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Clearing Hurdles to Learning

For children with learning disabilities, early intervention can make the difference



At age three, Jessica Anders* could string only two words together, and she was hard to understand. Adopted at seven months, she was healthy, bright, early to walk. But language seemed to elude her. By age four, her sentences were longer but convoluted; she’d say “Please I can have a napkin” instead of “May I have a napkin please?”

Other problems emerged when Jessica started school. In kindergarten she struggled with learning her address and the days of the week. By the end of first grade, her reading skills were lagging by almost a year. Her teacher refused to refer her for testing, however, deeming her work acceptable. Her speech therapist shrugged off the strange sentences and focused on pronunciation instead. But her mother, Carol, saw “a huge red flag.”

“The girl couldn’t sing a song,” Carol recalls. “I always sing to my kids, and they go to Sunday school every week. But Jessica couldn’t remember even the simplest hymn.” Finally, Carol approached a psychologist who specializes in learning disabilities. Testing showed that Jessica has an “auditory memory disability,” which makes it hard for her to remember what she hears.

For the first time it all made sense. And while it wasn’t good news, having a name for Jessica’s problem made it possible for her family to get help.

Different Symptoms, Different Causes
Jessica is among the 20 percent of schoolchildren who find it hard to master specific learning skills, the result of a brain not quite wired to code. Although they’re often of average intelligence or above, kids with learning disabilities have trouble processing information. For some kids, the difficulty is getting information into the brain. If the problem involves visual input, they may stumble over words or fumble a ball. When it’s auditory input, they process sounds slowly or confuse similar-sounding words.

Once information reaches the brain, some children can’t organize it, put it into sequence, or mine it for meaning. Some, like Jessica, have memory problems. When the problem involves sending information out, a child may flounder in expressing himself or have trouble with motor activity.

Children with learning problems can’t improve merely by trying harder. They need new approaches to acquiring skills, says Larry B. Silver, M.D., clinical professor of psychiatry at Georgetown University Medical Center in Washington D.C., and national president of the Learning Disability Association of America. Getting the right intervention for your child may take tenacity, year after year. But the payoff can be tremendous, says Dr. Silver, who has battled learning demons of his own. “Given the right help, these kids can excel.”

Another common disorder that affects learning is attention deficit hyperactivity disorder, or ADHD. Kids with ADHD are capable of learning, but their behavior won’t let them. Some seem to operate in overdrive—constantly talking or fidgeting. Others are easily distracted. And some are overly impulsive—grabbing, interrupting, and acting without thinking.

Children diagnosed with ADHD have one or more of these traits, though many professionals still use the term attention deficit disorder (ADD) for children who are inattentive but not hyperactive. Although learning disabilities are distinct from ADHD, at least 30 percent of children with ADHD also have a specific learning dysfunction, and 20 percent of kids with learning disabilities have ADHD.

Are Adopted Kids at Greater Risk?
In studies dating back to the late 1960s, researchers have found that adoptees are over-represented among children with learning disabilities and ADHD. However, many adoption experts argue that the larger studies, which focused on domestic adoption, were methodologically flawed. Some more recent studies show a different picture. In early findings from the Sibling Interaction and Behavior Study at the University of Minnesota, for example, measures of academic achievement were virtually identical between adopted children and children being raised by their biological families. And studies that looked at children adopted from overseas reflect conditions that no longer exist. There’s practically no data about the wave of children adopted internationally since the mid-1990s, who, for the most part, are just entering school.

There’s little argument, however, that many children from overseas orphanages arrive with poor language skills, which can be the basis for later learning disabilities. Ronald S. Federici, Psy.D., an Alexandria, Virginia, developmental neuropsychologist, suggests that a child over the age of two who isn’t speaking as expected should be evaluated in his native language within three months of arrival. Without early intervention, he says, children with language processing problems will have similar difficulties when they grapple with English.

Getting Help
If you suspect a problem, contact your child’s school and request to have her evaluated. Public schools are legally required to provide a free assessment if there is any suspicion of a risk for later learning problems—even if the child in question attends a private school. You can also request testing for your preschooler if he shows language delays, poor coordination, or other hints of a potential learning disorder. In fact, the Individuals with Disabilities Education Act (IDEA), the same law that mandates the services listed above, also assists states in providing early intervention for infants and toddlers. (For more information about how this law applies to your family, visit IDEAPractices at http://www.ideapractices.org.)

If your child is found eligible for special education services, you’ll meet with school officials to design an “individualized education program” (IEP). The plan may include special attention from remedial reading teachers, speech or occupational therapists, or other specialists. It will list accommodations to help your child compensate for her weaknesses—extra time on written tests, for instance, or a copy of the class lesson. It should also arrange for assistive technology devices, if needed, such as audio books or computer software to help children organize their thoughts.

Children with ADHD may also benefit from these services. But first they must be able to pay attention. Physicians and learning specialists often recommend drugs to increase levels of the brain chemical dopamine, which are abnormally low in children with ADHD. But some parents are concerned about these drugs’ long-term effects. If you share these concerns, consult a psychiatrist or other doctor who specializes in ADHD.
Treatment for ADHD also involves behavior management, in which parents, teacher, and child agree on clear expectations and follow through with appropriate and consistent consequences and rewards.

Your Role As Advocate
While the procedures for having your child evaluated and treated within the school system are spelled out by law, you’ll need to be involved to be sure your child is getting the right attention. Lisa Curry sprang into action when school officials refused services to her first-grade daughter, Chelsea, despite tests that showed she had trouble paying attention and was six months behind in class.
 
“I was the squeaky wheel,” Lisa recalls. “I called, I was there. They knew I wasn’t going to give up.” At first, the school offered limited tutoring. When an end-of-year review found that Chelsea still couldn’t focus, Lisa enlisted the aid of a neurologist. Only then did the school develop a comprehensive program to address Chelsea’s needs.

