Understanding Invisible Disabilities in Children: Strategies for Success

1. InvisableDisablitlites By Jenni, Marie, Christina and Jen

2. Purpose • to showcase a specific population we will come into contact with as professionals, focusing on knowledge of potential solutions we can be a part of as counselors.

3. Agenda • present a brief understanding of what an invisible/learning disability is • showcase four specific learning disabilities you are likely to encounter, including • symptoms, • considerations for counselors/educators, • and potential solutions • questions

4. Objective • Raise awareness among future school counselors • Make LDs more recognizable • Help Counselors learn how to address the issues associated with learning disabilities so our students can succeed in the realms of academic, social, and career development.

5. Invisible Disabilities in ChildrenStrategies for Success

6. What is an Invisible Learning Disability? • Learning disorders affect how a person understands, remembers and responds to new information. People with learning disorders may have problems listening, speaking, reading, writing, or doing math • Invisible disabilities are those that are not immediately apparent to teachers, students, or even parents • Invisible disabilities include known learning disabilities such as dyslexia and ADHD, as well as any mental, neurological or physical conditions that can affect learning

7. Why is this important? • The National Institutes of Health estimate that 8 to 10% of children in the United States suffer from a learning disability • Currently, 2.9 million school-aged children in the United States are classified as having a specific learning disability • The National Center for Learning Disabilities estimates that 15 million Americans suffer from learning disabilities • Many children have not been diagnosed and helped because their disabilities go undetected by teachers, parents, counselors.

8. Anxiety DisorderWhat is it? • Characterized by irrational, persistent, and overwhelming fear, worry and anxiety that interfere with normal functioning and everyday activities. • Symptoms vary but often include irritability, nervousness, difficulty sleeping, and physical symptoms (headaches and stomachaches) • Anxiety disorders often co-occur with other disorders such as depression, eating disorders, and ADHD

9. Anxiety disorderWhy is it important? • Most common mental illness in children • 13% of children and 18.6% of adolescents suffer from an anxiety disorder • Most common anxiety disorders: • Social Anxiety Disorder (6.8 %) • Specific phobias (8.7%) • Generalized Anxiety Disorder (3.1%) • Obsessive-Compulsive Disorder (1%) • Panic Disorders (2.7%) • Post-Traumatic Stress Disorder (3.5%) • Anxiety disorders impact a students ability to succeed in school

10. Considerations • Academic Considerations • Children with anxiety disorders are at a higher risk to perform poorly in school and dropout • Teachers often recognize symptoms of anxiety but may not realize they are caused by an anxiety disorder • Social/Personal Considerations • Children with anxiety disorders suffer from low self-esteem and often feel fearful, embarrassed, and alone • Anxiety disorders can affect a child’s ability to interact socially with others and adjust to the school environment • Children with anxiety disorders are more likely to engage in alcohol and substance abuse • Transitions / Careers • Left untreated, anxiety disorders tend to be chronic and can continue and progress into adulthood • Cognitive-behavioral therapy (CBT), Acceptance and commitment therapy (ACT), and Dialectical behavioral therapy (DBT) as well as certain medications have all been shown to be effective treatments

11. SolutionsWhat can we as school counselors do? • Both teachers and counselors need to be trained in recognizing the signs and symptoms of anxiety disorders • Counselors can create guidance unit related to stress and anxiety and how teachers and students can tell what anxiety is normal and what is not • Counselors can work with students and families to find appropriate treatments and therapists • Counselors can work with teachers to find effective accommodations to help students succeed in the classroom

12. ADHD

13. Attention Deficit Hyperactivity Disorder (ADHD) What is it? ADHD is defined as “a condition characterized by severe problems of inattention, hyperactivity, and/or impulsivity; often found in people with learning disabilities”. (cite) • Symptoms • Short attention span • Distractibility • Disorganization • Procrastination • Poor internal supervision • Interrupting • Squirming Three Types Combined Type (most common) Predominantly Hyperactive-Impulsive Type Predominantly Inattentive Type

14. Why is this important? • Prevalence: Three to seven percent of the school-age population have ADHD. (Hallahan, Kauffman, & Pullen, 2009) • Students with ADHD have significantly higher dropout rates, increased frequency of failing grades, and poor academic outcomes compared to students without ADHD (Fischer, Barkley, Fletcher, & Smallish, 1993). • ADHD is widely recognized as one of the most frequent reasons, if not the most frequent reason, children are referred for behavioral problems to guidance clinics (Hallahan, Kauffman, & Pullen, 2009).

