Toilet Training While in Preschool? Communication is Key!

Megan Sexton, director of Creative Scholars Preschool in Chicago, shares important insights about how to approach the topic of potty training with your child’s preschool.

The toddler years are joyful, busy times of great growth for children! These are the years where children Blog-Toilet-Training-Main-Portraitare finding their sense of self, exerting their will, and discovering what effects they have on the world. With these new discoveries comes a toddler’s desire for independence driven by a desire to find a sense of control over themselves and their world. Because of this, learning self-help skills such as toilet training can be a stressful time for children and their families especially when you also consider that approaches to teaching a child to use the bathroom independently vary greatly from family to family.

When a child is enrolled in preschool and is in the process of toilet training, the potential for differences in approaches multiplies and another layer of anxiety can build up for children and families. This is where the importance of frequent and clear communication between you and your child’s teachers comes into play. In fact, this ongoing communication should begin even before the toilet training process begins! Some parents are unsure about when is the best time to begin potty training and will rely on the recommendation of a toddler teacher who has likely helped many children and their families with the toilet training process. Other parents have a clear timeline of when they would like to begin the process for their child. Whichever way works the best for you, it’s important to have those conversations with your child’s school. This helps get everyone on the same page and sets the child up for success.

What do teachers want to know?

In order to best support children and families, there are a few pieces of information that are helpful when shared with your child’s school.

  • What words does your family use when talking about body parts and elimination? If a teacher doesn’t know a family term for something, your child may become confused when the teachers use different vocabulary.
  • Does your boy sit or stand when trying to use the toilet? Some little boys find it uncomfortable to sit because they don’t like having to direct their penis down and accidentally getting their finger wet. Others don’t like to stand because they become nervous about the potential of falling forwards.
  • What signals does your child’s body give when they have to use the bathroom? Do they wiggle? Do they stand in a corner? Will they use words to let someone know they need to use the restroom?
  • How do they react when they have an accident? Let your teachers know if they get embarrassed or afraid that they will get in trouble if they have an accident.
  • How often do you want your child to try to use the toilet? Some children are able to inform teachers when they have to go, others get so involved in their play that they need reminders to try.
  • Is your child wearing pull-ups or underpants? If your child is wearing underpants, do they use pull-ups at nap?
  • Is your child nervous about anything, for example, when the toilet is flushed?
  • What can your child do independently and what do they need support with? Can they pull up their pants, but struggle with buttons or zippers?
  • How do you want soiled clothing to be handled? Do you want teachers to keep underpants that have had a poop accident or just throw them away? Do you have a dirty clothes bag you would like the soiled clothes placed in or can teachers put the clothes into a plastic grocery bag? Where do you want the soiled clothes placed to make it easy to find at dismissal time?

Make a communication plan.

Whether your child attends a half day program in which all children are picked up at the same time or they attend a full day program in which children are picked up at various points in the evening, it is important to make sure that teachers and parents are able to connect regarding your child’s day and their progress with using the restroom during the day. Maybe your child has the same teachers the entire day or maybe they have a different set of teachers in the afternoon than they do in the morning. How do you make sure that everyone is on the same page?

Some ideas to help maintain this two-way communication, in addition to face-to-face conversations, include:

  • Keeping a notebook in your child’s cubby where each teacher and parent can write notes including how many times your child tried to use the toilet, how many times they were successful, and any notes regarding soiled clothes or questions.
  • Having a toilet use log with times across the top in which teachers and parents make check marks under the times the child tried and went to the restroom.
  • Sending the teachers a follow up email at the end of the day asking how things went.

When parents and teachers work together and have clear communication, the stress of toilet training can be greatly reduced; everyone ends up working together to help the children feel successful and proud of their latest accomplishment!

Megan-Sexton-1Megan Sexton has a master’s degree in child development from the Erikson Institute. She has taught children aged toddler through first grade and is currently the director at Creative Scholars Preschool. Megan believes in the power of play, inquiry, and relationships in shaping a child’s early years.

