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Strategies helped Dominic adjust to primary school 

Starting a new school, and meeting new teachers, assistants, and friends is a big adjustment for any child, and it takes time to adapt. Every family wants their kids to feel good, thrive, and enjoy school. Meet Dominic, a seven-year-old boy who loves numbers and lego. 
Dominic lives with his parents and brother. He loves numbers, letters, watches, clocks, and to build with lego. He has a unique memory for names, people, places, and dates, speaks two languages, and can understand English as well. He can read in all three languages proficiently.
”Dominic is kind and loving and has a great sense of humour.”
Dominic is kind and loving and has a great sense of humour. He enjoys spending time with adults and talking with them about life and interests. Also, he likes to learn about other people and their family lives.
Among his friends at his inclusive primary school, he is popular. After the first weeks of school, he began to show them a little more interest and now he spends more time with them. Dominic likes the school subjects and finishes his work quickly, so he gets extra tasks. 
Speech- and physical therapy is regular on a weekly basis. When he was younger, he had occupational therapy as well every week. Dominic gets support from teachers, special education teachers, a social educator, and teaching assistants at school. 
He doesn’t participate in any sports or hobbies after school at the moment and the family has been waiting for a support family or after school support for two years now. It is difficult to find someone for this job, and many families experience the same problem. His parents try to give each other some time for themselves, but both of their extended families live in another country, so it is not easy to find support.

Challenges with CHARGE syndrome combined with talents 

Dominic has a facial nerve paralysis which mainly affects his facial appearance. He cannot close his right eye and needs eye drops several times a day. His vision is 6/12 in both eyes, which means that he can read or see things at a six-meter distance that a person with normal vision could see at a twelve-meter distance. 
Dominic is sensitive to light, but he does not have coloboma. However, he was born with a heart condition called mitral regurgitation, which means a leak in the mitral valve in the heart. The family also recently discovered that he lacks a sense of smell but can still taste food. CHARGE syndrome has impacted his speech and both fine and gross motor skills. He is also diagnosed with autism and has hearing loss in his right ear due to the absence of a cochlea, so he uses hearing aids. This affects his balance.
”Despite these challenges, Dominic has exceptional talents for numbers, people, and things that interest him.”
Despite these challenges, Dominic has exceptional talents for numbers, people, and things that interest him. He speaks two languages and in addition can read in English. When using his first language, his vocabulary and understanding are better, and he uses 5–6-word sentences.
Dominic likes to repeat things a lot, and his language compre​hension and communication are in constant progress. He used sign language till he was five years old, and it helped him a lot, but now he no longer uses signs.

Assistance in everyday life 

Due to his hyperopia (farsightedness), Dominic wears glasses. When outdoors he also has filter glasses with a protective frame against the wind. For the time being, he does not need enlarged text or pictures, but the school knows what to do if this changes. The school has access to advisors at a national institute for blind and visually impaired and deafblind, who provide guidance on Dominic’s sensory functioning.
It is important to stay close to Dominic when speaking with him, ensuring eye contact and good acoustics. This facilitates the communication.
He has a designated contact person at the National Hearing and Speech Institute for adjustment and assistance at school.  
Dominic’s balance is weak due to the lack of his cochlea. Earlier he used to wear a soft helmet outside for protection, but he does not need it anymore. He tends to stumble and fall easily and tires quickly. The use of extra time combined with good quality shoes are important for his comfort. For longer walks, he needs a pram or a bike.

Daily routine is important 

Dominic is sensitive to both loud noises and light. He prefers routines and may find sudden changes challenging, such as when the teaching assistants cannot be with him due to illness or if the daily schedule changes. For a period of time, in the after-school program he enjoyed reading the same book every day, sitting on the same sofa. 
”Dominic has excellent skills and memory on topics of interest and can do his daily activities independently.”
Dominic has excellent skills and memory on topics of interest and can do his daily activities independently. However, he prefers to do things his way. When he is in distress, the teachers may not always understand why this occurs.  
Sometimes, too many changes coincide, creating a lack of control. One semester Dominic got both a new teacher, new teaching assistants, and new support staff. He needs time to get to know everyone and build trust with them.
Keeping him well-informed through spoken language, written information, or both, is a good strategy so that he knows in advance what to expect during the day. In kindergarten he and his class had a visual schedule and that has been used in primary school as well.   
After school, Dominic is often tired and can have challenging behaviours. Sometimes he struggles to sleep which also affects his energy and well-being.  

