The Gift of Learning – Part 5 (of 6)

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 bored student

Janie came into my office, shyly hanging back behind her mother.  An adorable and bright little 7-year-old girl, she was compliant and loved by her teachers, but she struggled to keep up with her schoolwork.  She seemed to know the answer to the questions, but she could not seem to organize herself enough to get her thoughts on paper.  Descriptors like, “distractible”, “disorganized”, and “talks too much” were sprinkled throughout the conversations Janie’s parents had with her teacher, and so they decided to bring her in for a psycho-educational assessment to see if she had Attention Deficit/Hyperactivity Disorder (ADHD).  Their family doctor had already “diagnosed” Janie with ADHD and wanted to put her on medication, but her parents were reluctant to consider this until they had exhausted all of their other options.

ADHD, learning disabilities, Aspergers… these are some of the labels that are popping up more and more frequently in our everyday language.  We’re familiar with the terms, but many of us don’t fully understand what they mean, or even how they get identified.  We want to have answers on how to help our kids who are struggling in school, yet we dread hearing the potentially bad news that there’s something “wrong” with our kids.  We also fear our kids being “labeled” and therefore being ostracized.  And so for some of us, we keep hoping that somehow things will get better for our kids.  We arrange tutoring, edit their papers, nag them to finish their homework, and basically help them bump along the unforgiving corridors of academia, hoping that someday they will grow up and be successful.  “That’s just the way he’s wired”, we say.  But unfortunately, in our fear of finding out answers we don’t want to hear, we forget that our kids are developing their sense of competence, worth and confidence based on the constant message that they are somehow missing the boat at school.

By the time many parents bring their kids into my office, their children are often suffering from anxiety, depression or even suicidal thoughts.  We see sullen teenagers who have already checked out of school, and still others who are involved in drugs or alcohol as a way of coping with the negative message that they’re a failure or “stupid”.  Their academic history is littered with labels like “attitude problem”, “unmotivated” and “lazy”.  But after testing, the significant number of kids and teens who end up having undiagnosed learning disabilities affecting their academics is astounding.

While early identification and intervention is always ideal, thank goodness that it’s never too late to help these teens or young adults understand why they struggle.  I’ve wept with joy many times over the relief and hope that light their faces as they realize how bright they actually are.  Knowing the cognitive barriers that prevent them from demonstrating their full capabilities have helped many students understand that there is hope, and at the same time, how to develop strategies to overcome these barriers.

Learning Differences

Although I use the term learning disabilities, I want to clarify that oftentimes, these are really just learning differences – a child whose brain is wired differently from what is typically required of him or her in school.  Learning disabilities are more of an educational term that allows an identified child to receive accommodations, and so that is what needs to be officially documented to get that support.  As I said earlier in this series, a child who tends to do well in school is someone who is able to handle the auditory, sequential way in which most lessons are taught.  Concepts are introduced in a step-by-step fashion, practiced with drill and repetition, assessed under timed conditions, and then reviewed. This process is ideal for sequential learners whose learning progresses in a step-by-step manner from easy to difficult material.

Students who are diagnosed with a learning disability can often be very bright, so this type of diagnosis does not infer a lack of intelligence or capability.  A learning disability is diagnosed when there is a significant difference between the different realms of thinking – for example, between verbal versus non-verbal (or visual-spatial) reasoning.  Some of the common types of learning disabilities are:

Verbal Learning Disability – This is diagnosed when a student is much stronger with their non-verbal thinking, and struggles to articulate in words what they are thinking.  These visual-spatial learners tend to create a mental picture of a concept and see how the information fits with what they already know. Visual thinkers and learners can literally see pictures in their heads while auditory thinkers and learners hear streams of words. Visual-spatial thinking is approximately eight times faster than auditory thinking, and can be rich, creative in problem finding and problem solving. However, because they focus on the larger picture, they often don’t know how they have arrived at a conclusion or solved a problem.  Writing can be particularly difficult for visual-spatial learners, because it requires considerable effort and well developed visualizing skills to translate words into pictures in order to be able to think, translate the pictures back into words and then hold them still in their head while they writes them down. This process requires constant effort which is physically exhausting and mentally draining.

Non-Verbal Learning Disability (NVLD) – Students with NVLD learn best by using language, by speaking or hearing words. They typically show strengths in their receptive and expressive vocabulary, are typically highly verbal, and strong in utilizing their crystallized knowledge of facts.  In contrast, they may have difficulty learning by analyzing what they look at without spoken language (non-verbal learning).  Students diagnosed with NVLD also tend to struggle with spatial and coordination problems (so they can be clumsy), which can make printing and writing, learning math, telling time, reading maps and keeping their place on the page difficult from early grades.  And even though these students are strong in their verbal skills, they can struggle by high school, because more complex verbal language is based on nonverbal processes like spatial relationships (in science, for example), logical ordering, and sequencing (both skills necessary for math and writing essays). Hence, they will tend to have difficulty in demonstrating all that they know, particularly in later years.

Processing Speed Learning Disability – Processing speed is one of the measures of cognitive efficiency or cognitive proficiency, involving the ability to automatically and fluently perform relatively easy or over-learned cognitive tasks. It relates to the ability to process information automatically and therefore speedily, without intentional thinking through.  While often these students can be very bright, their capacity can be compromised to keep up with the rapid pace of information in a typical school environment. Because learning often involves a combination of routine information processing (such as reading) and complex information processing (such as reasoning), a weakness in the speed of processing routine information may make the task of comprehending novel information more time-consuming and difficult for these students.