How Teachers Can Help a Child With Tourettes

When you look at someone with Tourettes, all you see or hear are the tics. You don’t see the constant struggle, the constant commotion that is going on inside the person’s body. Although it might be easy to assume that when a person is not ticcing, they are okay or calm or not experiencing anything related to Tourettes, more often than not, that assumption would be entirely incorrect.

Here are a few tips on how teachers can help a child with Tourettestourettesteachermain

  1. Trust that if the person did not have an urge to tic, they would not be doing the tic. Know that although there might be some level of control for some kids some of the time, it is difficult to control and takes an inordinate amount of energy. The consequence of “not-ticcing” is often delayed tic-bursts, decreased concentration, lost instructional time and/or social time, and muscle soreness.  The consequence of ticcing is often embarrassment, shame, isolation, muscle soreness, decreased concentration, loss of instructional and/or social time.
  2. Ignore the tics. Don’t worry what the other kids will think or if they will become distracted. Be the role model. Keep on and so will the kids. They will get used to the noises just like you would get used to hearing the sound of a fire truck if you lived near a station or the smell of baked goods if you worked in a bakery.  If the noises bother you, just remember they bother the child a whole lot more…and he can’t walk away from himself.
  3. Remember that, as bad as the tics can be, they are usually just the tip of the iceberg. The common Tourette Syndorome (TS) co-morbid conditions are OCD, ADHD and Learning Disabilities.  Your student is battling, not only a body out of control, but some major disabilities that even adults have difficulty living with.  Remember this is a real, neurological disorder that the child did not ask for and does not want.
  4. Learn as much as you can about the disorder(s) and the child. Just because you knew one kid with Tourettes in the past does not mean that you know anything about the current student. Listen to the parents. Contact the child’s private clinicians. Ask questions. Above all, if the adults in the child’s life feel it is appropriate, talk to the child!  Let him know you are trying to understand, that you will do your best to protect him from the bullies, and that you care.  Let him know it’s okay to tic if he needs to and come up with safe places if he needs to leave the room.
  5. Does your student have behavioral issues? It’s possible that things you think are “bad behaviors” are manifestations of Tourettes. The shouting out? Tourettes. Doing what the teacher says NOT to do?  TS is a disorder of disinhibition. If the child hears “Don’t run” he will most likely feel compelled to run. If he knows he shouldn’t be saying certain words or doing certain things, the premonitory urge will center around those words or those actions and it will be extremely difficult, if not impossible, for him to control the urge.
  6. Work with administrators to schedule a teacher in-service for all the adults working with the child, including the related arts teachers, lunch monitors and bus drivers. TS does not go away when the child leaves your room. Children with TS need to know that there are in a safe place with understanding adults who will support them.
  7. With parent permission, set up a peer in-service. Have someone who is knowledgeable about TS speak to the students. There are organizations that have teens, young adults and adults who can provide this service.  This will help all the children, including the one with TS, feel less fearful and more comfortable with each other.

Click here for more information on what it’s like to live with Tourettes.

About the Author: Shari was the 3rd person in IL to be diagnosed with Tourette Syndrome (1976). Her parents co-founded the IL TS chapter along with several others, including Joe Bliss. In 1978, while at a board meeting in her parent’s home, Mr. Bliss told Shari about his theory of premonitory urges and provided some tips and tricks on how to control the tics. It was the first time Shari felt “understood” and attributes much of her success to Mr. Bliss and his strategies. She co-founded the Illinois Tourette Resource Network in 2014 and is honored that she can continue the legacy of providing TS support to the Illinois community.

What It’s Like To Live With Tourettes

tourettes1mainThe diagnostic criteria for Tourette Disorder is so simple, so clear, so straightforward:

For a person to be diagnosed with TS, he or she must:

  • have two or more motor tics (for example, blinking or shrugging the shoulders) and at least one vocal tic (for example, humming, clearing the throat, or yelling out a word or phrase), although they might not always happen at the same time.
  • have had tics for at least a year. The tics can occur many times a day (usually in bouts) nearly every day, or off and on.
  • have tics that begin before he or she is 18 years of age.
  • have symptoms that are not due to taking medicine or other drugs or due to having another medical condition (for example, seizures, Huntington disease, or postviral encephalitis).

