Different Learners: Identifying, Preventing, and Treating Your Child's Learning Problems

"My child is having trouble in school.

What should I do?"

When parents are told that their child is having difficulty in school, they often don’t know where to turn for reliable information and advice. They may be confused by conflicting claims of "cures" or may mistakenly think that, because some learning problems are genetically based, they can do nothing to help. Even the terminology of learning disorders is confusing: dyslexia, dyscalculia, ADD, ADHD, autism, Asperger’s syndrome, NVLD, executive function disorder—what are all these conditions, how do they differ from one another and, most important, what practical steps should parents and teachers take to remedy the situation?

This comprehensive, practical guide to children’s learning problems should be the first resource parents and teachers reach for when a child shows signs of difficulty in academic, social, or behavioral learning. Drawing on her decades of experience, educator Jane Healy offers understandable explanations of the various types of learning disorders. She distills the latest scientific research on brains, genes, and learning as she explains how to identify problems—even before they are diagnosed—and how to take appropriate remedial action at home, at school, and in the community.

Today’s fast-paced, stressed-out culture is hazardous to growing minds, says Healy, and a growing "epidemic" of children’s disorders is the result. Different Learners offers a complete program not only for treating the child, but also for making more beneficial lifestyle choices at home and improving teaching techniques at school. It shows parents and caregivers how to prevent some learning difficulties from ever happening in the first place. It explains how to have your child evaluated if necessary, and, if a problem is found, how to evaluate various treatments. Different Learners explains how medications for attention and learning work in the brain and why they should not be the first step in most treatment programs. It shows how schools can actually worsen a child’s learning difficulties and how to make sure this doesn’t happen to your child. It even offers a program for "brain-cleaning" that will help any child perform better in school.

Jane Healy draws on stories of real children to offer sympathetic as well as practical advice for children—and parents—who are struggling in an overstressed environment. She provides reassurance that parents and teachers can have dramatically positive effects on every child’s ability to learn.

Too Many Dyssed Kids

“I’m just wondering if there’s anything I can do. . . .”

My first educational therapy session with Edward took place before he was born. Actually, the meeting was with his mother, but Edward was very much in evidence as Susan, eight months pregnant, shifted uneasily on my office couch. We were both aware that Edward’s activity level was vigorous, to say the least.

“I need some advice,” Susan began. “I don’t mean to be all freaked out about this, but you worked with my girls on their reading and attention problems, and this is going to be a boy, and I know that dyslexia and attention disorders run in families and problems are usually worse in boys, and I’m just wondering if there’s anything I can do, now or later. . . .”

The answer to Susan’s question is an emphatic “Yes!” Parents have a powerful role in shaping a child’s learning abilities. Along with teachers, they create the environments that help determine how talents, skills . . . and problems develop. Positive environments at home and at school can prevent, ameliorate, and maybe even extinguish many types of learning and behavior difficulties. They can even improve the outcome for genetic learning disorders.

Nonetheless, we are experiencing an unprecedented number of “dyssed” kids—youngsters labeled with some sort of learning problem. This new “epidemic” affects children in every part of the socioeconomic spectrum and includes disorders of academic, social, and personal learning skills. Learning problems upset families, discourage teachers, impair educational quality, and make children miserable. They are all too real, but many could have been prevented and most can be significantly helped.

Unfortunately, today’s lifestyles are a big part of the problem. Even in affluent communities, the most basic needs of a youngster’s developing brain are violated on a daily basis. How are parents, teachers, or children to succeed in a culture that does not respect its most important asset—the developing mind?

The purpose of this book is to help you understand and improve every aspect of your child’s or student’s learning. We will be exploring the latest research on many categories of learning difficulties to understand the nature of these problems, where they come from, and how parents and teachers can help prevent them as well as deal with them once they surface. We will focus especially on the all-important interaction of nature (in the form of genetics) and nurture (home and school environments) in determining a child’s ultimate success.

Crisis in Childhood

Watching a child struggle unsuccessfully in school—with learning, with social relationships, or with skills such as motivation or paying attention—is a devastating experience for everyone involved. To make matters worse, there is often no obvious reason for the difficulty. Learning abilities are an incredibly complex interweaving of genes, environment, and brain development, with each of us possessing a very special, one-of-a-kind combination.

Just because a learning difficulty is “in the genes” does not make it inevitable. Nor do genes alone determine its severity.

In the following chapters you will learn about new research showing the significant effects of positive environments on the complex interaction of genes and brains. You will also learn why children are being diagnosed with disorders that might have been prevented and can still be remedied if only the adults involved had the right information. If you have a child or a student who might fall into the “problem” category, please take heart. The more information you have, the better you can help! This book provides what you need to help children learn, succeed, and feel confident about themselves in the process.

Quick Take: What This Book Is About

1. Learning differences, which are the cause of many school and personal problems, are variations in the way the brain processes information. They include academic, personal (as in attention or motivation problems), and social skills.

2. These patterns are caused both by genes (“nature”) and the environment (“nurture”). Both can be influenced by a child’s experiences before and after birth. Just because something is genetic, or inherited, does not mean that it is either inevitable or unchangeable. Nor does it mean that when problems arise, medications are the only solution.

3. Medications may be helpful in some cases, but probably should not be the first or only approach used. Many proven therapies are available, and many of them start right in your own home or classroom.