15. Considerations • Academic • High degree of classroom structure. • Teacher directed activities. • Determining rules and expectations of behavior prior to events. • Self- monitoring or self- management programs where students record their own behavior. • Social/ Personal • Rejected more often compared to non-disabled classmates. • Have a hard time controlling emotions often overreacting. • Students with ADHD have delayed “inner speech”. • Transitions/Career • Important to choose a path that maximizes individual’s strengths and minimizes weaknesses. • Coaching – a technique whereby a friend or therapist offers encouragement and support for a person with ADHD

16. Treatment Medication Considerations • Four Methods of Assessment • Medical Examination • Clinical Interview • Teacher and Parent rating scales • Behavioral Observation • Psychostimulants – medications that activate dopamine levels in the frontal and prefrontal areas of the brain that control behavioral inhibition and executive functions; used to treat persons with ADHD. (Hallahan, Kauffman, & Pullen, 2009) • Ritalin - Most commonly prescribed psychostimulant for ADHD. • Adderall • Strattera • Caution with Medication- Research is very positive on the effectiveness of medication for increasing appropriate behavior, there are still a number of cautions.

17. Dyslexia

18. Dyslexia • Symptoms • Poor reading (skills/comprehension) • Poor spelling skills • Poor writing skills • Trouble memorizing • Difficulty with directions (up, down, right, left, maps) • Difficulty finishing test/assignments on time • Examples • Thewordsarenotsp aced correctly. • The words are not spaced correctly • We spell wrsdxatleazthasnd to us • We spell words exactly as they sound • Sometimesallthelettersarepushedtogether • Sometimes all the letters are pushed together • What is it? • Trouble translating or understanding written materials. This can be letters, numbers and symbols. Dyslexia is considered to be a reading disability and can often times run in the family.

19. Why is this important? • Sometimes Dyslexia goes unnoticed because: • Students learn to cope and work around the disability • Sometimes symptoms aren’t apparent to teachers, counselors and teachers • Even though some students learn to work around the disability, once diagnosed and receiving assistance school will become much easier for the student • It is not uncommon for students to go though school and life without being diagnosed until adulthood • This is extremely important to address in school because many times children with dyslexia are viewed as stupid or lazy when in reality they are trying their hardest and my just need assistance to reach their full potential. • Between 10 -20% of school age children have been diagnosed

20. Considerations • Personal • When diagnosed later in life sometimes the person has trouble accepting • Getting used to having assistance • May feel different compared to their classmates. • Transition to Adulthood • Important to choose a path that maximizes individual’s strengths and minimizes weaknesses. • Understanding that there is nothing wrong with them. • Using the help that is offered to maximize potential • Academic • Receive additional time to complete assignments and exams • Permission to tape classes/lectures. • Using spell check • Books on tape • Tutors • Social • Sometimes seen as stupid or lazy • May feel different compared to classmates

21. Solutions • First get tested • Understand Dyslexia and the symptoms • Utilize services provided by schools • Extra Tutoring • Books on Tape • Extra Testing time • Support groups/counseling

22. Asperger Syndrome

23. Asperger Syndrome • Symptoms • Lack of social awareness • socially and emotionally inappropriate behavior • difficulty with non-verbal communication • Obsessive interest in a single topic • repetitive routines or rituals • peculiarities in speech and language • uncoordinated motor skills/movements What is it? • An Autism Spectrum Disorder • Unlike Autism, those with Asperger Syndrome do not have delayed or impaired cognitive and language development • Characterized by deficits in social interaction and repetitive or restrictive thoughts and behaviors

24. Why is it Important? • Often undiagnosed until school age • Formal diagnosis of students with AS is a recent phenomenon • High number of diagnosis suggest counselors need to know how to work with many students with AS • Estimated as many as 6.7 of every 1000 children have an autism spectrum disorder. It is estimated that about 4.8 of every 1,000 children have AS.