So simple, so clear, so straightforward.  So why is understanding the person with Tourette so complicated, so challenging, so confusing?  In large part because although it is easy to explain what it “is” it is exceptionally difficult to explain what it feels like to live with it.  Without that understanding, though, it would be incredibly difficult, if not impossible, for teachers and parents to effectively support children with TS.  And this is why…

When you look at someone with TS, all you see or hear, are the tics.  You don’t see the constant struggle, the constant commotion that is going on inside the person’s body.  Although it might be easy to assume that when a person is not ticcing, they are okay or calm or not experiencing anything related to TS, more often than not, that assumption would be entirely incorrect.

What causes Tourette tics?

Although once thought to be an “involuntary disorder”, there is a fair amount of peer-reviewed research that indicates people with TS have “triggers”, both internal and external. However, the triggers are ever-changing and inconsistent over time and even moment to moment. The initial documentation of a TS tic “trigger” was made by Joseph Bliss in 1980 (footnote) in the first-ever layman’s article published in the Archives of General Psychiatry.  His article describes how very slowly, over the years, he came to be aware of the faint signals that preceded a movement.  He described the sudden leap from impulse to movement as ”the moments before a sneeze explodes … almost as uncontrollable as a twitching nerve,” and concluded that the movements are actually voluntary: ”the intention is to relieve a sensation, as surely as the movement to scratch an itch is to relieve the itch.” Although a controversial concept in its time, it is now believed that in fact, most people with TS have “premonitory urges” in which they feel a sensation and then respond to it with a tic, which eliminates the sensation, but only for a fleeting moment when the urge begins again.

What are examples of triggers?

What are some of these triggers?  In addition to constantly changing, they vary person to person. Externally, they can be noises (loud noises but also softer noises like breathing and chewing), crowded places, certain people, unanticipated events, feeling as if someone is staring or talking about them, very cold weather, very hot weather, being physically over-stimulated, being physically under-stimulated, sitting for long (or even short) periods of time, being touched, certain foods, clothing, and smells, and so much more.  Internally, it can be hunger, over-eating, being tired, not having a specific task on which to focus energy, illness, injury and over-sensitivity to internal sensory input, to name just a few.  Although knowing what triggers a child’s tics can be helpful, for some children it is nearly impossible to figure out what they are, and some cannot be controlled regardless.  Therefore, as a start, it is essential for parents and teachers to gain a solid understanding of what Tourette feels like to the person living with it:  Joe Bliss’ concept of the Premonitory Urge.

What are Premonitory Urges?

Before a tic occurs, most people with TS feel a build-up of tension at a specific site within their bodies. Multiple “tension sites” can occur simultaneously.  This “tension” has been described in multiple ways such as an itch, a tickle, a punch, a storm, fullness, an ache, tingling, burning, and a feeling that something is not “just right.”  Once that feeling hits, the need to tic is extremely strong, analogous to holding in a sneeze or how it would feel if someone held their eyes wide and were told not to blink.  Although some people can control tics for periods of time, most people feel that if they don’t tic when they get the urge, that they will “burst” or get that feeling like they want to jump out of their skin. Even when tics are suppressed, eventually they need to be let out, creating a “tic storm” that can be painful, embarrassing, and create missed learning and/or social opportunities.

What is an example of a child with Tourette Syndrome?

So, let’s think about this in the context of a school setting.  Young Danny, aged 10, has Tourette. He was diagnosed at 5 and currently has no other diagnoses. However, over this past year, his parents are concerned about symptoms that look like anxiety and depression. They have also noticed that he is much more irritable when he gets home, than he has been in the past. He is a bright boy, with no learning disabilities but is not doing well in school.

Danny gets on the bus and sits with his friends. As they are talking, he feels an urge to lift his shoulders. It’s all he can think about and decides that a little shoulder movement isn’t going to cause attention to him so he does that tic and for a few moments he feels relief.  Then, he feels pressure building up in his arms and knows that if he tics, there is a chance he will punch the seat in front of him so instead of succumbing to the feeling, he focuses on tightening his arms, hoping that the feeling will go away. And it does until he exits the bus, but for the rest of the bus ride, all Danny can think about is squeezing his muscles as the tension build-up is getting stronger and stronger.  So much so that he has no available resources to talk to his friends.

