All You Need To Know About Learning Disabilities

How common are Learning Disabilities?

LD Boy

Learning concerns are one the most common neurological issues that children and adolescents present with. It has been estimated that approximately 20% of the general population in the prevalence rates indicate that 6% of the general population meet the necessary diagnostic criteria for a diagnosis of a specific learning disorder.

How are Learning Disabilities Defined?

There is great debate regarding how to accurate define, classify, and diagnosis learning disorders. Traditionally, it was assumed that a specific learning disorder exists when there is a significant discrepancy between a child’s ability (IQ, cognitive functioning) and achievement (performance on standardized reading, mathematics, and written expression tasks). However, there have been recent changes within the USA regarding how to classify and diagnosis learning disabilities. Currently, categorization of a child’s learning disability is based upon a multi-tiered process involving early identification and intervention. This multi-tiered process based approach is labeled Response to Intervention (RTI).

What are the Pros and Cons of RTI?

Researchers who are in favor of the RTI Model of learning disabilities argue that a combination of interviewing and behavioral observations are sufficient for identification of problems as well as to determine appropriate interventions. The RTI Model is most beneficial for children who have emotional or behavioral disorders that result secondary from a defined environmental factor, such as: inappropriate or inconsistent reinforcement or punishment. Read more

Vaccines and Autism: Science or Hoax?

Boy getting vaccineThe controversy surrounding the relationship of common childhood vaccines and autism has been raging for nearly two decades. However, the debate is comprised of about 10% science and 90% politics and media exposure. In the wake of the most recent revelation that Andrew Wakefield, MD, the original author of the 1998 article linking autism to MMR vaccinations falsified medical history on nearly all of the patients that comprised his study http://www.cnn.com/2011/HEALTH/01/05/autism.vaccines/index.html, many families are left to wonder if they can really trust any medical advice. The impact of Wakefield’s article has done egregious harm to the general health of children worldwide. While the article was ultimately retracted by the publishing journal and Wakefield himself was stripped of his medical license in May of 2010, many countries noticed a precipitous drop in childhood vaccinations in the past decade. Surges of measles outbreaks rose in the aftermath and the CDC reported that 90% of the outbreaks in th US of measles were in children not vaccinated.

In addition to the impact on general medical care for children, popular media sources were quick to raise concerns about the safety of childhood vaccines and the preservatives used in them. With the most recent revelation that the original data may have been fabricated, many parents wonder if there is any way to make a reasonable decision about vaccinations.

The Relationship Between Vaccines and Autism

There is some science that families can draw upon. Large scale epidemiology studies are available that shed light into the relationship of vaccines and autism. In my own practice, I tend to rely upon studies that track live births over long periods of time in several geographic regions. For example, the city of Yokohama, Japan decided to terminate their MMR vaccine program that ran from 1988 to 1993 and institute an alternative program. With the new system, the rates of vaccinations fell to under 2% of the population between 1993 and 1998. This rapid change provided an ideal model to study the rates of autism since essentially the MMR vaccination rate dropped to nothing. Results from the study indicated that autism rates rose dramatically during the 1993 to 1998 time frame and could obviously not be attributed to MMR vaccines (Honda, Shimizu & Rutter, 2005). Studies conducted in Denmark (Madsen et al., 2002) and the UK (Smeeth et al., 2004) also demonstrated no relationship between autism rates and MMR vaccinations. Read more

Is Toe Walking Normal?

child on tiptoe.It is not uncommon for toddlers to walk on their toes or on the balls of their feet. This practice is often referred to as toe walking, a hereditary condition that may be seen when a child is learning how to walk. It is considered appropriate until the age of two, but if your child continues to toe walk beyond this point, it is important to have him/her evaluated by a physical or occupational therapist.

Toe walking is a common sensory-seeking behavior – children receive intense proprioceptive input to the calf muscle in their legs when they do it. This intensified input helps them to better prepare their bodies for play and learning. However, toe walking may be a sign of other sensory integrative difficulties and should be evaluated by an occupational therapist if accompanied by other symptoms (e.g. decreased eye contact, decreased coordination, or difficulty with gross or fine motor activities).

