Valerie Critten and David Messer on teaching children with cerebral palsy to write and spell.
Many children with cerebral palsy have difficulties with learning to write. Often this is put down to the fact that the children’s muscles and ligaments in their hands and arms are tight or uncoordinated but sometimes there may be other reasons. In a special school for children with physical disabilities, where the majority of the children had cerebral palsy, some of the children were very able but were slow with their literacy development, and in particular with learning phonics—the association between letters and their sounds.
Many children learn to spell and write at the same time, sounding out letters while writing them out, for example simple words such as cat and dog. While the children with CP were able to sound out the individual letters, they were not able to point to the letters individually or write them. It was as though the children were not able to see the individual shapes of the letters.
By the way, there’s an article by Minnie (MLJ) Abercrombie from 1964 in which she asked children to copy simple shapes. Figure 1 shows how a 15-year-old girl with CP copied four simple shapes.
The drawings on the left show her attempt to copy the shapes. She was able to copy simple individual shapes but she was not able to connect them together. For the two shapes on the right side, she was only able to approximate parts of the more complex shapes. As the children in her class seemed to have the same difficulty in that they only copied parts of letters, we decided to try to help the children to perceive the shapes using different methods other than copying or tracing. The children were asked to make individual letters using play dough, copying magnetic letters of the alphabet. This was quite successful except that the alphabet letters kept skidding off the table. Rather than teaching them to write with cursive writing the class used the Ball and Stick method to teach individual letter shapes: the letter d is a circle (ball) and a stick, and the letter p is a stick and a circle. This worked for simple letters but it was more difficult with other letters such as the letter a. The children were asked what the letter a looked like, they said it looked like a circle with a mouse’s tail, so that is what they used as a mnemonic to help them remember the shape to identify the letter and to write it.
Some of the children like Harry found it difficult to write with a pencil on paper. His fingers and wrists were weak, but he found it much easier to make marks by using a white board and pen.
Once the children were able to identify and write a few letters, the children started to put magnetic alphabet letters together to learn to spell simple words, however they found them difficult to manipulate as they were small and skidded off the table. Instead, the children were given large laminated letters which they stuck using Velcro onto boards. Using word families such as -it, -an, or -ug, the children used their phonetic knowledge to add a letter at the beginning to make simple words, for example, jug, mug, and bug.
The advent of digital tablets helped to revolutionise the teaching of phonics and letter writing with free apps available to download. Once the children were able to write a few words they were able to compose simple personalised stories using their own photos and drawings on tablets which could be printed, emailed or shown on white boards in the classroom.
Although these photographs show children aged about seven, these teaching approaches were also used successfully with secondary aged children who were still learning the basics of spelling and writing.
Not all children with cerebral palsy will learn how to spell and write as other abilities such as intelligence will play a part in each child’s development. However, teachers can check to see if the children in their classes have difficulties in copying simple shapes and use these types of teaching approaches to help them develop literacy skills.