“We think your child should be evaluated.”

As a teacher, this sentence is one of the hardest to tell a parent of a young student. Often this is a conversation that is had during parent-teacher conferences, or perhaps the child’s behavior has warranted a special meeting with the parents. Hearing these words from a pediatrician, teacher or school counselor can be highly upsetting for parents, who often blame themselves, or immediately deny the issue. How can you bring up this issue in a way that parents can really hear you, and not immediately react negatively to a suggestion of having their child evaluated professionally?

I’m sure you’ve heard the phrase, “The context is decisive.” As a psychologist specializing in neuropsychological and psychoeducational evaluations, consultation, and treatment, I know that how I handle these sensitive conversations can make all the difference in how a parent feels when they leave my office, and in how they handle taking care of their child’s needs. Your demeanor matters, the order in which you talk about things matters, how you handle their feelings matters, and how you answer their questions matters.

1. Start with all of the positive things you have to say about the child—Tell the parents about how their child was kind to another child that week, or how excited they were to create a new piece of art in school. Say something positive about the child’s relationship with their parents if you can. Remember, parents blame themselves for their child’s behavior most often, so pointing out the positives helps reassure them that they are good parents. A great example is, “John is so creative and loves to talk about the art projects he works on at home with you. I can tell you have a real interest in helping him grow and develop the things he’s most interested in.”

2. Be kind and respectful no matter what—Keep in mind this is such a sensitive subject that parents may act defensive, may be in denial and may even try to blame you. It’s important not to take any of it personally, it’s not about you. Show warmth, empathy and respect to help parents trust and listen to what you have to share.

3. Ask if the parents have concerns and questions about how their child is developing—Ask specific who, what, when, where and how questions to find out if parents have noticed anything. This will help you gather more information and also move the parents towards focusing on the issue. It will also help you learn if the parents have observed anything at all different with their child. It could be as simple as, “Have you noticed if Mary is having a hard time hearing you when she’s turned away from you?” “How long has this been happening and where does it happen most?”

4. Share your concerns—Only do this after the parents have had a chance to talk. It may help to practice this part of the conversation on your own first, and to have some specific statistics to back yourself up. This might include typical developmental milestones for a child of that age etc. Choose your words carefully when doing this and don’t make statements that make it seem like you’ve already come to a conclusion about the child or have labeled the child in some way.

5. Avoid using labels at all or technical terms—Often when we are in a particular field, we become so used to verbiage we use with other professionals in the field that we forget “laymen” may not understand or worse, may misunderstand the terms. Especially in this case, you want to be sure to keep it simple and use only words that describe what you’ve observed about the child. Give specific examples of incidents that have occurred, rather than telling the parent their child “is” something in particular.

6. Stress the importance of checking things out right away rather than waiting—Sometimes a parent thinks a child’s behavior is “just a phase.” They are confused and scared and may want to wait and see if their child “grows out of this.” Stress that the evaluations will shed light on both their child’s strengths and their weaknesses. It’s important to let them know that early evaluation will ensure that their child’s strengths and weaknesses are addressed properly to have them grow and develop. And that the evaluations will help the school provide whatever support is necessary to keep their child from struggling and falling behind. No parent wants to see their child struggle, and this will go a long way toward avoiding that scenario.

7. Be prepared to offer information and resources to the parents—Have contact information and website information about the issues you’ve observed, about the types of evaluations you are recommending, and about the types of help a child can receive at school once the evaluation is complete. Give them a clear pathway to see what needs to be done next for their child. Let them know you are available for them, listen to their concerns, and offer whatever resources are available.

As someone who cares for children every day, you are in a unique position to see things about that child others don’t, and as such you are most likely to see if they are struggling in class. Sharing your concerns respectfully with parents shows you really care about their child. Let the parents know that having their child tested for learning and attention issues is an important step toward helping that child manage his or her challenges. It’s also an opportunity to help him or her make the most of his or her education.

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/

What’s In A Label?

Labeling students with learning disabilities—or even as gifted students—has become one of the most controversial subjects in parenting. In researching this blog post, I read dozens of articles entitled “pros and cons of labeling students.” Many of them point to labels causing “low self-esteem” in children with learning disabilities and “too much pressure” for gifted students.

However, when looked at from an academic viewpoint, there’s no question that there is a need to identify and label students with learning disabilities in order to give them the educational and emotional tools they need to succeed. This is where the controversy must end. Because without knowing why they are struggling, these students still know, without a doubt, that they are different in some way from their classmates. In fact, in the comments to one of the articles I read, a teacher pointed out that she had a learning disability and didn’t learn about it until she was 28. She knew all along that she was different though, and had to struggle and study three times harder than her friends. She said that until she discovered what her actual learning disability was, she just thought she was stupid. Her self-esteem was affected without the label, and what’s worse is she never got the extra help she needed while in school. Everything was a struggle, and nobody wants that for their child. 

It’s not the label that’s at fault

Really, the label isn’t the issue, it’s how everyone reacts to it that’s the issue. Using proper testing to discover and identify a child’s learning disability, and then setting up a plan to help them succeed, is paramount to that child’s growth potential. So let’s be clear that labels are necessary, and take a look at why that’s so. Any student who is treated differently is inevitably labeled. When we are unwilling, for whatever reason, to say that a person has a problem, we are helpless to prevent it or improve the situation. Clearly labeling a problem is the first step in dealing with it productively.

Not all uses of labels have negative consequences for children. For example, labels such as “ADHD,” can act as “labels of forgiveness”, relieving parents and children of guilt and blame by providing understanding and increasing the tolerance of teachers. Labels can also be used to bring together children and parents with similar experiences and foster a positive group identity where peers provide support for children and their families.

Medical and administrative labels can open the door to extra resources so children get the help they need, such as additional assistance in the classroom or access to counseling. Labels, where a shared understanding exists can facilitate inter-professional interaction, working for the benefit of the child. They can also help educators identify necessary professional development opportunities and implement appropriate inclusive teaching strategies.

One of the positive effects of labeling students with a "specific learning disability," is that it qualifies them to have an Individualized Education Plan (IEP). This plan allows them to receive instruction at their current level of functioning, provides them with accommodations and specially designed instruction, and creates personalized goals and objectives.

Labeling also qualifies students for services that they may not have been able to receive otherwise, such as instruction in a learning support room. In this setting, they receive instruction in a style and at a pace much more conducive to their learning profile. They receive tailored instruction in a much smaller setting with other students who have similar needs.

By labeling students with a "specific learning disability", they are able to receive help in order to remediate their challenges. For example, if a student has been identified as having a learning disability in reading (e.g., dyslexia), the instruction can be specifically geared at a suitable level, utilizing techniques that are evidence based for the child’s particular difficulties. Receiving instruction based on what students need is crucial in helping them excel and be successful in the future.

A learning disability does not take away a student's value; each person has strengths and challenges, and each person learns differently.  Through working to understand and label the challenge, the school intends to provide the specialized education required to help the student achieve success. As a parent, you can discuss the issue with your child’s teachers as well. Teachers can help prevent the negative consequences of the label by taking a few proactive steps to minimize the chance of problems occurring. Ask your child’s teachers to talk to their class about learning disabilities and how different paces and styles of instruction are used. Open classroom discussions about learning disabilities can help to create an understanding between peers.

Parents and teachers should also be careful not to lower their expectations for the student, and instead offer positive encouragement. A diagnosis can put a new structure in place without a need to lower expectations, but instead shift those expectations and the learning structure in such a way as to support the child by playing to their strengths and bolstering their weaknesses. In fact, many parents say their child has more confidence once the new structure is put in place, and they now have the opportunity to thrive.

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/