Once a learning problem is suspected, ask your child’s school staff about the free, special educational services (evaluation and, if appropriate, treatment) mentioned earlier. Sometimes teachers or principals are reluctant to request a consultation or make a referral. If you feel strongly that your child’s needs are not being met, persevere.
Individuals with Disabilities Education Act (IDEA)
Public school systems must make special services available under the Individuals with Disabilities Education Act, a federal statute enacted in 1975. In order to receive federal funds, every state and school district must have a procedure for identifying, assessing, and planning an educational program for these youngsters, from age three to twenty-two. This law covers not only children with learning disabilities, but also those with perceptual problems (hearing or visual impairments), cerebral palsy or other brain injuries, intellectual disability, orthopedic problems affecting mobility, and serious behavioral and emotional difficulties that can interfere with the process of education.
This law provides five basic rights:
A free, appropriate public education
An individual educational plan (IEP) based on a complete developmental assessment and approved by parents
Access to records or the right of parents to review the child’s educational records
Due process, or giving parents the right to participate in the evaluation and decision-making process
The least restrictive educational environment (placing the child in a learning situation that is as normal and convenient as conditions allow)
Learning disabilities result from a variation in your child’s central nervous system functioning. This does not mean that your youngster has “brain damage” or is mentally retarded, although in some cases, a previous head injury or brain infection might cause learning difficulties. In most instances, children are born with the tendency for learning problems; the cause is “invisible” and hard to pin down, and the affected children look and act like other children and are in other ways no different from them.
Learning disabilities tend to run in families. About 50 percent of these children have a parent, sibling, or extended family member with a similar difficulty, although in the past it was much more frequently misdiagnosed or mislabeled.
Learning disabilities can vary in severity, from mild to severe. They may affect a single learning task like spelling, or they can influence many of them, like reading, writing, and listening comprehension. In some children, their presence may be very obvious even before school age; in others, they may become apparent later and then only in subtle ways. Parents may not even be aware that their child has a learning disability until his learning capabilities are challenged and he is unable to keep up with classroom demands and expectations.
Learning disabilities can last a lifetime, becoming more or less obvious depending on the academic and other learning demands that the youngster faces. With help, however, they often do improve.
When a child does poorly in school or seems to lose his motivation to learn, he might be responding to other problems in his life. He might be experiencing problems with peers, or there may be family problems that he finds distracting. As with learning disabilities themselves, social and emotional problems that mimic learning disabilities require immediate and appropriate help.
The Impact of Common Learning Disabilities
When learning disabilities occur, they generally affect three general skill areas:
academic skills, such as reading, writing, spelling, and arithmetic
language and speech skills, encompassing areas such as listening, talking, and understanding
so-called motor-sensory integration skills, such as coordination, balance, and writing
When problems exist in any of these areas, there is a breakdown in one or more stages of learning. For instance, the child may have difficulty taking in information through hearing or sight. Or he could have problems remembering the information he has heard or read. Finally, he may be unable to utilize this knowledge in a productive way.
If your child is performing below grade level, is failing or struggling to maintain barely passing grades, or is not achieving to the degree to which you think she is capable, here are some suggestions for beginning to get her the help she needs:
Try not to focus on grades. Adolescents understand that how you do in school matters, but try not to make their value as a person be based on how they do in school.
Advocate for the right environment for your child’s learning style. A school where sitting still and being quiet is the rule, with no hands-on learning, may not be right for your adolescent.
Make sure to focus on what your adolescent is good at because if they are not doing well in school (where they spend most of their time), they are likely feeling bad about themselves. Even though it may seem that they don’t, adolescents thrive on adult approval and need to feel that they are valued.
Words like “lazy” and “stupid” should not be part of your or your adolescent’s vocabulary. Poor performance and a bad attitude are symptoms of a learning difference, not its cause. When adolescents understand why they are having trouble in school and how they can get help in the areas they need support, they can believe again in their potential for success.
Know when to strengthen and when to avoid a weakness. If an adolescent has dysgraphia (poor handwriting) and his school requires written exams, then it may help to get him occupational therapy to improve his hand-eye coordination. If his school allows him to take notes on a laptop and he types well, encourage him to do so. Sometimes a combination of approaches is the way to go.
Praise the process instead of the outcome. Praising a young person for his effort (“I can tell you really thought that through.”) rather than the outcome (“You are good at math!”) can lead to more confidence.
Help kids use their strengths to find confidence and to help compensate for their weaknesses. Figuring out an adolescent’s talent can help to drive her sense of self-worth.
Understand the dangers of perfectionism. Expecting perfection can only lead to eventual disappointment. Learning to put up with mistakes and even failure helps adolescents deal with the realities of the world, where things don’t always turn out as planned, even if we try really hard.
Use the right interventions for the right reasons. The goal of interventions should not be to change grades, but to support healthy growth and development.
Dyslexia is defined as difficulty reading. When children are learning to read and write in kindergarten and first grade, it is not uncommon for them to misinterpret a “b” as a “d,” a “6” as a “9,” the word on as no and so forth. An important distinction is that this is not a vision problem; rather, the brain is reversing, inverting or missequencing the information it receives from the eyes. Most kids outgrow this condition by age seven or so. For dyslexic youngsters, however, the reading problems persist.
