Getting to the Bottom of Things: Helping Families with Struggling Learners (Part 3)

This is article is by Melissa Shipman, Executive Director of PACE. You can read part 1 of the article here and part 2 of the article here. Melissa was a teacher of children with special needs for over 10 years, and has served with SHARE Education Services since 2002 as both a full-time and associate education consultant. She now lives in Georgia, USA with her husband and two young girls.

Over the last two weeks, I’ve written about some challenges that TCKs face that could disguise themselves as more serious learning issues: transitions, behavior/discipline expectations, second language, and learning styles can all lead to disruptions in learning. This week, I’ll discuss the issues that are more serious and call for an official diagnosis.

Issues that Need a Diagnosis

Finally, we come to emotional problems, ADHD, and learning disabilities, representing some areas where you will definitely need some professionals to help you do your investigative work. I want to discuss them collectively for a minute because they can so easily be misdiagnosed for each other.

Let’s say a family has just moved to the field with their eight-year-old son. He has always been active and playful, but has generally done well in school. He’s been in national school for six months, and his teachers are saying that he can’t stay still, can’t seem to pay attention, and can’t seem to get himself organized. Uh-oh! ADD, right? Well, maybe not. Read this list of other conditions that are often misdiagnosed as ADHD:

• Oppositional Defiant Disorder
• Pervasive Developmental Disorder
• Primary Disorder of Vigilance
• Hearing problems
• Bipolar Disorder
• Tourette’s Syndrome
• Fragile X Syndrome
• Vision disorders
• Thyroid disorders
• Lead poisoning or toxicity
• Restless Leg Syndrome or other sleep disorders
• Anxiety disorders

Anxiety disorders? Problems sleeping? Aren’t these things that TCKs experience, particularly when in transition? Don’t let the rest of the list scare you or a family with whom you are working, but I just want to underscore how easily some problems in these areas can be misdiagnosed.

So what do you do if you suspect a child is having difficulties that are out of the realm of what is “normal”? First, I would ask, ‘Am I sure that this child isn’t experiencing any other issues?’ such as those we’ve discussed over the last few weeks. Has the family recently transitioned? Is this child in a new language situation?

If you see that none of these are at the root of the problem, and unless you feel that this child or family is at risk of real harm, I would then ask, ‘Has the child been experiencing/exhibiting these difficulties for six months or longer?’ The diagnostic criteria for ADHD states that the symptoms must have been present at least six months before a child is even evaluated for attention deficit. For anxiety orders and depression, a psychologist would want to know that the symptoms you’re seeing have been persistent, and aren’t a result of something in the child’s environment that is bound to change or ease soon.

If the answer to the first key question is NO, this child isn’t experiencing any of the other issues, and your answer to the second question is YES, the problems has persisted for more than six months, then you have the oftentimes difficult task of finding a professional to help you in diagnosing and treating these problems.

Psychological or Emotional Issues

For any type of psychological or emotional problem, a psychologist is needed to diagnose. There are times, of course, when a counselor available within your agency can be quite helpful, and that may be the most practical place to start. I’d also like for you to encourage families to think of problems such as depression or an anxiety disorder as real neurological problems that need to be dealt with and can be treated just as other medical problems can be. This doesn’t mean that medication is always the answer, but we have seen some resistance to the idea in some families with whom we’ve worked. Medication can sometimes be effective in just helping chemicals in the brain get back to normal, and that’s what we want for a child who is, for example, depressed.

If you think a child may be experiencing serious emotional problems such as depression, I would recommend that you encourage parents talk to some other adults in their world to get their perspective. Find out what a child’s teacher has observed, what their youth leader thinks, and what other significant adults in the child’s life are seeing. These sorts of issues would be visible across a child’s environments.

ADHD

Let’s discuss ADHD briefly. I know this can be a hot-button topic! But let me share some facts with you. According to the British Medical Journal, 7% of school-aged children today have ADHD, with 3 times as many boys than girls diagnosed. There are 3 types of ADHD: primarily inattentive, primarily hyperactive, and combined. Loads of research is being done regarding how the brains of those with ADHD are different, but we haven’t gotten to the point that we can diagnose ADHD with an MRI yet.

ADHD is diagnosed based on a list of criteria regulated in the United States by the American Academy of Pediatrics. There are certain criteria they’ve identified, and a child (or adult) must display about two-thirds of the symptoms across environments and for more than six months. So, if a child is evaluated for ADHD, this needs to be based on the observation of more than just one person, because a child’s behavior can vary from person to person.

Learning Disabilities (US definition)

 Let me move on to learning disabilities. Learning disabilities, such as dyslexia or dyscalculia, impact how a child processes certain kinds of information. Right now, learning disabilities are diagnosed in many countries by comparing scores on an intelligence or IQ-type test with scores from an achievement test. When we see that a child’s achievement is far below their ability as measured by the IQ test, a learning disability may be diagnosed. But what does this mean?

It means that somewhere along the way, this child’s brain works differently than most. Let’s go back to my humiliation on the box-horse. So many processes were involved: running, timing, jumping, moving my legs, my hands, my feet all at certain times in certain ways.

Well, what about reading? Think about the processes involved in reading. First, I have to recognize a letter and the sound or sounds it might be making. Then I must be able to blend sounds together to form a syllable. Syllables must be blended together to form words. Then I have to know what the words mean. There are so many places where this process might break down!

Why should a family bother getting a diagnosis of ADHD or a learning disability? A diagnosis can help to locate resources and information need. It may, depending on the child’s schooling situation, allow for classroom accommodations. Knowing this may also empower a child to learn to speak up for what she needs and advocate for herself. NOT getting the problem diagnosed doesn’t really help a child or their family

OK, so now we’ve worked our way through these issues, and hopefully you have an idea of an area or some areas where you’d like to do some investigation with the families you serve. Many of these problems are fixable and will pass with time and support.

But some of these areas aren’t fixable, and have to do with how the Creator wired a child to learn. My humble opinion is that there aren’t therapies or medications available that can FIX learning disabilities or ADHD. There are certainly some therapies and strategies available that have benefited many children. But my belief is that we are all made differently, on purpose even, and that there are two things we need to do for children who are struggling.

First, we need to remediate. This means that we need to find out where the “holes” in their learning are and do our best to fill them in so that the child can go on to build more skills and knowledge. This sounds easy, but it’s not! It can literally take years to help children with dyslexia to begin to recognize letter-sound relationships. Some research suggests that there is a new opportunity to do this when a child hits puberty – I’m sure you’d agree that the adolescent brain suddenly starts acting differently! Well, researchers have found that new paths in the brain might be forged in reading during this time. So encourage families to keep up the hard work they are investing, especially in teaching and encouraging children to read, even as a child gets older.

But, when a child is faced with a true, hard-wired difference in how they learn, we also need to accommodate. To accommodate means that we need to help children find coping strategies, to find pathways around their weaknesses so that they can experience success. For a child with ADHD, that may mean that we don’t work on our homeschool work for three hours straight every morning. We may work for 30-minute stretches, with opportunities for rewards and exercise breaks in between. For a child with a learning disability that affects their writing, it may mean that they get to take their tests orally instead of in writing, particularly if writing has nothing to do with the skill being tested, like knowledge of American history.

A balance of remediation and accommodation is the only way to go with kids who have learning difficulties. I don’t believe that any program that only supplies one – only remediation or only accommodation – can truly serve children best. And that’s what we’re all seeking to do!

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