If your child toe walks occasionally, it may be a sign of a sensory issue. However, a child who consistently toe walks may eventually develop shortened Achilles Tendons (also known as tight heel cords) and should be evaluated by a physical therapist.

Toe walking may be considered appropriate if:

• Your child is just learning to walk

• Your child is under the age of two years old

• Your child can walk with normal gait when you ask them to

Seek professional help for Toe Walking when:

• Your child toe walks past the age of two years old

• Your child toe walks the majority of the time

• Your child demonstrates decreased eye contact, decreased coordination, or difficulty with gross or fine motor activities

Encouraging your child’s speech and language development through the holiday season

You’ve got shopping to do, parties to attend and checklists to conquer. Yes, the holidays have arrived! Amidst the busy schedules and high demands of the season, keeping up with your child’s developmental needs can sometimes feel overwhelming. Worry no more, because the holiday season is filled with natural and enriching opportunities to encourage your child’s speech and language development. So instead of postponing that family getaway or neighborhood potluck, enjoy these parent tips to keep your child learning through the holidays.

Tips to Encourage Speech in Children

Holiday Baby• Take digital pictures during special family events. Whether you’re building a snowman, baking cookies, or packing your suitcases for a getaway, document the adventures! Afterwards, print out pictures and create a construction paper book. Guide your child as you put each picture in order and glue them onto the pages. Talk about what happened. Who was there? Where did you go? What happened first? Encourage your child to share their book with family and friends! Read more

Top 9 Tips For Over-Stimulating Holidays

The holiday season can be a very fun and exciting time, but it can also be overwhelming for some of us and for our kids.  When a child becomes over-stimulated during the holidays, it can lead to stress, anxiety, or behaviors that can make this special time with family and friends difficult.  Here are some tips to help make the holidays more enjoyable. 

  • Make a visual schedule of the events to take place and go over it with your child prior to leaving the house.  This way,  they can better prepare themselves for parties and events.
  • Try to keep their mealtime and bedtime routine as normal as possible. Read more

Potty Training And Autism | The Complete ‘How To’ Guide

potty training rewarded childParents of children with Autism, especially those with more severe challenges like language and sensory issues, often fret about embarking on toilet training. Questions about when to start and how to do it may linger and create anxiety. Also, as a child develops in personality and behavior, they are also changing physically, so it is important to remember the differences among kids and try not to compare your child to others. Your child’s readiness will depend on their own learned skills as well as developmental abilities such as muscle control.

The other half of the toilet training experience depends on the parent’s readiness. It takes time and energy to begin toilet training and may not always be an easy process. However, with some hard work and consistency from the child and parent, it can be done. Remember your goal; having an independent, happy child will be well worth the effort.

Signs that your child is ready to begin toilet training:

• Stays dry for longer periods of time

• Shows visible signs of urinating or having a bowel movement (e.g. squatting, pulling up pants, touching themselves, crossing legs) Read more

Developmental & Fun Holiday Gift List For All Ages!

Holiday gift giving can be tricky to juggle when providing educational toys that also happen to be fun for your children. Here is a list of suggestions that is seperated by Ages, Sensory Considerations and Fine and Gross Motor Skill Development.  girl with gifts

Holiday Toys for Infants (0-1yr)

Gross Motor:

“Tummy time” offers strengthening of the back, core and neck muscles that are critical to a baby’s development. There are many tummy time mats on the market to help this important position be a part of your everyday routine,

Tummy time play mats; $14.99 – $24.99

Fine Motor:

Babies enjoy exploring environments that are filled with music, colors, lights and a variety of textures. Cause and effects toys are great for developing fine motor skills as well as eye-hand coordination such as,

Fisher-Price Little Superstar Classical Stacker (6mos & up); $13.99

Sensory:

Providing infants with teethers and rattles of a variety of shapes, sounds and textures will assist in their exploration of their environment as well as help sooth those teeth coming in. Read more

The Truth About Lying | 12 Ways to Make Sure Your Tween Doesn’t Lie

Below are 12 easy ways to ensure that you will maintain a healthy and honest relationship with your child:

1. Keep communication open. Designate time, every night, when you and your child can talk about the day’s events. Discuss parts of your day at dinner time, bath time, and bed time.

