• Dr. Ghilain

What Is a Learning Disability? Why is a Neuropsychological Evaluation the best approach?

Updated: Apr 10, 2020

Sometimes school-age children do not perform up to expectations for their age and/or grade. They may have difficulty keeping up with their classroom peers and may fall “behind” in reading, math or other academic areas. In today's blog post, we discuss the ways that a learning disability is identified, and the ways family members can better understand the struggles their child faces at school.

Traditionally, there were two ways of approaching the assessment of a learning disability. First, difficulties were described in terms of a “discrepancy model.” That is, a discrepancy between the child’s actual abilities and his or her level of achievement. For example, a child may have average intellectual abilities (also known as an average IQ), but nonetheless may be significantly below average in reading. Thus, there is a discrepancy between ability and achievement in reading.

The second model is termed “Response to Intervention”, or RTI. In this case, a school teacher or administrator identifies a child having difficulty in reading, for example, and the school provides extra help. Often there is a particular period of time during which this extra help is administered, and teachers or school personnel record how the child improves (or does not improve) over time. Should a child continue to struggle despite RTI, he or she may be referred to the Child Study Team for further evaluation.

When a child is referred to the Child Study Team in school, the team completes targeted assessments of the child’s abilities and achievement (again, looking for that “discrepancy”). These evaluations are typically focal, in that they focus solely on the area where the child struggles. In our blog example, this would mean that a child is assessed for their intellectual functioning and their reading skills. In cases where a discrepancy is not found, the child may be considered ineligible for special educational support.

Neuropsychologists understand that there may be additional factors that influence a child’s performance at school. For example, perhaps that child’s ability to read is age-appropriate, but they take longer than their peers (suggestive of slower processing speed). Or, for example, a child may have age-appropriate reading skills, but may struggle to sustain their attention to a long reading passage (suggestive of an attentional disorder). Perhaps it is a combination of many factors! Children who are struggling in school and not achieving up to standards may have cognitive differences – differences in the range of their abilities that underlie their struggles. These differences may not arise in the testing completed at school, though we know they are areas requiring of additional support and remediation. It is not the case that schools are inappropriately evaluating their students. On the contrary, often schools are assessing many children and are facing significant time and resource limitations, thus they are limited in the breadth and depth of their evaluations. With a private evaluation, families and schools gain a comprehensive picture of the child’s abilities, and we find that our reports are very well-received by school districts in the area.

Private neuropsychological assessment can be particularly helpful when a child’s difficulties appear less clear-cut, as the neuropsychologist will examine all of the child’s cognitive functions. By providing a complete examination, neuropsychologists can carefully determine why the child is struggling and pinpoint the most appropriate intervention. By partnering with the family and school, the neuropsychologist is able to assist in formulating a comprehensive intervention plan to help that child succeed.

We are grateful for the positive relationships built with school systems in the northern New Jersey area. We are also overjoyed to hear from students we assess who go on to achieve a multitude of accomplishments- both personally and professionally. It is these stories of success that remind us why we love our job!

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