By Shira Gottlieb, Psy.D., Licensed Clinical Psychologist
Your child’s teacher or school counselor has met with you to tell you that your child is struggling in a particular subject and may have a learning disability. Or maybe you’ve noticed that your child is falling behind, even though you know your child is very bright. You have become concerned. Now what? As a parent, it’s hard enough to hear your child is struggling. Now you are about to embark on a confusing journey of trying to find out if your child has a specific learning disability, what type it might be, and what needs to be done to provide your child with the best opportunity to succeed in school.
As a child psychologist, I provide testing for learning disabilities and have seen firsthand the difficulties parents face in understanding the testing methods, evaluation process, theories of learning, and disability labels. Learning disability diagnosis is an inexact science that relies on imperfect systems; however, it is important to understand the current systems as these are what we have in place.
In general, there are two models used in the diagnosis and treatment of learning disabilities. In my evaluations, I incorporate aspects of both supplemented by additional testing and observation. This multifaceted approach allows me to develop a comprehensive understanding of your child’s strengths and challenges in order to provide a clear and reliable diagnosis and recommendations. Here is some information on both models.
Traditionally, neuropsychological and psycho-educational testing use the discrepancy model. More recently, the education world has switched to focusing on the response to intervention (RTI) model to help identify children with learning disabilities. Let’s start by looking at this educator model.
RTI is a process used by educators to help students who are struggling with a skill or lesson. A teacher will use interventions (a set of teaching procedures) with any student to help him or her succeed in the classroom—it’s not just for children with special needs or a learning disability. If a student is struggling, his or her teacher will use test scores and other measures of progress to choose a researched and proven intervention suited to help the child learn. If a child does not respond to the initial interventions, more focused interventions are used to help the child master the skill.
According to the National Institute of Health website, RTI involves the following:
• Monitoring all students' progress closely to identify possible learning challenges
• Providing help on different levels or tiers based on the identified learning needs of a particular student
• Moving a student through the tiers as appropriate: increasing educational assistance if the child does not show progress and decreasing educational support as the child’s skillset improves and approaches grade-level expectations
While the RTI model focuses on the child in relation to his or her same-grade peers, the discrepancy model focuses on the individual, while also considering age-appropriate norms. The term “discrepancy” refers to a mismatch between a child’s intellectual ability (or cognitive potential) and his or her progress in school. The discrepancy model is a way to capture and compare a student’s scores on different types of tests. It compares assessments of a child’s intellectual ability with how much progress he or she is making in school (one’s academic achievement).
In some cases, there may be a significant “discrepancy” (difference) between various sets of scores. This difference may indicate that an underlying condition is making it unusually difficult for a child to learn.
For example, your second grader’s intellectual ability may fall in the high average range (e.g., 84th percentile). The expectation would be for him to be reading slightly above a typical second grade level. However, his scores may show that he is actually reading significantly below what one would expect, at the 16th percentile. In this case, there’s a discrepancy between his cognitive potential (ability) and his current reading level (achievement).
School districts and educational settings will have their own policies to follow in regard to which model they emphasize. Consequently, it’s not really up to you, as a parent, to make the decision to use one model or the other. I incorporate aspects of both models, as well as additional testing, to reveal underlying strengths and challenges that are impacting the child’s academic achievement. For example, if a child is struggling in reading, I will look beyond his or her basic reading level to consider the underlying skills necessary for reading mastery (e.g., phonological processing and rapid naming), as well as other challenges that may be impacting his or her performance (e.g., attention challenges and anxiety). Also, while my evaluation and report focuses more heavily on the discrepancy model, I incorporate information from the child’s teacher about his or her experiences in the classroom over time to incorporate the RTI method. Furthermore, my familiarity with both systems is important when talking with parents and schools so that I am able to help parents understand their child’s learning experience and communicate with schools using a common language. By using a combination of quantitative (statistically and clinically significant) and qualitative measures, I work to provide parents, teachers, students, and myself the most comprehensive understanding of why a child is struggling and what can be done to help him or her succeed.
Most child psychologists never leave their offices when conducting neuropsychological or psycho-educational testing. My testing package includes classroom observational time before I meet with the child in my office, in addition to a follow-up meeting with teachers, school staff, and other relevant professionals. These meetings typically occur in the school setting. I conduct school observations of the child working in his or her daily environment on a subject in which he or she struggles, and an area in which he or she excels. I also gather information about the child’s performance in real-life situations through questionnaires I provide to teachers and parents. Follow-up meetings include meeting with teachers and school staff to help create your child’s individualized education program (IEP).
Shira Gottlieb, Psy.D., Licensed Clinical Psychologist
Dr. Gottlieb is a licensed clinical psychologist. She received her B.A. in psychology, with a minor in neurobiology, from Harvard University, and her Psy.D. from the George Washington University. Dr. Gottlieb works with children and adolescents, and their families, to provide comprehensive neuropsychological and psychoeducational assessments to better understand the individual child’s attention capacities, learning profile, emotional functioning, and behavioral presentation. For more information on Dr. Gottlieb please visit her website at http://www.gottliebchildpsych.com/