Posts Tagged ‘Sensory Integration’
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:
- behavior support in the classroom and at home
- sensory motor support – handwriting
- executive functioning skill support (study skills, breaking down large assignments)
- 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.
PEN Speaker Series: Patricia Oetter
First of all let me tell you a little bit about PEN. The acronym stands for Parents Education Network, a coalition of parents collaborating with educators, students and the community to empower and bring academic success to students with learning and attention difficulties. If you live in the San Francisco Bay area and have children with these challenges, this is a lively group, well worth your time and energy.
In mid-March PEN Speaker Series welcomed Patricia Oetter talking on Sensory Integration: Do we really need it?
She began her presentation defining the senses. Nerves can best be described through neurobehavioral organization. These sensory neurons work in tandem with our motor neurons. Why? We need to do something with the neuro-sensory part of our selves.
I referred to biologyreference.com for a little more detail.
Sensory neurons bring information about the world within and around the body from sense organs to the brain and spinal cord.
Motor neurons carry messages from the brain and spinal cord out to the muscles and glands.
An example: if a mosquito lands on a person’s arm, sensory neurons in the skin send a message to the spinal cord and then the brain, where the message is understood, and a reaction formulated. The brain’s response may be to use motor neurons to cause muscle contractions resulting in a slap on the skin.
Ms. Oetter expanded the usual definition of the senses: see, hear, taste, touch and smell, to include to:
- Vestibular system. This sense contributes to our balance and our sense of spatial orientation. It’s the sense that is about being in motion and knowing how to handle oneself. She reminded us that children learn balance by falling down purposefully – it’s movement through space.
- Proprioception. This sense indicates where the various parts of the body are located in relation to each other.
Ms. Oetter cautioned us to remember that our senses are continually providing information to the brain which means that in any given moment, a person may react in one way or another, depending on what sense is dominant at that moment. For this reason she seemed to eschew placing too much emphasis on the phrases “hyper” meaning beyond or excessively or “hypo” meaning under or below normal. She re-iterated for the teachers present: A student in a state of hypo-activity is just in a momentary state. Before you know it, the student may become hyper-active.
She talked about the intensity of sensation which is experienced through the duration of its frequency and pattern: novelty vs repetition. She explained that the neuro-chemistry inside our cells when turned up or down are a part of how we perceive something. Our cells are turned up when we are not feeling comfortable or safe.
She had an interesting comment that touch is the key for vision: If you don’t know what is going on with your vision, your body doesn’t know where it is.
She re-iterated several times her concern that boys in our school systems are lacking experiences they need for development. The reason? It seems the schools learning systems are focused on a girl’s point of view. As a result the experience of risk is diminished, an important component for young boy’s growth. She recommended three books that are helpful in raising boys:
Raising Boys by Steve Biddulph and Paul Stanish
Raising Cain: Protecting the Emotional Life of Boys by Dan Kindlon and Michael Thompson,
The Trouble with Boys: A Surprising Report Card on Our Sons, Their Problems at School, and What Parents and Educators Must Do, Peg Tyre
Ms. Oetter made a sobering comment. It takes 25 – 30 years of age before the brain is mature enough to handle the senses. It seems it takes that long for mylenation, the development of an insulation material to form a layer, usually around a neuron. This sheath is essential for the proper functioning of the nervous system. One of the components that ensures mylenation is the condition of feeling safe. She reminded us that boys, girls, young adults, all of us actually, need smiles and touch to find a way to feel safe.
There is so much more information that Ms. Oetter shared. However, now brevity is important.
I would like to comment on the value of these lectures sponsored by PEN. Over this last year I have attended most of them. As a dyslexic and hyperlexic these perspectives have been very useful to me. And, as each dyslexic/hyperlexic has different reasons for their challenge I know it is important to examine a wide variety of solutions. Each speaker gave me another clue into how I function or not. In Ms. Oetter’s case, over the last twenty years I have focused on my senses to understand some of my dyslexic behavior. I found her information most helpful. It gave me another point of view on the topic.
I just wish that parents and teachers challenged with children who have learning issues were in attendance in droves so they, too, could learn. These lectures are one of the best “buys” in the Bay Area.