Assessment

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.

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.

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.

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.

With about 500 blog posts under our belt, we look for inspiration where we can find it.

Those of you who follow this blog, know that we strive to talk in “down-to-earth, plain language,” which is the overriding, mission of the website (www.shutdownlearner.com), the books and the blogs.

Parents, rightfully, come to me frustrated, worried and concerned.  They are looking for an answer, usually a “diagnosis.”

Even though many in the field seem comfortable with offering  a  definitive diagnoses, I am hopelessly muddling in the gray zone. Or as I explain to parents, as I push back on the label, “Well, you know it’s a ‘pie-chart’ of variables.”

Or to really make things really clear, I refer to what’s going on with their child, as a “soup-pot of variables.”

In other words in this “soup pot” (or pie chart) you can have a, helping of dyslexia, mixed in with a dash of impulsiveness,  a sprinkling of oppositional behavior and occasional meltdowns, coupled with a tendency to be socially annoying.  Oh, wait. We forgot to mention the pervasive spelling and writing issues with inattentiveness.

So, you tell me, what should we call it?

Thinking about the “pie chart,” brought to mind a kid I saw recently who stopped me in my tracks.

Nine year old, Liam, had been brought in to see me to assess his school struggles.

Midway through the testing, Liam stopped what he was doing and looked up at me. “Tell it to me straight, Doc,” he said.  “Do I have ADD?”

I have to admit, I almost spit out my coffee when Liam asked that question.  He’s nine years old!!!

How have we gotten to a point where a nine year old is asking whether he has a neurological disorder?

To answer Liam I did my usual tap dance, trying not to answer the question directly, mumbling something like, “Liam, listen, there’s nothing wrong with you.”

While shuffling papers, I continued, “We’re just trying to find out why school’s been so hard for you, so we can give you pointers on what can be done about it.”

Liam remained unmoved.

“Yeah, but do I have ADD?”

At that point, I probably squirmed my way into another part of the office, looking for something else for him to be doing to distract him from the question.

How could I talk to Liam about the “pie chart of variables,” no less the “soup pot,” so I chose the path of least resistance.

I avoided answering him.

Reflecting on the interaction, I don’t think I’d want the session on Psychology TV!

“Answer the child directly,” the viewers would comment.  “Tell him in straightforward terms whether he has the disorder or not,” the chorus would chant.  “Stop squirming and beating around the bush. We thought you were a doctor!  What’s your problem?”

My problem is I can’t see things in “black or white,” “this or that” terms.

99% of the time there is a pie chart (soup pot) to understand.  The different pieces are rarely of equal size or proportion, but they are there.

Takeaway Point

Hey, Liam, if you are reading this, there’s nothing wrong with your brain.

We just need to work on a couple of things.

No matter how many kids I’ve seen over the years, I am continually struck by the assumptions made about children and how wrong they may be.

Typical assumptions that are heard all the time include:

“He’s just not trying hard enough.”

“You just don’t care.   You need to care more.”

“If you just paid attention more, you’d know what you were supposed to do.”

“Your writing shows how much you don’t care.”

The fact is these are all assumptions, mostly attributing academic struggling to emotional variables such as low motivation.

A recent story about an 11 year old that I see frequently illustrates how we need to check our assumptions.

The boy, Ryan, was showing very low motivation for engaging with his township football team, even though he had always been a pretty good football player.  Not the most articulate of kids, he would just shrug when parents would challenge his lack of enthusiasm.

Grumbling something like,  “I don’t know. I just don’t like football.  I don’t want to play,” Ryan said.

“We know why,” his parents responded.  “You just want to get on your screens and play Fortnite.  Nothing else matters.”

Admittedly, I bought into this hypothesis/assumption.  So many of the kids I see seem to care about little else than their video playing or social media sites like “TikTok.”

So, as the appointed intermediary I tried in my own way to lean in on Ryan, to see if I could get him to “buy in” a little and show some motivation, at the same time counseling his parents on how they could set their limits and expectations with him.

