Learning Disabilities Demystified

Learning concerns are one of the most common neurological issues with which children and adolescents present.  It has been estimated that approximately six percent of the general population meet the clinical criteria for a diagnosis of a learning disability.  The Diagnostic and Statistical Manual, Fifth Edition (American Psychiatric Association, 2013), which is the guide book for psychologists and psychiatrists that provides information regarding diagnostic information, indicates that there are several essential features of specific learning disabilities in children.

5 Features of Learning Disabilities in Children:

  1. Persistent difficulties learning basic foundational academic skills with onset during the early elementary years.  The manual indicates that these foundation academic skills include: reading of single words accurately and fluently, reading comprehension, written expression and spelling, arithmetic computation, and mathematical reasoning.
  2. A child’s performance is well below average for his or her age.
  3. Learning difficulties are readily apparent in the early school years in most individuals.  That being said, there are some instances in which the concerns are not fully evident until later in the individual’s academic life.
  4. The learning disorder is specific in that it is not attributed to other factors such as intellectual disability, socio-economic status, medical conditions, or environmental factors.
  5. The deficit may be restricted only one academic skill or domain.

Prior studies have indicated that learning disorders are more common in males than females.  There are several long-term consequences associated with learning disorders in which the individual never receives any intervention, including:  lower academic achievement, higher rates of high school dropout, higher levels of psychological distress, higher rates of unemployment, and lower incomes.
Data has indicated that children with learning disabilities are often at risk for a variety of co-existing conditions including ADHD and social-emotional concerns.  Click here for more information on learning disabilities.


The Sleep Discrepancy: How Much Sleep We Need and What We Actually Get

Sleep is incredibly vital to our everyday health.  The questions of why we sleep and in the manner we do (consolidated to approximately eight hours) has been accumulating and theories surround its “cleansing” and “restoring” properties have been coming to light.

Theories on Why We Sleep:

One theory suggests that sleep helps to clear our brains of unwanted toxins (Xie, L., Kang, H., Xu, Q., Chen, M., Liao, Y., Thiyagarajan, M., O’Donnell, J., Christensen, D.J., Nicholson, C., Iliff, J.J., Takano, T., Deane, R., & Nedergaard, M., 2013).

An additional theory hypothesizes that our brains have a limited capacity based on a 24-cycle which can only be restored through sleep (Nauert, 2010).  So, if we fall short an hour or two every night, you can imagine the cumulative effect on our cognitive functioning!

Why Are We Sleeping Less Than Before?

Nonetheless, the fact remains that we are all getting fewer hours of sleep than in generations before. Why?  Reasons can be explained by our longer work days that often continue well beyond the time we arrive home, easy access to distracting (albeit entertaining) modes of technology, more events and activities to attend, and an increasing academic workload for junior high and high school students, to name a few.

How Much Sleep Do We Really Need and How Much Are We Actually Getting?

In the school years (6-12), the recommended duration of sleep is between 11 to 12 hours.  Yet the incidence of sleep problems may be as common as 30-40% in children at any one time (Fricke-Oerkermann, L., Pluck, J., Schredl, M., Heinz, K., Mitschke, A., Wiater, A., & Lehmkuhl, G., 2007).  While likely to be transient and not in need of professional care, when the problem is persistent and clearly interferes with the child’s functioning, intervention is warranted.  It is best to begin with your pediatrician who can determine whether Melatonin (an over-the-counter supplement with sleep-enhancing properties), cognitive-behavior therapy, and/or a sleep study to rule-out medical conditions are warranted.

What About Teens and Sleep?

As I have mentioned in my previous blog: Teens and Sleep-How Technology Plays a Role in Restless Nights, adolescents are notorious for their poor sleeping habits and insufficient sleep.  While it is recommended that teens get 9 to 9.25 hours of sleep per night, the reality is closer to 7 hours on weekdays and 8.5 hours on weekends.  Clearly, these teens are not “catching up” on non-school days, creating an ever-increasing cumulative deficiency.  If you suspect that your teen is struggling with optimal sleep and is being negatively impacted as a result, first consider whether environmental factors (e.g., late-night cell phone use, late-night homework and study sessions, overscheduled nighttime activities, etc.) may be contributing and could be adjusted to make sleep a priority.  When this is not successful, recommendations are similar to those for school-age children and include speaking with your pediatrician about effective treatment options (Melatonin or other sleep-enhancing agents, cognitive-behavior therapy, and/or a sleep study to rule-out medical conditions).

To Summarize:

The fact is that our society is one that values hard work, grueling academic schedules, and an abundance of extra-curricular activities, which ultimately end up harming us when it comes to sleep.  It is time for the focus to be placed on sleep once again so that we are in a position to raise healthy adults who will pass on this wisdom.

Need help getting your family’s sleep on track?  Meet with our sleep specialist.

Teens and Sleep: How Technology is Playing a Role in Restless Nights

We are all familiar with the marked increase in media usage and availability over the last 10 years.  From televisions and computers to cell phones, iPads, and hand-held videogame devices, we all use technology.  All the time.

