““Walk A Mile In My Shoes”Walk A Mile In My Shoes”

An interactive workshop An interactive workshop

on learning disabilitieson learning disabilitiesMelissa Rowbotham, M.EdMelissa Rowbotham, M.Ed

mrowbotham@integra.on.camrowbotham@integra.on.ca

Copyright © 2010 by Integra FoundationCopyright © 2010 by Integra Foundation

_ to _% of children/youth have a LD ___% of children who have an LD also

have a social, emotional or behavioural problem

_ to _ % of kids with ADHD also have a LD

___% of children with ADHD who also have anxiety

1 in __ children and youth in Canada have a mental health disorder (which includes anxiety and depression)

““Walk A Mile In My Shoes”Walk A Mile In My Shoes”

Learning Objectives: To introduce the concepts of Learning To introduce the concepts of Learning

Disabilities (LDs) Disabilities (LDs) To experience what it might feel like to To experience what it might feel like to

have LDshave LDs To talk about resources around anxiety To talk about resources around anxiety

and depressionand depression

What are learning disabilities?What are learning disabilities?

• Neurologically based disorders• Affect the ability to take in,

understand, remember or express information.

• Specific, not global impairments• Found in individuals who possess average to

above average thinking and reasoning skills• Lifelong disorders

What are learning disabilities?What are learning disabilities?

• LDs reflect LDs reflect neurobiological neurobiological factors, including factors, including genetics, congenital genetics, congenital or acquired conditionsor acquired conditions

• LDs are not due to LDs are not due to differences in culture, differences in culture, language, SES, language, SES, motivationmotivation

What are learning disabilities?What are learning disabilities?

Impairments in one or more of the Impairments in one or more of the following psychological processes:following psychological processes:

• Language processingLanguage processing• Phonological processingPhonological processing• Visual-spatial processing Visual-spatial processing • Processing SpeedProcessing Speed• Memory & attention Memory & attention • Executive functioningExecutive functioning

What are learning disabilities?What are learning disabilities?

Impairments may affect Impairments may affect learning in the areas of:learning in the areas of:

• ReadingReading• Oral languageOral language• Written languageWritten language• MathMath

What Do LDs Affect?What Do LDs Affect?

LDs come in many forms & affect everyone differently

Possible problems in social situations: Understanding sarcasm Figuring out how someone is feeling from

their body language or facial expressions Understanding the unwritten social rules Participating in groups

If a large solid-hoofed mammal If a large solid-hoofed mammal becomes available to you without becomes available to you without compensation, refrain from compensation, refrain from casting your faculty for seeing into casting your faculty for seeing into the oral cavity of such a creature.the oral cavity of such a creature.

Demystifying ProcessesDemystifying ProcessesTermTerm DescriptionDescription ApplicationApplication

Verbal Verbal ReasoningReasoning•Verbal Verbal ComprehensionComprehension

•General Verbal General Verbal AbilityAbility

•Ability to think through problems using words

•Ability to understand words and connected language

•Understanding instructions, lessons, stories

• Logical thinking and problem-solving

•Understanding word meanings

• Expressing ideas in words

Demystifying ProcessesDemystifying ProcessesTermTerm DescriptionDescription ApplicationApplication

•Perceptual Perceptual processingprocessing

•Visual-Visual-spatialspatial

• Ability to make sense of what one sees

• Putting together visual information

• Noticing & understanding facial expressions• Understanding a chart or graph• Reading a map

Demystifying ProcessesDemystifying ProcessesTermTerm DescriptionDescription ApplicationApplication

Non-Verbal Non-Verbal ReasoningReasoning

•Perceptual Perceptual reasoningreasoning

•Visual-spatialVisual-spatial

•Perceptual-Perceptual-organizationalorganizational

•PerformancePerformance

•Visual problem-solving

•Ability to organize, put together or orient visual information

•Ability to form and mentally manipulate images

•Understanding concept Understanding concept words related to time, words related to time, space space

•Building according to a Building according to a plan or modelplan or model

•Judging space and Judging space and distancedistance

•Math (geometry, shapes, Math (geometry, shapes, measurement) measurement)

•Following sewing patterns, Following sewing patterns, IKEA instructionsIKEA instructions

What symbol has to come next in the sequence of the five What symbol has to come next in the sequence of the five symbols on the left? Can you sketch this sixth figure?symbols on the left? Can you sketch this sixth figure?

What symbol has to come next in the sequence of the five What symbol has to come next in the sequence of the five symbols on the left? Can you sketch this sixth figure?symbols on the left? Can you sketch this sixth figure?

Kids with LDs and other disabilities are at risk –

why? Frustration at not being able to do what

child knows he/she should be able to do Feelings about having a “disability” Sense that others’ expectations are not

being met (parents, teachers) Peers’ responses Lack of others’ understanding/responses Responses to others’ feelings & anxieties

Invisible DisabilitiesInvisible Disabilities

Neurobiological impairments are Neurobiological impairments are invisible.invisible.

Mental Health Issues are invisibleMental Health Issues are invisible Behaviour may be are only clue.Behaviour may be are only clue.

Where else can we look?Where else can we look? OSR, past reports, grades, parents, OSR, past reports, grades, parents,

teachers and kidsteachers and kids

What is Anxiety/worry?What is Anxiety/worry?

Diffuse uncomfortable sense of Diffuse uncomfortable sense of apprehension, often accompanied by apprehension, often accompanied by autonomic symptoms” (Barlow, 2002)autonomic symptoms” (Barlow, 2002)

Basic human emotionBasic human emotion Part of normal developmentPart of normal development

Can be adaptiveCan be adaptive

What is an Anxiety What is an Anxiety Disorder?Disorder?

