Learning Difficulty Information Session

As part of National Psychology week 2012 we ran a free information session for local parents on helping children with learning difficulties.

You can view a video of the slides with the audio narration by clicking the image below (34 mins):

Or click here to download the presentation slides (PDF)

And click below to listen to the audio narration (34 mins):

Here’s the full transcript of the audio:

Georgie: This is a presentation about helping your child reach their academic potential. We’ll be going through how to identify their individual learning profile and some examples about that. And some examples of effective strategies that can overcome learning challenges. We’ll be going over the differences between learning difficulties and disorders as well as the signs to look out for. Discussing the importance of an educational assessment. What an assessment involves and how to interpret their results? And discussing common interventions and treatments that are available. There’s handouts and also great sources that you can go to for further information.

According to teachers, approximately 10 to 16% of students do have learning difficulties or may require additional support. And unfortunately, teachers often can’t provide this kind of support in a normal classroom situation. There are lots of factors that can hinder the child’s ability to learn. And we’re talking about academic or developmental skills.

And we’re talking about whether they are performing at the expected level for their age. But we’ll just go through a few of the common factors now. Child may have had some kind of developmental delay and a really common one is that they may have started speaking later than usual.So by the time they’re at school, they’re still having some kind of communication difficulties. They may have poor coordination and the fine motor skills for example, can affect their ability to write accurately.

There may have been some kind of emotional difficulty or trauma in the early years of their life. They may have been involved in a natural disaster, death of a family member. Or there’s lots of other different kinds of emotional trauma that they may have experienced. They may have had limited environmental experiences due to things at home. Their parents may have been undergoing a mental illness, other kinds of illness. The family may have financial difficulties and that may stop the child from being able to really consolidate their learning skills at home.

There may also have been a lack of appropriate educational opportunities due to poor teaching, due to other factors in the school environment like bullying and other social issues. The schooling may have been interrupted and that’s commonly when the child has had to move countries or interstate. And they have may have missed a bit of school as a result. Health issues of the child can obviously also relate to their missing a bit of school. Or when they are at school, the health issues may get in the way of their learning.

And one of the big factors that can cause a learning difficulty is that there is an underlying learning disorder. So learning disorders can affect approximately two to four per cent of children. And a learning disorder is a term we use for those who have developmental and academic skills that have to be significantly below expectation for their age. And we can’t explain it by any of those other factors that we’ve just gone through. A learning disorder does affect their, not only their achievement at school, but often also their daily life skill. The most common kinds of learning disorders are in reading, written expression and maths.

And there’s a handout that goes through the common learning disorders, brief definitions of those. Some children do also have difficulties with their working memory. Working memory affects the amount of information that they can hold in their mind at one time when their trying to perform some kind of task. And that can stop them from being able to follow a long series of instructions or being able to solve maths problems in their head. Some children have difficulties with sensory issues. They may have auditory processing problems. They’re not really hearing or understanding the information that’s coming in.

They may have other visual issues like visual perception problems as well. And then motor skills, we’ve already talked about their fine motor skills, that can affect their writing. Also gross motor skills can affect them when they’re running, jumping, playing and doing those kind of activities. So obviously, the signs of a learning disability or disorder does really depend on what kind of problems the child is having. Whether it’s in reading, written expression, maths or working memory. But the hand-out goes through seventy common characteristics that you may need to look out for. It is usually identified in early primary school but it can also be even younger than that especially if they’re having problems with their spoken language.

Just a few examples of signs of a learning difficulty or disorder. Children with Dyslexia or reading problems often reverse numbers or letters or misread words or numbers. Children often have other short term or long term memory problems and they may need to have things repeatedly a lot of times. And don’t’ seem to retain information very well. Children may have auditory perception difficulties. They appear to mishear things, have difficulty following instructions, especially if there’s a lot of background noise going on. Some kids may take a lot longer to do things and this can be evident particularly when they’re trying to copy things from the board.

May be related to their fine motor skills. May be related to issues with reading, eye sight, all other kinds of things. But it is a very common sign. They may have difficulties in identifying and discriminating different sounds which can affect their ability to follow instructions. Often children with learning disorders also come across as being disorganized, as having a short attention span. They can have quite messy work and their gross motor skills can also be commonly affected. And they come across as being uncoordinated or clumsy. But it’s very important to note that children are also very good at covering up their learning difficulties.

