Written by Dr. John Carosso
I am often asked, “does my child have dyslexia.” A follow-up question usually pertains to what exactly is “dyslexia” and what can a parent do to help. Here’s what you need to know:
‘Dyslexia’ vs a ‘Learning Disability’
Dyslexia (disorder of reading) and Dysgraphia (disorder of writing) are two conditions that are often labeled by school districts, more generally, as a “learning disability”. In fact, over 90% of students classified as having a ‘Specific Learning Disability’ (and given an IEP) are classified as such because they have some form of dyslexia.
Like father, like son
These conditions are almost always inherited (that’s right kids, don’t say your parents never gave you anything) and can greatly interfere with a child’s ability to make progress in school.
More than just a reading disorder
Dyslexia is actually a problem with the processing of language; kids have difficulty processing the sequence of sounds that comprise spoken words. Consequently, you get words like “psghetti” and “amninal.” Interesting, these kiddos genuinely don’t ‘hear’ themselves saying the words incorrectly so it’s difficult for them to self-correct. Moreover, they also struggle with visually processing the specific sounds. Consequently, they may read “gut” for “glut” and so on.
The foundation of treatment
All of the effective strategies are based in a ‘multi-sensory’ approach that incorporates, in the learning process, visual, auditory, and kinesthetic.
In that respect, a child may be shown the word, asked to say the word, hear it spoken by the teacher, write the word on paper, and write the word or letter (using his finger) on a rough surface. Consequently, the child is receiving varied feedback (visual, auditory, kinesthetic) regarding how that word looks, sounds, feels, and is written.
Kinesthetic tends to be especially important (once you learn how to ride a bike, you never forget…)
The Orton-Gillingham approach is commonly used, and incorporates this multi-sensory approach.
What you can do
Here are some considerations:
Read to your child daily, assuming that the person reading to the child is a good reader and can clearly and accurately pronounce the letters and words. In that regard, there’s no sense in confusing the child further. Books on tape can be helpful otherwise and Kindle is becoming popular (read-aloud option)
Two second rule
When reading to your child and taking turns, use the ‘two second rule’. When your child struggles, wait two seconds, then quickly pronounce the word for your child and move-on with the reading. Otherwise, the reading experience becomes burdensome, boring, and your child will resist. Moreover, basic reading passages have lots of repetition of words, so you’ll re-encounter that word soon enough.
Practice makes perfect
Practice writing by tracing and progressively moving to free-hand. Tracing and writing of problem letters (b’s, p’s, d’s…) is helpful. There are also various helpful tricks (“bed” featuring a picture of two people - pictured as the ‘b’ and ‘d’ - holding between them an ‘e’ on which a person is sleeping…).
“Those letters are jumping around…”
Use off-white paper or background with larger-size (14 pt or more) comic sans font to reduce the letters appearing to “move around on the page” (a common complaint from kids struggling with dyslexia).
Technology is our friend
Practice phonics on-line; simply google “free phonics games” and plenty of sites will be available for daily, fun-filled practice. There are also inexpensive ‘apps’ that can be downloaded. I also refer parents to any number of commercial software products that provide comprehensive instruction, in a child-friendly manner, on the computer.
Get our Dyslexia Packet free of charge
Simply email me at jcarosso@cpcwecare.com and ask for our Dyslexia Packet that outlines these strategies, helpful websites, websites addresses for software, and a host of other treatment options.
What to do in the meantime
Parents often ask how their child can manage during the time they’re receiving support at school, but not yet showing marked improvement, and therefore still struggling in completing assignments. I’ll cover those very helpful tips in my next post. Stay tuned.
Lets hear from you
Please comment on what you’ve found to be helpful for your child. Also, if you found this helpful, please forward to a friend. Thanks.
Written by Dr. Carosso
Every so often we get a review of research that tries to shed some light. Three government funded studies, published in Pediatrics, is the latest in that regard. Lets take a look:
Three targets
The researchers looked at meds, behavioral interventions and, for some reason, Secretin (it’s long been recognized that Secretin doesn’t work, not sure why they wasted time with that).