As he exits the bus, he can no longer control the urge in his arms and is also aware of pressure building throughout his body. He stands still so he can fling out his arms, jerk back his head, and make a loud grunting noise.  It only takes a couple of seconds and when he is re-composed, he is acutely aware of 2 girls standing near the school door, laughing and pointing.  Danny feels a sinking feeling but is used to this, he ignores it, walks into the school, and starts to feel the premonitory urges build up once again.  As he heads down the hallway he wonders if there will be a lot of kids by his locker. He knows that if there are, it could set off his tics again if they get too close or touch him. If he’s touched on his left shoulder, he needs to touch his right shoulder. The closed in feeling will increase his urge to tic. Just the thought of this, combined with not knowing what to expect, starts to make him feel nervous. As he is reaching his locker, he sees only 2 boys there and feels some relief, but then all of a sudden he is aware of building tension in his mouth and throat and before he knows it he lets out a shriek. The kids turn and he feels humiliated. But, he knows if he doesn’t hurry up he’ll be one of the last people in the classroom, and walking into a crowded classroom increases his urge to tic, so he ignores the stares and continues to his locker.

Once in the classroom, Danny is continually assessing the situation.  It’s a constant effort of managing and mediating situations, both internal and external.  “Do I tic now so I can alleviate the pressure because if I don’t it will be more embarrassing later on?”.  “Should I go to the nurse and say I’m sick because I know that having to be in a quiet library will set off my tics?”.  “Will my teacher make me work with the kids who were just making fun of me? If so, I know I’ll be nervous and my tics will increase.  That will make  the whole day bad and it’s only 9:00 a.m.”   “If I go to the library I can try to hold in the tics but that’s not a good long-term strategy because then they’ll all come tumbling out in Social Studies. But maybe it’s worth it because the worst place to tic is in a quiet library.”  All the while, Danny is trying to listen to the teacher, trying to suppress some tics, but still ticcing, and then trying to ignore the stares and murmurs.  Now it’s 9:30 a.m. and he can’t wait to go home and take a hot bath because he knows his body is going to be in so much pain from ticcing and his brain is going to be so tired from trying to hold everything together.  “And my mother wonders why I’m so crabby when I get home,” he thinks to himself.

What does the teacher see?

Let’s look for a moment at the same situation from the teacher’s perspective.  She sees Danny walk into class seeming okay because he’s not ticcing. Of course she has no idea that already twice he’s been embarrassed by his tics, been laughed at, and that his arm and shoulder muscles are hurting from trying to contain the tic.  She notices a few tics but since they are slight shoulder and hand tics and a couple of eye blinks she again assumes he’s doing okay. Then, as she is talking about the group project she notices that Danny doesn’t seem to be listening.  She wonders why such a smart boy always seems to be daydreaming. She calls out his name and tells him to pay attention, which he does immediately.   Then, as they are lining up for library she commends him and tells him she is proud of him for controlling his tics.  “If only my teacher knew how much effort it takes, how stressed I am all the time thinking about it, and how tired and bad about myself I feel by the time I go home. If only she knew that when I say I have to go to the bathroom it’s really because I want to release my tics. If only she knew how much the comments and stares bother me. If only she knew that the reason I have trouble starting my work is because the pencil on my paper needs to feel “just right” or I’ll need to erase and start over again. If only she knew that the reason I stop working so much is because my socks don’t feel right and I have to adjust them until they do.  If only she knew.

