Dr. Stein's Psychology Blog
My thoughts on mental health counseling, therapy, neuropsychology, collaborative divorce and more.
As parents, we tend to trust in our child’s school system, with the notion that its priority is our children’s educations. However, these days, thanks to state and federal policies, most school districts are in a cash crunch. Sometimes it seems like they may care more about saving money than discovering how to meet students’ individual educational needs better. That means in-school evaluations may be shortchanging your child’s learning potential.
Over the course of my years in practice as a Neuropsychologist in Monmouth County, New Jersey, I have completed many educational evaluations. As part of that process, I’ve reviewed hundreds of evaluations for children of all ages that were completed by specialists employed full-time by school districts. Unfortunately, some of these have not been as valuable as they should have or could have been. Simply put, in-school evaluations may fall short in several important areas and provide only partial information. Why is this limitation a significant problem? That is because time is of the essence in terms of a child with special learning needs. Specifically, the longer a child with special learning needs waits for proper academic or behavioral interventions or accommodations, the further he or she will fall behind. Below are some of the restrictions of an in-school evaluation compared to a private psychoeducational evaluation.
1. So Many Students, So Little School Time: In-school specialists have large caseloads of students and a narrow amount of time and resources to spend on each of them. This can severely limit the breadth and depth of their evaluations. While an in-school evaluator may be afforded two hours of time to complete testing, enough for a basic intelligence test and perhaps an academic battery, an independent neuropsychologist is free from those restraints. A thorough evaluation can take 10 hours of face-to-face interaction with a student and his or her parents/guardians. Discovering what specific problems a student is having in school, why he or she is having those difficulties, and what can be done to help simply cannot be accomplished in a two-hour evaluation. Learning problems are complex and intricate. Most often, a student has more than one learning struggle and maybe even a co-occurring psychological issue with external stressors at home or in his or her social life. When I complete an evaluation, I gain a comprehensive understanding of a student’s personal strengths and weaknesses. I use this data to provide very specific recommendations and accommodations that are tailored to meet the individual needs of the child rather than the school’s financial needs.
Also, there is a long process that teachers and parents are required to go through before schools agree to evaluate students. Sometimes just getting the wheels turning can take up to nine months while the student flounders. Once the process begins, schools have a legal time frame they are required to stick to, but sometimes they purposely take the entire time allotted in order to stall the process or save money. Using an independent evaluator tends to be not only more effective, but also more efficient.
2. Educational Evaluations Require A Lot Of Detective Work: An educational evaluation is a mystery to be unraveled. In order to come to the right conclusion, every clue must be followed until the student’s problem(s) can be correctly identified and solved. But in-school evaluations typically are “once size fits all.” That means that all students get the same tests and the same evaluation. This is discouraging; an effective educational evaluation should be specifically tailored to each and every student.
For instance, I have seen many in-school evaluations note a student’s difficulty with attention and focus. But, they simply stop there, and draw conclusions. Identifying whether or not a child can pay attention in class is only the first step. Attention is a very broad skill; there are many different types of attentional abilities including visual, verbal, simple, complex, sustained, selected, alternating and more. An evaluator must identify the specific type of attentional difficulty in order to determine the correct type of intervention to implement. A second example of the limitations of a school evaluation is when the report identifies the student struggles in reading. Reading is a broad ability made up of many other skills including visual perception, phonetics, short-term memory, lexical abilities, and comprehension. Simply identifying a reading problem, like many in-school evaluations do, is like a plumber coming to your house and telling you there is leak, but not bothering to find out where it can be found. There is no real help in that. In contrast, an independent neuropsychologist can provide the full range of necessary insight.
3. It’s a Challenging Puzzle to Piece Together: Completing an effective comprehensive educational evaluation requires a deep breadth and depth of knowledge and abilities across many areas. Some in-school evaluators lack this expertise and are not able to comment in-depth about a student’s cognitive abilities, academic skills, neuropsychological functioning, and social skills. Having this expertise and knowledge base is essential in taking large amounts of information gained in an evaluation, understanding the interaction of cognitive skills and academic functioning, and distilling this information into a cohesive and understandable report that will benefit the student. Too often I have seen a school’s computer printouts of intelligence tests or academic batteries used as ineffective, “cookie-cutter” reports that do not clearly explain a child’s strengths and weaknesses to a parent.