4. Emotional development, which is one important aspect of learning, is tightly intertwined in the brain with academic and social learning. Stress is a significant and often underestimated contributor to children’s learning problems, and love is a powerful remedy.

5. Every child—and every child’s problem—is part of a much larger system of home, school, community, and culture. It is short-sighted simply to label and treat the child without examining how the larger system may be contributing to the problem.

6. Today’s lifestyle habits can cause problems and make existing ones worse. Fortunately, many of these negative outcomes can be prevented or reversed.

7. Learning “disabilities” and special talents often come in the same package. It is important to nurture the abilities at the same time we help with the difficulties.

8. “Late bloomers” are easily misidentified as “learning disabled.” Often the children with more leisurely developmental timetables turn out to be the smartest of all. Parents and schools that push too hard cause problems.

9. In our efforts to make kids “smarter,” we must not forget that brain development is closely tied to the development of the body. Neglecting play and perceptual and motor skill development may endanger foundations for other types of learning.

10. The human brain is wonderfully “plastic” and can be altered by experience. The more we understand about the way it works, the better we can help each child unfold his or her own tent of potential talents.

11. There may be positive reasons for certain types of learning differences. Unique thinkers could have important future roles.

12. Never give up. The brain retains its ability to change throughout a lifetime.

Sick Culture, “Sick” Kids

Most youngsters’ problems do not develop simply because the child has a genetic “flaw” or the parents somehow “messed up.”

I have never met a parent who did not truly want to do a good job, but our stressed-out world does not make parenting easy. Parents feel under incredible pressure to produce a “successful” child, yet find they must constantly battle against the many factors in everyday life that interfere with development of solid brain systems for intellectual and emotional skills. Likewise, overwhelmed schools and time-pressured physicians wonder how to cope with a seeming avalanche of learning and behavioral disorders in a culture that does more to cause them than to cure them.

The childhood and teen years are critical for optimal brain development. Environments can shape brains into more efficient learning patterns, but remember—and this is important—they can also make an existing tendency worse or even create a problem. At all levels of the economic spectrum, children’s daily lives allow and even promote habits that can severely disrupt both the developing networks in the brain and the chemistry that makes them work. Why are such record numbers of children being labeled as educationally, socially, and emotionally “sick”?

Our culture is sick and our children are getting the diagnosis.

Each child is a complex, growing, learning system who develops as part of a much larger system including home, school, neighborhood, the supports available (or not), and the habits and expectations of the surrounding society. Consider:

• 
  frantic, stressed-out lifestyles
  
• 
  brain-hazardous types of media use
  
• 
  physically toxic everyday environments—at home and at school
  
• 
  unrecognized brain disruptors in daily habits, such as food choices, sleep habits, and uses of playtime
  
• 
  one-size-fits-all expectations for how children should act and what they should achieve
  
• 
  some professionals who are overly eager to pin a label—and maybe even a medication—on normal developmental differences
  
• 
  a medicalization of problems that should be treated educationally
  

We live in a culture that is both clueless and careless about what kids’ brains really need. No wonder there is trouble in the schoolroom!

Learning Disabilities or Disabled Expectations?

Not long ago I presented an evening workshop about young children’s brain development to a group of parents in a section of an East Coast city noted for its competitive school admissions culture. During the question and answer period, a concerned-looking mom was the first to speak.

“A group of us here have four-year-old sons whose teacher has told us she thinks our boys may have problems with auditory discrimination [difficulty listening effectively to the sounds in words]. She wants us to have them evaluated for a learning disability. Do you agree? And, we are wondering”—she looked around, clearly embarrassed—“do you think it could be something we’ve done wrong?”

Of course, without meeting her son, talking to the teacher, getting a family history, or finding out if the school’s expectations were unrealistic for four-year-old boys (it happens), I wasn’t able to come up with a very helpful response. But this incident got me thinking. I was troubled by the guilt trip laid on this concerned mother. I was even more troubled that no one had taken the time to help her understand the many factors that might be contributing to her son’s problem or how he could be helped.

“It seems odd that parents have been driven to seek a diagnosis that something is wrong with their children. In the past, such a diagnosis was probably the last thing most parents would have wanted. . . .”

—Robert Sternberg in Our Labeled Children1

For example, do these little boys—at a critical period for development of language circuits in the brain—have caregivers who do not speak clearly or who do not speak much at all? How much time do they spend watching screens as opposed to listening carefully to stories? Do adults have the time and patience to carry on conversations with them to build language and comprehension skills? Are they under brain-damaging stress because they don’t have enough free time or unprogrammed play? What, if anything, do they eat for breakfast? Is the school expecting rambunctious little kids to sit quietly at desks and complete worksheets for which their brains aren’t ready? These are the questions that should first be addressed. As critical as it is to heed early signs of a language problem, we must also admit that the “problem” may lie as much in the child’s environment as it does in the child himself.

Nicole Kroupa, a preschool teacher and graduate student at Gonzaga University, recently sent me an unsolicited e-mail emphasizing this point. “I have seen such a change over the years in the speech/language development of kids that it is VERY disturbing. And I am NOT talking about special ed kids either. Children from educated/straight-A adults whose four- to six-year-old children have retarded language skills. [“Me do.” “Me no want.” No past tense verbs, etc.] Really bright children. It’s scary.”

