Psychological Analysis of the book "Invisible" by Eloy Moreno
«Invisible» by Eloy Moreno is a novel that addresses the complex and devastating phenomenon of school bullying from an intimate and psychological perspective. Through the story of a teenager who feels invisible due to the bullying he is experiencing in his life, Moreno offers a deep exploration of the emotional and mental effects of bullying. This psychological analysis examines various aspects of the novel, including the impact of school bullying, the protagonist’s defense mechanisms, the role of empathy, the formation of self-concept, the recovery process, and the long-term consequences.
Impact of School Bullying School
Bullying is a phenomenon that can have devastating consequences on an individual’s psychological development. In «Invisible,» the protagonist experiences constant bullying that leads him to feel invisible. This feeling of invisibility is not just a literary metaphor but a reflection of the profound dehumanization and isolation that a bullying victim suffers. Continued victimization can lead to low self-esteem, anxiety, and depression.
Isolation and invisibility
The isolation and invisibility that the protagonist feels are representations of how bullying can make victims feel worthless and that their existence doesn’t matter. This sense of irrelevance can be especially destructive during adolescence, a crucial stage for the formation of personal identity.
Defense Mechanisms and Coping
To manage the emotional pain of bullying, the protagonist develops several defense mechanisms. Invisibility becomes a coping mechanism, a way to escape the oppressive reality he experiences during this process. Psychologically, this can be interpreted as dissociation, a separation between his identity and reality to protect himself from emotional trauma.
In addition to invisibility, the protagonist exhibits other defense mechanisms such as avoidance and repression. He avoids situations that could lead to more bullying and represses his emotions to avoid showing vulnerability. These mechanisms, while understandable as responses to a hostile environment, can impede healthy emotional development and perpetuate the feeling of isolation.
The Role of Empathy
One of the central themes in «Invisible» is the importance of empathy in resolving bullying. Throughout the novel, some characters begin to recognize the protagonist’s suffering, highlighting the transformative power of empathy. This recognition and resulting compassion are crucial steps in combating bullying. Observers of any type of bullying are also complicit in allowing the situation to continue for the victim.
From a psychological perspective, empathy involves understanding and sharing another person’s feelings. For bullying victims, being seen and understood by others can be incredibly validating and help rebuild damaged self-esteem. Empathy not only helps victims but can also deter bullies by making them aware of the impact of their actions.
Impact on Self-Concept
Self-concept refers to the image a person has of themselves, which is deeply influenced by social interactions. In «Invisible,» constant bullying distorts the protagonist’s self-concept. Internalizing the negative and humiliating messages he receives leads him to question his own worth and abilities.
The protagonist’s internal struggle with his identity and self-esteem reflects how bullying can erode a person’s self-perception. This psychological damage can manifest as severe self-criticism, self-loathing, and a negative outlook on the future. The novel shows that recovering a damaged self-concept is a long and complex process that requires support and self-reflection.
The Power of Voice and Visibility
The protagonist’s journey towards reclaiming his voice and visibility is a crucial theme in the novel. Initially, his invisibility symbolizes his despair and desire to escape the constant unpleasant situation he is experiencing. However, as the story progresses, he begins to find the courage to be seen and heard by others.
From a psychological perspective, finding one’s voice is essential for self-affirmation and recovery. Moreno’s narrative underscores that being heard and understood is fundamental to overcoming the trauma of bullying. Building support networks and the ability to express emotions and experiences are vital steps towards recovery.
Long-Term Consequences of School Bullying
Moreno not only focuses on the immediate impact of bullying but also on its long-term consequences. The trauma of bullying can have lasting effects that affect victims in adulthood. These may include anxiety disorders, depression, difficulties in interpersonal relationships, and trust issues.
The novel suggests that the trauma of bullying does not simply disappear over time. Overcoming bullying requires continuous self-reflection and therapy. It also highlights the importance of early intervention and ongoing support to prevent long-term consequences from becoming more severe.
Psychological Interventions
To address school bullying and its effects, it is essential to implement appropriate psychological interventions. These may include cognitive-behavioral therapy to help victims rebuild their self-concept and develop healthy coping strategies. Family therapy can also be useful to strengthen support at home and improve communication.
In the school context, promoting an environment of inclusion and respect is crucial. Emotional education programs and empathy training can help reduce bullying and foster a culture of support and understanding. This novel emphasizes that fighting bullying requires a community and multidisciplinary approach, where all members of the school community are committed to creating a safe and welcoming environment.
In conclusion, «Invisible» by Eloy Moreno is a powerful work that offers a rich and nuanced representation of the psychological effects of school bullying. Through the story of the anonymous, yet victimized, protagonist, Moreno explores how bullying can dehumanize and isolate victims, distort their self-concept, and cause lasting trauma. The novel also underscores the importance of empathy, finding one’s voice, and community support in recovery and overcoming bullying.
From a psychological perspective, it is not only a moving narrative but also a call to action to effectively and adequately address bullying by professionals and society. Understanding the psychological effects of bullying and implementing appropriate interventions are essential to helping victims heal and thrive.
Written by:
Lidia Fernández
Sinews MTI
Psychology, Psychiatry and Speech Therapy
The Emotional Challenges of Being an Expat in Madrid
Have you just started a new life in Madrid? Congratulations on that decision! Moving to a new country is an exciting adventure, but it can also be an emotional challenge that feels overwhelming. In this article, we will accompany you on the emotional journey of being an expat in Madrid. We will also explain how therapy in Madrid can be a valuable resource for your emotional well-being during this new stage of your life.
The Excitement of the Beginning
Upon arriving in Madrid, it’s common to experience a great sense of excitement. It’s normal to feel thrilled, anxious, and a bit overwhelmed by the beauty and culture of this great city. The architecture is stunning, the cuisine is delicious and the Spanish lifestyle is very joyful and full of vitality.
However, this initial excitement can give way to a series of emotional challenges as you adapt to your new environment. This is where understanding and managing your emotions becomes crucial as you navigate this new stage of your life.
The Challenge of Adaptation
One of the most common challenges expats in Madrid face is adapting to a new way of life. From the language to the new customs, everything can seem different and disconcerting at first. The feeling of not fitting in or being out of place can generate anxiety and loneliness.
Therapy in Madrid can be a very useful resource to help you manage this process. A therapist can provide you with the necessary tools to handle the stress and anxiety that accompany adapting to a new country. Additionally, they will provide a safe space to talk about your concerns and fears.
The Feeling of Distance
Another common emotional challenge among expats in Madrid is the sense of distance from family and friends left behind. Nostalgia can be overwhelming at times and you might find yourself missing all those people with whom you were used to sharing every day.
When this happens, it’s important to remember that you are not alone. Many expats face these same feelings and a great solution is to create new relationships in Madrid. Moreover, therapy in Madrid can help you find strategies to maintain and strengthen your emotional bonds with your loved ones from a distance.
Culture Shock
Culture shock is a common experience for expats. As you immerse yourself in Spanish culture, you might encounter differences in how people communicate, interact and perceive the world. These differences can cause misunderstandings and interpersonal friction.
It’s essential to keep an open mind and be aware that cultural differences are neither good nor bad; they are simply different. Therapy in Madrid can help you better understand the local culture and develop intercultural communication skills, making your adaptation easier.
The Feeling of Loneliness
Loneliness can be a significant challenge for expats in Madrid, especially in the early stages of their stay. Sometimes, it may seem that no one else understands what you are going through, which can intensify the feeling of isolation.
Seeking out local activities and expat groups can be an excellent way to combat loneliness. Participating in social events, language classes, or activities that interest you will allow you to meet like-minded people and build new friendships.
