How do you get a teenager with a learning disability to accept help when he says he doesn’t want services?
I work with a high school student who is in foster care and was on IEP that lapsed due to numerous placement changes and bouncing from school to school. He recently was evaluated and found eligible for special services. The student has refused to accept these services because he believes that special education means “retarded.” He is failing all classes. How can I influence this student's decision to accept services?
Joan
Your brief description suggests that this high school student has been through a lot. He probably does not feel very secure, safe, or good about himself. Getting him to accept yet another problem, “I’m dumb,” will not be easy.
Maybe the school counselor can help him. Maybe a concerned tutor can show him how the help will be useful. Maybe the concept of a learning disability might not be used but, “You know, you have had to move around so much that your education has not been good. You need help to make up for what your school did not teach you.”
(June 2007)
How should ADHD be treated when there is also an anxiety disorder?
My eight-year-old son was diagnosed with inattentive ADHD and Central Auditory Processing Disorder (CAPD). He has always been a shy anxious child and uncomfortable socially. We have been trying different stimulant medications for him that have helped the inattentiveness, but have exacerbated the anxiety (separation anxiety and peeling his finger tips particularly).
We are now going to try Straterra. Should he get a formal diagnosis for anxiety disorder and be taking something more like Wellbutrin, or should we see how he responds to the Straterra? I have always been bothered by his anxiety issues and feel that the professionals I have seen seem to focus more on the ADD issues. Only now is the present doctor recommending he also has therapy for anxiety.
Thank you,
Judy
When someone has ADHD and also has an anxiety disorder, it is not uncommon for the medication used to treat the ADHD to exacerbate the anxiety disorder. It is best, therefore, to treat the anxiety disorder first.
Once this disorder is under good management, it should be possible to reintroduce a stimulant medication to treat the ADHD. The most frequent medications used to treat anxiety disorders are called “Selective Serotonin Reuptake Inhibitors.” Discuss this approach with the prescribing doctor.
(June 2007)
What are some symptoms of pervasive developmental disorder?
A student shows signs of inattentiveness. Often, he does not do work without constant one-on-one redirection. Still, minimal work is done. He is often playing with hands in an imaginary way, assuming they are action figures. He shows concern for only himself. He has no empathy for others, even when he uses inappropriate physical or verbal aggression. The child is 8 years old.
His parents are seeing him as gifted, but no classroom observation or information has been used in the diagnosis. Critical thinking activities and a diverse learning environment, as well as curriculum, are given. The child does not complete the basic work even when extensions are given to expand on the subject.
What are the steps to getting a child tested, evaluated as gifted, or having a disability? Can a child be gifted (only) and still not be able to interact with classmates and stay on task in order to get the introduction to a lesson. Thank you for your help.
Based on the descriptions you provide, your student might have what is called a Pervasive Developmental Disorder. Discuss this concept with your school consultants and explore how to get the student’s parents involved in a full evaluation. If my clinical impression is correct, the student will need special education services.
(May 2007)
What do you do when the school won’t test your child for learning disabilities?
Dr. Silver,
I am a parent of a 15-year-old son who has not been diagnosed. The school district he is in tells me that they do not have a way to assess him. Therefore, his needs are not being met. They keep sending me to all kinds of doctors to be diagnosed (i.e. medical, eye, psychologist) and they are all sending me back to the school district for testing.
What can I do? It is very frustrating to know that if my child is diagnosed, there are people and foundations that would fit him perfectly. His school's learning disability teacher does not know the techniques that are suggested in the articles at this site. Please help me.
I do not understand what your school professionals mean when they say they do not have a way to assess him. (Is it possible that you have not provided me with other important information?) Your public school system cannot send you to someone else to do studies.
Step one (if not already done), seek a parent consultant/advocate who can advise you on your rights. Step two, with this advocate, present a formal request to the principal of his public school, requesting an evaluation. Step three, if refused, ask for the procedure for filing an appeal and file one. Good luck.
(May 2007)
Can a person who writes but can’t read be dyslexic?
