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For kids with learning disorders -- from ADHD to dyslexia -- the new school year means extra challenges, both for them and their parents and teachers. We discussed testing, working with your child's school, and other academic issues with Amy Bobrow, PhD, of the New York University Child Study Center.
The opinions expressed herein are the guest's alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.
Moderator: Welcome to WebMD Live, Dr. Bobrow. What are the first steps parents can take to make the return to school more positive and productive for students with special needs?
Bobrow: Parents should start by beginning communication with their children's teacher and/or teachers and help their child and the teacher together develop a structured routine. Then at home, parents and children can work together to put together a similar routine.
Moderator: What kind of communication do we need to do with the teachers? And how do other school personnel fit into the picture?
Bobrow: It's important to let teachers know your children's areas of strength and weaknesses and how they learn best. For example, if your child learns better through auditory channels or by listening, it's important that the teacher knows this.
Also important is communication with other school personnel who might be working with your child. That could include the principal, the school psychologist or guidance counselor, resource room staff, etc. They should also be told some helpful hints about how best to work with your child.
Moderator: If you aren't sure what your child's problem is (you don't have a name for it) but know he struggles in school, what should you do?
Bobrow: The first step would be to express your concerns to your child's teacher. The teacher can then let you know how your child is doing on a day-to-day basis in the classroom. If the teacher is noticing similar struggles in your child, the next step would be to approach a guidance counselor or a committee for special education that is based at your school. The reason for this next step is to make a formal request to have your child evaluated for any academic/learning difficulties.
As a parent, you should know that the law is on your side, although it may seem overwhelming at times to serve as an advocate for your child, it is your child's legal right to sit for an evaluation done by the school if you believe that is what is necessary.
Moderator: What role can your pediatrician play in diagnosing your child's problem?
Bobrow: Your child's pediatrician is often the first person for you to seek advice from. Although many pediatricians have knowledge and experience in child psychiatry, not many have specific expertise in this area. That being said, your pediatrician is a great person to help you identify any difficulties your child might be having and can then give you referrals for appropriate professionals who specialize in helping your child with his or her specific difficulties.
Member question: My son has all of the symptoms of ADHD. He is very hyperactive at home, but at school he's fine. Should I have him evaluated for ADHD at the doctors' office?
Bobrow: A pediatrician can make a preliminary evaluation of ADHD or any other psychiatric disorder. However, it is best to seek out a child psychiatrist or a child psychologist to do a full diagnostic evaluation.
Member question: My son is dyslexic. He has an IEP and I am very active in making sure he gets what he needs. What do you feel are the most important things for a dyslexic child in a public school?
Bobrow: An IEP is an individual education plan for a child who has been evaluated by the Board of Education and it has been determined that this child needs additional services. An IEP details a child's strengths and weaknesses; it details the services that must be provided by the school district, for example resource room one time per week, or speech therapy three times per week.
The IEP also details specific goals that the child will work towards in a given academic year. So for a child who has been diagnosed as dyslexic, that child will have an IEP that will detail the services provided by the school, accommodations in the classroom, and what goals that child should be working towards.
You're doing them already. You have gotten hour child evaluated, you have obtained an IEP for him, and you are following up with the school to ensure he receives the appropriate services and accommodations.
Moderator: How often should an IEP be re-evaluated?
Bobrow: An IEP should be updated at regular intervals based upon the guidelines that the state provides. An IEP should also be updated if there are any changes in your child's functioning. You as a parent can request a re-evaluation and therefore an updated IEP at any time.
Member question: What can I do if the school is reluctant to evaluate my son? They keep putting me off.
Bobrow: Again, as a parent, you are your child's best advocate. As tactfully as possible, remind the school it is your legal right to have your child tested. If they still refuse, you can seek out legal guidance.
Member question: Hi, Dr. Bobrow, I have ADHD, bipolar, and Tourette's syndrome. I hate school; most time its really hard for me to concentrate on the schoolwork. I've been changing schools the last two years so I don't know any of the teachers. I'm very depressed about starting school again. Any ideas to make it easier? I'm 16 and in 10th grade.
Bobrow: I can understand how frustrating and overwhelming school must feel at times. In terms of thinking about returning to school, it would help to think about what strategies have helped in the past. For example, having a detailed schedule for after school activities, including when homework will get done.
It might also be helpful to speak to someone about your feelings and frustrations about school. A guidance counselor or a psychologist is someone who can help you figure out what strategies might work for you, as well as provide an ear to listen.
Member question: My son is in high school now. How do I sort out normal teen behavior from the ADHD problems? And does ADHD change as the person gets older? What can we expect? He has an IEP.
Bobrow: ADHD remains pretty much the same over the course or time. A child who is hyperactive as a youngster may have less difficulty in that area as he ages; however, concentration difficulty and problems focusing are not likely to change.
