ADHD and learning Difficulties: Assembling a Team

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The 2011/12 Parents Education Network lecture series in San Francisco began with a bang, a powerful bang.  The lecturer, Dr. Leyla M. Bologlu, shared advice that made my heart sing.  She underscored the importance of good, thorough evaluation for both ADHD and learning difficulties stating that the faster the parents take action the better.  It is now proven that early intervention can impact neurological change. The goal is to ensure that the child has a healthy psychological life as he or she goes through the challenges of the learning process.

Some clues: A child exhibiting behavioral issues is a flag that the problem could generate from  a brain-based neurological issue. (A dyslexic has different neurological pathways.)  Or a child exhibiting executive functioning shortcomings as a result of the brain’s inability to manage learning activities may be experiencing ADHD.

Dr. Bologlu gave a graphic description of the brain’s development. The infant brain is relatively smooth.  As the child grows and develops the complexity of bumps and squiggles on the brain increases from experience and exposure.  This description had me wondering how physically crisscrossed is my brain from my dyslexia and hyperlexia.  It wasn’t until I was in my forties when I learned i am dyslexic and in my sixties when I discovered that my real issue is hyperlexia meaning I had trouble in imaging words which are essential for reading and aural comprehension.

The lecture moved on to many types of specialists.  At the outset is the need for parents to identify a competent evaluator who is comfortable embracing specialists in several different fields with discreet skills to address particular shortcomings.   Dr. Bologlu reminded us that kids want to do well.  The adult team needs to discover what is holding them back, what skill set they are missing and sets in motion the steps necessary to improve the ability of the child to learn.

The path Dr. Bologlu recommends to identify the learning challenge includes.

1.       Obtaining a clear statement from the school with details of what seems to be going on/what are their concerns?  If it is you, the parent, who is recognizing there is an isuue, ask for a meeting at the school to check out your hunch.

2.       The next step is identifying a highly qualified educational therapist ( with a master’s degree) who knows and works with a battery of tests available and has experience with children of your child’s age. Tests include:

  • Administration of cognitive tests  (not an IQ test)
  • Academic achievement tests
  • Other screenings/tests including but not limited to: Slingerland,  Levine,  language development/auditory processing, phonological awareness, visual-motor integration etc.

3.       Specialized testing includes:

  • Speech & Language Evaluation (be sure the tester has at least an master’s level education)
  • Occupational Therapy:  These evaluations and treatments are specific to motor
    development, sensory-motor integration and nonverbal weaknesses.
  • Psycho-educational Evaluation:  Be sure the consultant has a PhD in clinical psychology.  The evaluations involve IQ testing, achievement tests, behavioral
    questionnaires, social/emotional testing.
  • Psycho-educational Evaluation.  Be sure the consultant has a PhD in clinical psychology.  The evaluations involve IQ testing, achievement tests, behavioral questionnaires, social/emotional testing.
  • Neurpsychological Evaluation.  This can include testing for intellectual skills  (IQ testing), as well as congnitive functioning ability which may involve testing for skills in a) language (expressive/receptive), b) visio-spatial/visio-perceptual function c) memory, d) attentional systems, e) executive functioning, f) fine and gross motor functioning, g) sensory integration and more.

The Educational Therapist oversees the testing process.  When she/he receives the assessments from other specialists, she/he draws conclusions and makes recommendations to the parents.  The Educational Therapist must provide the names of the suggested treatment providers – more than one for each type of service.  In addition, the Educational Therapist should make contact with all of the treatment providers recommended to outline the reason for the referral, the treatment focus and the number of sessions per week needed.

Additional appropriate support may include:

  1. behavior support in the classroom and at home
  2. sensory motor support – handwriting
  3. executive functioning skill support (study skills, breaking down large assignments)
  4. medication management.  I found it interesting that Dr. Bologhu’s point of view on medication is that it may help with behavior but not with the core issue.

At the conclusion of this lecture the President and Co-Foundter of PEN, Dewey Rosetti, when thanking Dr. Bologlu for her remarks commented:  If only we had had this kind of information ten years ago, what a difference it would have made!  I agree and am just grateful that teh PEN lucture series exists so parents now have the information to take reasoned steps with their child’s learning challenge.

