Invisible Disabilities in Children Strategies for Success

Invisable Disablitlites By Jenni, Marie, Christina and Jen1Purposeto showcase a specific population we will come into contact with as professionals, focusing on knowledge of potential solutions we can be a part of as counselors.2Agendapresent a brief understanding of what an invisible/learning disability isshowcase four specific learning disabilities you are likely to encounter, including symptoms, considerations for counselors/educators, and potential solutionsquestions3ObjectiveRaise awareness among future school counselors Make LDs more recognizableHelp Counselors learn how to address the issues associated with learning disabilities so our students can succeed in the realms of academic, social, and career development.Invisible Disabilities in ChildrenStrategies for Success5What is an Invisible Learning Disability?Learning disorders affect how a person understands, remembers and responds to new information. People with learning disorders may have problems listening, speaking, reading, writing, or doing mathInvisible disabilities are those that are not immediately apparent to teachers, students, or even parentsInvisible disabilities include known learning disabilities such as dyslexia and ADHD, as well as any mental, neurological or physical conditions that can affect learning-Have you ever judged somebody for parking in a handicapped parking space when they did not seem to have any physical disability

-This type prejudice is encountered everyday by children with invisible disabilities

-Because they are often difficult to diagnose, a student with an invisible disability may be labeled lazy or underachieving

-It is important for all educators to be aware of these invisible disabilities and how to diagnose them6Why is this important?The National Institutes of Health estimate that 8 to 10% of children in the United States suffer from a learning disabilityCurrently, 2.9 million school-aged children in the United States are classified as having a specific learning disabilityThe National Center for Learning Disabilities estimates that 15 million Americans suffer from learning disabilitiesMany children have not been diagnosed and helped because their disabilities go undetected by teachers, parents, counselors.

-It is obvious from the statistics that many students are not being helped children are not receiving the help they need to succeed academically, socially, and in their future endeavors.

We will now discuss 4 of the most common invisible disabilities that teachers and counselors will encounter. Having knowledge of these disabilities could potentially help million of American children who are suffering in silence.7Anxiety DisorderWhat is it?Characterized by irrational, persistent, and overwhelming fear, worry and anxiety that interfere with normal functioning and everyday activities.Symptoms vary but often include irritability, nervousness, difficulty sleeping, and physical symptoms (headaches and stomachaches)Anxiety disorders often co-occur with other disorders such as depression, eating disorders, and ADHD-Why I chose anxiety disorders (personal experience)-Importance of differentiating between normal fears, worries and stress and an actual disorder (degree to which the anxiety interferes with ability to function)

Many different types of anxiety disorders each which there own symptoms.

Because these disorders are often present with other mental and emotional disabilities, they are difficult to diagnose8Anxiety disorderWhy is it important?Most common mental illness in children13% of children and 18.6% of adolescents suffer from an anxiety disorderMost common anxiety disorders:Social Anxiety Disorder (6.8 %)Specific phobias (8.7%)Generalized Anxiety Disorder (3.1%)Obsessive-Compulsive Disorder (1%)Panic Disorders (2.7%)Post-Traumatic Stress Disorder (3.5%)Anxiety disorders impact a students ability to succeed in school

-High likelihood that counselors will encounter students in the school environment

-In this class alone, 5 students would be suffering from some sort of anxiety issue

-Social Anxiety: Fear of social and performance situations (school)-Specific phobias: Intense, irrational fear of a specific object (dog, heights, school)

-Together, 15% of students suffer from these two types of anxiety disorders

-Generalized Anxiety Disorder: excessive irrational worry about a variety of issues(natural disasters, relationships, health, grades)

-Obsessive-Compulsive disorders: Obsessive thoughts causing person to repeat rituals or routines to relieve anxiety (examples germs washing hands; fear of harm to a loved one constantly checking)

Panic disorders: At least 2 panic attacks in one month (physical symptoms include rapid heart beat, sweating, chest pain)

PTSD: Intense fear and anxiety after witnessing a traumatic or life-threatening event (accident, natural disaster, physical abuse)

9

Considerations

Academic Considerations

Children with anxiety disorders are at a higher risk to perform poorly in school and dropout

Teachers often recognize symptoms of anxiety but may not realize they are caused by an anxiety disorder