As seen above, TS causes a constant struggle between the mind and the body.  Ticcing is no different than blinking or scratching an itch.  No one WANTS to tic, yet the urge becomes so strong it is virtually impossible to block it.  If the child controls the blinking, it might come out in squeaking. What’s better, what’s worse, when to do it?  The mind of a Touretter is constantly navigating a body that is out of control.  It’s annoying, discouraging and, at times, self-defeating. And, most bodies with Tourettes usually have additional disorders with which to contend.  So, Danny’s scenario was really quite “tame” as compared to most kids with TS. The tics are just the tip of the iceberg.  Add on ADHD, OCD, Depression, and/or Learning Disabilities and the “perfect storm” is created.  Put that child into a class where the teacher, understandably, has a difficult time knowing how Danny feels, alongside kids who either make fun of him, are scared of him, get annoyed with him, or “put up” with him at the risk of losing other friends who think Danny is “weird.”  Layer on top of that parents who are worried about their child, don’t feel like anyone else understands them, becomes alienated from friends and family, is frustrated by the notes home from school wondering why Danny can’t finish his homework (well, if he can’t finish it during the day he’s probably not going to be able to do it at home, either), frustrated with the lack of medical options, and feeling so guilty and so bad for their son who comes home every day with sore muscles, an exhausted mind, and feeling very beaten down.


  • Illinois Tourette Resource Network This group provides 3 support group meetings a month, monthly family activities, adult activities, online support, and workshops. They also provide speakers, teacher in-services and peer in-services.

Bliss, J. “Sensory experiences of Gilles de la Tourette syndrome.” Archives of General Psychiatry 1980; 37: 1343-1347.

About the Author: Shari was the 3rd person in IL to be diagnosed with Tourette Syndrome (1976). Her parents co-founded the IL TS chapter along with several others, including Joe Bliss. In 1978, while at a board meeting in her parent’s home, Mr. Bliss told Shari about his theory of premonitory urges and provided some tips and tricks on how to control the tics. It was the first time Shari felt “understood” and attributes much of her success to Mr. Bliss and his strategies. She co-founded the Illinois Tourette Resource Network in 2014 and is honored that she can continue the legacy of providing TS support to the Illinois community.


A Teacher’s Guide To Helping Students Of All Ages With Handwriting

Handwriting is a very important skill that can affect a child’s ability to learn, keep up with class, and ultimately express themselves. However, learning and honing that skill can be a stressful experience, for students and teachers alike. There are many factors that affect this (assumedly simple) skill of writing. The position of the paper, chair, and desk along with the paper and pencil used all can positively (or negatively!) affect a student’s writing. Below are suggestions to help make children of all ages beautifully legible writers!

Handwriting for Students Ages 5-6:

  1. Make it a (fun!) multi-sensory experience: Learning letters can be difficult (how to formA Teacher's Guide To Helping Children With Handwriting them, which direction they face). Help children learn with more than just their eyes by practicing letters in shaving cream, sand trays, gel-filled bags, Play-Doh, and Wikki Stix. Using songs can help as well!
  2. Teach uppercase letters: Children’s brains at this point are made for learning how to draw shapes, followed by uppercase letters. If children learn lowercase too soon, they may be forming them inefficiently, which could affect their legibility and speed later on.
  3. Check formation: Formation of letters (i.e. where to start and stop writing letters) is important for efficiency, especially when kids will be learning lowercase letters in the near future. Imitating the teacher writing a letter a certain way is also a great visual motor integration activity that is good for their sequencing of movements and attention to task.
  4. Use thick utensils (ages 5 and younger): Pencils can be difficult for these young ones to hold on to without an adaptive gripper, so give them the thick markers and crayons to help develop those hand and finger muscles needed for holding pencils when they get a little older.

Handwriting for Students Ages 6+:

  1. Use a writing checklist: This can be a list you and your students make for what to remember when writing (e.g. capital letter at the beginning of a sentence and names, punctuation, are my letters on the line? etc). This is a great tool to help students self-monitor their writing and know what is expected.
  2. 90-90-90: This refers to the ever-important 90 degree angles of the ankles, knees, and hips. Make sure your students are able to sit at their desks in this position, so they have the right amount of proximal stability to allow their arm and hand do he intricate fine motor movements required for writing at the end of their pencil.
  3. Check the position of the paper: For right-handed students, make sure the paper is tilted slightly up to the right, and the opposite goes for left-handed writers. This gives kids the optimal angle for their arm and wrist for writing smoothly. Also make sure they are stabilizing the paper with their non-writing hand.
  4. Type of paper: Some students may have difficulties with visual-motor integration or visual perception, which could make writing on standard wide-ruled or journal paper difficult. If the student’s spacing between words and/or sizing of letters are poor, try having them skip lines or give them triple-lined paper (with the dotted line in the middle) to help with overall legibility.
  5. Grasp (ages 5-7): Children ages 5 and up are expected to use a dynamic tripod grasp on their writing utensils (pads of the thumb and index finger on the pencil, pencil resting on the last knuckle of the middle finger). If your students have something other than this that seems to be affecting their writing and they are 7 or younger, it is not too late to change their grasp to help with legibility. Using a pencil gripper or a referral to an occupational therapist might be warranted.
  6. Environment: Help make the environment conducive for writing by limiting distractions. This could be anything from helping a visually distracted student move to a desk that faces a blank wall, or allowing a student block out auditory distractions use noise-canceling headphones. Give a particularly wiggly student a structured movement break during long writing assignments (e.g. at 1:10 you can go get a drink of water).

If you have students who continue to have great difficulty with writing, an occupational therapy evaluation may be appropriate.

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

reinforcement and punishment in the classroom

Using Reinforcement and Punishment at School

Classroom management can be a very challenging part of teaching. Keeping 20-30 students calm, engaged, and motivated to learn is no easy feat! For optimal learning, it is necessary for the teacher to have the student’s behavior under control. It is also important for students to be given clear expectations so they know exactly what behaviors are expected in the classroom. Just as the principles of reinforcement and punishment can be utilized in the home, they can also be used to help with the management of behaviors at school.

Using Reinforcement in the Classroom:reinforcement and punishment in the classroom

Reinforcement is a consequence following a behavior that increases the probability that the behavior will increase in the future.

In addition to keeping behavior under control, reinforcement in the classroom should be used to keep students engaged and motivated to learn. Teachers should use reinforcement often in order to maintain a positive learning environment and to promote appropriate classroom behaviors.

Examples of reinforcers that can be used in the classroom include the following:

  • Teacher praise
  • Earning privileges
  • Teacher attention
  • Taking away a homework assignment
  • Extra recess time
  • Extending a deadline

Using Punishment in the Classroom:

Punishment is a consequence following a behavior that decreases the probability that a particular behavior will occur in the future.

Punishment should be used in the classroom to decrease undesirable behaviors. Punishment in the classroom needs to be implemented with care, and should never be used to single students out or to punish behaviors that are due to a specific disability. If a particular student has challenging behaviors as a result of a disability, it is important to seek additional assistance so a behavior plan tailored to that child can be developed.

Generally, reinforcement should be the primary strategy utilized in the classroom, but if punishment is necessary, it should be the least restrictive type of punishment. Before implementing any punishment strategies, it is important to check with your school’s policy on appropriate classroom management strategies and what is and is not permitted in your specific school.

Examples of punishments that have been used in classroom include the following:

  • Loss of recess time
  • Extra homework
  • Loss of other privileges
  • Detention

Examples of more restrictive and inappropriate punishments include sending a student to a solitary time-out room and missing lunch or snack.

Many teachers use classroom-wide behavior management systems that utilize both reinforcement and punishment. These systems are very popular in many classrooms because they can be easy to implement and the students know exactly what is expected of them.

Classroom-wide behavior management systems that utilize both reinforcement and punishment:

  • Stoplight Management System: A large stoplight with green, yellow, and red is placed in the classroom along with moveable buttons or clothespins with each student’s name. The students begin each day on green, but depending on their behavior can move to yellow or red. At the end of the day the students who are still on green receive some type of reward or privilege.
  • Token Economy: A behavior change system where students earn tokens for engaging in specific behaviors and then at a specified time, can exchange those tokens for desired items.
  • Group Contingencies: These types of contingencies occur when one consequence is delivered based on the behavior or performance of either certain students or all of the students in the classroom. There are three different types of group contingencies.
    • Independent group contingency: A reward is available to all of the students in the classroom, but only students who meet the specific criteria earn the reward.
    • Dependent group contingency: The reward for the entire group is dependent on the behaviors or performance of one specific student or small group.
    • Interdependent group contingency: All of the students in the classroom are required to meet the specific criteria (both individually and as a group) before earning a reward.

