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10 Steps to Diagnosing A Learning Disability

If your child has difficulty with reading, writing, math or other school learning-related BlogLearningDisabilityDiagnosis-Main-Landscapetasks, this does not necessarily mean that they have a learning disability. Lots of children struggle at times with school.

Common signs of a learning disability:

  • Difficulty with reading, writing or math skills
  • Short attention span or difficulty staying on task (easily distracted)
  • Difficulty with memory
  • Trouble following directions
  • Poor hand-eye coordination
  • Difficulty with time management
  • Problems staying organized
  • Inability to discriminate between or among letters, numerals, or sounds
  • Difficulty with paying attention
  • Inconsistent school performance

Each learning disability has its own signs and not every person with a particular disability will have all of the signs. These signs alone are not enough to diagnose a learning disability, so a professional assessment is necessary to diagnose a learning disability.

If some of these symptoms sound familiar, below are 10 steps to take:

  1. Talk to your child about the areas they are struggling in order to understand the symptoms.
  2. Provide empathy and emotional support for your child. Let them know that lots of people struggle at times with school related tasks.
  3. Get specific feedback from teachers regarding problem areas or grades.
  4. Set up an initial intake session with a Psychologist/Neuropsychologist to discuss symptoms and background information.
  5. Have the child tested in specific areas:
    1. Intellectual/IQ
    2. Achievement/Academic
    3. Language/Communication
    4. Memory
    5. Attention
    6. Visual/Motor
    7. Problem Solving
    8. Social, Emotional, Behavioral
  6. Get feedback from teachers with specific forms regarding behaviors
  7. Discuss with Psychologist/Neuropsychologist the results of the testing and recommendations.
  8. Talk to the child’s school about accommodations and services.
  9. Follow up with teachers about effectiveness and gains of accommodations.
  10. Follow up Neuropsychological testing in 6 months to 1 years’ time.

References:

https://www.nichd.nih.gov/health/topics/learning/conditioninfo/Pages/symptoms.aspx

http://ldaamerica.org/symptoms-of-learning-disabilities

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

How is Torticollis Diagnosed?

Congenital muscular Torticollis should be a suspected diagnosis if your infant demonstrates a preferred head position or posture. Infants will present with reduced cervical range of motion, a potential palpable mass in the sternocleidomasoid muscle and/or craniofacial asymmetry.BlogTorticollisDiagnosis-Main-Landscape

A diagnosis is made by your pediatrician and can usually be done based on a simple history and physical examination. Physical examination findings may include:

  • Head tilt to one side
  • Reduced range of motion
  • Palpable SCM tightness
  • Absence of findings associated with non-muscular causes of congenital Torticollis

[1] Cheng JC, Tang SP, Chen TM, et al. The clinical presentation and outcome of treatment of congenital muscular torticollis in infants–a study of 1,086 cases. J Pediatric Surg 2000; 35:1091.

[2] Kaplan SL, Coulter C, Fetters L. Physical therapy management of congenital muscular torticollis: an evidence-based clinical practice guideline: from the Section on Pediatrics of the American Physical Therapy Association. Pediatr Phys Ther 2013; 25:348.

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

Meet-With-A-Physical-Therapist

Does Hand Flapping Mean Autism?

With today’s easy access to the Internet, it is common for many of us to try and diagnose our own symptoms and ailments; however,girl stimming even if your symptoms come to a match, it does not necessarily mean that you have that particular diagnosis that shows up on your computer. The same can be said with children. If you notice what might be a ‘red flag’ in your child, it does not automatically imply that your child has something ‘wrong’ with him/her. One such ‘red flag’ that many parents get overly worried by is the action of hand flapping. It should be noted that hand flapping can occur for many different reasons, and not only in children with Autism.

Hand flapping can occur due to:

  • Excitement
  • Nervousness/Anxiety
  • Fidgeting
  • High engine level/Arousal level
  • Habitual behavior
  • Decreased body awareness (child does not even know he is doing it)

Overall, it is important to keep in mind that every child is unique and reacts to various situations in a different manner as well as with different mannerisms.  Be sure to reach out to your child’s teachers and therapists if you notice that your child using hand flapping behaviors, so that you may all be on the same page in relation to treating this behavior. It is important to monitor when the hand flapping occurs in order to look for trends. If hand flapping does occur with other “red-flag” behaviors, talk to your pediatrician or a Pediatric Therapist.  

What to Expect When You Suspect Autism Download our free, 17-Page eBook

Stay tuned for my next blog on strategies to replace hand flapping behaviors.