Social/Personal Considerations

Children with anxiety disorders suffer from low self-esteem and often feel fearful, embarrassed, and alone

Anxiety disorders can affect a childs ability to interact socially with others and adjust to the school environment

Children with anxiety disorders are more likely to engage in alcohol and substance abuseTransitions / Careers

Left untreated, anxiety disorders tend to be chronic and can continue and progress into adulthood

Cognitive-behavioral therapy (CBT), Acceptance and commitment therapy (ACT), and Dialectical behavioral therapy (DBT) as well as certain medications have all been shown to be effective treatments

Counselors need to be aware of the academic, personal/social, and future effects of anxiety disorders

The good news is that if caught early enough, anxiety disorders are completely treatable through therapy and medication

-CBT: teaches skills and techniques to help reduce anxiety by replacing negative thinking patterns with positive ones and understand realistic and unrealistic thoughts

-ACT: strategies of acceptance and mindfulness-DBT: strategies for taking responsibility for feelings and dealing with negative emotion

The key to minimizing the effects of anxiety disorders on children and adolescents is identifying and treating the disorders as soon as possible

10SolutionsWhat can we as school counselors do?Both teachers and counselors need to be trained in recognizing the signs and symptoms of anxiety disordersCounselors can create guidance unit related to stress and anxiety and how teachers and students can tell what anxiety is normal and what is notCounselors can work with students and families to find appropriate treatments and therapistsCounselors can work with teachers to find effective accommodations to help students succeed in the classroom

-Teacher training is key as teachers are often the first to see how a student deals with anxiety in the classroom setting

-A guidance unit should include effective ways to deal with stress as well as ways for students to know when their own anxiety has become severe enough to require additional help

-Counselors trained in CBT and other effective therapies can offer individual or group counseling to work with students suffering from anxiety disorders.-When necessary, counselors can refer students and families to outside therapists and mental health professionals trained in this area

-Accommodations can include preferential seating during class or tests, extra time on assignments or tests, allowing testing in quiet areas, 11ADHDAttention Deficit Hyperactivity Disorder (ADHD)What is it?

ADHD is defined as a condition characterized by severe problems of inattention, hyperactivity, and/or impulsivity; often found in people with learning disabilities. (cite)

Symptoms

Short attention span

Distractibility

Disorganization

Procrastination

Poor internal supervision

Interrupting

Squirming

Three Types

Combined Type (most common)

Predominantly Hyperactive-Impulsive Type

Predominantly Inattentive Type

- Definition- Boys with ADHD outnumber girls, most likely owing to biological differences and perhaps some referral bias. Estimates are about 3 to 1. Three kinds- ADD falls under the predominantly inattentive type. It is ADHD without the hyperactivity aspect. Symptoms- Inattention may not become apparent until a child enters the challenging environment of school. In adults, symptoms of inattention may manifest in work or in social situations.-difficulty paying attention to details - easily distracted- frequent shifts from one uncompleted activity to another- forgetfulness frequent shifts in conversation- Hyperactivity symptoms may be apparent in very young preschoolers and are nearly always present before the age of seven. Symptoms include:- fidgeting, squirming when seated- getting up frequently to walk or run around- being always on the go- often talking excessively- Impulsivity symptoms include:- impatience- difficulty delaying responses- blurting out answers before questions have been completed- difficulty awaiting one's turn- frequently interrupting or intruding on others to the point of causing problems in social or work settings- initiating conversations at inappropriate times

13Why is this important?Prevalence: Three to seven percent of the school-age population have ADHD. (Hallahan, Kauffman, & Pullen, 2009)

Students with ADHD have significantly higher dropout rates, increased frequency of failing grades, and poor academic outcomes compared to students without ADHD (Fischer, Barkley, Fletcher, & Smallish, 1993).

ADHD is widely recognized as one of the most frequent reasons, if not the most frequent reason, children are referred for behavioral problems to guidance clinics (Hallahan, Kauffman, & Pullen, 2009).

ConsiderationsAcademic

High degree of classroom structure.

Teacher directed activities.

Determining rules and expectations of behavior prior to events.

Self- monitoring or self- management programs where students record their own behavior. Social/ Personal

Rejected more often compared to non-disabled classmates.