In another form of dyslexia, the mind accurately identifies a word it “sees” but is slow to connect a meaning to it. These teenagers read extremely slowly and may have to reread material several times before they understand it. Other tasks of communication may pose difficulties as well, such as comprehending spoken language and expressing themselves orally and in writing.
Dysgraphia is defined as difficulty writing, as a result of dyslexia, poor motor coordination or problems understanding space. How it is manifested depends upon the cause. A report written by an adolescent with dysgraphia due to dyslexia will contain many illegible and/or misspelled words, whereas motor clumsiness or defective visual-spatial perception affects only handwriting, not spelling.
Dyscalculia is defined as difficulty performing mathematical calculations. Math is problematic for many students, but dyscalculia may prevent a teenager from grasping even basic math concepts.
Auditory Memory and Processing Disabilities
Auditory memory and processing disabilities include difficulty understanding and remembering words or sounds. A teen may hear normally yet not remember key facts because her memory is not storing and deciphering them correctly. Or she may hear a phrase but not be able to process it, especially if the language is complex, lengthy or spoken rapidly, or if there is background noise. For youngsters with central auditory-processing disorders (CAPD), the hum of a fan or the routine sounds of the classroom may interfere with learning.
Attention Deficit/Hyperactivity Disorder (ADHD)
The American Academy of Pediatrics (AAP) has published recommendations on guidelines for the diagnosis and treatment of ADHD. The guidelines, developed by a panel of medical, mental health and educational experts, are intended for primary-care physicians (and parents as well) to help better understand how to recognize and treat ADHD, the most common childhood neurobehavioral disorder.
Between 4 and 12 percent of all school-age children have ADHD. The first step, diagnosing the condition, cannot usually be done successfully until a child is about age six.
The AAP guidelines include the following for diagnosis:
ADHD evaluations should be initiated by the primary-care clinician for children who show signs of school difficulties, academic underachievement, troublesome relationships with teachers, family members and peers and other behavioral problems. Questions to parents, either directly or through a pre-visit questionnaire regarding school and behavioral issues, may help alert physicians to possible ADHD.
In diagnosing ADHD, physicians should use DSM-IV criteria developed by the American Psychiatric Association (symptoms include distractibility, hyperactivity and impulsivity). These guidelines require that ADHD symptoms be present in two or more of a child’s settings, and that the symptoms adversely affect the child’s academic or social functioning for at least six months.
The assessment of ADHD should include information obtained directly from parents or caregivers, as well as a classroom teacher or other school professional, regarding the core symptoms of ADHD in various settings, the age of onset, duration of symptoms and degree of functional impairment.
Evaluation of a child with ADHD should also include assessment for coexisting conditions: learning and language problems, aggression, disruptive behavior, depression or anxiety. As many as one-third of children diagnosed with ADHD also have a coexisting condition.
Treatment guidelines include the following recommendations:
Primary-care clinicians should establish a treatment program that recognizes ADHD as a chronic condition. This implies the need for education about the condition and a sustained monitoring system to track the effects of treatment and developmental changes in behavior.
The treating clinician, parents and child, in collaboration with school personnel, should specify appropriate goals to guide management. Goals should relate to the specific problems of the individual child, such as school performance, difficulty finishing tasks and problems with interactions with schoolmates.
If appropriate, the clinician should recommend behavior therapy and/or stimulant medication to improve specific symptoms in children with ADHD. The guideline provides a review of the scientific evidence for recommending medication and behavior therapy.
When the treatment for a child with ADHD has not met its goals, clinicians should reevaluate the original diagnosis, all appropriate treatments, adherence to the treatment plan and coexisting conditions, including learning disabilities and mental health conditions.
The clinician should provide a periodic and systematic follow-up for the child with ADHD. Monitoring should be directed to the child’s individual goals and any adverse effects of treatment, with information gathered from parents, teachers and the child. The guidelines recommend areas for future research in treatment options, long-term outcomes and other areas in the management of children with ADHD.
Although ADHD often appears to subside during puberty, “We now know that isn’t true,” says Dr. Suzanne Boulter, a pediatrician from Concord, New Hampshire. “In reality, hyperactivity may decrease, but the inattention and impulsivity remain unchanged. As these young people navigate their way through high school and college, these problems may stand as their biggest obstacle to academic success.”
Autism is a disorder with a variety of symptoms that range from mild to severe. Labels such as classic autism, Asperger’s syndrome and pervasive developmental disorder not otherwise specified are often confusing, because youngsters with these conditions share many of the same characteristics, such as deficient social skills, hypersensitivity to sights and sounds, difficulties adapting to change and other idiosyncratic interests. The difference between one child and another is frequently a matter of degree. As a result, all of these diagnoses are part of autistic spectrum disorder.
Asperger’s and autism occupy opposite ends of the spectrum; in fact, AS is sometimes referred to as “mild” autism. Whereas most children with AS are of average or above-average intelligence, four in five autistic boys and girls exhibit some degree of an intellectual disability. Another key difference involves speech. Children with autism are frequently speech-delayed; kids with Asperger’s syndrome, on the other hand, tend to be verbally precocious. And once they begin talking, it can seem as if a dam has given way. Dr. Hans Asperger, the Austrian pediatrician who discovered the disorder, called his patients “little professors,” on account of their penchant for pontificating.
