Dear Jacqui, My son is ten years old and very bright. However, he keeps getting into trouble at school as he does things his own way, and he has temper tantrums at home over his homework. He is very artistic, creative and can be kind and caring. He concentrates for hours on his art but school says he struggles to concentrate in the classroom. He can misread social situations and be ‘black and white’ in his thinking. I’m baffled at how to support him further. Please can you give me some advice?

Your son is not alone having these types of difficulties. Some years ago this was described by psychiatrists as CREST (Cognitively Rigid, Egocentric, Socially awkward, and Tempestous) but more commonly today it is called a social communication disorder or difficulty (SCD). However, he may only have some traits of SCD so may not fit a diagnosis. It would be worth having a multi-disciplinary assessment with a Speech and Language therapist, Clinical/Educational Psychologist and if necessary, a Psychiatrist. This would look into any underlying difficulties that may be a contributory factor in areas such as: attention, auditory processing, language processing, specific social communication skills, reading, writing, spelling, working memory and processing speed, in light of his overall cognitive ability.

There is usually some improvement of these CREST traits as the child gets older. Skills can be developed and supported through therapy intervention in liaison with the parents and school, and specific strategies for home and school can be given.