The Stress of the Unknown
Stress is a natural response to the unknown and living in a new country can create uncertainty in many areas of your life, from logistical issues like finding a home and job to adapting to a new healthcare system.
This is where therapy in Madrid can be a very valuable tool. A therapist will help you develop coping skills and manage stress effectively. They can also offer practical guidance on how to understand and handle the most challenging aspects of expat life.
The Strength of Resilience
As you adapt to the country and culture, it’s important to remember your own resilience. Overcoming emotional challenges is a gradual process and each step you take brings you closer to feeling a sense of belonging and comfort in your new home.
Being an expat in Madrid can be an emotional challenge, but it is also a very enriching and transformative experience. Therapy in Madrid can be a valuable resource to help you overcome emotional obstacles and build a healthy emotional life in this great city.
The Impact on Mental Health
Mental health is a fundamental aspect of your well-being as an expat in Madrid. The pressure to adapt to a new environment, the distance from your loved ones and the day-to-day challenges can significantly impact your mental health. You may experience symptoms of anxiety, depression, or stress. At this point, therapy in Madrid becomes even more essential. A therapist can help you identify and address the specific challenges you face in your life as an expat, offering strategies to improve your mental health and increase your emotional resilience.
Seeking Support Resources
As an expat in Madrid, it’s important to seek out support resources available in the city. Besides therapy, there are expat groups, cultural organizations and social activities that can help you connect with others going through similar experiences.
In your new stage as an expat in Madrid, it’s important to know that you are not alone. Seeking emotional support through therapy in Madrid is a brave and effective step to overcome the emotional challenges you may face. Adapting to a new country takes time, but with the right resilience and support, you can navigate the emotional challenges and find happiness in your life in Madrid.
If you have just moved to Madrid, are struggling to adapt, and need professional support, do not hesitate to contact us. Our team of therapists is here to help you in your process and provide you with the tools you need to make the most of your new life in this wonderful city.
Sinews MTI
Psychology, Psychiatry and Speech Therapy
What is Academic Support and What Does a Support Therapist Do?
The educational field today faces significant challenges. After the COVID-19 pandemic, various studies have shown negative consequences on the cognitive development and academic learning of children worldwide. This has been reflected in the complexity and diversity of learning needs, requiring new approaches for each student. In this context, the role of the educational support therapist becomes crucial to ensure proper learning development and overcome any difficulties that may arise. We generally understand their professional work, but we are often unclear about the scope of their professional competence. So, what exactly is an academic support therapist?
The Importance of the Academic Support Therapist
Academic support therapists or psychologists are professionals specialized in the educational environment of children and adolescents, focusing on analyzing special needs and learning difficulties to design strategies aimed at acquiring skills and abilities. With this objective, the academic support therapist studies the difficulties encountered, determines, and provides a series of tools, which are individually adapted to help and foster the development of their learning.
The work of the educational support therapist begins with «Understanding,» which means identifying and understanding the underlying causes of the difficulties students face. This initial understanding is fundamental, as it allows for the precise design of procedures and strategies to effectively address these difficulties. To achieve a holistic understanding of the students, brief reports and evaluations are used, providing a broader view of the student’s educational needs.
This comprehensive approach is key to their professional execution, as it allows the support therapist to develop individual interventions that address not only the surface symptoms but also the root causes. From this point, strategy planning begins, adapting to the student’s academic curriculum. These strategies are primarily implemented in learning areas that pose difficulties and where the student lacks sufficient resources for proper coping. In this regard, the support therapist provides specific tools tailored to the identified needs.
Psychopedagogical Support: Beyond Cognitive Aspects
Psychopedagogical support has its roots in cognitive psychology, initially focusing on learning difficulties, especially those related to executive function regulation. However, after the COVID-19 pandemic, support needs have been significantly exacerbated.
Functions like planning, inhibition, and working memory have suffered cognitive deterioration after the confinement period. Additionally, new adaptation difficulties to education have emerged: anxiety became a significant trigger within the adolescent and even child educational landscape. This symptomatology impacted these functions, particularly working memory, due to anxiety caused by confinement, directly affecting reading and writing performance as they are key to processing.
Therefore, we must consider that today, psychopedagogical support is not limited exclusively to cognitive functions. It is essential to understand the relationship between emotional and cognitive factors that affect a child’s development. These factors constantly interact in the execution of their skills, directly reflecting on their performance. A clear example is the common situation of facing a difficult exam and experiencing what is popularly known as a «blank mind.» These paralysis symptoms, loss of control, and insecurity are nothing more than anxiety states caused by emotional symptoms, demonstrating how emotional management can facilitate or complicate the execution of our skills and the application of our knowledge.
Current Challenges in the Educational Field
The educational context reflects what develops outside of it. After the confinement period, the COVID-19 pandemic has imposed significant challenges on the educational system:
1. Impact on the Socio-Demographic Framework:
The adaptation effort of education during the confinement period relied heavily on technological resources, which were limited for part of the school population. This lack of access has hindered the schooling period, reflecting predominantly negative effects on learning and development processes, especially in contexts with fewer economic and cultural resources. This period has further highlighted social inequity, exclusion, and educational barriers that many children and young people face, underscoring the importance of education from a more inclusive and equitable perspective.
2. Role of Teachers:
It is crucial for teachers to reflect on how they can contribute to reducing learning barriers, both cognitive and affective-motivational. The pandemic has highlighted the importance of supporting teachers and strengthening the pedagogical use of technological tools. However, there is the challenge of improving the effectiveness of training, as many teachers find it difficult to use new tools. It is necessary to promote training programs that facilitate the use of flexible strategies for a variety of students and teaching contexts. Masland’s (2021) proposal on resilient pedagogy, which meets psychological well-being needs such as autonomy, competence, and affiliation, can be an effective model to increase motivation and engagement.
3. Challenges for Parents:
Parents also face challenges, such as reviewing and modifying practices that negatively affect their children’s learning experiences. The current most prevalent issue is the excessive use of video games, cell phones, and television, which can exacerbate learning and development difficulties. Conversely, practices that promote reading, sports, and the arts should be encouraged, as they facilitate other types of learning and improve self-esteem and self-concept by developing competence strategies. Additionally, reward mechanisms are highly motivated by prizes, neglecting the practice of intrinsic motivation. The practice and discovery of this motivation foster more resilient development and improve frustration management.
4. Preparation of Educational Institutions:
Educational institutions must prepare for the return to classrooms with flexible mechanisms to design recovery and learning acceleration courses, as well as emotional support programs for students and teachers. It is essential to implement policies that allow reasonable adjustments so that students can equitably access resources and opportunities, evaluating possible losses in learning and development. These adjustments should seek to level students in cognitive, emotional, and social aspects.
Future Lines of Action for Support Therapists
Given the current challenges in the educational field, it is essential for professionals to analyze new lines of action and reflect on the measures and practices implemented. The pandemic caused a readjustment of previously established routines, incorporating new methodologies and resources. It is crucial to critically evaluate how students are adapting to these changes. Some of these lines of action include:
- Evaluating the Use of Technology: Investigating whether teachers' efforts to use and adapt to technology have facilitated effective knowledge construction processes and whether this benefits all students. It is important to adapt technology as a tool and not as the primary basis on which educational quality rests.
- Sustainability of Adapted Practices: Examining to what extent changes and adjustments in teaching practices are maintained after returning to in-person learning. Developing a routine adapted to new student needs will be crucial for development.
- Learning and Psychoeducation in the Family: Investigating the informal learning that has taken place in families during the pandemic and post-pandemic, identifying which of these are beneficial or harmful to cognitive, social, and emotional development. Professionals must guide and provide orientation in dynamics to promote improvement in different parenting styles and offer psychoeducation on new needs within the educational framework.
