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Problem solving

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Solving problems every day

We solve problems every day, often without really thinking about it. It can be as simple as realising that we need to put another jumper on to stay warm. It can be about deciding how we use what’s in the fridge to make a meal. We need to work out how to think and act in lots of different situations, and with different people. All ‘problems’ start with having a goal: something we want or need to happen. The ‘solving’ part is working out a way to reach that goal.

Some problems are easy to solve: getting a drink when you’re thirsty for example. Others are more difficult: working out why everyone is talking so quickly and at the same time, what they are saying or doing and how to join in. A child or young person with hydrocephalus can have difficulty with all kinds of problems, even the simple ones.

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Problem solving steps

There are lots of steps to solving a problem. We need to realise that there is a problem to start with, eg my stomach is rumbling. Once we are aware of the problem we need to think about which bits of information are most important. This helps to shape or define the problem: to work out what we want or need (our goal) and what is in the way, e.g. my body is telling me I’m hungry but I don’t have any food with me. Once we've done that we can think about what we can do to solve it.

We might have lots of ideas so we need to work out which idea is best for the situation: which one is most likely to help us reach our goal, eg I do have money and there’s a shop across the road. Once we’ve settled on the idea that fits best we need to plan how we will put it into action. Planning also takes a lot of thought and is easier for some than others. Once we put the plan into action, we need to work out whether our plan is working out the way we want it to: are we on the way to reaching our goal? If not, why not and what can we do about it? This might take us back to the start with a new problem to solve.

Problem solving diagram

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Doing simple things/Taking initiative

Some of the simplest problems don’t need all the steps shown above. If we are hot, we take a jumper off, for example. It can be perplexing and frustrating when a child or young person doesn’t seem to know how or when to do even these simple things. It may be that they have failed to recognise that there is a problem, or they can’t define it. This would stop them from doing anything: from initiating any action.

Example 1

Dawn regularly came home from school and just sat down with her jacket on even when the house was really warm. She didn’t seem to have the same problem in school. But then, in school everyone else takes their jackets off at the same time. This gives Dawn the prompt she needs. At home, someone needed to tell Dawn to take her jacket off. Once she had a prompt, Dawn knew what to do.

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Always needs a reminder/Always needs to be told to do something

People with hydrocephalus may need a lot of reminders to do even basic things. Some families may be happy to go on giving reminders (prompts) once they know why they are needed. There are situations when family members aren’t around to give a spoken (verbal) reminder such as when the young person is at school or out with friends. Here are some other ways to give a reminder:

  • Visual or written signs or signals on pin boards, wardrobes, bedroom or kitchen doors (depending on what needs prompted). You might need to change these now and again if the person stops noticing them. Use size, colour and pictures that draw the person’s attention.
  • Text reminders or mobile phone alerts. This might suit an adolescent. It’s not obvious to their friends because most young people have mobile phones (or other devices).
  • Diary notes. Some children (and adults) get used to using their diaries daily and carry them everywhere. This might be a good place to put reminders.

Providing a prompt may be enough to get someone started on a simple task but it may not help when the ‘problem’ is harder to solve.

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Can’t seem to find a solution to problems

Solving harder problems means that we need to imagine different ways that a situation could work out. We need to think about:

  • What is most likely to happen?
  • What does that mean for me? How does it affect my goals?
  • What are the different things I could do?
  • Which of these will work here and now?
  • What does that mean for other people? Am I happy with that?

There could be many more questions that are ‘asked’ when we try to solve a problem. We may not be conscious of all these questions. The brain may be taking care of all these things without us being aware.

Hydrocephalus can change what happens in the brain. This might mean that the brain is less able to ‘ask’ all the right questions. Or, it may not be able to find the answers. The brain can only do all these things if it is able to hold lots of bits of information in mind while it chooses which bits it needs and which bits it doesn’t. This is done in ‘working memory’. Any or all of the brain’s activities (processes) involved in problem solving could be affected by hydrocephalus.

Example 2

Jacob, aged 14, seemed to have difficulty getting through a lot of his school work. He would be given a problem in maths or an English essay for example, and would just doodle on the page. Jacob’s English teacher spent some time talking through an essay question with him.

His teacher broke it down so that Jacob just had to think about one bit at a time. As they worked, Jacob’s teacher helped him to put a mind-map together. The mind-map had lots of notes and doodles about characters, the plot, what needed to be at the beginning, middle and end and so on. Jacob’s English teacher was really pleased – he found that Jacob could deal with the problem if it was broken down. Jacob managed to use his notes and doodles to put a pretty good essay together.

Jacob needed a bit of support to do this the first few times. Now he has a basic mind-map template that he uses to prompt him to think about different bits of the problem. This has helped a lot in English. Jacob and his maths teacher are trying to do something similar to break down maths problems. It’s helping a bit but some maths just doesn’t make sense to Jacob.

Not being able to find a solution is difficult but finding the wrong one can also cause problems.