After learning about dyslexia in my AP psychology class, I've been wondering whether I had it. It would explain my constant and perpetuating difficulty reading, but I seem to be an ok writer and have always taken honors and AP English classes. Of course, I was never able to read any of the required novels. Instead, I relied on classroom discussions and summaries to help me understand the books. Would it be possible for me to be dyslexic if I can write but not read? I seem to have some of the symptoms but not all.
I’m sorry it took high school and reading about dyslexia for anyone (you) to question why you have so much difficulty reading. Speak to your parents about requesting formal testing to clarify why you have this problem. Only by understanding the reason(s) will you be able to know what type of help will be most useful.
(May 2007)
If a parent wants a new objective evaluation performed by a professional, should they share former evaluation results?
Dr. Silver,
My daughter was tested for learning disabilities through the school in second grade. She was diagnosed with expressive language disorder and with short-term auditory and visual processing disorder. She's in sixth grade now and I want her to be retested by outside of the school to see what issues she's dealing with now.
I don't want the school to know that I'm doing it and want to see if the new testing is in line with the old results. I contacted a licensed psychologist who wants to review the school's diagnosis before he tests her. I'm afraid it might sway him and I want a completely new, fresh and unbiased diagnosis. Must he see the old evaluation or can I keep it from him until after the testing? What's the right thing for me to do?
Thank you,
Gail
I support your wish to have updated studies for your daughter done privately. However, it is important that the psychologist doing the updated testing have a previous baseline in order to assess for progress or for lack of progress. Showing previous testing will not bias the examiner. The testing is based on standard scores and the results will be accurate readings for your daughter.
(May 2007)
How can I help my homeschooled daughter who has trouble with comprehension?
My daughter is in sixth grade. She had attended public school since kindergarten and had begun to have falling grades in fourth and fifth grades. We began homeschooling her this year and were shocked at her lack of comprehension skills. She forgets things as soon as she reads them. Even when I try to read assignments to her in an exciting way, she does not retain the information. Last week we did a whole unit on the Scientific Method in Science. This week the term was reintroduced and she acted as if she had never heard the term. I hate getting frustrated when I know this is not something she is doing intentionally. Is she ADD? She never acts hyperactive. She is very laid back and can concentrate on and remember TV shows and comic book stories. If she is ADD, I have no intention of medicating her. Is there a natural medicine or change in food or curriculum that can help her?
Thank you,
Darcey
Yes, she can be helped. She needs a diagnosis. I bet that if your daughter had continuous headaches or stomachaches or any other physical problem you would have rushed to her doctor and perhaps seen as many specialists as you needed in order to help her. Why do you see disorders of the brain as different?
You describe what might be learning disabilities and you describe possible ADHD. Discuss each with your pediatrician. There are formal test to clarify if she has a learning disability. These studies can be done by your school professionals or by private professionals. Your family doctor should be able to assess for ADHD; and, if she has this disorder, treat it. Treatment would be based on what she has. Home schooling might give you a false sense of security because of the lack of the same expectations needed in school.
Please, have the right professionals make the right diagnoses. Then, design your interventions/treatments on the confirmed diagnoses. Disorders of the brain are just as debilitating as those of other body systems.
(April 2007)
Can a really busy person get diagnosed without spending much time at it?
Is there a way I could be diagnosed without having to go to my general practitioner? During the week, I have college and have to work so I never have spare time to go to the doctors. But I want an official diagnosis that I have ADD or ADHD. It would help me get a little extra help in college
There is no easy or quick way to diagnose or treat ADHD. You need to be seen by a physician to establish the diagnosis and to receive treatment. Maybe you could find someone at your college's Health Services so that you do not have to travel. Again, if you have a problem that is impacting on your success, you must find the time to get the proper diagnosis and treatment.
(April 2007)
Where can low-income people get help for three-year of children who might have learning disabilities?
I need assistance with my 20-month-old son who may be showing early signs of learning disabilities. I need some assistance with counseling for him and just learning in general how to direct his energy. We are a low income family and don't know where to start to look for free assistance. Can you please direct me to the appropriate place. Thank you for your time, our family greatly appreciates it. We live in Monterey CA.