Different support systems 

The support systems differ between kindergarten and primary school. Kindergartens often assign one teacher or teaching assistant to have the main responsibility for supporting a child during the day, which includes different types of therapy, organising meetings, sharing knowledge, and working with advisors. The team of teachers works together during the day with the children. 
In primary school, a team of people provides support and works with the children during the day, including teachers, special education teachers, developmental therapists, and teaching assistants. In addition to this the children meet a lot of other persons during the week. Both systems have their advantages and disadvantages.
In situations where Dominic needs to relax, the teachers found it helpful to go to a quiet room with him before returning to class. They have also noticed differences in his energy levels during the day, and the week. He has more energy in the morning, and at the beginning of the week but is tired at the end of the day and the end of the week. This is taken into consideration when planning the week's schedule.

Relationships developed with time 

Dominic has good relationships with the teachers, although he can become dependent on specific individuals and get upset when they are not around. 
In the beginning, when his classmates wanted to play with him, he was not very interested. After the first semester this changed, he was more responsive and began to interact with them. He still struggles with group work sometimes which may be related to CHARGE syndrome or his autism diagnosis. 
The teachers have tools to assist with social learning, but those are not always suitable due to communication challenges. Understanding Dominic's feelings and triggers is crucial for the teachers if he gets upset, and that understanding takes time. 
During the first year, various situations would upset Dominic, which showed some potential triggers such as loud noises, group size, proximity, room acoustics, or if he was tired or hungry. Sometimes a class, that he usually enjoyed, could upset him but the teachers did not understand why.  

Strategies to help Dominic adjust to a new school

  • Independence: Encouraging Dominic to get his books, papers, snacks, etc, and setting reasonable demands. This includes setting limits, being firm but kind, giving him time, assisting him at the beginning of a class, giving him space when needed, and then again refocusing on his interests, and finding more new and interesting things.
  • Visual aids: Using a visual schedule helps Dominic to understand the agenda for the day or month. 
  • Time: Allowing time for adjustment, such as progressing from having lunch in a quiet room to joining the entire class in a larger setting.
  • Breaks and quiet time: To provide breaks or quiet time when needed. Introducing breaks during the day to reduce anxiety and increase routine and predictability.
  • Adjustment: Organising the environment/classroom and making changes to enhance interaction. For example, removing a couch he always sat in during circle time encourages him to sit with his classmates and interact with them.
  • Group size: Organising small groups when necessary, ensuring more attention and opportunities for interaction. 
  • Introducing a variety of activities: Encouraging a variety of activities, like clubs in the after-school program, to help Dominic participate more actively. 
  • Sensory overload and stress: When Dominic feels overwhelmed, it's important to listen, give him room, and provide quiet time for him to regain his balance. 

Strategies that gave results 

With time, adjustment, and good assistance Dominic is now happy in school. He is more independent, social, and relaxed. Now, he gets less upset, interacts more with his classmates, and participates in all activities during the day. He handles unexpected events much better. Knowing the routine and schedule makes him safe and calm and helps him enjoy school.
The first year in school is always an adjustment period. Getting to know the teachers, classmates and the school requires effort and patience. To build trust takes time, but a positive attitude, passion, teamwork, and solution-oriented mindset will give results.
Every family wants their children to participate in school and society with joy, understanding, and the freedom to be themselves, to belong, and to be accepted. It is essential to maintain good communication and cooperation with families, providing support in their everyday lives.

For Dominic, the CHARGE acronym means

C: Challenges with vision: sensitivity to light, with visual acuity at 6/12, but without coloboma.
H: Heart condition, mitral regurgitation.
A: Anosmia, a loss of smell.
R: Remarkable talent for things he is interested in. General impact on speech, and fine and gross motor skills.
G: Not applicable.
E: Ear/hearing-problems, loss of hearing in the right ear and the absence of a cochlea.