What’s Broken—the Child or the System?

I am thrilled that things have changed dramatically since I first started teaching, when there were very few services and little understanding for students who couldn’t keep up or were somehow different. These unfortunate kids were ignored, blamed, sometimes emotionally destroyed, or turned into antisocial horrors by an ignorant and uncaring educational system. Yet progress sometimes goes too far. Now we need to be concerned about categorizing too many youngsters who fall outside rigid expectations as “disordered” and in need of “fixing” rather than as “different” and in need of patient, effective teaching within an understanding and flexible system.

My challenge here is to help you walk the critical line between celebrating each child’s uniqueness and taking positive steps to avoid the enduring pain that can accompany too much “difference.”

Many children who are tortured by learning differences are bright and talented, with the potential to reach high goals if they receive the proper support. A recent study by Julie Logan of London’s Cass Business School found that almost half of a group of successful entrepreneurs in the United States met the criteria for dyslexia, a learning difference that affects reading and written language.2Adults with Asperger’s disorder communicate online about their unique talents, which they attribute to not being “neurotypical.” Many creative, high-energy adults are also sure they would have been diagnosed with attention deficit disorder had the current diagnostic criteria been applied. It seems that what looks like a flaw in school sometimes looks like a talent later on!

Yet if such youngsters are part of a system lacking the understanding, patience, or expertise to deal with individual differences, they may find themselves in the growing pile labeled “broken.” Tragically, they may never realize their inborn potential.

Grown Up and Turned Off. On a recent vacation with a tour group, I happened to be seated one evening at dinner across from a couple who, when they discovered my profession, began to tell me about their twenty-four-year-old son.

“Well, he’s still sort of finding himself,” Mom acknowledged in anxious tones. “He just dropped out of community college again—he never did like school very much, and he’s not motivated.”

“. . . his teachers have always said he’s smart enough and just needs to apply himself.”

Every time I hear this story, which comes up with amazing frequency, I immediately suspect an undiagnosed learning problem.

“Did he ever have an evaluation?” I inquired.

“Oh, yes, but they said he didn’t have a learning disability. His teachers always called him an ‘underachiever.’”

As these parents described their son’s history, it became apparent that this boy had clear symptoms of a specific language disability that had never been identified or treated. He was smart enough to bluff his way through for a while, but his reading and writing were painfully slow and laborious, he couldn’t concentrate on teacher’s lectures, and he eventually just turned off and gave up. As our dinner ended, tears welled in Mom’s eyes.

“Is it too late,” she asked. “Can he still be helped?”

Fortunately, it’s never too late, so we may hope that this story ends happily. But stories like this make me want to scream—or write a book that may help other children who end up feeling “broken” and don’t know why.

No Easy Answers. Parents often feel they are helpless, at the mercy of a societal system that passes judgment, accurate or not, on their child. What they don’t realize is how fuzzy our definitions really are and how much power they themselves have to get a child on track. Often a parent’s work involves making changes in the child’s environment or daily activities to eliminate contributing factors, as well as working with the school to make sure expectations are realistic and supported by the right kind of teaching. This book is meant to serve as a guide for developing a systematic, effective, and multipronged plan.

In today’s technological world, we are conditioned to want quick results. If a problem shows up, we want it fixed. But children are not machines. They are complex and precious individuals who learn and flourish, or fail to, as part of a much wider system of home, school, community, and popular culture. Children with learning problems need help, but the system also needs a remedy.

The Reality of Learning Differences

Learning differences, whatever their cause, are not a figment of anyone’s imagination. Many youngsters come into the world with inborn propensities that set them up for problems. Often these problems are related to innate brain patterns that help determine whether various types of learning will be easy or difficult. Some children seem preprogrammed to be poor spellers, readers, or writers, math challenged, personally disorganized, clumsy at athletics, inattentive, or socially clueless.

The more inflexible the system, the more kids will find themselves with a label.

The term learning disabilities usually refers to specific problems with school subjects such as reading, writing, spelling, or math. These problems have nothing to do with overall intellectual capability. Many learning disabled individuals are very smart or even gifted. If your brain easily accommodates tasks such as keeping your attention focused on an oral lecture, writing a neat page, reading a text, spelling nonphonetic words like “said,” or instinctively understanding what another person’s facial expression or gesture means, it may seem peculiar to you that such routine skills can be so difficult for some people, especially if they seem bright.

A brain with a specific learning disability may need to exert many times as much mental effort as that of a typical student to do a seemingly “simple” task.

In this book I will be using the general term learning problems to include both specific learning disability and a range of other “learning disorders,” such as attention deficit disorders, sensory processing problems, and disabilities in social learning such as autism or Asperger’s syndrome. Here are some of the reasons I prefer this term:

• 
  Learning disorders rarely occur as tidy diagnostic packages. They tend to overlap and are often comorbid (a nasty-sounding term meaning “occurring together”) with behavioral or emotional issues. For example, reading problems are often comorbid with attention disorders.
  
• 
  As we learn more about the brain, we recognize that it is impossible to separate its cognitive (thinking) and affective (emotional) capacities.
  
• 
  A problem at one level often creates other problems elsewhere.
  
