From infancy on, each child clearly displays her sensory preference—that is, an affinity for visual, auditory, or tactile information—and can be categorized as a Looker, Listener, or Mover, with skills particular to her learning style. Indeed, throughout the preceding chapters, all of our case- study learners' development and academic achievements have been very much a function of the ways in which they absorb and respond to the vast array of information that surrounds them.
Sometimes, a child shows such a decided preference for one kind of sensory input—one learning style—over another that she blocks out information coming in from other channels and actually gets "stuck" in one way of perceiving environmental stimuli. Because the world of academics taxes the senses of sight and hearing equally, a single-channel Looker or Listener, or a Mover who has failed to adequately develop either of the academically oriented channels, is bound to experience frustration in the classroom. And so, quite often, these children wind up being labeled "learning disabled."
In some cases, of course, a child's history reveals a possible organic origin of the learning disability, such as prenatal problems, a head injury, or a family history of learning problems. Happily, the course of educational therapy is the same whether a child's classroom difficulties are primarily learning-style related or organic in nature, so parents needn't despair if a specific diagnosis can't be agreed upon.
This chapter examines learning preferences that can become learning disabilities, and also provides a look at other conditions that can disrupt the academic process. Since so many learning problems surface during the elementary school years, the relationship between learning problems and the onset of academic work is clarified.
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Academic problems usually result in a child's being referred for evaluation. Therefore, this chapter offers some valuable information about the nature of educational and diagnostic testing. Included are descriptions of commonly used tests, suggestions for making sense of your child's test results, tips for highlighting strengths instead of weaknesses, and definitions of some frequently encountered diagnostic terms. In addition, since there has been much debate about the fallibility of various diagnostic tests, you'll find within this chapter a hard look at the validity of a typical testing situation.
Besides classroom modifications and such school services as individualized reading instruction, speech and language therapy, and daily time in a resource room, additional outside support is available to struggling learners. This chapter describes various treatments and therapies, and looks at the pros and cons of delayed school entry and grade repetition. Finally, for parents of children whose self-esteem is battered by the daily challenges posed by learning problems, a list of guidelines is included to help you offer the maximum at-home support.
A generation ago, most parents bowed to the authority of school personnel when it came to the fate of the challenged learner. But times have changed! If you wish to become actively involved in educational decisions that will have a direct bearing on your child's future, you've come to the right place.
No hard-and-fast relationship exists between learning preferences and learning disabilities. In fact, educational professionals disagree about what constitutes a learning disability in the first place. Partly because there is no universally accepted test battery to confirm such a condition's existence, the definition of "learning disability" can differ not only from state to state, but even between neighboring school systems. Some districts, for example, consider a thirty-point discrepancy between a child's scores on the visual-motor and language segments of an IQ test to be a reliable indicator of learning disability. Others hold that even a ten-point difference reveals a decided and potentially problematic preference for one sensory modality over another.
The employment of the learning-disabilities label itself is subject to debate. Many authorities subscribe to the idea that all learning problems, regardless of severity, are physiological and representative of varying degrees of brain dysfunction. Other experts believe that the
majority of learning problems are learning-style related; that is, incidences of near-exclusive adherence to one sensory mode. The learning- disabilities cause-and-effect war has, in fact, already spanned many years, and as it rages on, I find it helpful for my clients and their families to focus on the positive—the fact that a great many learning problems, regardless of cause, can be minimized through a specific course of learning-style-modification techniques such as those described throughout this book. How much more inspiring is this belief than the suspicion that a quirk of genetics or an injury in babyhood has made a child's academic performance a foregone conclusion, and that it may therefore be resistant to anyone's efforts at remediation!