While we cannot argue with the convenience of these technologies, not to mention their entertainment value, there is a downside when it comes to our sleep.  In the sleep world, we call these devices “sleep stealers” because, as their name implies, time spent using these devices at night robs us of the optimal duration of sleep we really need.

Teens are frequently the subject of studies on this topic.  Likely because not only is a great deal of their lives are spent socializing but, let’s be honest, teens hate to go to bed early.  And, to some extent, rightfully so. There is an actual phenomenon of the sleep-wake cycle shifting in adolescence toward a later sleep time.

How Does Technology Use Affect Teen’s Sleep?

But nighttime technology use only adds to the struggle to get teens sufficient rest.  Recent studies revealed that 20% of teens are texting and 17% are making calls between 12am-3am.  20% are awoken in the middle of the night from an incoming text at some time, 9% several times per week, and 3% every night (van den Bulck, 2003, 2007).  If you add up the hours of lost sleep over the week, the result is staggering!

Aside from the obvious outcome of delaying sleep onset, what are the other effects?  Evidence shows that excessive nighttime technology use (>2 hours) can lead to increased arousal (cognitive and physiological), circadian rhythm disruption due to bright light, and decreased total sleep time (Cain & Cradisar, 2010).

So, what can you do to help your teen get the sleep they need?

  • Make it a house rule for everyone to put their technology in a designated place outside of the bedroom (e.g., the kitchen counter) prior to bedtime.  If children see that their parents are willing to adopt this practice, they may be more accepting of the routine.
  • If excessive nighttime technology is a problem and your teen is reluctant to give it up, pick an alternative nightly activity that can be done as a family, such as playing games, talking about the day, reading, etc.
  • Some teens and adults do need the television to fall asleep.  While I would not recommend someone starting this, it can be a difficult habit to break.  If this is the case, it is best to set a timer on the TV to automatically turn off after 30 minutes.  This will prevent night-time awakenings from noise and light.
  • Talk about the importance of sleep and make it a priority for the whole family.  If teens are aware of the negative impact that lack of sleep can have on their functioning (decreased attention, increased emotionality, weight control problems, etc.), they may be more motivated to make a change.

Read here for more strategies to help your teen make good decisions.

Who’s putting the “Work” in “Homework?”

Many parents can relate to the struggles that homework can create each and every night. Although, at times, it may seem more frustrating than anything else, homework provides an opportunity to practice and integrate what your child has been learning. It also lets the teacher see how your child is doing…so resist doing it for him! 

What is your role as the parent during homework time?

Your child has a better chance of being successful during homework time if he feels you are interested in what he is doing. It lets him know that what he is doing is important. You can show your support by doing the following:

  • Demonstrating organizational skills
  • Doing your own work with them (i.e. paying bills, reading, etc.) Read more

My Child has a Significant Other, Now What?

Childhood dating can look many different ways. Two five-year-old children may hold hands and think that they’re married. Two children in sixth grade may be ‘dating’ and be chaperoned by parents to a PG movie.  Another two children, teens in high school, may be kissing in cars. If you suspect that your child might have a significant other of some sort, it can become a question of “What do I do about it?” There is no black and white answer to this question, however read below for some tips on ways to approach your child if you feel that they might have a special someone.

Tips to talk to your child about her significant other:

  • Ask her in a calm, straightforward manner, “Do you have a special someone (boyfriend/ girlfriend)?” Avoid snooping around; it can only cause stress and problems with trust and communication. Asking your child this question in a calm and straightforward manner can increase the chances of having a calm and straightforward conversation about it. If you sense, or if your child says, that she is not ready or wanting to talk about it, let her know that you are here to talk about it if she wants to.
  • If she opens up and lets you know there IS a special interest or person in her life, ask her if she has any questions.  Crushes, dating partners etc., especially when new, bring on a lot of emotions: anxiety, worry, and also excitement. Letting your child know that the door is open for her to ask you questions and share her feelings will help her navigate her relationship in a healthier and more confident manner. Your child will feel comforted by the fact that you are open to talking to her about it, whether or not she chooses to ask you questions and share her feelings. This in turn will make her feel greater confidence when making decisions and interacting with others, and her special someone.  Read more

Tips for Improving Your Child’s Social Skills

Why don’t they just get it? When it comes to appropriate social interactions, it can be surprising when a child does not innately posses the tools and skills to foster successful conversations and peer relationships. This should not be alarming, as social skills can be acquired like any other skill; we all go to school to learn math and science, and without assistance one might not understand these concepts. Social skills function the same way – without education and practice, children may struggle in social situations.

It is important for children to understand the rules of language (e.g., using language, changing language, and following rules) in order to succeed in various social environments. Using language comprises greeting (“Hello”), informing (“I am watching TV.”), and requesting (“Can I watch TV?”). Children also need to learn to change language, depending on the environment. Children will adjust their message depending on their needs, the needs of their communicative partner, the age of their partner (e.g., talking to a baby differently than talking to your principal), and based on their environment (e.g., yelling on the playground is acceptable, however yelling in the classroom is not). Children will learn to follow the rules of conversation as well, including taking turns, staying on topic, reading verbal and non-verbal cues, and understanding personal space boundaries. If your child is struggling with any aspect of social language, the tips below can help!