“They’re very dependent on their language skills to get by,” observes Dr. William Lord Coleman of Duke University Medical Center and the University of North Carolina School of Medicine, “and so they use them excessively, which can overwhelm people.” This plays a large part in their difficulties interacting with their peers. Adolescents with Asperger’s syndrome spend an inordinate amount of time in their own world—even for teenagers—but they’re often lonely and want to make friends. The problem is, they’re not sure how to act in social settings. Between that and their eccentricities, they may become victims of teasing and bullying. Parents of a child with AS, or any other disorder, should try their best to stay attuned to their youngster’s moods. Rates of anxiety, depression and suicide are unusually high in this group.
To distinguish classic autism from Asperger’s syndrome, pediatricians and pediatric specialists rely on the diagnostic guidelines from the Diagnostic and Statistical Manual of Mental Disorders. Most children fall somewhere in the middle of the spectrum. Only about one in one thousand youngsters is diagnosed with classic autism. The incidence of Asperger’s is believed to be double and possibly triple that.
There are about half a million adolescents with an intellectual disability in the United States. Nine in ten are classified as having a mild intellectual disability, 1 with an intellectual-functioning level, or IQ, between 50 and 69—some fifty-five points below average. (An IQ of 35 to 49 places a person in the category of a moderate intellectual disability; 20 to 34, a severe intellectual disability; and under 20, a profound intellectual disability.)
Cognitively, many boys and girls with a mild intellectual disability function not that far below their non-disabled classmates. They absorb new information and skills, only more slowly. The problems they do have may be related to memory, problem solving skills, logical thought, perception and attention span.
Like parents of other adolescents with special needs, mothers and fathers are probably as concerned about their child’s social development as they are with his academic progress. Adolescence, of course, is a time when being different can set one up as an object of teasing. Youngsters who have an intellectual disability, in addition to their intellectual limitations, may possess physical and/or mental health problems that also make them stand out. They are often keenly aware of feeling set apart from their peers without learning deficits. Understandably, they are susceptible to feelings of frustration and depression.
Having a learning problem doesn’t by itself qualify a student for special education services. It’s the gap between her current school performance and her academic and intellectual potential, as determined by the testing, that decides eligibility. A significant discrepancy between the two would warrant special services. Now the question is, which services?
One of the cornerstones of the Individuals with Disabilities Act is that students with disabilities be educated alongside their nondisabled peers to the maximum extent possible. By that standard, the ideal situation is inclusion: being taught in a regular classroom in the regular school building, but with additional services provided as needed. One teen’s schedule might include weekly speech therapy and time in a resource room; another might require sessions with a school psychologist.
In general, fewer options exist in junior high and high school than at the elementary-school level, where special education often takes place in separate, self-contained classrooms. As early as kindergarten, a student may spend one or two periods in a regular classroom, with an eye toward full mainstreaming before going on to middle school. In U.S. public schools, four in five youngsters with learning disabilities and nearly two in five boys and girls who are mentally retarded are taught in regular classes.
By the time of junior high, only those adolescents who have been diagnosed with severe learning problems are likely to be placed in alternative sites, which typically offer small class sizes and a curriculum that blends both academic and vocational skills. Students with mild or moderate disabilities are almost always mainstreamed. However, they may receive special accommodations in classroom environment or instruction to help them learn, depending on their needs. Below are some examples of special measures that might be implemented in a regular classroom:
Having the student sit front center, near the teacher’s desk and away from windows, doors, air conditioners, radiators and other potential distractions.
Simplifying instructions and avoiding multiple commands.
Allowing the student to take exams in a small, quiet room.
Allowing the student extra time to finish tests and other classroom assignments.
Reviewing test instructions or homework assignments on the blackboard.
Allowing a student with an auditory-processing problem to wear earplugs, to block out extraneous noise. Or alternately, having her wear a wireless device that transmits the teacher’s voice directly to an earpiece while blocking out ambient noise.
Ordering a second set of books to keep at home, in the event that a student leaves his books in his locker—a not-uncommon occurrence.
For dyslexic, dysgraphic students who have difficulty spelling and poor penmanship, grading papers primarily on content rather than on spelling and neatness.
Allowing students with learning disabilities to use word processors, calculators, audiobooks, tape recorders, spellers and other assistive technology.
Reading is a cornerstone of learning. However, it’s not always easy for all kids to read. About 10 million children in the United States have some sort of reading disorder.
People with reading disorders can face challenges when their brain processes written words and text differently. Writing and math can also be challenging for children with reading disorders.
Usually, reading disorders develop at a young age, although a brain injury can cause a reading disorder at any age. There are also certain medical conditions that can be underlying causes, such as speech and hearing problems.Keep in mind that children develop at different rates and spend varying amounts of time at each stage. In case your child’s reading level is lower than what’s expected for their age, check with your child’s doctor. Children who are having trouble reading benefit from early intervention. Your child’s doctor may suggest strategies to help your child or refer them to a reading specialist.
