ParentConfidante Blog

Changing the Diagnostic Criteria for Autism and Asperger Syndrome

The American Psychiatric Association is reassessing the diagnostic criteria for autistic and the proposed changes, as described in the NY Times article of Jan. 20,2012, may exclude many people who are now diagnosed as having Autism, Asperger Syndrome or Pervasive Developmental Disorder-Not Otherwise Specified (P.D.D.-N.O.S).  These diagnoses would be consolidated under one category - Autism Spectrum  Disorder - eliminating the Asperger's and PDD-NOS categories.  While the new criteria will have little impact on the diagnosis of youngsters who are "classically autistic" - those who have severe limitations in their cognitive and social functioning- there may well be an impact on those youngsters who are cognitively able but have a social disability.

Parents are understandably concerned given that mandated services (IEP) are often dependent on a diagnosis.  It will be important to see how the changes  will ultimately affect the delivery of services, but the attempt to clarify diagnosis is an important and needed undertaking. In the past, there has been a good deal of confusion especially regarding the identification of Asperger Syndrome - does every child who prefers to play alone have Asperger's and are deficits in social intreraction the main determinant?  In fact, there are other determining factors for a classification of Asperger Syndrome and many children who fall within this group need continued support.

There was some concern when it was first divulged that there would be a consolidation in criteria with Asperger's eliminated, because Asperger Syndrome, properly diagnosed, is distinct from classical autism and descriptive.  It will be important, in the tightening up of this diagnostic category, that those who need services continue to receive them.  While these youngsters are cognitively able, their narrow interests, perseverative behavior, and social incapacity makes it very difficult from them to succeed without support.

 

 

Dyslexia and Auditory Discrimination: Is There a Link?

 Unfortunately there is no definitive understanding of what causes dyslexia, a severe reading disorder.  In spite of numerous studies and theories, the underlying causes are unknown and remediation can be a hit and miss process.  A recent article in the New York Times on 8/2/11 (Study Says Dyslexia May have Auditory Tie) described a research project at MIT which found that dyslexics had much much difficulty recognizing voices than non-dyslexics.  The  difference was so great that a problem in this area could be used as a diagnostic tool.

While this study is interesting, the link between weak auditory discrimination and dyslexia is well known and in fact one of the first clues may be trouble rhyming  - the child just doesn’t hear the sounds. Early intervention is crucial because auditory discrimination can be improved and children can be taught to read by other methods if they can’t latch onto the sound/symbol relationship.

If you think your child may have a problem, early assessment by a speech/language therapist, learning disabilities specialist or psychologist is critical.  If you live in Manhattan, Brooklyn, Riverdale, Westchester, or New Jersey, I can help you by meeting your child and hooking you up with some of the most highly regarded and experienced local practitioners.  Call me at 646-300-1881 or toby(at)parentconfidante.com for information about my consulting services. 

 

TWICE EXCEPTIONAL SCHOOLS for NYC 2e children

  Two recent additions to the array of private schools in NYC focus on the twice exceptional child - that child who has excellent cognitive ability but also a learning disability, ADHD, or emotional or social difficulty which impacts their success - thus 2e.  The Quad Preschool opened it's doors in September, 2010 as did the Lang School (K-8).

The time is right for these schools to open as I think there is a real need.  In my work with children as a school psychologist, CPSE Chairperson and as a special needs educational consultant, I have seen many children who have been exceptionally bright but were hampered by social or learning problems.  They often had superior language skills but couldn't concentrate or listen in a group - one on one with an adult they were a delight.  It was often difficult to find the right school for these children, because in spite of their learning difficulties, they need high level language stimulation and an enriched curriculum - as well as the right educational, behavioral and emotional remediation and support.  Without that stimulation, there is increased danger of underachievement and a lack of motivation.

I'ts wonderful to have these "twice exceptional" schools as special needs private school options in NYC.

 

  Two recent additions to the array of private schools in NYC focus on the twice exceptional child - that child who has excellent cognitive ability but also a learning disability, ADHD, or emotional or social difficulty which impacts their success - thus 2e.  The Quad Preschool opened it's doors in September, 2010 as did the Lang School (K-8).

The time is right for these schools to open as I think there is a real need.  In my work with children as a school psychologist, CPSE Chairperson and as a special needs educational consultant, I have seen many children who have been exceptionally bright but were hampered by social or learning problems.  They often had superior language skills but couldn't concentrate or listen in a group - one on one with an adult they were a delight.  It was often difficult to find the right school for these children, because in spite of their learning difficulties, they need high level language stimulation and an enriched curriculum - as well as the right educational, behavioral and emotional remediation and support.  Without that stimulation, there is increased danger of underachievement and a lack of motivation.