Sandy
Every public school in the country is required to run a "Zero-to-Three" diagnostic program. Go to the principal of your neighborhood elementary school and ask how to be referred to this program. Your son will be seen by many professionals. Should help be needed, it will be provided. And, there is no charge.
(April 2007)
How can I get evaluated when I have social anxiety disorder and LD or ADD?
I think I may have Social Anxiety Disorder and ADD or a learning disability and I think the effects of my childhood have played a role in it. I think I have had it for most of my life but I can't deal with it anymore. I feel like I am going to have a nervous breakdown. I'm always irritable, I can't communicate well with people (especially around a group of people, I get very nervous). I feel disconnected and frustrated.
It is affecting my job. My boss tells me that I don't focus and I make stupid mistakes all the time. I'm afraid I will get fired. I don't know where to go. What places in New York City specialize in both disorders? I want to get a full evaluation. I get very overwhelmed trying to find the right resources.
Maria
Anxiety Disorders and ADHD are best diagnosed by a psychiatrist. Learning Disabilities are best diagnosed by a psychologist who does psycho-educational testing. I would start with a psychiatrist and go from there. Sorry, I cannot give you a name in NYC. Perhaps your family physician can recommend someone.
(April 2007)
Should a practitioner diagnose a learning disability if the client also has a mood disorder?
I am working with a client that has a long history of emotional and behavioral difficulties. To make a long story short, he has significant and mood disturbances and does meet the discrepancy criteria for an LD. Is it appropriate to give an LD diagnosis even in the presence of a severe mood disorder? His lack of achievement in my opinion is better explained by the mood disorder rather than an LD. I know that most clinicians would give the LD diagnosis, but I don't feel like it is ethical when considering the underlying process.
Thanks for your advice!
Dr. Smith
There is a continuum of neurologically-based disorders that are frequently found together. This continuum includes learning disabilities, ADHD, emotional regulatory disorders (anxiety disorder, depression, anger-control problems, obsessive-compulsive disorder), Bipolar Disorder, and tic disorders.
Thus, the question is not whether your client has a learning disability or a mood disturbance. He might have both and assessing for all possibilities is essential. Should he have learning disabilities, he will need special education services along with accommodations. If he has one or more of the emotional regulatory disorders or Bipolar Disorder, he will also need treatment for these diagnoses.
(April 2007)
How can I help my sixteen year old son who has not been helped by the school for the past eight years?
My son is 16 years old. After eight years of requesting an evaluation, the school finally did it this past July. This showed my son is ADHD deficit in three areas of Auditory processing and has the age equivalency of an eight year old in speech.
I don't even know where to start with him. He's getting resource room and is repeating the ninth grade. I don't really know where he is at academically or where to begin. I filed complaints with the state education department and they found in my favor on ten findings. This child has been denied FAPE for eight years. How or who can help him?
He is very angry and is seeing someone for this. He says that suicide is not an option, because he loves his family, but it scares me. The first time he was seen by someone they said he was angry, which is something that I always suspected.
I really don't know what I can do to help him. He is meeting with success this year and feels good about it. He talks of summer school so he can join his peers in the eleventh grade. I'm not sure if he's ready for all of this. Your advice and help would be greatly appreciated.
Mary
Your story is a sad one. It is because of such stories that I try so hard to educate parents on what to look for and how to address a school system that is not seeing what the parents are seeing. Your legal victory supports that your school let you and your son down.
The real problem now is how to save him. The more he can stay with his friends and age group the better. Please get an outside educational consultant to advise you on what the school must do and what you may have to do privately. He might need psychotherapy to deal with his feelings of frustration and anger as well as the impact the past years has had on his self-esteem. Don't give up. He sounds like a good kid. Work on undoing the damage done over the past years.
(March 2007)
How can I help my dyslexic brother who is being homeschooled?
Hi. My little brother is almost 13 and was diagnosed with dyslexia a few months ago. He's homeschooled and has given up on anything that has to do with reading and writing. Our six-year-old little sister can read and write better than him. I'm worried and wondered what there is out there that I can do to help him?