Some children are able to use pictures, or other context cues to guess or problem solve their way around things. They can be very good at receiving help from others such as teachers or parents or other children. And some children do resort to becoming the class clown or deflecting difficult tasks with other kinds of disruptive behaviour. So learning difficulties or disorders are often picked up at school. The teachers are the ones who do notice that there is a problem but it’s very difficult for them to diagnose. They can find it difficult to distinguish between what is a learning difficulty or disorder or what is a behavioural or social problem.

When you hear teachers say things like, “He’s easily distracted,” or “She’s disorganized,” or “They need to work harder”. Classroom assessments also may make it very difficult to pin point what the exact problem is. Because many skills are used simultaneously for each task. And a good example of that is if it a teacher might tell the children that they have 10 minutes to write a story about their favourite family holiday. Now this activity is going to involve listening to instructions, they need to use their auditory skills. It’s going to involve remembering the instructions so they need to use their short term or their working memory.

They’re going to need to remember the holiday that they’ve been on. So that’s their long term memory. They need to use written expression tools like spelling, grammar and punctuation. They’re going to need to use their fine motor skills for actually writing. And they’re going to need the speed to get it all done in 10 minutes. Concentration and the ability to sit still for 10 minutes. Now you can see that if a child’s having problem with that particular task, it’s very hard for the teacher to know exactly what the problem is. Different teachers do teach and assess differently as well.

Some teachers are very much focused on the English part of the curriculum. Other teachers are very much focused on maths. Some teachers are much more interested in behavioural areas. So if a child is fairly easy going, easy to teach, they’re least likely to pick up that there’s a learning difficulty going on because they can say that they’re really trying hard. And some teachers also might find it hard to communicate the problems to parents in a straight forward manner. And parents are left to read between the lines of NAPLAN. And school reports can be vague often and very unhelpful.

The bottom line is that if there’s any kind of suspicion of a learning difficulty, the child should be referred for an assessment. It’s very, very important that the assessment is followed up with early intervention. Regardless of what kind of problems the child’s having. Because every year that these things are going through unnoticed, the child is missing out on basic building blocks of learning. They’re probably starting to lose motivation for learning. And they’re going to start to fall behind. Lots of associated problems if they do go undiagnosed. Underachievement, it’s pretty obvious. They’re not going to be working to their potential at school.

They can also suffer from social problems like low self esteem. They can suffer from bullying or started to become isolated. Behavioural problems, we’ve already talked about some children that start to act out. They can become aggressive. They can begin to avoid school if they’ve got a learning difficulty going on. And then there’s the emotional side of things. And there’s a lot of research to suggest that children with learning difficulties are much more likely to experience depression or anxiety throughout their school life but also later into adulthood. So should you decide to bring your child along for an educational assessment, it’s important to know that you don’t actually need a referral from the GP.

But some parents do choose to go and see a GP first just to rule out any kind of health problems or visual or auditory problems. Generally, the referral does come from a parent or a teacher. They can be vague or specific. Sometimes parents would come saying that they just want to find out about their child’s strengths or weaknesses. But sometimes they can come along saying, “There’s Dyslexia in the family. My child’s having problems with reading. They’re reversing numbers and I would like to have an assessment for Dyslexia.” Other professionals can be very useful either before or after the educational assessment.

And commonly this involves speech pathologists, audiologists to see if there’s a hearing or an auditory processing problem and behavioural optometrists. Behavioural optometrists are different from regular optometrists because they can look at visual perception, visual discrimination and eye tracking type issues. Rather than just seeing whether the child can read something on a wall a couple of meters away. If you do have private health insurance, generally you can get rebates for the educational assessment as well.

Now not all educational assessments are created equal, unfortunately. The assessment should be done by a fully trained psychologist. And preferably one with a background in educational and developmental psychology. And preferably one who is used to working with children and adolescents. Checklists for parents and teachers can also help to pick up any behavioural issues that are not readily assessable in a one-on-one testing situation. How the child assessment is actually done is very important. Preferably it should be done over two sessions. Some places can try to squish it all in into one session. And by the end of it, the child is often fatigued or lacking in concentration. A one-a-half-hours in length is probably ideal.

