Autism and Speech/Language Disorders

By

Susan Kasdorf, MS

April is Autism Awareness Month. May is Better Speech and Language Month. Why is there so much national attention being devoted to these disorders?  Probably because the numbers of children diagnosed as Autistic and with Speech and Language Disorders is staggering!! The latest statistics indicate that 1 in 110 children are diagnosed on the Autism Spectrum (1:70 boys).  And, between 5 and 10 percent of all children are diagnosed with some speech or language disorder.

There is a 10-17% increase in diagnosed children/year. Why are so many more children being diagnosed as Autistic?  The number of children diagnosed on the Spectrum MAY be so high because of the increased specificity of the diagnosis (children on the “mild” end once were speech and language disordered and “quirky”). Also, more children are being assessed as parents are becoming more educated and aware (via internet, TV news shows, celebrity books about their own children, etc.). And, another factor may be that funding for services is offered to children who are diagnosed on the Spectrum versus no funding without the diagnosis (i.e., some manipulation of the diagnosis to get funding for much needed and expensive services).

The primary areas of concern with children’s development are communication (speech, language, and non-verbal), social interaction, and repetitive behaviors. Regardless of whether a child is on the Autism spectrum or has a Mixed Receptive and Expressive Language Disorder it is crucial that they receive early intervention services (particularly speech therapy) to be given the best opportunity for the most improvement and best outcome! Keep in mind, a few months (or more) in the life of an adult is nothing, whereas in a child’s world a few months can make all the difference. The expectation for an 18 month-20 month old is to have 3-20 words. A 2 year old should have between 50 and 200 words and using phrases and short sentences. By 2 ½ this increases to 300-500 words (and longer sentences) and by 3- 3½ to 500-1000 words.  So, you can see that during this critical language developing period there are tremendous changes.  Small gaps become big if children don’t begin catching up. Herein is the dilemma of where/how to get services. While you may be entitled to free early intervention services through your local Regional Center, there is a lengthy process to be evaluated, get a diagnosis, and actually begin treatment.  This process may take weeks, or even months (especially now with the state’s severe budget cuts), at a time when therapy is critical to your child’s development and future academic and social success. Another option to consider is private therapy. There are no bureaucratic hoops to jump through and little or no time is lost.  The downside…it can be expensive. 

Susan is a California licensed and ASHA certified speech/language pathologist who lives in, and has had a private practice in, the Santa Clarita Valley for the past 20 years.  She has a BS in Communication Disorders from Buffalo State College and a MS in Speech Pathology from Columbia University.  You can call her directly with any questions (661-259-1858).

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Attention Deficit Hyperactivity Disorder:  Part I of a III Part Series

By

Ramona Hall, MA

Santa Clarita, CA

www.ramonahalleducationalpsychology.com

                 Hyperactivity has been studied for over one hundred years and has had many names.  And though the names may change, they all describe the same cluster of behaviors.  Today, the term used is Attention Deficit  Hyperactivity Disorder and the behaviors  come to our attention because they are usually those that cause the most difficulty and discomfort for adults. These behaviors are typically found in children who challenge our need to be in control of our environment, to be good parents, or to be competent teachers.  Dealing with these youngsters frequently leaves us feeling frustrated, ineffectual, incompetent, and angry.  These children are disorganized, late to important events, have no sense of time, do not learn from mistakes.  have poor impulse control, poor self-regulation, and lack adequate self-monitoring skills. These are kids who challenge our faith in ourselves.
                The current definition is found in the Diagnostic and Statistical Manual – Fourth Edition (DSM-IV-TR),  the manual used by mental health professionals as a guide to  identifying and diagnosing all kinds of mental disorders.  The section for ADHD is found among disorders that are usually identified in childhood.  There is a good reason for that, as the definition for ADHD includes the stipulation that some of the symptoms must have been present before 7 years of age.  And typically, ADHD is identified once a child has entered school and must conform to a new set of behavioral expectations.  Prior to school entry most children spend their days in loosely structured settings where they may select many of their daily activities.  Once in school, demands for focused and sustained attention become much greater while, at the same time, activities become much more adult determined and controlled.  Thus, for perhaps the first time in his or her life, the child must engage in tasks that require effort and are not intrinsically interesting.  Children who have developed age appropriate self-control and self-monitoring skills are able to adjust more rapidly to these changes than children who are below their same age peers in the development of  those skills.

                So what are the criteria for the diagnosis of Attention Deficit Hyperactivity Disorder?  There are presently three major subtypes which hinge on three aspects of observable behavior:  inattention, hyperactivity, and impulsivity.  In each case, the problem behaviors should be inconsistent with the child’s age, significantly impair normal development in areas of social, academic, or occupation, and must be observed in two or more settings.  The type of ADHD the child has depends upon the symptoms the child shows. 

