11830 Westline Industrial Drive St.Louis,MO 63146 LEARNING RE-ENABLED: A PRACTICAL GUIDE TO HELPING CHILDREN 0-323-02772-5 WITH LEARNING DISABILITIES Copyright © 2004, Mosby, Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means,electronic or mechanical,including photocopying,recording,or any information storage and retrieval system,without permission in writing from the publisher.Permissions may be sought directly from Elsevier’s Health Sciences Rights Department in Philadelphia,PA,USA: phone: (+1) 215 238 7869,fax: (+1) 215 238 2239, e-mail: [email protected] may also complete your request on-line via the Elsevier Science homepage (http://www.elsevier.com),by selecting ‘Customer Support’and then‘Obtaining Permissions’. NOTICE Occupational therapy/special education is an ever-changing field.Standard safety precautions must be followed,but as new research and clinical experience broaden our knowledge,changes in treatment and drug therapy may become necessary or appropriate.Readers are advised to check the most current product information provided by the manufacturer of each drug to be administered to verify the recommended dose,the method and duration of administration,and contraindications.It is the responsibility of the licensed prescriber,relying on experience and knowledge of the patient,to determine dosages and the best treatment for each individual patient.Neither the publisher nor the author assumes any liability for any injury and/or damage to persons or property arising from this publication. International Standard Book Number 0-323-02772-5 Publisher:Linda Duncan Managing Editor:Kathryn Falk Publishing Services Manager:Pat Joiner Project Manager:Gena Magouirk Design Project Manager:Bill Drone Printed in USA. Last digit is the print number: 9 8 7 6 5 4 3 2 1 In loving memory of my parents, Lillian Levinson Schriber and Max Schriber. Your lessons in life andlove live on as a vibrant guide and a loving benediction. Road, n. Astrip of land along which one may pass from where it is too tiresome to be to where it is futile to go. Ambrose Bierce U.S. Political Journalist 1842-1914(?) And so this pessimistic view of life in the early part of the last century seems very close to what some children are probably feeling about their daily life in school. It is anxiety-provoking and tiresome to go to a place every day where, no matter how hard you try – you fail. Learning Re-enabled WHYOT? AND WHAT CAN IT DOAND NOT DO FORYOUR NEEDS? If you have ever asked yourself... Why me? Why my child? How can this be? Where do I go? What does this mean? Why didn’t my pediatrician/doctor pick this up? Where do I start? Can this be fixed? The possibility exists that if you are reading this book,you are either a parent,a teacher,a therapist,or an individual with a learning disability. It is the mission of this book to talk with and to you.Irrespective of what you may feel inside,what kids ontheplaygroundhave said,or a boss made you feel,YOU are not “damaged goods.”We allhave our unique style of doing things.If we were all the same,we would all be Einsteins,Olympic athletes,and world-renowned scientists.Where to go,what to do,how to do it,what to expect: It is the intent of our services to answer these key questions and to give you a foundation from which to be both an informed consumer and an advocate for yourself,your child,or your student. Your reactions are normal,and they need to be addressed,acknowledged,and responded to with empathy and constructive support. So if you have ever asked yourself: Why me? Why my child? How can this be? Where do I go? What does this mean? Why didn’t my pediatrician/doctor pick this up? Where do I start? Can this be fixed?, you are not alone. This is often the first set of questions parents,children,and other“first-time hearers”ask themselves and anyone they feel they can trust or in whom they have placed educational confidence.The denial,the anger,and the need to control,if taken at face value,are obnoxious, distancing behaviors that impede rather than impel parents into proactive positive directions and, ultimately,solutions for their children’s learning issues. They are good questions. They are valid.However they are more than that. They are lifelines,not yet attached,not yet secured,which if allowed to tether properly,will serve to guide both the parent and the child into safer waters. The parents must simultaneously learn the lingo,make discriminating choices,and trust at a time when they feel as if they have been transplanted to the proverbial shifting sands. Page ix Learning Re-enabled And then some matter-of-fact administrator,teacher,or psychologist plays Sergeant Friday and just “gives ‘em the facts,”and we well-intentioned professionals wonder in amazement just why these supposedly well-educated people are so weird! It is from this vantage point that parents read the initial reports in unfamiliar lingo while sitting on unfamiliar shifting sands.Often on those reports the recommendation is to have an“occupational therapy”evaluation.More new words,more new people,more trusting what is foreign,more fear. Parents come into occupational therapy not knowing what to expect,protective of their child,half- hearing,whole-heartedly hoping this will“fix it.” Thus comes the second set of questions: How much? How often? It is a time of emotional free-fall for parent and child,and the job of guiding that flight often falls to the pediatric occupational therapist. The careful application ofsensory,integrative,cognitive,perceptual,and developmental therapies is the essence of individualized occupational therapy.The stuff parents and teachers see—coloring, cutting,drawing,building,playing,remembering—happen only after specific neurosensory developmental abilities have reached a level of meaningful processing.Ferreting out the difference between a resistive behavior and an unstable perceptual system of a child is the art of occupational therapy.Understanding the neuromuscular organic systems influencing these reactions is the science of occupational therapy.The therapeutic application of activity is the culmination of both the art (intuitive) and the science (factual) of play and class simulation in occupational therapy. However,with the art and science must come the empathy.Both parent and child are entering a situation fraught with uncertainties.It is the job of the occupational therapist to calm the fears and make familiar that which is not. No pediatric occupational therapy program can be successful without the comments and participation of the parents.They are the foundation from which we begin our work together.We all exist within the context in which we live—our homes,our families,our friends,our jobs.For children,their“job”is going to school.It is what they must do every day.For some children,just the act of entering the classroom can be