Have a hard time controlling emotions often overreacting.

Students with ADHD have delayed inner speech.Transitions/Career

Important to choose a path that maximizes individuals strengths and minimizes weaknesses. Coaching a technique whereby a friend or therapist offers encouragement and support for a person with ADHD

Academic Self monitoring- students with ADHD keep track of their own behavior and then receive rewards. Example: The teacher might have students record how many times they left their seats during a class period. 5 point scale- (0 = unacceptable to 5 = excellent). Student and teacher both give a rating and the student is awarded points based on how closely the ratings matched. Points could be used for privileges. - Social/Personal - Inner speech is the inner voice that allows people to talk to themselves about various solutions when in the middle of solving a problem. This results in problems with guiding behavior in situations which rules and instructions need to be followed. 15TreatmentMedication Considerations

Four Methods of AssessmentMedical ExaminationClinical InterviewTeacher and Parent rating scalesBehavioral Observation

Psychostimulants medications that activate dopamine levels in the frontal and prefrontal areas of the brain that control behavioral inhibition and executive functions; used to treat persons with ADHD. (Hallahan, Kauffman, & Pullen, 2009)Ritalin - Most commonly prescribed psychostimulant for ADHD. AdderallStrattera

Caution with Medication- Research is very positive on the effectiveness of medication for increasing appropriate behavior, there are still a number of cautions.

Medication ConsiderationsFour methods of assessment are usually used:A medical examinationClinical interviewTeacher and parent rating scalesBehavioral observationOne of the most controversial topics in all of special education is the treatment of ADHD with medication. Psychostimulants Three types of medication that are offeredRitalin and Adderall are both stimulants with Ritalin being the most commonly prescribed.Strattera is newer so there hasnt been as much research done on it but it is a nonstimulant and has been shown to be effective for some children and adults. Cautions Medication should not be prescribed at the first sign of a behavior problem. The use of psychostimulants for ADHD as increased eight-fold from the 1970s to the 1990s in the United States. The first five years of the 21st century the rate has doubled. Monitor dosage levels- Proper dosage levels vary considerably. Dont let children believe it is a substitute for self initiative and responsibility.

16DyslexiaDyslexiaWhat is it?

Trouble translating or understanding written materials. This can be letters, numbers and symbols. Dyslexia is considered to be a reading disability and can often times run in the family. SymptomsPoor reading (skills/comprehension)

Poor spelling skills

Poor writing skills

Trouble memorizing

Difficulty with directions (up, down, right, left, maps)

Difficulty finishing test/assignments on time

ExamplesThew ord sare notsp aced cor rect ly.The words are not spaced correctly

We spell wrsd xatle az tha snd to usWe spell words exactly as they soundSometimesallthelettersarepushedtogetherSometimes all the letters are pushed together

What is it?Trouble translating or understanding written materials. This can be letters, numbers and symbols. Dyslexia is considered to be a reading disability and can often times run in the family.

SymptomsPoor reading (skills/comprehension)

Poor spelling skills

Poor writing skills

Trouble memorizing

Difficulty with directions (up, down, right, left, maps)

Difficulty finishing test/assignments on time

ExamplesThew ord sare notsp aced cor rect ly.The words are not spaced correctly

We spell wrsd xatle az tha snd to usWe spell words exactly as they soundSometimesallthelettersarepushedtogetherSometimes all the letters are pushed together

18Why is this important?Sometimes Dyslexia goes unnoticed because:Students learn to cope and work around the disabilitySometimes symptoms arent apparent to teachers, counselors and teachers

Even though some students learn to work around the disability, once diagnosed and receiving assistance school will become much easier for the student

It is not uncommon for students to go though school and life without being diagnosed until adulthoodThis is extremely important to address in school because many times children with dyslexia are viewed as stupid or lazy when in reality they are trying their hardest and my just need assistance to reach their full potential.Between 10 -20% of school age children have been diagnosed

Sometimes Dyslexia goes unnoticed because:Students learn to cope and work around the disabilitySometimes symptoms arent apparent to teachers, counselors and teachers

Even though some students learn to work around the disability, once diagnosed and receiving assistance school will become much easier for the student

It is not uncommon for students to go though school and life without being diagnosed until adulthoodThis is extremely important to address in school because many times children with dyslexia are viewed as stupid or lazy when in reality they are trying their hardest and my just need assistance to reach their full potential.Between 10 -20% of school age children have been diagnosed

19ConsiderationsAcademic

Receive additional time to complete assignments and exams

Permission to tape classes/lectures.

