Observe learning difficulties without making a diagnosis

Use observation to prepare a decision

“He lacks attention”, “she is slow”, “he refuses to read”: these statements convey concern, but provide little direction for action. Seek a more precise description: during which activity, at what point, with which materials and with what consequences for learning?

The purpose of teaching observation here is to understand access to a task and plan support. It can inform discussion with a health professional, without establishing a diagnosis. For ADHD, NICE states that observation or a rating scale used alone is insufficient for diagnosis. ^[3]

This approach can accompany a known diagnosis or a difficulty that remains unexplained. The examples below are fictional. Quantities and durations illustrate how to write a note; none is a clinical threshold.

Separate events, reported experiences and hypotheses

A useful note allows someone to identify what was actually seen or heard. “While copying six lines, the student stopped three times and shook her hand” describes a task and actions. “Writing hurts her” should be recorded as her account if she said so, or as a question to explore if you inferred it.

A hypothesis is still useful when identified as one. “Moving between the board and the notebook seems difficult; try placing the model on the desk” links a tentative interpretation to an observable change. Writing “visuospatial disorder” on the basis of this scene alone would give the note an unwarranted clinical meaning.

• Observed events: instructions, actions, work produced and support provided.
• Reported experience: what the learner communicates, specifying who reports the information.
• Hypotheses: possible explanations that still need discussion.
• Decision: the next attempt, whom to involve and when to review it.

Notice what makes the task accessible

WHO’s framework for functioning and disability takes environmental factors into account. ^[1] Make access conditions visible in your notes: noise, layout, how instructions are given, available equipment, time allowed and usual assistance. Select what is relevant to your question without creating an inventory of private life.

Include a situation in which the person succeeds. For example, they locate information on a clearly spaced page but lose their place in a dense document. This difference suggests a presentation change worth trying. It does not, by itself, establish a cognitive mechanism.

Ask what the learner found clear, difficult or helpful. If they communicate through means other than speech, use their established methods and allow time to respond. Identify an interpretation offered by a supporter as such; it does not automatically become the person’s own account.

Use language that stays descriptive

Clinical terminology can help you understand an assessment report, but a teaching note often benefits from simple action words. You can organise observations into areas without turning them into categories of people.

• Understanding: what does the learner do after an instruction, and what changes after rewording it?
• Starting and continuing: can they locate the first action and subsequent steps?
• Communicating: how do they ask a question, express a choice or request assistance?
• Reading, writing and mathematics: which particular part of the task is completed, with which support?
• Handling materials and moving: which actions are possible, difficult or reported as uncomfortable?
• Participating: which conditions help the person enter and continue the activity?

Gather enough information for the question

Choose a limited question: “Does a visual marker help the learner find the next step?” Observe a familiar activity over a period that fits your work. Record the duration and number of relevant opportunities. “Asked for the next step during three of four transitions” is easier to interpret than “constantly asks for help”.

When comparing sessions, record what changed alongside the support: a more familiar exercise, different instructions or a partner’s presence. An improvement is worth describing, but does not establish your adaptation as its sole cause. Avoid counting procedures that disrupt the activity or make the learner uncomfortable.

Do not remove necessary support to obtain an “unaided” observation. Describe success with the available supports. Work quality, participation and reported effort may provide more useful information than speed alone.

Example: make a writing difficulty easier to discuss

Situation: during history, write a response explaining two causes of an event. Fictional observation: after ten minutes, one sentence is written; during conversation, the student expresses two relevant ideas. He reports that holding the pencil becomes uncomfortable. The teacher has already reworded the question.

Proposed next attempt: prepare the two ideas orally, then choose an accessible response format with the student to work on historical reasoning. Plan writing instruction separately if writing is also a goal. During review, compare the ideas expressed, support used and reported discomfort.

This note supports a specific discussion with the student, family and relevant professionals. It does not establish dysgraphia, or rule out writing difficulty because the spoken response is satisfactory.

Share observations and seek appropriate advice

Prepare a discussion around a few observations, a strength or useful support, and a next action. Share only necessary information with relevant people, following your institution’s rules. In adult education, involve the learner directly in decisions about sharing.

In France, HAS asks professionals to take parental concerns and developmental regression seriously. Its 2020 identification guideline concerns children at risk up to 7 years and 11 months. ^[2] Collecting teaching observations should not delay a necessary health discussion.

End with a decision you can revisit: continue the support, refine the question or seek appropriate advice. Set a time to return to it. The observation record suggested by this approach is an original practical aid; it is neither a standardised test nor a validated diagnostic instrument.