Assessment

Why Ask ‘Why?'” (Part II)

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Frequently, I hear from parents that they just want to know “why” something  is taking place (e.g., a behavior or a learning problem) .  As I hear their question, I understand they are seeking a “diagnosis,” such as ADHD or dyslexia.

For many parents when they get the diagnosis, they find comfort in it, believing that they have gotten to the root of the problem.

As we discussed last week, (“Why Ask ‘Why'”) the concern of of “why” is that the answer is highly speculative.

Related to this, I would like to offer a couple of quotes from Dr. William Carey, the late, renowned pediatric researcher from CHOP.

“‘I think the current diagnosis of ADHD is a mess and has been wildly overdone.  It blames a variety of symptoms entirely on the child’s brain, and ignores the child’s environment and the interaction with it.’”

The assumptions that the ADHD symptoms arise from cerebral malfunction has not been supported even after extensive investigations.  The current diagnostic system ignores the probable contributory role of the environment, presuming  the problem is supposedly all in the child.” 

“The questionnaires most commonly used to diagnose ADHD are highly subjective and impressionistic”

“The label of ADHD, which is widely thought of as being beneficial, has little practical specificity and may become harmful.”

Parents may feel a degree of comfort relative to getting a “why,” but I can’t shake Dr. Carey from ringing in my ears.


Copyright, Richard Selznick, Ph.D.  2022, www.shutdownlearner.com.

To Contact Dr. Richard Selznick for advice, consultation or other information, email rselznick615@gmail.com.

 

 

 

“Pie Chart Revisited”

As those of you who follow this blog knows there are two overriding missions that drive everything done in the blogs, books, tid-bit tips, and in interactions that take place with parents.

These are:

  • Help parents to cut through the tremendous amount of misinformation that exists children and their struggles.
  • To talk to parents in  plain, down-to-earth, non-jargon terms about the various issues.  (We like to think of this blog as a “jargon-free” zone.)

Essentially, it’s been the same mission for a number of decades (not saying how many at this point).

Here are some points to keep to keep in mind as we talk about the “pie chart.”

  • In most schools, just walking in the door, approximately 20-25% of the children will show mild, moderate to more severe problems with reading, spelling and writing. Within lower income communities the numbers soar to over 60%.
  • Of the population of struggling children not all of them will be “dyslexic,” but up to about 70%  of that group will be showing some difficulty with “decoding” and reading fluency.
  • Beside struggling in reading, spelling and writing, a significant percentage of this group (over 70%) will also have issues with things like sustained mental effort, inattentiveness, inconsistent focusing, lowered motivation, low frustration tolerance, and other related emotional/behavioral variables.
  • Probably about 85% of this group will have mild, moderate and more considerable issues with self-esteem, anxiety and insecurity..
  • Nearly 100% of the time with the struggling children, it will  always be a “pie-chart” of variables (as opposed to one-factor explanations, such as, “He has ADD.”)
  • .

The pie chart of may not have equal pieces of the pie as is illustrated in the pie chart above of a recently diagnosed 8-year old. In fact more often than not the reading, spelling, writing piece may be as large as a 70% piece of the pie, but the important point is for you as a parent to move away from “black-white” thinking as in  “has it”  – “doesn’t have it.”

It’s the pie chart that matters.

Takeaway Point

Unlike something like taking a Covid test, where the result is a “has it” – “doesn’t have it” diagnosis, in this corner of the universe, that does not exist.  There are always a mixture of variables interacting to a greater or lesser degree

To help you get perspective, it would probably be a good exercise for you to get out a few colored pencils (I know very old school) and start creating your child’s chart.

Keep focusing on your child’s  pie chart.


Copyright, 2022 www.shutdownlearner.com
Questions or comments email Dr. Selznick:  rselznick615@gmail.com.

Our Explanations & Theories of Struggling Children

While meeting with parents to discuss the concerns they have regarding their  children’s struggling, numerous theories and explanations are often offered as to why children do what they do.

Typically, the theories are linked to medical explanations or what I refer to as “disorder thinking.”

Let’s listen to some recent statements:

After starting on Concerta, George seemed to be playing better with other kids, but now no one seems to want to play with him again.  Maybe we should try Adderall.”

“My daughter is refusing to do her work –  we thought the Lexipro was working.”

We don’t understand, we adjusted the Vyvanse, but he is still aggressive with his younger sister.”