In my experiences with a vast array of academic stumbling blocks in clients of all ages, however, I never lose sight of the fact that the issue of learning disabilities is complex and controversial, and that research can be cited to support almost any view of the subject. The definition of learning disability is constantly in flux, and there is no definitive measure of a disability's existence or the severity of a given problem. A so-called "severely reading disabled" grade schooler may respond beautifully to therapy focused on improving her Listener skills. Or, a child whose neurological tests show negative results for organic causes may nevertheless fail to progress when learning-style modification is attempted, seeming to defy her own test results. It is sometimes necessary to change approaches midstream, working over time to determine what helps and what does not.
Meeting a particular child's needs by effecting change in her learning skills is my top priority. However, if a child's history suggests that her school struggles may have an organic cause—if she was born after an abnormally long labor, for instance, or if she has suffered a head injury— I refer that child to a pediatric neurologist for evaluation. I make similar referrals for children who achieve little or no academic headway despite a course of therapy involving multisensory materials and tailor-made strategies aimed at effecting learning balance. Conversely, family doctors, pediatricians, and neurologists refer patients to me when it is evident that a child's learning skills—amassed over a lifetime of reliance upon a favored sense—are holding her back in the classroom.
How does a learning style become so extreme that it leads to a learning disability? Let's look at Amanda, a seventh grader who came to me for evaluation because of difficulty with reading assignments. Amanda has trouble pronouncing and remembering the meanings of multisyllabic words, and cannot seem to pinpoint a passage's main idea or recall facts related in the text. IQ testing reveals a twenty-five-point spread between Amanda's verbal and performance abilities—a spread
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indicative of a learning disability. (See page 238 for details.) Amanda, it turns out, is a Looker who has failed to develop the auditory skills critical to classroom success.
The same nearly exclusive reliance on a single sense can develop in Listeners and Movers, as well. Nine-year-old Peter, for example, wrestles with spelling and math, and has very poor handwriting. In contrast, his language skills are excellent. Peter's testing shows a discrepancy between verbal and performance scores that is ten points greater than Amanda's, suggesting a Listener who has thus far failed to develop essential visual perception and eye-hand skills.
Then there's Evan, an extremely active preschooler who cannot seem to follow directions, has little success with coloring and cutting, avoids sit-down activities at all costs, and has nearly unintelligible speech. Since the diagnosis of "learning disabled" is seldom used until mastery of academics poses a problem, Evan will not be labeled as such until he is of school age. However, it is immediately evident that this little boy is a Mover with significant language and visual-motor delays.
As with all my clients, I treat Amanda's, Peter's, and Evan's learning problems with educational remedies. As you've seen in earlier chapters, there are a host of strategies that children and their parents can apply to make difficult school work more palatable by involving a favored sense in an academic task that taxes a weak area. And, most of the children in my practice show significant improvement in their skill levels in a surprisingly short time, while enjoying a corresponding and much-needed boost to their self-esteem in the bargain. In my experience, the positive approach almost always yields equally positive results.
Why do so many learning problems escape notice until the grade-school years? A tremendous amount of learning certainly takes place beforehand, but at the child's own pace and usually with a loving and unfailingly attentive parent to hand-pick the experiences that the child will like best. Even in preschool and kindergarten, though there may be some study of letters and numbers, the chief emphasis is usually on socialization. Preacademic work is introduced only through experimentation and play.
Suddenly, with the advent of first grade, there exists standardized testing and a curriculum jam-packed with materials to memorize, concepts
to grasp, and tasks to perform on command. No matter how creative the teacher and how child-centered the classroom, children sense the pressure to adjust to a stranger's routine and to then meet her expectations, to match the performance of classmates, and—at report card time—to emerge shining from a subject-by-subject evaluation.
All of this is unfamiliar and stressful territory to a child, and some children are better equipped to conform than others. Chapters Six and Seven showed that school-related responsibilities as simple as sitting through a music class can be torture for as many children as are delighted by the activity. Similarly, certain children pick up new reading vocabulary on the first try, while others are still wrestling with letter sounds or last year's material at Christmas time. In the long run, many children will breeze through academic subjects on the strength of their learning skills. More than a few others, though, will find their paths slowed by a learning disability; an inability to focus their attention on the work at hand; or a hearing, vision, or language problem.
