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5 Learning Diagnosis FAQ, Without the Jargon
Your child is not keeping up. You are worried about learning readiness. What to do?
Getting a learning diagnosis is traumatic. The terms are scary, and it feels insanely complicated. You have friends who have done it, only to come back with an impossibly long list of deficits, and now they feel even more at sea. And of course, it impacts your child – he is now labeled and knows there is “something wrong” with him.
The school says they have it handled, but you are not so sure. You hear stories of kids who started off slowly, but then everything just clicked. And stories of regret, parents of older children with lingering reading or learning difficulties, who wish that they had taken action earlier.
Which story will be your child’s? Is there a way to know?
There are a number of misconceptions and misunderstandings about the nature of a learning diagnosis in part encouraged by most of the folks you reach out to for help, who are in the business of finding deficits and naming things. Before you make any decisions about next steps for your child – an evaluation, an intervention, tutoring, nothing – here are a few thoughts that might help.
- There are very few actual learning ailments, mainly just symptom descriptions
- Most lists of diagnoses come back to one source issue
- There are only two primary sources of learning delays: language and sensory processing
- Trust your instincts
- Accommodations and interventions – very different choices
#1. Is a learning diagnosis a description or an ailment?
Almost all learning diagnoses, e.g., dyslexia, dyspraxia, Asperger’s, and executive dysfunction, are descriptions of behavior. Unlike a medical diagnosis, where symptoms identify a problem that can then be treated, in the learning-diagnosis world, the symptoms are the diagnosis.
More than that, the same type of behavior can be labeled differently depending on the severity or frequency of symptoms. For instance, when a generic “reading difficulty” is more severe, it is called “dyslexia.” Dyslexia is not an ailment or specific problem, just a more serious reading delay.
Yes, dyslexia can be detected with a functional MRI – the indication being a lack of activity in the language region of the brain while reading. But this is also true of children with lesser reading difficulties – their fMRIs show insufficient activity in language areas. This is important to understand.
Part and parcel of a medical diagnosis are identifiable germs, etc., that have treatment options. For example, treating an underlying infection may involve some art, but it is mainly based on science.
Learning diagnoses do not work that way. A learning diagnosis might identify related issues that help identify the underlying problem. And in the vast majority of cases, the learning diagnosis confirms 95% of what parents already know or suspect. Really, all you come away with is a description of behaviors, most likely with proficiency against norms. Better than nothing, but still not a treatment plan.
#2. Are multiple learning diagnoses common?
Yes, they are common because deep-seated cognitive delays cause difficulties in multiple areas of life, and each of those has a label or diagnosis.
Diagnoses are descriptions of behavior. Each diagnosis does not necessarily describe a new problem; it’s just a description of different behavior. For instance, a processing delay makes language hard to understand. This can lead to reading delays (dyslexia) and a tendency to tune out while listening (ADHD).
One underlying problem, two diagnoses.
It’s not unlike a child breaking her ankle. A learning assessment-style diagnosis focuses on behaviors, such as being unable to walk and unable to jump. Different behaviors, but one problem: the broken ankle.
About 50 to 60 percent of people with ADHD also have a learning disability. ADDitude
These kinds of diagnoses can be overwhelming for parents. A lack of focus is a natural reaction for a child who finds learning difficult. If you find reading torture, you might want to get up and do something different.
The proliferation in learning diagnoses has also led to around 11% of kids between 4-17 being diagnosed with ADHD,
In the case of a comorbidity of ADHD and a reading delay, focus on the reading problem. If you can resolve the most deep-seated source issue, more often than not, the other behaviors will take care of themselves.
#3. What are the two primary sources of learning problems?
When you get into why a child is lagging, there are all kinds of factors that come into play. Listening to language, learning, and reading are all amazingly complicated. Really, they are miracle skills that require so many things to go right. While there have been 40+ separate cognitive skills identified, many are related.
Most learning difficulties can be traced back to delays in two broad areas:
- Language processing
- Sensory processing and integration
Again, there are nervous conditions, personality traits, seizures, and countless other variables. However, the reason these two come up time and again is that both are foundational skills for all learning, and both are amazingly complicated.
Language Processing
Language processing is the foundational skill for listening, speaking, thinking (we think in our native language), reading, writing, and learning comprehension and reasoning.
For all of these skills to function properly, language processing has to be not only 100% accurate, but it also has to be automatic. It is a background skill that allows the mind to notice, comprehend, and analyze – to process. However, that’s not easy. Language is lightning fast. Hearing and manipulating the sounds inside every word requires processing at a rate of 40 sounds per second. If this becomes an issue for a child, it can show up as speech issues or difficulty rhyming at 3 years of age.
Rhyming is the first time a child plays with sound, hears it, and analyzes it, which is why it’s such a famous predictor of reading delays. Processing and natural language speed is a skill that less than half the population achieves by the age of 8 years, when they need it for reading. This is why so much of the 4th-grade population reads below grade level.