The school said Michael was very disrespectful and rude this week – maybe his Intuniv needs to be changed.  Or maybe it’s his ‘sensory’ problems again.”

“Marla’s so unmotivated.  She just wants to do nothing but go on TikTok.  It must be the medication wearing off.”

And the beat goes on.

Things I don’t hear very much:

I know my kid is manipulating us when he avoids his homework to go play video games.”

“I don’t see her showing empathy with her friends –  she can be very insensitive.”

“Maybe the school is not the problem. Perhaps we need to look at how we are dealing with him at home.”

“Even if you don’t like doing the work in school, it’s not ok to refuse to do your work and say whatever you feel like. It isn’t a choice – you don’t have to like it.”.

“Zach never shares with other children and no one wants to invite him to their house or to a birthday party.  He only wants it his way.

 Takeaway Point

The point is not that children may not have certain disorders or possibly benefit from medication when appropriate, but double-check your hypotheses and theories.

There may be other things at work.


Copyright, 2021 www.shutdownlearner.com
Questions or comments email Dr. Selznick:  rselznick615@gmail.com.

Getting a Roadmap

When it comes to their  children struggling with reading, parents could use some road maps.

An “old-school” concept  not discussed much anymore, but that is still quite relevant has to do with the “stages of reading development.”

The stages provide a type of road map, as every child (not just those who are struggling) are somewhere on a continuum within the stages.  Knowing where your child is on this continuum helps to guide you as to what you should be doing relative to any type of instruction or tutoring that may be taking place.

The stages help in what I call “next-step thinking.”

Fundamental questions such as “Does might child need decoding? Fluency? Comprehension?  Vocabulary?” should be answered by knowing where your child in in the stage your child is in the stages.

The stages reveal answers to such questions.

For example, if you know that the child is in early Stage I of development (regardless of the child’s age and grade), will have clear implication for what the emphasis should be relative to any instruction taking place.

The concept of the Stages of Reading Development originated from the theories of the late Dr. Jeanne Chall, a renowned reading expert, psychologist and  researcher from Harvard University.  Even though her theories were written decades ago, they continue to apply today.

Over the next few weeks we will drill down on the stages so that you’ll have a full understanding of the relevance for your child’s development.


Copyright, 2021 www.shutdownlearner.com
Questions or topics email Dr. Selznick.  Not in the South Jersey area? For a free 15 Minute Consultation, contact Dr. Selznick: email – rselznick615@gmail.com.

Bewildering Treatment Options

Treatment options and the range of professional recommendations can be bewildering, not to mention all of the “on the street” opinions.

Just like the parable of “The Blind Men and the Elephant, different professionals will identify a part of the “elephant” and recommend a treatment from their particular vantage point.

Recently a mom came in to discuss her struggling 8 year old daughter, Samantha, who had seen a number of different professionals.

“Since kindergarten we’ve been on this three year mission to help her,” the mom said.  “She just isn’t making progress and the gap is widening.”

“So, what was recommended?” I asked.

“We first saw an OT who felt there were ‘sensory issues’ and recommended that Sam should get Interactive Metronome Therapy.   Then someone told us about a colored lens treatment and we found a person who specializes in tinted lens, which she recommended for Sam.”

“An auditory specialist identified a ‘central auditory processing disorder’ and recommend that we go to her office for a year of computer training to address the ‘auditory issues.’  The neurologist we saw said she had ADHD and  wants her on medication.  Then there was the “train the brain” program offered at a nearby learning center.”

“I really have no idea what to do and am overwhelmed by all of this, not to mention how expensive it all is since it is out of pocket.”

Samantha’s story is like many I have heard. My best advice is to narrow down your range of “experts” and to trust your “parent gut.”

Ask yourself, does the recommended advice pass the “smell test” in terms of your major concern?

For example, if you are concerned about your child’s reading and are recommended to engage for a year with a type of metronome therapy, does that pass the “smell test?”

Is the child going to be reading better by the end of the treatment?

As close as possible, recommendations should match the area of concern.

To hit a tennis ball better, you wouldn’t go for swimming lessons.


Copyright, 2021 www.shutdownlearner.com
Questions or topics email Dr. Selznick.  Not in the South Jersey area? For a free 15 Minute Consultation, contact Dr. Selznick: email – rselznick615@gmail.com.

“We Got the Diagnosis”

Most struggling children that I know have what I have refer to as a “soup pot of variables” interacting to a greater or lesser degree depending upon a variety circumstances.

