Month: February 2018

“Off With Their Heads,” Screamed the Queen

“I guess I really messed this up,” said Jennifer, the mom of an 8 year old child who was extremely difficult and challenging.

The kid, Olivia, was one of those kids who melted down when she didn’t get what she wanted.  With the slightest bit of frustration or difficulty she starts screaming, crying and flailing around.

Along with being “meltdowny” (I know it’s not a word), she was also demanding.  As an example the mom told the story of trying to pick out a communion dress for Olivia.  Every one the mom picked was quickly dismissed by Olivia.  “I hate it!!!” she would scream, while the mom would scour the internet for just the right dress, having already had numerous unsuccessful experiences shopping with Olivia at various dress shops.

As the mom told me the story, I had the image that Olivia was like the Queen in Alice in Wonderland, with all of the scared servants running around trying to please the queen.

Parents (well, at least the moms) will think that they “messed things up,” as Jennifer suggested, and that the kid is a direct product of poor parenting.

That is, it was all her fault.

I really don’t see it that way.

I wasn’t trying to let Jennifer off the hook, but I said to her that there were essentially two types of kids:

Group A:  These are the flexible and easy going ones.  They roll with the punches, can handle curveballs (“No, we’re not going to McDonald’s tonight as we had originally planned), and are able to tolerate frustration.

Group B:  They are the opposite of Group B kids.  They are inflexible in style.  The smallest change leads to major eruptions. (“But, you promised we were going to McDonald’s,” as the child screams, cries and carries on at great length.)

It is my impression that the moms (haven’t seen it with the dads) are all too quick to blame themselves, that if they were only a different kind of a parent, their child would be a Group A type.

Rather than thinking that these children fall into these categories as a direct result of parenting, I see them primarily the result of their temperament.

Almost always, when the parent tells the story, the behaviors and style emerges long before any parenting (good and bad) has had a chance to take hold.  (You may want to read the classic book by Stanley Turecki,  The Difficult Child, which was revised and expanded in 2000 from the original.)

Difficult kids are difficult kids. They are consistently a challenge.

Next week we will elaborate on this theme and talk about parent role and involvement with these kids.

Takeaway Point

Temperament rules.


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Assessment Basics – Part III

In the last two blog posts we discussed some of the basics considerations with regards to assessment (Assessment Basics Part I Assessment Basics Part II). 

Among the points included:

  • Longer, more complicated reports are not necessarily better.
  • Assessment reports should be practical and understandable.
  • Assessments provide a snapshot at a moment of time.
  • Assessments identify whether there are “cracks in the foundation” that need to be understood.
  • Ideally, you should be guided on what to next with your child.
  • There should be commentary on the independent, instructional and frustration ranges

In this, the last post in the series, we focus on the issue of “the diagnosis” as a part of the assessment process.

People are rightfully interested in whether the assessment offers a diagnosis on learning disorders such as dyslexia, or other learning disabilities.

For me, as someone who is performing the assessments the challenge is what I call the “not-a-broken-bone” dilemma.

Common learning disorders all occur on a spectrum from very mild issues to more moderate and severe.  I know it is comforting to parents (mostly) to be told that the child does, in fact, have dyslexia (or ADHD), but understand that it is rarely a clear-cut, “yes-no” proposition.

Even after giving a broad battery of tests that are designed to offer such commentary, I still  find it challenging because there is no exact cut-off or place on the continuum that says “yes” or “no,” “has it,” “doesn’t have it.”
Ideally, with a good assessment there is a weighing of variables, a collective combination of both quantitative and qualitative data that adds up to provide a diagnostic profile leading a clinician to say with pretty good assurance that “Yes, your child has dyslexia,” for example.

This weighing of variables means there is clinical judgment involved.

Just yesterday, for example, I evaluated a college student who read somewhat inefficiently, who reported that she had trouble “focusing while reading,” yet in my judgement, after weighing a host of variables, I didn’t see her as “dyslexic.”  (I did see her as having a lot of anxiety, along with indicators of mild ADHD, along with her inefficient reading style.)

When the diagnosis is warranted giving the struggling a name helps to encapsulate it and feel more manageable and less overwhelming to parents and kids.  Once the name is given, there is typically an implied course of action.

Regardless, if your child has had an assessment, make sure that whether there is a formal “diagnosis” or not, you have a frank discussion with the clinician as to what he/she sees as the appropriate next steps.  Since there are many variables involved with these steps, the recommendations need to fit in with the reality of the child’s (family) situation.

Variables such as cost of treatment, availability of appropriate interventions in the child’s community, and the family’s scheduling logistics are all examples of to consider.

Takeaway Point

It’s not a broken bone.  Make sure you know the constellation of strengths and weaknesses identified in the assessment.  Maintain a “next-step thinking” mentality.


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Assessment Basics – Part II

Last week we talked about assessment and my view that there is often endless and unnecessary complication when it comes to assessing kids and their issues (Assessment Basics).  To help assess kids’ weaknesses in the classroom, there is now a easy grader system which does just that. Alongside this, individual feedback is given, where teachers can spend more time focusing on students individually. This week I want to elaborate on a couple of points.

As I noted, a good assessment provides a “snapshot” at a moment in time.  This snapshot should help you to understand a couple of basic questions:

  • Does my child have a problem in the key areas assessed? (If so, how mild moderate and severe is it?)
  • What is the nature of the problem? (e.g., is it and issue with reading fluency and decoding? Comprehension?  Anxiety? Avoidance?)
  • What are my next best steps?

Those are basic, but very central questions to answer.

Since most of the concerns raised in special education and private childhood assessments involve the child’s struggling with reading, spelling and writing, I want to remind you (if you’ve been following my stuff over the years) of another important concept that is not discussed enough, but which is central in knowing what you should be doing with your child.

To make my point I will draw an analogy:

Twelve year old Avery is trying to build his upper body strength.  Currently, he can lift 10lb weights pretty easily.  At this weight he can do many repetitions without getting too winded.  In educational terms, the 10 lbs represents his “independent level,” the point where it is very easy for him and he can succeed without needing any support. When the gym teacher puts a few more pounds on the bar he notices that Avery is showing greater signs of struggling, but that increased weight represents that “sweet spot” of where Avery is moderately challenged, but not overwhelmed.   Effectively, this next increase of weights (say 15 lbs.) is Avery’s “instructional level,” the point where Avery can work pretty well but he may need some support.  When the gym teacher asks Avery to lift 20 lb. weights, he could lift the weights once, but is quickly overwhelmed.  That level was one of clear frustration to Avery.

When it comes to reading, it is less helpful to say the child is at a 2.4 or “Level M” (or whatever the letter is that corresponds to that grade equivalent).  It is much better to think in terms of ranges of instruction as described with Avery.

Commentary on these ranges should be a part of any psychoeducational assessment you are seeking.

Questions to ask your child’s clinician include, what range is the child fully comfortable and independent?  Where is he showing signs of difficulty, but reasonably capable (the instructional level)? At what point is the child fully overwhelmed (the frustration level)?

 Takeaway Point

Answering these questions on instructional ranges are central and fundamental to a good psychoeducational evaluation.  Make sure you are getting them answered.


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