Some people may experience fewer common features, and the level of impact can vary from person to person.
Physical health symptoms
- May be born with physical differences which may or may not be obvious.
- Differently shaped fingers or toes, weak hand muscles.
- Visual problems (e.g. squint).
- Hearing differences.
- Reduced strength and speed.
- Challenges with coordination and balance.
Mental health symptoms
- Social and general anxiety.
- Low mood and energy.
- Differences in regulating emotions.
Sensory processing
- Some individuals may have a heightened sensitivity to noise, movement or touch and may become easily overwhelmed.
- Some may be slower to notice signals from their environment and from their body such as hunger, pain, emotions, the need to use the toilet.
Language
- Early speech, language and communication needs.
- Differences in understanding and using spoken language.
- Often diagnosed with a language disorder.
Social skills
- May be diagnosed with autism and may need support with making and managing friendships, recognising and expressing feelings, being in busy or crowded places.
- May present with differences in social communication without having an autism diagnosis.
Thinking (cognitive skills)
- Paying attention, understanding and retaining new information.
- Executive functions such as getting started and finishing tasks, being organised, and planning.
Physical health – more information
Common physical features
- Physical differences which may be noticed at birth (birth defect) or later in life.
- Facial features that are different to the family.
- Differences in the shape, size and strength of hands and fingers. This can impact on activities of daily living.
- Frequent ear infections which can affect hearing.
- Need glasses or have a squint.
- Experience teeth abnormalities and problems such as poor enamel quality, missing teeth and teeth in the wrong place.
Differences with muscle strength and coordination can vary but often include:
- Reduced postural tone (tone is the natural resting tension in muscles) and reduced strength in hips shoulders and trunk. This can make it difficult maintaining an upright sitting or standing position and completing movements more tiring
- Altered range of movement including loose (lax) joints in the fingers, elbows and knees
- Ankle tightness
- Curved upper spine (kyphosis)
The combination of looseness and tightness in different joints along with postural changes can lead to:
- Pain, muscle aches and discomfort
- Challenges with activities or movements such as walking, running, climbing and balance
- Poor ‘proprioception’ (the body’s sense of where it is positioned). This can lead to clumsiness and balance issues
- Issues with coordinating both sides of the body together (bilateral coordination)
- Reduced balance, strength and speed
- Feeling physically tired (fatigued) when completing normal amounts of activities.
Things that may help
These physical challenges can impact on everyday activities. Some of the things which may help can include:
- Maintaining physical health through activity and exercise is encouraged within a person’s abilities and interests.
- Small aids e.g. pencil grips, laptop/tablet, jar opener, non-slip matting.
- Allowing extra time for tasks.
- New tasks may take longer to learn. Support and practice may be needed to break tasks down into small parts.
- Support with planning the day, prioritising the most important activities and balancing this with time to rest, calm and reset.
- Care should be taken to match the physical requirement of a task/job to the abilities of the person. Support may be required for physical activities which require bilateral co ordination and high-level balance activities.
It can be helpful to pace activity throughout the day, for example:
- Regular short breaks particularly when completing tasks that require long periods of sitting, standing or being physically active
- Adaptations for a task to be completed in an alternative postion
- Limiting the distance that needs to be walked and use of stairs
- Making others aware of difficulties
Mental health – more information
Common mental health features
- Increased risk of feeling anxious. This can frequently be related to social situations, or more general in nature.
- Low mood.
- Differences in regulating emotional responses, for example becoming frustrated and angry very easily or quickly.
Things that may help
A referral to a mental health team should be considered when emotional health symptoms are impacting on daily life. Referrals to occupational health programmes may also be helpful. It is important that the persons cognitive and language abilities have been formally assessed and are considered when selecting the appropriate
mental health approach.
Sensory processing – more information
Common sensory processing features
- Being slower to notice internal signals such as hunger, pain, temperature, emotions or needing the toilet.
- Being slower to notice the sensory signals from the environment, meaning that people with FVSD may struggle to respond in the best way.