Medications
It’s long-since been established that meds don’t “cure” autism but treat symptoms, which can be helpful for some children. For example, the study indicates that Ability and Risperdal can decrease irritability, crying, hyperactivity, and noncompliance. However, side effects, especially with long-term use, can be troubling.
Behavioral Interventions
Behavioral strategies are undoubtedly effective for all kids with autism. There is a host of studies suggesting that discrete trial and other interventions, relying on Applied Behavioral Analysis (ABA), improve children’s IQ, language, and social skills. The question, however, is how much any given child benefits? In fact, it’s disheartening to note how much we don’t know about the traditional interventions based in ABA, early intervention programs, and parent-training models. Upon the researcher’s analysis of the years of past research, they found the results biased and flawed. Moreover, generalizing any finding is challenging given the wide range of functioning demonstrated by kids on the spectrum, i.e. two children may both be diagnosed with PDD, but present very differently. Not to mention factoring-in the cost-benefit ratio; Lovaas found his discrete trial methods were very effective, but at 30 hours per week of individualized attention, which can cost tens of thousands of dollars per year. These days, trying to persuade any insurance company to pay for that is an uphill battle.
We are what we eat?
In a separate set of analyses, there is more evidence that we can “let food to be thy medicine” (Hippocrates). It only stands to reason; what we put in our bodies affects every aspect of our functioning. Would you put water in your car’s gas tank? It’s well known that children with autism tend to have nutritional deficiencies, gut problems, and food allergies. Upwards of 69% of parents report positive outcomes from dietary regimens including going gluten and casein free. Yes, these surveys can be quite biased, but my own clinical experience suggests they’re not far off.
Just when you thought it was safe to vaccinate…
To vaccinate or not to vaccinate? I wonder if this debate will ever end? I think it continues because it is difficult for parents, and practitioners, to not have some intuitive inclination that putting a bunch of chemicals in an infant can possibly cause some problems. We first hear that it’s harmless, then later that it does cause problems, then an onslaught from the medical community that it does not. Helen Ratajczak now tells us, in the Journal of Immunotoxicology (“Theoretical Aspects of Autism: Causes – A Review”) that “documented causes of autism include genetic mutations and/or deletions, viral infections, and encephalitis (brain damage) following vaccination” especially due to an ever-increasing number of vaccines given to an infant over a short period of time. Of course, critics suggest that her review is of theories, not science, so the saga continues. However, as I have blogged before, it’s encouraging that pediatricians are more prone to space-out the vaccinations.
Where does that leave us?
It leaves us where we usually find ourselves especially with any research related to social “science” or psychology; in the dark. Consequently, we have to rely on clinical experience and anecdotal evidence, which leads to a multi-faceted approach using strategies based in applied behavioral analysis including discrete trial and verbal behavior; social-based interventions including floor-time; psycho-educational pursuits whereby parents are taught how to intervene; beginning treatment with children as young as possible; modifying diet accordingly, and closely assessing the child’s response. That’s why data collection is vital; how else are we to know if the intervention is working? Fortunately, in spite of the ‘darkness’, with a diverse approach focused primarily on the fundamentals of ABA, and an open mind to trying new things, daily I see children’s improved eye contact, communication, play, and social interactions, and the accompanying smiles and happiness from parents and kids alike. So, hang in there, keep fighting the good fight, pay close attention to results (i.e. your child’s improvement) and then you can rest-assured that what you’re doing is effective, and that your child is benefiting. God bless.
Feel free to comment, and forward to a friend. Thanks.
Written by Dr. Robert A. Lowenstein MD
Bullying at school has become a major source of anxiety and trauma for many children in school. Going to school on the bus, eating in the lunchroom, or simply walking school hallways has become a time of pain and suffering for too many of our children. In severe instances, it even has led to children committing suicide.
Here are some tips parents can use to counter this experience:
Written by Dr. Carosso
I was perusing a recent Personality and Social Psychology Bulletin and came across a research article that caught my attention. I think it will catch your attention too.
