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Dr. Larry Silver answers selected questions from LD OnLine users regarding diagnosis and options for managing learning disabilities.
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What's wrong with a child who throws tantrums, refuses to listen, and can't concentrate?
I am worried about my five-year-old grandson. He refuses to listen, has trouble concentrating, throws tantrums, and asks the same question over and over. He is very bright, cute, funny, imaginative and loves to be the center of attention. He doesn't sit still if there is external stimuli. I literally can't take my eyes off of him. He doesn't know boundaries. He doesn't sit to eat a meal. The doors have to be locked from the inside, he may decide to visit the neighbor or go on a journey. Two years ago, I thought it was a phase, but it is getting worse. It's as if he has no control.
Please help!
Jackie
The behaviors you describe suggest a possible Attention-Deficit/Hyperactivity Disorder. Have your grandson's parents explored this possibility with their family physician? If not, you might suggest that they do. If they are resistant, ask them to learn more about this disorder. Have them check the ADHD Basics section of LD Online, ADDITUDE and CHADD.
My child went on ADHD medication and is now depressed. What now?
My daughter, who is now 7 years old, has been diagnosed with ADHD, Dyslexia, Motor Function delays and Executive Function disorder. This diagnosis came after about four months of testing and evaluation. The ADHD diagnosis came as a surprise, not just to us, but to her teachers and specialists as well. They just didn't see it.
The plan of action included continuation with what we are already doing and medication. We tried the medication and were told we would see an immediate change. The medication did nothing other than make her depressed. She is known for her sweet personality so the change was obvious. We tried other meds with the same result.
I am wondering if she has been misdiagnosed. She is now reading and writing through the help of a specialist as well as at home. She is also doing well with math. She is still struggling with her ability to stay focused and follow directions (ie. if I ask her to face me she will turn around with her back to me). At this point in her treatment, do you have any advice as to what I can do next? Thank you, in advance, for you time and consideration.
I would trust your observations and judgment. It is possible that her inattention is the result of her learning, motor, (and probably language) disabilities. If so, medication may not help; remedial tutoring, OT, Speech-Language will help. I suggest that you hold off on trying medication and give the interventions a chance to help. If the professionals working with her feel that her inattention is a major concern, you might want to have her reassessed by a Child and Adolescent Psychiatrist to explore why the medications did not work and to find if other interventions might help.
How can you get the school system to help a child who is doing well now, but needs intervention to prevent failure next year?
My son is 10 years old and soon to start the fifth grade. In early 2007, he was diagnosed with mild learning disabilities, specifically with a phonemic awareness deficit and short-term memory deficit. It was also suggested that he perhaps has some trouble with CAP, but that no one in this area does this type of testing. His public school can do nothing for him because his intelligence was at a low-average to average level and compared to his academic output, there was not a significant gap between the two.
He makes a few A's, mostly B's and some C's. He loves to learn new things about the world; however, he is increasingly frustrated with the demands of higher elementary school. He is doing as well as he is in school because I work with him so much after school. His teachers try to help in the class as much as they can, but with almost 30 kids, it is impossible. I am concerned that he requires so much help now and wonder how we will get through middle school next year when the teachers won't be so helpful.
I am returning to school to finish my master's degree and will not be available to help him as much. His counselor said we might need to retest him in middle school if his problems become worse because by then, he might be more than a few grade levels behind instead of the one he is now. He would then most likely qualify for special education and an IEP.
It doesn't end here...my son also was born with congenital heart defects and almost lost his life this past year due to his heart issues. However, with everyone's preserverance, he has recovered wonderfully. The point is, my son wants to lead a full life, but that full life may be shortened unfortunately by his medical condition. I can't let him get two or more levels behind. He wants to go to college and do so much more.
Is there anything else that I should be doing? What else can I do to help him? Anyone else I should contact? Any tips on how to help him be a successful reader, speller and writer? Why must my son get two or more grades behind before anyone will help him? It frustrates me and disgusts me to no end that our schools are failing the kids that need them the most.
Anyone can teach a bunch of straight A students. You know, the ones that don't even need a teacher and would do fine on their own. To be a true teacher they must be able to connect with and teach our kids who are having trouble in school; that is the true art and science of teaching. The trouble is finding one of those rare teachers.
Thank You,
Tina
Your son is lucky to have you as his mother. You have been there to help and you are not ready to accept what the school is saying. It sounds as if the school is saying that only if you stop helping him so much at home and you let him fail, will he be eligible for help.
Public schools often use a "wait to fail" model for providing help. "Your son has to be two standard deviations behind before he is eligible for services." This is wrong, but it is not uncommon to be used to avoid services. If you can afford to do it financially, seek a comprehensive private evaluation. Get another opinion on where he is and what he needs. (If you cannot afford to do this, seek out a private educational consultant to review the school evaluations and to advise you.) Start an appeal process and use good consultants to help you fight.
You need to be an informed and assertive advocate for your son. Seek help from a private consultant to help you do this. (Ask friends who they have used. Or, go to the website of Learning Disabilities Association of America, then click on your state, which is on the left side of the site. Find out the name of the State chapter of this organization. Contact them and ask for names of advocates in your areas.
Good luck and don't give up.
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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