- Experiences and Meanings of the Pandemic: Exploring students' experiences and the meaning of the pandemic and how it has affected them within the educational system to establish new support programs that improve their impact on learning.
The pandemic has transformed the educational landscape, presenting challenges that require innovative and adaptive responses. Academic support therapists play a crucial role in this new context, helping students overcome cognitive and emotional barriers exacerbated by the health crisis. By reflecting on these new needs and adjusting our practices, we can work towards a more equitable, inclusive, and effective education for all students. The role of the therapist goes beyond cognitive reinforcement; they are the support link that will help steer in the same direction.
Written by:
Paula Taguas Labrador
Sinews MTI
Psychology, Psychiatry and Speech Therapy
Nutrition for Health and Wellness: Tips from a Madrid-based English-Speaking Nutritionist
Nutrition plays a key role in a person’s overall health and well-being. Adequate nutrition provides the nutrients necessary for growth, development, maintenance of optimal bodily functions and prevention of disease. Although each person is unique and may have individual nutritional needs, there are some general guidelines for healthy nutrition that I usually consider in consultation for those seeking an English-speaking nutritionist in Madrid.
It is true that in supermarkets or regular markets we may not find the same foods as in our home countries. However, in Madrid we can find all kinds of foods from different cultures, you just have to know where to look. That’s why, as an English-speaking nutritionist, I usually recommend different markets depending on what we are looking for. In addition, I often remind us to eat a wide variety of foods to ensure we get all the essential nutrients, to make sure we control portion sizes by learning to listen to your body’s hunger and satiety signals, and that we should also limit processed foods and added sugars to reduce health problems such as obesity, type 2 diabetes and heart disease. Finally, we should exercise regularly to maintain a healthy weight, strengthen muscles and bones, and improve cardiovascular and mental health.
Specific advice for vegetarians and vegans
Vegetarians and vegans in Madrid can face some specific challenges due to the predominantly meat-centred food culture in Spain. As an English-speaker nutritionist living inn Madrid, I come across a high percentage of people who do not consume any meat and/or fish at all and who, therefore, upon moving here have certain barriers when it comes to shopping or eating out. These include:
- Although the situation is improving, some restaurants may have limited options for vegetarians. Vegetarians may find that menus do not offer a sufficient variety of meat-free dishes. Even so, we should always make sure that the place we go to has some choice of fish if we eat fish or pulses. If we opt for the first option, it is easy, as there is a wide range of fish and seafood on offer in our country. Remember that, even if it is vegetarian or vegan, it does not have to be synonymous with healthy. For example, pasta with tomato sauce, although healthy, is not balanced.
- Food labelling in our country is very precise, but nevertheless, vegetarians may need to pay extra attention when reading product labels to make sure that they do not contain animal ingredients or other additives, preservatives or other unhealthy ingredients. This is why we should rule out foods high in saturated fats and those with a high sugar content. For example: A veggie burger may be healthy if it contains only vegetables and pulses, but not if it contains additional ingredients.
- It is necessary to consume a variety of vegetable proteins by including foods such as legumes (lentils, chickpeas, beans...), tofu, tempeh, edamame, quinoa, nuts and seeds in your diet to ensure you get enough protein. Sometimes the gastronomic offer in our country is different from that in your home country. Therefore, as an English-speaking nutritionist in Madrid, I recommend that all meals incorporate these types of foods to help maintain muscle mass.
- We must ensure an adequate intake of micronutrients such as vitamin B12 and calcium. Vitamin B12 is mainly found in animal products, so vegetarians may need supplements. Calcium can be obtained from foods such as fortified almond milk, tofu made with calcium sulphate, broccoli, kale, almonds and sesame seeds.
- Ensuring a good intake of iron: Plant-based iron (non-heme iron) is found in foods such as spinach, chard, legumes, dried fruits and fortified cereals. Combine them with foods rich in vitamin C, such as peppers, broccoli, or citrus fruits, to improve iron absorption.
Despite these challenges that vegetarian eating in Madrid can present, our city offers a wide variety of vegetarian and vegan options in restaurants, supermarkets and local markets. Many restaurants now have specific menus for vegetarians and vegans, and there are numerous shops specialising in vegetarian and vegan products. In addition, vegetarian and vegan communities in Madrid are growing, making it easier to exchange information and recommend vegetarian-friendly places.
Specific advice for people who do sport
As an English-speaking nutritionist in Madrid that exercises quite often and play different sports, I can tell that people doing sport in Madrid may face some common dietary problems, especially if they are not receiving proper guidance on sports nutrition. This can be a problem if you also do sport outdoors where, depending on the time of year, your needs change. Also, if we have just moved to another city, we can make the mistake of eating as we did before and the type of training has changed.
- Firstly, I see a lot in consultation that people who do sport tend to overtrain and underfeed. Some athletes can fall into the cycle of overtraining and underfeeding, which can result in decreased performance, chronic fatigue, loss of muscle mass and risk of injury. It is important to recognise the importance of proper nutrition to support recovery and athletic performance.
- Inadequate hydration: Madrid's climate can be hot for much of the year, increasing the need for adequate hydration during exercise. Lack of adequate hydration can negatively affect athletic performance and increase the risk of dehydration and heat stroke.
- Excessive processed foods: In Madrid, where the food culture often includes a wide variety of processed and fried foods, athletes may be tempted to consume too many foods high in empty calories, saturated fats and added sugars, which could negatively affect their health and athletic performance.
- Plan your meals around training: Eat a meal or snack containing carbohydrates and protein approximately before exercise to provide adequate energy and nutrition. After exercise, consume a meal or snack containing carbohydrate and protein to support muscle recovery and replenish glycogen stores.
- Dependence on supplements: Some people who play sport may rely excessively on sports supplements instead of obtaining necessary nutrients from dietary sources. If not used properly and under supervision, supplements may not be necessary and potentially have negative side effects.
To address these dietary issues, it is important for athletes moving to another country where they do not control local foods to seek nutritional guidance specific to their individual sporting needs. Working with a registered sports nutritionist can help design a balanced eating plan that meets energy, nutrient and recovery needs to optimise sports performance and overall health.
Sinews MTI
Psychology, Psychiatry and Speech Therapy
Autism Spectrum Disorder and Pathological Demand Avoidance
What is “demand avoidance” and when is it pathological?
We all experience “demand avoidance” at times, i.e. we resist doing something which is either requested of us or expected of us. This article sets out to raise awareness of and explore a specific “condition” or profile which has been identified in the field of Psychology but about which there is still some controversy and lack of understanding. The focus here is on children. Recommended strategies to support PDA sufferers, both at home and in education, are also outlined.
Demand Avoidance in People with ASD
People with Autism Spectrum Disorder (ASD) sometimes avoid situations which cause them anxiety or give them sensory overload as well as activities which are not in their usual routine. They also sometimes resist transitioning from one activity to another or avoid activities which seem pointless to them. They may refuse, have an emotional crisis or try and “escape”.
How does Pathological Demand Avoidance differ from the above?
Individuals with PDA might avoid the above situations for the same reasons. However, PDA has some unique aspects:
- Many everyday demands are avoided simply because they are demands. It is the expectation (from someone else or yourself) which leads to a feeling of lack of control, and this feeling triggers anxiety increases and even panic.
- There can be an ‘irrational quality’ to the avoidance – for instance, a seemingly dramatic reaction to a tiny request, or the feeling of hunger inexplicably stopping someone from being able to eat.
- The avoidance can vary, depending on an individual’s capacity for demands at the time, their level of anxiety, their overall health/well-being or the environment (people, places and things).
What kind of everyday demands are we talking about?
- A direct demand (an instruction like “brush your teeth!” or “put your coat on!” or “do your homework!”).