If your child is having problems with class work, this book should help you identify her learning-style strengths and weaknesses, and suggest plenty of ways in which you can develop her weaker skills while helping her apply her strengths to specific course work. However, if, even with your help, your child struggles with academics, you should by all means seek assistance from your child's school. This does not mean that you should discontinue working with your child at home. Your support, encouragement, and learning-style-based suggestions will be of tremendous help to your child, both emotionally and practically. However, in many cases, a child stands to benefit greatly from the diagnostic testing and remedial services available in schools or from outside professionals.
Resource labs and self-contained special education classes, designed to provide support and tutorial services to struggling learners, abound throughout the country. The exact criteria for entry into such programs vary from state to state, but to qualify in all cases, a student's academic performance must be significantly lower than that predicted by her tested intellectual ability. It's important to remember that despite poor classroom performance, some children's test results do not support the existence of a learning disability. In these cases, one must look elsewhere for the cause of learning problems and for assistance with developing strategies to minimize them.
An educational evaluation is in order any time one or more of the following statements characterize your child's classroom performance. Seek assistance if your child:
• Is in first grade and cannot grasp the names of letters or the sounds they make.
• Is in first grade and cannot write or recall numbers, forgets the sequence of numbers, or cannot recall the meaning of such math symbols as the "plus" (+) and "minus" (-) signs.
• Has great difficulty with one school subject while others come easily.
• Is not performing at grade level in one or more subjects despite average or above-average intelligence.
• Displays emotional distress through frequent crying, school avoidance, loss of self-confidence, or the onset of bed wetting.
When a child's classroom behavior or performance suggests the existence of a learning disability, the teacher refers the child to the school psychologist or psychometrist for an evaluation. (See "Who Are the Experts?" on page 252.) Should test results prove the teacher's hunch correct, goals and methods of remediation for that child are put in writing in the form of an Individualized Educational Plan (IEP). The child then receives needed help from the appropriate support personnel—a learning disabilities teacher, a speech-language pathologist, and/or a reading specialist. Consultations with outside medical professionals such as an audiologist or developmental optometrist may be recommended, as well.
Educational and diagnostic testing are used to determine the scope and nature of a child's school-related problems, as well as the best course of treatment. Generally, the school psychologist or psychometrist undertakes an assessment of the child's abilities. Private-practice psychologists or developmental specialists affiliated with a local college, medical center, or mental health facility can provide the same service to students.
The sooner a learning problem is identified and remediation is set in motion, the better the chances that a child will be able to catch up with her classmates. Since parental observation can be as strong an indicator of classroom difficulties as are a child's grades, I routinely recommend that parents make teachers aware of changes in their child's attitude toward school and school work.
An educational assessment covers all aspects of the referred student's background and classroom performance, and includes some variation on the following:
• The teacher's report
• A classroom observation
• A developmental history
• An IQ (intelligence) test
• An achievement test
• Learning-modality testing
• Criterion-referenced testing
• Class-work samples
The descriptions that follow will help you better understand the purpose and nature of each of these diagnostic tools.
When a child is referred for testing, the classroom teacher is usually asked to clarify problem areas by completing a detailed checklist of classroom behaviors. In many cases, the evaluator confers with the teacher for additional details.
By observing and noting the attentiveness, classroom performance, and peer interactions of the child in question, the evaluator can glean important information about the student's academic and social skills. This practice gives the evaluator a firsthand look at the child's classroom behavior and responses to ordinary methods of instruction.
In this component of the diagnostic evaluation, the parents furnish information about the child's medical and educational history, including the ages at which physical and social milestones were met (e.g., when the child first sat up or was toilet trained). This data helps the evaluator paint an overall picture of the child's development, and in some cases pinpoints early indicators of a learning problem.