You know what I mean with the “soup pot.” In the pot, there can be a helping of reading problems, with a dash of inattention,  mixed around with a teaspoon of oppositional behavior, and a tendency to melt down when things are not going well.

Parents will wander the landscape looking for solutions and much depends on whose professional doorstep that they land on in terms of what they hear regarding their child and the solutions offered.

Quite often, they will get “the diagnosis.”   Medication may be recommended as a result.  On some level, the parents may feel some relief that they, “finally got to the bottom of it.”

If parents go forward with the medication, the child may start focusing a bit better.  Some improvements are immediately noticed which helps to turn down the household heat.

Before long, though, the rest of the soup pot starts to bubble up again:

  • Tantrums emerge around homework time.
  • Demands are made to play video games until late at night.
  • Hatred  and resistance of reading (spelling and writing) are expressed.
  • Constant arguing takes place, especially when things are not going the way the child wants it to go.

This “soup pot” is always very challenging and it is one of the reasons I consistently push back on the view that we “got the diagnosis.”

So, what’s needed?

Each child and each family circumstance is unique.  Ask yourself what’s  your child’s particular “pot” and start peeling off the layers one at a time, rather than focus on “the diagnosis.”

For example, specialized tutoring and approaches to address challenging behaviors may be what you need to be doing in a “next-step” thinking mentality.

You also may want to consider having “adivsors” (professional and personal) on your team, so they can help you peel off the layers.


Copyright, 2021 www.shutdownlearner.com
Questions or topics email Dr. Selznick.  Not in the South Jersey area? For a free 15 Minute Consultation, contact Dr. Selznick: email – rselznick615@gmail.com.

 

Our Theories & Explanations: #Child

When you are in “Child Land,” there are all kinds of theories and explanations as to why children do what they do.  More than another generation, the explanations are tied into medical explanations or what I refer to as “disorder thinking.”

This type of thinking is usually revealed in the statements that are made as to what is behind the child acting a certain way.

Let’s listen to some recent statements:

We don’t understand, we adjusted the Vyvanse, but he is still aggressive with his younger sister.”

“My daughter is refusing to do her work –  we thought the Lexipro was working.”

The school said Michael was very disrespectful and rude this week – maybe his Intuniv needs to be changed.’

“Marla’s so unmotivated.  She just wants to do nothing.  It must be the medication wearing off.”

After starting on Concerta, Jack seemed to be playing better with other kids, but now no one seems to want to play with him.  Maybe we should try Adderall.”

And the beat goes on.

Things I don’t hear very much:

I know my kid is manipulating us when he avoids his homework to go play video games.”

“I don’t see her showing empathy with her friends –  she can be very insensitive.”

“Maybe the school is not the problem.”

“It’s not ok to say whatever you want in the class, even if you don’t like the work.”

“No one wants to invite Zach to their house or a birthday party; he never shares with the other kids and he has become alienating to them.”

One step it to help kids recognize that choices have built in consequences.  (“If I don’t share others will not want to play with me.”)

If we buffer kids continually from these consequences, there will be no reason for them to learn from their mistakes and try a different approach.

 Takeaway Point

Double check your hypotheses and theories.


Copyright, 2021 www.shutdownlearner.com
Questions or topics email Dr. Selznick.  Not in the South Jersey area? For a free 15 Minute Consultation, contact Dr. Selznick: email – rselznick615@gmail.com.

To purchase a signed copy of  “What To Do About Dyslexia: 25 Essential Concepts” & Dr. Selznick’s other books and to receive blog updates go to https://shutdownlearner.com.

Wrestling With My “Underself”

There’s always that point  in the assessment process  that I know is coming that frequently gives me an anticipatory, somewhat squeamish feeling.  Let’s  call it, “The final chapter.”

(Underself immediately jumps in responding  to Self: “Really? After, at least 9, 995 assessments that you’ve done, you still get squeamish?  What’s that about?”)

“If you would just stop yapping,” I tell Underself, “I will explain it to you.”

I continue talking to Underself.  “After I’ve gone through all of the data explaining  things in straightforward ways so parents will ‘get it,’ there’s always the looming  question, ‘OK, so, what’s next? What do we do about it?’  It’s that question that makes me a bit uneasy?

(Underself yaps again raising the volume: “You can’t answer that????  Are you serious?)