The time of day the assessment is done is also very important. We find that younger children tend to do better in the morning. And older children are more switched on in the afternoon. And it is a testing situation but it is not designed to be scary. A good psychologist should be able to build rapport with the child before starting, be able to chat to them and help them feel at ease. The environment is also a really big factor in that. So the offices or the place where the testing is being done shouldn’t be intimidating. Shouldn’t be too hot or too cold. Shouldn’t have any noise coming from outdoors. And shouldn’t have other things around that are going to distract the child. So we know that the way they’re performing on this test is really a good indication of their true ability.

After an educational assessment you should receive a clear and an accurate report from the psychologist. There are certain aspects of the report that do need to be technical so that another psychologist or professional can pick that up and be able to see all of the results and be able to interpret those. But it shouldn’t be overly technical and it is designed for parents and teachers to easily understand.

A profile of learning will give you a picture as to your child’s strengths and weaknesses in different areas. A diagnosis would be given if relevant, but even if the child doesn’t fit into a specific learning disorder, it’s still important to identify the areas that they may need help with. Handouts can give parents articles to read, can give them specific activities to go away and work on. And all of the recommendations provided should be as practical and specific as possible. They should preferably be divided into activities to do at home and at school. They can involve websites, computer apps to go to, they can involve specific books, activities or programs outside school that the parents can go to.

Because, unfortunately, some places will just give you very vague recommendations. And parents are left to walk away with a recommendation like, “He just needs to work on his reading”. Not particularly helpful. The feedback session is absolutely vital so that the psychologist can go through all of the results. And make sure that they’re all understood and parents can have all of their questions answered.

The educational assessment does involve a few different areas. And one part of that is the cognitive side of things which is looking at the child’s potential or their ability. And most of these areas that are assessed are not really based on things that they would have learned at school. So the areas are verbal comprehension, perceptual reasoning – which is kind of their visual spatial reasoning, their working memory and their processing speed. And you can also derive a full scale IQ score from these four different areas. But we find that it’s more important to look at their strengths and weaknesses across those areas. Rather than focusing on one particular number to describe their ability.

The cognitive assessment that is given would be tailored towards your child’s specific age and they would be compared to other children within a three months of their own age so that their results are standardized.

This is a bell curve which helps us to see which children results are going to fall in the general population. We have the IQ scores along the bottom there. Now most, 95% of people’s IQ score are going to fall between 70 and 130 with 100 being the average. So most kids are going to fall somewhere in this area. There are children whose IQ is going to be below 70. They’re the ones that are really going to need a lot of significant and specific support. Children who are gifted are going to have IQ’s above 130. And although they may receive an IQ score overall that maybe in the average range, it’s, as I’ve said, very important to look at their profile.

Even it if their overall IQ is here, they may have verbal skills up in the high average range but working memory skills down in this low average range. And we need to look at those so we know the areas they’re going to need support with.

The other side to an educational assessment is the academic side of things. It does generally look at the areas of reading, mathematics, written language and sometimes oral language as well. And this is much more based on the areas that they would have learned at school. It is generally compared with their cognitive results. So we can say whether they are performing to their potential in different areas.

And if there’s a big difference between their cognitive results, their ability and their actual way that they are performing, that can point to specific difficulties or possibly a learning disorder as well. Apart from the cognitive and academic assessment, educational assessments can also involve very specific testing. For example, in the area of looking only at the aspects of reading skills, looking at auditory skills and things like that. So if parents come in with a very specific referral reason and something that they would like to be looked at, it can go a bit deeper into those things.

Again, the academic assessment compares the child to children their own age. So they can come out with a score that tells them what equivalent scores are for their age and what equivalent scores are for their year level at school.

An example will hopefully help us to understand this a little bit better. So Daryl is in Grade 2. His teacher says he’s having difficulty with reading and spelling. Daryl is very sociable and talkative and comes across as being bright. And his parents decide to bring him in for an educational assessment. So this table gives us an understanding of how Daryl’s gone.

The top table looks at his cognitive assessment results. Try not to focus too much on the numbers over here but we can see that Daryl has achieved high average scores on his verbal comprehension area, but his perceptual reasoning, or looking at his visual skills, is in the extremely low range. That’s an issue that we will need to investigate further. Working memory is in the average range but his processing speed is also in the low average range. Now his full scale IQ does come out in the low average range.

And the percentile rank of 16 means that he’s performing better than 16 out of 100 children his own age. But because of the big differences we’re seeing between these four different areas, it’s probably not a very good indicator as to his overall ability. When we look at his academic results in the table below, we see that reading is low average. And that’s fairly consistent with what his teacher has said. His math is actually in the average range. And written language is also in the average range.

