Learning Disorders and Brain Organization (continued)

Collaboration between home and school in reviewing findings in the context of the child's history, including medical, familial and social factors, is critical. Depending on the child's age, the child should be included as a partner in order to help him understand himself, to be able to advocate for himself, and to cooperate with a remediation plan, when appropriate. The family should be informed of their legal rights.

Possible diagnoses, according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), that might result from a neuropsychological evaluation include Reading Disorder, Mathematics Disorder, Disorder of Written Expression, Learning Disorder Not Otherwise Specified, Developmental Coordination Disorder, Expressive Language Disorder, Mixed Receptive-Expressive Language Disorder, Attention-Deficit/Hyperactivity Disorder.

Educational options

After the evaluation has been completed and the parents and professionals have met, the next step is a meeting with school personnel to make decisions about what class placement would be appropriate and what special services the child requires to be successful in class.

Class placement options

The child may remain in the mainstream in a regular class or in what might be called a "collaborative" or "inclusion" class. When a child remains in the mainstream, in a regular education class, daily instruction is provided by the classroom teacher, sometimes in consultation with any specialists with whom the child works. In an inclusion class, which consists of a selected number of students with special needs, there is a team of teachers -- one regular education classroom teacher and one special education classroom teacher. Often in an inclusion class the class size is somewhat smaller.

A self-contained special education class is another placement option. Usually this classroom is in a child's home school, but sometimes the class can be anywhere within the school district. Special education classes can have 8 to 12 children, one special education teacher and one paraprofessional. The size of a special education class depends on the classification of the students and the severity of their special needs.

Special or related services required by the child during the school day.

These services can be included or "pushed in" to the classroom, or they may be provided in another room so that the child is "pulled out' of the classroom for the services. Sometimes push-in and pull- out services are combined. Services may consist of the following:

A child in the mainstream may receive one hour daily of resource room services with a special education teacher who is often a learning specialist by training. This service can be in a small group of 5 or as many as 8 children. The focus of resource room services can be development of an academic skill area as well as specific strategy development in one domain. In addition, resource room teachers work on organizational skills and time management.

A child with specific needs related to speech and language development requires special services provided by a speech /language pathologist. These services can target articulation (the clarity and mechanics of speech), or language development, and can be provided individually or in a small group from one hour weekly to five hours weekly.

A child who struggles with motor coordination may meet with either an occupational therapist or a physical therapist who targets fine motor precision, motor planning, or other motor coordination issues, including adaptive needs such as use of a laptop or other aids. These services can be one hour per week or more, individually or in a small group. Some children who struggle with motor coordination might be in an adaptive physical education class.

The last related service that might be appropriate would be related to a hearing impairment, visual impairment or auditory processing issue. In some cases, a consultant works with the child and classroom teacher regarding hearing or visual aids, or auditory training equipment.

About the Authors

Susan Schwartz, MA.Ed., Clinical Instructor of Psychiatry, is the Clinical Coordinator of the Institute for Learning and Academic Achievement at the NYU Child Study Center Ms. Schwartz has expertise in the assessment and treatment of children with language, reading, writing, math and study/organizational difficulties. She has worked extensively with children and adolescents and has lectured to professionals and parents at numerous conferences and seminars.

Matthew Cruger, Ph. D., is an Assistant Research Scientist with the Institute of Learning and Academic Achievement at the NYU Child Study Center. Dr. Cruger has a strong interest in neuropsychological and psychological assessment and has worked with children, adolescents, and adults with a variety of problems including learning difficulties, mental health problems, traumatic and acquired brain injuries, and medical illnesses. He is also the Director of the Prevention and Relationship Enhancement Program (PREP ®), a research-based program designed to help couples improve their communication and satisfaction, through the Family Studies Program.

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About the NYU Child Study Center

The New York University Child Study Center is dedicated to increasing the awareness of child and adolescent psychiatric disorders and improving the research necessary to advance the prevention, identification, and treatment of these disorders on a national scale. The Center offers expert psychiatric services for children, adolescents, young adults, and families with emphasis on early diagnosis and intervention. The Center's mission is to bridge the gap between science and practice, integrating the finest research with patient care and state-of-the-art training utilizing the resources of the New York University School of Medicine. The Child Study Center was founded in 1997 and established as the Department of Child and Adolescent Psychiatry within the NYU School of Medicine in 2006. For more information, please call us at (212) 263-6622 or visit us at http://www.aboutourkids.org/.