Learning Disabilities and Your Child

Many children have learning disorders that affect everything from their reading comprehension to their math abilities. Learning disabilities affect the brain’s ability to receive, process, analyze, or retain information.

If your child has a learning disability, he’s certainly not alone; roughly 5 percent of children in public schools are receiving special education services for a learning disability, says Dr. Jonathan Romain, a CHOC Clinical Neuropsychologist.

Many dyslexic children also have another learning disability or neurological disorder, often Attention Deficit Hyperactivity Disorder (ADHD), says Dr. Romain, adding that ADHD and dyslexia should be treated separately when diagnosed. Medication and behavioral support and counseling, as well as helping your child to stay organized and have an organized environment, will help, he says.

Here are some tips from Dr. Romain on more ways parents can help their child with a learning disorder:

  • Get your child to read and read often! This can be challenging for parents of kids with ADHD, says Dr. Romain. “With ADHD, you don’t like to do the things that you don’t want to do, so this impacts the motivation, follow-through and determination to become a better reader. Parents should provide positive reinforcement. If Jimmy doesn’t want to read, have him practice reading for 10 minutes and then do something fun afterward. You want to tie positive outcomes with reading.” The goal is to get children with a reading disability and /or ADHD to be proficient enough at reading so they will find books or magazines they like and read them on their own.
  • Children may have a learning disability in relation to numbers or math. Parents should be aware if their child is having trouble in math and seek an evaluation for a learning disability in first or second.
  • Make sure your child has adequate exposure to the material (reading or math) before having him evaluated. First or second graders from low-income areas will often benefit first from more exposure to the material if they are having trouble. They can be evaluated more extensively if they are not making progress.
  • Watch out for your daughter! In the classroom, boys are identified as having a reading disability up to three times as frequently as girls, but in research studies, it’s evident that dyslexia is only modestly more common in boys. The conclusion is that girls tend to be underdiagnosed in the schools and this is also the case for other school-based struggles, including ADHD.
  • Public schools can evaluate a child to see if he or she needs special education support or accommodations if the problem impacts learning; a clinical evaluation will look for an underlying disorder, developmental delays, mood issues and other medical issues. Concerned parents can ask their school district or pediatrician as a starting point, and seek an outpatient evaluation or a second opinion if they want. If you seek a private evaluation for your child outside of the school district (possibly at your cost, since medical insurance may not deem this as a medically necessary), make sure it’s from a developmental psychologist or neuropsychologist familiar with educational development.

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Diagnosing ADHD

boy_sad_sittingCHARTING THE MIND AND ACTIVITIES OF YOUR ADHD CHILD
“I help families understand that attention deficit hyperactivity disorder (ADHD) is a neurobehavioral disorder. It is not a disorder of effort, character, intelligence, parenting skills or self-control. ADHD is characterized by a pervasive and persistent pattern of inattention and/or hyperactivity and impulsivity that interferes with day to day functioning,”
says Dr. Grover. A child can be diagnosed as predominately inattentive or combined inattentive and hyperactive-impulsive subtype. ADHD may be diagnosed in the preschool years through adulthood but is typically diagnosed between the ages of 6 and 12 and is more common in boys than in girls by a two-to-one margin.

STAYING ON TRACK IN SCHOOL
“Kids with ADHD get stigmatized by their behavior at school. They may get labeled as troublemakers and face peer rejection and social isolation,” says Dr. Grover. “We tell parents to get a comprehensive evaluation and to make sure the diagnosis is correct. I tell families, ‘Don’t just focus on weaknesses, find your child’s strengths.’ This helps keep their self-esteem up. Give them opportunities to shine. Parents need to educate
themselves about ADHD, the education laws and what services their child may be eligible to receive from the school district. You have to become your child’s number one advocate and cheerleader.”

COPING TIPS FOR PARENTS

  • Provide your ADHD child with structure. Clear and consistent expectations are important.
  • Set up routines for getting ready for school, mealtime, homework and bedtime, and stick to them as much possible.
  • Praise your child and provide positive reinforcement whenever possible.
  • Help your child discover his strengths.
  • Make sure your child gets a good night’s sleep. “Many of these kids have insomnia. The biggest thing is to get them to unplug. Taking electronics to bed is stimulating. They have to wind down so they can fall asleep,” says Dr. Grover.
  • Have your child exercise regularly and feed him a healthy diet.
  • Offer unconditional love and support. Start each day fresh.

FAST FACTS

  • Percentage of children diagnosed with ADHD globally: 5-8
  • Estimated percentage of adults with ADHD: 2.5 – 4
  • The average age of ADHD diagnosis: 7 years old

View the full feature on Kids and ADHD

Dr. Grover
Dr. Geeta GroverCHOC Pediatric
Developmental and
Behavioral Specialist

PHYSICIAN FOCUS: DR. GEETA GROVER

Dr. Grover is an attending physician for the developmental and behavioral pediatrics rotation for the UC Irvine-CHOC pediatric residency program, and a consulting physician for CHOC’s Early Literacy Program. She completed her internship and residency at Harbor/UCLA Medical Center and also completed a fellowship in ambulatory pediatrics at
Harbor/UCLA Medical Center. Dr. Grover is an associate clinical professor in the pediatrics department at UC Irvine and she sees patients both at CHOC and the Center for Autism and Neurodevelopmental Disorders in Santa Ana. She specializes in evaluating and
managing children with ADHD, learning disabilities, educational concerns and autism-spectrum disorders.