• 
  One of the primary purposes of this book is to urge that we view each child as a whole person, rather than as a diagnosis. Your child’s math disability (dyscalculia), for example, may have several contributing factors, such as a fundamental problem in visual-spatial reasoning, a poor “gut-level” understanding of quantity (Is 9 bigger than 7?), a language disorder (what, exactly, does equals mean?), the quality of the teaching she has received, her willingness to take intellectual risks, or her physical and emotional health. Perhaps she has lacked adequate experience with quantities of real things, such as children get from playing with unit blocks or moving a counter on a board game. Each factor should be considered when we plan a treatment program for her.
  

TIP: Your child’s math disability may be helped (or even prevented) by playing board or card games with her.

Learning Problems: A Broader View

Academic skills are really only the tip of the learning iceberg, since successful students must master many other learning tasks during the childhood and teen years. As they do so, they exercise and improve important brain connections. Particularly critical are the brain systems associated with

• 
  self -control
  
• 
  directing and controlling one’s own attention
  
• 
  getting oneself motivated, even when things look hard
  
• 
  interacting effectively with others and in groups
  
• 
  managing emotions
  
• 
  harnessing the creative forces of one’s brain
  

All these qualities profoundly affect school progress and later success in life. New research tells us that genes are often involved in how easily children master these personal skills, so it is very good news that they, like cognitive skills, can be significantly improved by parents and teachers who employ the right strategies.

Currently, however, our children’s lives contain many influences that can derail these skills—especially in a brain that is genetically more vulnerable. Moreover, it often appears easier to treat this type of learning problem as a medical condition, especially if a pill is available that seems to do the job.

Does He Have to Take Pills?

Before I presented a recent workshop for California teachers, one of the conference organizers urgently drew me aside.

“Are you going to talk about ADHD?” (attention deficit hyperactivity disorder) she asked. “My fifteen-year-old son was just diagnosed and the doctor and the school are pressuring us to put him on medication, and we’re just so confused. We don’t want to medicate him, but they told us it’s a brain problem, that it’s genetic, and all we can do is give him the pills.”

“Did they ask anything about his activities, his sleep habits, his diet, his school environment, his media use [all of which have been linked to attention problems] or recommend any other changes?” I inquired.

“No, the doctor was pretty rushed.”

At lunchtime, after I had showed slides illustrating how both the biochemistry and the physical connections of the brain can be changed by appropriate intervention (which doesn’t always start with drugs, by the way), my anxious questioner approached me again.

“Thank you for giving me the ammunition I needed! Now I understand at least where I can begin.”

In my experience, most parents do not like the idea of putting their child on medication. I hope later chapters will also give you the information you need to make wise decisions about everything that goes into your child’s brain.

A Lot of Dyssed Children

In Appendix A you will find a list of accepted terms (and, trust me, there are dozens of others) used to describe conditions that affect children’s academic, social, and behavioral learning. Many of them begin with the prefix dys (or dis), meaning things aren’t working exactly as they’re supposed to. The prefix a means inability, such as in the medical condition alexia (inability to read) or apraxia (inability to carry out purposeful movements). A syndrome is a collection of symptoms that are often found together. For example, autism, or autistic spectrum disorder (ASD), is a syndrome characterized by difficulties in social communication usually accompanied by certain specific symptoms. Many syndromes, like autism, are spectrum disorders, meaning that different individuals have different degrees of severity.

So-called emotional or mood disorders, (e.g., bipolar illness and childhood depression) are outside the scope of this book. Nonetheless, they often co-occur with specific learning disorders, and it can be hard to sort out what is responsible for what. Their alarming recent growth is one more clear indication that something is drastically wrong in the world of childhood today.

Improved diagnosis accounts for some of the rising numbers of children’s problems. Yet experts agree that other factors—some as yet unidentified—are involved. Adding up current estimates of learning, behavioral, and emotional disorders suggests that a child born in the United States now has up to a 30 percent chance of being diagnosed with some type of problem that affects learning.3

Difference or Disability?

Most learning problems are variations in normal development and are better viewed in terms of difference rather than outright disability. Whatever it is may not be working “right” as is currently expected, but let’s think seriously about who is defining “right.” Consider a five-year-old boy who cannot sit patiently at a desk, coordinate his fingers around a pencil, or use advanced visual tracking skills to copy sentences neatly and accurately. Both common sense and brain research support the fact that he is having a problem because these expectations are out of line with his level of development. Moreover, his individual style of learning may require a more effective style of teaching. In later sections you will find other examples of youngsters deemed “disordered” who in another time and place might have seemed just fine.

Academic Failure: Who’s Disabled and Who Will Pay?

“If things keep going the way they are, we’ll have more kids in special ed than in regular ed.”

—Midwest school superintendent

Special Education was designed for students with problems that can’t be addressed in the regular classroom without special help. Yet “special” education threatens to become the tail wagging the educational dog. Unfortunately, it is also a morass of confusion. With more than seven million students and a spiraling budget in the United States, Special Education receives federal funding, but every state (and often school district) operates under its own set of rules that dictate who gets services according to how much money is available. Exactly what constitutes “learning disability” or “special needs” and the type of help available varies enormously from state to state. Other disorders that affect learning (such as autism, Asperger’s, and sometimes attention problems) usually receive funding from different sources. Are you confused? So are the parents who brave this labyrinth. Enough educators are also confused that they are redesigning the current system, so stay tuned for plenty of changes.

