Ask Dr. Silver
Dr. Larry Silver answers selected questions from LD OnLine users regarding diagnosis and options for managing learning disabilities.
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If a nine-year-old suddenly starts having trouble focusing in school, is it ADHD?
My gifted nine-year-old, who is an advanced reader, writes and illustrates stories, finds patterns and relationships in math problems, and likes to have theological discussions, has suddenly started having extreme difficulty focusing in school. For example, his teacher often saw him staring off into space for long periods of time during standardized testing and his gifted teacher said that on a recent assignment he wrote only 12 words in one hour without one complete sentence!
He still has all A's in classes except for Science, in which he has a low D. Lately, the Science assignments have been done on your own during center time while the teacher helps small reading groups. The gifted teacher has mentioned the possibility of ADD since this seems to go beyond occasional daydreaming and reminding him to focus really isn't cutting it.
Do I ask the school to test him? Do I take him to our pediatrician or ask that his office's psychologist test our son in some way? Should I go first to an eye doctor since he recently mentioned seeing double at times? Where do we start? I would like to look into this before he goes into fourth grade next year (known to be harder and faster paced).
ADHD is a neurologically-based disorder. Key to making the diagnosis is to establish a chronic and a pervasive history of the behaviors noted. That is, if inattentive, there needs to be evidence of inattention/distractibility since preschool or kindergarten. And, these behaviors should be noted in most situations (home, school, with friends, on vacation , etc). If the problem of focusing "suddenly started" at age nine and seem to be related only to "difficulty focusing in school," other possibilities need to be considered.
I would start by meeting with his teachers and other school professionals to explore what might be the cause. Ask that someone come to the class and do observations to clarify when this problem is present and to explore for possible causes. Don't rush to have further studies done until you have more observational data.
What can an ADHD teenager do who feels like their parents see only the bad things they do?
I am 14 years old and I have ADHD. I have had it all my life but it only started to become a real problem in 8th grade. I started to slack off and my grades dropped. I knew it was because I was not paying enough attention in class, but I can't help it. So my parents just made my suffering worse by making threats. I was not going to go back to my school if my grades didn't improve, or I was going to go to military school and never see my friends again. It just all made me feel worse.
My parents just emphasize all the bad things that I do and just make me feel like I want to die or something. They have no idea that I feel this way. The only person that does know is a trusted teacher. I am not sure how to cope with all the built up sadness and anger towards myself for not being the perfect child that my parents seem to want me to be.
I have a younger brother with mental disabilities and all their attention seems to be on him and less on me. I feel like they don't even notice the little good I do. They only seem to see the bad that I do.
Nikki
You are struggling and I am glad you are trying to get help. You mention several problems: (1) You are struggling in eighth grade: (2) your parents appear to be responding with punishment and criticism rather than responding by trying to figure out why you are having difficult; (3) your brother sometimes gets most of your parent’s attention; and, no one appears to realize how much you are hurting emotionally. I am glad you are seeking help. You are fortunate to have a trusted teacher.
You need help from people at school to work with you and with your parents. Start with that trusted teacher. Maybe show this teacher my comments. The two of you might know a school counselor or special education teacher who could be asked to help.
First, many students with ADHD also have problems with organization and with what is called executive function. They have problems organizing their materials (notebooks, papers, reports, homework) and they have equal problems organizing the information in their head. They might read well but not remember what they have read. They might know a lot but have difficulty organizing this information in order to write and answer to a question or to write a report or paper. If this sounds like you, further educational studies might clarify your problems and then clarify how to help.
Second, ask this teacher to go with you to the school counselor to discuss how best to bring your parents on board in an effort to help you rather than to make you upset and angry.
Can LD be unrecognized until a student goes to college?
Is it possible for a learning disability to go unrecognized until a student first enters college? I struggled intensely my freshman year of college to keep up with the readings and writing papers. It is difficult for me because the vocabulary I tried to develop over the course of high school seems like it has left me. I used to memorize vocabulary words and use the thesaurus a lot in high school to help me but it seems like new and complex vocabulary words don't stick.
I am also a very slow reader and the ideas and concepts I'm trying to understand are difficult to remember after reading. It seems as though I can't quickly process the information. I end up highlighting passages like crazy and going back to re-read them again and again. It makes it difficult to remember what was read and summarize it.
It is also difficult for me to do mental math which limits my computational skills. All of these struggles actually led me to become so frustrated that I attempted suicide. I am now in recovery for depression and anxiety but still wonder if all of my academic problems are directly related to depression only.
Most people are telling me that since I was never diagnosed with any disability earlier in life, it would be impossible for me to have one. But I definitely remember struggling in high school to keep up with my peers. School was pretty much my life. Are there any tests which could be done to investigate this further?
I am sorry to hear of your problems. First, may I comment on your emotional difficulties. Anxiety and depression might be the result of adjusting to college or to the frustrations resulting from poor academic performance. However, more often, they are the current expression, maybe more intense, of a chronic problem. That is, I suspect that you have had periods of anxiety or depression since childhood. It is critical that you continue psychological help beyond getting through the acute phase.
