What Do You Do If You Suspect That Your Child Has A Learning Disability?
By: Larry B. Silver, M.D. and Ruth B. Spodak, Ph.D.
Your son or daughter is struggling in school. He is not mastering expected academic skills. She is having difficulty completing work accurately or on time. Maybe your child or adolescent is no longer trying in school, perhaps refusing to work or hiding work. Or, maybe he is disrupting the class or getting into trouble out of class. Your high schooler might be skipping classes. You wonder if the problem is a learning disability (LD) with resulting frustrations and failures. How do you find out if you are correct?
First, what do you not do: don't fall into the easy trap of blaming the victim nor should you let teachers do this. "He could do better if he tried." "She just does not work hard enough." "If he only paid attention more, he would have less trouble." Children want to please their parents and teachers. They want to learn and to succeed. Before you blame them for their problems or allow teachers to do so, be sure to check if there might be a reason for their lack of success.
At this time, there are two models used within public school systems to clarify that a student might have an LD. Since the inception of the concept of learning disabilities in the 1970s, the primary diagnostic approach has been formal testing. If these studies focus primarily on educational issues, the assessment is called a "psycho–educational" evaluation. If the focus of the studies is on educational issues as well as on a broader range of brain tasks, the assessment is called a "neuro–psychological" evaluation. Either will help to clarify if an individual has a LD.
The latest revision of the Individuals with Disabilities Education Act (IDEA), the federal law that governs special education, offers another approach for assessing called a "Response to Intervention" (RTI). It is currently designed primarily for the elementary school grades. RTI has three steps. If a student is struggling academically, the first step is for the classroom teacher to try additional approaches to help the student master the expected material. If the student still does not make progress, a second level of intervention is tried. A support teacher with special training in addressing learning problems assists the classroom teacher and works individually with the student. Should the student still not make progress, the third level of intervention is initiated. An individualized education program (IEP, explained later) is written and the student is assigned to special education. Ideally, assessments such as psycho–educational testing are done to clarify the reasons for the difficulties before deciding what programs or services are needed. For example, difficulties resulting from specific LDs, intellectual level, bilingual issues, Pervasive Developmental Disorder, emotional problems, or other causes may each require a different intervention. Based on these test results, an IEP is prepared and the child is provided the necessary special education services.
So, what do you do?
If you are concerned about your child's performance in school, meet with the principal. (If your son or daughter is in a private school, discuss your concerns with the principal of that school and the principal of the public school your child would have gone to. As taxpayers, you are entitled to help from your public school.) Explain your concerns. The public school principal should call a meeting with the classroom teacher and relevant special education professionals to discuss the student. If there is general agreement that there might be a problem, either permission is requested to start psycho–educational testing or the RTI model is initiated.
If you cannot get the principal or the school professionals to agree with your concerns, request information about appealing this decision. Or, you can have the studies done privately. Should the results of the private assessments support your concerns, these studies would be given to the principal and another meeting requested.
What is a Psycho–Educational Evaluation?
Psycho–educational studies consist of a battery of tests that will provide information on your child's overall abilities, particularly learning style, information processing abilities, and academic skills. A significant part of this assessment is the IQ test which helps to clarify the student's strengths and weaknesses. It provides information regarding the student's ability to process verbally and visually presented information as well as his or her overall intellectual potential. Considerable additional information is derived relating to sequencing abilities, short and long–term memory issues, language functioning, and processing speed. The most widely recognized IQ test is the Wechsler Intelligence Scale for Children (WISC). There are corresponding versions for preschoolers (the Wechsler Preschool and Primary Scale of Intelligence) and for students over the age of 16 (the Wechsler Adult Intelligence Scale). In addition to the IQ test, the examiner might do specific tests to evaluate the student's cognitive abilities, typically tests of memory and organizational skills.
The other parts of the psycho–educational evaluation assess the student's academic skills: reading, written language, and math. There are many standardized tests that can be used to obtain this information. These studies include brief tasks and, for older students, more complex activities consistent with grade demands (e.g., reading multiple paragraphs, writing essays). Studies might include informal measures but should also involve standardized tests which provide objective scores that can be compared to grade level expectations as well as to the student's intellectual potential. Testing should also allow comparison of the student's performance under timed and untimed conditions.
In addition to test data, the evaluation includes a clinical interview as well as questionnaires and rating scales completed by parents, teachers, and the student. These data help to identify whether attentional and/or emotional issues might be contributing to or resulting from the learning difficulties.
What will the results of such testing tell you?