- An internal demand (e.g. willing yourself to do something or bodily needs, e.g. the need to eat when you are hungry).
- An indirect or implied demand (including any expectation, for example a question that requires an answer, food that you are expected to eat, or a bill that needs to be paid.
Conversely, a demand that triggers stress or anxiety in individuals with PDA is not necessarily something unpleasant: it could be, for instance, opening your presents on your birthday.
When was the PDA profile first identified?
The term was originally coined by Elizabeth Newson in the 1980s but it took until 2003 for it to appear in formal scientific research (Newson et al., Arch Dis Child 88:595–600, 2003). Originally, PDA was a term used to describe a group of children who did not fit into the stereotypical presentation of autism recognised at that time but who shared certain characteristics with each other, the key one being a persistent and marked resistance to demands. According to Newson, autistic children display rigidity through rules, routine and predictability; in PDA their rigidity is in their need to avoid demands and control situations, which can often lead to the child appearing extremely impulsive in their emotions and behaviour, as they react to what they perceive to be demands.
Whilst autistic children often show little or no sociability, children with PDA display surface sociability. However, they often fail to recognise boundaries and struggle to understand the social norms of relationships. Children with PDA, like autistic children, often experience early language delay but often catch up later. They might have normal facial expressions and make eye contact; however their speech content can seem odd and, importantly, communication can be significantly affected by demand avoidance. The predominant characteristic of children with PDA is their continued resistance and avoidance of the ordinary demands of life. Whilst autistic children can be reluctant to comply, this is often in a non-social way; they lack the empathy to make excuses or develop strategies for avoidance. In contrast, children with PDA develop multiple strategies of avoidance, which they are able to adapt to the adult involved and can appear socially manipulative. (Newson, 2000).
Outside the UK, there is little awareness of PDA. However, in the UK, the term has been given some attention in TV and social media and this has led to an increase in pressure to consider PDA as a diagnosable disorder. Currently, while PDA is mentioned in latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) it is treated as a specific profile under the umbrella diagnosis of autism spectrum disorders (ASD). However, this does not mean that clinicians cannot use PDA as a descriptive diagnosis alongside a clinical diagnosis of ASD.
How common is PDA?
We don’t know. Because demand avoidance is currently understood as one characteristic in a person’s neurodevelopmental profile and is neither a diagnosable stand-alone condition nor is there a standardised assessment for the characteristic, there are no data to reliably indicate how common it may be. Research to date has been limited and often unreliable.
“Can’t” versus “won’t”: the difference between PDA and Oppositional Defiant Disorder
It is without doubt very stressful for parents to experience their child avoiding simple tasks or refusing to follow rules or basic routines. However, it is essential that we distinguish between PDA (Pathological Demand Avoidance) and ODD (Oppositional Defiant Disorder). Whereas PDA is an anxiety-driven need to be in control and avoid demands or expectations, ODD is characterised by angry and irritable mood, an argumentative and defiant attitude and vindictiveness.
Accurately identifying whether a child has PDA or ODD is key for implementing the right support strategies and can help others outside the immediate family to better understand the child’s needs. Some key characteristics of PDA which can help us with this distinction are:
- Difficulty tolerating uncertainty or unpredictability;
- Language delay and trouble with social interaction, which is common among autistic children;
- Mood swings and emotional dysregulation;
- Impulsivity and risk-taking behaviors;
- Obsessions and compulsions related to control or avoidance.
Tactics PDA children might use include distraction, making excuses, or shifting blame to avoid tasks and maintain a sense of control over their surroundings. Understanding these coping mechanisms is crucial for designing effective strategies to support them in managing their anxiety-driven behaviours.
How might a PDA child behave in a school environment?
It is possible that approaches used by teaching or special needs staff for autistic children can be ineffective for a PDA child and might even make things more difficult. In a school setting:
- They may have poor self-esteem, although this might not be obvious from their behaviour.
- Like many young people with ASD, they may behave very differently at home and school due to masking
- They may find regulating their emotions very challenging.
- A PDA learner may not seem interested in ‘doing well’ and may respond negatively to praise, for example by destroying work.
- They may say that the work is boring, or that they already know it.
- They may use charm, imaginative talk or attempt to shock to avoid demands.
- They are likely to want to build friendships with peers, but may find maintaining friendships difficult due to a need for control.
In terms of school attendance:
- They may have experienced school exclusions, even from an early age.
- A PDA child or young person may be absent from school altogether. 70% of PDA learners are either not in school or regularly struggle to attend. Many PDA children are home educated.
- Not every PDA child will have attendance difficulties – some may have slipped under the radar completely.
Support strategies for Parents at home
Unfortunately, there is limited research on support strategies. However, it is evident that people with PDA are best supported with strategies and approaches personalised to their specific strengths and needs.
The following advice is compiled from an American organisation called Trails Carolina (Trails Carolina – Leading Wilderness Therapy For Teens and Adolescents) and the Autism Society, U.K.:
- reduce and/or remove demands whenever possible;
- a collaborative approach is likely to work best, where the child is treated as an equal, rather than adults acting as an authority;
- use indirect communication styles (rather than making demands directly)
- avoid potential stressors such as eye contact, touch and confrontational postures/physical stances;
- if the child is distressed, give them space, remove spectators or move the child to a quiet space if possible;
- a coordinated approach to support is essential, involving the child, their family, school and health or social care professionals;
- In addition, it has been suggested that people with PDA may benefit from:
- identifying and understanding their demand avoidance and its triggers;
- sensory regulation and creating a sensory environment that works for them;
- therapy, counselling, mindfulness and meditation.
Support Strategies for School or Education
- Focus initially on building relationships and trust with a key adult before learning is attempted.
- Focus on the end goal rather than the means of getting there.
- Collaborate with the learner, adopting a child-centred approach focusing on their needs and strengths, and negotiating with them.
- Allow PDA learners to follow their interests and passions, and ensure learning topics are useful, meaningful and relevant to their lives.
- Provide choices and options over what work is completed, when, where, how and with whom.
- Try to recognise any signs of escalation of stress or anxiety and address them before the student reaches crisis point. Distress is usually caused by emotional, social or sensory overload; be aware of the child or young person’s potential triggers.
- Avoid direct requests; use a tone of voice and phrasing so that requests are made indirectly and allow for flexibility.
- Keep expectations to a minimum so that you can focus on the ones that are really important. This may mean having to be flexible about, for example, uniform, timetabling, homework expectations and the way results and progress are recorded.
- Provide a quiet area such as a calm corner for learners to use when they feel overwhelmed.
Some of these approaches may require significant adjustments on the part of the school, but they could be essential in ensuring that a PDA child continues to attend school.
The ongoing debate about PDA
Finally, it is necessary to highlight that, within the autism community (which includes autistic people and their families, autism researchers, health care professionals and education professionals) there is a great deal of disagreement about the validity and usefulness of the concept of PDA. However, one point on which there is broad agreement is that more and better research into Pathological Demand Avoidance is required.
Resources on PDA for Teachers and Parents
- Twinkl has partnered with the PDA Society to provide some helpful guidance documents (PDA PANDA Approach: Disguise and Manage Demands | Twinkl)
- The Autism Society (Demand avoidance (autism.org.uk). This page includes some real-life experiences in the form of quotes.
Abouth the author
Julia Jakubovics is from the UK. She has lived in Spain for over 20 years. She has a degree in Psychology and recently completed a Masters course in Interventions for Learning Difficulties in Children at ISEP (Instituto Superior de Estudios Psicológicos). She is currently working as a Shadow Teacher and Study Coach for Sinews, providing one-to-one and in-class support for children with special education needs.
Sinews MTI
Psychology, Psychiatry and Speech Therapy
What is narrative therapy and how can it help me?
