Parents who have a child with a learning disability — or believe they see early signs of one — may be understandably concerned about the process of getting a diagnosis and early support services for their child. In this series, Noodle Expert Jules Csillag introduces parents to the evaluation process and provides in-depth examinations of seven common learning disabilities.
All parents want their children to do well in life.
Academic achievement can be a big part of success. The skills that children acquire, both in school and out, help them to grow intellectually and academically, and to gain confidence in their achievements. But what if your child isn’t developing in the same way as her peers?
Many students with learning disabilities do succeed in school, especially when they’re provided with the right interventions and accommodations. As a parent, you have the responsibility to convey to your child that she is much more than her report card. Children with learning disabilities especially need to know that their parents see their unique strengths and empathize with their struggles.
As a parent, you will need support, too. A great first step is to turn to the free resources available from the professional organizations that set the diagnostic criteria for learning disabilities.
The APA produces the Diagnostic and Statistical Manual of Mental Disorders (called the “DSM"), which is a volume that defines the diagnostic standards or criteria for all of the types of mental health and learning disorders recognized by the APA. The first DSM was published in 1952, and since then five revisions have been made.
The DSM-V, which was published in 2013, is the current standard used by mental health and learning professionals. The APA collaborates with experts from the National Institutes of Health (NIH), the World Health Organization (WHO), and other related bodies to create the definitions of disorders included in the DSM-V. Without an APA recognition, a condition — such as any of the non-verbal learning disorders — does not have an officially recognized diagnosis. And the lack of such a diagnosis can have implications for the range of learning supports to which children are entitled.
The AAP is a professional association of pediatricians who carry out a variety of functions in public education, research, professional development, and the creation of Academy policy statements. These statements are based on current research, and they provide recommendations and Clinical Practice Guidelines for member pediatricians. Guidelines are also developed by other professional organizations and may be endorsed by the AAP when they are research-based and relevant to pediatricians.
The CDC provides data and statistics, research summaries and guidelines, and health-related travel recommendations to the public and professionals. The organization covers a range of diseases and disorders (mostly medical, but also psychiatric and learning-based). Its mission is to keep the public informed and safe in areas related to health, medicine, and psychiatry.
ASHA is a professional association for Speech Language Pathologists, who are clinicians trained to work in the field of speech, language, and hearing functions in children and adults. The organization has a number of roles, including public health, advocacy, and professional education. It reports on the most current research through peer-reviewed journals and a “Clinical Topics" webpage on which it summarizes current, evidence-based assessments, and treatments. The association also provides recommendations for other related organizations, such as the APA.
Either of these professionals can diagnose a variety of learning disabilities, including dyslexia, dysgraphia, dyscalculia, attention deficit hyperactivity disorder (ADHD), language-based disabilities, and autism spectrum disorders (ASD). Typically, a clinical psychologist or neuropsychologist would conduct a battery (or sequence) of tests, which may include intelligence tests (IQ tests), as well as assessments of reading, writing, math, executive functions, and organizational skills.
Test scores alone are not all that matter for a learning disability diagnosis. Astute psychologists will look at patterns of errors and successes as well as how students undertake each task. They will consider such questions as:
Are there significant differences between a child’s verbal and nonverbal skills? This may signal a dyslexia diagnosis.
Are there difficulties with initiating and staying on task (even if the child’s output is strong)? This may suggest an ADHD disability.
Is a child unable to refrain from pushing a button on a computer-based inhibition test? This may indicate an executive function disorder.
Each of these medical practitioners can diagnose attention-based difficulties, such as ADHD and autism spectrum disorders. Like other professionals who diagnose learning disabilities, they will use interviews, standardized assessments, and teacher checklists (see below) to arrive at a diagnosis.
Speech pathologists can diagnose speech sound disorders and spoken language disorders, and may also be part of a team that diagnoses autism spectrum disorders, since communication is a principal component of ASD.
Learning disabilities cannot be meaningfully diagnosed using a single tool, or even a series of assessments. Good evaluators rely on multiple tools to develop a complete picture of a child’s capabilities. Dynamic assessment — that is, seeing how a child learns as opposed to what she already knows — as well as caregiver observations and clinical judgment are essential for accurate evaluations.
Additionally, great evaluations include “differential diagnoses," meaning that they rule out possible disorders over the course of the diagnostic process. For example, a child’s hearing ought to be evaluated as part of an accurate speech and language assessment to understand if there is a physical basis for a child’s struggles. In the absence of a hearing impairment, a child may still have a speech or language-learning disability — but it’s important to rule out hearing problems as a possible root cause of speech struggles.