The purpose of an IQ measurement is to separate a child's innate ability from environmental influences. The scoring process compares the child's responses with those of other children in her age group. The Wechsler Intelligence Scale for Children-Revised (WISC-R) is one test commonly used for measuring IQ. This test is divided into two parts—a Verbal Scale, which corresponds with Listener abilities, and a Performance Scale, which involves Looker skills. The student earns a score on each subtest, and the scores are combined to determine the child's Full Scale, or overall, IQ.
An individual achievement test such as the Wide Range Achievement Test-Revised (WRAT-R) is used to determine the grade level at which the child is performing in reading, spelling, and math. The examiner's observations of the child's approach to her work constitute an important facet of the achievement test.
Testing devices such as the Zaner-Bloser Modality Kit or my own Learning Style QuickChecks identify a child's learning strengths, whether auditory, visual, kinesthetic, or a combination thereof. This information reveals the best sensory channel through which to approach a child's skill development.
Instead of providing a statistical comparison of the child's abilities, criterion-referenced testing determines the level of the child's skills. For instance, the evaluator might note, "Bobby can multiply single-digit numbers, sound out two-syllable words, and use a table of contents." These tests can be borrowed from the regular curriculum, or made up as needed based on a checklist of skills expected to be mastered by a particular grade.
In this segment of the diagnostic assessment, the parents provide a file of recent school work. A review of sample test papers, compositions.
work sheets, artwork, and creative writing pieces tells the examiner which assignments are most difficult for the child, how much positive and negative feedback the teacher routinely provides, and which aspects of class work the child excels in.
When all tests have been administered and scored, and all observations and interviews have been completed, the evaluator prepares a report that spells out his or her findings and makes recommendations for educational modifications, if needed. As a rule, diagnostic reports are quite detailed and can run as long as ten to fifteen pages in length. It's understandable that parents, stunned by the revelation of a problem and very likely baffled by educational jargon, often leave the postassessment meeting somewhat in the dark about their child's test results and the reasons for particular recommendations. But, this doesn't have to be the case! Here are some suggestions that will help you play an active role in your child's educational planning.
1. When reviewing the diagnostic report, begin at the end—the "Summary and Recommendations." The compilation of test data that precedes this section can be confusing and, by itself, meaningless.
2. Ask the examiner to define any professional jargon. Jot down his or her responses, and use these notes to refresh your memory later on.
3. Ask permission to tape the session during which test results are explained. The scope of the discussion and the unfamiliarity of the terminology and subject matter make it virtually impossible to digest everything at once.
4. Request a copy of the report to reread and absorb at a slower pace at home.
5. Once you have reread the report at home, feel free to call the examiner with additional questions or comments.
6. Guard against feeling intimidated by the professionals who are working with your child. You know your child better than anyone else, and you may feel that some components of the evaluation simply do not "fit." If so, it's important to be honest about your reaction before the test results and recommendations become a part of your child's Individualized Educational Plan and permanent record.
It's important to be aware that test results can be wrong. To begin with, the validity of the entire test battery depends upon the experience and expertise of the examiner. Any child, too, can have an "off" day and fail to display her actual potential, or suffer from test anxiety that disrupts her performance. The following considerations should also be kept in mind when reviewing the diagnostic report and meeting with teachers and other professionals at your child's school.
• While intelligence testing attempts to separate innate ability from environment, most tests reward experience. This means, for example, that the child with frequent opportunities to work puzzles at home or school is likely to do better with a particular test puzzle than a child lacking this experience.
• Children from cultural and socioeconomic minority groups are prone to poor performance on individual test batteries. Intelligence tests, in particular, have been criticized as largely reflecting white middle- class values and attitudes, and, in fact, may be administered by a professional who does not understand the child's home culture and language.
