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Where do I start?

Submitted by an LD OnLine user on

My son has had difficulties in school since 1st grade. He was diagnosed with ADHD in 4th grade and just started taking medication this year (6th grade). He is still having problems and I wonder if I should have him tested for learning disabilities. I have always worked with him at home and he has such a hard time with homework. He is intelligent (he learned to play chess before kindergarten). He gets so frustrated and so do I. He is failing this year in school and I need to do something now. Where do I start. How do I get him tested? Is there a series of steps I should take? Please help!

Submitted by victoria on Wed, 02/02/2005 - 3:28 AM

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I work with a lot of kids on this level who have shockingly low reading skills. Combine a weak reading program which depends on memorize and guess with a little ADD to make the memorization part unpalatable, and a very bright kid can get to middle school as an illiterate. So if he is having school problems, first get his reading level evaluated by someone who gets down to the roots of the issue, not just happy talk. The same, if not more so, for math knowledge and writing. If his skills are a lot lower than they should be, and this is often the case, individual tutoring can bring big improvements.

Submitted by Anonymous on Wed, 02/02/2005 - 5:49 AM

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I like Victoria’s take on this. Find a good speech pathologist and ask about a complete speech and language evaluation. This should include extensive testing of reading skills. This eval is usually covered by medical insurance if the referral is worded correctly. Ask the speech pathologist how the referral should be worded or coded before you ask your doctor for the referral, and you will be able to tell him how to do it.

The same goes for an occupational therapy evaluation. Sometimes sensory integration disorder (SID) contributes to symptoms of ADD and ADHD. An OT eval is usually covered by medical insurance and, if there is SID, it is often very responsive to therapy.

There are different types of ADHD. Some attention skills are highly trainable. The H portion of ADHD is not, and impulsivity is not. However, the ability to sustain focus, the ability to sustain focus in the presence of distractions, and the ability to multi-task are all trainable. You may want to look into programs such as Interactive Metronome (http://www.interactivemetronome.com ) and PACE (http://www.processingskills.com ). When underlying skills are strengthened, academic work becomes easier.

I am not a huge fan of the usual educational testing for disabilities. Very often all it does is confirm everything that you have already observed. It does not tell you why the problems exist, and it does not tell you how to reduce the problems. At most it will make suggestions about how to work around problems. If you can get it for free through the public school system, then it can be a good deal because it will provide you with some additional information. If you have to pay a great deal of money for it, often you are better off simply doing research on the internet and providing some direct remediation programs yourself.

Nancy

Submitted by Anonymous on Wed, 02/02/2005 - 1:55 PM

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[quote:43d77754c0=”Nancy2”].

I am not a huge fan of the usual educational testing for disabilities. Very often all it does is confirm everything that you have already observed. It does not tell you why the problems exist, and it does not tell you how to reduce the problems.
Nancy[/quote]

I agree. That is why I think it is important that children with suspected LD or ADHD be seen by a neurologist who has expertise in diagnosing these conditions. This kind of expert can tell you (to the extent it is known) what part of the brain is likely involved, whether the conditions is likely to improve as the brain matures, whether there are programs that have worked for people with injuries to the particular part of the brain, etc. LD and ADHD originate in the brain. A person who specializes in knowing how the brain works can really provide valuable information. The top of the line would be a diagnosis from somebody with expertise in neurology and psychiatry, as well as LD and ADHD. The best place to find these experts is at childrens’ hospitals and universities with medical schools. This kind of examination should then be followed up by further testing by an educational diagnostician, usually someone with psychology credentials. Both parts are important to the diagnosis, but schools usually only provide the second half. The “third half” would be evaluations by experts such as audiologists, occupational therapists, vision therapists, etc., if the prededing examinations indicate a need. This all costs a mint, which is why schools don’t provide it.

Submitted by victoria on Wed, 02/02/2005 - 3:45 PM

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Well, since you already have the ADHD diagnosis and the present issue is school failure, I would suggest going to a good individual tutor (not a commercial chain) and getting his skills evaluated directly one-to-one. This will cost quite a bit, but less than the full neurology workup, and the results of an educational assessment will be directly applicable to what you need to do now.
The majority of students improve rapidly with good one-to-one tutoring. If he doesn’t improve, then time to look for deeper reasons.

Submitted by Anonymous on Thu, 02/03/2005 - 1:55 AM

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Thank you for all the advice. I was thinking about getting a tutor and I had also thought about going to a Sylvan Learning Center type program. I believe that I just may go the route of an individual tutor and take it from there. Thanks again and I will check back from time-to-time to see if there is any more helpful information.

Submitted by Anonymous on Thu, 02/03/2005 - 1:15 PM

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Sylvan has a poor record with LD children. I wouldn’t waste my money.

Beth

Submitted by Anonymous on Thu, 02/03/2005 - 3:47 PM

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I would chime in on the one-to-one tutoring. In my opinion, its the most efficient for an ADHD’er. They can attend to one person.

Do shop around. Finding a good tutor is sometimes difficult. If you do a search on the parenting LD board, victoria, des and others gave a fairly precise list of questions to ask. You want someone who can tailor to your child’s needs and is not tied to one particular program/method/style. Ask, ask, ask. Good ones are not cheap but you are paying for lots of experience and knowledge.