The big 5 of reading skills
The process of reading is complex and consists of many components. A good reader needs to develop 5 skills as they begin their reading journey: phonemic awareness, phonics, vocabulary, fluency and comprehension.
Phonemic awareness is the ability to identify and use individual sounds in spoken words. Phonemic awareness helps students learn the language better and improves their reading abilities.
In phonics, a child learns the relationship between the letters of written language and the individual sounds of spoken language. Phonics is an essential skill that children use to read and spell and recognize words instantly.
Vocabulary is a child’s stored and growing collection of words they use in conversations and in reading.
Fluency is the ability to read text accurately, quickly, and with good expression.
A child having good comprehension skills can understand, remember, and make sense of what they read.
Children who have problems with one or more of these components can find reading difficult. A child with a reading disorder usually has more trouble understanding and recognizing what they read.
Common reading disorders in children
Hyperlexia and dyslexia are well-known types of reading disabilities.
A child with hyperlexia has a very high ability to read before they turn 5 years old and is fascinated by the written material, including letters and numbers. They have strong visual and auditory memories and can recall what they see and hear without too much effort.
However, despite their high reading skills, they have low reading comprehension. It is common for them to repeat phrases or sentences without comprehending the meaning. Children with hyperlexia are unable to use their language skills effectively. They have difficulty with who, what, why, where, and how questions. They also have difficulties speaking and communicating with kids their age.
Hyperlexia is often, but not always, associated with autism spectrum disorder (ASD). About 84% of children with hyperlexia are on the autism spectrum. It is estimated that only 6% to 14% of children with ASD have hyperlexia.
Types & symptoms of hyperlexia
There are 3 types of hyperlexia.
Hyperlexia type 1: Children with hyperlexia type 1 learn to read early and far above their expected level without developing any disabilities.
Hyperlexia type 2: Children with ASD have hyperlexia type 2. These children show more signs of ASD, such as avoiding eye contact, avoiding affection, having sensitivity to sensory input, and obsessing over letters and numbers.
Hyperlexia type 3: Children with hyperlexia type 3 have remarkable reading comprehension but lack verbal language development. They are outgoing, make eye contact, and show affection. Hyperlexic type 3 symptoms gradually disappear with time.
Hyperlexia diagnosis & treatment
There is no specific test to diagnose hyperlexia. Children with hyperlexia typically show symptoms and changes over time in their behavior. It is possible for a child with this disorder to also have another disorder, such as Autism Spectrum disorder, language disorder or social communication disorder.
Early intervention increases a child’s chances of learning language and social skills. Discuss developmental issues with your child’s doctor to diagnose hyperlexia.
A child with hyperlexia type 1 does not need any treatment. Early-age intervention is beneficial for children with hyperlexia types 2 and 3. Children with hyperlexia can benefit from speech, language, and occupational therapy.
Dyslexia impairs a person’s reading ability and can affect both children and adults. Kids with dyslexia may have difficulty decoding words, matching letters to sounds, and recognizing words and spelling. Having dyslexia does not reflect a person’s intelligence. As many as 1 in 5 children in the United States have dyslexia.
Symptoms of dyslexia
Dyslexia symptoms and severity can vary with age. Symptoms of dyslexia often appear before a child begins school. A young child may have speech delay, difficulty processing language, or trouble following directions. They have difficulty putting things in order and pronouncing new words and avoid reading activities. It may take them a while to process and summarize what they read.
Such children are prone to having difficulties memorizing and figuring out left from right. When reading, they may use reverse letters/sounds, such as “d” and “b” or “p” and “q,” and may have a speech delay.
Dyslexia diagnosis & treatment
Dyslexia is usually diagnosed in childhood, but it can remain undiagnosed until adulthood. As a result of dyslexia, kids have difficulty reading, writing, spelling and speaking clearly. Dyslexia is genetic and often runs in families.
It is not possible to diagnose dyslexia with a single test. Evaluations typically involve identification, screening, testing, and gathering information about the child’s history and issues. Professionals then assess a child’s specific needs and determine how best to assist the child.
There are no medications that treat dyslexia. Early educational intervention can help a child learn effective ways to learn and read. Research shows that phonics instruction that involves letters and sound associations can significantly enhance the reading ability of children with dyslexia.
How to help your child with reading difficulties
It’s important to act early if you notice problems with spoken language, rhyming, pronouncing, or finding words, especially if there is a family history.
Early intervention is essential because effective instruction boosts a child’s learning abilities and prevent anxiety, depression and low self-esteem.
Reading the same book over and over again helps children who have dyslexia. As a result, they learn how to focus on one word at a time and develop a natural reading rhythm.
Reading aloud helps children who have dyslexia decode unfamiliar words and build fluency and confidence. Another excellent alternative to reading is listening to audiobooks.
Don’t hesitate to talk with your child’s teachers and pediatrician if you have any concerns about your child’s reading development so they can get the right support to help them thrive.