It has been estimated that 80 to 90 percent of those in Special Ed are there primarily because of reading failure, but most of these students also have other areas of academic weakness, such as writing, spelling, or math.4 Many also have emotional and/or behavioral problems. According to Robert Pasternack, formerly of the U.S. Department of Education, these numbers are a vast underestimate since only about one-fifth of students needing specialized services to help them learn are receiving them. Yet the kids who truly need help and don’t get it are at severe risk, especially if they come from a home unable to provide needed support. Some estimates suggest that up to 85 percent of current inmates in U.S. prisons have some sort of a diagnosable learning disorder and 75 percent of school dropouts report difficulty learning to read.5

Learning problems are found at all levels of the socioeconomic spectrum, but they come disproportionately from neighborhoods without the financial clout to fund adequate services for families and kids. It’s not surprising that many kids never make it through the daunting (and often expensive) obstacle course of getting an evaluation and a diagnosis. School psychologists can’t keep up with their referrals, even while teachers are crying out for help with too many troubled students. These kids can continue to struggle miserably without anyone taking any action to alleviate the problem. Needless to say, they are at high risk for dropping out.

Learning problems are fundamentally about a mismatch between the child and the learning environment.

Disordered Children: A Red Flag for Trouble

One clear index of trouble is a disturbing cascade of emotional and conduct disorders even in our youngest children and even in financially secure families. In 2006 a report from the Yale Child Study Center found that unprecedented numbers of children were being expelled from preschool for serious behavior problems.6 Dr. Judy Ripke, director of early childhood education at Concordia University in Nebraska, commented on the reality of this new trend.7 “We are seeing so many preschool children who are out of control,” she told me. “They’re aggressive to the teacher and to other children—hitting, throwing things, and they can’t choose an activity and follow through with it. What is going on? We’re actually having to expel more and more!”

Further evidence of serious disorder—and an area in which the United States is unique—involves increasing numbers of youngsters at all ages who take powerful psychotropic (mind/brain-affecting) drugs for learning, behavior, and emotional disorders. U.S. children place far at the top of international charts. About 2.5 million children in the United States take stimulant drugs (e.g., Ritalin, Adderall) or attention and hyperactivity problems.8 Such statistics are not surprising, according to Leonard Sax, in his pointed book Boys Adrift, since “For white boys in affluent suburbs, the odds of being diagnosed with ADHD at some point in childhood may be as high as one in three,”9 and drug treatment is a common sequel to diagnosis.

Many physicians are also skeptical about overlabeling and overtreating children and teens. Growing numbers (up to two million) take at least two psychiatric drugs in combination.10 Highly controversial diagnoses such as “bipolar disorder” are increasingly accompanied by prescriptions for drug cocktails of multiple prescriptions, some of which have been insufficiently tested for safety with children. Peg L. Smith, CEO of the American Camp Association, whose members serve three million campers, says about a quarter of the children at its camps line up for pills each day for attention deficit disorder, psychiatric problems, or mood disorders (e.g., depression or bipolar disorder).11 “This is the American standard, now,” states one camp owner. “It’s not limited by education level, race, socioeconomics, geography, gender, or any of those filters.”

The use of potent new antipsychotic drugs that were designed for seriously sick adults “amounts to a huge experiment with the lives of American kids,” maintains psychiatrist John March of Duke University. When children are taking three or four different drugs, “How do you even know who the kid is anymore?” asks pharmacologist Julie Zito at the University of Maryland.12

Could this trend toward multiple medications for children be evidence more of problems in the systems surrounding the child than of problems within the child’s brain itself?

While such psychiatric diagnoses as mood and conduct disorders are outside the focus of this book, they (as well as the medications involved) clearly affect children’s learning abilities. Or perhaps it is the other way around. “If the learning problems were addressed, we wouldn’t have so many behavioral and emotional problems,” I was informed by Glenda Thorne, a psychologist who treats developmental and learning problems. “I expected to be a psychologist, not to deal with learning disabilities, but I found this was impossible—learning problems and emotional problems are a two-way street.”13

Autism: A New “Epidemic”?

Autism is a serious disorder, once thought of as rare. The autistic spectrum, which includes Asperger’s syndrome, often has genetic origins and affects language and social and personal learning skills. Current data now put the chance of an autistic spectrum disorder at a staggering rate of 1 child out of 150 and rising.14 This increase is partially, but far from fully, explained by improved awareness and diagnosis. Many experts believe that environmental influences are implicated in an unprecedented recent rise in cases.

“This has been an almost 2,000 percent increase in autistic spectrum disorders since 1987! There are clearly some sort of environmental triggers operating here,” Dr. Ricki Robinson told me.15 As a noted autism specialist in California, she is overwhelmed by the number of new cases that come to her attention, although she points out that the earlier the diagnosis, the better the child can be helped.

Martha Herbert, a pediatric neurologist at Massachusetts General and McLean Hospitals and an expert on brain structure abnormalities in developmental disorders, has specialized in looking for causes of autism. She describes alarming recent changes in the type and severity of problems she and her colleagues are seeing. Herbert is not shy about delivering a searing indictment of the role played by our culture: “Overall, more children are presenting with diffuse difficulties—not discrete learning disabilities where everything else is more or less intact, but difficulties spread over multiple cognitive, sensorimotor, social, and emotional domains. And the scale of this is enormous. . . . I think we are dealing with the impact of the disintegration of family and community bonds and a profound environmental insult on our very neurological wiring.”16

No matter what statistics you use, the fact is that far too many children are in educational and personal trouble. As the saying goes, however, “Statistics are really people with the tears wiped away.” Many teachers would like to weep, as well, as they find themselves unable to meet the complex needs and demands of this generation of students and are forced to spend far too much time on problems they feel ill qualified to address.

