Learning Disorders – Evaluating your child

When to Consider Seeking Additional Help

• We all worry about our kids. One of the challenges of parenting is knowing when a worry should prompt action. How do you know when to get help for a child who is struggling?
• When the behaviors you worry about are seriously interfering with your child’s ability to do things that are age-appropriate, or your family’s ability to be comfortable and nurturing, it’s important to get help.
• Here are some things mental health practitioners recommend you consider in deciding whether a child needs professional help.

What are the behaviors that are worrying you?
Observe and record specific things you are concerned about. Try to avoid generalizations and record specific actions.

How often does it happen?
Since many problematic behaviors—fears, impulsiveness, irritability, defiance, angst—are behaviors that all teenagers occasionally exhibit, duration and intensity are often key to identifying a disorder.

Are these behaviors outside the typical range for his/her age?
It’s often useful to share your observations with a professional who sees a lot of teenagers—a teacher, school psychologist, or pediatrician, for instance—to get a perspective on whether your child’s behaviors fall outside of the typical range for his age group.

How long has it been going on?
Problematic behavior that’s been happening for a few days or even a few weeks is often a response to a stressful event, and something that will disappear over time. Part of diagnosing a child is eliminating things that are short term responses, and probably don’t require intervention.

How much are they interfering with his/her life?
If a child is unable to do things he wants to do, or take pleasure in many things his peers enjoy, or get along with teachers, family members and friends, he may need help.

What’s next?
If you’ve determined that your child’s behaviors, thoughts, or emotions might call for attention, your next move is to consult a professional.

Where should you go?
Where to start depends on the makeup of your child’s current healthcare team and the services available in your area. Not all of the specialists below will deliver a diagnosis, but many of them (pediatrician, school psychologist) can be valuable in the process of getting an accurate diagnosis that will help your child.

Where do I start?
For most parents, consulting your family doctor is the first step. While medical doctors are not required to have substantial training in mental health, many do diagnose and treat psychiatric disorders, and others may be able to refer you to a specialist who can.

Who can I consult?
After consulting your family doctor, seek a referral or find another clinician if you’re not comfortable with what your doctor offers

How do I get an evaluation for learning issues?

Formal evaluations examine how your child processes information. There are different kinds of evaluations, including educational evaluations (which assess reading, writing, math, and spelling ability) and neuropsychological evaluations (which develop a wide profile of a child’s skills and abilities in reasoning, learning, memory, visual and auditory processing, listening comprehension, verbal expression, executive functioning skills, and academic abilities). Evaluations also establish a baseline for measuring your child’s progress, and they are a necessary step to qualifying for accommodations or special education services. Schools are legally required to provide an evaluation according to the Individuals with Disabilities Education Act (IDEA). The school might be the first to suggest an evaluation, or you can begin the process yourself by requesting an evaluation in writing. The National Center for Learning Disabilities has a sample letter you can use. After receiving your written notice, the school will set up a time to discuss an evaluation with you. You should bring your child’s school records, notes from teachers, and your own written observations to the meeting, and come prepared to discuss them. The school staff is required to share with you the kind of evaluation they feel is appropriate, and you have the right to object to the kind of assessment offered, or request a different one. You will ultimately need to sign a consent form before the school is allowed to perform a formal evaluation. After the evaluation the school is required to give you a copy of the results. If you prefer, you can also get a private evaluation from outside the school, although you will need to pay for it yourself. You can then choose whether or not to share the results with the school.

Types of Doctors

Child adolescent psychiatrist – medical doctor equipped to diagnose full range of disorders recognized in the Diagnostic and Statistical Manual (DSM)
Clinical child psychologist – trained to diagnose whole range of disorders, and can coordinate with other necessary evaluations

Neuropsychologists – specialize in brain function related to behavior and cognitive ability. Consult if your concerns include issues of focus, attention, problem-solving, or learning. Neuropsychologists can determine the likely cause of these problems

Neurologists – medical doctors who specialize in the nervous system. They can determine whether symptoms are the result of nervous system disorders, such as seizures.

School psychologists – serve as a repository of information from school reports and perhaps as a coordinator for a larger intervention team for your child. A school psychologist, much like a pediatrician, is a great place to start with your concerns, get advice, and, perhaps, a referral.

Social worker – one of the first people a child will see if he is having difficulty in school or is referred to a mental health facility. Licensed clinical social workers are extensively trained to assess the needs of a child and his family needs, diagnose psychiatric problems, and develop a treatment plan with the family.

Questions to Ask
When looking for a mental health specialist to provide an evaluation for your child, you’ll want to be prepared with questions that will help you decide if a particular clinician is a good match for your needs:

• Can you tell me about your professional training?
• Are you licensed, and, if so, in what discipline?
• Are you board certified, and, if so, in what discipline?
• How much experience do you have diagnosing teenagers whose behaviors are similar to my child’s?
• How do you arrive at a diagnosis?
• What evidence do you use?
• When do you consult with other professionals?
• Do you provide the treatments you recommend, or do you refer to others?