Friday, June 19, 2015

Does my child have a learning disability?

Every time I start a blog post, I end up with several other related topics that I feel compelled to write about.  My draft queue is full of post titles with one or two notes about what I want to discuss.  And then I get started on one and can't find a good stopping place!  This blog post is another one that has had me writing, adding more, then adding more, and then, oh wait-- there's this, too, and I ought to mention this, and...

I have worked with some learning disabilities from the parent side as well as the teacher side.  There are countless books and websites dedicated to individual diagnoses, and I am no expert on any of them, so I will try to limit my discussion. But it's hard.  Apparently I have a case of lexiarrhea.

Seriously, though, there are a lot of diagnoses out there:  Dyslexia.  Dysgraphia.  Dyscalculia.  Dyspraxia.  Scary words that mean a child is struggling with one or more foundational skills, interfering with her ability to do basic academic tasks, such as "reading, writing, and 'rithmetic."  A summary of each of these terms is here.  And that doesn't even complete the list of the possible barriers to a child's academic success.

But how do you know if your child has a learning disability?  And what do you do about it?

Many children have legitimate, brain-based learning disabilities.  Their brains actually receive and process information differently than other children.  This may be due to brain development issues that happened before birth, or even after.  Most of these issues do not affect actual intelligence, but they can frustrate his ability to absorb information or express himself, or both.

One child that I dearly love, for example, knew all her alphabet letters and their primary sounds at age two, and yet by third grade was still having trouble comprehending what she read.  Turns out she had auditory processing problems-- most likely caused by frequent ear infections that had resulted in functional deafness during her first year of life.  There was a domino effect:  her ears had not been correctly delivering sounds that she needed in order to process speech, so critical neurological connections were weak.  Although her hearing was restored before her first birthday, the damage was such that she still needed more time than her peers to think through what she heard in order to understand it. This affected how easily she could acquire new words from conversation.  By the time she started school, she lacked the wealth of vocabulary that most of her classmates had.  The same domino-effect processing damage can happen with children who have visual impairments.

Then there are those children whose hearing and vision are normal, with normal processing skills, but a lack of exposure to certain activities has made them functionally dyslexic, dysgraphic, or otherwise disabled.  They simply don't have the tools to learn the skills.  A common example is seen in children who show up to kindergarten without ever having been read to-- who don't even have books in their house.  They have no experience with letters or words in print, no nursery rhymes or Dr Seuss to form the basis of their phonemic awareness.  Similarly, some children arrive at school without being able to count, identify colors and shapes,  hold a pencil, or use scissors.  They are behind before they even start.   And because they are not ready for learning from the starting point that the school is prepared to teach them, they fall further behind each year.  (This is the motivation behind the government push for preschool for all.)

Years ago, lack of preparation was less of an issue, because kindergarten was all about learning these foundational skills.  Children sang rhyming songs and strung beads, kicked balls and colored and dug in the sand, all the while developing important brain connections.  Now, however, kindergarteners are expected to come with these skills already in place.  So those who come "unready" are at an extreme disadvantage and often never catch up, because there's no time allowed to go back and build the missing foundation.

Your child may struggle mightily with reading.  But before you decide that your child is dyslexic, make sure he has had the opportunity to develop phonemic awareness: your Dr Seuss and Mother Goose books are well worn.  You've played so many rhyming games, you could moonlight as a rapper.  Or, your child may be frustrated out of his mind by writing, avoiding it at all costs and having a meltdown over copying a single sentence.  Before you decide he is truly dysgraphic, consider whether he has had opportunities to develop his fine motor skills through tasks such as bead stringing, card sewing and button sorting.  If the struggles don't get easier,  seek help.

Does your child know his phone number and address, and can he remember where the matching cards are when he plays a memory game such as Concentration?  Depending on his age and what he has been exposed to,  not being able to do these things could be a red flag.  If your child is about seven years old and has developed phonemic awareness, but still struggles with putting the sounds together to make a word, or making sense of the words in a sentence,  there may be memory issues involved. Comprehension of sentences and paragraphs-- even reading longer words-- requires that the reader hold the first pieces of information long enough to put it with the last pieces, and process them together.

One quick screening test for short-term memory issues is the digit span test (With an explanation here.)  Research suggests that a child needs enough memory storage to be able to hear and repeat back (auditory memory), or see, look away and repeat (visual memory),  about six single-digit numbers in order to be most successful at reading.  This generally happens by age six or seven.  If he's not there yet, practicing digit spans can help.  If it doesn't improve, seek help.

Another indicator for reading problems is whether a child's vocabulary seems less developed than her peers'.  If your child often mispronounces words, doesn't seem to know what common words mean, becomes frustrated or angry or simply "tunes out" if you use too many words to explain something, or doesn't understand jokes that are appropriate to her age, she may have some "holes" in her language data bank.  Those were all clues for one child's auditory processing problems.  One day her parents tried turning on the subtitles in a comedy they were watching, and all of a sudden the girl was understanding the jokes in the dialog. All those words coming at her ears had been exhausting when she had to process them at the speed they were spoken. They realized that her low reading comprehension was tied in, too, because her vocabulary acquisition had been limited by the number of words she could actually process in a conversation.

ADHD is a common diagnosis.  There is a lot of debate over who has it, what causes it, and what should be done about it, but it's pretty clear that students who have trouble focusing on what they're being taught will have trouble learning.  I personally lean toward dietary/nutritional therapies-- undiagnosed chemical and food sensitivities can cause all kinds of behavior problems-- coupled with child-friendly, hands-on, active learning and ample physical activity, but sometimes medication is the only life-line a parent has.

If your child is in school, his teacher(s) may or may not suspect learning disabilities.  Don't wait for them to act first.  If you think your child's academic performance doesn't match his true intelligence, you may ask to have him tested.  That may take a while, but by law the school has a certain number of days to complete the test.  Then if they find evidence of a disability, they will begin to work with you to develop a 504 plan or an IEP (Individualized Education Plan).

A 504 plan outlines accommodations for a student whose disabilities interfere with his success in school. Accommodations can be specific changes that the teachers make in their requirements for the student, such as more time on tests, fewer items for homework, alternate testing methods,  or being allowed to turn in typed work instead of handwritten assignments.  They can also involve access to mechanical or electronic assistance, such as wheelchair ramps, computers, calculators, wiggle chairs, or amplified sound devices.  Special seating arrangements and permission to move around the room are also accommodations.

An IEP may include both accommodations and remediation.  It is designed for students whose needs are significantly different from the general student population, due to severe learning disabilities, cognitive or intellectual impairments, physical impairments, autism, or any number of other issues.  Remediation addresses the gap between what the student can do and what he needs to be able to do, and may include individual assistance, modified pace of instruction, alternate educational goals, physical therapy, and/or occupational therapy.

In either case, 504 or IEP, it is important to be a part of the planning process, and to advocate for your child if you think his needs aren't being met.

If you're a homeschooler, or your child is not old enough yet for school, you may still notice that things are not quite right.  In this case, you can still have him evaluated.  Knowing what the problem is makes it a lot easier to work with.

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