by Stanley I. Greenspan, M.D. A child in my room, who is bright and very verbal, still doesn't know his way around. He can't figure out how to find me, his friends, or whatever materials or toys he wants to use. He gets so frustrated that he has tantrums. His mother says the same thing happens at home when he looks for her and can't find her. He panics, cries inconsolably, and becomes clingy or enraged. Children, like the rest of us, use their senses — vision, hearing, smell, touch — and their own movement patterns to take in the information they need to understand their world. Ordinarily they process this sensory information. But some children have difficulty processing through one sense or another. The child you describe seems to have difficulty processing visual information, including spatial relationships, which affects how well he can understand what he has seen. Understanding From the Child's Point of View Most children have a mental road map of their school after a few weeks, so they are able to go out of their room and find their way back; and within the room, they easily find the block corner, the snack table, or their cubbies. They know where they are and how to get to the teacher; how to find their best friend; and where their mommies will meet them later in the day. But the child you describe is having trouble processing the necessary visual information to do these things even now, after being in school for months. And not knowing where important people or his things are understandably causes him to panic. Since he has visual-processing problems and doesn't have a mental map of where Mommy or you are in relation to himself, he doesn't feel secure. Another child who can't remember what she hears, because of auditory-processing problems, would have trouble learning language. You point out that the boy in your group is very verbal and seems bright. This makes it less likely that adults will consider that he might have special needs. By speaking with the parents and discovering that similar things go on at home, you have confirmed his lack of a sense of direction. You might also find out whether he is able to play copycat games. I would expect him to be very good at listening and repeating words, letters, or numbers, but not at remembering things he has encountered visually. How Can You Help? The brain is tremendously flexible; just because a child starts off with a challenge like this one doesn't mean it must be permanent. Once you are certain that his trouble is with creating mental road maps, there are things you can do to help. The key is regular exercise, just as it is for developing muscle groups. With guided practice, some children's processing capacity will grow faster than other children's, depending on their natural abilities, but it's rare that we can't help any one of them make major gains. It's important to recognize that this particular child's anxiety is the result of not being sure where he is in relation to people he relies on. Providing extra practice in creating visual and spatial road maps will enable him to become more and more secure in space. I have some concrete recommendations but there is one more general point about processing I'd like to make first. All of the sensory channels — sight, smell, touch, sound, movement — are also involved in what we call emotional processing. We humans use our emotions as a sensory system. Children, too, use their emotions as sensory antennae. But children with special needs vary in their ability to process information emotionally, in part because at least one other sense often doesn't work well. For example, it would be difficult for a child with an auditory-processing difficulty to figure out whether a person's voice suggests friendliness or meanness. And many children with special needs have a hard time using their emotions or desires to process information and act appropriately in interpersonal settings. It will be helpful to keep that in mind when following these recommended steps. First, establish the limits of the child's abilities. Let's say that both his mother and you notice that when he has either of you in sight, he's very relaxed and functioning well. Since he is quite capable of expressing himself, he's also calm if there's a familiar adult nearby to help when he needs something. So start your intervention by being within sight of him and letting him know that he can count on you or your aide to provide what he needs as long as he asks. Then, slowly but surely, raise the stakes. Challenge him more, but do so in very, very small steps. Go from being very near him to staying within his sight but a little farther away. You may notice that he gets a little uneasy as you move another step or two away. Still, very slowly, move farther away, all the while guiding him to rely more on your explanations and verbal directions about visual location. Up the stakes a little more and help him tolerate your being in another room, where he can't see you, but keep talking to him from the room so he has the benefit of using his good hearing and knows he is not totally without support. You might also play treasure-hunt games for which you provide clues in the form of pictures as well as spoken words. Make sure that each time you play there are more and more picture clues and fewer word clues. Again, do this gradually so the child learns to find things with visual clues. If the hidden treasure is a favorite snack, he'll be even more motivated to find it. Play lots of games that are versions of hide-and-seek, which will enable the child to tolerate brief periods of not seeing you followed rapidly by finding you. He can play this with his siblings and other family members, as well as other children. Begin in the most familiar environment, such as his home, and then expand the game to a friend's or grandparent's house and then to other places, such as school. By going from simpler to more complicated seeking in less familiar settings, he'll be getting the road-mapping practice he needs. Share these ideas with the child's parents. Explain to them what happens when their son goes to a new place, with new people, even with new toys and perhaps a lot of new colors or bright lights that overwhelm him. Adults should provide extra security at times like these. Together, all of these interventions should help this child who has visual-processing problems gradually become a spatial problem solver. Back to top Stanley I. Greenspan, M.D., the author of The Child with Special Needs, is a clinical professior of psychiatry, behavioral sciences, and pediatrics at the George Washington University Medical School.