Narrative therapy is a form of therapy that is based on the idea that people are the storytellers of their own lives and that by changing the way they tell their stories, they can also change the way they perceive themselves and the world around them. In this article, we will explore in depth what narrative therapy is, how it works, and how it can help us.
What is Narrative Therapy?
Narrative therapy is a form of therapy that focuses on the narration of personal stories and the exploration of how those stories affect a person’s life and experiences. It was developed by Australian therapist Michael White and New Zealand therapist David Epston in the 1980s. Narrative therapy is based on the idea that people construct their identities through the stories they tell about themselves and that these stories can be modified to promote change and personal growth.
Key Principles of Narrative Therapy
Narrative therapy is based on several key principles that guide the therapeutic process:
- Externalization of the Problem: One of the central principles of narrative therapy is externalizing the issue. This involves separating the problem from the person, allowing the person to see the problem as something external to themselves and, therefore, easier to address and change.
- Co-construction of Alternative Stories: Instead of accepting a single narrative about their lives, clients are encouraged to explore and co-create new alternative stories that may help them reinterpret their experiences in a more positive and empowering way.
- Respect for the Client's Experience: Narrative therapy believes in respecting the client's experience and the importance of allowing people to tell their own stories in their own terms. This involves active listening, validating the client's experiences, and working collaboratively with them to find solutions that are meaningful to them.
Why is Narrative Therapy Healing?
Narrative therapy is considered healing for several fundamental reasons that are rooted in its approach and therapeutic practices. Here are some key reasons why narrative therapy is perceived as a healing form of therapy:
1. Identity Reconstruction:
Narrative therapy allows people to reconstruct their identity by challenging dominant narratives that may be contributing to their emotional distress. By changing the way personal stories are told, clients can develop a more compassionate and empowering understanding of themselves, contributing to a renewed sense of self-esteem and self-acceptance.
2. Empowerment Promotion:
Narrative therapy promotes empowerment by focusing on the individual’s strengths and resources. Through the co-construction of new alternative stories, clients discover that they have the ability to influence the direction of their own lives and to face challenges with resilience and creativity.
3. Redefinition of Past Experiences:
By rewriting past stories from a more positive and empowering perspective, narrative therapy helps people find new meanings and lessons in their past experiences. This can lead to greater acceptance and inner peace regarding past events that may have previously caused distress or emotional pain.
4. Encouragement of Self-Reflection:
Narrative therapy encourages self-reflection by inviting individuals to examine their own stories and narratives in a more conscious and reflective manner. This process of self-exploration can lead to greater self-awareness and self-understanding, facilitating personal growth and positive change.
5. Building Meaningful Relationships:
The therapeutic relationship in narrative therapy is based on respect, empathy, and collaboration. This genuine connection between therapist and client provides a safe and supportive space where individuals can explore their personal stories and work together to find meaningful and lasting solutions.
Applications of Narrative Therapy
Narrative therapy has been successfully used for a wide range of issues and populations, including:
- Depression and Anxiety: Helps clients reconstruct negative narratives about themselves and find new ways to relate to their emotions.
- Trauma: Allows trauma survivors to rewrite their stories of survival and resilience.
- Family Conflicts: Facilitates communication and conflict resolution within families by helping members understand and redefine their relationships.
- Identity Issues: Helps individuals explore and assert their unique identity in the face of social and cultural pressures.
Examples of Narrative Therapy Exercises
Here are some examples of tools employed in narrative therapy:
- Self-Compassion Letters: This exercise involves the client writing a letter to themselves from a compassionate and understanding perspective. In the letter, the client can gently express their feelings, acknowledge their strengths, and remind themselves that they are worthy of love and acceptance, even in times of difficulty.
- Strengths Family Tree: The therapist guides the client in creating a family tree that represents the strengths and resources that have been passed down through generations. The client can reflect on the strengths of their ancestors and consider how these positive qualities have influenced their own lives.
- External Observer: The client takes on the role of an external and objective observer to examine their own experiences from an emotional distance. This can help the client gain a new perspective on their problems and separate their personal identity from the events and circumstances that have occurred in their lives.
- Life Book Creation: The client creates a life book that includes significant moments, achievements, and experiences that have shaped their identity. By reflecting on these events and narratives, the client can identify common patterns and discover new ways to interpret their personal story.
- Gratitude Journaling: The client keeps a gratitude journal where they record things they are grateful for each day. This exercise fosters a more positive and appreciative approach to life and helps the client recognize the good things that exist amidst challenges and difficulties.
In conclusion, narrative therapy is a powerful tool that can help people reconstruct their life stories and find new ways to relate to their experiences. By changing the way they tell their stories, people can change the way they perceive themselves and the world around them. Whether facing depression, overcoming trauma, or navigating family conflicts, narrative therapy offers a client-centered approach that promotes meaningful and lasting personal change and growth,
Abouth the author
Verónica Sarria is a health psychologist at Sinews. She is specialized in eating disorders and obesity, working with adolescents and adults. She also treats other problems such as anxiety, depression, grief, self-esteem and interpersonal relationship problems, among others. Her orientation is cognitive behavioral but she integrates tools and techniques from other currents according to the needs of each patient, thanks to her training in mindfulness, mindful eating, attachment theory and systemic (family) therapy.
Sinews MTI
Psychology, Psychiatry and Speech Therapy
Improving Your Eating Habits: A Guide by an English-Speaking Nutritionist in Madrid
Food has undergone significant changes in recent decades due to a variety of factors, including changes in eating habits, technological advances, food availability and lifestyle changes. Added to this is the change in food consumption patterns. With the fast pace of life, many people are relying more on foods prepared outside the home, such as takeaways, fast food and restaurants. These foods are often convenient, but they also tend to be high in calories, saturated fat, added sugars and sodium, and low in essential nutrients such as vitamins, minerals and fibre. In addition, they can contribute to weight gain and related health problems. This way of eating is very in common in certain countries. However, in Spain, it is more common to eat home-cooked meals. As an English Speaking nutritionist my task is to adapt your foods to similar ones to make them as healthy as possible.
There are also several common mistakes people make when eating. Here are some of the most common ones:
Most common eating mistakes
- Eating too many processed foods: Processed foods are often highly palatable, tasty, but high in calories, saturated fat, sugars and sodium, and low in essential nutrients such as vitamins, minerals and fibre. Eating too many processed foods can contribute to obesity, heart disease, type 2 diabetes and other health problems.
- Consuming sugary drinks instead of water: Sugary drinks such as soft drinks, fruit juices and energy drinks can be a major source of empty calories and added sugars. Opting for water instead of these drinks can help reduce calorie intake and improve hydration.
- Eating fast and distracted: Eating quickly and without paying attention to hunger and satiety cues can lead to overeating. It is important to take time to savour food and be aware of when you are full.
- Not paying attention to portions: Many people are not aware of proper food portions and tend to overeat. This can lead to unwanted weight gain and make it difficult to control portion sizes in the future.
- Not including a variety of foods in the diet: It is important to consume a variety of foods to get all the nutrients needed for good health. By limiting yourself to a few foods or food groups, you run the risk of not getting all the essential nutrients. For a complete diet we should eat at least 20 different foods a week.
- Skipping meals or extremely restrictive diets: The belief in wanting to be in line with current beauty standards leads many people to believe that skipping meals or following extremely restrictive diets is the quickest way to lose weight. However, this can lead to nutritional imbalances and long-term health problems.
- Relying too heavily on supplements: Supplements can be helpful in certain situations, but they should not be used as substitutes for a balanced diet. It is important to get the majority of nutrients from food rather than relying exclusively on supplements.
Fortunately, in recent years there has been an increased awareness of the importance of a healthy, balanced diet to prevent chronic diseases such as obesity, type 2 diabetes and heart disease. This has led to increased interest in nutrition and greater availability of information on healthy eating habits.