(Keep in mind, it wasn’t that the playing of football was crucial in my mind relative to Ryan, but it was a physical activity and it got him out of the house with other kids and in the past he had been very enthusiastic about playing.)

When I was alone with Ryan, I asked Ryan what was going on with football, about to start my leaning and then he said, “I just don’t want to play.  I don’t like it.”

Of course it was fair enough not to like it, but I pushed a little more to understand how he had gone from loving it the year before to wanting to quit. Ryan spoke in a low mumble, “They (his teammates) make fun of me a lot.  They call me names and I’m never included with them.”

My mouth dropped in an “aha” moment.

Feeling embarrassed and ridiculed, the wind was out of his sails.  It was just hard for him to effectively articulate these feelings, as it is for most of the boys I have known.  Being clear about feelings was never a strong suit of theirs.

Continuing in my role as intermediary, I explained to the parents what I thought was going on with Ryan.

As I spoke to them, they, too, were having their  own “aha” moment.

Whether Ryan was going to stay with football or not was a discussion they were going to have later, but for the moment, everyone in the room was checking the assumptions that we brought in.

Takeaway Point

Things are often not what they seem.

Before making the assumption, pull back a little.  Maybe there is something else going on.

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.

A frustrated mom named Jan, who  I spoke to some time ago really reduced things to its basic terms.  Discussing her 12 year old sixth grader, Jackson, she went through a list of issues:

• resistant to homework
• hates reading
• frequent meltdowns
• constant YouTubing
• disrespectful to his parents
• sees school as pointless
• seemingly no motivation
• no sustained effort
• low tolerance for any difficulty or frustration

Two different physicians “diagnosed” Jackson as “ADHD,” and signed off on a prescription with the “check-back-with-me in four months” approach.

As Jan reported, the medication seemed to help some for maybe two or three weeks where Jackson appeared mildly more focused and compliant.

However, Jan offered a more accurate description in her reductionist view.  As she noted, “It’s just a big bowl of sh-t!”

Yep, that’s about the size of it.

We seem to want to ascribe specific categories or labels to this big bowl, but this is challenging as there is no x-ray, no one measure that says a child has this one thing vs. another.

Yet, I hear it all the time.

“She has a ‘sensory disorder.’”

“My child has ADHD.”

“Yes, it’s dyslexia.”

On and on it can go with the “disorders” that always attempt at putting pure neurobiological explanations to some of the struggling that is taking place.

Today, I spoke with a cute and endearing 8 year old, girl, Maria, who has had difficulty being accepted by her peer group in school.  Instead of talking about ADHD or “sensory issues” with the mom and the girl, ” I tied to help the Maria understand the skill of getting along with others.

We talked about  how she can “go over the top” and not read the signals.

When I asked her to play back what I was saying to her to get a feel for whether she was hearing me, she said, “I try too hard to be cool and it can get annoying and on people’s nerves.”

“Bingo!!!!!!”

Staying focused on the “skill of…” thinking is a whole lot more productive than overemphasizing a theoretical neurobiological disorder.

So, back to Jan and the “big bowl of sh-t,” breaking things down in “skill terms” would probably be a lot more productive than “disorder thinking.”

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.

Whenever I do an assessment I know that in many ways I am swimming against the tide in the way that I approach things.

Parents are focused on “the diagnosis,” largely supported by the medical model.   Such a model embodies a, “Yes, he has it,” or “No, he does not have it,” perspective.

I wish my corner of the universe were that straight-forward.  I am hopelessly mired in identifying the the “soup-pot” of variables interacting, in terms of the skill domains or areas of functioning that are in need of either direct remediation or some type of accommodation.

Often I find there is a blurring in thinking about these issues with the parents with whom I interact..  That is, I will hear parents talk about getting accommodations, when what they really mean is they are seeking direct services.

For example, a mom said to me the other day, “I want him to get extra help – he needs a 504 and in-class support.”