The research:
In the article, researchers found that when people were provoked by somebody, they were less angry and much quicker to calm when they spent a few minutes praying to God, compared to those who used other coping methods (thinking about a person or other distraction methods).
Not even close
In comparing the results for the two groups (praying vs non-praying), it wasn’t even close. Those who briefly prayed were much calmer and felt better about the situation than those who did not. Similar outcomes were seen in four separate trials and, in every instance, the results were significant when compared to those who did not pray. It didn’t matter if the person rated themselves as devout or not; they calmed quicker just the same. Most identified themselves as Christian, but not all.
Not too surprising
I imagine God isn’t too surprised by these results; He’s been telling us for quite some time to pray when we’re troubled or distressed (James 5:13). We shouldn’t be surprised either. However, it’s always nice when the “scientific” supports the spiritual. However, one of the researchers explained the outcome in a manner discounting the spiritual; but we know better;)
Practice makes perfect
Many of you have particular prayer-times for your kids (before bedtime, before sending your kids off to school, saying Grace before dinner…), which I trust you've found to be meaningful and helpful. How about also incorporating prayer into your daily arsenal to combat arguments and conflict? You may want to practice with your child to use prayer to calm, feel more in control, and tap-into a source of comfort and guidance.
Pray for your “enemies”?
The research was also compelling in that the prayer was directed toward helping another person. It’s especially useful to teach our kids (and remind ourselves) to move away from self-absorbed anger and focus on helping those in need, including the person doing the provoking. Okay, I know, kids may not be too enthusiastic about that last part, but it’ll grow on them.
The Enhancer
Of course, a brief prayer doesn’t replace conflict-resolution, it enhances it. It’s easier for your child, after a prayer and feeling a bit calmer, to talk about a peer bothering him at school and figure out a game-plan.
Give it a go
Try it and let me know how it works for you and your kids. I’ve done this with my kids and have seen, first hand, how this can be helpful.
That reminds me
By the way, this article reminded me of a post I wrote last year. I reprinted it below (Spirituality: Father knows Best). Feel free to check it out; I hope you find it worthwhile.
Spirituality: Father Knows Best
Written by Dr. John Carosso
Wouldn’t it be nice to be omniscient, omnipresent, and omnipotent, especially when it comes to caring for your kids? Well, you’ll never be any of those things, but you can introduce your child to someone who is. Imagine how comforting and reassuring for your child to know, during times of good and bad, that he or she is being watched-over, protected, helped, comforted, and that he is part of a larger, heavenly clan of his Father, brothers, and sisters. I have seen time and time again: children with a spiritual sense tend to have a stronger conscience, are easier to comfort, and have a better understanding and sense of purpose and meaning in their life. Parent can pull from the Bible to teach and help their child to understand about morality, compassion, love, the destructiveness of sin, and how stay on the ‘straight and narrow’. I can say, first-hand, that having a personal relationship with my Heavenly Father is rewarding beyond words, and I relish sharing Him with my kids and watching them grow in their spiritual relationship. I strongly suggest that you take advantage of developing, within your child (and why not within yourself too?) a strong spiritual life, based in a loving relationship with God. Otherwise, you lose access to an invaluable anchor and rudder that can be the utmost guiding force for good and joy. God bless. Feel free to comment and forward to a friend.
Written by Dr. Carosso
Okay, here it goes; whether your child is a typical kiddo or struggles with attention, learning, social, or developmental issues, these strategies will help any child perform at his or her best. These strategies are well-founded in research and over 20 years experience in clinical and educational practice.
Let’s get to it:
Billboard your child’s strengths
Go overboard to inform teachers, and remind them regularly, of your child’s strengths. Send notes and emails, write in a daily log, leave phone messages, yell if from the roof-top, send smoke signals, and do whatever else it takes to establish and maintain the teacher’s positive impression of your child. Over 10 years of research is abundantly clear that teacher’s preconceived notions about a student, whether good or bad, even if untrue, tend to come to pass. For example, students who are described as smarter (even if they’re not) subsequently score higher on tests; students who are described as social and cooperative (even if they’re not) later do better socially, and on and on it goes… I’m not suggesting that you mislead, but simply ‘talk-up’ your child’s strengths:)
Power-sitting
Make sure your child is seated in the ‘Attention Zone’ of the classroom (i.e. the triangle-shaped area with the base of the triangle being the front row of the class). Students seated in this triangle area receive more eye contact, oversight, monitoring, and attention than anywhere else in the classroom. These students subsequently tend to score higher, and feel more supported.