All evaluations of your child’s present level of functioning should include:
A complete history of her developmental milestones (these can sometimes offer early signs of a learning disability)
A family history to understand if there may be a genetic component to a learning disability
Teacher checklists and school work, including work from prior years or previous classes
Whenever possible, observations or interviews with people who care for your child in a variety of contexts
For children who are enrolled in school, parents can request an evaluation, which will be provided at no cost in public schools. That said, these assessments may not be scheduled immediately in some of these schools. In light of this reality, parents sometimes hire a professional to conduct an Independent Educational Evaluation (IEE) for which they pay out of pocket. Private health insurance plans may reimburse some or all of these costs, though not all plans cover learning disability evaluations. The fees can be quite high — as much as $9,000 in the New York metropolitan area — but many graduate schools and other facilities (such as hospitals) offer sliding scales or low-cost evaluations.
_Follow this link for further information about the 2004 Individuals with Disabilities Education Act and the rights you have for your child's education._
How a school first responds to a suspected learning disability will vary according to the disorder. Many public school districts use a Response-to-Intervention (RTI) approach; children who are having academic difficulties may get a little extra push at school — such as being placed in a special reading group or being given multiple sessions with a tutor — before the school initiates the steps for a formal evaluation.
Although some advocates argue that time is wasted for children with learning disabilities during the RTI stage, this approach exists to allow children who may lag behind their peers to catch up academically. Not everyone who is having academic difficulties has a learning disability, and RTI is designed especially to support students who are at-risk but do not have a disability. That said, early interventions — whether they are for at-risk or disabled children — are critical for long-term academic success, so continue advocating on behalf of your child if you believe that her learning needs are not being met.
Accommodations affect how students access the curriculum. Accommodations can include assistive technologies (e.g., text-to-speech, speech-to-text, spelling and grammar checkers, and so on), audiobooks, extended time on tests or assignments, or quiet or separate workspaces.
Modifications influence what a student is tasked with doing at home or at school. These may entail reading a text with simpler vocabulary, writing a shorter response to a question, or having spelling not marked on an assignment.
Remediation, or therapy, refers to activities or exercises provided by a trained professional. These aim to improve some aspect of your child’s thinking or learning. Examples include multisensory reading or writing instruction, speech and language therapy, and social skills groups.
By law, parents must approve the educational decisions made to meet the special learning needs of their children — your voice matters! Here are some ways to advocate for your child:
Build a relationship with your child’s teacher and other school staff. Understand that you are on the same team and want what’s best for your child. Communicate regularly — and not just when things aren’t going well. Treat every conversation as a respectful, two-way interaction.
Be honest about your child’s challenges and needs. This approach benefits everyone: It shows that you are an involved parent; it will help inform the person working with your child; and, while the person you’re addressing may be an expert in the field, you know your child the best.
Come prepared. Know your rights and your child’s learning challenges. You can bring past report cards, written observations, an evaluation, or an Individualized Education Plan (IEP) (if your child has previously received one).
Keep a record of all correspondence — written and electronic — regarding your child’s learning needs. This can help you to recognize her progress and may be used as part of a new plan going forward. It could also be useful if you ever need — and ideally you won’t — to resort to legal proceedings.
Understand next steps. If you are unhappy with something that has happened at your child’s school, know whom to talk to: her teacher? the principal? a mediator? If you don’t agree with an aspect of the IEP process or with your school’s decision to refuse an evaluation or accommodation, you have the right to formally appeal this decision. You can also request a change in school placement, ask for an Independent Educational Evaluation (IEE), or file a complaint with your state’s education department.
_Follow this link for a guide to the special education evaluation process, and read the Parents Reaching Out tip sheet to learn more about advocating for your child._
For details about definitions, the latest research, evidence-based therapies, and recommended reading about each of the learning disabilities highlighted in this series, read these comprehensive articles:
Please note that professionals, parents, teachers, and members of disability communities may use the terms “learning disability" or “learning difference" when speaking of a person with one of these disorders. Many people, however, believe that “disability" implies a pure deficit, while the term “learning difference" captures the often unique and innovative ways in which individuals with these disorders think and learn.
That said, “learning difference" is not legally recognized as a basis for providing students with learning supports or services. For children between the ages of three and 21 years old, the relevant law that entitles them to the same educational opportunities as their non-disabled peers is the federal Individuals with Disabilities Education Act (IDEA), which only recognizes the term “learning disability." (Moreover, the Americans with Disabilities Act relies on the same language in the protections it affords adults with disabilities.)
Because Noodle’s mission is to help parents, educators, and learners make better educational decisions, we have chosen to use the legally recognized designation “learning disability" throughout this series. This choice does not suggest that we believe people living with these disorders are “lacking," but rather that we aim to provide our readers with information and resources that align with officially recognized education language.
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Screening and Diagnosis. (n.d.). Retrieved March 8, 2015, from Centers for DIsease Control.
Speech Sound Disorders-Articulation and Phonology. (n.d.). Retrieved March 15, 2015, from American Speech-Language-Hearing Disorders.