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Diagnosing ADHD

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neurological conditions that affects between 3 to 6 percent of school-aged boy jumping on couch children.  Children with this condition exhibit significant issues with their ability to pay attention to tasks, inhibit their impulses and/or regulate their behavior.   In order for the diagnosis to be made, one has to witness significant impairment in regards to attentional regulation and/or activity level within multiple settings.  This means that the child must exhibit the concerns within the home, school, after-school program, sports team, etc.  In reality, the diagnosis can be made by a pediatrician or health care provider that is able to ascertain levels of functioning in the various domains by observing behavior or collecting parent and teacher report forms.

In the Neuropsychology Department at North Shore Pediatric Therapy, we focus on a comprehensive evaluation of a child’s functioning, including cognitive functioning, academic achievement, attentional regulation, executive functioning and social/emotional functioning.  Now, if the diagnosis can be made by a parent and teacher report, one must ask why a comprehensive evaluation should be mandated.  The answer to this is that over 45% of children that have been diagnosed with ADHD meet clinical criteria for multiple neurodevelopmental conditions.  Children with ADHD often present learning disabilities, emotional concerns and deficits with social regulation.  Sole treatment of the inattention may improve attentional regulation; however, there are other unaddressed concerns that may still linger.

Research has continuously demonstrated that the most common treatment of ADHD is a combination of pharmacological intervention, behavioral therapy, parent training, and teacher education.  Pharmacological intervention consists of stimulant medications that help to improve the child’s ability to attend to tasks.  A recent research article, which was even reported in an October edition of the Chicago Tribune, indicated that the majority of children who have been diagnosed with ADHD and are prescribed medication report significant improvement within their daily lives.  In the past, the main identification of improvement within children with ADHD was based upon teacher report.  Parents can now feel comfortable when asking their child if medication is helping. Behavior therapy focuses on the modification of the child’s environment to improve the frequency and duration of positive, on-task behaviors while extinguishing negative behaviors.  Parent and teacher education has a primary intent on discussing expectations within the home and school settings as well as possible modifications to ensure success.


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What is Scoliosis?

Scoliosis can be a very scary diagnosis, especially if you aren’t exactly sure what it is or what can cause it. Scoliosis is a lateral curvature of the spine to the right or left as you are looking at the spine from behind. There is typically a rotation of the involved spinal segments as well.scoliosis

There are 3 different types of scoliosis, each the result of a different mechanism:

  • Congenital scoliosis– the child is born with the lateral curvature due to an atypical development of the spine in utero.
  • Neuromuscular scoliosis– caused by an underlying neuromuscular condition that results in abnormal muscular pull on the spine. Conditions such as cerebral palsy or spina bifida are examples of underlying diagnoses that may result in neuromuscular scoliosis.
  • Idiopathic scoliosis-this means that there is no known cause of the scoliosis. This is the most common form of scoliosis and can present in childhood, adolescence, or adulthood.

Adolescents, predominantly female, who are currently or have recently gone through a growth spurt are the most likely to develop scoliosis. Kids between the ages of 10-15 are therefore at the greatest risk. Except for more severe cases, scoliosis is typically not associated with back pain; however, kids with scoliosis are at an increased risk of having back pain during adulthood.

Treatment for scoliosis will depend on the severity of the curvature:

  • Conservative-for mild to moderate cases of scoliosis, treatments such as bracing, postural exercises, and physical therapy are used to prevent progression of the curve.
  • Surgical-for severe curvatures, surgical placement of rods to maintain a straight spine is often utilized.

Regardless of the type or severity of scoliosis, the key to optimal outcomes is early recognition. With early detection through school screenings or screening from a physician or physical therapist, treatment and monitoring can begin immediately. If you are concerned that your child may have scoliosis, or are looking for treatment for a child with a diagnosis of scoliosis, please see a physical therapist at North Shore Pediatric Therapy.

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What is Failure to Thrive and What Can Be Done About It? | Pediatric Therapy Tv

In today’s Webisode, a Registered Dietitian discusses Failure to Thrive and how you can help.

In this video you will learn:

  • The causes of Failure to Thrive
  • Steps and measures to take when your child shows signs of Failure to Thrive
  • How a dietitian and a doctor can help when your child has Failure to Thrive

Video Transcription:

Announcer: From Chicago’s leading experts in pediatrics to a worldwide
audience, this is Pediatric Therapy TV where we provide experience and
innovation to maximize your child’s potential. Now your host, here’s Robyn.

