Therapy in L.A.

  article of the month
June 2003
By Alan M. Solomon, Ph.D.

Many of us know children who struggle with developing basic academic skills in school:

  • Johnny is a second grade student with difficulties in reading. Despite much effort and practice he repeatedly stumbles over simple words even when he has been provided the correct pronunciation only a sentence or two earlier.
  • Annie, a fourth grade student, seems to sound out words skillfully enough, but then has little memory or understanding of what she has read.
  • Billie, a fifth grader, seems "unable to spell a lick", even simple words like "what" or "house". Even when he can painstakingly prepare for a spelling test and have some success, the words seem lost by the very next day.
  • Melissa, a seventh grader, reads and spells with some ease, but has a "block" with math, and thus avoids it as much as she can.
In past generations, these children would likely be identified as "lazy", lacking in motivation, or even lacking intellectual ability ("retarded"). Punitive, unrelenting pressure and/or negative judgments would have been enforced. Perhaps expectations would have been relaxed to the point that they would be promoted through school with limited academic skills actually being learned. In either scenario, the child loses in terms of self-esteem being lowered, feelings of competence being undeveloped, and basic life skills not being developed.

Many of these children are struggling with a learning disability. Their brains process information differently than those of us without learning difficulties, due to fundamental neurological differences. These are not "lazy" children who lack motivation or basic intellectual ability. In fact, many of them are quite bright - often above average if tested with a standardized intellectual measure. Unlike children with a physical handicap, this handicap is invisible, not obvious to most observers, but powerfully disabling just the same.

People learn through various channels, any one of which can be a source of strength and skill, or weakness and disability. It is in one, or more, of these channels that a learning disability impairs a child's ability to learn: sensory-motor, auditory, or visual modalities.

Sensory-motor skills involve both big and small muscles. Big muscles include such examples as a baby's ability to crawl, walk, and maintain his balance. Small muscles involve a child's ability to cut with a scissors, learn to write letters or numbers, and track words across a page from left to right. An athletic youngster generally develops skill in big or gross motor skills, while an artistic youngster has strengths in small muscle or fine motor skills.

Disabilities in gross motor skills manifest as a "clumsy" kid, who struggles with moving his body through space with much coordination or grace. This youngster has a hard time learning to play sports, ride a bike, or even move from one place to another without tripping, falling, or bumping into others when the difficulty is more severe. He may confuse left and right beyond the usual time when kids are learning this basic orientation about their body.

When fine motor skills are slow to develop, a child may continue to reverse "b's" and "d's", or other letters/numbers, beyond the usual cut-off age of seven years old; most kids developmentally mature out of this typical process by their eighth birthday, if not sooner. This child struggles with forming letters or numbers efficiently, correctly, and accurately. Handwriting is often a serious problem, even when the child makes great efforts. So, these kids often avoid writing tasks when they can, because it is such an intense, unrewarding labor.

Auditory processing involves listening to and accurately perceiving verbal input. Hearing is fine, but the brain's ability to organize and make sense of what the child hears is impaired. A child may have difficulties with reception: being unable to hear the difference between basic sounds like "v" and "th", for example, which can make either reading or spelling, or both, torturous. Receptive deficits may make it near impossible for this youngster to take in verbal directions, so that following instructions becomes very difficult, especially if multiple steps are expected. Memory deficits can also be involved, so that the youngster can initially receive and absorb the data, but then not remember the information, even in the short-term. This is the child who seems to take in and understand directions/input, but then is unable to recall it and effectively make use of the information - the child who irritates his parents because he "doesn't listen and follow directions." Even if reception and memory are intact, the deficit may be in association, so that reasoning, problem solving or connecting data to other data in a verbal format is limited. This is often the older child who can remember facts and details of what they read, but has difficulty with making connections between different pieces of information or reasoning with the material.

Visual processing involves taking in data visually. Again, basic vision is often not the issue, but the brain's ability to make meaning of visual information is weak. Akin to auditory issues, visual deficits may be in the basic reception, memory, or association of data. A child with receptive deficits has difficulty absorbing data in a visual format; looking at a picture and noting missing details, for example, becomes quite difficult. Visual memory issues may make it very hard for a child to learn basic arithmetic facts, since this kind of information is generally presented visually and remembered with visual images. Visual association requires that a child can reason and connect material in a visual format. A very pure example of this involves learning geometry, which is a highly visual subject. Reading comprehension actually involves visualizing what is being read, so that the reader develops visual images to remember and work with the information. While this is most obvious when we read novels (generating "scenes" and images of the characters and plot), it is also often true with nonfiction as well. While a child may read the words skillfully, he may not be able to visualize the information sufficiently to understand what he is reading.

All of us have relative strengths and weaknesses in these channels of learning. Our career choices are often indicative of our strengths. Engineers, architects, or mathematicians, for example, are usually visual learners, with strengths in the visual-processing realm. Writers, lawyers, or other jobs based largely on language skills are more talented in auditory processing. If you observe your children, you can see where their strengths and weaknesses lie. A child who reads, spells, and writes with relative ease is probably more an auditory learner. Youngsters talented in math or graphic arts are likely to be strong in visual areas. Some kids learn best through their body awareness: athletes are a prime example of this sensory-motor skill.

If you observe your child more closely, and perhaps ask him how he does a particular task, you'll gain more insight into this fascinating process. If you ask him how he learns multiplication facts, he may say that he does them like a song - lyrics that go together; this is auditory. Or, he may say that he can see the table in his mind's eye, which is a visual process. If you ask your daughter how she remembers a phone number for a friend, she may say that she hears it in her thoughts in the correct order (auditory), that she can see it like it's on a pad of paper (visual), or that she remembers it by fingering the keypad on the phone (sensory-motor). If we become aware of our child's strengths, we can help him develop intentional strategies to employ these strengths as much as possible when he is facing a learning challenge.

A systematic method of identifying a child's strengths and weaknesses, and specifying whether a learning disability is impacting a child involves psychological testing. Please see a previous article on "Psychological Testing - the Beginning of Help for Many Children." This article (from May 2002) is listed under my biographical information at the heading, "Locate a Therapist".

Maximizing strengths is the key to helping children with learning disabilities. This is how such children can learn to compensate for their weaknesses and thereby improve their development of basic academic skills. Most children with learning disabilities benefit from individual educational therapy, in addition to individualized educational services in their school program. More about this will be coming in another article·

Meanwhile, it is crucial to shift away from the automatic assumption that a child who struggles with learning is "lazy", lacks motivation, or has limited intellectual ability. Many of these children are actually "above average" in intelligence. They are strongly motivated to learn when material is presented to them in a modality they can absorb, with sufficient support and encouragement, and based upon a deeper understanding of their strengths and weaknesses. By acknowledging their learning disability, an invisible but real disability, and building on their talents, such children are capable of significant success in school and in life.

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

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