4. Privacy Concerns: Although your child has a confidential school record, the results of an in-school evaluation can be seen by anyone who has a right to look at those records. You might not feel comfortable with that. However, the school staff only sees a private evaluation if you decide to release it to the school. Also, even though an in-school evaluation would take place in the somewhat familiar setting of the student’s school, he or she would likely be pulled out of his or her regular schedule for the testing process. This sometimes makes students feel stressed out or embarrassed. Your child may prefer the privacy of a Neuropsychologist’s office outside of school.
5. Freedom Of Expression: School evaluators are part of a school’s team. You can’t select them. Plus, their suggestions may be influenced by school concerns, such as resources. As someone who does not work for a school district and who is independent, I am free to make any and all recommendations that I see fit to benefit the academic, social, psychological, and cognitive functioning of a student. Additionally, since my evaluations are conducted in a methodical and scientific manner, those recommendations are easily supported and defended.
In conclusion, although it is always important to keep an eye on one’s budget, psychoeducational evaluations may not be the place to cut economic corners. A child who is struggling in school does not deserve to be shortchanged; the student needs his or her parents and teachers to get as much understanding into the situation as possible to maximize learning prospects. If you think your child might need a psychoeducational examination, call me for a free, 15-minute, consultation where we can discuss it. In certain circumstances, the relief that appropriate learning accommodations and interventions can give are priceless, and only a comprehensive evaluation can provide the information you need. 732-747-8818
Finding out your child has been diagnosed with dyslexia is not easy news for any parent to hear. One of the first things you should do is take a deep breath and watch this YouTube video: https://www.youtube.com/watch?v=fzHaLYsTgJc. In it, you will see that your child’s potential is still endless.
In my many years of counseling and conducting neuropsychological examinations in Red Bank, New Jersey, I have helped many parents move through and beyond their child’s diagnosis of dyslexia. Once parents digest the news and get assistance with a learning plan for their child, parents they often still have a wide variety of fears and concerns. The feedback I give is influenced by both clinical research and my own personal experience as being diagnosed at age 7 with dyslexia. Below are some of the most frequently questions I am asked along with the advice I offer:
Will My Child Be OK? I always answer this with a resounding “YES.” By the time I gather enough data to diagnose dyslexia, I have already conducted a full neuropsychological examination that also includes a thorough evaluation of a child’s many cognitive, academic, and psychological strengths. While a lot of time and effort is focused on the dyslexia itself, what is equally, if not more important, are the child’s assets. Utilizing the child’s strengths helps to set them up for success, and while there is no “cure” for dyslexia, a strengths-based approach is a time-tested compensatory strategy in the school setting.
Do I Tell My Child They Have Dyslexia? Again, I always answer this question with a resounding “YES.” While I recognize this is a difficult conversation for parents to have with their children, it is an important one to have, multiple times, throughout their academic career. Children are often relieved to know that there is a name for the struggles that they are experiencing in school. After all, the child most likely already recognizes a problem exists because of feedback he or she has received from other teachers, parents, or by their own observation of others’ performance in the classroom. What is most important to help your child understand is that he or she will learn to read and that he or she is not “dumb”, “stupid,” “lazy, or any other pejorative adjective.
Do I Tell My Child They Will Be Getting Special Services? Yet again, I always answer this question with a resounding “YES.” Much of the time, this is the part of the conversation that children dislike the most. While they may feel better by being able to put a name to their reading struggles, most balk at the idea of change -- actually getting help, tutoring, or special services –even though it’s designed to assist them become stronger readers. While children can keep the diagnosis of dyslexia to themselves, others may notice that they are indeed different learners. Kids generally don’t like the idea of being perceived as different. It is important for them to be able to express their concerns. They need to hear that you understand their anxieties, dislikes, and frustrations with any modifications to the school routine. Talk to them about how these changes will not just help them become better readers, but will also increase their enjoyment of school. With gentle reassurance your child will not just adjust, but thrive. Also, you should highlight your child’s special talents, skills, and personality traits.