I know I’ve been beating this drum for some time (I have over 450 blog posts on my site; some will repeat), so let me keep beating.

Direct remediation is just that.  Whether in academics, sports, music, life coaching or any endeavor where a skill is involved, a teacher, therapist or coach  teaches a skill directly, followed up with a great deal of follow-up practice.

The language of direct instruction sounds like the following:

“Here’s how you play these chords on the guitar.”

“Let me show you what the backswing looks like.”

“Let’s look at how these words are broken down.”

“Here’s a way of quieting your mind, when you get anxious.”

504 Plans offer things like “in-class support” and extra- time (even though most kids want less time).

For struggling kids, they usually need a combination of direct instruction/practice and support.

If I had my way, the ratio would be about 80% direct instruction and 20% support and accommodation.  Unfortunately, in my experience with the struggling children, it’s probably a completely reversed ratio with about 90% focused on things like in-class support and extra time.

Assessment ideally should be guiding you on “next-step thinking.”  The assessment should identify major areas of need and what should be done next.

Important questions to ask include:

What are the areas of greatest need?  How mild, moderate and severe are the areas of need?    How much direct instruction is needed?  What is realistic to expect from the school in terms of direct instruction?  What type of accommodation would be helpful in addition to any direct instruction?  If no direct instruction is offered, what should we do?

Notice, the questions are focused on the practicality of the skill needs and the consideration (ratio) of direct instruction to support and accommodation.

Takeaway Point

Assessment drives “next-step thinking.”  Ask the right questions!

Today I chatted with parents about their 10 year old fifth grade child,  Lianna.   Since kindergarten they have watched her struggle.

They saw other children in Lianna’s peer group progressing, while she seemed stuck, barely moving forward.

Even though they would raise their concerns with teachers,  they heard statements like, “She’s so sweet – she’s so friendly,” or  “Well, she’s young for her grade,” or “She can always use spell check,” and other such statements.

As the grades went by the parents continued to share their concerns,  a frequently heard comment was, “We’re not doctors…we can’t diagnose, but…,” with the not so subtle suggestion that Lianna needed to be on medication

To say Lianna’s parents were frustrated is a major understatement,

At the start of fifth grade, Lianna was then tested by the school.  Based on the district’s use of a  “significant discrepancy,” she was not found to be eligible for an IEP.

This significant discrepancy was based on there being a 1.5 standard deviation unit discrepancy or greater between the child’s overall IQ score and their overall score in academic achievement, typically in reading.

The fact that Lianna maintained above average scores on nonverbal thinking tasks mattered little.   She was not eligible.  “Perhaps you should consult with a neurologist,” was what the parents were told.

Seeking another opinion, the parents shared the findings with me.

Glancing at the numbers it was clear that Lianna’s parents were correct in their view that she was a struggling child in spite of not being classified for special education.

Her overall standard score in reading of 88 put her at the  21^st  percentile compared to other children her age.  However, her FSIQ of 92 (30^th percentile) only resulted in a 4 point difference between her identified intelligence and her academic achievement.

I explained, “Look, you have seen your child struggling since kindergarten and the gap has only widened.  She’s in the 21^st %ile in reading and the 10^th %ile of spelling.  That is clear struggling.  However, based on the school’s model, there is no significant discrepancy.  She’s in what I refer to as the ‘zone of no zone.’”

I call this being in the  “zone of no zone,” because in spite of the objective data showing her struggling, no life preserver will be offered to Lianna.  In the model used by the school her IQ wasn’t high enough (in spite of above average functioning in key areas of intelligence) to justify giving her services or support.

This leaves Lianna’s parents the only choice to seek outside help in the form of specialized tutoring at their own expense, probably on a twice-weekly basis for at least two years to try and close the gap.

Takeaway Point

I’ve said it many times before – struggling is struggling no matter what name or label we give it.  Struggling children need help whether they are “eligible for services” or not.

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. )