The classroom stepping-machine
Look for teachers who wear running shoes (or buy the teacher running shoes). There is an inverse correlation between the number of steps a teacher takes throughout a classroom and the subsequent behavior problems in the class. The more steps, the less behavior problems (and more academic success!). Kids do better when an adult frequently passes by.
The break that keeps on giving
Okay, we know that kiddos need breaks throughout the day, but these breaks need to involve movement; at least a brisk walk if not vigorous running for at least five minutes; and be offered two or three times per day (sometimes more; e.g. for kids who have ADHD). Thereafter, students are more attentive, cooperative, and interested in learning. Moreover, walking in a green-space area has shown to be far superior than a gray-space for subsequent attention to task and achievement.
Fill-er-up
Kids want attention. Okay, I know, that’s no revelation. However, what isn’t so well known are these two points, 1.) kids want their ‘attention-tank’ to be full, but they are not particular with what, or how, it gets full. Students will seek attention negatively if teachers don’t give it positively. So, for every negative redirection, there needs to be at least 10 praises (“catch them being good…”). This way, your child can focus on learning, not getting attention, and feel confident in doing so. 2.) Research shows that kids do better if praised about their hard work, rather than their intelligence. The former can be improved, the latter ends-up being an expectation that increases pressure and stress, and has actually been shown to cause grades to drop.
Your child will be happier, more successful, and confident when these strategies are used (maybe they can be used at home too:) Each needs to be tailored to your child, but you get the idea. You only have so much control over what the teacher will do in the classroom, but now you know what needs to be done. Stay tuned; I’ll provide some more tips in weeks to come. In the meantime, feel free ask questions, comment, and forward this to a friend (or maybe to a certain teacher…). God bless.
Written by Dr. Carosso
In the autism community, parents must sift through a host of confusing, murky, and contradictory words, terms, and concepts. It’s no wonder there is frustration and misunderstanding. Hopefully this post will help to clear the waters a bit.
In a prior posting (autism: facts and fallacies), I discussed that “autism” is not a diagnosis, but simply a term that represents the ‘autism spectrum’. However, that begs the question; what is the autism spectrum?
Okay, I suppose we’re all aware that the ‘spectrum’ reflects that any child with autism may ‘look’ quite different from another. One child may be nonverbal, while another may be fully conversational but with some social quirks. However, how does that relate to the actual diagnosis any given child on the “spectrum” might get from a doctor?
Okay, here goes an explanation, for better or worse:)
The three most commonly used diagnoses for a child on the autism spectrum are:
Autistic Disorder………….Pervasive Developmental Disorder NOS………….Asperger’s Disorder
More Severe Less Severe
I know it’s not perfect, and many of you will see shortcomings (as do I), but I find it helpful to view these three diagnoses as reflective of the “spectrum” we hear so much about.
At the far end of the spectrum is ‘Autistic Disorder’, which is how we tend to perceive classic ‘autism’ such as what was seen in the movie “Rain Man.” These kids tend to have more significant social and language difficulties.
At the other end of the spectrum is ‘Asperger’s Disorder; kids who are conversational but have social problems and tend to obsess on things.
For those kiddos who do not meet the diagnostic criteria of those two extremes, we have the diagnosis of ‘Pervasive Developmental Disorder Not Otherwise Specified’, or PDDNOS, or simply PDD. These kids show signs of ‘autism’ but have strengths and differences that exclude an ‘Autistic Disorder’ or ‘Aspergers’ diagnosis. For example, they may be quite social and talkative, but don’t always “know what to do” in social situations. These children may also speak mostly in short phrases, which precludes an Asperger’s diagnosis.
