How Learning Problems are Managed

Learning problems can often be managed very successfully, even though they cannot be cured. The goal of therapy is to enable youngsters to live with their limitations as productively as possible. Treatment is usually waged on four fronts:

1. Psycho-social-behavioral therapies: teaching children strategies for maximizing their strengths and compensating for their weaknesses.
2. Other interventions: Specialized language instruction, taught by a teacher or therapist who has received special training, is used to teach dyslexic teenagers to read, write and spell. Comparable programs exist for children with dysgraphia and dyscalculia.
3. Medication therapy: using medications to improve concentration problems and other conditions such as depression.
4. Special education: a school environment tailored to the unique needs of each child with a learning disability. Until such time as it is determined that a teen no longer needs special services, once a year the school and parents work together on formulating an appropriate individualized education plan, or IEP, for the following academic year.

With so many differences among adolescents who have learning deficits, treatment must be individually tailored. Anticipate frequent lane changes on the road to improvement, as one medication gets substituted for another or you switch therapies midstream because the behavioral technique you were hoping would help your son or daughter fell short of expectations. This is a field where even the experts freely admit that no one has all the answers.

Like rest stops on the interstate, useful advice and tips come along sporadically, assembled from physicians, therapists, special-ed teachers, other moms and dads, support groups, on-line chat rooms and so on. The members of your team may include the pediatrician, a private pediatric psychologist or psychiatrist, and the school psychologist or social worker. Whomever you choose, make sure that they treat children with your teenager’s disability on a regular basis. You want people who have a broad and long-term overview of your child’s ongoing saga.

Psycho-Social-Behavioral Therapies

• Cognitive-behavioral therapy: teaches children techniques to change their behavior. For example, children may be taught to place their hands on their stomach and relax when they feel upset, or be taught to think through tasks step by step when problem solving.
• Behavior modification: a technique for modifying behavior through reinforcement. Desirable behaviors are explained to the youngster, as are the small rewards for complying and the mild penalties for when he doesn’t. If this sounds like the method of discipline described in other places, you’re right, only boys and girls with learning difficulties may need more frequent reinforcement.
• Social skills training: teaches youngsters fundamental social skills such as making eye contact when talking to someone else and how to read people’s facial expressions. Typically held in a group setting.
• Psychotherapy: is talk therapy intended to help patients reverse defeatist attitudes and also to understand and accept their disabilities.
• Support groups: gatherings of adolescents who have learning disorders or their parents. Support groups bring together people in similar circumstances to share their experiences and feelings in a supportive, nonjudgmental atmosphere. Meetings, typically sponsored by patient-support organizations, hospitals and other health-related agencies, are often more productive when they’re led by a social worker, nurse or other health-care professional. Members take away the knowledge that they are not alone—always comforting—as well as practical advice, referrals to specialists and local services, and other valuable information.
• Family counseling: Destructive family patterns can become so deeply ingrained that they persist even after a youngster with a learning deficiency begins to make progress. Family counseling can be a useful forum for airing interfamily conflicts, reexamining issues through the eyes of an impartial third party and discovering new solutions for breaking an unhealthy cycle.

Medication Treatment

Stimulants are the most widely used pharmaceutical treatment for attention deficit hyperactivity disorder. At least 1.5 million young people take the stimulants three or four times a day. “Stimulant medication can have a very dramatic effect,” concludes Dr. Wolraich. “Most kids benefit from being on it.” Why, then, have stimulants sometimes received a black eye in the popular press? Several criticisms have been leveled against the drugs: They are irresponsibly prescribed as a performance enhancer, a by-product of our success obsessed culture; they are likely to be abused by the same teens they are supposed to help; they stunt growth and may produce other unwanted long-term side effects. Not true.

The American Medical Association publicly repudiated the claim that doctors were overwriting prescriptions, while studies show that teens that use stimulants to manage their ADHD are less likely to engage in substance abuse and other risky behaviors. As for side effects, says Dr. Wolraich, “I usually tell parents that stimulants have fewer side effects than aspirin and no known severe long-term consequences.”