In summary, rest assured that a brain with dyslexia is healthy. It just works differently. Is school going to be as easy as it is for some other children? Probably not. It is going to take some hard work. But, it can generate a lot of creativity and resilience in your child. If you had asked my mother when I was in middle school if I would go on to earn a PhD, she likely would have answered no. But look at me now.
If you think your child may benefit from an evaluation to determine whether or not he or she has dyslexia, let’s chat for a free 15 minutes. Or if you need some help adjusting to a new diagnosis, I’m here in my office for that as well. 732-747-8818
While it’s common knowledge that kids who have dyslexia find reading to be a more challenging task than others, most people don’t realize that there are actually different types of dyslexia, all of which can make mastering reading difficult. In my experience as a child neuropsychologist in Red Bank, New Jersey, I have gained expertise in distinguishing the different types of dyslexia. I tailor specific remediation or compensation strategies based on the specific needs of the child and his or her type of dyslexia in order to help solve the problem.
Generally speaking, there are three different broad categories of dyslexia. (Also, it is possible for a child to have more than one type of dyslexia.):
Phonological Dyslexia: Phonological dyslexia is one of the most common forms of dyslexia and is aquired developmentally through heredity and genetics. Approximately 75% of all dyslexia cases fall into this category. It is characterized by problems with subtle deficits in auditory abilities, because believe it or not, learning to read is a skill heavily influenced by oral language abilities. In laymen’s terms, phonological dyslexia is an issue with breaking words down into syllables and into even smaller units of speech referred to as phonemes. For instance, if you verbally present a word to a child who has trouble sounding out words, he or she can hear the word without difficulty and even repeat it back to you accurately. However, the child will not be able to tell you how to divide that word apart into the different sounds that make up this whole word.
A child with phonological dyslexia finds it frustrating to match the phonemes (sounds) with their written symbols (graphemes). When testing for phonological dyslexia, psychologists provide children with made up words to determine if the child can sound it out correctly. For example, the psychologist would show the word “bab,” a made up word, to the child. A child with phonological dyslexia would typically struggle to read the word “bab” aloud correctly.
Surface Dyslexia: Surface dyslexia is a type of dyslexia is also development and passed down through genes. Unlike phonological dyslexia, a child with surface dyslexia can sound out words well, even nonsense words. However, he or she can’t read or spell words spelled irregularly. It’s hard for the child to recognize irregular words, even after seeing them more than once. They need to scruntinize some words, sound them out, and decode them upone every encounter. Some examples of challenging sight words for a child suffering from surface dyslexia are “island” and “yacht.” Surface dyslexia impacts rate of speech and reading comprehension. Surface dyslexia also negatively impacts spelling skills.
Attentional Dyslexia: Although the name suggests that there may be a focus problem, attentional dyslexia is NOT connected with Attentional Deficit Disorder (ADD). Attentional dyslexia is a rare type of dyslexia, typically caused by damage to the left parietal lobe of the brain from labor, illness, or accident. It is a reading problem in which letters migrate between neighboring words. The child can accurately pronounce and sight read words. However, in this form of dyslexia, letters actually seem to move to other words. For example “lap dog” could be read as “dag log.” It’s a challenge for the reader to keep the relative position of the word intact. As they child becomes older and is presented with longer and more complex words, reading comprehension decreases. Also the disorder is negatively impacted by strong emotions such as anxiety, anger, and excitement. Behavioral therapy with a psychologist may help manage emotions and improve reading ability.
Once a reading problem is identified, it is possible to learn strategies to improve reading skills and minimize frustration. If you or someone you know is struggling with reading in any way, consider scheduling an appointment with me for a psychoeducational evaluation. Feel free to call me at my office for a 15 minute free consultation to determine if this is right for you.
I'm a clinical psychologist and neuropsychologist with a private practice in Red Bank, NJ.