               The first type of ADHD is called Combined Type and describes the child who has symptoms of inattention, hyperactivity, and/or impulsivity.  This is the child who is demonstrates many physical symptoms such as constant talking, moving, fidgeting, running/climbing in inappropriate situations, and who has difficulty working in a large group situation (such as the classroom) because he talks loudly, calls out, interrupts others, leaves his seat without permission, and is unable to wait for the teacher to call upon him. Other children in class may become annoyed with the child because he frequently disrupts others activities.  The child may also have a short attention span, distractibility, forgetfulness, disorganization, and poor organizational skills.

              For  children who are diagnosed with ADHD Inattentive Type, the symptoms are mostly associated with problems of inattention such as poor organizational skills, forgetfulness, distractibility,a short attention span,  and reluctance to perform mentally challenging tasks.  In the classroom setting, this is the student who has difficulty starting and completing assignments, forgets homework assignments, loses materials, and who is sometimes described as a daydreamer or “in a fog.”  This child creates problems for himself because work is incomplete, grades are inconsistent, and parents and teachers become frustrated with the child’s lack of follow through. 

             The third category of ADHD is called Hyperactive-Impulsive type.  This child does not have many symptoms of inattention but does have many of the symptoms of hyperactivity and impulsivity such as motor restlessnes, poor self-control, and acting without thinking.  This is the child who may appear to be completely inattentive, wandering about the room, touching and playing with things, talking to others, dropping objects,  but  who is still able to correctly answer the teacher’s questions regarding the topic under discussion.  

            Fortunately for children who are challenged by ADHD, there are many techniques that  have been developed and tested in real life situations that help the child and his family live more comfortably.  Future articles will discuss specific interventions to help with problems  at home and in school.

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Are you having a problem with learning?

by Laurie Adachi, MA, ABSNP, Educational Psychologist

As seen in the Santa Clarita Magazine

 Students spend 30 hours or more per week in class followed by homework in the evening.  If the student is unsuccessful in their attainment of just one academic skill they can be devastated and yet they are forced to return every day to face the same struggle.  Difficulties with learning can negatively impact a student’s feeling of self-worth and undermine their confidence in themselves as capable learners.  When school is difficult, students will do whatever they can to remove attention from their failure.  Some passively give up by appearing to be helpless, while others rebel by refusing to do work, not paying attention, or acting out in class.  In time, they may get into fights with peers, talk back to adults, or stop attending school altogether.

Learning problems can have different origins.  Some students are hesitant to take risks; every time a new skill is taught they face possible danger of failure.  Anxiety can cause students to fear new tasks or do poorly on tests.  A weakness in memory development can make it difficult for a student to retain previously learned information.  When a student is a visual learner and the teacher uses a lecture format for teaching, an otherwise average student can be lost.  Limitations in attention and concentration often make learning a challenge because the individual is only processing a portion of what s/he is exposed to.  Whatever the cause of the learning problem, it is important that it be identified and the student’s needs be addressed so that they can be spared additional problems and improve their chance for success.

To identify the cause of a learning problem ask for the opinions and ideas of the experts at your school.  If a learning disability is suspected, the student will require an assessment.  This can be done through the public school or privately with an educational psychologist.  A learning disability is not something to fear.  Most students with learning disabilities welcome help and are relieved to find they are not stupid or lazy.  It enables them to focus on and make use of their strengths rather than remaining prisoner to their weaknesses.  Assistance for them should focus on teaching the student methods for compensating for their difficulties while helping them to catch up to their grade level peers.  As a result, the student’s self-esteem is enhanced and they find the confidence to persevere.

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LET’S TALK ABOUT STRESS AND ANXIETY

by Ann R. Aronin Hausman, MA, Marriage and Family Therapist, Licensed

Educational Psychologist 

            ANXIETY is a universal experience that can be part of normal development. It can range from an alert to possible danger to a state of impaired functioning. The common characteristic is fear or worry about an event that has a real or imagined threat. It does not matter whether the fear is based on a real situation; if the person believes a threat exists, anxiety can occur. Therefore, any situation has the potential to produce anxiety. So how can you tell if your anxiety or the anxiety your child is experiencing is a normal part of everyday living or whether it has become a problem requiring intervention?

Here are a few warning signs:

*Constant seeking of reassurance about work or school performance, friendships, or

  upcoming events.

*Strong fear of dying or losing control.

*Worrying incessantly about appearance, clothing, behavior, possessions, or future

  events.

*Frequently seeking to stay home from school or work.

*Morbid fears of accidents or illnesses affecting himself or important others.

*Clinging to parents in public (among older children).

*Fear of being outside of home alone; being in a crowd; traveling in a moving vehicle.

*Crying or tantrums to avoid social situations with unfamiliar people.