overwhelming. To manage fears,to find solutions,to expand choices,and to discover inner trust—these are the real goals of occupational therapy.When that happens,all the rest of the fabulous puzzle that is your child comes together. Page x Acknowledgments ACKNOWLEDGMENTS I would like to thank Chris Bonsonatta Doane,MS OTR/L,President of Advanced Rehabilitation Services,for her guidance and generosity.She let me participate in the development of her company, which specializes in staffing and continuing education. Originally,my company,Children’s Special Services,was a division of Advanced Rehabilitation Services.Upon Chris’s insistence,we made Children’s Special Services,LLC a separate entity.Chris, this book is a tribute to your support and confidence in me.Your wisdom and friendship continue to guide me,nurture me,and sustain me. I also would like to recognize the support staff from Advanced Rehabilitation Services,Inc.:Teddi,Bobbi, Beth,and Lorraine.Thank youfor always being there for me.You all are consistently supporting me, handling workshops,and assisting with staffing.To former ARS therapist,Pam Dillard,I wish to say a most sincerethank youfor your patience with me as I learned how to run a business,pace clients,and mentor additional therapists.It has been a pleasure to be part of your professional and personal life. To all the children with whom I have worked over the years,thank youfor briefly letting me into your lives.A special thank youto all the children who came in on a sunny summer weekend morning so that the photos you see in this book could be taken.A very special thank youto Allison and Austin LaBreque,Kaitlin Mullen,Eric Campos,Andy Howell,and Phillip and Nathan Brown. Thank youalso to the many professionals and school principals and directors who had faith in me and allowed occupational therapy into their curricula when even the words seemed weird and out of place. To the faculties and staffs at the Heiskell School,Greenfield Hebrew Academy,The Schenk School, Woodward Academy,Mt.Vernon Presbyterian School,Eaton Learning Labs,Dunwoody Prep Pre-School,Kehelliat Chaim Pre-School,Infants of Dunwoody,the Epstein School,and the Davis Academy all in the Atlanta,Georgia area: thank youfor helping me make my professional dreams come true. This book would never have come to be without the guidance,corrections,interjections,creativity, enthusiasm,direction,and support of Kathy Falk,my editor,and Gena Magouirk,who proofread and fine tuned this manuscript. And last but not least,to my children,Jenny,Rachel,and Nathan.Seeing their learning struggles through their eyes has allowed me to help other children with more clarity. And to David,my husband and best friend,all of this is possible because you constantly support andsustain me. Page xi ✑ Introduction ✑ Page 1 Learning Re-enabled N o t e s This book is all about you,the Listener,the Hearer,the Sayer.Whether you are a teacher or a therapist or a parent,this is about COMMUNICATION. How to say it. How to ask it. How to hear it. There is no way to delete emotion.The information is hard to say,hard to hear,and hard to decipher. To the parent: This is your kid.No one knows him better. To the teacher: You know him thoroughly in task and in socially specific situations. To the therapist: This is the child you have looked at through the microscope of acumen; you’ve got his style nailed. How can all these essential people coalesce proactively? How can they become cooperating citizens of this child’s Babel when they all speak a different language from the heart? How in the world to reach accurate interpretations of all our crucial messages? So this book is about your needs,written by a former special education teacher,a parent of learning-disabled children,and a practicing occupational therapist. How to use this book, and what it can (and cannot) do for you This book is designed to help decipher the maze of information and the confusing, often pressured decisions that parents and teachers (as well as individuals themselves) feel when confronted with situations implying a learning disability. This book is designed to answer your whats,whens,and hows: Whatis a learning disability? Whatis “normal development”? Whenshould you pursue extended help? Howcan you go about getting help? Howcan you help your child at home? It does not answer: Why you? Why your child? or Why did this happen? For those questions,there are no answers.As billions of cells combine and recombine as an individual is being formed before,at,and after birth,many of the combinations are a Page 2 Introduction result of random pairings as well as those predetermined by genetics.This is no one’s N o t e s fault. This book is not designed to help you diagnose your child.For that,you need specialized testing from an educational and developmental psychologist. Chapters 1 to 4 describe what a learning disability is and is not.They illustrate how we learn and how we can adapt learning styles for success.Chapters 5 and 6 scope out developmental frameworks,what the“average”(whatever that means) individual is doing at a particular milestone,and what red flags to respond to or ignore.You are walked through the evaluation and IEP (individual education plan) processes.You will find a to-do suggestion box,suggested activities,and lists of learning toys and equipment and places to buy them.Pictorial demonstrations of occupational therapy in action and writing samples that show dramatic changes in writing skills after therapy are found in Chapters 7 and 8.Finally,in the Appendices you will find a glossary and even more information on the IDEA,Section 504 of the Rehabilitation Act of 1973,and the Americans with Disabilities Act. Remember that there is no expert who will know more about your child than you do. The psychologist,the occupational therapist,and the teacher only see your child in short capsules of time in very specific situations.You,ultimately,are the one in charge. I have found over the years that the only mistake parents make (myself included) is thinking the issues will“grow away.”The nagging feeling you have when your child is 3 or 4 can be quieted briefly,but it cannot disappear.Early intervention can help quell the anxiety for both you and your child. I have written this book to be a conversation between us—parent to parent.I have been where you are.I have walked the walk,and I have talked the talk.I have been spoken to and told flat out:“Something is wrong with your child.”I have had to find solutions.My children have all gone to college and are leading independent, successful lives.This book is to support you on this uncharted journey toward your personal solutions.Take a deep breath.You are not alone. NOTES Take notes here and anywhere else.This is a working instructive book for you. Page 3 ✑ CHAPTER ONE Learning Disability in Plain English ✑ Page 5