The Power of Environments

One thing that brain research tells us—loud and clear—is that the way we raise and teach our children not only helps shape their brains, but can also influence or even alter the way genes play out their roles. This promising news also means, however, that we have a serious obligation to attend to factors over which we have some control—namely, most things that happen to children at home and at school throughout their growing-up years.

The prestigious Journal of the American Medical Association recently published a series of articles pinpointing recent changes in children’s daily environments that are causing, according to the authors, these “new epidemics” of problems—both physical and mental from all walks of life. The JAMA authors acknowledge the importance of genes, but they insist:

“Nonetheless, gene pool changes cannot explain the recent dramatic growth of these conditions. Changes in families and communities over the past few decades have greatly affected the social environment and life experiences of children and adolescents; for example, parents with less time and energy available to nurture children, many parents working away from the home, increased stress on parents, decreased social and family support for parenting, increased television watching and other media use, decreased physical activity opportunities, increased indoor time, increased consumption of fast foods, and unsafe neighborhoods.”17

Barry Brazelton and Stanley Greenspan are two eminent physicians who have spoken out about the extreme pressures on today’s parents and children. In their book The Irreducible Needs of Children, they point out that overstressed parents, too, need help. Instead, the trend is to diagnose even preschoolers with brain disorders and apply “alarming” numbers of drugs—sometimes up to three or four—which may or may not even be approved for use with children, all without offering the family any counseling or support to learn better coping strategies. Such unhealthy mental and emotional environments for families, they insist, are a recipe for societal disaster.

What Counts

In 2007, when UNICEF conducted a study of children’s well-being in twenty-one industrialized nations, the United States and the United Kingdom came out near the bottom. The Netherlands, Sweden, Denmark, Finland, and Spain were at the top. In all these relatively rich countries, a child’s position on the economic scale wasn’t nearly as important as factors such as physical health, feeling safe, adequate free playtime, and nurturing relationships.

When children all over the world were asked about the most important ingredient for their well-being, they overwhelmingly named their families.

Parents and educators are in a double bind. Advertisers and popular opinion exhort them to produce brainy children who are “ahead of the curve” for success in a competitive, product-oriented world. Yet child-rearing and teaching have become uphill battles in a culture that is physically, intellectually, and emotionally damaging to growing brains.

Many extremely able children naturally learn “outside the curve.” They are at the greatest risk.

This book will offer both the understanding and the tools to help you structure a brain-positive environment for your children or students. Even with the most supportive environments, however, we need to acknowledge the reality of some types of learning problems. Let me close this chapter by telling you about a few of my students with real problems that were either helped or worsened by their environments.

The Reality of Learning Differences

Some children just seem to come with some sort of glitch in the learning system. Take Mollie, for example. I learned a lot from her, both about the power of love and determination and about the reality of what we call a learning disability.

A Glitch in Learning. I first encountered this earnest little girl early in the 1970s when she was in the third grade at a school where I had just taken a job as a reading specialist. In those days the term learning disabilities had only just been invented, and kids who didn’t learn in the standard ways were mostly viewed as lacking in intelligence. Although I am now horrified to think of how little I—the “specialist”—knew at that point, even with my shiny new graduate degree, my job was to “fix” the kids who didn’t fit in. I was assigned to work in a former storeroom, which could best be described as cozy. (Like many specialists who have worked in hallways and unused corners of gymnasiums as well as a beautifully equipped “learning lab,” I was happy to have any space of my own.)

Mollie appeared at the classroom door my first day on the job, part of a group of third-graders referred by their teacher for special help. With long skinny limbs askew, a confusion of blond curls asserting their individuality, shoelaces flapping (Velcro hadn’t yet been invented), and shirt untucked, she always struck me as a child who had been hastily assembled by nature. When I assigned a simple written exercise, Mollie attacked it earnestly, her fingers white-knuckled as they clutched her pencil and her tongue gyrating as she struggled to form the letter shapes. (I learned only later that this “overflow movement” of the tongue or other body parts, normal in a four-year-old, is a sign of neurological immaturity at age eight.) Even with all this effort, Mollie’s output could, frankly, only be called a mess. Her letter formation and spelling would have embarrassed a first-grader, and they took up so much mental energy that her sentence structure completely fell apart. When I asked her to read out loud, the results were equally disastrous. As I got to know her better, I realized that Mollie had difficulty not only with reading and writing, but also with expressing her ideas clearly in grammatically appropriate sentences. She had experienced good, standard teaching, but it just hadn’t worked for her.

Here is an original summary of the story “Beauty and the Beast” that Mollie wrote when she was in third grade.

In case you are not a learning specialist accustomed to deciphering such text, it says:

“Buty(Beauty) was sherd(scared) at fast(first) and stad(stayed) in the plais(palace) for the and the fell in love and mered(married) the best(beast).”