How to improve our diet
There are several ways to improve the quality of our diets and eat healthier. Among them are:
- Incorporate more fruits and vegetables: these foods are rich in vitamins, minerals, fibre and antioxidants, and are fundamental to a healthy diet. Try to include a variety of different coloured fruits and vegetables in your daily meals and snacks.
- Choose whole grains: Opt for whole grains instead of refined grains to increase your intake of fibre and nutrients. Choose whole grain products such as brown rice, whole wheat bread, whole wheat pasta and oatmeal instead of their refined versions.
- Eat lean protein: Lean protein sources such as chicken, turkey, fish, tofu, legumes and low-fat dairy products are excellent choices for healthy eating. Try to limit consumption of processed and red meats, which can increase the risk of chronic diseases.
- Limit consumption of processed foods and added sugars: Reducing your intake of processed foods, such as packaged snacks, fast food and baked goods, can help you reduce the amount of added sugars, saturated fat and sodium in your diet.
- Cook at home more often: Preparing meals at home allows you to have more control over the ingredients you use and cooking techniques. Try to cook with fresh, healthy ingredients and limit the use of unhealthy oils, fats and seasonings.
Making better food choices is fundamental to maintaining a healthy and balanced diet. As a nutritionist, and specifically, as an English Speaking nutritionist I try to help people adapt their meals to their lifestyles while respecting cultural aspects as well as food preferences. Many times in my practice I find that people have barriers to, for example, finding certain ingredients that are very important in their culture, or that meal times are very different.
It is not always easy, but in my practice, I always try to help plan meals in advance so that we can make more conscious and healthier choices. Spending time each week planning menus and making a shopping list with the necessary ingredients makes our lunches and dinners more beneficial for us.
Once the menus have been drawn up, which should prioritise fresh and unprocessed foods, we should also read food labels. When buying processed foods, it is important to read labels for nutritional content. Pay attention to the amount of calories, saturated fat, added sugars and sodium contained in the products. Usually fresh and unprocessed foods (fruits, vegetables, whole grains, lean meats, fish and low-fat dairy products are excellent choices for healthy eating).
It’s not just a matter of meal planning but also portion control. Pay attention to portion sizes and practice moderation when serving yourself. Use smaller plates, share plates in restaurants or save leftovers to avoid overeating. Just as it is not good to eat 3 plates of pasta, it is not good to eat 3 oranges in one sitting.
Finally, drink water instead of sugary drinks. What you eat is just as important as what you drink. Water is the best choice for hydration and contains no calories or added sugars. Opt for water instead of sugary drinks such as soft drinks, fruit juices and energy drinks.
It is important to be aware of these mistakes and try to avoid them in order to maintain a healthy and balanced diet. By following these tips and gradually making changes to your eating habits, you will be able to make better food choices and enjoy the long-term health benefits. Remember that the key is to adopt a balanced and sustainable approach to eating. As I say in consultation, there has to be time for everything. To eat well and also to indulge from time to time. It’s OK to eat something less healthy from time to time, but be aware that you can’t overindulge.
About the author:
Adriana Martín is an English Speaking clinical nutritionist at Sinews. She treats adults, adolescents and children seeking to improve their health through nutrition. She specialises in public health and also treats ED, SIBO, chronic diseases and other pathologies, as well as muscle mass gain or weight loss. Her approach is not to prescribe closed menus, but to make people understand the importance of nutrition at every stage of life through different tools.
Sinews MTI
Psychology, Psychiatry and Speech Therapy
The Shonagai philosophy: The power of acceptance in the face of difficulties
We live in the era of «chaos» forgetting our wallet, being stuck in traffic or our battery discharged can make us go into an emotional outburst. These situations beyond our control are part of the stress we face in our day-to-day lives. The ability to remain calm in the face of what we can and cannot control is fundamental to preserving a healthy mental and emotional well-being. Faced with this, in Japan the concept «shou ga nai» was born, which in our western version would be «what are we going to do». It is very easy to say, but how can we integrate the concept «shou ga nai» in our lifestyle?
Get to know the concept of "shou ga nai"
From the Japanese philosophy comes the expression «shou ga nai» part of a philosophy where many of those who practice it, recognize it as «the secret of happiness». The Shoganai philosophy has its origins in Buddhism, therefore, it reflects a style of coping from the acceptance of circumstances that we cannot control.
This ability to maintain serenity in the face of difficulties does not deny our emotions, indeed, it does not focus on the conformism of our reality but preserves our efforts to change that which we can transform. This direction of our energy is a great protective factor when considering the disease of the 21st century: stress.
This refreshing new perspective brings us a new coping strategy that takes us away from cognitive rumination, automatic thoughts or paralysis by analysis, to bring us greater peace in our daily life situations and in which we can find a point of support, to look at our concerns with a broad outlook.
The integration of shonagai into the western world
The Shoganai philosophy is based on the pillars of mindfulness, where the importance of living in the present is recognized, moving away from «what I could have done» in the past or «what I will do» in the future. This concept has been tried to be transferred within the Western world as (it is what it is) in English or the popularly known (C’est la vie) in French. In other languages such as Icelandic we find (Petta reddast).
Beyond the globalization of the concept, the real key to this philosophy lies in its integration into our daily lives. In the Western world, it may seem fatalistic or pessimistic to «throw in the towel» in the face of difficulties. The key has been practiced by the Japanese, who focus their efforts on respect and acceptance of good and bad cycles as part of the way.
This philosophy makes us see beyond the concept, a lifestyle completely removed from western standards of «productivity» and how little we are allowed to «stop». We can find different translations of «shou ga nai» but sadly it is very far from our integration in the face of difficulties. A good starting point to establish a new cognitive reframing in the face of difficulties focuses on the differentiation between: «Conforming» as a reactive attitude while «Accepting» is a mature and proactive attitude, which translates into emotional stability, a sense of inner control and self-knowledge.
How to practice the Shoganai philosophy? Here are 4 simple steps for its integration
Take an instance of things
Before starting to analyze a situation, it is key to take a step back and try to find a moment where our emotions are more settled. When we all receive bad news, we are flooded with negative and even catastrophic thoughts, we tend to put ourselves in the worst, going into a state of alert as a strategy of preparation for danger. A vital tool that can help us in practice is the puppy metaphor:
«We have a puppy and we see how it does not stop sitting on our sofa, chewing the cushions and even begins to leave us some gift around the house … through this metaphor, we will see how we will see how we sprout frustration and anger to have our house impeccable, however, we must be patient and focus our efforts on educating the puppy, since a scolding would not help us at all.»
Identify which are and are not in your control
Once the metaphor has been put into practice, we will begin to analyze those things that have disturbed our routine and have led to a state of chaos in our order. Before their appearance, we will take enough perspective to establish a critical judgment. We will differentiate between: Can I change it? Yes, we take action. Can’t I change it? «In this case, we should accept it and save our energy.
Practice gratitude
Gratitude is a crucial part of integrating this philosophy, so that when our efforts are focused on the things that inspire gratitude, we encourage the development of a positive attitude. In the term this attitude refers to the cultivation of our resilience as a tool for adaptability in the face of difficulties. In addition to this, an attitude of serenity in a «calm mind» makes us find new solutions in situations we had not previously contemplated.
The more practice, the greater the mastery
This type of strategies, like mindfulness, do not try to be established with a goal of hours of practice. The key lies in its frequency, i.e., if you have 5 stressful situations during the day and you practice these simple steps in the 5, you will be training the mastery of the flow of thoughts, seeing how they become less and less present and that you have much greater awareness and control over your emotions in front of these. This continuity of short time and high frequency is what really works our ability.