Tips for Improving Your Child’s Social Skills:

  • Ask questions: Model how to ask peers or adults questions. Examples may include the following: asking how someone’s day is going, asking likes/dislikes, or asking communicative partners to elaborate or repeat phrasing in order to aid in listener understanding. Utilizing these strategies will help children better interact in social situations.
  • Answering questions: Talk with your child to help him learn that answering questions can help further a conversation and will allow for the back-and-forth flow of an interaction.
  • Topic maintenance: Children will often change the topic to something of interest to them. Help your child practice topic maintenance skills by each taking turns picking the topic and see if you can each make 5 questions/comments for a non-preferred topic.
  • Role playing: Pretend that you and your child are in different social situations and adjust your tone of voice, volume, and message based on each scenario. Different scenarios include talking to a teacher, explaining a favorite game to an adult, asking a peer for help with homework, ordering in a restaurant, and not getting your way.
  • Non-verbal skills: Alter your non-verbal skills when your child is telling you a story. This will help your child to pick up on signs of confusion, frustration, boredom, and anger. Explaining that non-verbal skills are integral parts of social interactions can help children to learn to maintain eye contact and use whole-body listening.

For further information, please read Social Skills: Improving Social Skills to Enhance Socio-Emotional Health or click here for more information from a licensed speech-language pathologist or a licensed clinical social worker.

Co-written by Ali Wein

How Does Occupational Therapy Help with ADHD?

It has been well documented that children with ADHD often struggle with maintaining focus in various areas of their day to day lives and consequently achieving their full potential. As Dr. Greg Stasi explains in his June blog, ADHD and Learning: Attention Deficit Hyperactivity Disorder’s Impact on Learning, children with ADHD often exhibit impulsivity or hyperactivity, difficulty with following directions, and poor executive functioning skills. The impact of these difficulties can be extensive on a child’s success in school, relationships, and overall self esteem.

How does occupational therapy help a child with ADHD?

Occupational therapists often work with children to help them develop self-regulation and executive functioning skills. By teaching children strategies to address these challenging areas, we empower them to become more independent and self assured by targeting two important areas: Read more

Social Thinking: Improving Social Skills to Enhance Socio-Emotional Health

What is social thinking?

Social thinking is what we do when we interact with people. For successful social interactions, it is important that the individual take in and process information embedded in both verbal and non-verbal cues and process how to effectively respond based on the context and topic of presented material. Joint attention, knowledge of expectations regarding behavior, and mental flexibility are all key components for appropriate social relationships.

What happens when social skills are impaired?

When a child has difficulty with focus, understanding the context of the environment around them, and lacks knowledge of how their behaviors make others feel, social thinking may be impaired. Social skills deficits can have profound effects on your child’s academic performance, feelings about self, ability to connect with others, and ability to achieve desired wants and needs. Read more

Socialization Concerns in School

Many times there is an over emphasis on the academic aspects of a child’s school day.  Now, of course, academics are vital and should be put on the forefront in school.  However, what is just as important is the child’s social and emotional functioning.  Unfortunately these are often domains that are left unnoticed until they become a major problem with a child’s day-to-day academic achievement.  It is important that teachers identify any possible socialization or emotional concern that one of their students may be exhibiting, prior to it becoming a major concern for that student’s daily academic life.  Teachers should be on the lookout for various warning signs regarding socialization or emotional concerns.

Warning signs for social or emotional concerns:

  1. The child prefers to be by himself at recess.
  2. There is an increase in argumentative or oppositional behavior.
  3. The child ‘avoids’ or ‘escapes’ certain classes and situations by repeatedly going to the nurse or bathroom.
  4. The child appears more irritable or becomes easily frustrated.
  5. The child cries easily.

Many children will engage in a variety of the above behaviors at some time, and just because one or two of them appear, it does not mean that there needs to be a rush to intervention.  However, if a teacher does notice any of the above behaviors in a child, it is definitely recommended that he or she bring up this information to the child’s parent.  The parent may be able to provide some insight as well as help the child attain some needed interventions.

A Primer for Parents on Individual Education Plans

One of the major concerns that parents face when they have a child with special needs or neurodevelopmental concerns is working with the school system in order to ensure that the child receives the best accommodations and interventions to help him or her perform to the ultimate potential.  There is legislation created that provides parents and children support and services in the school system.  The main piece of legislation that guarantees certain provisions for children with neurodevelopmental disabilities is the Individual Disability Education Act (IDEA), which had its most recent revision in 2004.  This act creates special education services as known today.

The Individual Disability Education Act has a few main components that provide children and families safeguards in the school system:

  • Concept of Zero Reject:  this states that every child, regardless of disability must be educated.
  • Nondiscriminatory Evaluation:  this requires an unbiased assessment of the child be conducted in order to help determine what special education services are most appropriate.
  • Free and Public Education:  this concept ensures the appropriateness of academic placement as well as the provision of services at no additional charges to the parent or guardian.
  • Least Restrictive Environment:  the child should be placed within the mainstream classroom as much as possible with accommodations and support. Read more