“Look, Underself, it’s easy for you to just sit there all the time constantly  criticizing, but the fact is that parents have lots of preconceived ideas about what follows after an assessment, and many of these ideas are not grounded in the reality of the way it works in the schools.”

(Underself impatiently foot tapping:  “I’m waiting…go on”)

“Look.  Let’s take a child evaluated recently, Marty, age 8, a third grader.  He’s not on the school’s radar screen at this point.  He’s not classified.  There’s no IEP or specialized intervention taking place.  But, when I evaluate him, he has significant reading, spelling and writing issues.  His struggling is clear.”

(Underself:  “So, what’s the problem? What did you recommend?”)

“Well, here’s where it gets squeamish for me, because I know what he needs in ideal terms, but the ideal is rarely to never a reality.  Trying to explain that to parents makes me want to reach for the Tums.”

(Underself:  “Look.  This isn’t therapy. Just tell me what he needs.”)

“Ideally, he needs structured,  focused multisensory type of instruction that is well-supported  in the research.  Short of that, small group instruction (no more than three kids) would be ok using the same methods.”

(Underself:  “So, just tell that to the parents.  What’s your problem?”)

“I told you before.  This kid is not even classified – he has no IEP.  Even if he did have one, typically these things being recommended are not offered at the level that I am recommending.”

(Underself: “So, what do they offer?)

“Usually after a child gets an IEP they offer what is called ‘In-Class Support,’ but that’s like putting a lifeguard in the pool so the kid doesn’t drown.  It doesn’t teach him to swim.”

(Underself:  “I think you need to gobble some more Tums.”)

“Ok, Underself.  I’ve had enough of you… the parents are in the waiting room and I need to tell them what I recommend.  I just need you to stop yapping while I talk to them,” as I go out and face my sense of uneasiness.


Copyright, 2021 www.shutdownlearner.com
Questions or topics email Dr. Selznick.  Not in the South Jersey area? For a free 15 Minute Consultation, contact Dr. Selznick: email – rselznick615@gmail.com.

To purchase a signed copy of  “What To Do About Dyslexia: 25 Essential Concepts” & Dr. Selznick’s other books and to receive blog updates go to https://shutdownlearner.com.

“A ‘Tin Ear’ for Music”

Years ago I had the privilege of being in an audience of about 500 participants listening to a lecture  on learning disorders from the renowned neurologist, Dr. Martha Denckla.

As Dr. Denckla noted,  “It’s like these kids who are struggling with reading, spelling and writing are not  tuned in to the language –  it’s  like not having an ear for music.”

Exactly!!!!

That statement sums up the underlying issue for the vast majority of children who are called “dyslexic” or “learning disabled.”

They have a “tin ear” for language, that is, how words work, whether it’s how the words go together in a sentence or a paragraph.

   

Let’s look at young, Gavin, age 9, a fourth grader who does not have an “ear” for music.

When Gavin writes it’s the equivalent of him screeching on the violin. Below are two samples of Gavin’s writing.

In the first sample Gavin discusses how he and his sister have been trying to convince their parents to get a dog.  In the second, Gavin talks about his love of the holidays.  (Note: The upper and lowercase lettering and punctuation are as close to the original as possible.)

me a nd Mi sitter Bine in for a Dog for a year we wunta Dog so s soso Bad leyMy sitt ersay she is going to Do The work wen she is not going to Do the Wrok”

“ever crimus We Do it my Huose and see my family and These Year my House is getting redown so it will be exsided for them to see it and on Thanks giving we to my Mom-Mom and Pop-Pops and my cosans come over to my mom-mom and pop-pops and my mom-mom makes super good food evry year they get Pie and aother deserts and we get a choes and I PikeThe Best Cokeand we get wiped crem with it.  I love Thanksgiving and crismus

A child of above average cognitive functioning on nonverbal tasks, Gavin is not classified in special education and he receives no special remediation.

Occupational therapy  (OT) has been considered by the school for him.  While OT works on strengthening the fine-motor skills, it isn’t intended to teach the concepts of writing

Underneath Gavin’s writing, he doesn’t understand the concept of a sentence, that a sentence expresses a complete thought that starts with a capital  letter and ends with a period.

By fourth grade, about 70% of the children have intuitively internalized these concepts.  They understand the concept of a sentence and its basic components.  They understand that a paragraph represents a singular theme.

