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Teacher Wants to Help Child with LD
Q: First of all, I am a teacher. I have a child identified with learning disabilities who needs to be on medicine. He is extremely hyper and unable to stay in his seat or listen longer than about five minutes. He is a second-grader. My question is how can I help this child become successful in the classroom while we wait for the doctor's decision? His mom has trouble making payments and may not be able to pay for the Ritalin® or whatever the doctor wishes to put the child on.
A: Thanks for writing about this concern which is shared by many teachers. It's really important to help this little boy get settled enough so that you can teach him and he can learn. Since there is no medication for learning disabilities, I will assume that the doctor has recommended this treatment for ADHD (Attention Deficit Hyperactivity Disorder). A lot of children have both LD and ADHD, which are two different but related conditions. Some children act "hyper" and leave their seats often as a way to avoid having to do tasks that are difficult because of the learning disability. It's very important that the work that is expected of this child is well within his ability level, and presented in a way that takes his learning disability into consideration. Even if the activity is appropriate, this little boy may respond to any academic tasks with this "flight" response, since he has learned that "if it looks like school work, it's gonna be hard!" So he may need to be shown, in little steps, that he can be successful.
Assuming that his excessive activity is also due to the attention deficit hyperactivity disorder, your question about what to do in the meantime to help with the behaviors is very important. It's important to remember that a lot of children with ADHD have never learned how to settle themselves. Does this boy know what that "calm down," or "relax" feel like? Lots of parents and teachers tell children to do these things, so the words are very familiar to kids. But if you've always been "hyper," then the feeling is unfamiliar. He may need to rehearse these behaviors so he can better associate the word with the feeling. Sitting next to a child with your arm around his shoulder while you're reading to him is a good way to help him feel more contained. Asking him to wrap his arms around himself ("give yourself a 'get in control' hug") is another way to help him take some responsibility for self-control. Playing games, which involve stopping, starting or "freezing" on command will be hard, but helpful for him. Having him join hands with another child while doing this can help provide external controls in a fun, non-punitive way. ("Now, freeze and tell your study buddy the answer to my question before telling it to me".) This also encourages positive social interaction while reinforcing academic concepts. Remember that ADHD is a neurologically based condition. Medication can often be very helpful, but there is still a need to teach children how to gain a better sense of self-control. You can help a child like this a great deal by asking him how many minutes he thinks he can stay focused (use an egg timer to make the passage of time more concrete), and then give lots of positive reinforcement when the goal is reached. Charting on-task behaviors will also give this child (and his parents) some visible evidence of positive growth. If the mom is willing, but financially unable to get the medication, perhaps the school nurse or social worker can be of some help.
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Jerome (Jerry) Schultz is the founding clinical director of the Learning Lab @ Lesley University, a program that provides assessment, tutoring, and case management services for children with learning challenges. Schultz holds a Ph.D. from Boston College, and has completed postdoctoral fellowships in both clinical psychology and pediatric neuropsychology.