Month: November 2020

“What’s the Ratio?”

One of the biggest challenges in this business of struggling children is deciding what’s the ratio between a legitimate disorder of some kind or another and a child’s choice.

For example, homework or chore avoidance is frequently explained due to a disorder not allowing the child to complete the task.

Parents reveal the ratio as they say things like, “Well, he couldn’t help clean up his room last night because of his ADHD.”

While I am not denying the existence of disorders, I would encourage parents to question their ratios.

Recently, I had a talk with a dad, Gerald,  about his 8 year old daughter, Abbey, a third grader who has becoming increasingly challenging to manage.

As Gerald informed me, Abbey has been very “anxious” to the point where she can’t do things asked of her and that she might need medication.

“How do you know she’s anxious,” I ask him.

“Well, every time we start to do homework she starts crying and having a fit.  We try to find out  what’s wrong, but she will only say things like, ‘I’m scared.’  It’s the same when we want to put her to bed – she starts crying and having a fit.  Even when we ask her to put her clothes away, she starts whimpering on the floor, saying things like ‘I can’t do it.  I’m too scared.”

(At this point in the conversation, if I had a beard, I envision that I’d be stroking it trying to look as thoughtful as possible, as I’d be nodding and saying something like, “Hmmm…hmmm…” in curious and seemingly wise tones.)

I ask, “What do you do when all of this is going on?”

“Well, we comfort her, of course, and we tell her that everything’s going to be all right.  We do what we can to soother her.”

(I do my best not to roll my eyes.)

“Does she show this “anxiety” when she’s in school?”

The dad explains that pre-COVID and even with partial school attendance under the current conditions that Abbey has never shown any of her anxiety in school or in social situations.  It’s only at home.

Not being able to hold back further, I dive in.

“Look, Gerald.  What is the one thing that kids are driven by?  What is it that they want above all else?”

Gerald looks at me like I am a bit off center and he’s not really sure how to respond.  He says, “Well, they want to be loved, of course.”

In somewhat teasing tones, I respond, “Gerald…Gerald… I know they want to be loved. But, beyond being loved, what drives them?”

Gerald doesn’t know.

I say, “OK.  I will tell you.  It’s simple.  It’s one word… Pleasure!!!!  They want to have pleasure.  That’s it. Putting your clothes away and doing homework does  not give pleasure.”

When asked what about his ratio of Abbey’s anxiety to avoidance, Gerald admitted that he saw it as about 80% due to anxiety vs. avoidance.

If Abbey showed even a hint of anxiety in school, I might agree with him, but since she showed no anxiety anywhere else other than at home, I had a different ratio.

Looking at Gerald squarely, I offered a different perspective.

“Gerald, my ratio is pretty lopsided too….except mine is going 90/10.  That is 90% of the behavior you are seeing is Abbey’s attempt to avoid momentary pain (i.e.,  homework, putting clothes away) for pleasure.”

Takeaway Point

Gerald has been an all too willing fish, biting the bait whenever Abbey puts it on the hook.

Check out your ratios.

Maybe they are not what you think.

Have a safe and happy Thanksgiving.

Copyright, 2020
Questions or topics email Dr. Selznick.  Not in the South Jersey area? For a free 15 Minute Consultation, contact Dr. Selznick: email –


Part II: Gina, The Inefficient Reader

Last week we discussed Gina, a frustrated 17 year old who was not getting the results she had hoped  on tests like the SATs, in spite of her putting in a great deal of effort prepping for the test  (Gina, Part I).

Gina had been previously evaluated by the school’s special education team who found her to be “fine,” with scores falling in the average range or better.

When I subsequently evaluated Gina, I found that she had an unrecognized “heel spur,” affecting her ability to perform effectively on challenging tests.

This “heel spur” did not allow her to read complex words very efficiently, slowing down her overall reading process.    While ultimately reading words like mechanic, pedestrian and multitudinous correctly, she did so with a great deal of effort, expanding time considerably while reading, greatly impacting timed tests like the SATs.

After the post went public, questions were received from New York to Thailand,  including:

How is this type of problem addressed/corrected?”

“What exactly is her “heel spur?”

Why was she able to ultimately  correctly read the words that were challenging to her?

As it turns out Gina always struggled with reading words, but she was always “good enough” to fall in the dreaded portion of the average range where nothing is done (around the 30th % ile of the bell shaped curve).

Primarily, Gina read words from her memory.  This was a habit (style) of hers since first grade.