Know the 5 Benefits for your mental health through the practice of the "Shoganai" philosophy
- Reduce your cortisol hormone: As the hormone responsible for stress, cortisol is produced by our body in "emergency" situations in order to cope with those situations that are out of our routine. Cortisol is as necessary as any other hormone, since it is indispensable for those situations in which we are in real danger. However, its prolonged maintenance can be detrimental to our health, promoting emotional irritability, lack of sense of humor or provoking emotional outbursts of anger or sadness. Beyond this, our quality of sleep or our immune system is weakened by this continuity. In view of this, the practice of the Shoganai philosophy can reduce our reactivity to stress and thus establish a correct regulation of the hormone.
- Increase your ability of resilience: Resilience is one of the most important skills when facing the challenges of our life, and is that, bring serenity is also focus your inner energy to listen to you, understand you and especially recompose yourself from those setbacks that assail us without warning. The absence of this ability can cause fear or loss of control to paralyze us, leading us to a state of obsession or rumination of our own thoughts. It is clear that resilience will not make our problems disappear, however, it gives us the ability to see beyond them, to continue and to appreciate the good despite the difficulties.
- Improve the stability of your emotions: The Shoganai philosophy leads us to a greater state of consciousness by focusing on the acceptance of the present, that is, to focus our strength on what we really have, in order to be able to modify our reality. This makes emotions that lead us to frustration move away, establishing a greater mental balance and learning to manage those that appear to us with relativity to the facts.
- Promotes Self-knowledge: The practice of Shoganai leads us to a state of resignation which brings us to an encounter with our emotions, this encounter from the acceptance gives us a deeper understanding of ourselves and the recognition of where our limits of will are, being more aware of those things that predispose us in that state of alertness. This self-knowledge is a key ability to know how to work in these stressful situations.
- Improve your attention span with creativity: Controlling your focus of attention directly improves the quality of your attention. The Shoganai philosophy, not only helps us to establish this control, but, with the acquisition of this, we find new solutions through creativity. This valuable quality, as experts say, is blocked in those situations where there is an overactivation of certain brain areas. When we approach problems from worry or pressure, our brain goes into a "state of alert" trying to solve situations quickly and automatically and therefore limiting our ability to find creative solutions.
The importance of lifestyle for wellness
Having learned about the many benefits of this innovative philosophy, it is essential to recognize its practical application in order to integrate it as a pillar of our lifestyle. The concept of «shou ga nai» may begin as a simple expression, but it has the power to transform itself into a new way of perceiving life and every circumstance around us. Its adoption is not a passive process, but requires active commitment, willingness and awareness. However, the efforts invested in its practice bring us the peace and mental balance essential to face daily challenges with serenity. Now, I ask you: Are you willing to immerse yourself in the practice of the Shoganai philosophy?
Written by:
Paula Taguas Labrador
Sinews MTI
Psychology, Psychiatry and Speech Therapy
Dyslexia: no need to wait until children fail to read
Dyslexia is a specific learning disorder of neurobiological origin, characterized by difficulties with accurate and fluent word recognition, verbal memory and verbal processing speed. It stems from a deficit in phonological awareness. It is a life-long disorder, although its impact on an individual can vary in different stages of their life. “Neurobiological” means that it is caused by certain cerebral abnormalities which are genetic in origin.
Although the number of early intervention programmes in schools, at least in Madrid, is growing, too often in schools, dyslexia is only detected when a child “fails” to learn to read and intervention only begins after a formal diagnosis is received, usually at around 7 years of age. The effects of delaying support-provision until this point is reached can include, not only bad academic performance, but also a negative attitude to school, low self-esteem and behaviour issues.
This article aims to provide information to teachers and parents on detecting risk of dyslexia in pre-readers and on the best techniques to ensure that children with difficulties learn to read successfully.
How much do teachers know about dyslexia?
Unfortunately, in contrast to the United States, there is still a lack of teacher training in dyslexia in Early Years and Primary schools in Spain, and the amount that teachers know about the disorder varies, depending more on their individual experience of children than anything else. The fact that dyslexia is one of the most common disorders to encounter in the classroom (in Spain the percentage of children with dyslexia is 7-10%) underlines the importance of addressing this problem, through the provision of training and information resources.
Common myths surrounding dyslexia, which need to be dispelled, are, for example:
- that the main symptom of this disorder is writing letters back-to-front or reading words backwards;
- that dyslexia is caused by a problem with visual processing;
- that dyslexia is associated with a low level of intelligence;
- that dyslexia can be cured.
How can dyslexia be detected in children before they reach reading age?
There is considerable consensus amongst researchers as to what are the early signs that a child is at risk of later experiencing reading difficulties. Below is a list of the signs which should alert teachers and parents to the possibility of risk. It is important, however, to bear in mind that many children present at least one of these behaviours to some extent. It is when at least three of these signs are present, and especially if they persist over time, that the red flag should be raised:
Many of the early signs of dyslexia are listed in this article. Other early signs (in children of 3-5 years) include:
- Difficulty remembering the names of familiar things, or with learning numbers, colours and letters;
- S/he likes listening to stories but shows no interest in the words or letters on the page;
- “Good” and “bad” days at school, for no apparent reason;
- Difficulty remembering sequences, such as days of the week, months, etc.
- Lack of attention or concentration;
- Lack of motor control, especially fine motor skills with writing tools, or with buttoning up clothes, tying shoe-laces, etc.
- Problematic social behaviours.
In many schools in the United States, there are periodic screenings for children at risk of dyslexia. These take place in the classroom and are based on what is known as the Response to Intervention model. The success of this model has been backed up by substantial research.
How can teachers screen for children at risk of dyslexia?
The screening of children at risk is more likely to be accurate if it is based, not only on the early signs mentioned above, but also on family risk. When children enter the school system, Early Years teachers have the opportunity to gather information about the child’s family when they meet with the parents of the children in their class. By asking whether parents or siblings of the child have had reading difficulties or been diagnosed with dyslexia, they will know whether the genetic risk exists. Children who have a close relative with dyslexia are at significantly higher risk of having the disorder themselves.
Meetings or interviews between parents and teachers are a way that teachers can be made aware of the child’s development and behaviours at home. Teachers could also provide information to all parents about dyslexia and the signs to look out for. However, it is important that pre-readers are not labelled at this early age; the aim of the screening should be to identify children who might have problems with the learning-to-read process. It is always possible that children who are identified later do not demonstrate any problems, or that with a little extra support, they are able to attain the reading level of their classmates. It is also important to take into account that difficulties may also be linked to another type of disorder.
What should happen after children are screened?
Initially, the idea would be that children who are identified as being at risk of developing reading difficulties are given extra support and reinforcement with phonics and developing their phonological awareness, either by regular school teachers, teaching assistants or special needs teachers. Over time, it is possible that several groups of children need to be taught separately at different levels, although this depends on the availability of teachers to give such multi-level instruction. Screening children from a very early age is never going to be an accurate predictor. It is always possible that children who appear to show early red-alert signs later turn out not to have difficulty with phonics and reading. Screening children periodically means that there can be regular monitoring of how each child’s reading skills are developing. In this way, if a child who was identified as “at risk” is found to be learning at a faster rate than expected, they can always be moved to another group to receive less intensive instruction.
How do we give children the skills to learn to read in the classroom?
The basic steps which should be taken in order to prepare children for learning to read are outlined in this article. Some other guidelines to follow are:
- Teach letter sounds (phonemes) with small letters first;
- Start with the most frequently used letters;
- Associate letters with words through pictures (e.g. /b/ with a picture of a baby);
- Reinforce letter shapes by getting children to trace them in the air, in sand, or over the printed letter shape;
- Ask the child to find things (e.g. in the classroom), starting with that letter.