Using spell check

Books on tape

Tutors

Social

Sometimes seen as stupid or lazy

May feel different compared to classmates

Personal

When diagnosed later in life sometimes the person has trouble accepting

Getting used to having assistance

May feel different compared to their classmates.

Transition to Adulthood

Important to choose a path that maximizes individuals strengths and minimizes weaknesses. Understanding that there is nothing wrong with them. Using the help that is offered to maximize potential

Academic

Receive additional time to complete assignments and exams

Permission to tape classes/lectures.

Using spell check

Books on tape

Tutors Social

Sometimes seen as stupid or lazy

May feel different compared to classmatesPersonal

When diagnosed later in life sometimes the person has trouble accepting

Getting used to having assistance

May feel different compared to their classmates.

Transition to Adulthood

Important to choose a path that maximizes individuals strengths and minimizes weaknesses. Understanding that there is nothing wrong with them. Using the help that is offered to maximize potential

20SolutionsFirst get testedUnderstand Dyslexia and the symptomsUtilize services provided by schoolsExtra TutoringBooks on TapeExtra Testing timeSupport groups/counseling

First get testedUnderstand Dyslexia and the symptomsUtilize services provided by schoolsExtra TutoringBooks on TapeExtra Testing timeSupport groups/counseling

21Asperger SyndromeAsperger SyndromeWhat is it? An Autism Spectrum DisorderUnlike Autism, those with Asperger Syndrome do not have delayed or impaired cognitive and language developmentCharacterized by deficits in social interaction and repetitive or restrictive thoughts and behaviors

SymptomsLack of social awareness socially and emotionally inappropriate behavior difficulty with non-verbal communicationObsessive interest in a single topic repetitive routines or rituals peculiarities in speech and languageuncoordinated motor skills/movements

What is it? An Autism Spectrum Disorder- but not Autism. There is no cognitive/language delaypeople with AS often have extensive vocabulariesinstead, it is characterized by deficits in social interaction.Asperger SymptomsThe biggest is the lack of social awareness. Students w/AS dont understand how they are expected to act in social situations, leading to behavior that is socially/emotionally inappropriate (like dominating a conversation, interrupting, or reacting with excessive anger or sadness), and difficulty with non-verbal communication like body language. 23Why is it Important? Often undiagnosed until school ageFormal diagnosis of students with AS is a recent phenomenonHigh number of diagnosis suggest counselors need to know how to work with many students with ASEstimated as many as 6.7 of every 1000 children have an autism spectrum disorder. It is estimated that about 4.8 of every 1,000 children have AS. There is argument over how many students actually have Asperger Syndrome. This gap in data is a result of the newness of the disability (the original research only dates back to the 40s, and it wasnt included in the DSMV until the 90s), the tendency for a misdiagnosis of ADHD or just behavioral problems. Some children with Asperger Syndrome are able to mask some of their symptoms by learning the skills for social interaction often missing in those with AS. 24Asperger SyndromeConsiderationsAcademic

Students with Asperger are easily stressed, but may not display their stress outwardly. Stress can be eased by creating a set routine and/or letting the student know what to expect. Difficulty with creative writing/art assignmentsTrouble focusing on the task at hand instead of their own professed interests

Social/Personal

Students with Asperger Syndrome have difficulty interacting socially with peers.lack social awareness Social difficulties may be masked by advanced vocabulary Can often initiate social interactions (basic greetings, etc), but have difficulty with reciprocal conversations Self-Esteem problems can arise because students are aware of being different from their peers

Transition/Career

Work should be done before each major transition to get the student comfortable with a new place, new people, and a new routineThe number of students with AS continuing to post secondary education is on the riseAS is a high functioning disorder; they can be very successful in the right workplace

Academic/Social/Career reflecting ASCA model. Academic Considerations:Students with Asperger Syndrome are often intelligent studentsDifficulty with creative writing assignments stem from difficulty understanding other peopleTrouble focusing is because of a lack of interest, not a lack of the ability to focus.

