By: Loren Shlaes, OTR/L
Certified Teacher of the Alexander Technique
Grownups, please do some detective work if your child {or student} is struggling in the classroom. You may be expecting him to function under circumstances that you would be unable to tolerate yourself.
I recently evaluated a little boy whose teacher reported that he was unable to produce much, if any, written work during morning writing time. He would sit quietly, not bothering anyone, but not getting anything done, either.
The first thing I saw, when I walked into his classroom, was that my little friend, who is a bit small for his age, was sitting in a chair that was so low that the height of the table came up to the top of his chest.
What’s the big deal? You say. Furniture is furniture, what’s the difference?
OK. Go get a footstool and pull it up to the desk where your computer is sitting. Now go ahead and do some work. I’ll wait for you.
Back so soon? How was it? Couldn’t stay that way for long, could you? Pretty uncomfortable, I bet. Could you even see your keyboard?
If you were assigned a desk at work that came up to the height of your chest, after your initial fit of indignation at being so mistreated by the imbeciles in management, who had no concept of what constituted proper seating — how did they expect you to get anything done with such a poorly designed work space? The idiots! — you’d be on the phone with human services first thing, demanding office furniture that was calibrated to fit you, so that you could see and reach your computer and the papers on your desk.
When a desk is so high that it comes up to your chest, you can’t see anything on it. Raising your arms up above your chest to try and write or type would tire you out instantly and make your back ache almost immediately.
But the grownups were expecting this little boy to sit there for hours and hours and do his work like that, day after day, and then getting on his case {quite loudly and exasperatedly, from what I saw in class} because he wasn’t producing much.
As bad as it was, this wasn’t the only thing with which the poor boy was contending. He was chronically stuffy, according to his parents. He had indeed sniffled and snuffled his way through the evaluation, blowing his nose frequently, and breathing through his mouth.
How are your critical thinking skills, attention span, and alertness levels when your sinuses are blocked and your nose is so stuffed that you can’t breathe? How does your throat feel, when you breathe through your mouth all day?
I also saw that this child was highly sensitive to sound and movement, which made him hypervigilant. In contrast to most of the other children, who were sitting and writing through the occasional interruption of the teacher’s voice as she spoke to individual students, he alerted and attended to everything that happened around him. Each time the teacher, or another child, spoke or moved, he watched and listened to the entire interaction. He was sitting with his back directly against the door, so that every time anyone had to come or go, they had to pass directly behind him, further disrupting his already tenuous ability to concentrate.
The children in this little boy’s classroom, who were six and seven years old, were required to sit still for 90 minutes and write independently every single day. I was there for about the first 40 minutes of writing time, and as I was getting ready to leave, the teacher was already doing a lot of shushing, reprimanding, and ordering children to stop moving, stop talking, and get back to work.
How realistic is it to expect six and seven year olds, even neurotypically developing ones, to sit for 90 minutes and write without a break?
Those were the obvious things. The less obvious ones were the child’s weak eye muscles, which made reading and copying from the board difficult, his low extensor tone, which made sitting for long periods extra effortful, his impaired fine motor planning, which made manipulating his pencil a struggle, and his weak tongue, which made eating less than pleasurable, {because it was so much effort to chew his food, and to keep it away from the back of his throat before he was ready to swallow} so that he limited himself to bland, soft, highly processed foods, and wasn’t getting the nutrition he needed to fuel his brain and body. He also had very poor habits of letter formation, since the school did not formally teach handwriting. He hesitated before writing many of his letters, which meant that he was still struggling to recall how to make them, and when he did manage to get something down on paper, it was messy, poorly organized, and in no way reflected this child’s abilities, which were considerable.
Children do not have the verbal sophistication to tell us what is wrong. All the child knows is that he can’t do what the grownups expect him to do, and so he feels inadequate. He is unhappy, lost, confused, often highly uncomfortable, and no one is stepping in to help him; quite the opposite, they are nagging him to do things that he just is not able to do.
As therapists, we we need to be aware of the environmental factors, like furniture that does not fit, that have an impact on the child’s school performance. This child’s mother and the school occupational therapist had been in the classroom to observe him on numerous occasions, but had never occurred to anyone, including his teacher, that one reason that he couldn’t write was simply because he couldn’t see or reach his work!

Featured Author: Loren Shlaes, OTR/L
Many thanks to Loren Shlaes for providing us with this article for our newsletter and website.
Loren Shlaes is a pediatric occupational therapist specializing in sensory integration and school related issues, particularly handwriting. She lives and practices in Manhattan. She blogs at http://www.pediatricOT.blogspot.com/.