us to organise, plan and complete a task. Executive functioning issues are not considered a disability on their own. However, these difficulties often appear in children with learning and attention issues.
Children who have executive functioning difficulties may be challenged by the following ways:
- Planning: The ability to think about objectives. The child may have difficulty deciding when and how to get started, or prioritising what is important or creating a step-by-step plan.
- Organisation: The ability to create and maintain a system to keep track of information and materials. The child may struggle to manage their belongings.
- Task Initiation: The ability to begin a task. A child may show task avoidance as they may lack motivation or skills to begin a task.
- Time Management: Having a sense of the passing of time. The child may procrastinate and have trouble meeting deadlines.
- Goal Oriented: The ability to follow through a long-term plan. The child may appear to be living in the moment and have no specific direction.
- Working Memory: The capacity to hold information long enough to complete a task. The child may misplace his belongings, appear unprepared for class, or struggle to recall an event.
- Response Inhibition: The skills to think before acting. The child may struggle with impulsivity or may have poor social judgement.
- Emotional Control: The ability of the child to manage feelings to achieve goals. The child may be easily frustrated, and gives up easily.
- Flexibility: The child’s capacity to come up with, modify, or make new plans based on feedback and cues. The child is unable to find alternative ways to solve problem, and gets stuck with only one solution.
- Self-monitoring: The ability to measure one’s own performance and to adjust one’s behaviour in response to feedback. The child may be out of sync with others and is unaware that she is acting inappropriately.
Many children experience anxiety, however, it is mostly mild and temporary and has no long term effects. Some children, however, may have overwhelming anxiety. This may affect a child’s daily functioning at home and at school as they may start to avoid people and activities when they feel uncomfortable.
A child may repeatedly avoid going to school because of anxiety. This affects two to five percent of school-aged children, especially those transiting between schools (ADAA, 2016). A child who refuses to go to school may complain of physical discomfort or show excessive worry before school. The discomfort or worry subsides as soon as they are allowed to stay at home, though it may reappear at the mention or thought of attending school. The anxiety may be masked by symptoms such as headaches, stomach aches, nausea, diarrhoea, nightmares, irritability, tantrums and separation anxiety.
Besides school refusal, anxiety may also manifest in classroom performance. Anxious children may be afraid of speaking up or may avoid being in social contact with peers. Pressure may come from the children themselves or from perceived pressure from parents, teachers and friends.
Social Communication Difficulties
Social communication difficulties (SCD) are characterised primarily by pragmatic language difficulties. Children with SCD may have typical speech development to produce words and construct sentences, however, they may struggle with the use of language within the social context.
Here are some symptoms to look out for:
- Dominate conversations
- Have difficulty staying on a topic
- Have difficulty understanding non-verbal cues, such as body language
- Not adapting language to different situations
- Have difficulty making inferences or understanding things that are implied
- Have a tendency to be over literal and be unable to understand jokes or sarcasm
These difficulties may affect the child’s ability to make and keep friends. The child may not be able to comprehend what they have read or heard, affecting them academically.
If you notice your child having any of these difficulties, talk to your child’s teacher, paediatrician or a child psychologist.