Dr. Grover’s philosophy of care: “I look at my job as a privilege. It’s my privilege to
have this opportunity to interact with my patients and their families.”

EDUCATION:
University of California, Irvine, School of Medicine

BOARD CERTIFICATIONS:
Pediatrics Developmental and Behavioral Pediatrics

More about Dr. Geeta Grover

This article was featured in the Orange County Register on June 24, 2014, and was written by Amy Bentley.

ADHD and Diet: Fact vs. Fiction

ADHD_dietBy Vanessa Chrisman, RD, CLE, CHOC Children’s clinical dietitian

Learning to care for a child with attention deficit hyperactivity disorder (ADHD) can be a daunting task for parents. Families must decide whether to use medications, nutrition or other therapies as treatment.

To help parents make informed decision, here are a few common myths about the relationship between diet and ADHD.

Myth: Consuming sugary foods and drinks causes hyperactivity in children with ADHD.

Fact: While many parents will agree that excessive sugar does indeed make their children hyperactive, there is no conclusive evidence that sugar causes increased hyperactivity in children with (or without) ADHD. Cutting out sugar will not make the ADHD go away. Nevertheless, too much sugar in the diet is unhealthy and it would be wise to limit sugar.

Myth: Following a strict elimination diet will drastically reduce behavioral symptoms of ADHD.

Fact: While there is evidence that some children with ADHD may have sensitivities to artificial food colors, artificial flavorings, preservatives, salicylates and other foods, there is no one elimination diet that has proven effective in the treatment of ADHD. While some children may respond positively to the elimination of certain foods/additives in the diet, others may have no reaction at all. Following a strict diet can be challenging and should be supervised by a registered dietitian.

Myth: Mega-dose vitamins and herbal supplements are recommended for children with ADHD.

Fact: High doses of vitamins have not been shown to be effective and can actually do harm to the body, especially the liver. With herbal supplements, there is not enough research to support their efficacy and safety at this time. In most children, a daily multivitamin is all that is really recommended. Supplementing with omega 3 fatty acids could be helpful as well, but more research is still needed. Before taking any supplement, be sure to talk with your child’s physician first.

Conclusion: As with all children, a healthy well-balanced diet is recommended for children with ADHD. Offering three regular meals plus two to three snacks daily helps ensure that children get a steady stream of energy and nutrients throughout the day. Including foods from all the food groups (with emphasis on fruits; vegetables; whole grains; low-fat dairy products; and lean protein foods like poultry, beans, lentils, fish, nuts and seeds) will help provide all the nutrients that a growing child needs. Optimizing nutrition in a child with ADHD can help complement their treatment and manage their symptoms better.

Learn more about Clinical Nutrition and Lactation Services at CHOC Children’s.

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Four Ways to Help Children with ADHD

Raising a child diagnosed wHelping_with_ADHDith attention deficit hyperactivity disorder (ADHD) can put even the most patient of parents to the test. However, therapy and other techniques can help children with ADHD have the best opportunity to behave better, function better every day, do well in school and grow up to be happy and successful.

“The goal is to help these young people to become productive, happy members of our society,” says Dr. Geeta Grover, a CHOC Children’s pediatric developmental and behavioral specialist. Dr. Grover specializes in evaluating and managing children with ADHD, learning disabilities, educational concerns and autism-spectrum disorders.

Treatment options can be broken down into four general categories, according to Dr. Grover:

Educational support

Dr. Grover suggests families work with their child’s teachers and use a daily home school report card to keep the child on track. Parents also should ask about classroom accommodations and whether they are needed to help the child be successful in the classroom, she advises.

“Parents have to know what their educational rights are and help to advocate for their child,” says Dr. Grover. “Parents should learn the laws that help them access services from schools and school districts.”

Behavior, psychosocial support

Individual therapy, parenting classes and social skills classes can help families address functional impairments in the ADHD child and help parents learn ways to cope. Social skills classes can help the child develop better social cueing so he can behave more appropriately and relate better to peers, Dr. Grover says.Helping_with_ADHD_2

The child’s pediatrician or family doctor can diagnose and help with treatment and, if necessary, refer the child to a specialist like a psychologist, developmental-behavioral pediatrician or a psychiatrist.

Medication

Medication, when appropriate, is available to reduce symptoms and offer clear, short-term benefits, Dr. Grover says.

Demystification of ADHD

The child and the entire family should learn as much as they can about ADHD. Parents need to understand how to work with their child and how to provide the structure and support the child needs.

Dr. Grover emphasizes that parents should provide strong structure, clear rules and expectations, and positive reinforcement for children with ADHD.

“Discipline a behavior, not the child,” she says. “Be clear about expectations and consequences, but always provide unconditional love and support.”

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