Social Personal Considerations:Because of a lack of social awareness, students with AS have trouble interacting with their peers. Though they can often initiate interactions, they have difficulty with reciprocal conversations. Students with AS are often aware of being different from their peers, leading to self-esteem problems. Transitions:Because transitions and change cause students with AS stress, its important to help them prepare for change and to familiarize them with what will become their new routine. Introducing them to their next teacher before summer break can help, as can visiting the new school and/or classroom(s). If the transition is to middle or high school (more than one teacher), a single person (teacher of school counselor) should help monitor this transition. The same ideas about transition apply moving to the college setting, where more and more students with AS are continuing their education. In the workplace, a person with AS can be successful when their needs are addressed-a workplace with a structured schedule, well defined expectations, and a relation to their interests.25SolutionsWhat can school counselors do?Often a school counselor will be the first person to recognize the symptoms of AS. Small changes to the day can help a student cope, such as establishing signals between students and teachers, allowing extra time to transition between classes, and establishing rewards around subjects the student enjoys.Networking with teachers, parents, and outside Mental Health Professionals. working collaboratively to develop plans to help the child succeed. Offer resources, knowledge and training to teachers.Advocate for the inclusion of students in general education classrooms26Bringing it all togetherWhile a student with a LD may not be in every classroom, the will be in every school. The prevalence of these disabilities means that we as counselors have to be prepared to help students, teachers, and others involved in education to adapt so that every student can be successful. This chart is merely a visual aid; weve only discussed 4 of the many invisible learning disabilities that exist, and much of our data tells us that estimates of occurrence in students may be quite low. 4 in every 1000 isnt a lot, but if you have a caseload of 250 students, that means its likely at least one of them has AS.

Asperger .6%ADHD 5%General Anxiety 12.5%Dyslexia 13%

27ReferencesAnxiety disorders in children. (n.d.). Retrieved from http://www.adaa.orgBailet, L.L. (2006, August). Understanding dyslexia. Retrieved from http://www.seattlechildrens.org/kids-health/page.aspx?kid=20965&lic=400&cat_id=20179Bailet, L.L. (2006, April). Understanding dyslexia for parents. Retrieved from http://www.seattlechildrens.org/kids-health/page.aspx?kid=21346&lic=400&cat_id=142Brown, T.A., & Barlow, D.H. (2007). Casebook in abnormal psychology. Belmont, CA.: Thomson Wadsworth.Essau, C., & Peterman, F. (Ed.). (2001). Anxiety disorders in children and adolescents: epidemiology, risk factors and treatment. East Sussex, England: Brunner Routledge.Fischer, M., Barkley, R. A., Fletcher, K. E., & Smallish, L. (1993). The adolescent outcome of hyperactive children: Predictors of psychiatric, academic, social, and emotional adjustment. Journal of the American Academy of Child & Adolescent Psychiatry, 32(2), 324-332. ISSN: 0890-8567Gibbons, M. M., & Goins, S. (2008). Getting to know the child with asperger syndrome. Professional School Counseling, 11(5), 347-352.Hallahan, D.P., Kauffman, J.M., & Pullen, P.C. (2009). Exceptional Learners: An Introduction to Special Education (11th ed.). Bostom, MA: Pearson Educaiton, IncMyles, B. S. (2005). Children and youth with asperger syndrome: strategies for success in inclusive settings. Thousand Oaks, CA: Corwin Press.National center for learning disabilities. (n.d.). Retrieved from http://www.ncld.org/National Institute of Health, Initials. (2010, May 14). Asperger syndrome information page: national institute of neurological disorders and stroke. Retrieved from http://www.ninds.nih.gov/disorders/asperger/asperger.htmNinds learning disability information page. (2010, October 18). Retrieved from http://www.ninds.nih.gov Thompson, D. (2009, April 1). Dyslexia demystified: how multisensory reading instruction can make all the difference. Seattle's Child, Retrieved from http://www.seattleschild.com/article/20090401/SCM02/903259989Winter, M. (2003). Asperger syndrome: what teachers need to know. New York, NY: Jessica Kingsley Publishers

28Questions?