So we’ll have a look at the difference subtests in those areas to help us understand that better. This table gives us more information about how Daryl has gone in the various subtests on the academic achievement assessment. In this case, our language wasn’t actually assessed. The bottom two subtests look at spelling and written expression which form the written language composite. And Daryl has performed similarly in both of these different areas. Spelling, he’s given verbal words that he needs to write down.

Written expression, it’s more about generating words in a category, combining sentences and writing a paragraph on a particular topic. Even though these are in the average range, we can still provide him with recommendations to help him improve those skills. These two subtests in the middle, numerical operations and maths reasoning, go together to form his maths composite. Big difference here between how he’s performed on those two areas. The maths reasoning subtest is when Daryl would be given real world problems and they are presented to him verbally. For example, he would be asked that, “If there was five ducks in a pond and two ducks fly away, how many ducks are left?”

It’s often accompanied by graphs, pictures and diagrams as well. He’s done quite well in that area. Numerical operations is also maths problems but they’re written down. He’s got a paper and pencil to try to solve a series of equations such as 34 plus 42. And his lower result on this area is quite consistent with how he went in the cognitive ability area of perceptual reasoning. In that, he appears to struggle when things are presented visually. We can provide him strategies to start to improve those skills. The top three subtests are looking at his reading skills and they form the reading composite.

Again, there’s a bit of variability as to how he’s performed on these areas. Word reading skills are in the average range but slightly towards the lower end. And in this subtest, Daryl would be asked to read a series of common words but they do increase in complexity as he goes through. So that is ok, but he can still improve that area a little bit. Reading comprehension subtest a little bit higher. And that would be when he’s given sentences or passages with a story and asked questions about what he’s just read. So Daryl’s quite good at that and children can often use pictures or other context cues to help them to solve the meaning.

And that’s something that he seems to be doing there. But this area down here is the real issue. Pseudo word decoding is a subtest in which children are given nonsense words like bim, fam, mib. And they’re asked to use phonological skills to sound out how they think the words should go. So phonological skills involved them having to understand the relationship between sounds and the letters that they represent. Now this is the problem that seems to be affecting his reading. This bell curve gives as a visual representation as to how Daryl’s performing in those different academic areas. We can say that number three is down here towards the low average range.

And that’s the pseudo word decoding subtest that we’ve just discussed. The four is numerical operations which we also said was a bit of a weakness for Daryl. Number one is word reading and the other areas are appearing in the average range. An important question for us to ask is, based on Daryl’s cognitive ability, how would we expect him to be performing? And we do a bit of a discrepancy analysis. We come out saying that he does score higher on maths reasoning than would be expected for a child with his cognitive ability. His pseudo word decoding is much lower than would be expected for a child with his ability. And spelling and written expression were about average.

It’s also relevant for us to ask what kind of mistakes Daryl was making. When reading he was noted to sometimes add, sometimes omit syllables. When spelling he often reversed the order of letters or he used the incorrect homophone. And that means that he’s going to confuse the spelling for new, n-e-w or the other knew, k-n-e-w. Those are homophones. But obviously with his spelling, he’s still managing to score in the average range. Daryl showed really good motivation and persistence when he was approaching these different tasks. So we can say that it was a really good indication of his true ability and there’s none of that behavioural problems that are kind of skewing the results one way or another.

To summarize, Daryl does have difficulty reading and processing visual information. This is very consistent with what his parents and his teachers have noticed. In his case, we can say that the results are significant enough to be consistent with a specific learning disorder in the domain of reading which we’re used to call Dyslexia. And we can’t explain his reading difficulties through any other factor. Recommendations are provided to help support Daryl’s learning in the various areas that he’s struggling with. And it’s important to know though, that the example we’ve shown is not the only profile that can come up as looking like Dyslexia.

There’s lots of different issues that children can have with the skills involved with reading and this is just one particular case. As we previously mentioned, after the educational assessment, Daryl’s parents would sit down for a feedback session with the psychologist. They would go through all of the results. Probably in a bit more detail than what we’ve just gone through. And they would go through all the recommendations for him. An action plan is formulated so that the parents know exactly where to start and what recommendations are really the most important ones.