What is a learning disability? Even the experts can’t always agree. An important definition is found in the American Psychiatry Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM), the main reference book physicians rely on to help them diagnose these conditions. The most recent edition, the DSM IV, identifies three types of learning disabilities: dyslexia, the inability to read, spell and write words, but not as a result of faulty eyesight; dysgraphia, the inability to write properly; and dyscalculia, the inability to perform mathematical calculations.
Definition of “Learning Disabilities”
The federal government takes a broader view. Under the Individuals with Disabilities Education Act (IDEA), all eligible children between the ages of three and twenty-one are guaranteed free and appropriate special education and related services in the public schools. IDEA defines “learning disabilities” as follows:
A disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, which may manifest itself in an imperfect ability to think, speak, read, write, spell, or to do mathematical calculations. The term includes such conditions as perceptual handicaps, brain injury, minimal brain dysfunctions, dyslexia, and developmental aphasia.
That encompasses not only the trio of disorders mentioned above, but also attention deficit hyperactivity disorder (ADHD) and pervasive developmental disorders, including autism and Asperger’s syndrome. Although the law expressly does not include intellectual disabilities, states and individual school districts are free to modify the guidelines. Some do classify an intellectual disability as a learning disability; others may provide special-education services for students whose academic achievement falls well short of their potential, as measured by test scores.
To add to the confusion, you may hear the same learning problem referred to as a learning disability, a developmental disability or yet another term. Ultimately, how these disorders are classified isn’t as important as recognizing that each one can seriously interfere with a youngster’s ability to learn.
All learning impairments share one thing in common: deviations in processing in one or more locations of the brain. Several studies employing sophisticated brain-imaging technology have been able to observe the workings of brains with learning problems. At Yale University School of Medicine, for example, patients with dyslexia were asked to read while they underwent a magnetic resonance imaging scan. The researchers clearly observed a difference in the parts of the brain that normally handle reading.
Similarly, imaging studies of people with ADHD have found decreased functioning in the areas that enable us to concentrate; and scans of people with autism reveal abnormalities in brain structure, particularly within the shellshaped cerebellum nestled at the base of the brain. Impaired brain development from a variety of causes is also at the root of an intellectual disability. (These imaging procedures were employed strictly for research purposes, incidentally; they are not part of a routine diagnostic workup.) Learning difficulties are diagnosed in at least four times as many boys as girls. This may be due in part to the fact that boys who have problems academically are more prone to disruptive behavior and to resisting reading and other challenging tasks in school. Therefore they tend to be referred more to specialists and subsequently diagnosed.
Many of these disorders may weave their way through family trees. According to the National Institute of Mental Health, children with ADHD usually have at least one close relative who also has the disorder. Frequently it’s the father; at least one in three who have ADHD themselves pass it on genetically to their offspring.
Typically, a learning deficit becomes apparent early in childhood, though not always. If the problems are subtle, a child may compensate sufficiently for quite a while; in fact, some of these boys and girls happen to be extremely bright. It’s only after the work in school becomes more complex, beginning around third or fourth grade, that they start to struggle. “This is the time when the curriculum begins to shift from ‘learning to read,’ to ‘reading to learn,’ ” explains Dr. Mark L. Wolraich, a specialist in learning disabilities. Of the more than 2.4 million children with learning disorders in U.S. schools, about four in five encounter problems with reading and language.
Several of these conditions have overlapping features; consequently, misdiagnoses are not uncommon. For instance: Difficulty concentrating in school characterizes ADHD, but is also a hallmark of Asperger’s syndrome, intellectual disabilities or depression. Furthermore, learning difficulties are typically accompanied by secondary problems.
Let’s return to the example of ADHD. Some of these children are additionally diagnosed with another learning problem, such as dyslexia. A number develop the behavioral disorder oppositional defiant disorder. Their belligerence and fits of temper can be attributed partly to their lack of success in school and other circumstances. “But some of the misconduct,” says Dr. Wolraich, “is due to the fact that the two conditions tend to occur together.” Less commonly, adolescents or young adults with an attention deficit have or will develop bipolar disorder, a serious mood disturbance also referred to as manic depression.
Learning Problem? It’s That and More
Rarely are the effects of a learning problem confined solely to the classroom. They frequently spill over to other areas of daily life. Making friends can be especially difficult for many of these youngsters, some of whom lack fundamental social skills, such as the ability to understand nuances of language and read facial expressions. A joke that sends others into hysterics may sail right by them. Of course, many boys and girls with learning difficulties get along splendidly with their peers, but for those who are socially awkward, adolescence can be a painful time. Adolescents with learning problems can be screened by their pediatrician or other health professional for other difficulties, such as anxiety or depression.
A child’s diagnosis thrusts parents into the role of advocate: the person(s) charged with getting her whatever educational, psychological and rehabilitative services she needs. Mothers and fathers are also advocates in the sense of providing constant love and encouragement. Keeping self-esteem aloft and promoting a positive self-image vie in importance with helping a child with a learning problem academically. In short, be your child’s number-one fan. Remember: No one will love and support him or her more than you.
If you suspect your teenager might have a learning problem of some kind, consult his pediatrician, who can outline a plan of action. Don’t deny your instincts, as parents sometimes do, largely out of fear that a finding of ADHD, or autism or another problem will permanently stigmatize him.