Mollie came from a family riddled with subtle language problems that showed up especially in reading, writing, and spelling. We know now that her difficulties fit a pattern of “dyslexia,” which research has shown to have a genetic base. As you will see in later chapters, dyslexics’ brains tend to be structured and to work somewhat differently from those of nondyslexics. Yet this family had not only attained a considerable degree of material success through work in creative fields but they were delightful people, with a wonderfully loving and supportive family life. I give them credit for the fact that, for all the years I have known Mollie, she never failed to be cheerful, hardworking, and exceptionally thoughtful. They showed me it is possible to hold high standards for effort while simultaneously providing that unconditional emotional support so badly needed by any child.

Many talented teachers and specialists contributed to the rest of Mollie’s story. She gradually began to capitalize on her many attributes while working on her weaknesses. The day Mollie strode confidently to the platform at college graduation to deliver a motivational speech—which she had written herself—I wasn’t the only teacher in the audience with very moist eyes.

One reason for Mollie’s triumph is that the type of teaching she received changed her brain—quite literally—to enable it to accommodate verbal tasks more easily. Fortunately, those changes did not remove this child’s charming and insightful character and her quirky originality.

You may be intrigued, as I was, to hear what a fellow teacher observed when Mollie was in the sixth grade. “You may not believe this,” he told me, “but that child has been beating all of the middle-school faculty in chess!” Moral: Don’t judge a child only by her symptoms, and don’t assume that child with a “disability” is necessarily a disabled child!

“Weird but Wonderful.” Marko also taught me a great deal when I encountered him while still in graduate school. The principal of his small middle school phoned me one day.

“Do you know anything about a learning disorder that sounds like ‘asparagus’?” he asked. “One of our students has just gotten this diagnosis from a hospital clinic and we don’t have any idea what it is or how to treat it.”

At that time I was conducting research for my doctoral dissertation on hyperlexia (an unusual sort of reading problem that I will discuss in a later chapter), which often accompanies Asperger’s syndrome or autism, and I was indeed aware of this diagnosis. Asperger’s syndrome is now in the news as a high-end variant of autism, but at the time not many people—even professionals—had heard the term.

When I met Marko in an unoccupied classroom at his school soon afterward, I understood the reason for the diagnosis. This handsome seventh grader had difficulty looking me in the face, much less the eyes, when I attempted to shake his hand. Instead of responding to my efforts to strike up a conversation, he launched into a lecture, delivered in a near monotone, about the intricacies of the layout and technical workings of the school’s heating system, which he finally concluded by jabbing his finger toward the floor at my feet,

“And your chair is sitting on one of the pipes, right there!” This last phrase was delivered at such an inappropriately loud volume that several students passing in the hall peered in the door. Seeing it was Marko, they exchanged knowing looks and went on.

Like Mollie, Marko was lucky to have a very supportive family. Among other things, his mother’s brother had many of the same characteristics and really related to Marko’s unique personality. Marko’s mother once described them both as “weird but wonderful.” His middle school, too, was an unusually small and nurturing one, which prided itself on human as well as academic values. And Marko had a champion: a classmate who was not only popular as a leader but also quite formidable physically. All the kids knew that it wasn’t in anyone’s best interest to be mean to Marko. These factors reduced the biggest difficulty that youngsters like Marko usually face—social ostracism, teasing, and a sickening sense of social isolation that they really don’t understand.

Although Asperger-type youngsters are often very bright, they have difficulty reading the normal social cues—gesture, facial expression, the appropriate use of social language—that the rest of us recognize and use instinctively. These youngsters can be challenging for others. Nonetheless, like Marko, they often possess exceptional talents, along with needs like any other child. I am glad to report that Marko completed high school and at my last contact, his story was playing out happily with a promising job in a plumbing company that installs and services heating systems. This success is due in no small part to the fact that other people have accepted and worked with Marko’s abilities and his disabilities, and that special programs and wise choices have helped him along the way.

Until we return to the topics of Asperger’s syndrome and autism in Chapter 3, I thought you might begin to understand Marko’s world better by looking at a picture he drew when he was in eighth grade. The fact that the people are portrayed without facial features is neither an accident nor Marko’s attempt at a new sort of surrealism. It is simply the way he perceives the world. Research has shown that the brain activity of individuals on the autistic spectrum differs from other people’s when they look at human faces. Their brains react to faces as if they were looking at inanimate objects. What a puzzling world that must be!

Clearly, learning problems are not only—or even primarily—caused by neglectful homes or bad schools. Genes are powerful determinants of who we are and how our individual patterns of learning are set up. But genes definitely aren’t everything.

An Environment That Spells TROUBLE. A few years ago I met a little boy who worried me a lot. His mother had called for advice in dealing with the school and the problems her child was having there. We had agreed to meet in a nearby restaurant during her brief lunch hour, but when I arrived, to my surprise, I encountered not only Mom but also Joshua, aged five.

Joshua had just been sent home from kindergarten—for the third time that month—in the middle of the school day.

While Mom and I tried to talk, Joshua roared around the restaurant, unrestrained, testing every rule that anyone—including our frazzled waitress—attempted to impose on him.

