Therapy in L.A.


  article of the month
Fall 2005
By Alan M. Solomon, Ph.D.

Children and adolescents with learning difficulties need and deserve specialized assistance to improve their academic performance, repair damage to their self-esteem that may have developed over years of frustration, and open doors to opportunities that have been closed. Previous articles (see the list under my personal statement on "Therapist Profiles") have discussed learning disabilities, attention deficit-hyperactivity disorder, and assessments; these have included some comments about help once such struggles have been diagnosed. This article will describe in more detail one particular intervention with academic issues: educational therapy.

Educational therapy is an individualized, customized program to help someone with the difficulties that have impeded his/her development not only in more formal academic learning efforts, but in other learning experiences that may be less structured or formal. In other words, someone's learning disabilities will obviously impact them in school, but also in other life circumstances where learning needs to take place: participation in organized sports, engagement in social situations, or informal activities in which learning plays a crucial part.

In partnership in individual sessions, with an experienced teacher who has training in special education issues, educational therapy focuses primarily on the learning process in an effort to remediate deficits as much as possible, as well as to compensate where necessary. A process oriented intervention like this develops the basic building blocks of learning skills, which have often been only partially developed. Tutoring, in contrast, applies most efforts to specific subject areas by instructing in these areas, complemented with structured efforts to complete assignments, finish projects, and meet classroom requirements.

For example, if seven year old Johnnie, a second grader, is struggling in reading, a tutor might work with him on his classroom reading text and other assigned reading materials in a concentrated program of repeating the assignments and completing any work needed. Phonics would likely be taught within the context of these materials. While this may indeed be helpful for the particular class/teacher, an educational therapist would work instead on the more fundamental sources of Johnnie's difficulties.

If his struggle was due to an inability to recognize individual letters and/or differentiate them from each other (e.g. "b's" and "d's"), or link letters with their phonetic sounds (know that a "b" makes a particular sound), that's where the remediation would start. Rather than use the classroom materials, other materials specifically targeting Johnnie's deficits would be used primarily. While much of this may be drilling and repetition, some of it is often in the form of exercises that are more game-like, interactive, and even playful - intentionally so, to keep Johnnie engaged and motivated as much as possible. This apparent play is quite educational, actually. Efforts to apply the newly developing skills to classroom materials would also be included, but not as the primary focus.

As much as possible, direct remediation, as described above, would be attempted. This strengthens the skills that are lacking with immediate benefits, much like a physical therapy program works on strengthening muscles that have been injured. Such remediation is more often attempted and successful with younger children and in cases where the learning disability is less severe. When the child is older and/or the difficulties are more severe, direct remediation may not be as successful.

In such instances, compensatory skills are brought into play to a larger degree: a child's strengths are used to help compensate for, or work around, the areas of weakness. Mary's handicap with learning multiplication tables for example, may be due to difficulties with visual memory. Traditional efforts with flash cards or an expanded table with the facts on it, depend on a student developing a visual image of the material; for Mary, this employs her weakness and is less likely to succeed. With repeated frustration, she is likely to give up more easily and fulfill the stereotypical expectation: "Girls just don't learn Math." Yet, if Mary likes to sing and she learns the lyrics to songs relatively quickly, then these strengths can be used with Math. Why not make the flash cards secondary and emphasize listening to the table, repeating it verbally, even generating a sing-song pattern for it? This would employ her verbal, auditory strengths, perhaps even a good sense of rhythm, too, that would likely generate more success with this basic Math requirement. Educational therapy would identify her strengths and make use of them to compensate for the weakness, so that she could develop mastery in an important academic area.

Whether the strategy in educational therapy involves remediation or compensation, or some combination of both, a thorough understanding of a child's development is needed. Identifying his/her learning deficits and areas of strength are crucial so that an individualized program can be developed to respond to the needs of each child. A comprehensive assessment provides just such a "road map" to help guide the educational therapist in efforts with each child. Please see previous articles on assessment, learning disabilities, and ADHD for a more thorough discussion of these issues about how children learn, what modalities of learning may be strengths or weaknesses, and how an assessment provides a "psychological X-ray" of each child.

For some learning disabilities specialized programs have been developed with powerful help. The Lindamood-Bell program exemplifies a well-established, documented approach to reading difficulties. It has been proven effective in helping children who are struggling with basic phonics, so that they can begin to build the skills needed to sound out words and read with some greater fluency. Another aspect of Lindamood-Bell works on more advanced skills for reading comprehension. Many such pre-existing programs are available for a wide range of learning disabilities, and many experienced educational therapists can select a program for each child and apply it in an individualized effort to suit each student.

At other times, a more creative, highly customized program is needed when a pre-existing program is not available or is not a good fit for a particular child. In such a case, an educational therapist will develop materials, exercises, and "lessons" for each child. The example above of Mary learning her multiplication facts is just such a situation in which auditory strengths are engaged to compensate for visual weaknesses. Another fairly frequent example is teaching a child keyboarding and word processing skills to compensate for fine motor skill deficits, so that instead of torturous labor over handwriting tasks (which often produces work of poor quality), a youngster can use a portable word processor (or laptop computer) to take notes, complete written assignments, and even take tests in class. A ten year old boy, very bright and curious about learning, was able to greatly improve his performance in social studies/History, language arts/English by using highly developed word processing skills to sidestep his chronic difficulties with any task requiring handwriting. Countless other examples of this kind of individualized approach could be cited.

Of course, such efforts at remediation/compensation need to be closely coordinated with a child's teachers to insure that the private efforts being made will contribute to a youngster's school performance. In a similar vein, parents need to be informed and directly coached about how to help their children in these new ways, so that the adults in a child's life are working in the same direction. Inadvertently, parents often make efforts to help in ways that fail to make use of a child's strengths, employ his/her weaknesses instead, and engage in repetitious drilling that can simply repeat the child's failures/frustrations.

Educational therapists can be certified as having achieved minimal levels of education, training, and experience, which insures that a child is receiving help from a qualified professional. These educators generally have a master's degree, or more, as well as a significant amount of hours of direct service provided under supervision. The Association of Educational Therapists, headquartered in Burbank, CA, can be contacted to identify such professionals around the country, with many of them in California (800 286-4267; online at My own assessments include comprehensive suggestions for each child, including a list of educational therapists in the local community whom I can usually personally recommend.

Realistically, such an intervention program may require a year, or more, of intensive work. There are often "no quick fixes" for learning disabilities, unfortunately, but many children can make significant gains in their academic efforts, their ability to learn, and their self-esteem through a consistent program of educational therapy.

Dr. Solomon is a psychotherapist working in Torrance. He is a member of the Independent Psychotherapy Network.

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