- Being hyper-sensitive to specific sensations such as noise, movement or touch.
- This can mean that people with FVSD may over-respond or may avoid specific situations, activities or environments.
Things that may help
- Pre-planned toilet and meal breaks, prompts to drink water, and using timers or alerts on a phone. Extra time and prompts to notice what their body is telling them may also be helpful.
- Use of calming and alerting sensory strategies and incorporating them within daily routines (e.g. fidget toys and access to quiet rooms).
- Using noise cancelling headphones when out and about or where trigger/background noise is likely.
Language skills – more information
Common language skill features
- May have speech, language and communication needs and a referral to speech and language therapy may be needed.
- Language skills can continue to develop as children with FVSD grow older but differences with understanding and using spoken language may always be present to some degree.
- A diagnosis of language disorder is more common for people with FVSD.
Things that may help
- A preschool referral to speech and language therapy if support is required for speech, language and communication needs.
- To break down spoken instructions into shorter chunks.
- Repeat instructions and explanations.
- Provide visual support for spoken language e.g. demonstration, pictures, gestures, written key words.
- Allow additional time for responses.
Social skills – more information
Common social skill features
People with FVSD are more likely to be diagnosed with an autism spectrum condition or having autistic features. They may show differences in the way they interact with other people. They may need help with:
- Making and managing friendships.
- Recognising and expressing their feelings.
- Find it difficult to be in busy or crowded places.
- Literal understanding of what other people say.
Things that may help
- If social difference is suspected, a referral to local autism pathway can be discussed with the GP.
- Support to develop and maintain friendships. For example, provide opportunities to build relationships with peers by taking part in shared interest activities e.g. sports, clubs etc.
- Education for others to understand and accept differences in social interaction e.g. eye contact may be uncomfortable and should not be requested.
- Building a relationship with a specific trusted person in education/ work setting.
- Accessing support from that person when social interaction and/or sensory demands feel overwhelming.
Thinking (cognitive) skills – more information
Cognitive development can be delayed and whilst children with FVSD continue to develop and learn new skills, they often function below age-expected levels. In some cases, they may require support to live as independent adults. It is important that formal assessments are carried out and that difficulties are not assumed to be due to autism or another co-exiting diagnosis.
Common features with thinking skills
- Attention span can be lower
- Processing of information can be slower
- The amount of information which can be held in mind (i.e. verbal
- instructions) is lower
- Understanding and remembering new information can be more
- challenging
- Differences with executive functions such as: getting started on and finishing tasks, being organised, acting impulsively, multi-tasking and planning
Things that may help
- Support with planning and undertaking everyday tasks.
- Allow more time for thinking tasks to allow for slower processing and tiredness
Things that may help in an education and workplace setting
A neuropsychological assessment is recommended for children before starting school, and again at the end of primary school. This is done by a neuropsychologist or educational psychologist and can be organised via school or GP.
- Extra support from teaching staff or colleagues to map out strengths and to identify what extra help is required.
- For new learning, it can be helpful to repeat information and/or instructions. It may also help to repeat information and revisiting previously learnt topics.
- Reduction is the number of subjects, to provide more time to focus on fewer subjects.
- Instructions should be written down in clear steps e.g. flowcharts, and visual demonstrations given where possible.
- More time to complete tasks.
- Movement breaksSupport to maintain attention and reduce sensory challenges e.g. a quiet working environment and regular breaks.
- In an education or work environment, teachers and employers should be aware that people with FVSD can feel overwhelmed quickly and that this can show as anxiety or distress. Having a plan of how to deal with feelings of overwhelm should be in place. For example, a nominated person to talk to or a calm space to visit.
- A review may be required for an education and health care plan. For the workplace a referral to occupational health may be helpful to review what adaptations are available.
- Flexibility with work schedules or timetables is important to allow time for hospital appointments. Because FVSD can be complex, people living with FVSD may need to attend regular appointments throughout the year to manage their care.
- Ensure reasonable adjustments are provided in line with the Equality Act 2010 to support the individual in the workplace.