Robyn: Hello, and welcome to Pediatric Therapy TV. I’m your host, Robyn
Ackerman. I’m standing here today with a registered dietician, Stephanie
Wells. Stephanie, can you tell us what failure to thrive is and what can be
done about it?

Stephanie: Sure. Failure to thrive is diagnosed in children that are less
than two years old when their weight for length is less than the fifth
percentile on the growth chart and for kids that are over two years old, if
their BMI is less than the fifth percentile on the growth chart.

So in terms of what can be done, first a doctor and a registered dietician
can assess if there are any medical factors that are causing the failure to
thrive and then address those medical issues if that’s necessary. Second,
then a dietician can meet with the parent and the child and put together a
high calorie, high protein diet that includes three meals and two to three
snacks per day. Third, often these children need to be on some sort of a
high calorie, high protein formula or oral supplement beverage which the
dietician can recommend and get a prescription for, if needed. And then
from there, the dietician and doctor will closely monitor the child’s
weight and growth to make sure that they’re moving in the right direction
and meeting the goals that the dietician has made for the child.

Robyn: All right. Thank you, Stephanie, for that explanation and thank you
to our viewers. And remember, keep on blossoming.

Announcer: This has been Pediatric Therapy TV, where we bring peace of mind
to your family with the best in educational programming. To subscribe to
our broadcast, read our blogs, or learn more, visit our website at
learnmore.me. That’s learnmore.me.

New Definition of Autism for DSM

Another firestorm of controversy was unleashed recently as experts continue to argue over proposed changes to the diagnosis of autism and related disorders. The American Psychiatric Association has proposed changes to the Diagnostic and Statistic Manual of Mental Disorders (DSM) for the fifth edition that would effectively consolidate Autism, Asperger’s Disorder and autism ribbonPervasive Developmental Disorder Not Otherwise Specified into a unified diagnosis of Autism Spectrum Disorder. The changes come, in part, because of the APA’s belief that these disorders share common set of behavioral manifestations that are reliably differentiated from non-autistic disorder; but not well differentiated from each other.

Reasons For The Autism Diagnosis Criteria Change:

In the published rational, that APA stated “A single spectrum disorder is a better reflection of the state of knowledge about pathology and clinical presentation; previously, the criteria were equivalent to trying to ‘cleave meatloaf at the joints’.” This belief reflects emerging data that several similar brain regions develop in a pathological fashion in all three conditions and underlie the similarities between the conditions.

Autism Diagnosis Criteria Change Consequences:

However, the change in criteria may have other consequences. Fred Volkmar, MD, director of the Yale Child study Center and a leading expert in the field released results from his upcoming study that posited that changes in criteria could lead to as many as 50% of subjects in previous studies being eliminated from the spectrum and facing an end to needed services. While others have challenged this assumption, there is little doubt that a more narrow definition is being sought in part to limit the expansion of children meeting criteria for one of the pervasive developmental disorders. The CDC indicates that current estimates of autism and related disorders is about 1:150 children. However, studies have reported rates as high as 1:90 depending on the methods used in establishing the diagnosis.

Other experts in favor of the new DSM criteria contend that since some states do not provide the same level of care to children with PDD NOS and Asperger’s Disorder, rolling these conditions into an Autism Spectrum Disorder may actually increase access to care in some states.

How This Changes The DSM:

What seems to be lost in this discussion is the paradigm shift proposed to the structure of the DSM. Historically, most categories of disorders (such as Depressive, Anxiety, Amnestic, Substance Use, etc) are made based on behavioral characteristics as opposed to objective data or lab findings and all have maintained a “Not Otherwise Specified” category to allow for partial symptom presentations or atypical patterns that would still fall under the general heading. This format is consistent for the current range of Pervasive Developmental Disorders including autism. The new spectrum model is a departure from existing diagnostic nomenclature and the rational for this has not been explained. Imagine if spectrums were used for all conditions. Depressive Spectrum Disorders could range from a bad week on one end to inpatient hospitalization and suicidal ideation on the other. Researchers would simply treat them all as a continuum of severity. This does not happen mainly because differences in the onset, treatment and prognosis of each depressive disorder are very different even though the characteristics of dysphoria, loss of interest and behavioral changes may be similar. Clearly differences in diagnoses within categories are possible based on factors other than behavioral characteristics.

