What teachers need to know: PWS in the classroom

by Linda Thornton

It is important that we recognise the learning ability of the child, and meet their individual, special needs as required. 

Students with PWS are very receptive to learning and are keen to please.  In general they have good reading skills, but poor numerical skills and handwriting can be slow to develop.  They show ability to learn computer skills and often have excellent fine motor skills, for instance, many are particularly clever with jig-saw puzzles, threading beads, and many show an aptitude for fine handiwork including needlework and knitting.  The IQ level generally falls in the just-below-normal category, but often shows “islands of

competence”, in other words, they might be equal with their peers in some areas, but need support to reach potential in others.

Throughout integrated primary and secondary education, it is important for the student to have teacher aide time.  Although this is not always available for many students with special needs, it should be applied for on all levels.  The need for teacher aides will not decrease as the student progresses.

Teachers should be as familiar as possible with the characteristics of this syndrome, even including the genetic sub-types, as this will impact on the learning ability of the student and the teaching strategies employed.

Genetic sub-types:  Within the deletion on Chromosome #15 which causes Prader-Willi syndrome come three sub-types:

1. The most common is the actual Deletion (a deletion on their paternal side)
2. Secondly comes the Maternal Disomy  (a double copy of the mother's chromosome)
3. Thirdly is the the mosaic imprinting.

Certain characteristics are now being recognised in each group and a flurry of research has provided us with the information that those with UPD generally have better-developed expressive language (Roof et al., 2,000; Whittington et al 2004), but somewhat poorer visual memory and puzzle-solving skills (Dykens, 2002; Verdine, Troseth, Hodapp, & Dykens, in press). Individuals with UPD may be less apt to skin-pick (Dykens, Cassidy, & King, 1999; Symons et al., 1999

Comparing 12 participants with Deletion and UPD deletions, Butler et al. (2004) found that the Deletion group had lower reading, math, and adaptive behavior scores, and higher externalizing behaviors and severity of compulsions"

Those with the mosaic imprinting tend to have more behaviours similar to those with autism, so if your skills lie with teaching those with autism, many of your practices will be similarly employed with PWS. 

Although you may not be told the deletion type of your student, it will help you to understand why not all students with PWS are the same!

(Further reading scroll to "Differences in Genetic Subtypes")

Relative learning skills:

 Maths teaching needs to be conceptual, practical, and often repeated several times before there is understanding.  Teaching the use of a calculator immediately helps the level of understanding.  Once understanding has occurred, the concepts generally remain.  Like all students, they thrive on praise.

• Good long-term memory skills
• Receptive language
• Good at puzzles
• Visual processing (relative to auditory processing)
• Basic maths skills (especially with calculator)
• Reading skills
• (Some) good computer skills
• Social and friendly

Learning weaknesses:

• Poor short-term memory skills (visual-motor and auditory-visual)
• Expressive language
• Poor fine and gross motor skills
• Sequential processing deficit
• Difficulty with abstract concepts
• Short attention span
• Communication difficulties (may end in temper outburst)

It is important that the behaviours or issues that challenge are identified.  Some will result in having to manage the actual environment with school lunches and all food being kept out of reach, money being held by teachers (for all students ) and some new management skills.

TEACHING STRATEGIES

Give positive instructions:

Students with PWS tend to have a fairly rigid or concrete way of thinking, and tend to work best to a set routine and positive timetable.  They can accept change if prepared for it beforehand, but a sudden, unexpected change may result in an uncooperative student.  It is sensible preparation to warn beforehand if something is to be postponed or cancelled.  If the student doesn’t clearly understand the instructions, you may find resistance to change.  Do make sure the student knows that this will not change lunchtime!  A common indicator of this might be persistent or repetitive questioning from the student in spite of having heard the answer.  Be patient, use visual as well as verbal, instructions.

Perseveration:
Constant persistent questioning is a common characteristic of the syndrome.  Answer questions up to two times, then write it down if necessary.  Check with the student to see they clearly understand your answer.  Ask them to tell you what they are going to do, or what the answer is; even ask them to write it down for you.  Clear communication is the key here.

Use visual schedules:

The student may have difficulty in finishing a task on time, or may display perseveration (repetitive questioning), a characteristic common to the syndrome.  Perseveration indicates an inability to process information coherently or sequentially.  Not finishing a task on time can incite some obessive compulsive behaviour.  In both cases, using both a verbal reminder, combined with a visual schedule, or prompt, will assist the student.  This may be anything from a simple egg-timer, to a daily pictorial class schedule to help with time-keeping. Children with PWS greatly enjoy achievement charts, no matter what the age.

Always have Plan A and Plan B:

It is sensible to have a fall-back plan in the likelihood that your Plan A does not eventuate.  This will prevent disappointment, frustration and anger, and keep the student in the loop.  Working out probabilities and possibilities beforehand, including extra staffing, is a precaution that is essential.  Occasions will arise when the student refuses to go on an outing, or to participate in a class activity.  Rather than have this spoil the day, Plan B can be brought into play.

Break tasks down into manageable parts:

• Have no more than two-step directions
• Have shortened assignments
• Brief (or no) homework
• Ask - don't demand
• Control access to food and money
• Identify areas of accessibility (to food and money)

All teachers have their own workable strategies - the above is designed to help understand the thinking of the student with PWS.

If you would like further information on strategies to use in the classroom, contact us.