November 2011: The Honeymoon is Over!

The "Flags" May be Flying Now!

 I asked five questions in my last post (September 1, 2011). They were:

I'd like to introduce Debra and Miriam. Debra lives in a metropolitan area in the Midwest. She had concerns about her daughter, Ella, ever since she was a toddler. Debra's other daughter always seemed to take care of herself. However, Ella was different. She always seemed to get in accidents and had trouble keeping on task. Ella also had problems with self-image even as a young girl in the third grade. Debra just assumed that everything would work out.

Miriam lives in a metropolitan area on the coast.  Haley's troubles seemed to start in the third grade. As mentioned in the September blog, Haley had difficulties focusing in classes and problems keeping her assignments together and handing them in on time. She lost a lot of weight and just was not hungry anymore. The weight loss worsened in September. Oftentimes, Haley was too tired to show up for dinner and complained that she had too much homework to do. Clearly, the situation had gotten more complicated since August.

Let's hear what Debra has to say:

Debra: "Ella was not working up to her potential at school.

She was having a hard time listening in class,

forgetting to turn in her assignments,

and doing poorly on her tests.

Her teacher liked her and felt that she was capable of doing better work because she had done very well in school before. We were all frustrated-Ella, her teachers and us."

Debra: "I began by talking with friends who had children with learning disabilities. I was fortunate that my best friend is a special ed teacher for preschoolers. She had always remarked that Ella seemed to enjoy fantasy more than reality and that could potentially be a problem. I didn't think much of it because Ella is an incredibly creative child and since my husband and I are both artists it seemed natural she should enjoy play acting and make believe. My friend also has a daughter who was diagnosed with ADHD and Ella seemed to have some of the same behaviors. We would compare notes on our children and it seemed that many of Ella's characteristics matched her daughter's."

Debra: "After talking with her second grade teacher we decided to have Ella tested by the same person who tested my friend's daughter. She was highly regarded as one of the best psychologists for educational testing in the area. She also specialized in ADHD and had a book published on the subject. I asked the school counselor and my physician and both concurred that she was a good choice."

Debra: "It was first noticed in the 2 nd grade when she was

having trouble in school-missing key information,

not doing well on tests and

had a hard time following directions.

When we had her tested there was evidence that she had some problems with remembering things and taking in information quickly, but she wasn't bad enough to qualify for any help in school and she did not test as ADHD. We made a point of working with her more closely to help make sure she was keeping up with her studies and turning in her assignments.

For a couple of years things seemed o.k., but things got worse again in the 5 th grade. A couple of things may have triggered this. In our district 5 th grade is the last year of elementary school and is considerably more rigorous than previous grades. Also, Ella had been clustered with the same group of gifted kids until 4 th grade. Even though she did not qualify for gifted, she seemed to work harder when she was with this group of high achievers. She needed to make new friends in 4 th grade and this took a toll on her emotionally. By 5 th grade she was getting behind and again her teacher talked with us about her

poor performance,

inability to focus, and

failure to turn in assignments.

Since it had been three years we had her retested by the same psychologist. The second round of education testing results were much the same, but this time she added some psychological testing which indicated some depression and anxiety in addition to her comprehension and memory problems. We began special tutoring for Ella to learn mind-mapping skills, comprehension skills, and organization skills. She also started therapy to address her anxiety, depression, and "intrusive ideation" issue (these are thoughts that kept her from being able to pay attention.) Ella was dedicated to her studies, often staying up later than anyone in our house, to make sure she got her work done. She seemed to enjoy school more. School went well for a few years.

 Things got worse in middle school-seemingly with the onset of puberty. In retrospect, Ella became increasingly self-conscious about her looks and abilities. Her focus shifted from school achievements more to peer approval. Again, we assumed this was normal for her age until we saw

her grades drop dramatically. She struggled to keep up at school. Ella also had some tough issues with friends which resulted in

anxiety,

depression, and

plummeting grades.

We decided that Ella needed more in-depth testing by a neuropsychologist when she was 14. This time we found more specific things to be on the lookout for as well as a plan to continue working in her difficulties. The doctor's report resulted in her getting an IEP (Individualized Education Program) at school based primarily on her emotional problems."

Debra: "I was concerned but felt that I had plenty of resources between friends, physicians and the school to help us work through it. I have always been confident in Ella's abilities-just frustrated when they don't always shine through. I guess there have been times when I've wondered about the stigma of Ella being labeled as a special ed student and what that might mean for her future. But, ultimately, it's been a positive and helpful change and it's helped to ensure her success."

Let's hear now from Miriam:

Miriam: "Everything was fine before 3 rd grade. Third grade is when it went downhill.

Somehow the assignments were not getting into her backpack at school to bring home. Haley goes to a public school and no one was watching her.

Then, she would forget to turn in her work even when she did it at the teacher's desk in the morning.

Then, there was the weight loss.

She thought she was fat in second grade. I couldn't believe it. I watch my weight but this was way off. I just thought this new thing would go away."

Miriam: "No. I did not. Honestly, I did not want to look at it. I work full-time and my husband does too. It's enough just to work all day, make dinner, round the kids up at night for dinner, do laundry, and then have this all repeat itself the next day. I thought Haley just was not into the teachers. One teacher said she was immature and that it would get better as she got older. The weight loss is what got my attention. My pediatrician told me not too worry in August. Now, I'm really worrying. Haley is too thin.

Haley told me she wanted to die a few days ago.

That was it! I went back to my pediatrician."

Miriam: "My heart sank when Haley lost all the weight. How could you not notice? She was skin and bones."

Miriam: "Haley is now in ninth grade. You know.....things had been festering for a long time. There were the

missing assignments in the 3rd grade,

the lying about the missing assignments, and the hiding of the teacher's grade about the tests and quizzes, and

the weight loss .

I just thought things would go away. Haley is a good kid. No trouble. We work hard. It was really when she lost weight that we noticed something was really wrong. Haley is very thin. I must tell you that she is in the hospital now. We waited too long. We were told things would get better and we did not listen. You have to listen to your child. We were too busy keeping food on the table. I should have acted sooner....."

Miriam: "I was sad. I was lost. I had no one to turn too."

These are stories from two different parents and two different parts of the country. Debra and Miriam processed their child's challenges differently. I think that both would agree that EARLY INTERVENTION IS EVERYTHING. In addition, these stories revealed the following themes:

• There is usually more than one "flag."
• It is not your fault as a parent.
• It is better to get potential problems checked out rather than assume that your child will "grow out of it."
• Pay attention to the warning signs if your child's difficulties are frequent, severe (intense), and occur in many situations.
• Reach out to your spouse and significant others such as friends for support.
• Seek out your pediatrician's opinion if you have a concern.
• Believe in your "gut." You know your child and check things out if you are not sure if they are problems or not.
• Remember that you are your child's chief advocate.
• Listen to your child.

Thank you, Debra and Miriam, for sending in your stories and taking the time to help others. I appreciate your honesty and sincerity.

Best Wishes,

Karen L. Schiltz, Ph.D.