 

 

Hyperlexia characteristics.

Recently I came across a website, www.csld.org, that discussed  hyperlexia. Included are response to frequently asked questions. Phyllis  Kupperman, the author, has given permission to reproduce these.

Is a child who is not yet reading, but is very interested in letters, considered hyperlexic’?

Strictly speaking, these children are not hyperlexic because they are not reading. Some children who do not read at 2 or 3 years old may still develop reading decoding or sight-reading at 4 and 5 years old and may then be diagnosed with hyperlexia. Some children who are strong visual learners, though not readers may still benefit from the intervention techniques developed for children with hyperlexia.

Do children with hyperlexia understand
what they are reading? 

They understand what they read about as well as they understand language in general. Many children with hyperlexia have difficulty processing what people say to them. They may have a difficult time using language for thinking and reasoning. They also usually understand concrete language better than abstractions or inferences. Reading supports language learning because it makes the language visual. Therefore, language learning improves, and reading comprehension also improves.

What causes hyperlexia in children? 

The presence of hyperlexia within the context of another developmental disorder reflects a difference in the neurological organization of the brain. While a cause is not yet known, research in genetics and functional MRI studies may provide some information in the future.

Isn’t hyperlexia just a savant skill or a “splinter skill”?

 A savant (like having photographic memory, playing music perfectly after hearing it just once, or doing complex mathematical calculations in one’s head) or splinter skill is an isolated ability that appears within individuals with developmental disabilities. Generally, these skills have no relationship to other aspects of the individual’s functioning. Hyperlexia is not an isolated skill, but a tool which can be used to develop language, to modify behavior and to help the individual make sense of the world.

Does the presence of hyperlexia mean that the children are” higher functioning”?

In working with a large number of children with hyperlexia, we have seen a spectrum of outcomes. Some children, though they may be excellent readers, may exhibit severe and persistent symptoms of autism. Other children have great difficulties
developing verbal expressive language, though their written expressive language
may exceed their verbal abilities. Some children may do well academically, but
may have difficulties socially. It is hard to predict what a child with hyperlexia will be like as a young adult; however, we do know that using writing to supplement their learning leads to better progress.

Do children with hyperlexia get better? 

Children with hyperlexia do improve in language and social skills. Some individuals improve to the point that they are able to go to college or live independently, although some will need special education and supervised living arrangements throughout their lives.

 

Hyperlexic kids use art

I found this blog posted on June 28, 2011 by tedelschick.  It shares a story that corroborates my experience as a hyperlexic.  Thought others might find it useful.   It follows:

Hyperlexic kids read precociously early but have poor comprehension skills. If you ask them to picture a frog, what they picture is F-R-O-G. They are all about the letters, having almost the opposite problem from that of dyslexics. If hyperlexic kids want to comprehend, which most dyslexics do just find, they need to become all about the pictures.

Gratefully, hyperlexic kids can often be helped by teaching them to visualize what they are reading. Most of us having a dynamic picture in mind as we read. If you aren’t too sure, think about the last time you saw a movie based on a book you have read. If you have ever said to yourself, “Oh, that’s just how I pictured that scene,” or “Noooo! That’s not how I pictured him at all,” then you are creating little movies while you read.

The reading intervention we are considering for Zach helps kids create pictures of what they are reading, and then helps them string those pictures together into an internal movie. I’m going to two days of training to learn how to do it, but it’s not until the end of the month. In the meantime, we have the ever-creative Wendy. She came up with the idea to have the boys use clay to make the scenes for a book they had written with her a couple of months ago.

This past Saturday, we printed the book, sculpted the scenes, and the boys and I took pictures of them. We did a few voiceovers on iMovie and, voila, we’ve got a digital book of sorts.

Enjoy the show: Two Hungry Species on YouTube

(If you notice Mommy’s voice on a couple of pages, it’s because it was dinner time when I decided to try to finish this project. My two hungry species revolted at the end, and they headed to the kitchen to kill someone’s babies if that’s what it took.)