Stigmatize him? With whom? Between increased public awareness and 120,000 new cases of learning disorders among students every year, a learning problem no longer carries the stigma it once did. But, frankly, what other people might think shouldn’t even cross a parent’s mind. When mothers and fathers ignore the reality of the situation, in a well-intentioned but misguided attempt to protect their child, they are depriving him of the help he needs in learning to live with his disorder. Until then, his schoolwork is likely to suffer, reinforcing a destructive pattern of failure. And without therapy to show him ways to control any alienating behaviors, the more likely it is that he will suffer the rejection of his peers.
Approximately two in five boys and girls with ADHD aren’t diagnosed until they reach junior high or high school—sometimes not until college. Imagine what it must be like to spend years not understanding why you can’t seem to do better in school. How many teens conclude it must be because they’re “stupid”? Or “lazy,” a frequent accusation. To receive an explanation for why learning has always been hard usually comes as a relief. Although it is preferable for learning problems to be picked up early in childhood, know it is never too late to help a youngster turn things around.
Initials, Initials, and More Initials
attention deficit hyperactivity disorder
autism spectrum disorder
central auditory processing disorder
pervasive developmental disorder
pervasive developmental disorder not otherwise specified
A minimal evaluation includes a psychological assessment of cognitive function (an IQ test) and an educational assessment of academic achievement (a standardized test). Other testing might evaluate so-called neurodevelopmental functions (such as language, memory, attention, and motor skills), the emotional status of your child, and a social assessment (family and environment).
This evaluation process can be complicated, time-consuming, and difficult for parents and child to understand. Sometimes it is quite expensive if you obtain the evaluations outside the school system. In most cases, you should start with the full evaluation provided by your child’s school. If it cannot be done within a reasonable time or if specialized testing is needed, request payment from the school system before you get a private evaluation. However, regardless of where they are done, these evaluations can be both informative and productive.
Because the entire evaluation process may be complex and involve many people, a case manager or services coordinator (like a pediatrician, psychologist, or learning-disability educator) may be helpful. The coordinator can also assist you in planning appropriate interventions or treatments, making referrals, monitoring the effect of treatment upon your child, and arranging for follow-up evaluations. Frequently this takes a team effort.
Once an evaluation is completed, schools usually arrange a meeting to fully discuss the findings and your child’s educational plan. This meeting might be attended by your youngster’s teacher(s), guidance counselor, the special-education teacher, the principal, the school psychologist, and nurse. Sometimes children attend the meeting. Occasionally you may want to ask your pediatrician to attend to provide support for you and your perspective. If you wish, bring someone with you who might serve as the child’s advocate and who is familiar with these evaluations and meetings and understands the implications of the findings and interventions. Make sure the results are explained to you in terms you can understand.
In explaining the learning problem to your child, avoid simplistic, negative labels such as learning disabled, handicapped, and hyperactive; instead, help him look at himself in a comprehensive and positive manner that acknowledges weaknesses but also emphasizes strengths and special attributes.
Children with learning disabilities generally respond well to a sensitive and appropriate evaluation and treatment plan. This is particularly true if this plan is supportive, removes blame from both child and parent, focuses on the present problems, attends to other associated concerns, allows the youngster to achieve at a higher level than before, and results in his feeling more confident, self-reliant, and motivated. It can be helpful to point out successful adults who also have learning disabilities.
Children learn many skills in life—how to listen and speak, for example, or how to read, write, and do math. Some skills may be harder to learn than others. If your child has had appropriate learning experiences and instruction, but is not able to keep up with peers, it’s important to find out why and how to help.
Children who learn and think differently can succeed in school, work, and relationships. Often, they can benefit from help that uses their strengths and targets any areas of need.
What is a learning disability (LD)?
Learning disability is a term used to describe a range of learning and thinking differences that can affect the way the brain takes in, uses, stores, and sends out information. Some children have specific learning disabilities (also known as LDs), such as reading or math disabilities. Others may have conditions that affect learning like attention deficit/hyperactivity disorder (ADHD) or hearing loss. Many children with learning differences and difficulties can have more than one learning disability or condition that affects learning.
What causes learning difficulties?
There are many reasons why a child may have difficulties learning. The causes aren’t always known, but in many cases children have a parent or relative with the same or similar learning and thinking differences and difficulties. Other risk factors include low birth weight and prematurity, or an injury or illness during childhood (for example, head injury, lead poisoning, a childhood illness like meningitis).
Regardless of the cause of learning difficulties, the first step is to recognize your child is struggling and to discuss your concerns with your child’s teachers and doctor. Together, you can find out what is contributing to the difficulties and make sure your child gets any help needed.
How do I know if my child has learning differences and difficulties?
Learning and thinking differences aren’t always obvious, but there are some signs that could mean your child needs help. Keep in mind that children develop and learn at different rates. Talk with your child’s teacher and let your child’s doctor know if your child shows any of the following signs:
How We Found Answers & Support
As a baby and toddler, my son Benjamin met or exceeded every developmental milestone on the list. He was stacking dozens of blocks by the time he should have been able to stack several. He talked very early and was reading at some level by 2 years old. I was thrilled to have such a bright, happy, and active kid.
