Is your child or teen finding every excuse in the book to avoid going to school? Spending all her time alone? Having trouble eating or sleeping? Or, is something just not quite right, and you're not sure how to deal with it?Maybe it's time to think about seeking some professional help to cope with these emotional challenges. Chances are you know your child best. But take some tips from three professionals in the field who can help guide you through this process.
Not Just a Problem with Academics?
Some research indicates that those with learning disabilities (LDs) are more often challenged by social-emotional issues than those without them, says John T. Beetar, PhD, ABPP, director of Psychological Services for School Programs at the Kennedy Krieger Institute in Baltimore, MD. These are some possible reasons:Poor self-esteem. "Students with learning problems can be lonely and withdrawn," says Beetar. "They may deal with mood variability and teasing and bullying by others. Their motivation tends to be poor and there are high dropout rates in this population."
That can be a setup for poor self-esteem, says Dominick Auciello, PsyD, neuropsychologist with the Learning and Diagnostics Center at the Child Mind Institute in New York City. But it's important to not jump to conclusions, he says. "That's because kids with LD can have many different combinations of strengths, weaknesses, and outcomes. LD comes in many forms, too."
Distorted processing. Learning disabilities can distort emotional processing, says Beetar. For example, a problem understanding nonverbal communication might interfere with a child's ability to "read" other people or cause a child to take things too personally. Misunderstanding can also arise for children with language-based learning challenges, says Auciello. "Much of what happens socially is verbal, so these kids are at risk for not understanding what others are saying or for not expressing themselves effectively."
Coexisting disorders. Psychiatric disorders such as anxiety, depression, or Attention-Deficit/Hyperactivity Disorder (AD/HD) also tend to coexist at higher rates in those with LD than in the general population, says Rebecca S. Martinez, PhD, NCSP, associate professor of the School Psychology Program at Indiana University in Bloomington, IN. "So we want to put our heads together to take care of them," she says. "It becomes a school issue, parent issue, and private practitioner issue."
Signs of an Emotional Problem
Is your child becoming increasingly distressed over schoolwork? Many students with LD that end up with a diagnosis of LD handle the early grades quite well, says Beetar. "But in the third and fourth grades, academic work begins to get quite challenging for students with learning disabilities." That's because there is a shift from learning to read to reading to learn. "At that time, work may become more and more frustrating and the student may start refusing to do certain assignments. This could also be the start of behavioral difficulties that could become worse over time."In general, a younger child will have fewer words to describe how they are feeling, says Martinez. For them – and to a certain extent, for teens, too – behavior becomes the language you need to translate.
Here are some signs that a child or teen could benefit from psychological help, whether or not he or she has a learning disability:
- Extreme anger, acting out, or mood swings
- Increased sadness, tearfulness, or crying
- Increased sensitivity, irritability, or hostility
- Being bullied or bullying others
- Withdrawal or isolation
- Persistent low energy or decreased interest in activities once enjoyed
- An increase in physical complaints such as headaches or stomachaches when everything checks out with the doctor
- Sudden changes in appetite or eating habits (especially in teens)
- Trouble sleeping or increased sleepiness
- Excessive school tardiness or absenteeism
- Signs of alcohol, drug, or substance abuse
- Self-destructive behavior
- Thoughts or expressions of suicide
Finding the Source of the Problem
No doubt, you're concerned if your child has displayed signs such as these. "When changes in behavior are marked and your child is starting to 'fail' at things – even at daily living – then it may be time to seek mental health services," says Beetar. This professional may also refer your child for testing to rule out learning problems as the cause of emotional distress."It is important to try and figure out what that overarching problem is," says Beetar, "because you will not get to the root of the difficulties if you only treat what is secondary. It's like a Band-Aid approach." There may be one overarching problem or many distinct difficulties that impact one another. For example, depression might interfere with learning. So resolving the emotional disturbance might make a big difference. On the other hand, when frustrated by learning problems, a child might become depressed.
This can all be challenging to figure out on your own. "But an astute clinician who takes a good history, makes behavioral observations, and can work with a great deal of both qualitative and quantitative data is often able to figure out which issue or issues are primary and which are secondary," says Beetar.
Timelines and context can help sort out what is a preexisting behavioral problem or one made worse by LD, says Auciello. "The first step is always a good evaluation, which will guide the direction you take." This might be conducted by a neuropsychologist or education specialist, or other specialist who is equipped to assess both the learning and psychological aspects.