• The intimidating nature of the test situation can cause an anxious child's performance to break down. The examiner's unfamiliar face, his or her no-nonsense air, the briefcase, the stopwatch, and the silence of the testing room can all be threatening to a child.
• Speed is considered a virtue in IQ testing. This means that the child who daydreams, contemplates answers carefully, or does not perform well under pressure will be penalized.
• The Verbal and Performance Scales of the WISC-R (see page 244) correspond to Listener and Looker skills, respectively. Since scores can be expected to reflect the subject's learning preference, both of these scales penalize Movers.
• By their very nature, IQ scores set up expectations in the minds of teachers, parents, and children. Too much may be demanded of high-scoring children, or too little from those who earn low scores.
On your own, you can translate your child's diagnostic summary into more positive learning-style terminology. This technique shifts the focus away from a learner's weaknesses—"Kristin exhibits auditory perceptual difficulties," for example—to her strengths—"Kristin is a Looker, highly attuned to visual stimuli." This positive approach helps to pinpoint appropriate remedial techniques and specialists simply by identifying inborn learning style. For example, a Listener child often has lagging Looker skills that might warrant the use of books on tape or the practice of reading instructions aloud. Similarly, a Looker's or Mover's weak Listener skills might convince her parents to consult a speech-language pathologist.
On the whole, the use of learning-style terminology can help you view your child's overall educational picture—from learning problem to at-home course of action—clearly and succinctly, as in, "To improve classroom performance, Kristin needs to develop her Listener skills." To help you become more familiar with the technique of reframing standard diagnostic terminology, here is an example of a typical summary and its learning-style-focused counterpart. This report concerns Sarah, a third-grade student who is eight years four months of age.
Diagnostic Report
Verbal IQ: 92 Performance IQ: 114
Sarah's reading problem affects all academic subjects. Her auditory perceptual skills related to reading are at a beginning first-grade level; her actual reading level is second grade, second month. Sarah demonstrates problems remembering what she hears, and her ability to attend breaks down in the presence of noise. She has difficulty memorizing math facts. Her strengths include visual memory and eye-hand skills.
Learning-Style Report
Sarah is a Looker by learning style. She has average intelligence, excellent visual memory and visual-motor skills, is a good speller, and is strong in math computations. Sarah would benefit from auditory training with the school speech-language pathologist to sharpen her ability to distinguish sounds and blend them. This, in turn, should improve her reading skills. Prefer-
ential seating near the teacher may improve her ability to follow verbal instructions.
As you can see, both of Sarah's diagnostic summaries deal with the same issues—her weak auditory and reading skills. In the first report, Sarah's strengths and weaknesses are simply listed, almost as a "given," with no attempt made to tie the two together or suggest a reason for the discrepancy in her ability levels. However, the report that is reframed into learning-style terminology acknowledges the child's academic difficulties while maintaining a very positive tone. The blame, so to speak, for Sarah's academic shortcomings is placed on learning-style imbalance—auditory skills that don't measure up to the child's demonstrated visual abilities. Most parents. I'm sure, would rather their child's diagnostic summary read as the second does, if only because it states that help is available!
Some deterrents to academic progress are more common than others. The problems listed below, which are often cited in diagnostic reports, may at first sound ominous and unfamiliar. However, the accompanying explanations will help you better understand those obstacles that may be facing your child.
A child with a language disorder usually has a limited vocabulary and difficulty expressing her thoughts in words. Auditory memory and auditory perceptual skills are weak, so she is impaired in her ability to understand language and remember what she hears. It's not surprising that children with language disorders usually have a great deal of trouble following directions.
A learning-disabled child has average or above-average intelligence, normal hearing and vision, and no primary emotional problems to interfere with learning. Despite these facts, the LD child is unable to perform academically on par with her intellectual potential because of problems
with attention, perception, memory, or thinking. As a result, she is unable to do grade-level work in reading, writing, spelling, or math.