Still, there was something different about this child. He seemed to never stop moving—his body or his brain. He was alert and aware all the time, never napped, and hardly ever slept for more than a few hours at a time. He wasn’t fussy, but he just seemed to be on 24-7.
Once Benjamin was in preschool, his differences became more apparent. He was more active than the other kids—always bouncing in his chair or walking about the room. When he was concentrating hard or excited, he would flap his arms and legs. He was very sensitive to textures and sounds. Benjamin seemed anxious, too.
I didn’t know what it all meant, but I knew it wasn’t the norm. My wife was worried, too. As a former early intervention specialist, she knows a lot about child development. But even with all that knowledge in our household, we still didn’t know what was going on. So we talked it over and decided I would take him in to see the pediatrician.
I wasn’t sure about the appointment. I didn’t know what to ask, and I didn’t know if the pediatrician would know what to do with my concerns. So instead of asking questions, I just described my observations on what seemed different to me. I described his constant motion, his anxiety, and his sensitivities. I described his repeated questions and repetitious activities and how he would line up his toy cars into rows and talk about them just as much as playing with them.
Our pediatrician listened intently and asked some clarifying questions. When I was done describing, right away he knew what our next step should be: He referred us to a developmental-behavioral pediatrician who specializes in neurology.
I was relieved to have a clear course of action. The developmental-behavioral pediatrician did the appropriate assessments and ultimately gave my son his diagnoses of ADHD and autism spectrum disorder.
I had mixed emotions when Benjamin got the diagnoses. But I was so grateful to our pediatrician for helping us get answers. Benjamin now gets the support and services he needs to thrive. He really is a happy and fun kid, and he doesn’t consider having ADHD or autism labels. They are just part of his identity.
Thanks to the help of the pediatrician, our family is set up for success. Not all children with learning differences will need to see a specialist or have the same diagnosis as our son. I encourage you to talk with your pediatrician to help figure out what is best for your child. I’m so glad we had the conversation.
Jon Morin is a contributing blogger for Understood.org, which encourages parents to Take N.O.T.E.
Notice if anything is out of the ordinary.
Observe behaviors to determine patterns.
Talk to a teacher, social worker or caregiver to validate.
Engage with trusted professionals, like pediatricians.
Preschool children may have:
Delays in language development. By 2½ years of age, your preschool-age child should be able to talk in phrases or short sentences.
Trouble with speech. By 3 years of age, your child should speak well enough so that adults can understand most of what they say.
Trouble learning colors, shapes, letters, and numbers.
Trouble rhyming words.
Trouble with coordination. By 5 years of age, your child should be able to button clothing, use scissors, and hop. They should be able to copy a circle, square, or triangle.
Short attention spans. Between 3 to 5 years of age, your child should be able to sit still and listen to a short story. As your child gets older, they should be able to pay attention for a longer time.
Frustration or anger when trying to learn.
School-aged children and teens may find it difficult to:
Get and stay organized at home and school.
Understand verbal directions.
Learn facts and remember information.
Read, spell, or sound out words.
Write clearly (may have poor handwriting).
Do math calculations or word problems.
Focus on and finish schoolwork.
Explain information clearly with speech or in writing.
Is there a cure for learning disabilities?
There is not necessarily a “cure” for learning disabilities, but there are many ways to help children and families manage them in a way that helps children learn and thrive in life. Be wary of people and groups who claim to have simple answers or solutions. You may hear about eye exercises, body movements, special diets, vitamins, and nutritional supplements. There’s no good evidence that these work. If in doubt, talk with your child’s doctor. Also, you can contact trusted resources like the ones listed at the bottom of this page for more information.
Who can help?
Talk with your child’s doctor and teachers about any learning struggles you notice. Pediatricians can evaluate developmental delays and other conditions that may be contributing to learning difficulties. They can also refer you to specialists in neurodevelopmental disabilities, developmental and behavioral pediatrics, child neurology, or child psychology, for example. Teachers and other education specialists perform screening or evaluation tests to identify problems and determine if early interventions or school-based supports can help. Most school evaluation teams include psychologists and learning specialists.
4 ways parents can help children who learn and think differently
In addition to working with your child’s teachers and doctors, you can help support your child with learning disabilities and difficulties. For example:
Focus on strengths. All children have things they do well and things that are difficult for them. Find your child’s strengths and help them learn to use them. Your child might be good at math, music, or sports. She could be skilled at art, working with tools, or caring for animals. Be sure to praise your child often when she does well or succeeds at a task.
Develop social and emotional skills. Learning differences combined with the challenges of growing up can make your child sad, angry, or withdrawn. Help your child by providing love and support while acknowledging that learning is hard because their brain learns in a different way. Try to find clubs, teams, and other activities that focus on friendship and fun. These activities should also build confidence. And remember, competition isn’t just about winning.
Use resources & support groups to help you learn more about parenting a child with learning difficulties. Learning and thinking differences are common. You and your child are not alone in this journey.