Geri
You call it dyslexia. School systems call it learning disabilities. It is still the same problem. Your brother needs specific special education help if he is to overcome or compensate for his disabilities. The problem with home schooling is that most parents are not trained special education teachers and do not have the knowledge or skills to help remediate the problems. He must have skilled special education help if he is to improve with reading and writing. Show this answer to your mother and ask her to think about what I said.
(March 2007)
Can a teenager have a receptive-expressive language disorder?
My 14-year-old eighth grade daughter has bipolar disorder and has an IEP under SED. She is in both GATE and special ed programming. She receives medical services from her HMO and from County Mental Health. She is currently stable and doing acceptable work in her academic classes. However, she has always struggled with written assignments (even before she became ill), and particularly struggles with answering the call of a question. Her grades on homework tend to be A's or F's, depending on the nature of the assignment.
Today her psychiatrist said that she almost certainly has a receptive-expressive language problem that is masked by her emotional problems and her intelligence, and that is definitely not part of the thought disorder.
However, the psychiatrist can't diagnose an educational problem so I'll have to ask the school to test my daughter.
My daughter has always had some trouble with writing mechanics and with organizing her thoughts on paper. However, she began talking at a very young age (full sentences before 12 months), has always had a precocious vocabulary, and reads well, so it never occurred to me that she could have a language-based disability. Is this possible? What testing should be done? Can a receptive-expressive language problem be remediated in a teenager?
Thank you so much.
P. Johnson
Your daughter's psychiatrist is right. In addition to her bipolar disorder (the SED program) and her learning disabilities (her special ed program), she appears to have a receptive-expressive language disability. This problem is often seen when learning disabilities exists. She needs a speech-language assessment to clarify these problems and then she will need speech-language therapy along with appropriate accommodations to succeed. Yes, it is not too late to address these problems as a teen.
(March 2007)
What can a child do when their cousin with a learning disability often hits or kicks them?
My name is Alexis and I am 12 years old. My cousin has a learning disorder and gets mad really easily and he takes it out on me. He can hit, pinch, kick, and even bite! But I sometimes do something back to him and he runs crying and I get in trouble. And when I try to tell my Aunt that he hurt me also she doesn't even care about my feelings. I hate it!
Do you have any advice that might make my life run more smoothly? Also do you have advice that might make my Aunt start listening to me?
Thanks,
Alexis
Wow. You do have a problem. And, I am afraid that you will not be able to explain to your aunt what her child is doing. Discuss your problems with your parents. Help them understand what you are dealing with. Ask them to observe. Your aunt's brother or sister (one of your parents) might be listened to before they listen to you. Good luck.
(March 2007)
What happens when family members have ADD and other disabilities such as depression, anger-control problems, and anxiety disorders?
My daughter, who is 11 years old, was diagnosed with ADD. She is on Focalin. For the most part she is doing pretty good but she has her occasional breakdowns. How do you help get a person out of a meltdown without a lot of screaming, yelling, crying from that person?
My wife suffers from depression and also is ADD. She is on medication which does not help when my daughter has one of her meltdowns. Then my wife starts to have a meltdown. Sometimes panic attacks arise from what my daughter is saying etc during a meltdown. Any suggestions would be grateful in dealing with my wife and daughter.
Thanks
Bruce
It is important that you learn about what is called comorbidity with ADHD, as I discussed in my book, The Misunderstood Child. Fifty percent of children with ADHD will have one or more of a pattern of emotional regulatory problems. These include anxiety disorder (with panic attacks), depression, anger control problems, and obsessive-compulsive disorder.
These comorbid conditions are neurologically-based as is the ADHD. Usually, each of these problems existed over many years and can occur in school as well as at home. The medication may have made each worse but may not be the cause. Often, there is a family history of similar problems. It sounds as if your daughter might have one or more of these regulatory problems. I recommend that you have her evaluated by a Child and Adolescent Psychiatrist. It is essential that you clarify all of her problems so that a comprehensive treatment plan can be done.
(March 2007)
What should a parent do when a child does their homework and then doesn't turn it in?