Yes, it is possible to have learning disabilities and not be recognized until college. There are several possible reasons. Perhaps a parent or both parents provided much support with homework and projects during school, covering up any areas of difficulty. You might have gone to a school that cared enough to adapt their teaching to fit your abilities to perform or that provided much support and assistance during school. You graduated with a sense of competence that might not have been there.
What ever the reasons, meet with someone in your college's Office of Disability Services. Arrange to receive the necessary testing to either document your learning disabilities or to clarify other possible problems. Based on these findings, seek appropriate help plus accommodations.
Note from LD OnLine: For more on diagnosis, see What Do You Do If You Suspect Your Child Has a Learning Disability.
For more on the social and emotional problems, see Social and Emotional Problems Related to Dyslexia. Good luck.
How is a psychoeducational evaluation different from a nueropsychological evaluation?
I have an 8-year-old son who is struggling with reading and writing, but does fine with mathematics. I've taken him to a developmental optometrist, who found some problems with tracking and binocularity. He's also been tested by an audiologist, who found that he has problems hearing in background noise, but felt that due to his age, he might still be developing this skill.
I feel like I need to take him to someone who can give me an overall idea of what's happening. I'm unsure whether to take him for a neuropsychological exam to someone who does psychoeducational exams. Can you explain the difference between these two and tell me which you think would be better for him now?
It is important to identify why he has a reading and writing problem. Formal testing should provide this information.
Psychoeducational evaluations focus on identifying if the individual has cognitive/academic problems. If present, what are they, were are the strengths, and where are the weaknesses. The results help to develop an intervention strategy. A neuropsychological evaluation assesses does not focus on learning but on the function of most areas of brain function. The testing is more elaborate (and probably more expensive). The results will help to clarify if there is a learning disability and, if so, what to do about it.
Note from LD OnLine: To find out more about evaluation, please visit What Do You Do If You Suspect That Your Child Has a Learning Disability?.
How can I work with the professionals who help my son to improve his behavior difficulties?
My 4-year-old son has some language processing difficulties. I need advice on how to deal with his tantrums of hitting, throwing stuff, peeing on his pants, etc. when he is in his very frequent temperamental behavior. He does not behave like this in school though. This is affecting my other normal six-year-old son's life terribly. Not to mention mine, as well. Please help. Time out or ignoring his tantrums does not help. His tantrums most of the time is due to him not being able to interpret as to what we are asking him to do or him not having it his way.
Laticia
Who identified that he has a language processing problem? I hope it was by a speech-language therapist or a special education team. Do these language processing problems interfere with his ability to process what he hears and what he tries to speak? Do they interfere with early preschool learning like letter and number recognition?
I would suspect that his behavior at home is the result of his frustrations with handling life. If he does not always know what he hears or has difficulty finding the words to express himself, he will be angry and upset. If he cannot do play activities or peer interactions at his age level, he will be frustrated.
Start by sitting down with the professionals who diagnosed him as having a language processing difficulty. Ask this person(s) to help you answer your question about his behavior. Have them explain the frustration and teach you how to help you son be less frustrated.
Note from LD OnLine: For more information on Language Processing Difficulties, visit LD OnLine's Speech and Language section.
How can I learn my basic academic skills when the high school will not help me?
I am an early high school student. I just completed eighth grade but I find that a lot of my skills seem well below my classmates skills.
I have had a learning disability since before I can remember. I have dysgraphia, fine motor difficulties, and speech difficulties. However I take a combination of regular, college prep, and honors classes. I am in no "special ed. classes" with the exception of supplemental. I know for a fact however that my skills in grammar, written expression, and spelling are well below the eighth grade level.
However, I am receiving no help in those areas outside of my college prep English class. My teacher seemed to think of me as "stupid." I have asked for extra help but she seems too busy to provide any after or before school help. So instead she sent me home with English text books to borrow over summer which doesn't help much since it takes me hours to get through one page due to my handwriting difficulties. I learned very little in her class and I know the skills I lack in are not taught in high school but in elementary and middle school.
I fear that without these skills I won't be able to be successful in school and work.
A tutor is financially out of question and my case worker, who also happens to be my supplemental teacher, doesn't seem to think that I lack these skills or just doesn't realize it. I find she doesn't pick up on a lot of my difficulties.
How can I learn these skills that I need (e.g. basic grammar, spelling, and vocabulary) if I will not receive it through my classes? Do you have any suggestions?
Thanks
Cassie
I am so delighted that you understand your learning disabilities and learning abilities so well. As you know, this means that you have areas of great strength and areas of weakness.
If you have learned good compensatory strategies to minimize your weaknesses, you can handle most classes. However, in some classes, you struggle. Ideally, the special education coordinator for your school would work with the teacher for this class and help to develop any necessary adaptations or accommodations. You seem to be in a difficult situation where no resources are available. And, it seems that you did not get the necessary help in elementary school to compensate for your disabilities.
Don't give up. First, let's get your parents on board. Ask them to read this response. Then, ask them to go to the library and get a copy of a book, The Misunderstood Child. This book will help them understand what help you will need.
Maybe there will be a way to provide private help. Or, maybe, your parents can go to the school and insist on more help than you are now getting. If this does not work, e-mail me again.
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