The rest have a “tin ear” for the music. Just sending them for fine-motor exercises or asking them to just “write what you feel,” is not doing them a service.

Takeaway Point

Writing deficits are largely deficits in language awareness.  Spelling and writing are the X-rays that we have that such deficits are meaningful and need to be addressed.

Dr. Denckla has it right on the money.


Copyright, 2020 www.shutdownlearner.com
Questions or topics email Dr. Selznick.  Not in the South Jersey area? For a free 15 Minute Consultation, contact Dr. Selznick: email – rselznick615@gmail.com

To purchase a signed copy of  “What To Do About Dyslexia: 25 Essential Concepts” & Dr. Selznick’s other books and to receive blog updates go to https://shutdownlearner.com.

(***  Please note: Dr. Richard Selznick is a psychologist, clinician and author of four books.  His blog posts represent his opinions and perspectives based on his years of interacting with struggling children, parents and schools.)

The  advice in the blogs and in practice is governed by one overriding principle – “If this were my child, what would I do?”   The goal of the blogs and the website is to provide parents and professionals with straight-forward, down-to-earth, no-nonsense advice to help cut through all of the confusion that exists in the field.)

Disorder or Immaturity? A Confession

Sometimes this blog serves as a bit of a confessional, providing  a forum to voice some concerns regarding the issues that emerge while working with struggling children and their parents.

So, with that in mind here’s a confession. Sometimes I honestly don’t know when a child’s struggling is related primarily to immaturity (i.e., they are not ready and need more time) or whether their struggling is a legitimate disorder/disability.

This dilemma is particularly predominates when the child is between four and seven years of age, that is,  from pre-K to second grade.

(As I write this I hear the chorus calling out behind me.)

“Well, Mr. Big Shot.  You’re the doctor.  That’s why we are coming in to see you – to tell us what it is.  What do you mean you are not sure if it’s immaturity or a disorder? Stop rubbing your head! What’s the matter with you???”

I try talking back to the chorus.

I tell  them things like, “It’s never clear cut.  There is usually a ‘pie chart or a soup pot of variables.’”

At that point the chorus gets louder.  They are almost screaming, “‘A soup pot of variables!!!!!’ What does that mean??? Does she have it or not?  Does she have a learning disorder????  Does she have dyslexia???  And what about ADHD?  She pays attention to nothing!!!!  Isn’t that ADHD?”

Relentlessly badgered by the chorus, I think of Chloe, age 7, a child I recently evaluated who doesn’t read very well or stay on task without a lot of reminders.

Chloe’s teacher vaguely spoke to the mom about her not paying attention very well in school, with the implied suggestion that she might have ADHD, always with the caveat that “We are not doctors.  We don’t diagnose.”

After running Chloe’ through a bunch of tests, I  had one overall impression.

Chloe struck me as immature.

“Immature????,”  the chorus cries out.  “Are you kidding me?”

Yes, I push back against the chorus.  I tell them that Chloe’ seemed more like a five-year old-rather than seven in her manner and way of interacting – that her preoccupations came across as a bit babyish.

The problem there is no test to quantify “babyish,” such as a “Maturity-Immaturity Scale.”

It’s the same with the disorders, like dyslexia or ADHD.  Even though there are more objective tests involved in the assessment, there is no X-Ray or blood test to say,  “Has it  or Doesn’t have it.”

It’s still a weighing of variable to tilt the scales one way or the other.

Takeaway Point

I am sticking with the view that the Chloe’s needs time and perhaps some tutoring to help her mature and improve her skills.

“Back down, chorus. I’m going back to rubbing my head.”


(***  Please note: Dr. Richard Selznick is a psychologist, clinician and author of four books.  His blog posts represent his opinions and perspectives based on his years of interacting with struggling children, parents and schools. The  advice in the blogs and in practice is governed by one overriding principle – “If this were my child, what would I do?”   The goal of the blogs and the website is to provide parents and professionals with straight-forward, down-to-earth, no-nonsense advice to help cut through all of the confusion that exists in the field.) )

Copyright, 2020 www.shutdownlearner.com
Questions or topics email Dr. Selznick.  Not in the South Jersey area? For a free 15 Minute Consultation, contact Dr. Selznick: email – rselznick615@gmail.com

To purchase a signed copy of  “What To Do About Dyslexia: 25 Essential Concepts” & Dr. Selznick’s other books and to receive blog updates go to https://shutdownlearner.com.

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