It’s that time of the year when many children struggle to cope with the daily routine of school. School is their safe haven away from home. It is the place where they have learnt to trust people other than their parents and to know that those people will always have their best interests at heart.  At Christmas time the cracks begin to appear for the children and some just can’t cope. There’s a very good reason for that, the routine they need and cherish so much in schools disappears out of the window at Christmas time. Teachers and teaching assistants have the best intentions, they try their hardest to ensure that anxious children will manage their day without experiencing a full blown melt down or become so anxious that they retreat into themselves. For most children Christmas is a time of joy, excitement, presents and laughter. They are allowed to watch festive films at the end of term, listen to music, play with ipads and generally have some ‘down time’ for the last day or two in school. Its the most magical time of the entire year to be in school, filled with anticipation and dreams of what Santa might bring.

For other children it’s a time of absolute despair. Each new day brings a new activity that isn’t on that visual timetable. Some neuro typical children are not happy with this lack of structure but for children with ADHD and ASC Christmas is an incredibly challenging time. To understand what these children are experiencing we need first of all to look at the cold hard facts of these two conditions and how they present when they co-occur.

For those who aren’t aware ADHD is far more than just an inability to concentrate or sit still for 5 minutes. If it was, special schools up and down the country and teachers in general would be patting themselves on the back for being able to help children with ADHD sit still for more than a few minutes. A quick fidget toy or the promise of a reward would easily solve the problem. ADHD is so much more than that. For example, these children are often emotionally incontinent, they may be unable to focus on the person speaking to them making it difficult to follow instructions. They are oblivious to their surroundings, have little sense of danger, most have poor organisational skills and an inability to control their own behaviour. It is true that they have an inability to sit still when required to do so but this remains true even with the promise of their motivator as an incentive.

Moving on to Autistic Spectrum Condition quite often the problem is in the child’s understanding and communication skills. Although they may be verbal, they sometimes prefer not to join in a conversation and prefer to be alone. Children with ASC often have sensory issues such as being irritated by the feeling of some clothing, may only eat certain foods and have a fear of loud noises and crowds that sends them into a sheer panic. There may also be some real temper issues. Research is now showing that children with ASC may share some genetic traits with those with ADHD, bipolar disorder and clinical depression. Scientists are unsure of the exact cause of ASC and ADHD but they are agreed that the brain of these children is wired differently.

Imagine being a child who has a dual diagnosis of ADHD and ASC. Just looking at the raw facts it is easy to see how a child with either of these challenges will struggle at this time of the year but it must be devastating to have that dual diagnosis. A child like this would be totally swamped by being in a crowd, feel positively ill from being around all the different food smells at this time of year and be sent into absolute panic at the complete lack of structure and routine.  Their normal class staff may disappear for any number of reasons and the child in question who has no sense of danger may remove themselves from the room without telling anyone. It’s a lonely time for this child too. Everyone else is laughing and having fun and loving all the changes, our child might just have taken themselves off to what they think is a safe space but may in reality be a danger for them.

In our school we have a a few young people who I could be writing about today. However, I have chosen a 14 year old girl who has this dual diagnosis. Like many schools up and down the country we have suspended our lessons this week in order to rehearse for our Christmas show. Every single child and young person takes part in this show irrespective of the challenges or illnesses they face. The vast majority absolutely love performing for their parents and they love all the rehearsals. It is a wonderful sight to see everyone singing and dancing on stage and able bodied children helping those with more severe medical challenges to join in. It brings a tear to your eye if I’m honest.

Today I went to watch the rehearsals. As I’m assistant head I don’t often get the chance to see the rehearsals and as today was a whole school run through I popped up to have a look. The sound of singing met me in the corridor so I was looking forward to it before I was anywhere near it. As I approached it I could hear a  raised voice. A 14 year old girl wasn’t going in. She was shouting, thumping her fists and banging her feet on the floor and expressing her dislike. Very soon she was on her feet and about to take flight. Her problem as I’m sure you’ve guessed was sensory overload. There was just too much noise, too many people and too much going on in a confined space. Our girl couldn’t see any way she could cope with this and was expressing herself in the only way she knew how, with a sensory meltdown. To the untrained eye, this would appear as a behaviour issue and result in sanctions. To those who understand and have training in ADHD and ASC it was quite apparent what was happening. I took her to a quiet part of the corridor and waited until she was calm enough to listen. ‘Shall we go and get Doodles?’ She looked at me questioningly. I told her that Doodles needed to get used to loud noises and that she  and the therapy pup could sit right at the back where we could take him out if it became too much for him. It took her a few minutes before she agreed and off we went to fetch Doodles. As promised we sat at the back where we could beat a hasty retreat if needed. After a short time our girl and our puppy had moved right up to the centre of the hall. She was able to cope with her own sensory issues because she was helping the puppy to cope with his. She was blotting out all her sensory problems as she concentrated on Doodles.

Today was a good day. Doodles had worked his magic on this young girl and had saved the day. The afternoon’s events made me ponder about how difficult it is for children like her at this time of year. Well done Doodles!