2. Make yourself approachable. If your child is scared of you, they won’t feel comfortable telling the truth about certain things. Make sure you welcome any news with open arms. Mom and Teenage Daughter

3. Be proactive. Discuss the meaning of truthfulness, honesty, and sincerity. Discuss why honesty is important at home, in school and in the community. Teach The Boy Who Cried Wolf principle (a very effective moral lesson).

4. If you catch him/her lying, sit down and have a serious talk. Remove all distractions and give your undivided attention. Tell them you need to understand why they lied, and have them walk you through what happened or what they were thinking.

5. What are alternatives to lying? Share with them what you might do instead of lying and model it for them.

6. Make sure your child knows that you understand them – you’ve been a teenager too. Show them you can relate by making statements that reflect the feelings behind what they’re saying.

7. Give them the right to not tell you everything. What is acceptable to be kept private and what is not?

8. Make sure they are not lying to cover up another serious problem. Explain how this can turn into a vicious cycle and how they can get themselves into even more trouble this way.

9. Insist that your child take responsibility and apologize when it is due. Some children lie for the purpose of avoiding responsibility, so this is an important skill to focus on.

10. Use self-admittance and repentance as your course of discipline if lying is a new problem for your child, letting them know what consequences will follow if the behavior continues.

11. End the conversation on a positive note whenever you can. Is there any part of their decision, action, or feelings that is praiseworthy? Was there any good intention that they could pursue differently next time?

12. If lying becomes serious and pattern-forming, parents should consult with a professional counselor in order to understand and correct the lying behavior.

References: American Academy of Child & Adolescent Psychiatry, November 2004, No. 44

*Blog Disclaimer

North Shore Pediatric Therapy, Inc. (NSPT) intends for responses to the blogs to provide general educational information to the readership of this website; all content and answers to questions should not be understood to be specific advice intended for any particular individual(s).  Questions submitted to this blog are not guaranteed to receive responses.  No ongoing relationship of any sort (including but not limited to any form of professional relationship) is implied or offered by NSPT  to people submitting questions.  Always consult with your health professional first before initiating or changing any aspect of your treatment regimen.

What is DEVELOPMENTAL DYSLEXIA?

DyslexiaDyslexia is one of the more common conditions to affect school age children. It is estimated that between 5 and 10% of children between the ages of 5 and 20 meet criteria for the disorder. The definition of dyslexia is an inability to read; however, while this is a disorder that is very easy to define, it can be difficult to diagnose and treat. Reading is an intimate and essential skill in our school systems. Children are taught to read in first and second grade; but by grade three they are expected to acquire new information from what they read and children who have difficulties in reading will begin to suffer in all subjects if left untreated.

Dyslexia and The Brain

There has been a wealth of information published on this disorder since first conceptualized nearly a hundred years ago. What researchers have essentially concluded is that we don’t have a formal reading center in our brain. Rather, we utilize language and speech areas to make sense of written words. Thus, any disorder that affects language systems can impact reading. In fact, in adult stroke patients, there is an unusual condition called alexia (can’t read) without agraphia (can’t write), which means that a person could write a sentence but be unable to read what they had just written. Through the advent of neuroimaging, we have been able to trace the pathways that lead from the visual perception of written text to the decoding of that text for meaning and have a pretty good understanding of how children with dyslexia read (or don’t read) differently than normal children. We have not been as successful in figuring out the cause of this disorder.

