A Doctor and a Mother: Blurred Roles and Clear Insights

Written by Debbie Walhof M.D. | 5 years ago

Growing up I loved children, loved school and I always knew I wanted to be a mom. I can’t think of anything more fundamental to my nature. Often our professional lives and personal lives intermingle. For me it is no different. I am a pediatrician and a mother.

When I am in the office I am happy to be able to work with kids but they are often sick or healthy and anxious about getting shots. So you can imagine how excited I was to be able to volunteer in my son’s classrooms once he started attending school. I could not think of anything that I enjoy more than spending the entire day with my son in a school filled with other happy healthy kids.

How Did the Patient Present?

In medicine when we discuss a diagnosis, our first question is “How did the patient present?” We recognize that all individuals are unique—their bodies don’t read like textbooks. The more we understand how different people present with different symptoms for the same diagnosis, the better we will be at identifying that diagnosis. And as pediatricians, most of the information we gather is through our intuition with our patients as well as the parents’ intuition of their child. Although we rely on history and sometimes lab work, we are very astute at non-verbal cues.

So in the past decade, looking back at our family’s journey with dyslexia, I thought I would share some insights from both my perspective as a pediatrician and as a mom. My son has moderate dyslexia. He was identified as dyslexic at the beginning of second grade.

How Did My Son Present?

So how did my son present? He didn’t. Perhaps he would have a year later if I didn’t pick up on some of these subtle clues.

In preschool, kindergarten and first grade, all of his classwork was the same as the other kids. He was not a behavior problem and the teachers loved having him in class. In fact they did not understand why I wanted him evaluated for an Individualized Education Program (IEP). These were good teachers in a good school.

So what were the red flags that made me push to get him evaluated? Number one—in first grade he started crying at times when he did his homework. Once he called himself stupid. I thought this was odd because he always got everything correct on his homework.

I have since learned that children always know instantly when they feel different. I have come to believe that if an intelligent child is calling himself “stupid” even if he is doing well in school, parents may want to consider having him evaluated for learning disabilities (LD). The kids are smart and can often compensate for a long time.

The second red flag? When the teacher gave directions in class my son looked around at the other kids before he began working on the project. He did not get his understanding of the directions from what the teacher had said to the class. In my gut I knew something was different for him. I brought it up but since his work was fine no one thought it was an issue. In retrospect, I now realize that he was actually trying to figure out the teacher’s directions by watching his peers.

As a parent, if you have a strong gut feeling that something is wrong, don’t back down. Investigate further. Your child needs you to advocate for them. I forced an IEP against teacher recommendations. His dyslexia was identified a year earlier in the system. His teacher thanked me.

Insights I Learned as a Mom

  • Kids with LD are often working really hard all day in their area of weakness. Make sure parts of their day are filled with activities in their areas of strength.
  • Show your children your areas of weakness. It might even be their area of strength. In my case, I am horrible with visual-spatial things, which happen to be my son’s strengths. He helps me all the time in that area.
  • One in ten people are dyslexic. Point out famous dyslexic people to your child. Dyslexic people are successful in all walks of life and are wonderful role models.
  • Teach your child to laugh and learn from his or her mistakes. We all make them. Without failure there is no success.
  • Try to keep balance in your child’s life. My son is on the honor roll and grades are important but he also takes three times as long to do his homework as other kids. I want him to be happy and do his best but balance that with not spending every waking moment studying. He needs to find balance and celebrate his unique path and sometimes it might mean getting a lesser grade.

Insights I Learned as a Doctor

When I hear that a child is struggling with reading and writing and in addition has some of the items listed below, I encourage my patients to investigate the possibility of an LD.

  • Dyslexic family member
  • Family member that hates reading or dropped out of school
  • Very good at puzzles in preschool and elementary school
  • Thinks in pictures
  • Great with math concepts but cant remember the grade appropriate times tables

No One Wants to Be Defined or Limited by his or her Weaknesses.

No one wants to be defined or limited by his or her weaknesses. Unfortunately, dyslexic kids are misaligned with the traditional educational system’s methods of teaching which often focuses on the dyslexics’ areas of weaknesses—a language-based, rote memory-based style of teaching.

Many of these kids’ areas of strength would best be fostered in a visual-spatial, project-based style of teaching. This is not the basis for our current system. Recognizing this misalignment would also hopefully one day allow for early identification of a dyslexic child in preschool. And initiation of a reading style program that is appropriate for dyslexic individuals so that they learn to read initially in a style that works for them.

Debbie Walhof, M.D., is an associate clinical professor at the University of California San Francisco and a practicing pediatrician at Kaiser Permanente with additional fellowship training in the area of Integrative Medicine.