Another area that's often apparent in teenagers is difficulty with organization. It can be difficult at times to tease apart what is normal teenage behavior, but chances are if you talk to other parents of teens without ADHD you will notice some differences, and chances are those differences will be exaggerations, meaning that your son is even more disorganized, your son is even more forgetful, because teenagers as a group are learning to deal with their responsibilities of becoming adults.
Member question: My child, who is 15, has a problem with numbers. She can't seem to dial a phone number correctly, do simple or complex math, or distinguish between left and right always. What could this be and how can I help her, because otherwise she is a healthy, bright, articulate girl?
Bobrow: Lots of intelligent children and adults, for that matter, have areas of weakness. It sounds like your daughter is having some difficulty with math and possibly spatial relationships. The good news is that she can be helped to develop these weaker skills.
In order to get her the appropriate help, she must first be evaluated in order to determine the specific nature of her difficulties. Once an evaluation is completed, recommendations will be made regarding services and accommodations to assist her.
Member question: My 9-year-old son is in third grade and has a history of academic difficulty (His biggest difficulty is staying focused and on task) He is already showing these difficulties this year; he has been tested and did not qualify for any "special" help. Do you think he is ADHD? I have spoken with his pediatrician about medication; what do you think? This is basically my last resort because he doesn't seem to be learning the way he should (orally he does pretty good but putting things on paper is extremely difficult).
Bobrow: Based on the wording of your question I am assuming that your son was tested through school. If parents are not happy with the evaluation done at school, they always have the option of seeking out a private diagnostic evaluation by a child psychiatrist or child psychiatrist. If you haven't already done so, I would suggest such an evaluation, as I can't diagnose over the Internet.
You brought up the issue of medication. That is an important question and one that should be addressed with a pediatrician or even better, a child psychiatrist once a thorough evaluation has been done. Research shows that medication for ADHD is highly effective; however, it is important to determine, through evaluation, whether that medication is fully necessary.
Sometimes for milder cases of ADHD, behavioral interventions on their own are successful. Some families choose to try behavioral interventions in the classroom and at home prior to trying medication.
Member: I have set up a system where I email the teachers on Wednesdays to ask how my son is doing that week. I ask them to reply by Friday so that we can address any problems before they get out of hand.
Bobrow: There are a lot of different ways to ensure communication with your child's teacher. It sounds like you have found a way that works, not only for you and the teacher, but also meets your child's needs. Some parents choose to communicate by email, some parents call their children's teachers on the phone, while others send a notebook back and forth between home and school so teachers and parents can stay up to date and find ways to help children when difficulties arise.
Member question: How much should the student be involved in the planning of a program to assist them in school? With a young child I know they can't really be involved. When can they?
Bobrow: When setting up a behavioral system, whether at school or home, children play an integral role in the planning. Of course, young children will play less of a role than older children, but child input should always be sought out.
When planning a behavioral system for a younger child, the plan is mostly worked out between the teacher and the parent. It is important for the teacher to have input on what it is that they can realistically do in an average school day.
A young child can provide important information on salient rewards. If a child is working towards something that they have chosen as a reward, it is much more powerful. Older children cannot only be involved in choosing rewards, but they can also be more involved in the planning process. That way, they feel more connected to the plan and the likelihood of the plan being successful increases.
Member question: What if a child doesn't care about rewards?
Bobrow: There are some children who do not care about rewards at first glance. Usually once a child is asked what it is that is important to them, a reward schedule can be worked out. Rewards are not always monetary or material in nature. Oftentimes a reward is getting to spend quality time with a parent, or even lunch with a teacher. With enough investigation and listening to a child, some form of reward can usually be uncovered.
Moderator: What should be involved in an initial evaluation for learning disorders?
Bobrow: An initial evaluation will take a look at all areas of functioning in your child's life. So questions will be asked regarding social and emotional functioning, as well as academic and intelligence testing. Questions will be asked about your child's functioning in the classroom, as well as at home.
Parents play an integral role in the evaluation process, along with teachers and other adults that play a role in your child's life.
You can expect that your child will be given academic and IQ testing, as well as emotional/personality testing. At any point in time during the evaluation process, if you have any questions about the tests your child is given, just ask.
Moderator: Before we wrap up for today, Dr. Bobrow, do you have any final comments for us?
Bobrow: Thanks for having me. It's always a pleasure to talk with parents who are so concerned and who really serve as advocates for their children.
Moderator: Thanks to Amy Bobrow, PhD, for sharing her expertise with us today. For more information, please visit the NYU Child Study Center website at www.aboutourkids.org. And of course we have plenty of great information for you right here on WebMD - visit the our WebMD message boards.
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