Supporters of the new DSM criteria may also be undervaluing the neurological and genetic markers currently under study. Recent evidence has suggested high rates of seizures and EEG abnormalities in autism and PDD NOS not seen in Asperger’s syndrome. Numerous genetic disorders have now been shown to have increased risk for autistic symptoms though none have been shown to have increased risk for Asperger’s Disorder. Accelerated head growth, ventricular abnormalities and pathological development of the language centers are all commonly found in autism and PDD, though not frequently present in Asperger’s Disorder. Conversely, neurological conditions that impact right hemisphere function show marked similarities to the nonverbal learning difficulties found frequently in Asperger’s Disorder. Even birth order, high risk pregnancies and prenatal complications are over-represented in autism and PDD NOS though all these biological markers were not considered in the spectrum model currently proposed.

Ultimately, continued research is needed to evaluate the similarities and differences in these conditions and many of us in the field are concerned that lumping related conditions together will weaken this process and potential our understanding of the root causes of these disorders. However, there is no denying that the ongoing discussions related to changes in the diagnostic nomenclature have brought needed attention to escalating rates of these diagnoses and the need for standardization.

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How To Advocate For Your Child Now

Mother Talking to DoctorA parent is their child’s number one advocate. If a parent does not act on behalf of their child, who will? There are multiple areas where parents must act as an advocate for their child.

Advocating At The Doctors

When a parent is sure that a child is falling behind the other children in their play group, the first step is to visit the pediatrician. However, if after consulting the child’s pediatrician they say, “just wait,” a parent does not have to wait. They must listen to their own instincts Read more

Why Does My Child Need a Diagnosis?

-“I don’t want to label my child.”

-“Teachers are biased against diagnosed children.”

-“My son doesn’t act like most kids with _________ (particular diagnosis).”

 

These are statements that I hear on a routine basis, and they are all valid points. Any diagnosis that a child or adolescent may have carries a certain stigma to it. This is human nature. As a neuropsychologist, one of my biggest tasks is to develop the most appropriate and effective diagnosis for any child. My goal with writing this blog is to help identify the importance of an appropriate diagnosis.

How A Diagnosis Can Help Your Child:

First and foremost, an appropriate diagnosis will help explain and answer the “why” questions. Why does my child continue to struggle to read? Why is it impossible for my child to sit still? Why is it that my child cannot make friends? Once we identify the “whys,” we are on our way to solving the problems.  An appropriate diagnosis is intended to help develop the most effective means of intervention. If I diagnosis a child with Dyslexia, I know that traditional teaching of reading and phonics wouldn’t do much good. I would know instead to utilize an empirical approach consistent with the disorder at hand. Read more

Your Child Has Been Diagnosed With Autism, Now What?

What To Do After Your Child Is Diagnosed With Autism:

Several weeks ago Deborah Michael posted a blog about warning signs that parents should look out for regarding Autism Spectrum Disorders.  That blog article got me thinking about the next steps and how to help prepare parents for those important decisions.  The initial diagnosis is often heart wrecking for parents.  Too many times I have seen parents develop a sense of hopelessness once the diagnosis is given.  Autism is a spectrum disorder.  There are children who are really low functioning and will require one-on-one assistance for the rest of their lives.  Yet, at the same time, there are many children who are really high functioning and will be able to lead normal lives, get married, and live on their own.  I was supposed to write a blog article on a checklist for parents as to what they should do once a diagnosis is given.  After thinking about that, I came to the realization that doing so would be impossible and also act as a disservice towards parents.

Therapies Available For Children With ASD

Hand in HandThere are many therapies available for children with a diagnosis along the Autism spectrum.  Children with the diagnosis often require speech/language therapy to develop their pragmatic and social language skills.  These children often benefit from participating in a social skills group in which they are forced to engage in social activities in a safe, non-judgmental environment.  The children often have difficulties with fine motor functioning and sensory regulation and would benefit from woSchedule A Visit To Our Autism Clinicrking with an occupational therapist to develop those skills.
Additionally, the children often would benefit from participating in behavior therapy to focus on increasing positive, on-task behaviors while extinguishing negative behaviors.  However, due to the fact that Autism is a spectrum set of disorders, one cannot say how many hours a week or even what specific therapies are warranted for any particular child.  As a neuropsychologist, I would work with the individual providers to help develop any particular child’s treatment plan.  So, the only checklist of services parents need to seek for their child with an Autism Spectrum Disorder is:  work with the neuropsychologist who made the initial diagnosis to help develop a treatment plan including speech/language therapy, occupational therapy, behavior therapy, and social work.  Read more