I'ts wonderful to have these "twice exceptional" schools as special needs private school options in NYC.

  Two recent additions to the array of private schools in NYC focus on the twice exceptional child - that child who has excellent cognitive ability but also a learning disability, ADHD, or emotional or social difficulty which impacts their success - thus 2e.  The Quad Preschool opened it's doors in September, 2010 as did the Lang School (K-8).

The time is right for these schools to open as I think there is a real need.  In my work with children as a school psychologist, CPSE Chairperson and as a special needs educational consultant, I have seen many children who have been exceptionally bright but were hampered by social or learning problems.  They often had superior language skills but couldn't concentrate or listen in a group - one on one with an adult they were a delight.  It was often difficult to find the right school for these children, because in spite of their learning difficulties, they need high level language stimulation and an enriched curriculum - as well as the right educational, behavioral and emotional remediation and support.  Without that stimulation, there is increased danger of underachievement and a lack of motivation.

I'ts wonderful to have these "twice exceptional" schools as special needs private school options in NYC.

Best Early Intervention Helps Manhattan Preschooler into Mainstream Private School

I was very happy today to get this email from a former client.

Toby,

I just want to let you know that <child's name> made dramatic improvement this year and actually made it into <mainstream Upper East Side NYC private school>!!!  Can you believe it?  We can't and as you can imagine we are overjoyed!

The audiologist and the speech therapist you recommended made all the difference, especially after <NYC preschool director> sent us on that wild ride.  You would not believe how <child's name> is now totally in the mix in class.  He even gets invited to playdates.  What a difference we've seen this school year.

Thank you again.

Help for NYC Siblings of Autistic Children (Unlike During Allen Shawn's Childhood)

In the New York Times Style Magazine (12/5/10), there is an excerpt from Allen Shawn’s upcoming memoir, “Twin”, in which he writes about the disappearance from his life at the age of 8 of his twin sister, Mary.  Allen, the son of William Shawn, the legendary New Yorker editor, describes how he felt when Mary, diagnosed as autistic, was sent to Sandpiper, a residential school for mentally disabled children.  Except for scripted letters and occasional visits, she vanished from the everyday life in Manhattan of Allen and his brother Wallace, leaving Allen disoriented, with a fierce fear of loss and a consuming focus on “truthfulness”.  As he puts it, Mary’s “departure from our life was like an unmourned death”.  The family rarely referred to her.

Mary is described as inner directed, but also connected to her siblings, showing affection and sometimes joining them in their games.  She could be erratic in her moods and not communicative verbally.  She is not described as explosive, out of control or a danger to herself or others and there’s no question that in our time, she would have stayed with the family.  What happened to Mary is reflective of how children with severe mental, developmental or emotional disabilities were treated in the 50’s and 60’s and her residential placement was no doubt recommended and supported by the professionals who were working with her.

Parents, often bewildered and surely guilty, felt that sending children with disabilities away was beneficial to them and the whole family and it seems that little notice was taken of the impact that such a banishment had on the other children in the family.  While it is probable that Mary’s life experience was narrowed and her potential curtailed, the impact on the other children was also profound.  Allen didn’t understand until he was an adult that his severe anxiety disorder was directly related to what happened to his sister.

There is currently much more of a realization of what should have been clear - that the normally developing siblings are impacted by the decisions made regarding the child with special needs.  Allen’s life experience would certainly have been different if his parents were able to talk about why they sent Mary away and maintain more contact with her.  However, in those days such openness would have been extraordinary.  More common then, and often now, is the shame and guilt that limits communication.

Today, there are programs available to help brothers and sisters of individuals with special learning, health, emotional of developmental needs.  One of the best known programs is Sibshops which provides a framework for siblings to meet with peers and share experiences, feelings and advice.  The meetings have a recreational aspect as well and are fun.  Many agencies sponsor Sibshops and availability should be checked on the internet. 

Perhaps if Sibshops were available for Allen, he would have been spared some of the emotional stress in his adult life.  But that wasn’t the style in those days (maybe that’s why this article was in the Styles section.)

I have lead Sibshops and know first hand how liberating and beneficial these groups can be for youngsters with special needs siblings.

In addition, numerous Manhattan, Brooklyn, New Jersey and Westchester families have hired me to meet privately with them to discuss how to help siblings of autistic children.  Luckily, today, we recognize the needs of all children in a family.