The psychologist is also there for long term support. They can offer counselling to either the child or to the parents. Sometimes around anxiety issues. Sometimes around behavioural issues. We can offer educational coaching like BCE and study skills programs. There’s other specific programs available. For example, we have a four-session working memory intervention that can help children having particular areas of difficulty. And it’s very important to continue reviewing the strategies that have been put in place to see where they are being effective. The psychologist is happy to stay in contact with the parents, to talk to the school. And the child should be reassessed every two to three years to look at the stability of the results. And that’s particularly important as they get into the lighter years of high school. So if they need special consideration or additional help with their exams that can be put in place for them.

Some of the common interventions and treatments that are put in place after an educational assessment, we will just go through some of those now. These can be important for all children, not just those who are experiencing learning problems as well. So this classroom or environmental strategies, which can include making sure the child has a quiet area for learning, working away from distractions. The way that the material is presented to them either at school or at home can really help with their learning.

For example, material can be presented visually, verbally, or in several different formats. Even the way that the information is chunked and broken up can also help the child process that. Assessment formats – a lot of schools are these days are willing to assess children orally if they’re having problems with their reading or their writing. Some teachers are able to adjust the amount of work load that different children may have or to give them extra time to complete tasks. Very important to take advantage of the kinds of technology that is out there these days. There’s obviously spell checks that we all use on our computers but a lot of other little processing tools.

There’s computers that can read out written work to the child so that they can check that they’ve spelled things and written things the right way. There’s obviously a lot of different calculators out there as well. Personal development is a really big part and can often be missed as a strategy to help children with learning disorders. Because we need to ensure that we’re helping keep their motivation up, keep their self esteem up and help them to understand exactly what’s going on for them so that they can still find learning enjoyable.

Lots of other support is out there – there’s tutors, there’s external programs. There’s computer programs, so that the burden of helping the child is not put completely on teachers and put on parents and they do have somewhere else to go.

One last thing to discuss is the role of everybody after an educational assessment. Now, the educational psychologist has performed the testing. They’ve provided the results. It’s their responsibility to make sure the feedback is given in a clear and accurate way. And that parents and teachers do understand exactly what has come out of the assessment. It’s important for them to provide recommendations that are practical and specific and the ones that parents are actually going to be able to follow. It’s also their responsibility to continue liaising with the school and parents in the short and the long term to see how effective these strategies have been and to continue to provide more ideas if they do need more support.

The parents’ role, well, they do end up being the advocate. Most schools are good at implementing strategies but the parents are the ones that often need to provide gentle reminders. Especially as the child progresses through the years to make sure that each classroom teacher is aware of the kind of support that they need. Can also be very important for the parent to communicate the child’s needs to other relevant teachers at the school, like support staff. To communicate the needs to the child’s doctor, to babysitters or to any other extended family that are responsible for looking after the child from time to time. The parents can really help to help with the child with being proactive about their learning difficulties.

And parents should take it on board to continue reviewing and revising the learning plan as the child progresses through school. The school’s role is obviously to implement the strategies that have been suggested. But to provide feedback if these aren’t working or they think there might be something that might work better. It is their role to raise any concerns if something is going on with the child that may not have shown up in the past. And the school really needs to be really strict about the kind of support that they can provide.

Some schools can be really enthusiastic but sometimes they can be overly optimistic about the kind of help that they can give. So if the schools’ unable to provide the support, they should be saying to their parents, “Maybe your child needs something else outside of school or maybe they would be better off at a different school.”

So if your child is showing signs of a learning difficulty or disorder, if you will feel they’re not achieving to potential or you just might want to understand them better, you can arrange an educational assessment. Making sure that it is with a trained psychologist in the area of educational and developmental psychology. After the assessment, the next step is to implement recommendations at home as early as possible to help your child get the best chance at being successful in their school life. And after that, continue to support them, to continue to review how they’re going at school. And continue to reassess every two to three years to see how they’re developing.

So for more information, you can refer to the handouts on the common characteristics of learning difficulties or disorders. The handout about definitions of common learning disorders or the list that’s provided of helpful websites and organisations. Feel free to come and talk to one of us. We are educational and developmental psychologists here at School Psychology Services. Or you may want to talk to other professionals to rule out different problems you may be suspecting.

You can talk to GPs, behavioural optometrists, audiologists, speech pathologists or occupational therapists as well. And there is a list of really good resources you can go to for further information. Thank you for listening to this presentation. We hope it has been useful. And feel free to contact us if you have any further questions or queries.

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