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Concern for 17-Year-Old's Future
Q: My son had two bad things happen to him when he was young. First, he was hospitalized a week after his birth with severe jaundice and a bilirubin level of 20. He also was diagnosed with a congential psosis, which we were told he would outgrow. When he was in kindergarten for the second time, we finally found out that he had severe "lazy-eye" and was found to have not acquired many necessary preschool skills.
When he was still a preschooler, he was very smart -- highly verbal and independent at a very early age. In kindergarten he had a vocabulary of an 11th grader. He astounded people with songs, poems and acting out parts of fairy tales all by himself.
Now he is 17. All of his school years have been a constant struggle and he is currently failing several subjects. I want him to be well educated and to get a good job, but I am very worried. What can I do to help him? Shall I take him to a neuropsychologist? I have taken him to an education specialist, who tested him but offered nothing to help him. His IQ tested at 99. He is terrible on standardized tests. Thank you.
A: Adolescents and young adults with learning disabilities often have a history of medical problems, especially during the perinatal period, or the time just before, during or after birth. There is no direct correlation between jaundice or congenital ptosis (the drooping of one or both eyelids), but there may have been other problems early in life, such as high fevers or lack of oxygen, which certainly could have resulted in learning disabilities. The fact that your son was in kindergarten twice suggests that either he was late in maturing compared to other children his age, or that he had some problems with early learning. Some professional fortunately discovered that he had severe "lazy eye" (called amblyopia). This condition is caused by weak eye muscles and can affect the way a child sees, or perceives, the world around him. Double images can make it difficult for a child to work with shapes or lines, the very building blocks of early learning.
At any rate, it is clear that your son has had difficulties learning, but also that he has some obvious strengths. It is very important to get your son a comprehensive neuropsychological evaluation to identify his true potential, as well as identify any factors that may have been getting in the way of his learning. Since your son has had such a difficult past, an educational evaluation alone will not be sufficient. You can get the name of a good clinical neuropsychologist from your son's physician, or by calling the Board of Psychology in your state. You can also contact a children's hospital in your area, and ask them if they have a diagnostic clinic for older adolescents (or tell you where to go to have a young adult evaluated).
If your son has been identified as having a special need and has not graduated from high school, his school has an obligation to provide services to him until he is 21, so make sure they are involved. Even if he has already received a diploma, the guidance counselor at the high school might be able to offer some recommendations about programs for recent graduates with learning problems. Also contact the state office of the Learning Disabilities Association for information and referrals. The office of vocational training or rehabilitation in your state may offer both evaluations and training that would help your son get and keep a job appropriately suited to his skills. Above all, don't give up. There are agencies and services that can help your son.
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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.