Coping with Dyslexia

I recently read an article about Dannel P. Malloy who is running for Governor of Connecticut.  Although Mr. Malloy graduated magna cum laudi from Boston College and from Boston College Law School, as a child he had trouble learning to read, do math and master basic skills such as tying his shoes.  As late as the fourth grade, his teachers thought he was retarded.  However, his mother knew better and she encouraged him to concentrate on what he could do well.  For instance, she knew Dannel had a good memory and gave him a radio so he could hone his oral listening skills.

It turned out, Mr. Malloy had a learning disability which thirty years ago wasn't as readily discerned as today.  Mr. Malloy eventually learned to read although to speed the process, he listened to books on tape until he was a sophomore in college.

I find Mr. Malloy's story interesting in many ways. He was so lucky.  First, his  remarkable mother listened to her intuition about her son and not what she was told.  She encouraged him to use the skills he had, while helping him overcome his weaknesses.  Too often, we as parents overlook our children's strengths because we're so concerned about the implications of their weaknesses.  In addition, he was lucky that he was in a mainstreamed learning situation where he could learn and be intellectually stimulated by listening.  Mr. Malloy also learned what it takes to be successful.  Learning disabled children have to work harder than anyone just to keep up.  But that hard work, determination and perseverance pay off.  It certainly has for Mr. Malloy.

We often tell children about famous people (e.g. Nelson Rockefelor, Tom Cruise) who also struggled with learning disabilities.  To that list we should add Mr. Malloy (and his mother).

In my special needs consulting in NYC, Westchester and New Jersey, I often hear parents say that their pediatrician told them not to be concerned about the delays they saw- that all children develop differently.  But, these parents listened to their intuition, had their children evaluated and had them receive early intervention special education services.  Early Intervention made all the difference - many of the children are now in regular classes doing well.

 

 

Should Parents Share Information regarding Special Education Services?

Parents of youngsters receiving special education services are often concerned about telling their child's prospective kindergarten teacher that their child has received services through Early Intervention or CPSE. Early intervention services did what it's supposed to do and their child is now ready to go into a regular class, but parents are uneasy about sharing the history of special needs. They fear that if the teacher knows that their child once needed additional help, their child will be stigmatized in some way and that the teacher will look for problems that aren't there.  This is especially true in the NYC where parents are knowledgeable and wary. 

In my experience this concern is unfounded if understandable.  Teachers are much more concerned with how a child is functioning now than what they needed in the past.  If the parents were proactive enough to get early intervention services, that's positive.  In addition, there might be some residual weakness that the teacher should know about so that teaching is more effective.  For instance, if there was a receptive language issue, the teacher would double check to see that the child understands the classroom directions. If auditory processing is slow, the child may need extra time to respond to a question. If OT was needed, the child might still benefit from a special pencil grip which could be put in place from the beginning of the year to limit frustration.

In short, when a child has or is still receiving some kind of services, it's a good idea to let the teacher know.  The teacher and child will only benefit from the sharing of this knowledge.

 

Why to NYC Toddlers Need Therapy?

A recent article in the Wall Street Journal focused on the growing practice of providing mental health professionals to preschool and child care centers.  These counselors help children who are having behavior or social issues.  They work with the youngsters, teachers and sometimes parents to help children find more acceptable ways of expressing their feelings - such as saying what they are feeling instead of hitting.  They help children socialize and manage other anxiety feelings.  These services are especially needed in communities where there is an emphasis on academic achievement like NYC private schools.

The mental health intervention comes amid growing concern that young children are exhibiting more behavioral and social problems than in the past and increasing numbers of children are being "expelled" from preschool.  There are various explanations for this trend from too much and too early large group care, to increased anxieties in familor increased academic pressure on young children.

While all of these issues enter in, I think that a major factor is the pressure on children to develop reading and math skills before they're ready to grapple with those concepts. Increased behavior problems may well be an unintended consequence of the trend to make the preschool curriculum (which used to be learning through play) explicitly academic.

I'm a great believer in mental health services and social skills developed now will last a life time, but it may be past time to take a good look at what we expect of our youngsters in preschool these days.  I would guess that there are fewer behavior problems in those preschool settings that are play centered as compared to those that are more academically based.

I'll be writing more on this issue which has long been of concern and interest to me.  As an educational consultant (toby@parentconfidante.com) I'm often asked if children need special services, what can be done to help them focus, what can be done to help them learn better.  I make referrals to the most trusted professionals but sometimes it's also important to take a good look at what is beiing expected of these little kids.