Dr. Stein's Psychology Blog
My thoughts on mental health counseling, therapy, neuropsychology, collaborative divorce and more.
Recently a second grade female visited my office, along with her mother, in my Red Bank office for an initial consultation. Her mother reported that the girl was unable to read, write, and spell at grade level, and the teacher reported the daughter was “lazy,” “careless,” and “immature.” The student’s grades were high enough that the school district was not offering any additional help. However, her mom suspected that the average and below- average grades her little girl was earning did not reflect the student’s true abilities. And what was even more concerning to the mom was how the girl described how she often felt “dumb” and frustrated in school. Outside of the classroom, the elementary school girl appeared bright, highly intelligent, and articulate. Her mother asked me to assess whether or not her daughter was suffering from a learning problem.
The parent was familiar with dyslexia, but believed many of the myths that she had heard about in passing that are listed below.
Myth 1: Dyslexia is a visual or visual perceptual problem.
FACTS: Dyslexia is a problem with language processing at the phoneme level, sounds in a specified language that distinguish one word from another, not a problem with visual processing. While dyslexia impacts reading, it is not a visual problem. Dyslexia occurs in children with normal vision and intelligence.
Myth 2: Writing letters and words backwards is a symptom of dyslexia.
FACTS: Assessing written letters or words is not very useful in determining the presence of dyslexia, especially in older children and adults. In fact, a child can be severely dyslexic and have no history of letter or word reversal. It’s common for all beginners to write letters or words backwards as they are learning to write. This happens because young children are still in the process of mastering letter forms and spelling (orthographic representations.) Therefore, backwards letters or words do not necessarily signify a reading disability in children.
Myth 3: Dyslexia can only be diagnosed after a child begins school.
FACTS: Because a large part of a child’s ability to read is based on spoken language, parents and teachers may spot clues to dyslexia before formal education begins. Very young children who struggle with dyslexia often don’t recognize simple rhyming patterns such as “fit, sit, and bit”. Also, very young children who have dyslexia also find it difficult to learn the letters of the alphabet and appear to be unable to recognize the letters in their name. Dyslexia can be accurately diagnosed at about five years of age.
Myth 4: Dyslexia is more common in boys than girls.
FACTS: A well-known study by the Journal of American Medical Association (JAMA) demonstrated there are no differences for dyslexia between genders. Previously, it was supposed that boys were more likely to have dyslexia compared to girls. However, the gender myth of dyslexia continues and, unfortunately, the possibility of dyslexia in females is usually considered later in their academic career than it should be.
Myth 5: There is nothing one can do to lessen the burden of dyslexia on reading, writing, and spelling skills.
FACTS: Because dyslexia ranges from mild to severe, it may not be recognized unless a school or parent pursues an in-depth psychological evaluation of the child. Without a diagnosis and understanding of the condition, learning to read typically takes more time and effort than it does for dyslexia-free children. Dyslexic children benefit from learning strategies that will help them compensate for the condition. Usually, they gain these strategies with tutoring or an individualized education plan.
After we reviewed the myths and facts, the parent in my story gave me the green light to go ahead with a series of tests and interviews. I diagnosed her daughter as having dyslexia. Once the girl’s dyslexia was identified and other learning disabilities were ruled out, I made suggestions for classroom accommodations and interventions. With that information, her school specialists were able to devise an individualized and detailed learning plan. Over time, the student's reading abilities improved and so did her motivation and enjoyment of learning.
In conclusion, a psychologist can be of assistance with dyslexia, or ruling it out as factor in one’s life. The earlier the problem is diagnosed in the academic career, the easier it is to lessen the issue. If you think you child may have dyslexia or another type of learning disability, feel free to call my office for a 15-minute free consultation to discuss how I may be able to meet your child’s needs. 732-747-8818.
Have you been referred to a psychologist by a school or medical professional because it’s suspected that your child may have Attention Deficit Hyperactivity Disorder? Over my 13 years of mental health private practice, I’ve noticed how confused and overwhelmed parents and guardians can get when faced with this task. When they initially contact my Red Bank, New Jersey office they are unsure about what an evaluation will entail and what kinds of useful information it will uncover. Below are 5 valuable and frequently asked questions parents ask in their first phone call or initial visit to me.
1) What exactly happens during an evaluation For ADHD?
A child neuropsychological examination should be comprehensive and extend over the course of several visits. That means the examiner over a period of time will want to meet with at least one parent or guardian, the child, review medical and school records, interview a teacher, and conduct a wide variety of intellectual, academic, cognitive, psychological, and social assessments. All testing data, should be scored and statistically compared to other children or adolescents your child’s age.
2) What are the tests like?
My office embraces the digital world and kids engage with the tests using an iPad. This tool speeds up the comprehensive process and provides accurate results. The tests themselves present a wide variety of tasks ranging from visual and verbal attention to reading comprehension. For most, testing begins at an easy level and becomes more challenging as the child progresses.
3) Why is about six hours of testing necessary?
Attention Deficit Hyperactivity Disorder is challenging to correctly assess and cannot be accomplished through simple observation. Also, children and adolescents with ADHD are very likely to have a second or even third diagnosis that includes additional types of learning disabilities, anxiety, and/or depression that all can impact school and social functioning. In order to boost the child’s academic and social functioning, other diagnoses must be identified or ruled out.
4) Who will do the actual testing?
It is crucial for a psychologist to do the testing, without the use of testing technicians. In addition to the data gathered through interviews and the iPad, the psychologist needs the opportunity to observe and gain insightful information about the student. I personally and directly handle all aspects of the assessment procedures. This allows me to get first hand observations of how the child problem-solves challenging test items and handles frustration. At the end of six hours or more of direct testing and observation, I get to know the child’s personality very well and am able to comment on other important aspects that may impact academic functioning such as anxiety, impulsivity, or inattentiveness.
5) What happens once testing is completed?
After the assessment procedures are finalized and the data has been analyzed, I write a detailed report, typically 12-16 pages long, regarding the child’s medical, social, and academic history. The report will also describe the child’s intellectual, academic, and psychological functioning in terms of strengths and weaknesses. I provide an accurate diagnosis or diagnoses, and most importantly, recommendations for treatment and academic interventions. The report is easy for parents and guardians, teachers, and other healthcare professionals to read and understand. The report can also be used as a baseline measure to the effectiveness of both academic and treatment interventions and/or for a school Individual Educational Plan.
If you think your child or teen would benefit from a psychological evaluation for ADHD, or a learning disability, please call me at my Red Bank, NJ office at 732-747-8818 for a free 15-minute consultation where we can decide together if making an appointment is the right move.
I'm a clinical psychologist and neuropsychologist with a private practice in Red Bank, NJ.