Over many years of assessment we have seen a large number of children with a characteristic pattern that did not fit neatly into an existing label. They would have a relatively high verbal I.Q. in relation to their non-verbal I.Q., and problems particularly with hand-eye coordination and visuospatial ability. Maths would often not be a strong subject for them, due to their visuospatial difficulties, and they would often have a poor memory for the shape of a word for spelling, although they had no trouble with phonics. Letters would often be missed out or transposed. Generally their handwriting was poor and their letters would wander around the line rather than sitting neatly on top of it. They usually had a great deal of trouble making the transition to cursive writing, and many of them would never fully achieve it.

The children usually had a great deal of difficulty with overflow movements, unwanted motor activity. These movements would be distracting for the child and for other people. They would just not be able to stop fiddling with things or swinging backwards and forwards on their chairs. Sometimes they would have a tic, or there would be a family member who did. Some would appear to be genuinely hyperactive, always out of their seat and up to something, with poor impulse control.

Obsessive behaviours were common, too. This could be beneficial, because it meant that they would become great experts in whatever was the current obsession, and then they would move on to something else. It was a problem if it was so extreme that it made them appear odd, however, and also if this obsessive tendency led to them being perfectionists, unwilling to put pen to paper unless what they had to say was perfect. Often the children would have significant problems with organisation, motor control and time awareness, and if this was coupled with a perfectionist tendency it often resulted in very little being put down on paper, even in the case of children who were exceptionally bright.

The children almost always had acute organisational difficulties, which meant that they had great difficulty in being in the right place at the right time with the right equipment. Many of them showed perseverative behaviours, with an unwillingness to leave one activity for another. “I’ve just got to do…” was a common catch phrase. Children with a combination of perseverative behaviours, organisational difficulties and time awareness problems would be very hard to get to school on time and the task of getting their homework started in the evening would be just as challenging.

They were always hypersensitive in one or more sensory areas. Where this was extensive it would lead to extreme distractibility, particularly in the classroom, and a sensory overload which could ultimately overwhelm their immune systems. Hypertactility would make it hard for them to sit still, hyperacute hearing made concentration in the classroom extremely difficult, photosensitivity might cause poor reading stamina, because the words would begin to move on the page after a while, and they would always have poor eye teaming ability.

Emotional sensitivity would lead to heightened intuition and tenderness, but where it was extreme, children could be ruled by their emotions. They could also have a strong reaction towards those who they felt did not like them. Usually they would have a strong sense of justice which could get them into trouble. There were often subtle difficulties in their interaction with their peer group, and some children could be easily provoked to the point of violence. Others would be bullied. There were almost always self-esteem problems because the children did not quite fit in unless they could find a soul mate. They would struggle with motivation unless the task was the subject of an obsessive tendency or something they found particularly interesting.

These children would often find it hard to get to sleep at night, and many of them would also have difficulty in becoming fully awake in the morning. Sensitivities to chemicals and environmental pollutants were common and they often showed symptoms of reactive hypoglycaemia, which would cause their blood sugar to drop if their diet was not carefully controlled. Almost all of them had problems paying attention as a result of their hypersensitivities and associated dysfunctions. The older ones would sometimes suffer from depression, and there was often a relative who suffered badly from depression or was slightly obsessive.

These children shared many of the characteristics of the children we saw with tic disorders, although very few of the children actually had tics. We called them T-type for short, because they were either a bit of an enigma with no label or did not fit easily into the categories that had been assigned to them: dyslexia, dyspraxia, ADD, ADHD etc.

We found that there were three particular problems which were strongly indicative of the syndrome. The children could not track a moving object without overflow movement (unless they had been coached), they did not have binocular fusion, even though they might read well, and they found it hard to sit their letters on the line properly in their handwriting. We would see this pattern at any age and at any level of ability and attainment. The children tended to be very bright, although this had often not been spotted because their written work was unimpressive.

Many of these children have been through a programme now and grown into outstanding individuals and powerful communicators. They operate out of the right brain and tend to be as innovative in their approach as children who are classically dyslexic, but their strengths are in words rather than in pictures. The often come into their own only when they can devote their time and energy mainly to the things which fire their enthusiasm.

Suggested action

It is very important that these children are understood and there is at present no general label that can be used to help the school. Try to make sure that they are not in trouble for fidgeting, poor presentation of work and low output. Support their organisation as much as possible so that they have the information and books they need and know what they are supposed to be doing. Pack their bags for them and have them ready in the morning if they cannot manage it themselves.

Organisational skills are dependent on good brain integration, which is a big problem for them, and made worse if they are put under stress. Don’t use negatives to motivate them – they will only respond to a carrot, never a stick. Try to find what it is they really love doing and support it at their level of ability. If their needs are being met in that way they will cope better with doing the things they are less interested in.

Case histories

HEATHER

Heather was a delightful baby and toddler. Cheerful, wilful and extremely articulate. She spoke very early and amazed nursery helpers with her vocabulary and confidence talking to adults. We happily despatched her to primary school, certain she would take to it like a duck to water.

