(Picture: Dark blue background with different sized blue spheres with central black holes. Courtesy of: https://earthsky.org/astronomy-essentials/definition-what-is-dark-matter/)
“This isn’t done! This isn’t done! This is incomplete! He is reading well below grade level.” As my husband and I sat across from my son’s first grade teacher I tried to contain myself from yelling back. “THEN WHAT IS HE DOING?” It just wasn’t making sense. This was the child that asked me if I could explain “dark matter” to him a few weeks prior (something I promptly googled and still am not sure I can accurately explain). This was the child that drew a Pangolin (pre-COVID19) as his favorite animal the first week of kindergarten and had to explain to his teacher that he was in fact saying pangolin not penguin (also worth googling-they are quite interesting). Things were not adding up. As a mother I was worried, frustrated, and sad. As a pediatrician I was asking myself how I missed this.
As a pediatrician, the checklist started going off in my head. He needs to be evaluated for Attention Deficit Hyperactivity Disorder (ADHD), he needs to get a school evaluation to see if he needs an Individual Education Plan (IEP). Should he see a developmental pediatrician? As a mom, I just wanted to give him a great big hug and let him know it was going to be okay. How stressful it must be to sit in a classroom where things were not making sense, being constantly corrected and feeling not good enough. He was diagnosed with ADHD but didn’t qualify for an IEP because although his reading was behind “it wasn’t delayed enough” (story for another blog). I received great advice from a close friend, a mother of four, and a developmental pediatrician (yes in my eyes she is a bit of a rockstar). She said he could have a learning disability and you should get further testing. She was right, several months later he was diagnosed with dyslexia. We got him connected with an amazing reading specialist in our community who used evidence based techniques which his brilliant brain latched onto. Now, several years later we can’t pull his head out of a book and he is reading well above grade level and still asking me questions I need to google.
Why am I sharing this? I want others to know a lot of times ADHD doesn’t occur in isolation. Learning difficulties can be seen in up to 50% of children diagnosed with ADHD. They are also more at risk for other conditions such as depression and anxiety. You have to look at and treat the whole child for them to thrive. As a general pediatrician, I was trained to evaluate, diagnose and treat ADHD. I was not trained to diagnose learning disabilities and unfortunately we don’t have consistent screening systems available and rely heavily on schools to pick up learning disabilities-something that needs to change. Learning disabilities pose a major threat to a child’s short and long term health and need to be treated as such.
Finally, of all learning disabilities, dyslexia is most common and affects up to 20% of people. We need to examine how schools are teaching our children to read. We need to ensure all schools are supporting their teachers and students by providing training and instituting an evidence based reading curriculum proactively. First you need to learn to read so that you can read to learn. Lastly, as a pediatrician, a mom, and the daughter of a retired children’s librarian-go check out your local library. They have amazing programs and resources for children (and adults) and are often a source of wonder and awe for all ages.
References:
Sanfilippo J, Ness M, Petscher Y, et al. Reintroducing Dyslexia: Early Identification and Implications for Pediatric Practice. Pediatrics. 2020;146(1):e20193046
https://www.nytimes.com/2022/09/01/opinion/us-school-reading.html
Great resources to check out:
https://dyslexia.yale.edu/dyslexia/dyslexia-faq/
https://www.readingrockets.org/article/learning-read-reading-learn
https://reachoutandread.org/what-we-do/resources-2/
https://www.chipublib.org/kids/