Dyslexia, one type of learning disability, is, by definition, "a disturbance in the ability to read." This diagnosis is sometimes misapplied to struggling readers who can be readily helped with therapy aimed at strengthening auditory and visual skills. A truly dyslexic child is one with average or above-average intelligence who continues to be a nonreader or progresses only slightly despite an individualized therapy program.
A child with ADHD is overactive and unable to control her motor behavior. As a result, she cannot focus attention sufficiently to be successful in a classroom setting. Attention Deficit Disorder (ADD) is the term applied to children whose concentration and task-completion problems exist without hyperactivity.
A child can have 20/20 vision, yet still have visual-processing or visual- perceptual problems that hamper her school work. A developmental vision problem may be at fault when a child becomes quickly fatigued when reading, tends to skip words or sentences, or makes many errors when copying from chalkboard to paper.
When the reason for a child's learning difficulties has been isolated, the parties involved in her educational-planning conference formulate a set of goals for the child and then schedule appropriate support services. Such services might include classroom modifications and such in-school support as speech-language therapy, individualized reading instruction, peer tutoring, or time spent in a learning disabilities lab. There are other treatments that can help, as well, and these fall into two categories: those that ready a child to learn, and those that teach specific skills and
subject material. Some of these treatments are controversial, some work best in conjunction with others, and none can be considered right for every child. It is sometimes necessary for the professionals to recommend several different courses of action in turn before discovering which treatment or therapy is most helpful.
What follows is a look at some of the currently available treatments and the professionals who use them. The inset "Who Are the Experts?" on page 252 describes the training and role of various experts in the different child-related fields.
Some children who receive the label "learning disabled" or "hyperactive" have specific nutritional deficits—vitamin or mineral deficiencies, for example—that interfere with learning. Other children have food allergies that result in inattention and poor classroom performance. Still others have a diet too heavy in refined sugar, which can lead to unstable blood-sugar levels and fluctuations in activity level.
A nutritional evaluation can determine a particular child's dietary needs, and an individualized diet can eliminate food additives and other unwanted substances, and supply needed nutrients in appropriate amounts. The Feingold Diet, for example, targets hyperactivity and short attention span by removing sugar, food colors, and chemical additives from a child's diet. As is the case with all therapies, dietary modifications of this type are extremely successful with some children and ineffective with others.
The tests necessary to determine if a child is a candidate for nutritional therapy are performed by an allergist. He or she may then refer the child to a nutritionist for the development of a personalized diet.
When hyperactivity or an inability to control attention continues over a prolonged period of time and persists even after educational and clinical intervention, medication may be prescribed. Ritalin and Cylert, both of which stimulate neurotransmitters needed to process information, are most often used in these circumstances. Medication
is not always an effective means of reducing activity level or improving attention span. However, when these drugs do work, a child's academic performance can improve dramatically. Only a medical doctor can prescribe and monitor a child's progress during a trial period of medication.
Vision therapy consists of special optical training exercises designed to coordinate and relax eye muscles. Vision therapy can improve a child's ability to sustain extended periods of close work—reading and writing, for instance—without tiring. These exercises can also improve a child's ability to copy work from chalkboard to paper. A developmental optometrist is the professional to consult about the feasibility of vision therapy for your child.
The Irlen technique is a relatively new treatment that has proven helpful to some children with dyslexia and other reading problems and learning disabilities. With the Irlen method, colored lenses are prescribed to lessen the effects of full-spectrum light sensitivity, a problem that can cause a distorted perception of print. The appropriateness of Irlen therapy and the color of the lenses to be used is determined on an individual basis by a trained Irlen examiner.
Physical therapy is prescribed by a medical doctor for children with organic problems brought on by birth trauma or childhood injury. During this treatment, a physical therapist uses massage and specially designed exercises to help a child improve or regain mobility.
This treatment, which, like physical therapy, requires a doctor's prescription, is most frequently suggested for children with fine motor and coordination problems. During treatment, the occupational therapist