Learning Disorders:

My child has been labeled...Twice!

What does this mean and what should I do?

Having more than one condition at a time, is referred to as “co-morbidity”, or dual-diagnosis, or co-existing disorders, or simply as multiple disorders.  It’s like having the flu and a broken leg at the same time.  It can happen.

Similarly, it is possible to have more than one learning disability, attentional problem or behavioural problem at the same time.  In fact the possible combinations are long. It is not uncommon for children diagnosed with one learning, attentional or behavioural problem to have a second and even a third. Knowing how often conditions co-occur, which combinations are most likely and the identification of these conditions, requires training, experience and careful data collection.

First and foremost, a careful assessment of the child is necessary to determine which conditions, if any, your child does have.  This is best done by a trained psychologist who has experience with children who have multiple issues. 

These assessments require time and effort, and include many screening questions about multiple disorders, as well as questions about the child’s functioning at home, with others, and at school. Since parents and teachers are usually effective at describing observed behaviours, the psychologist will ordinarily interview the family and attempt to collect information from school teachers  Specialized testing is used to provide information in a structured setting and format. The testing allows the psychologist to compare the results to results expected from other children of similar ages. This comparison then tells the psychologist how far behind or ahead a child may be in any particular area.  Once all of the information is collected then the diagnostic process can occur, resulting in a diagnosis and formal labelling of any disorder that may have been identified.

Following diagnosis, the most important part of an assessment becomes the recommendations. These recommendations allow educators to plan for your child’s particular needs.  The importance of the recommendations increases with a child who has multiple disorders to avoid any confusion and provide clear management strategies.  Good recommendations provide the teacher with the directions they need to plan interventions and modifications for the child.  With direction, most educators are able to bring their teaching skills to bear on the particular issues that have been identified. 

As an example of the need for good recommendations, consider the following: 

Billy requires extra time to complete tests.    

Fine, as far as it goes, but compare this to:

Billy may require additional completion time for tests, or alternative response methods  to adequately assess his knowledge.  Flexibility will be important.  Consider alternative testing formats (e.g., multiple choice or brief answer tests will be easier than essay type formats).

The second example provides a direction for the teacher to go in and suggestions for doing so. The second example guides the teacher towards solutions to better meet the child’s needs.

A good report will have more than two or three or even more recommendations and they will be geared towards your child’s specific needs.  This makes the parent’s job easier, because the parents will have a better idea of what is required for their child.

What should you do if your child is diagnosed as having multiple disorders?

1.  Read the report over carefully.  Ask questions of the person who wrote the report, if you are not clear.

2.  Learn more about the conditions that your child has.  Start with some basic material, go slowly, because it is easy to be overwhelmed by all of the information. 

3.  Discuss the situation with your child’s teacher;  share the report and the recommendations.

4.  If it is suggested that medications may be helpful for your child’s condition, then discuss this with your family doctor.  

Estes Moustacalis, Ph.D. C.Psych (Dr. “M”)

info@oakvillepsychologist.com

www.oakvillepsychologist.com

905 617-8308