Symptoms interfere with the youth’s ability to Symptoms interfere with the youth’s ability to function in everyday lifefunction in everyday life

PersistentPersistent Intensity of reactions is severeIntensity of reactions is severe Anxiety disorders are relatively common in Anxiety disorders are relatively common in

childhood: Prevalence rate of >10%childhood: Prevalence rate of >10%

Can look like skipping, lack of motivation, Can look like skipping, lack of motivation, withdrawal, externalizing behaviour, “aggressive withdrawal, externalizing behaviour, “aggressive avoidance”avoidance”

Types of Anxiety Disorders Types of Anxiety Disorders in Childhoodin Childhood

Generalized Anxiety Disorder (GAD)Generalized Anxiety Disorder (GAD) Social PhobiaSocial Phobia Specific PhobiaSpecific Phobia Post-traumatic Stress Disorder (PTSD)Post-traumatic Stress Disorder (PTSD) Panic DisorderPanic Disorder Obsessive-Compulsive Disorder (OCD)Obsessive-Compulsive Disorder (OCD) Separation Anxiety Disorder (SAD)Separation Anxiety Disorder (SAD)

What is Distress/sadnessWhat is Distress/sadness Always associated with a trigger, event or situationAlways associated with a trigger, event or situation Will improve with environmental accommodation or Will improve with environmental accommodation or

removal of stressorremoval of stressor Functional impairment usually mildFunctional impairment usually mild Professional psychiatric treatment not usually Professional psychiatric treatment not usually

necessarynecessary Counselling and therapy will often helpCounselling and therapy will often help Social supports (friendships and family) will often Social supports (friendships and family) will often

helphelp Medications would not be normally used Medications would not be normally used

What is Depression?What is Depression?

• Referred to as Major Depressive Disorder -MDDReferred to as Major Depressive Disorder -MDD• Characterized by:Characterized by:

• Feelings of hopelessness, sadnessFeelings of hopelessness, sadness• Loss of interest in activitiesLoss of interest in activities• Vegetative signs: change in eating or sleeping, low Vegetative signs: change in eating or sleeping, low

energy or fatigueenergy or fatigue• Poor concentration, difficulty making decisionsPoor concentration, difficulty making decisions

• PersistentPersistent• Interferes with daily livingInterferes with daily living• Rare in children under 12 years oldRare in children under 12 years old

Depression in ChildhoodDepression in Childhood

Diagnosis of Depression is often Diagnosis of Depression is often overlooked in childhood:overlooked in childhood:

Some symptoms are more typical of Some symptoms are more typical of children than of adults (e.g., irritability)children than of adults (e.g., irritability)

High co-occurence with other disorders High co-occurence with other disorders (such as ADHD & behavioual issues) may (such as ADHD & behavioual issues) may mask the symptomsmask the symptoms

Certain features of Depression are more Certain features of Depression are more typical at different ages typical at different ages

When to ask for more helpWhen to ask for more help• When you are concerned about safety or well When you are concerned about safety or well

being of studentbeing of student

• Watch for obvious indicators of mood issues:Watch for obvious indicators of mood issues:• Crying, shaking, avoidanceCrying, shaking, avoidance• Freezing in classroom situationsFreezing in classroom situations• Angry Outbursts & Increased IrritationAngry Outbursts & Increased Irritation• Physical Evidence of Self-Harm or DeclinePhysical Evidence of Self-Harm or Decline

• Watch for changes:Watch for changes:• In behaviourIn behaviour• In HygieneIn Hygiene• In peer interactionsIn peer interactions• In interactions with teachers and school staffIn interactions with teachers and school staff

What would help worry/distress at school?

Involve student in problem-solving process (they have great ideas!)

Acknowledge effort even if output is weak Encourage & support accountability Address barriers caused by LD, ADHD, OT,

Note taking Scheduling Planning & Organizing (Support Self-Reliance)

What would help worry/distress at school?

Make sure learning style is understood

Are accommodations appropriate and sufficient?

Watch for bullying or peer difficulties Teach pro-social skills to entire class

and be clear about classroom expectations

Discuss Fair versus Equal

What would help worry/distress at school?

Find out what is overwhelming them in the school setting & accommodate

Set up student for success and mastery to build self-esteem

Watch for activities/subjects/projects that are “too hard”

Empower them by encouraging and being receptive to attempts at self-advocacy

Support & Listen Reach Out - Ask student if they’re

alright Ask about any changes in their life Check in with other teachers, peers,

their family Be Real about limits of confidentiality

Always encourage parental involvement May chose to state policy outright Never promise you won’t tell anyone

Suggest Help In school support

School Team (rule out learning issues, bullying, or situation within class)

Social Workers Guidance Special Education Administrators

Suggest a Referral Inform family and student of your concern Enlist the help of your team Encourage a thorough assessment Be open to school involvement in

treatment Outside Referral for Assessment &

Treatment: Hospital Clinic or Program Children’s Mental Health Clinic GP

Resources GP’s will know local referral sources:

Hospital Clinics Children’s Mental Health Clinics Specialty Clinics (Integra, Sick Kids

Anxiety Groups, CAMH First Episode Clinic)

Pediatricians and specializing psychiatrists and psychologists

Private practitioners (play therapists, social workers, therapists) – only after a thorough assessment

Resources – Websites & Books

www.aboutkidshealth.ca Sick Kids – Information and Resources – “Trusted Answers”

www.kidsmentalhealth.ca Information on Referral Sources Resources for Teachers

TeachADHD The ABCs of Mental Health – A Teacher Resource Orientation to Children’s Mental Heath – Teachers Guide

www.ldao.ca Learning Disability Association of ON