When you approach your school about services you feel your child should be getting, you can do it with a team of specialists in tow—a neurologist, a child psychologist, a speech therapist, an occupational therapist, and/or others with relevant expertise. Many insurance plans will pay for these specialists to attend IEP meetings.

Whatever your approach, take your stand early. In some school systems, a child has to be two grades behind before he’s eligible for help. That puts a child in third grade or beyond before he gets appropriate attention. According to Dr. Silver, that may be too late. “If you intervene in the first, second, or third grade, the likelihood of success is tremendously high,” he notes. “After that, it gets harder.”

Colliding Issues
Learning disabilities are often diagnosed between the ages of seven and nine, about the same time children begin to grapple with adoption-related identity issues. “Both sets of issues can make a child feel different, and coming together, it’s a double whammy,” notes David Brodzinsky, Ph.D., associate professor of developmental and clinical psychology at Rutgers University in New Brunswick, NJ.

Learning disabilities can make it harder for a child to understand why he was placed for adoption. A child whose disability has hurt his self-image may conclude that he was too damaged to keep. “Really listen to him and let him know his feelings are valid,” says Dr. Brodzinsky. “Then help him figure out what can be dealt with and what can’t.” If counseling is needed, seek a professional trained in the area of adoption.

For parents, too, the intersection of such issues can be confusing. Early signs of a learning problem may be misinterpreted as an adoption issue. Julie Jameson’s daughter, Mimi, adopted from China, began to have learning problems in second grade. Her eyes followed everyone but the teacher, and she was too distracted to do her work. At the same time, Mimi became the butt of racial teasing by the class bully.

“I began to wonder whether her attention to every corner of the room wasn’t an appropriate level of vigilance,” says Julie. “She didn’t have social allies; she needed to watch out for herself.” Only when testing revealed that Mimi had ADHD—which can derail concentration and social relationships—did the real issue come into focus.

Weathering the Lows, Savoring the Highs
The stress associated with learning problems may reverberate throughout a family. Be sure to schedule in time for yourself and for the rest of the family. Consider family counseling, too. There are support groups for kids with learning disabilities and, in some places, groups for their siblings.

Above all, don’t let your child’s weaknesses take center stage. Nurture his talents in areas beyond academics, and let his teachers know you are doing this, so they can support his achievements. Cara Macdonald’s ten-year-old son, Keith, labors with writing and organization, and is being evaluated for ADHD. Last year, his schoolwork often brought him to tears. But he’s found success on his town soccer, basketball, and swim teams. Keith is also a talented artist, says his mother, and the two enjoy spending time together drawing in charcoal and pencil.

With patience, perspective, and the right interventions, your child can meet the challenge of a learning problem. But remember that learning disabilities are for life. Coping strategies that help in early grades may have to be modified as expectations increase.
You’ve probably read how Albert Einstein, Thomas Edison, and Leonardo da Vinci prevailed despite significant learning problems. Keep their successes in mind as you bend over your child’s shoulder to get through another night of homework.

* Names of parents interviewed for this article have been changed.

Rochelle Green is a freelance writer specializing in health and an adoptive parent. She and her family live in Connecticut.


Common Signals of Learning Disabilities
Consider an evaluation if your child:
* has difficulty understanding and following directions
* can’t remember what someone has just told him or her
* fails to master reading, spelling, writing, and/or math skills and thus fails schoolwork
* has difficulty distinguishing right from left
* has difficulty identifying words or has a tendency to reverse letters, words, or numbers
* lacks coordination in walking, sports, or holding a pencil or tying a shoelace
* often loses or misplaces homework, schoolbooks, or other items
* cannot understand the concept of time; is confused by “yesterday,” “today,” “tomorrow”

For more information, visit the Web site of the American Academy of Child & Adolescent Psychiatry at www.aacap.org/publications/factsfam/ld.htm. For more extensive, age-specific lists of warning signs, visit the National Center for Learning Disabilities online at www.ld.org/common_signs.cfm, or ERIC Clearinghouse on Disabilities and Gifted Education at www.ed.gov/ERIC_DIGEST/ed449633.html.


Beyond School—How Parents Can Help
Find teaching moments. Many household tasks require skills your child may need to work on. Cooking involves reading, counting, and following instructions in a sequence. Folding laundry requires fine-motor and sorting skills.

Sharpen social skills. Teach your child the rules of social behavior: How to take turns speaking, making eye contact, how to respect personal space. Focus on interpreting facial expressions and body language and practice how to respond.

Read together. Let your child choose the book and take turns reading, discussing as you go. Subscribe to magazines related to your child’s interests, such as Sports Illustrated for Kids or National Geographic World. If reading is too difficult, share an audio book or educational video.

Choose a suitable sport. If hand-eye coordination is a problem, choose activities that involve gross motor skills—swimming, soccer, track. Children with ADHD do best in sports that feature individual instruction and minimize distraction, including swimming, diving, wrestling, tennis, and martial arts.

Modify popular games. Board games teach kids to follow rules, pay attention to detail, plan strategy, and deal with frustration. Simplify rules so your child can stick with it. Gradually add more detail, increasing the skills to be mastered.

Enlist allies. Inform your child’s soccer coach, girl-scout leader, or religious school teacher about her learning problems. Teach them how she learns best, and help them plan ways to build on her strengths.

Model the art of making mistakes. Show that you accept your own mistakes with good humor and use them to find new solutions.

Be an emotional pillar. Let your child know that she can rely on you to be a good listener, to empathize with frustrations, and to celebrate good efforts as well as actual success.


Copyright 2002 Adoptive Families magazine. Reproduction in whole or in part without permission is prohibited.

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