Although not always necessary, in some cases a neuropsychological assessment may be helpful. In addition to an emotional-behavioral assessment, says Beetar, this may include an evaluation of the child's:
- History
- Intellect
- Attention
- Memory
- Language skills
- Visual spatial skills
- Executive functioning
- Sensory motor functioning
A somewhat lengthy process, this comprehensive evaluation varies in cost but is sometimes covered by insurance. "Along with background information and behavioral observations, the results of this testing often provide a good picture of the child's cognitive strengths and weaknesses and how psychosocial or medical and developmental risk factors and family functioning may all contribute."
Where to Begin
Where should you begin to get help? First, it's a good idea to see your child's doctor. Sometimes emotional problems stem from physical problems. Then, you might start by seeking resources at your child's school.Start with the school. If you haven't already, Martinez recommends discussing your concerns with school personnel. "When you have a good relationship with the school, you can move mountains," she says. If your child is at the elementary level, she suggests starting with the classroom teacher. If your child is at the secondary level, the place to start might be with the school counselor, social worker, or school psychologist.
Although each school might "look slightly different," most will have some kind of group counseling program, social skills program, or wraparound services available on an as-needed basis, particularly for children in special education, says Martinez. Start by finding out what's available. Exhaust these resources first. "You don't always have to go the $150/hour level to get good services," says Martinez.
Advocate for your child. What if you're not sure how to proceed with the school? "If you live near a university town that has a school psychology program or counseling program," says Martinez, "contact one of the faculty members and seek his or her advice on how to advocate for your child within the school system. If needed, go to the superintendent and ask what is rightly yours under special education law."
When Seeking Help outside the School
What if you find you need more help than the school is able to provide? How can you go about finding a reputable person? Here are some options.- Consult other parents. "Word of mouth can be very helpful," says Auciello. "Get a real sense from someone you might trust – another family. Find out firsthand who other folks have found to be helpful and sensitive and invested." But remember that one size doesn't fit all.
- Ask the school. "Every child is also obviously entitled to have an evaluation through their district," says Auciello. "That includes not just the learning piece, but also the psychological piece."
- Search the Internet. Search for professionals using keywords such as "counselor," "psychologist," or "therapist," advises Martinez. Check to see if the professional has received high ratings and is near where you live. "Then call and see how much time they give you on the phone."
Ask questions upfront. Ask about the person's therapeutic orientation. In other words, what types of treatment do they offer and what is their experience with different types of challenges, such as LD? These are other questions to consider:
- Is the therapist licensed in your state?
- Is she or he credentialed in psychology, social work, or psychiatry?
- Will your insurance cover this care?
- Does this therapist have experience with children or teens?
- What are the therapist's policies with regard to cancellation or emergency contact?
- Will this person's personality be a good match for your child?
Tread carefully. A child or teen with LD may already be dealing with self-esteem issues, says Beetar. "To be identified as needing counseling could intensify feelings of poor self-worth." Be sure to be honest and prepare your child for the first visit.
Establish trust. It is fine to meet with a few counselors to see which one may be the best fit, says Beetar. Establishing trust is always important, but crucial with adolescents, he says. "I always tell parents and older adolescents that they are the consumers in this process." With them, make sure there are explicit rules about confidentiality. "If the student sees that he or she can trust the counselor, there's a better chance for success," he says.
Seek and practice empathy. Whether it's you or the professional your child is working with, empathy is key. Remember that most kids are doing their very best. It can help to think about how you would react if you had a hard time reading or completing your schoolwork.
"I might want to escape, too, if you made me walk across town with a 100-pound backpack on," says Auciello. "I'd probably find another way to get there. The same is true for a child with LD: There is often a good reason for avoidance. Don't assume that it's laziness or lack of interest."
As best you can, try to understand things from your child's perspective. Try to figure out the triggers for frustration and emotional difficulties. "Take a close look at what is leading to these situations," says Auciello. "Try to be flexible about making changes and providing support that's appropriate and not enabling." Along with any professional support, this can go a long way toward helping your child make progress toward having a healthier – and much happier – life.
Additional Resources
- American Academy of Child & Adolescent Psychiatry
- KidsHealth from Nemours: "Taking Your Child to a Therapist"
- National Association of School Psychologists
Annie Stuart is a freelance writer and editor with nearly 25 years of experience. She specializes in consumer health, parenting, and learning disabilities, among other areas.