Attention Deficit/Hyperactivity Disorder – Inattentive Type (ADHD-I) – While there can be other issues for a student diagnosed with ADHD (e.g., impulse control, emotional regulation, problems with judgement), the discussion of these concerns is beyond the scope of this blog (for more information, check out any of the books and research on ADHD conducted by Dr. Daniel Amen).  Academically, students with ADHD-I tend to struggle with their mental control.  Mental control is the ability to attend to and hold information in short-term memory while performing some operation or manipulation with it and then to correctly produce the transformed information. A weakness in mental control may make the processing of complex information more time-consuming for these students, draining their mental energies more quickly, and perhaps result in more frequent errors on a variety of learning or complex work tasks. Often, the “tuning out” or acting out can be a result of cognitive exhaustion, rather than simple misbehaviour.

Autism Spectrum Disorder (ASD) – Although there are often many significant impacts of ASD on a student’s life that require support and accommodation (for more information, visit the Geneva Institute website), I want to focus on the academic issues for the purposes of this series on learning.  Cognitively, students with ASD tend to be very literal and black and white in their thinking, and have difficulty with abstract thinking.  They often have communication difficulties, both orally and in writing, particularly in social communication, and they may have deficits in comprehending verbal instructions or information.  While they can be bright (in this case, diagnosed with either Asperger’s or High Functioning Autism), they can struggle to problem-solve in novel situations, and so they often perseverate and stick rigidly to routines and familiar situations.  While they may sometimes learn to read well, they can have difficulty with comprehending what they are reading and understanding the subtleties of the text.  They can report factual information accurately, but fail to apply that information to new situations.

Why Academic Performance Can Drop As a Child Matures

At times, teachers and parents can miss learning problems in students because they start off strong in the early years and often achieve high marks in the elementary grades.  It’s only when their marks begin to drop that their parents begin to wonder what’s going on.  In a school situation, bright students will tend to use their intelligence to compensate for their weaknesses. This compensation requires constant effort which drains them of energy and is a source of stress. When they are tired, stressed, anxious or ill, their ability to compensate disappears, leaving them without a reliable mechanism for learning.

Also, while compensatory strategies can work well in the short term, they are not effective in the longer term as it is not possible to sustain the effort required. This means that as these students progress through school, their performance diminishes even though they are making considerable effort. Despite their high intelligence, these students often assume that they are “dumb” and that there is something wrong with them as a person. The result can be continuous underachievement, lack of motivation and low confidence and self-esteem, as well as reports from teachers of a lack of motivation or positive attitude for school.

Identification of Learning Issues

So how does identification work?  While many practitioners will diagnose ADHD and even Autistic Spectrum Disorder based on simply gathering developmental history and behavioural observations, in my opinion, it’s essential to go beyond the external behavioural identifiers to look at the cognitive profiles of these kids.  For example, all too often, a label of ADHD is slapped on a child simply because the child exhibits distractibility, hyperactivity and attention issues.  The problem is that while the behaviour can LOOK like ADHD, there are a number of other underlying causes that can lead to the same kinds of problems.  Back to Janie:  even though she initially presented with ADHD-like symptoms, she was eventually diagnosed with a non-verbal learning disability (NVLD), based on a series of cognitive tests that she underwent.

Beyond what I shared earlier about NVLD, students with NVLD can be inattentive and poorly organized because they have trouble integrating and interpreting incoming information. They tend to pay attention to each detail as it comes in, rather than combining them into more meaningful wholes. The effort quickly leads to information overload, with which these students will often cope by clinging to familiar habits and routines that help them to structure their world. Sometimes this adaptation appears as misbehaviour.   It’s easy to see why her doctor and teacher thought that Janie had ADHD, but had her parents simply accepted that diagnosis, they would have been steered down the wrong path with their daughter.

If your child is struggling in school, I urge you to go beyond the diagnoses that may be given to you by your doctor or pediatrician after spending only an hour or two with your child.  Remember to ask not just for a behavioural assessment but also for a cognitive evaluation as well – what is usually called a “psycho-educational assessment”.  Your school board will have this available free of charge, although unfortunately, there is often a very long waiting list.  Some local hospitals or treatment centres will also offer this type of assessment, so make sure you do some research to see what is available in your local area.

In most instances, psycho-educational assessments are conducted by psychologists in private practice.  Their fees can range, but are often covered in whole or part by work place insurance plans (ask your insurance company for what coverage you have for a “registered psychologist”).  The assessment typically involves a number of cognitive tests, behavioural input from parents and teachers as well as behavioural observations by the assessor.  In our office, we typically see students over a series of three half day appointments, the results of which are analyzed and then organized into a report that identifies diagnoses (if any), plus recommendations for academic accommodations.  Psychologists will use tests that have been well-tested and researched to ensure that they are valid and reliable in testing what they say they assess.  Experience will vary, of course, with the psychologist, and so the quality of the assessment will also differ.  Word of mouth or talking to your teacher or school will help you identify the psychologist who’s right for your child.

Next week, I will talk about what to do if your child has some academic struggles and/or has been diagnosed with a learning disability.  In the meanwhile, I know that I’ve covered a lot of material in a brief amount of time, so I welcome any questions or comments!

 

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