The Need For Student Observation
As a paediatric health professional, I prefer to observe and assess children within their natural environments, e.g. at home, school or other learning centres. My process at these settings can only be described as simplistic: I enter the room in a low key manner, settle in and become the most boring person in the world.
I usually enter these situations with a bare minimum of background information, preferring to trust my observation skills and clinical knowledge. This prevents me from making assumptions prior to the commencement of the observation.
On this occasion, I had been invited to visit a primary school which had been having problems with a student’s attention and behaviour and was reported by his teacher as having difficulty with instructions and work completion. There was unexplained tearfulness at times.
Having made my customary low-key entry, I proceeded to watch the class without focusing directly on the child, so that he remained unaware of the observation, which would have altered his behaviour.
On the whole, the boy appeared very social with his peers and showed knowledge of the class routines and he was quick to get his workbook out when asked. However, his ability to perform his work soon went downhill from there.
Over the course of the period, I observed the following during a writing class:
- The boy showed difficulty in fluency, frequently stopping during the course of the work. He squinted and frequently frowned at his book.
- He lifted the lid of his desk and attempted to put his writing book in the storage space underneath before being reprimanded by his teacher.
- The student then proceeded to take another book and place it across the front of his desk, hiding his face from the front of the class. This yielded another reprimand from the teacher.
- Finally, the boy put on his school cap with the brim held low over his face, which gained him his third strike from his teacher. The look on the boy’s face could only be described as being miserable.
An interview with the teacher afterwards showed her puzzlement and frustration with the boy’s behaviours during her class. There were many questions. Does he have a learning difficulty (e.g. dyslexia, ADHD)? Does he have visual motor integration difficulties? Is he upset from something that had happened at home? The teacher was also somewhat new to the class. Was this a rapport difficulty or a communication issue?
Fortunately, in this case the singular answer was a simple one.
The student had a low threshold for visual information, which meant that he found it difficult to concentrate when presented with visually busy or visually intense stimuli. On this occasion, the excessive stimuli was the bright sunlight, which fell on the student’s desk every morning. Faced with the brightly illuminated workbook, the child had attempted to minimize the stimuli by placing barriers between the light and his book — these efforts however, had been misinterpreted as being behavioural difficulties.
The use of a standardized sensory assessment tool at both the home and school settings, along with an interview with the student subsequently confirmed his visual sensory sensitivity. The boy was moved to a different desk in the room where he had better protection from the light.
While this is a simplistic example of a cause-effect solution, the story highlights the impact of sensory overload on our day-to-day functioning, and how it is often overlooked.
Sensory overload can be particularly difficult for children, who are required to absorb, process and retain new learning on a daily basis. It is also important to note that the affected students may not even be aware of their own sensitivities.
Overall, the workload of the average teacher is immense, and it would be unrealistic for staff to scrutinize each and every student in this way. Similarly, parents see their own children on a daily basis, and may not have seen the significance of their children’s preferences.
At times, parents may share their children’s sensitivities (e.g. being ‘picky eaters’), and as such had accommodated their lifestyle as adults without even noticing. The same sensory issue however, may affect their children at school camp, where they would be expected to eat new tastes and textures.
This is where external input can be useful for struggling students, which should always include, in my opinion, observation of the children in their natural environments.
While clinic appointments and paper assessments have their place, I believe that direct observation should always be employed to discern disability (i.e. activity limitations participation restrictions). This enables the health and education systems to view the child as a whole, as opposed to an over-emphasis on impairment alone.