At the school’s recommendation, Joshua had recently received an evaluation from a pediatrician who, after a twenty-minute meeting, had diagnosed attention deficit/hyperactivity disorder (ADHD) and prescribed a psychotropic medication (Adderall). When the pills did not seem to have the desired effect, the doctor suggested by phone that the dose be doubled. (If this mother’s account is accurate, it is a particularly bad example of superficial diagnosis and prescribing by a physician. Such treatment would be deplored by most pediatricians, although with doctors’ hurried schedules, it seems to be more common than it should be.)

“I gave him a double dose, and he chattered nonstop until midnight—he wasn’t even making sense,” Mom reported. “I just couldn’t get him settled down, so we went back to a regular dose. But it doesn’t seem to be doing much good. Today he tried to choke a little girl in his class, and that’s why they called me to get him—again!”

Joshua had been in trouble of one sort or another since he had been in day care, and as I learned more about this case, I became increasingly annoyed about the questions that had not been asked along the way. The school had arranged for a limited amount of diagnostic testing, which suggested that Joshua might have some treatable problems with his language development (which can sometimes show up as attention and behavior problems), but not much had been done about it. Josh had a lot of trouble with expressive language, and was inclined to strike out physically instead of expressing his ideas or feelings in words. What’s more, this child’s life to date had been disorganized, to say the least. His developmental history contained innumerable red flags: emotional and physical upheavals; erratic and inappropriate early child care arrangements that probably contributed to language delay; multiple ear infections with temporary hearing loss; a steady diet of TV and, now, semiviolent video games, which he played when he visited his father on the weekends. In addition, his fractured home environment was compounded by inconsistent expectations and inappropriate exposure to adult problems of all sorts.

“I think most of my family has ADHD,” Josh’s mom told me with a shrug, “so there’s not much we can do about it—right?”

Josh certainly had difficulty paying attention, but there were plenty of other possible contributors to his outrageous behavior than an organic attention deficit alone. Until some of these other issues were addressed, I seriously questioned any hasty decision to put him on a powerful, brain-altering medication without a thorough evaluation and ongoing supervision. Medications may help, but they may also mask critical and treatable issues—either organic or environmental—that should be attended to sooner rather than later.

Joshua is a very lovable little boy despite his exasperating behavior, so it was possible to get lots of adults to help. We were able to work with his school district to get him a more thorough evaluation and some specialized teaching in a small, therapeutic classroom. Mom has agreed to meet regularly with a counselor to try to put her own life and Josh’s home environment on a more positive track. In addition, Josh’s grandmother has stepped in to invite Josh for frequent visits and to spend the summers with her. When he returns from her home, he seems calm and happy.

So Many Stories . . . There are so many stories—and behind each one is a real, live, feeling kid. I think, for example, of sad-faced little Juana, whose “reading disability” was probably caused, frankly, by poor early teaching in a shockingly overcrowded and ill-equipped classroom. And Harrison, a very smart little boy, the youngest in his class, whose parents had insisted that he be accelerated in kindergarten. They relentlessly pressured both school and child, despite the fact that his perceptual-motor and social development were lagging far behind his intellect. Harrison ended up with a “learning disability” that he might not have suffered from had he only been in the right class at the right time. And Zack, who came from a home where reading was not a regular activity, and where his overstressed caregivers didn’t have the time to talk to him. Unfortunately, when Zack got to kindergarten, he was expected to start dealing with the alphabet and words he didn’t understand. It didn’t take long before his lack of background experience translated from bafflement to frustration to serious discipline problems, to a label of “learning disability, attention deficit/hyperactivity with a tendency toward conduct disorder.” Zack came into the world with a potentially keen mind, but he now has a high probability of dropping out and even tangling with the law.

The Ecology of Failure—and the Strategies for Success

Unsuccessful learners are costly for many reasons, but the most important is the human price paid in lost potential, family stress, societal disruptions, and personal anguish, which can last a lifetime. I hope the following chapters will set a positive course through the maze of genetic, neurological, and environmental factors that we must understand to address this growing “sickness” among our young.

It bears repeating, also, that the very notion of “disability” implies a value judgment. While academic skills are vitally important, there are other things in life that count, too. I often reflect on the many children I have treated who struggled academically but were simply fantastic human beings—kind, thoughtful, insightful, original, morally responsible. I have been in this business long enough to see many of my students grow up to become terrific adults. The fact that some of these kids turned out much better and are happier people than some of those who were much faster out of the scholastic gate strikes me as worth contemplating. After all, in terms of a human life and what you want for your children, what is “success,” anyhow?

Seeking Answers

Education consultant and reformer Andy Hargreaves tells a story about a gentleman who is taking a stroll by a riverbank when he comes upon a man who is frantically jumping in and out of the water to pull out drowning people. No sooner does he rescue one than another struggling person floats by, and then another, and another.

“What’s the cause of all these people drowning?” the observer asks.

“I don’t know,” gasps the rescuer. “I’m too busy jumping in and out to go upstream and find out who’s pushing them in.”

In the following chapters we will go upstream to seek both causes and remedies for our children’s learning problems. We will consider different categories of learning disorders or differences and review research on effective treatments. In Part Two, “Your Unique Child,” we will turn to the fascinating story of how and why children learn, how genetics interact with brain development, why “difference” does not always mean “disability,” and how environments quite literally reshape brains and learning skills. Part Three, “Childhood in the Twenty-first Century,” will identify specific factors that are harming children’s development today and recommend steps for creating successful learning environments at home and school.

© 2010 Jane M. Healy