The current thinking is that our visual system is built to recognize objects from a variety of different angles because we are creatures that move in the world. For instance, if I turn a chair on its side, it won’t take you longer to figure out it is still a chair. However, letters and words need to be identified in the same orientation and in the same order if they are to have meaning. The visual system, therefore, “cheats” by funneling letters and words over to the language centers for processing instead of in typical object recognition centers. If this process occurs correctly, most children will be able to read as early as five years of age. If they don’t funnel this information correctly to the left side, they will continue to treat letters and words just like objects in the environment. For instance, a child might see the word “choir” but say the word “chair” since they are visually so similar in appearance. However, their meaning is quite different and clearly comprehension is going to be affected if many of those errors occur.

Signs of Dyslexia in Children

Some of the common signs of dyslexia in younger children can be the omission of connecting words (i.e., in, an, the, to, etc.), taking the first letter or two of the word and guessing, or converting words that they have never seen into words that they already know, even when the meaning is quite different. I hear often that parents become worried because their child reverses letters and, while this does occur in children with dyslexia, it is also a fairly common phenomenon with children who are learning to read, particularly with letters that look similar (i.e., b and d). Thus, it often does take a trained professional to differentiate children who are poor readers or who are developing slowly or in a patch-like fashion from children who actually have dyslexia.

Dyslexia in School

One of the challenges with this condition is that many of the schools have gone to an RTI Model (Response To Intervention) for reading. This means that they wait to see how a child responds to a normal classroom and if they fail, they move them to additional services, and if that fails, they move them to further intense services. Failing that, an evaluation is ordered. In real life, this means that many children are not evaluated properly for several years and by that time there are major gaps in their learning and acquisition. We do know of several methods for remediating dyslexia, although they often involve multiple hours a week of tutoring on a one-on-one basis and some school systems are simply ill-equipped to provide those types of services for children.

Most children that we see here at the clinic with dyslexia are bright and capable children who become increasingly frustrated with school because they are unable to bring their intellect to bear on many of the activities they are asked to perform in the school system. Even subjects in which they find much enjoyment are limited in terms of their ability to access the material because so much of it is done through written form. They often look poor on standardized reading and math testing; but because they are bright they can usually “muddle along” just enough to escape attention until they have fallen several years behind by middle school.

Treatment for Dyslexia

Fortunately, several treatment methods have been developed over the years that lead to a “normalization” of the reading system within the brain on imaging studies and to a dramatic increase in reading scores on educational tests. Only a trained professional can determine if your child has a developmental delay, dyslexia, or some other condition that is impacting their reading; but these are often critical evaluations to get done early since the remediation process can take 12 to 24 months.

I have evaluated hundreds of children for this condition and seen rather dramatic improvements when these children are placed in evidence-based programs for even a short amount of time. I urge all families who have children who struggle with reading to at least get a consultation with a trained professional to determine an accurate diagnosis and appropriate treatment planning.

7 Activities To Keep Your Baby Active During The Winter

Active BabyThe leaves are changing, Thanksgiving is right along the corner, and the temperatures are dropping!  It is so important to keep your entire family active during the winter months, including your infants.  Many area community centers have “Mommy and Me” and “Gym and Swim” classes that encourage fine and gross motor activities.  Local music centers also have specialty classes just for the little ones.  There are still plenty of great activities that you can do indoors with babies to keep them active and achieve those gross motor milestones along the way.

Below are some fun activities to do with your little ones outdoors and indoors as the weather turns colder.

1)      After a diaper change when your baby is still on the changing table, ‘bicycle’ their legs in a rotating movement from their hips and knees.  This reciprocal motion is great for learning to crawl and walk!

2)      If you have a dog, include your babies in the daily dog-walking.  Quick, ten- to fifteen-minute walks with your kiddos that can walk or be pushed in the stroller get them (and you!) out into the fresh air.  As you are walking, talk to your children about the nature around them and how the seasons change the trees, grass and temperatures.  As a rule of thumb, dress your babies in one layer heavier then you would yourself. Read more