Read our other blogs on reinforcement and punishment:

prep your child's teacher to help your child with ADHD

How to Prep Your Child’s Teacher to Work with an ADHD Diagnosis

To start the school year out right for your child with and ADHD (or other) diagnosis, it is important to establish a close collaboration between you, your child’s teacher, any professionals of the treatment team, and your child!  Here is how you can prepare your child’s teacher to best understand your child’s needs to get off to a great start this academic year.

10 tips to prepare your child’s teacher to best help your child with an ADHD diagnosis:

1. Request to set up a meeting at the start of school year.

2. Get an idea of what your child’s teacher knows about ADHD and his general attitude towards ADHD. Some teachers may be more or less informed about ADHD, as research and diagnostic criteria has changed quite a bit over the years.
3. Inform the teacher of your child’s ADHD diagnosis (or other diagnosis), if he is on any medication or if you chose an alternative treatment method.

4. Find out what the culture of the classroom is like:

  • Structure: Is the daily schedule posted?  Does the teacher request frequent “brain breaks” during the day?
  • How does she describe her teaching style?
  • Rules & Expectations: Are there visual reminders posted around the room? What is the reward system? Incentives? Token System?  Nature of the homework assignments? Seating arrangements?
  • Can your child sit facing the front and close to the teacher?

5. Discuss the best way to contact one another (i.e. via phone or email).
6. Discuss if any notes home or behavioral report cards are necessary or how often?
7. Pass along any recommendations to your child’s teacher that she can implement that you have found helpful  for your child.


  • “Jake does well when given one command at a time versus following multiple steps at once.”
  • “At home, we have found that having Jessica repeat back directions or rules, helps her to be more accountable.”
  •  “We use the token system at home and Sam seems to do well with it when we are consistent.”

8. Be supportive and open.

  • Assist the teacher in any way by being supportive and open to suggestions he or she may have.
  • Let the teacher know you want to work as team to make it a successful year for everyone.

9. Offer Praise and appreciation: A positive attitude with your child’s teacher creates a stronger relationship with all involved!

10. Request to set up a follow-up meeting to check-in : This could be half-way through the school year or sooner depending on the needs of your child.

Click here to read about self-regulating strategies to help children with ADHD.

Child getting tutored

What Makes A Good Tutor?

It is quite common for a child in elementary school and junior high school to have an academic tutor. Parents often ask us what we recommend for a tutor. What characteristics, what training is needed, etc. It is impossible to give a patented answer for these questions. The characteristics and qualities of the tutor really must be dependent upon the concerns presented by the child.

If a child presents with a learning disability such as dyslexia, it is vital that the tutor have specialized training in an intervention for that issue. Remedial support to keep the child ‘afloat’ in class simply will not cut it. If the tutor indicates that they utilize a specialized approach to tutoring, parents should always ask the individual if they are certified in that approach. The certification will at least provide the bare minimum standards that the individual received quality training.

If the child does not present a learning disability but is struggling with learning concepts and material in the classroom, it would be recommended that he or she work with a tutor that actually knows the curricula. The first place the parents should turn is the school. Many times teachers within the school provide outside tutoring or at least the school can provide a list of tutors that they would recommend.

If the main concern is a nightly battle between the parents and the child, I have made the recommendation of hiring a high school student to come and spend an hour or so a day with the child to help with homework. This way the stress of battling with your child is taken away.

Packed tutoring programs may be beneficial for retention of skill sets. These might prove best to be implemented over the summer.

Overall, the type of tutoring and amount of intervention needed truly depends on the child as well as what the concern and need for intervention is.

