Our ignorance of learning disabilities

See on Scoop.itDevelopmental & Behavioral Challenges in Children

As the new school year begins this article/survey highlights the needs we have to provide more knowledge and training to our parents and teachers.  I know I will be out there doing my share to close the gap.  Who else will be helping to get the word out?

See on www.washingtonpost.com

Why have a label?

Labels are not bad or good.  They are a form of name. A means of being able to understand or know how to use something.  They help you understand what category they are in.  McDonalds, Nike,  oak tree, rose, alligator – they are all names or labels.

So why do so many people have problems with labels such as autism, dyslexia,  learning disabled, and ADHD?  There are definitions of these labels, books written on how to understand and help them, and a profile to make sense of the “whys” of their behaviors.

I have been told by parents and schools, that labels such as these limit children.  That they are not needed for providing help to children.  I have also been told that they are just excuses for laziness, poor parenting/or teaching, and bad behavior.  It seems to me that these are just other labels for the same problems, but with an entirely different set of interventions put into place.

I have also seen people accept these labels but not do anything to help children.  Instead they say that the children can’t help themselves, can’t achieve, can’t be encouraged to reach higher levels because they won’t be able to succeed.  I have seen that with children with Down’s Syndrome, who when moved to a different school or situation, then begin to learn.  I have seen the same with children in the autism spectrum, when interventions and strategies that have been shown in research to allow learning and achievement, are implemented and indeed these children do learn and achieve.

I see a label, or diagnosis, as part of that child’s profile.  Their profile helps the adults around them know where to look for understanding of how that child functions, processes, and interacts with their world. The profile allows the adults to develop interventions and strategies to help that child maximize their potential, not limit it.  The profile allows the adults to predict potential barriers and work around them.

Let’s embrace labels as a means of being better helpers to children. Let’s look at labels as means of helping children achieve despite neurologic wiring differences that make learning and succeeding more work than for their peers.  We all use labels.  Let’s just make sure we use them correctly and positively.

What interventions help children in the autism spectrum?

The  May 2011 journal, Pediatrics, published two review articles looking at the role of different interventions for those in the autism spectrum.  Researchers at Vanderbilt University did literature reviews from the last decade to determine what, if any, decent research there has been on the many types of interventions available.

I was not surprised to find that they found lots of studies, but few meeting the full criteria of quality research.  Out of over 7500  articles identified in searches, there were only 34 that met the criteria for quality research on behavioral intervention and 18 for medication interventions.  All the rest were lacking in one of 4 areas: 1) Risk of bias of outcomes based on study design, 2) Consistency or similarities of effect size across studies, 3) Directness of relationship of intervention and outcome and 4) Precision or level of certainty around the effect.

What they found with both articles were that behavioral interventions were more often linked with positive outcomes with language, social and adaptive skills.  There still needs to be more research to quantify better what behavioral interventions can do, however.  Medications were found to be focusing on inappropriate behaviors and did not have any significant effect on language, social and adaptive skills.  Risperidone (Risperdal) and aripirazole (Abilify) decreased irritability, challenging and repetitive behaviors but had significant side effects and no effect on language, social and adaptive skills.

I personally feel that we need to look much closer at how we are trying to behaviorally help these children. I have seen numerous children who did well if approached correctly, but who decompensated when pushed beyond their limits, and then were sent off to be started on a medication to make them more cooperative.  It almost never worked as well as people wanted and then they were back looking for more medication to fix “it”.

I am not against medication when needed, which is when a child’s own internal stress, anxiousness, obsessive and compulsive behaviors, or phobias, are making his/her life horrible.  But we have to spend more time understanding the “whys” of his behavior first, and making environmental alterations. Then, if these emotional stresses are still impeding his ability to function, adding medication would be a reasonable adjunct intervention.

If I ran the world, I would redo our educational system for these children.  I would allow them to have more time developing their language, social and adaptive skills before putting academics in front of them. If that meant that their first few years of school were spent with a large amount of time with ABA and Floortime/DIR or TEACCH interventions, then so be it.  We definitely are not set up in an inclusive classroom with pull out to accomplish what most of these children need.  They also need more access to para professionals (aka assistants, associates, aides, etc.) who can anticipate when they are becoming overwhelmed and provide them with the release from the situation to regroup and re-regulate their emotions.

These children have a lot to offer us, but we need to understand that we are there to be their teachers, coaches, and support people. We are not there  just to make sure a benchmark for that school year is reached.  Let’s think about how we can make today better for one child (or older person) in the autism spectrum.