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Not thinking before acting

When a child or young person does or says something wrong it can be tempting to think they have done it on purpose. However, it might be due to not ‘thinking before acting’. As children grow they get better at thinking things through, but even teenagers will not be able to see all the possible outcomes of their actions. This is because the brain’s ‘command centre’ doesn’t fully develop until late in teenage years and sometimes into early twenties.

The brain’s ‘command centre’ (in the brain’s frontal lobes) is very involved in problem solving. This is because different bits of information need to be held and assessed, and lots of decisions need to be made. The ‘command centre’ does this by using special processes called ‘executive functions’. Hydrocephalus may change the frontal lobes of the brain and areas they are connected to. This can mean that the brain’s executive functions don’t work as well as they should. This can make it difficult for a person to problem solve.

Example 3

David didn’t seem to think things through. Sometimes this was just a bit annoying but occasionally it was downright dangerous. If he saw his Gran on the other side of the road he would run off to meet her without even looking. David didn’t seem to understand that he should stop and work out whether it was safe to cross.

David’s Mum had heard about ‘social stories’ and after reading a bit about it she decided to try one out with David. She wrote him a short story about ‘being near roads’. It was very short but it told him what was important and why.

Mum and David remind themselves of the story before they leave the house. David is much better at remembering what to do around roads. He may not be able to solve the problem of crossing on his own just yet but at least he is safe.

For more information on social stories visit The National Autistic Society.

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Being impulsive/Acting on a whim

If someone acts on a whim or shows impulsivity this means they react without fully thinking through possible outcomes. Someone with hydrocephalus may seem to do this a lot. For example:

  • Interrupting and talking over others.
  • Blurting out answers in class.
  • Not playing co-operatively e.g. taking turns and sharing.
  • Running across roads (as in the example above).
  • Chatting to strangers.

Acting on impulse is like responding to the first idea that pops into your head. It is probably acted on because something good might happen, e.g. ‘My teacher wants an answer, I want to please my teacher.’ But, if we think about all the stages needed to solve a problem properly (explained and shown above), acting on impulse means we don’t think about whether there might be a better idea eg ‘My teacher wants the right answer and he wants me to put my hand up first. This will please my teacher.’ So, impulsivity (impulsive actions or behaviour) can get in the way of good (effective) problem solving. It can get in the way of doing the right thing or acting appropriately.

Example 4

Ben, aged 10, was always interrupting. He didn’t seem to be aware that some people thought he was being rude. It was difficult for other people to realise that Ben sometimes couldn’t help himself. He just had to say what was on his mind. This was often annoying at home and could be quite disruptive at school.

Ben’s teacher tried different things with Ben. She used a ‘take the stage’ sign that works for the whole class. When they have group discussion time, the only person allowed to speak is the one holding the ‘take the stage’ sign. Ben also has a ‘N.I.’ sign in bright colours on his desk. Only Ben and his teacher know that it stands for ‘no interrupting’.

Ben’s teacher talked to his Mum and they agreed that when Ben sees an adult pull at their ear it means ‘don’t talk, just listen’. This is used at home and in the playground. It doesn’t always work when Ben is excited or involved in a game but sometimes a tap on the shoulder then giving Ben the signal is enough to remind him.

When he gets it right his teacher and parents are quick to reward him with stickers or cuddles. When Ben forgets, they are also quick to tell Ben off and talk it through with him.

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Getting upset when it goes wrong

Not knowing how to behave and impulsive behaviour can lead to problems in class and socially (see Knowing how to behave for more examples). When a child or young person with hydrocephalus has difficulty working things out and doing the right thing this can be frustrating for others. But it can also be very upsetting and confusing for the young person. They may also be aware of disapproval from others. It could be that they just don’t know what to do.

Trying to avoid ‘getting it wrong’ is probably the best way of avoiding upset. This is easier to do when an action is repetitive (like the ‘interrupting’ in the example above) or predictable (e.g. it always happens in the supermarket). The best answer is to avoid whatever causes the upset (eg don’t take the young person to the supermarket at all). After avoiding a situation for a while the young person’s reaction to the situation might be different. A bit of time and space may be all that is needed. But, this isn’t always possible. See Knowing how to behave for more examples of tricky situations and some tips on how to deal with them.

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Doesn’t seem to learn from mistakes

Sometimes a child or young person with hydrocephalus does the same thing over and over again. This can be confusing and upsetting when it makes the child unhappy too. Sometimes things are repeated because the young person is ‘stuck’ in a certain routine or way of reacting to a situation. It may be that they need lots of practice to learn a different or new way to deal with it. It is likely that the young person will need lots of support and patience.

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Learning to problem solve (what happens in the brain)

Everyone is different and some may find it easier to stop acting impulsively and / or to problem solve. Learning ways of doing these things will also be easier for some than others. This is the same for children and young people with hydrocephalus. They may however have added difficulty because of changes in the brain. Changes in the brain can make it more difficult to:

  • Sense all the things that tell them there is a problem to solve.
  • Pay attention to the most important bits of information to help define then solve the problem.
  • Hold in mind lots of different pieces of information while the problem is defined and solved.
  • Remember things that will help to solve the problem.
  • Plan how to solve the problem. Put the plan into action and check that it works.

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