25. Asperger SyndromeConsiderations • Academic • Students with Asperger are easily stressed, but may not display their stress outwardly. • Stress can be eased by creating a set routine and/or letting the student know what to expect. • Difficulty with creative writing/art assignments • Trouble focusing on the task at hand instead of their own professed interests • Social/Personal • Students with Asperger Syndrome have difficulty interacting socially with peers. • lack social awareness • Social difficulties may be masked by advanced vocabulary • Can often initiate social interactions (basic greetings, etc), but have difficulty with reciprocal conversations • Self-Esteem problems can arise because students are aware of being different from their peers • Transition/Career • Work should be done before each major transition to get the student comfortable with a new place, new people, and a new routine • The number of students with AS continuing to post secondary education is on the rise • AS is a high functioning disorder; they can be very successful in the right workplace

26. SolutionsWhat can school counselors do? • Often a school counselor will be the first person to recognize the symptoms of AS. • Small changes to the day can help a student cope, such as establishing signals between students and teachers, allowing extra time to transition between classes, and establishing rewards around subjects the student enjoys. • Networking with teachers, parents, and outside Mental Health Professionals. working collaboratively to develop plans to help the child succeed. • Offer resources, knowledge and training to teachers. • Advocate for the inclusion of students in general education classrooms

27. Bringing it all together

28. References • Anxiety disorders in children. (n.d.). Retrieved from http://www.adaa.org • Bailet, L.L. (2006, August). Understanding dyslexia. Retrieved from http://www.seattlechildrens.org/kids-health/page.aspx?kid=20965&lic=400&cat_id=20179 • Bailet, L.L. (2006, April). Understanding dyslexia for parents. Retrieved from http://www.seattlechildrens.org/kids-health/page.aspx?kid=21346&lic=400&cat_id=142 • Brown, T.A., & Barlow, D.H. (2007). Casebook in abnormal psychology. Belmont, CA.: Thomson Wadsworth. • Essau, C., & Peterman, F. (Ed.). (2001). Anxiety disorders in children and adolescents: epidemiology, risk factors and treatment. East Sussex, England: Brunner Routledge. • Fischer, M., Barkley, R. A., Fletcher, K. E., & Smallish, L. (1993). The adolescent outcome of hyperactive children: Predictors of psychiatric, academic, social, and emotional adjustment. Journal of the American Academy of Child & Adolescent Psychiatry, 32(2), 324-332. ISSN: 0890-8567 • Gibbons, M. M., & Goins, S. (2008). Getting to know the child with asperger syndrome. Professional School Counseling, 11(5), 347-352. • Hallahan, D.P., Kauffman, J.M., & Pullen, P.C. (2009). Exceptional Learners: An Introduction to Special Education (11th ed.). Bostom, MA: Pearson Educaiton, Inc • Myles, B. S. (2005). Children and youth with asperger syndrome: strategies for success in inclusive settings. Thousand Oaks, CA: Corwin Press. • National center for learning disabilities. (n.d.). Retrieved from http://www.ncld.org/ • National Institute of Health, Initials. (2010, May 14). Asperger syndrome information page: national institute of neurological disorders and stroke. Retrieved from http://www.ninds.nih.gov/disorders/asperger/asperger.htm • Ninds learning disability information page. (2010, October 18). Retrieved from http://www.ninds.nih.gov • Thompson, D. (2009, April 1). Dyslexia demystified: how multisensory reading instruction can make all the difference. Seattle's Child, Retrieved from http://www.seattleschild.com/article/20090401/SCM02/903259989 • Winter, M. (2003). Asperger syndrome: what teachers need to know. New York, NY: Jessica Kingsley Publishers

29. Questions?