Clearly, PDD is the fastest growing diagnosis on the spectrum, likely for a bunch of reasons including we (professionals) are more aware of the condition than 10 years ago, and that the rates seem to be genuinely increasing for reasons we’re still exploring, e.g. vaccinations, genetics, toxins…
Understanding the ‘spectrum’ helps in many ways including appreciating the extent to which your child will improve and recover. For example, it’s not entirely uncommon for children at the upper PDD range, or upper Asperger’s range, to demonstrate wonderful progress and, down the line, recover and no longer need services. In fact, I’ve seen two discharges from services in just the past month, which further reminds us of the potential for very positive outcomes:)
However, even kids who are diagnosed with Autistic Disorder can, and do, show lots of progress but it’s more likely they will have some ongoing deficits.
Well, hope that helped in understanding the ’spectrum’. I know there are still lots of questions, so feel free to comment and I’ll follow-up. If you found this helpful, please forward to a friend. Thanks.
Written by Dr. Robert Lowenstein MD
I often get questions by parents who prefer not to have their children prescribed a stimulant medication for ADHD. They ask whether there are alternatives to help reduce their child’s symptoms of inattention, over activity, impulsiveness, lack of focus, and irritability.
The gold standard for the treatment of ADHD symptoms has been a combination of stimulant medication and behavioral treatment, that have been proven to be the most effective by many research studies over the past 70 years. However, the answer is that there are complementary and alternative biomedical (CAM) treatments for ADHD, which might be helpful. The scientific evidence for their effectiveness varies, and none should be tried without close collaboration with a physician or child psychiatrist to both confirm that a child truly has ADHD and to closely monitor their use for safety.
The alternatives that might be worth a try, despite lack of scientific study, include use of (1) Essential fatty acid supplementation (EPA, DHA, and GLA) or Omega-3 fatty acids, which can have other health benefits for the heart and brain. (2) RDI/RDA multivitamin supplementation could also be useful for children with appetite loss caused by use of a stimulant medication or children who are picky eaters; (3) Mineral supplementation (iron, zinc, magnesium) after their deficiency is proven; and (4) Food Elimination diets (sugars, and dyes especially) which have had some reported value. Other alternative treatments which might be of some benefit include (5) DMAE for milder forms of ADHD; (6) Carnitine, for inattention, and (7) Micronutrient supplementation to lower moodiness, and disruptiveness in children with ADHD.
All of these may in themselves have unwanted side effects. So, whatever is tried, close supervision by a child psychiatrist or pediatrician is required.
I welcome your feed back and personal experience with any of these.
Written by Dr. Carosso:
As parents, we expect kids to follow directions when told to do so, and that our child will do so immediately. Oh, that it would be so. To our despair, it’s not, and likely shall never be.
That’s the important point; kids are not automatons (or at least mine aren’t) – oh that it would be so:).
I tell parents that we don’t expect a table or chair to move immediately on our command; so why do we expect our kids, who have their own agendas, wants, and distractions, to immediately follow our direction with a sense of urgency?
In fact, we might have better luck with that wooden table.
So, should we simply give-up? Okay. Well, maybe not. Instead, how about changing our expectations and, in doing so, lower our blood pressure.
Recognize that kids often need that ‘softer and closer’ approach (see former blog on that subject) and a physical prompt (gently guiding them in the right direction) and getting them started on the task. Helping them begin the chore also helps.
It helps to back-up our direction with firm consequences, and soft-spoken reminders of rewards that can be earned, and privileges that will be lost.
However, to our avail, we as parents tend to rely on pestering with an ever-increasing volume. This approach is the least favorable, and results in the most frustration and bad-feelings for all involved.
Remember, as parents, emotion and words are your enemy, while a softer and closer approach, and clearly explained expectations and consequences, is your friend.
Rely on consequences and action, not pestering. After you've explained expectations and consequences (i.e. rewards and punishments), one time, then you've said enough; time to be quiet and follow-through.
Try it, you’ll like it. Now, go get softer and closer with your kids.
If you liked this, forward to a friend:)