- Once children have learnt all the single letter phonemes, teach them to blend consonants with vowels. Usually, the best way in the English language is to start with 3-letter consonant-vowel-consonant (cvc) words. However, if a child has difficulty blending the three sounds, it can be best to focus on blending vowel-consonant sounds first (at/ig/up etc.) or consonant-vowel sounds (ma/bi/po).
How can parents support this process with their pre-reader child at home?
If parents suspect that their child might be at risk of having difficulty learning to read (see the section above on early signs), they should not hesitate in informing teachers. It is also important that they share with teachers techniques which they have found work or do not work for their child at home.
Below are some more guidelines for parents:
- Try and look at books every day. Read stories and poems. A child does not automatically know how to hold or open a book, where the story begins, where the top of the book is, or in which direction words are read.
- Watch television or learning videos together. Children learn a lot more if they watch programmes together with their parents.
- Trace shapes and letters and make letters with plasticine.
- Play “I Spy” with letter sounds.
- Clap the syllables in words.
- Sing rhyming songs or songs about the days of the week, months of the year, etc.
- Magnetic letters are also very useful for reinforcing letter sounds, syllables and words at home.
- Expose your child to new words whenever possible to expand his/her vocabulary.
The following resources (Reading Rockets and Jolly Phonics) can be very useful for parents:
Family Guide from Reading Rockets | Reading Rockets
Hear all the letter sounds – Jolly Phonics (jollylearning.co.uk)
Although on the surface the Response to Intervention model requires an initial commitment of resources, especially human resources (teachers) for the regular screenings of young children and multi-group teaching, the argument in its favour is that if this results in fewer reading difficulties at a later stage, fewer resources will be needed for children once they reach reading age. Add to this the benefit of avoiding all the emotional, psychological and behavioural problems in children who do not receive the support they need in order to learn. Whatever strategy is used, it is very clear that we should not wait for children to fail at reading before we help them.
About the author:
Julia Jakubovics is from the UK. She has lived in Spain for over 20 years. She has a degree in Psychology and recently completed a Masters course in Interventions for Learning Difficulties in Children at ISEP (Instituto Superior de Estudios Psicológicos). She is currently working as a Shadow Teacher and Study Coach for Sinews, providing one-to-one and in-class support for children with special education needs.
Sinews MTI
Psychology, Psychiatry and Speech Therapy
Balancing diet and culture: Reflections from an English-speaking nutritionist in Madrid
Explore how cultural differences affect diet and nutrition, and how an English-speaking nutritionist in Madrid can help combining cultural dietary practices with healthy eating habits.
Moving to another country often involves significant changes in lifestyle habits, including eating habits. These changes can be due to a variety of factors, and it is important to be prepared to adapt to new practices and environments. The timing of (late) meals, for example, is something that comes as a big surprise to foreigners when they move to live in Spain.
In our country, food has a significant cultural, social, and economic importance as well as playing a central role in people’s daily lives. Spanish gastronomy is internationally renowned for its diversity, richness of flavours and the importance given to fresh, local ingredients. In addition, the socialising around food reflects the richness of the Spanish culinary tradition.
Cultural differences of food in Spain
This deep-rooted tradition of Spanish food can have a negative impact on the eating habits of people moving to Spain. It must be understood that cultural differences can have a significant impact on people’s nutrition. Here are some ways in which cultural differences can affect nutrition:
- Food preferences: Cultures have different preferences for tastes, textures, and types of foods. For example, some cultures may base their diet on spicier foods, while others may prefer milder or sweeter foods. These preferences can affect food choices and thus, the nutritional quality of the diet.
- Dietary patterns: Cultures also have specific dietary patterns, which may influence the frequency and quantity of meals consumed. Some cultures may have a habit of eating several small meals throughout the day, while others may opt for larger meals at certain times.
- Symbolic meanings of food: Food may have symbolic meanings in different cultures. Some foods may be associated with celebrations, rituals, or special events. This may influence the amount and type of food consumed on certain occasions, affecting nutritional intake.
- Food availability: The availability of certain foods may vary according to geographical region and climatic conditions. This can affect the variety and quantity of food available in each culture, which in turn influences the nutrition of the population.
- Social norms: Social norms around food, such as the acceptance or rejection of certain foods, can be strongly influenced by culture. These norms can affect food choices and quantity consumed.
- Gender roles: In some cultures, gender roles can affect nutrition, as expectations about who cooks, buys food, or decides about meals may vary. This can influence the quality and quantity of food consumed by different members of society.
- Tradition and intergenerational transmission: Recipes and food practices are often passed down from generation to generation. Culinary traditions can influence the choice of foods and how they are prepared, which affects the nutritional quality of the diet.
- Religious beliefs: Religious beliefs may have specific dietary restrictions that affect eating habits. For example, some religions may prohibit certain types of meat or processed foods.
How to find a balance between diet and culture
Finding a balance between diet and culture is essential to promote healthy and sustainable eating habits. Often moving to another country is synonymous with changes in our eating patterns, which can have a negative impact on our health. Seeing a Spanish nutritionist who speaks English and has lived in Australia can be beneficial for us as she will consider the following aspects:
- Respecting cultural preferences: Recognising and respecting the food preferences and culinary traditions of both countries is fundamental. This involves understanding the ingredients, cooking methods and food combinations that are significant in that culture. As a nutritionist, my job is to help combine aspects of both cultures to achieve a good diet.
- Adapt nutritional recommendations: It is important to adapt nutritional recommendations to the specific preferences and needs of a cultural community. This may include adapting dietary guidelines to reflect the most common dietary choices and to respect cultural or religious restrictions.
- Culturally sensitive nutrition education: Develop nutrition education programmes that take into account dietary practices and cultural beliefs. This helps people understand how to make healthy dietary choices within their cultural context.
- Incorporate local and seasonal foods: Encouraging the consumption of local and seasonal foods can be beneficial for both health and sustainability. Moreover, this aligns with many traditional food practices that have evolved to take advantage of the products available in the region. In Spain we have a great diversity of agricultural and livestock production that provides us with nutrient-rich foods.
- Promote dietary diversity: Encouraging dietary diversity is essential to ensure a balanced intake of nutrients. This can include exploring lesser-known but nutritious traditional foods.
- Celebrate festivals and cultural events with food: Integrating food into cultural celebrations and events strengthens the links between food and cultural identity. This can make people feel more connected to their traditions and at the same time promote healthy food choices. Spain is a country with a great diversity of festivities in which we eat traditional foods. Including us in our diet is a way of integrating into the new society.
- Address specific health challenges: Recognise and address specific health challenges within a cultural community. Some communities may face specific health issues related to diet, and it is important to address these issues in a culturally sensitive manner.
- Encourage home cooking: Promoting home cooking can be an effective way to maintain culinary traditions while controlling the quality of ingredients and portions.
- Adapt to cultural changes: Recognise that cultures evolve and change over time, and that eating habits may also change. Adapting to these cultural changes without losing sight of the importance of nutritional health is crucial.
In summary, consultation with a nutritionist when moving to another country can be essential to ensure that you maintain a balanced, healthy diet adapted to your new situation. Finding a balance between diet and culture involves respecting and celebrating traditional food practices while promoting choices that are beneficial to health and sustainable in the long term.
About the author:
Adriana Martín is a clinical nutritionist at Sinews. She sees adults, adolescents and children seeking to improve their health through food. She specialises in public health and also treats ED, SIBO, chronic diseases and other pathologies, as well as muscle mass gain or weight loss. Her approach is not to prescribe closed menus, but to make people understand the importance of nutrition at every stage of life through different tools.
Sinews MTI
Psychology, Psychiatry and Speech Therapy