Frankly, the biggest bargain of my lifetime was the $1200 I spent on a tutor who brought my ADD/LD child to reading on grade level in 6 weeks over a summer.

Good luck

Submitted by Anonymous on Thu, 02/03/2005 - 6:11 PM

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You might have a better shot at knowing what kind of tutor to employ and what tutoring methods would be most effective if you first had a better notion of the cause of your child’s difficulties. Just for example, if a child has difficulty writing a paragraph it could be because his motor skills are impaired and physically producing causes his to focus too much on how to write the letters rather than what he has to say. As a result, he writes as little as possible and leaves out lots of important detail. A tutor who works with him on how to write a paragraph will make little progress unless he or she first addresses the physical hand-writing problem. Another child who has difficulty producing a paragraph may have executive function or memory issues that make it difficult to get his thoughts organized. He has lots of ideas but can’t figure out how to put them in order. As a result, he becomes frustrated and angry and writes as little as possible so that he can be done with what he regards as a difficult and unrewarding assignment. A third child may not be able to write a proper paragraph because he has expressive language problems and is a slow processor. For him, generating the idea of what to say is the hard part and he needs much more time than his peers and much more guidance. School difficulties can look remarkably the same yet have quite different causes that require specific kinds of help. Knowing the root of the problem is important to the process of choosing a tutor and a method of remediation.

Submitted by Anonymous on Sat, 02/05/2005 - 5:44 AM

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Thank you for all of your thoughts. I really agree with Guest. I believe that if we know where the problem lies, we can address it specifically. Also, my son is so discouraged at this point, it is important that I find the right kind of help so he doesn’t give up completely.

Submitted by victoria on Sat, 02/05/2005 - 2:13 PM

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Aim for a happy medium. Testing is good to give you more info, but you can test and test forever and never get an absolute answer cast in stone; and no matter how much time and money and effort you put into testing, it never teaches the kid to read and write. It is usually a very good idea to treat the overt and harmful symptoms at the same time as you look ion depth for the detailed diagnosis.

Submitted by syas on Thu, 02/10/2005 - 12:08 AM

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[quote:ebf3e72c02=”Anonymous”][quote:ebf3e72c02=”Nancy2”].

I am not a huge fan of the usual educational testing for disabilities. Very often all it does is confirm everything that you have already observed. It does not tell you why the problems exist, and it does not tell you how to reduce the problems.
Nancy[/quote]

I agree. That is why I think it is important that children with suspected LD or ADHD be seen by a neurologist who has expertise in diagnosing these conditions. This kind of expert can tell you (to the extent it is known) what part of the brain is likely involved, whether the conditions is likely to improve as the brain matures, whether there are programs that have worked for people with injuries to the particular part of the brain, etc. LD and ADHD originate in the brain. A person who specializes in knowing how the brain works can really provide valuable information. The top of the line would be a diagnosis from somebody with expertise in neurology and psychiatry, as well as LD and ADHD. The best place to find these experts is at childrens’ hospitals and universities with medical schools. This kind of examination should then be followed up by further testing by an educational diagnostician, usually someone with psychology credentials. Both parts are important to the diagnosis, but schools usually only provide the second half. The “third half” would be evaluations by experts such as audiologists, occupational therapists, vision therapists, etc., if the prededing examinations indicate a need. This all costs a mint, which is why schools don’t provide it.[/quote]

Submitted by syas on Thu, 02/10/2005 - 12:13 AM

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I have no faith anymore in the educational testing for disabilities. I’m just getting started and gathering information on how to get the right help for my son. Needing to know where to start and who to contact regarding testing for my son. My eyes have been opened to information that I didn’t know about, because the school system doesn’t tell you about this!!!

[quote:bab00ce618=”syas”][quote:bab00ce618=”Anonymous”][quote:bab00ce618=”Nancy2”].

I am not a huge fan of the usual educational testing for disabilities. Very often all it does is confirm everything that you have already observed. It does not tell you why the problems exist, and it does not tell you how to reduce the problems.
Nancy[/quote]

I agree. That is why I think it is important that children with suspected LD or ADHD be seen by a neurologist who has expertise in diagnosing these conditions. This kind of expert can tell you (to the extent it is known) what part of the brain is likely involved, whether the conditions is likely to improve as the brain matures, whether there are programs that have worked for people with injuries to the particular part of the brain, etc. LD and ADHD originate in the brain. A person who specializes in knowing how the brain works can really provide valuable information. The top of the line would be a diagnosis from somebody with expertise in neurology and psychiatry, as well as LD and ADHD. The best place to find these experts is at childrens’ hospitals and universities with medical schools. This kind of examination should then be followed up by further testing by an educational diagnostician, usually someone with psychology credentials. Both parts are important to the diagnosis, but schools usually only provide the second half. The “third half” would be evaluations by experts such as audiologists, occupational therapists, vision therapists, etc., if the prededing examinations indicate a need. This all costs a mint, which is why schools don’t provide it.[/quote][/quote]

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