It is important to have HIGH LEARNING EXPECTATIONS for children who have Noonan Syndrome. Encourage use of the core educational curriculum and modify it in order to meet the individual needs of the child.
What you need to know
- Most children with NS have normal intelligence, but 10-40% require special education supports. Even in individuals with NS who have normal intelligence, their IQ is about 10 points lower than unaffected family members.
- Most children will perform well in typical education settings. It is important to identify their strengths and challenges.
- In adolescence, consider vocational needs. This can include: assessing cognitive strengths and weakness, teaching adaptive behavior, and teaching daily living skills as needed.
Motor development may be delayed. This is due to a combination of overly flexible joints and low muscle tone.
- May have a higher rate of clumsiness and coordination
- Physical and occupational therapy may help gross motor and fine motor skills
- Motor issues may lead to poor sitting posture and difficulties with balance
- Short stature may affect positioning
- Activities that require good hand eye control (i.e. writing, drawing and painting) may present difficulties
- Pencil and tool skills may be weak due to poor motor control and difficulty with coordination
Some people with Noonan Syndrome have hyperelastic skin, joint hypermobility, pain and/or fatigue issues. Tips that have been developed for those with Ehlers-Danlos Syndrome may be useful.
- Language difficulties in children are common and can be the root of future difficulties in literacy skills, including reading, writing, and spelling.
- Individuals with NS may have signs of developmental disorders such as dyspraxia, ADHD, autism spectrum disorder (ASD).
- Cognitive difficulties including, executive functioning, concentration, attention, impulsivity, short-term memory, receptive language, repetitive behaviors, dislike of change, and visual/spatial abilities may be evident.
- Verbal performance is typically lower than nonverbal performance.
- May have difficulty with higher order language such as reasoning, problem solving, understanding humor, and perceiving the rhythms and subtle contours of verbal speech.
- Articulation problems are common. However, most (72%) respond well to speech therapy.
- Language delay may be related to hearing loss, perceptual motor, or articulation deficiencies.
- Problems with sustaining attention, switching tasks
- Abstract language and concepts can be difficult to grasp
- Metaphors may be rarely used or understood
- Instructions may be heard but not retained long enough for action
- Difficulty with integration skills, working memory, and episodic memory
- Executive function issue affect planning, thinking flexibly, and understanding the abstract.
- May struggle to remember, process, and organize information efficiently
- This can lead to problems in math and reading.
- Executive function is based on a group of related cognitive and behavioral skills. They are responsible for goal directed activity including:
- Attention
- Short term memory
- Planning and organization
- Behavioral inhibition
- Social interactions
What you can do
- Ensure appropriate seating and positioning
- Make sure desk fits
- Storage and lockers are right size and height
- Occupational may be useful; OT may be needed to make changes due to short stature
- Physical therapy and/or education may help motor skill development
- Modify copying, for example, provide a copy of teacher's or other student's notes
- Provide simple overview or summary before lesson
- Provide clear tests that are as simple as possible with only a few problems on a page. Graph paper may help especially in math problems
- Use lined paper to help place written responses on the sheet
- Allow extra time on work, and limit written homework
- Practice tracing shapes and copying pictures
- Provide feedback as they may not be aware of mistakes
- Use verbal descriptions to reinforce visual information
- May have difficulty matching shapes and sizes
- Puzzles may be challenging
To help with pencil and implement skills due to poor motor control:
- Use thicker pencils or pencil grips
- Sloping surface may help (easels)
- Use fine motor activities (Legos, play dough)
- Practice folding
- Practice cutting with scissors
- Write on every other line
- Allow tracing
- Take learning style into account
- Many strategies that are used with dyslexia can be effective
- May appear to understand but have low comprehension
- Speech therapy for speech and articulation issues
- Seat with limited distractions
- Post schedule and assignments in easy viewing
- Review schedule visually and verbally
- Give reminders of schedule during the day
- Review homework
- Prepare for transitions
- Provide alerts 15, 10, and 5 minutes before transitions
- Consider visual and verbal reminders and instruction
- Help with daily organization
- Pair student up with well-organized peer
- Break instructions into steps
- Use priority lists for large assignments
- Allow extra time for tests
- Allow use of fidget toy
- Use communication book between teachers and parents
- Develop rules and routines
- Can be a problem with expressive language delays
- Individuals with speech and motor difficulties often benefit from speech and occupational therapy
- Promote language understanding by using simple short sentences, visual prompts, and pictures
- Use a child’s experiences and interests to engage in learning
- Allow extra time
- Repeat directions
- Provide lesson summaries
- Record lesson so child can listen again
- Promote language development
- Give ample time for responding
- Boost self-confidence by calling on them when they know answer
- Encourage child to repeat the questions before responding
- Allow time to rehearse and respond
- Help with organization
- Present information concretely
- Use manipulative materials to demonstrate concepts
- Simplify verbal and explain concepts clearly
- Provide visual cues and instructions
- Repeat information and use positive reinforcement
- Ask child to repeat instructions
- Help the child find a starting point especially on complex tasks
- They often have a hard time with multiple step tasks. They may lose track of what they are doing.
- Select relevant task goals
- Use a calendar to track important events
- Organize a means to solve complex problems
- Monitor and evaluate behavior and emotions
- Help organize everyday needs at school and at home
- have a place for all things
- use different colored notebooks for different subjects
- Early identification and intervention
- RTI (response to intervention) program