First, the psycho–educational evaluation will describe your child's overall intellectual potential. Be sure not to look at the single summary numbers (e.g., the Full Scale IQ) as necessarily the best indication of intelligence. Students with LD have many strengths as well as weaknesses. Averaging these high and low scores into one single score can be misleading. The evaluator should sit down with you and explain your child's strengths and weaknesses rather than focusing on a single score. You need to know the areas of strength and the areas of weakness.
The test results will also describe the student's overall academic skills. You will learn whether the student's reading is at grade level and, if not, where the specific deficits lie. For example, it could be that your child has trouble sounding out new words but uses intelligence to compensate, getting the gist of the information. Or, perhaps your child can read every word quickly and accurately, but struggles with comprehension due to underlying memory and/or language processing issues. Similar analyses should be presented for the student's skills in written language and in math.
The results of these studies might indicate other possible areas of difficulty. Your son or daughter might have difficulty with underlying language skills. There might be problems with processing, sequencing, or remembering what is heard (a receptive language problem). Or, the problems might relate to organizing thoughts and finding the words to use in order to express these thoughts (an expressive language problem). If such language problems are noted, a speech–language assessment will elaborate and clarify the interventions needed.
Or, your child's written language might be affected by the inability to produce written language. He or she might have difficulty forming letters. The mechanics of writing might be done so slowly and with such difficulty that he becomes frustrated and produces little or gives up. An assessment by an occupational therapist will clarify the best approaches for helping. If the test data suggest emotional problems or attentional problems, a further mental health assessment will indicate how best to help. It is always essential to clarify if the emotional, attentional, or social problems are causing the academic difficulties or if these problems are secondary to the frustrations and failures experienced by the student with learning disabilities. If the test results suggest Attention–Deficit/Hyperactivity Disorder, a health professional will help to finalize this diagnosis and to recommend interventions.
If your child has a learning disability, what next?
If the results of testing confirm that your son or daughter has an LD, the principal should call a meeting of the appropriate special education professionals. At this meeting these professionals might suggest a "504 Plan" or an "IEP Plan."
The 504 Plan is based on laws relating to adults, requiring that employers provide accommodations for individuals with disabilities. (It is Section 504 of this Law that refers to educational settings.) Often, the school's 504 Plan describes the areas of difficulty and lists the accommodations that will be provided in the classroom. Examples include sitting in the front of the room, using a computer or calculator, or more time on tests.
An IEP Plan is based on IDEA legislation requiring services in school for students with disabilities. After the assessment, three decisions are reached by the school team. Each must be accepted by the school professionals and by parents. No decision is finalized without your agreement.
First, it must be documented that your son or daughter has a disability. IDEA is an entitlement law. This means that unless you have a disability, you are not entitled to the services offered under the law. The disability might be identified as a "Learning Disability" or a related disability. If you do not understand why another term is used, ask for clarification. The second step is to describe what services will be needed — what specific remedial interventions and what accommodations. Given what is needed, what program would be best? For example, would your child remain in a general education classroom and receive services within the class or leave the classroom at times to see specific professionals? Or, should your child be assigned to a special education program, perhaps being pulled out to attend some programs in a general education classroom?
Once there is agreement on these questions, the third step is to decide where these services will be provided. Ideally, they will be available in your neighborhood school. If more intensive services are needed than are available in this school, another school placement may be necessary. If your child is in a private school, arrangements should be made for him or her to receive services at the nearest public school.
After there is agreement, a contract is written to outline what the school system will provide. This contract is called an "individualized education program" or IEP. This document must be signed by the school professionals and by parents before it is official.
Sometimes the services available within your public school may be less than you desire for your child or adolescent. You might want to seek a private consultant and supplement what the school is providing with private occupational therapy, special education, or speech–language services.
Follow–up after the IEP is initiated
It is difficult to plan for more than about six months at a time. Progress might be slower than expected or faster. New challenges might add new difficulties. On an annual basis, the IEP is reviewed and, if necessary, revised for the next school year. In the fall, the program is initiated. If parents are concerned with the implemented program, they can request a periodic review later.
About the authors
Dr. Silver is a Child and Adolescent Psychiatrist in private practice in the Washington, D.C. area. He writes Ask Dr. Silver, an advice column on people with learning disabilities.
Dr. Spodak is a psychologist and co–director of Spodak, Stafano and Associates, a private evaluation center that focuses on assessing students with academic difficulties, providing testing and follow–up consulting with parents.
Silver, Larry B., M.D., and Spodak, Ruth B., Ph.D. (2007, September). What Do You Do If You Suspect That Your Child Has A Learning Disability. Written exclusively for LD OnLine.