            Children and adults may exhibit excessive worry, fears, poor concentration, memory, attention, or problem solving; over sensitivity, nervousness, withdrawal, excessive talking, pacing, erratic or irrational behavior, aches and pains, nausea, vomiting, perspiration, tension, chest pain, headaches, stomachaches, diarrhea, restlessness, sleep disturbance, dizziness, trembling, extreme fatigue, or pounding heart as symptoms of anxiety. Consultation with a physician should be the first step in treatment should you or your child experience severe or ongoing symptoms that cannot be otherwise explained.

For children and adolescents, the school can be an excellent source of support, especially when signs of stress or anxiety are exhibited at school. Professional counseling should be target-oriented and help the client to identify the worries, confront them, and work on ways to help them fade.  Relaxation techniques such as deep breathing exercises and visual imagery can have a major impact on helping one to calm down when feeling stressed or in anticipation of impending stress. Is anxiety or stress affecting you or someone you love?

            Ann Aronin Hausman is a Marriage and Family Therapist and an

            Educational Psychologist. For more information, please call 661-287-0124

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 The Worried Child

    by Ramona Hall, MA

first published in the Magazine of Santa Clarita

Almost everyone worries sometimes. Children worry about things they see or hear on the news. They worry about how they look, how smart they are in comparison to others, and whether they are liked by peers. During the spring school semester students worry about tests, failure, year-end grades, and transition to new schools or classes. Feelings of anxiety or uncertainty are normal reactions to stresses that children experience every day. But some children worry to the point of pain. Their fears and anxiety interfere with family life and normal development. For these anxious youngsters, participation in normal activities creates frightening challenges that dominate their thoughts and emotions.

High levels of anxiety have a direct impact on learning. Excessive anxiety directly interferes with thinking processes such as problem solving and memory. The child develops a distorted view of the world. He or she sees threats and danger where there is none. Warning signs of excessive anxiety in children include sleeping difficulty, clinging/dependent behaviors, need for constant reassurance, unwillingness to try new things, avoidance of social situations, separation issues, and morbid, repetitive fears. Physical symptoms may also occur such as stomach aches and headaches.

There are many ways to treat anxiety and improve the child’s functioning. Parents first need to accept that the child’s fears are very real to him or her. Understanding comes with compassionate listening, support, and encouragement. The anxious child benefits from consistency in discipline strategies and in household routines. Because the child often sets unrealistic personal goals, parents need to model appropriate behaviors by having realistic expectations of the child. Worries about upcoming events can be addressed by helping the child develop plans for dealing with specific situations that might arise. For example, changing schools is difficult for all children. The anxious child can be helped by familiarizing him or her with the new school prior to the start of the school year. Understanding is key; worry about schedules, how lockers work, physical education routines, lunch/snack routines, and getting lost are among the many fears that commonly occur.

When normal strategies and interventions are not enough, individual counseling may be necessary to assist the child in a return to normal, age appropriate levels of anxiety. Cognitive behavior therapy can help pinpoint specific problem areas, teach new thinking strategies, improve relaxation skills, and address underlying deficits in areas such as study skills, test taking, problem solving, self-confidence, and social skills. Evaluations by the child’s physician and mental health consultant are necessary first steps in beginning the counseling process.

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 REPEATING A GRADE; A good idea or not

by Laurie Adachi, Licensed Educational Psychologist

As seen in the Santa Clarita Magazine

Many parents consider the option to hold their child back a year by repeating a grade.  It seems like it makes sense; one more year to grow and mature, to review and master concepts that they may have struggled with.  However, research suggests otherwise.  

Boys are much more likely to be recommended for grade level retention than girls.  As youngsters, boys are more active and more likely to be off task in the classroom.  Typically, early language development in boys is behind that of his like-age female peers.  In our classrooms, we expect children to walk into school ready to learn and perform.  Many children have not developed these student behaviors and, the result is often a lag in achievement.    

Research shows there is no benefit socially or academically to retention.  On the contrary, retention is more likely to be predictive of health and emotional risk factors as the child grows.  While initial gains may occur during the first year the child is retained, further declines are often observed during years two and three.  In adolescence, the risk factors increase which have been linked to emotional distress, substance use, and violent behaviors.  In addition, students who were retained are more likely to drop out compared with students who were not retained.

The alternative to retention begins with parent involvement.  Be involved in your child’s learning.  Take an active role in your child’s classroom and/or school.  Make sure your child is accessing intervention programs that your school offers.  Work with your child’s teacher to develop consistent strategies and expectations.  When needed, get your child a tutor to relearn and review concepts until mastered.  Early identification of the child’s strength’s and weaknesses through assessment can assist in providing you with appropriate means for intervention.

There is no easy way out when your child is struggling in school.  Jump into your child’s education with both feet.  You are your child’s best advocate.

For additional information call Laurie Adachi, MA, LEP, ABSNP at 255-2688.