From the first day school seemed to crush her. She seemed cowed and after a month I could no longer put it down to first-day nerves. Then she began to resist getting dressed in the morning. She would refuse to put on her uniform and we had to coax her out of the door with a combination of threats and incentives.

At the first parents’ evening we were told she was a delightful girl and appeared to have settled well. We explained that this was not the case as far as we were concerned. The teacher was surprised and asked whether anything was going on at home that might unsettle her! Suitably guilt-ridden we left and persevered.

I was concerned that Heather was reluctant to read. She had always enjoyed looking at books and I thought she would want to learn. A greater concern was the fact that she hadn’t made any real friends. She had made a very good friend at nursery. We hadn’t known the girl before Heather started and I had taken this as evidence of her ability to chose and make friends. Maybe we had just been lucky.

Heather seemed intimidated by some of the girls, often going along with what they suggested. This was not the feisty girl we knew. At the end of the first year, Heather appeared to have achieved nothing. She still couldn’t and wouldn’t read; she was reluctant to write and had no real friends.

We returned after the summer and were horrified to be called in for a meeting to be told that there were concerns about Heather’s progress over the last year. Apparently, she was not the only girl to be below the level expected after a year but she would need extra help to catch up. At this stage we decided to move Heather as we had lost confidence in the school and the following January she started her second primary school.

Heather got off to a good start at the new school. Parents were kind and invited her to tea and the class seemed to make a real effort to integrate her. Her reading began to improve but maths was a real problem. She appeared to have a complete mental block when it came to numbers. When looking for a new school we visited a school which refused to take her because she would have been too far behind the rest of the class. After the assessment the head teacher asked whether any members of the family were dyslexic. I had bought a book about dyslexia and I began to wonder whether this might explain Heather’s difficulties. We decided to have Heather assessed by an educational psychologist.

The report came back and was largely unintelligible. It had scores for pattern construction, matrices and quantitative reasoning and other alien concepts! What we did glean was that aged seven, Heather had an age for something called verbal similarities of twelve years and three months and an age for something called matrices of five years and seven months. This difference we were told was significant. The educational psychologist did not want to use the term dyslexic as she felt this was something Heather would grow out of. She recommended we find a tutor for Heather and encourage her with activities such as jigsaws to help her think systematically. More distressing was the psychologist’s assessment that Heather displayed a poorly developed self-image and that she needed help developing stronger feelings of self-worth. I felt that I had failed as her mother. She also talked about a girl Heather had perceived as bullying her. We talked to the school about the bullying and they said they would deal with it. They failed to deal with it and unknown to us it continued and became worse.

We struggled on, reluctant to move Heather a second time. As Heather completed year four, a place became available at a local primary school. We decided to move her and it was a good decision. For the first time she found a good set of friends. We had stopped expecting anything academically and were just delighted that at last she seemed happy to go to school.

I still had a suspicion Heather was dyslexic and through a friend I heard about Jane Lloyd. Halfway through the assessment in April 2002 Jane turned to me and said, “Do the school realise how bright Heather is?” “I’m not clever.” replied Heather. “I’m not even average.” Jane explained that to achieve the levels she had, given her learning difficulties demonstrated real ability. Heather had found ways around her problems that meant she could achieve a certain level but it was exhausting, explaining for the first time why she was so tired at the end of school each day.

Over the last few years, Jane has worked to remove the blocks to learning Heather has. We didn’t get it right straight away. She failed her 11 plus and virtually every other exam she sat. She did, though, pass the one she needed to go the school of her choice. Gradually Jane’s work has started to have an impact. Maths, Heather’s big nightmare has become easier and she achieved a level 6 at the end of her first year. A jump of two levels. However, the most noticeable change has been in her self-confidence. Heather has a much greater sense of who she is, what she wants and what she is capable of. She still encounters girls who cause her problems but she is much more able to stand up for herself and is no longer shaken by it.

Having lived through this with Heather I can see that removing blocks to learning is not just about improving exam results. I believe that Heather was very confused when she started school to find reading and writing so difficult. She began to feel inadequate and this affected her self-esteem. This, in turn, made friendships difficult and left her vulnerable to bullies. More worrying perhaps was the fact she started to do things because someone had told her to and to stay their friend. Jane has helped to re-build Heather’s confidence in a number of ways. First, by helping Heather to understand why she has found certain activities difficult, secondly by providing an objective assessment of Heather’s abilities – you never believe your Mum when she tells you that you are clever and thirdly, by removing the blocks that made learning so difficult.

About a year ago Heather told me about a green litter bin in the playground of her second school. Everyday when I left her she used to go and stand next to that bin and cry because she had to face another day. Then she would pull herself together and go in to face the torments of the girls who bullied her. Hopefully now, she won’t have too many more green litter bins in her life!

Heather has recently completed year 8 and in her end of term report her tutor wrote, “ If I could use my lab to siphon off whatever it is that makes Heather so cheerful and enthusiastic all the time I would do so without hesitation and bottle it and sell it on E-Bay”. It feels as though we have gone full circle and got back our delightful, cheerful daughter who I am now confident will go on to achieve her full potential whatever that might be.