Math Disability Strategies and Resources

Is your child struggling with math?  Do they have a hard time memorizing basic math facts, solving word problems or making sense of equations?  Approximately 3-5% of school-aged children are estimated to have a Math Disability.  With evolving teaching practices, electronic applications and online resources your child should not have to suffer without help.  The following can help your child become more successful and confident in math:

Math apps and online programs:

Classroom-based accommodations:

  • Graph paper to help with organization.
  • Use different colors for columns in solving equations (e.g., green is where to start, etc.)
  • Chunking can make an unmanageable amount of work manageable.  Play with the presentation of problems and/or break assignments into smaller pieces.
  • Teach common words in problems and create a list to refer back to.
  • Break down problem-solving into steps and do not proceed until a step is mastered.
  • Create a visual reminder for solving equations.

Incorporate multisensory techniques:

  • Make your own flash cards, each one unique.  Review two or three of the most troublesome at a time and fold in with new problems.
  • Clap while counting.
  • Use manipulatives for visual, hands-on learning.

For more information about Math Disability and its remediation, please visit:  For information about your child’s rights and standards in public education, please visit:

How Do I Know if My Child Has a Reading Disability?

Reading Disabilities are estimated to occur at a prevalence rate of 5-10%.  A disability, which is a more chronic struggle with reading without early identification and intervention, must be differentiated from the child who demonstrates a slower process in the normal developmental curve of reading development.  A disability will not resolve with repeated practice, extra attention, or the passage of time.  Below are a few clues to help figure out if there really is a disability.

Clues that Indicate Your Child May Have a Reading Disability:

  • Your child has difficulty with basic rhyming.
  • Your child has always been slow to learn the alphabet and maybe even numbers.
  • Your child struggles with sound-letter associations.
  •  Your child’s writing is illegible.
  • Your child likes to be read to but never wants to read.
  • Sight words, despite repeated practice, are easily forgotten by your child.

At times, differentiating between a disability and other factors (e.g., attention, motivation and interest, or behavior) can make accurate identification difficult.  An evaluation can help tease apart any related factors that may be impacting your child’s success.  If you are concerned with your child’s reading development, you can request an evaluation through our Neuropsychology Diagnostic Clinic.  We have clinicians trained in the diagnosis and assessment of reading disabilities and are able to provide efficacious recommendations to best help your child.
Click here to read about signs of a reading disability across grades.

How to Explain a Language Disorder to a Teacher

Of all the categories available under IDEA law, language impairments are often one of the most difficult to understand. It is not a surface level issue and is often lost in the shuffle. Explaining what a language disorder is and how it will impact your child to a teacher can be tricky. Here are some tips.

How to Explain a Language Disorder to a Teacher:

  1. Language disorders come in a wide variety of cases. Each child will present differently and as an advocate, you need to do your best to describe your child’s needs specifically. Language disorders can impact a child’s ability to verbally express themselves efficiently, effectively and with appropriate grammar. It can result in difficulty understanding sentences, following directions, asking/answering questions or in a number of other impairments.
  2. Enlist the school Speech Language Pathologist. Ask for help in explaining the disorder to the teacher and ask for ideas. Discuss options for adjustments and supports for your child like a visual schedule, repetitions of the directions or having him repeat the direction back to the teacher to ensure comprehension. Many school districts or state programs have materials and resources that can educate teachers on strategies to ensure better classroom learning.
  3. Remind the teacher to notice how your child interacts socially. Teachers will be able to identify a child that is isolating themselves from peers secondary to trouble communicating with them.
  4. Discuss the difference between listening, understanding and attending. One of the biggest complaints of teachers will be “He’s not listening to me!” As often as not, your child does not understand the direction provided and is not complying simply because he does not know what is required of him. It can be very frustrating to have difficulty communicating effectively and patience will go a long way.
  5. Know your child’s IEP or 504 plan and take the opportunity to discuss it with the teacher. Be specific about the types of services and accommodations he will receive and what they will look like in the classroom.

Remember, be proactive and provide as much information up front about your child and his diagnosis to avoid potential difficulties. Refer to this page from the National Dissemination Center for Children with Disabilities for 8 Tips for Teachers who have students with speech and language issues in the classroom.