Plan for the future. Many parents whose child learns and thinks differently worry about the future. Help your child plan for adulthood by encouraging them to consider their strengths and interests in education and career choices. Remind them that learning differently isn’t tied to how smart they are. In fact, many people with learning difficulties are very bright and grow up to be highly successful at what they do. Special career and work programs can help build confidence by teaching decision-making and job skills. Many colleges have programs to support students who learn and think differently successfully earn a degree.
Children who learn and think differently can thrive with the right support. The sooner you know what’s going on with your child, the sooner you can get your child help. Talk with your child’s teachers and doctor if you have any concerns about your child’s learning.
After you and your child understand the results of the evaluation, ask the school for a description of the various interventions or supportive services it can offer. This will begin to provide you with a clear, comprehensive view of what may lie ahead for your child.
Your decision about interventions will depend on the evaluation results and the school district’s resources, including the specific resources of your youngster’s school.
Resource Room. Your child may qualify for part-time or full-time special services in a resource room for certain specific academic subjects, while being “mainstreamed” for other subjects and activities. Make sure goals and expectations are set appropriately, with a timetable for achieving them. If needed, your child may also receive help for language problems (speech or language therapy) or motor problems (physical or occupational therapy).
Inclusion Mainstreaming or Full/Partial. This is a system in which a handicapped youngster is educated alongside her nonhandicapped peers to the greatest extent possible. For students who do not meet the discrepancy criteria for special services under federal law but still need some help, their regular classroom teachers should make changes in the classroom to meet the child’s needs, such as modifications in the youngster’s curriculum, the manner in which subjects are taught, homework assignments, and overall expectations. Throughout this process it is essential that the child’s strengths, including extracurricular activities, are nurtured and maintained.
“Bypass” Interventions. Besides direct intervention, “bypass” strategies also are quite effective for some children. This is a method in which weaknesses are circumvented or bypassed. For instance, a child with writing problems might use a word processor to write reports. If she has good oral expressive skills, she could be allowed to give oral reports rather than written ones, and take tests orally.
Home-Based Support. At home you can modify the environment or the emotional climate, keep expectations realistic, and generally be supportive of your child. Develop homework routines, be available for help, maintain quiet in the house during homework hours, and if necessary, reduce your child’s commitment to extracurricular activities to allow more time and energy for studies. Again, nurture and maintain other avenues of success and gratification.
Hiring a tutor may be very helpful and often can reduce or eliminate homework-related tensions between parent and child. However, be realistic and do not overload a youngster’s capacity to perform, or deprive her of time to pursue interests and activities unrelated to school.
Other Interventions. If your youngster is feeling depressed, anxious, or discouraged, psychological counseling may be appropriate. Sometimes family counseling is very helpful so family members can better understand each other’s feelings and needs, reassign roles and responsibilities, and diminish intense sibling rivalry.
If your youngster has serious attention problems, or hyperactive-impulsive tendencies, she might be helped by medication that reduces distractibility and increases attention span. This medication should be part of a therapeutic package that might include educational and behavioral intervention and psychotherapy. Also, any medical conditions that may be contributing to the learning difficulties or that cause school absenteeism need to be treated. These might include central nervous system illnesses or injuries (such as seizure disorders) or a hearing or vision impairment.
Controversial Treatments. There are many unproven treatments for learning problems, including megavitamins, patterning exercises, eye exercises, special glasses, and diets that eliminate certain types of foods or additives. The American Academy of Pediatrics does not recognize any of these treatments as being effective and therefore does not recommend them. Seek the advice of your pediatrician and other professionals about any treatment you are considering.
Children and Learning Disabilities
Here are some points to keep in mind about learning disabilities.
Children with learning disabilities are a very heterogeneous group. Their disabilities vary in degree, nature, and complexity.
Learning disabilities may affect more than just learning. Some of these children also have poor social and athletic skills. Behavior problems, emotional difficulties, low self-esteem, and family stresses can also occur.
Learning disabilities change with time. They may diminish or resolve themselves with intervention and maturation; they may appear when certain demands are placed upon the child in a vulnerable area; or they may last a lifetime.
Children with learning disabilities are often misunderstood. They are sometimes accused of being lazy, retarded, or not trying. They may be subjected to humiliation and inadequate teaching methods. They, their parents, and their teachers frequently do not really understand their learning problems, and thus these difficulties need to be clarified and explained by a professional in a nonjudgmental manner. Emphasize that these problems are not the fault of the child, parent, or teacher.
Learning disabilities affect families, and families affect learning disabilities. Children who are failing or struggling too hard feel confusion, disappointment, anger, anguish, and guilt, as do their parents. Parental attitudes and parenting style affect the children and their attitude toward learning.
Determine whether emotional, social, or family problems are causing or contributing to your child’s academic problems, or conversely, if his academic and learning problems are really the root cause. Professional help for family or emotional difficulties needs to be sought, but it should not divert attention away from the learning disability.
Children with learning disabilities are entitled to the full support of the school system and require a good advocate and long-term follow-up.
Be sure your child has other activities and interests that serve as avenues for success and gratification.
To ensure the best results for your child, recognize learning disabilities early, arrange for the appropriate intervention, and make sure that he is followed over the long term. Also, instill a sense of optimism and hope in your child that together you will work toward a solution to these difficulties.