My son is mildly dyslexic, 16 years old, and a sophomore in high school. Somehow homework and class work disappear between generation and turning it in. It has gotten worse. My son is taking AP Government and has a wonderful teacher. But how do we overcome this "missing link" where homework doesn't get turned it and occasionally class work doesn't get turned in.
Crystal
Many students with learning disabilities (a term used by school system rather than dyslexia) have problems with organization. They misplace or lose their papers, reports, homework; they leave things at home that are needed in school and in school things that are needed at home. Their backpack may be chaotic. This disorganization might include losing personal objects or keeping bedroom presentable. It sounds as if your son has such problems. He will need a special education tutor who can help him develop organizational skills much as special tutors helped him with reading and writing in the past. Getting upset with him won't work. Get him the help he needs.
(March 2007)
What can a parent do when the diagnosis just doesn't seem right?
My daughter's teacher recommended that we get Sophia tested for learning disabilities. We went to a neurologist that specializes in child development who did a full evaluation. She also referred us to an audiologist for central auditory processing testing. Our daughter scored significantly for a child with auditory processing disorder in tolerance fading memory, decoding, auditory closure & binaural separation. However she scored normal for auditory attention.
Thank you,
Marshia
Although in this part of the test she scored normal, the neurologist thinks she should be put on Focalin. I thought this is for ADD. Why would I want to put her on a medication for auditory processing difficulties? The neurologist said she still thinks my daughter has attention deficit disorder even though she scored well on this part of the exam.
I don't really understand, and I'm terrified of putting my daughter on medication - she is only 6.
Thanks,
Marishia
You are correct to be confused. First, the testing done is not comprehensive enough to clarify if your daughter has a learning disability or not. Second, the testing done would not establish a diagnosis of ADD. You may need to seek an educational diagnostic specialist to help plan for further testing to clarify why she is having difficulty. Ask the neurologist to clarify how the diagnosis of ADD was made. Specifically, does Sophia have a chronic and pervasive history of hyperactivity, and/or inattention-distractibility, and/or impulsivity?
If she is in a public school system, the teacher was incorrect in asking you to do testing. This teacher should have recommended that the evaluation team at her school do the evaluation.
(February 2007)
What can an adult do if they think they have Asperger's Syndrome?
When I was in elementary school, I was diagnosed with a Visual Spatial Non Verbal Learning disorder and ADHD. I am now 25, and I have recently read a book about Asperger's Syndrome. This disorder would make a lot of sense. For one, I give people very off putting eye contact, which has really caused major employment issues. Would it be worth getting a professional diagnosis? Is there anything a professional can do to help?
Matt
You should see a mental health professional who is familiar with adult Asperger's Disorder. He or she should be able to clarify if you have this disorder and suggest ways to help you. You can find more information on the Online Asperger Syndrome Information & Support website.
(February 2007)
How can I help my learning disabled son who is having trouble finding a job and getting into college?
My son is 19, and has been diagnosed as ADHD/LD when he was in Kindergarten. Over the years he has taken Ritalin, Adderall, and many others, nothing really helped. His neurologist said that the learning disabilities were outweighing his ADHD and that’s why the medication hasn't helped. His math disability is the worst, he never could retain much of the basic math facts they learn in grade school.
I feel that he was pushed through school, just to get him out, not learning much along the way. Now that he is one year out of school, he can't go to college because he can't pass the entrance tests, and cannot get a job as every job requires taking some kind of test, experience, certification, or schooling.
He is getting very depressed because he can't find a job. I feel lost because I have tried everything to help him find one and to help him cope with all the other things that go along with ADHD. Should he see another doctor?
Sherry
Your story is sad to hear. It would be important at this time to have your son evaluated. He needs a psycho-educational evaluation. These studies will clarify if he has learning disabilities and, if so, what help he needs. The results will also be part of reassessing if he still has ADHD and if it should be treated.
All is not over. Most community colleges will accept students like your son. The initial courses might be remedial, getting him ready to take college-level courses. There are also vocational training programs designed to help students like your son. Good luck.
(February 2007)