So, when she saw a word like “pedestrian,” her instinct was to immediately say a word from her memory like “pediatrician,” which looked like “pedestrian.”  Eventually stumbling on the word the process was exhausting.

This style/habit was her “heel spur.”

Relative to the question of how to address/correct the problem,  if Gina were younger specialized tutoring would be recommended to target her word reading and reading fluency skills.

At this point in her senior year of high school, Gina needs greater understanding  that her issue is not her intelligence, as she was getting down on herself and frustrated.  Gina needs to understand that we all have “heel spurs” of one sort or another, so she doesn’t make the harsh self statements she was starting to make about herself.

Gina is also in need of accommodations in the form of a 504 Plan, which offers accommodations to those with an identified disability.

Two accommodations come to mind.

First, Gina needs extended time.  Typically,  students are given either time and a half or double time extension on standardized tests.   Even if she is not given this accommodation for the SAT as sometimes happens, the likelihood is that she would be given such accommodations in college.

Another accommodation that is not done with standardized testing, but can be offered in less formal settings such as the classroom, would be to allow Gina the opportunity to preview the difficult words prior to taking a test.

This accommodation would not be giving her an unfair advantage, which is not the purpose of a 504 Plan, but would help to “level the playing field.”

For so many like Gina out there, they can’t manage difficult text and with a little assistance in the form of an accommodation or two, these allow them to get in the game.

Copyright, 2020
Questions or topics email Dr. Selznick.  Not in the South Jersey area? For a free 15 Minute Consultation, contact Dr. Selznick: email –


Gina, The Inefficient 17-Year-Old-Reader

Gina is a frustrated 17 year old junior in high school.

Feeling that she’s done everything  people have asked of her and more to prepare for the SAT’s, have left her frustrated with not great results.

Putting in practically an hour a day studying for the SAT’s (in contrast to the “the idiot boys,” she thinks, “who do nothing but play their stupid video games”),  she’s also  taken a six month course to improve her scores and “test-taking strategies.”

A year ago, Gina was vaguely “diagnosed” as “ADHD,” of the inattentive variety,  by a very wise-seeming grandfather type, medical specialist who spent about ten minutes with her, telling her, “I think you need medication,” while scratching his beard in professorial fashion.

Dutifully, Gina went on stimulant medication, but the SAT needle didn’t budg, nor did her test taking in school, where she continued to receive mediocre grade after mediocre grade.

At her parents’ request, Gina was evaluated by the school’s special education team. Their findings were not compelling, as scores clustered in the “average range,” even though some were in dreaded “lower portion of the average range,” (i.e., the 30th %ile).

The message indirectly given from the team to the parents was, “Yes, the doctor is right.  Even though we’re not physicians,  it does sound like ADD.”

When I meet Gina for an assessment, she was not on medication.  Working with her for over three hours, there wasn’t a moment of distractibility.  Gina recounted how hard she’s worked over the last year.

Here’s the thing, though, Gina had a metaphorical “heel spur,” that no one has ever commented on that impacted every aspect of her academics.

Here’s a glimpse into her “heel spur.”

As part of the assessment Gina was given tough words to read, such: 

  • mechanic
  • illustrious
  • tentative
  • pedestrian
  • investigative
  • metaphorical

Even though Gina ultimately read each one of these correctly, it was only after a great deal of effort for each of the words that she arrived at a correct response.

To give you a flavor of it, here’s how Gina read some of the words transcribed as close as possible to exactly what she said.

For “mechanic,” Gina quickly said, “machine…no, wait, medicine, no, mech…mech… mechanic,”

For “pedestrian,” there was a about a five second delay while Gina tried to figure out the word.  She started to say “pediatrician,” but stopped herself ultimately saying, “pedestrian.”

Illustrious,” started out as, “illustrated,” with considerable stumbling before arriving correctly at the word.

Technically speaking, Gina would probably have been given a check mark after each of the words, but the scores would not be telling the story of her “heel spur.”

When Gina read a high school level story to me out loud, there were no errors, but the reading was choppy, labored and strained, probably taking her nearly triple the amount of time expected for the reading of the passage.

Listening to her read the words and the story was exhausting (for her and me).

Takeaway Point

Often the scores don’t tell the story.  Regardless of the age of your child take out a book roughly within his/her grade level.

Have the child read out loud.  Is it smooth sounding without a lot of stumbling or choppiness?

If it is not, then there is a “heel spur” that needs to be identified and addressed.


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