... about learning disabilities

The kid'll be all right ? with a little help from mum, dad and doc

By Julia Cyboran

Needless to say, Mrs Miglia isn't looking forward to the school year. She turns to her family doctor to find out once and for all: is Anthony learning disabled or just a brat?

Her doctor is probably hearing that one a lot these days as the new school year approaches.

There are countless learning disabilities out there ? from dyslexia to dyscalculia to attention deficit hyperactivity disorder (ADHD) ? but diagnosing them isn't easy. In many cases they can go unrecognized by parents, teachers and even doctors, or are masked by behavioural problems. Many symptoms, such as difficulty in reading, doing math, memory troubles, and trouble with written expression, are simply brushed off ? many parents believe that the child will eventually catch up. Also, behaviour such as inattentiveness and failure to follow instructions can make it seem as though the kid is behaving this way intentionally, when they're actually displaying symptoms of learning disabilities. Here are a few tips on how to speak to both patients and their parents about learning disabilities.

TIPS FOR EASIER LEARNING
Recognize the problem "Simple comments by parents or teachers that the child is 'lazy, unmotivated, moody or irritable' might be a clue to delve deeper," advises Dr Nancy Cohen, director of research at the Hincks-Dellcrest Centre in Toronto and professor of psychiatry at the University of Toronto. Get parents to expand on this information by asking them:

Is the child struggling at school with tasks like reading or math? Has he or she had a history of difficulties with achievement-related tasks, like chores or sports?
Has the child had a hard time adapting to more difficult schoolwork in the upper grades?

Testing, testing Tell parents that these behaviours can sometimes signal that a child is having real difficulties in school and suggest that a thorough assessment be done. You can do some simple screening in your office using instruments like the Pediatric Early Elementary Examination (PEEX 2) and Pediatric Examination of Educational Readiness At Middle Childhood (PEERAMID 2). They're quick and easy and should tell you if the child needs further testing or if there's a more serious problem lurking, like ADHD.

Talk it over It may sound obvious, but it's important to reach out to your patients and their parents once you've identified a problem. Your patient is probably feeling 'stupid' or 'dumb,' words they may have heard from their peers. Dr Cohen suggests avoiding negative comments ? from both doctor and parent. "The most important thing is to be empathetic and to let both the parents and child know that everyone learns in a different way," she says.

A little support You can also help your patient and their parents by sending some useful literature their way. "Offer a list of resources to parents, like parent groups or support groups," encourages Dr Cohen. There are many resources available both online and in the community that can demystify the condition. Here are a few key resources:
Learning Disabilities Association of Canada: find local chapters ? 613-238-5721. LDOnLine: information for parents and clinicians ? www.ldonline.com. All Kinds of Minds: a resource for students ? www.allkindsofminds.org

Teamwork "It's really important that a child get a thorough assessment," stresses Dr Cohen, and for this they need all the help they can get. But parents are sometimes reluctant to invest time in the full battery of psychoeducational testing ? often because they aren't ready to deal with the results themselves. Doctors may need to reinforce to parents that their child has a better chance of learning how to cope if they have the support of their family, teachers, tutors and doctors ? and possibly a psychiatrist or psychotherapist.