Sensory Processing
Sensory processing is the second category of miracle and foundational skills. The brain must process information from all senses in a flash and respond accordingly. If there’s a timing issue, e.g., if vision and hearing are not in sync, problems develop.
You’ll see this early on in the physical world with balance issues, difficulty riding a bike, and spatial issues, such as getting lost on a soccer field. It is an even bigger problem in learning. This lack of coordination of the senses creates noise in the brain that most often causes ADHD -PH, but also impacts reading and learning.
Match Interventions To the Source of Difficulty
If you are looking at an intervention, at least choose one that matches the type of learning diagnosis. If your child has clear sensory issues or responded well to OT, then you should be looking in the sensory intervention world – Interactive Metronome, Balametrics, etc.
If your child had speech delays, trouble rhyming, reading delays, and/or has no sign of sensory processing disorder, then the chances are you are looking at a language processing issue. This is by far the larger of the two categories, and, unsurprisingly, there are dozens of options, such as Orton-Gillingham and Fast ForWord.
#4. Can you detect learning issues without a professional evaluation?
Sure, you can. Trust your instincts. You’re the world expert on your child.
The thing about evaluations is that they are a search for deficits, which, for your child, ends up being labels. And yet, we know one of the most powerful drivers of success is confidence, which typically grows out of strengths, not deficits.
The pressure on kids to be perfect in every way seems to ramp up every year. And so, you might be vulnerable to comparisons to other children who seem to be soaring past your child or even to your child’s sibling who finds things much easier.
However, please remember that every child’s journey to reading and learning proficiency is a little different. Some children are late bloomers. There are lots of things to look for, like this list of reading warning signs, but possibly the most important tell of possible learning difficulty is inconsistency — the gap between one area and another that only you, as the child’s world expert, will see.
For instance, if your child loves math but does not like reading, that’s a tell. Or perhaps he started to talk early and was well advanced in language, but now is not a keen reader; that’s a tell. Twice-exceptional children could well be above grade level in math and at grade level in reading.
These are the kinds of things a parent can pick up. You are tuned into your child, and you have a gut feeling about what he or she is capable of. Trust your gut.
Learning Evaluations Are Estimates
If you do decide to get a learning diagnosis, understand that you are still your child’s world expert. Clinicians are human, vulnerable to biases not too different from the saying that if you have a hammer, everything looks like a nail.
Yes, you will sometimes need an evaluation for practical purposes, such as persuading the school to get an IEP, insurance, etc. But if the learning diagnosis for your child doesn’t sound right or feel right, trust your gut and keep looking.
#5. What’s the difference between accommodations and interventions?
Interventions 101
Since the advent of fMRI and brain imaging, scientists have observed that brains are always changing and self-improving. We know that stroke victims who lose the use of the majority of their brain cells are often able to relearn using the remaining cells. It takes a while, but it happens all the time — the brain can change.
And therefore, programs that take advantage of that brain plasticity — generally called interventions— are often worth a shot. If they can identify and address your child’s underlying learning impediments, such as language or sensory issues, and work on cognitive skill gaps, the results can be life-changing. Learning is your child’s job. If an intervention can not only improve her job performance but also help her enjoy it and feel confident in her role, surely that’s worth the effort and expense.
Accommodations
Accommodations — like tutoring, medication, and learning aids — offer a different proposition. They solve a problem today; they help children get through the day’s classes, homework, or exams, but they do not address the underlying impediments to learning. This applies to schools also. Accommodations help get you through the school year, but chances are, next year will be more of the same.
Yes, there is sometimes a boost of confidence from passing a test, albeit drug- and/or tutor-aided. But that’s not a real or lasting confidence boost. Children are smarter than that. They recognize when they are floundering, doing it with smoke and mirrors.
And yes, many children grow out of their learning difficulties in high school. But at what cost in the meantime?
Unlike tutoring, which is tried and true and has been the go-to solution for decades, interventions – including Gemm Learning – are a relatively new option made possible by the fMRI.
True learning confidence and independence come from being a healthy learner. Most of the time, that means resolving the underlying impediments to learning, and that means taking on a learning intervention.
What to do with all of this info?
If you have doubts, start collecting free information. Start by seeing whether the school knows your child’s reading level. Share your suspicions with your child’s teacher – you might be surprised at how insightful many teachers are. You may consider a learning diagnosis, but it is often unnecessary if you plan to pursue a learning intervention, since most services include pre- and post-testing as part of their process.
If you have suspicions about a learning disability, you could also call a few providers. Most are staffed with knowledgeable people who have heard and seen a lot of stories. Most start out by offering a free consult, where they want to hear about your child and will offer their insights.
Yes, you have to be careful about bias – if you are holding a hammer, everything looks like a nail. And so yes, they might try to sell you their particular solution, but you don’t have to buy. Which type of intervention? Well, that’s a very different story.
This website has a lot of good information on it to get you started, particularly if you suspect your child’s learning issues are not related to sensory processing — you could tell us about your child here. If you think sensory processing is the issue, start with Understood.org.
