Trouble with school work

[Brandy]

I have a six year old son, who started kindergarten last August.  My first parent-teacher conference revealed that Ashton was not catching on as he should be according to the expectations of him from the teacher.  I did go have his ears checked at this time, as it was thought he was not hearing as he should.  His ears had a great amount of fluid, which the doctor stated that he was apparently from allergies, in which he put my son on Claritin, which did clear his ears up and therefore helped him pass the hearing test as he did not on the first visit.
     The following are the symptoms/behaviors that he is experiencing:  fatigue(the teacher said that when it is time to get up from nap she has to hold him up for several minutes so he does not fall), "zoning out"(I really do not think this is a seizure type zone, just as if he does not know what is going on), being incredibly quite at school during class, but not really participating, not working independently on his work, i.e, asking for help the majority of the time(at home when I try to help him he gets the answer right but always looks to me for my approval), low self confidence, unsure about answers, getting very frustrated if he cannot do something right away to the point of getting very angry (yelling, throwing things, etc...), he is having a very difficult time blending sounds of letters together to make a word, he started out at the first of the school year writing letters backwards, but then quit, but has since started doing again, he constantly rubs his nose, has dark circles under his eyes, sniffs, and coughs.
     I talked to the teacher again this week and she states that  he has not improved much and is in threat of having to repeat kindergarten.  I took him to a learning center where they  do essentially tutoring and then if they see a problem they will contact me.
     The teacher did again mention allergies.  Should I have him tested for allergies?  Should I get him tested for a learning disability?  And if so which one/ones?  Should he be tutored?  And which to do first?
     Please forgive the length, but I wanted to give a good overview of what is going on.  I am so worried,  the advice or answers would be tremendously appreciated!!!!

[Kevin Kennedy, Ph.D.]

Dear Tammy,

Your description suggests that your daughter is learning disabled, and in spite of generally adequate intelligence is unable to function well academically. If this is so, evaluation for learning disability should be a nmajor goal. If LD is diagnosed, determination of special education ressources would take place.

Now, under federal guidelines governing education, your daughter is entitled to evaluation (and provision of services if appropriate) through your local school district. You do not have to pursue this with private doctors.

A rferral through your insurance for a psychological evaluation would be sensible, to gauge your daughter's social-emotional status. But the foremost goal immediately should be to pinpoint the cause(s) of her chronic school difficulties.

[TAMMY IN ALABAMA]

I HAVE A 12 YEAR OLD DAUGHTER WHO HAS A VERY HARD TIME IN SCHOOL.
SO HARD THAT SHE IS A STRAIGHT F STUDENT.  SHE CAN NOT EVEN BEGIN TO SPELL A WORD CORRECTLY, AND WHEN SHE READS SHE DOES NOT COMPERHEND ANYTHING THAT SHE HAS READ. I HAVE TAKEN HER TO DIFFERENT TYPES OF DR.'S BUT THEY ALL TELL ME THE SAMETHING "BE THINKFULL SHE HAS A PERSONALITY".  ALL THE THINGS THAT SHOULD COME EASY IS SO HARD, BUT SHE WILL GET INTO DEEP DISCUSSIONS ABOUT TOPICS THAT SURPRISE ME AND SOME OF HER TEACHERS.  SHE HAS ALWAYS HATED SCHOOL FROM K5 UNTIL NOW. WE HAVE CHANGED SCHOOL 3 TIMES, BUT NOTHING HELPS. SHE IS ALWAYS THE POPULAR ONE IN CLASS,
SO I DON'T UNDERSTAND OR HAVE A CLUE AS TO WHAT I CAN DO NEXT.  MY INSURANCE IS VERY STRICT AS TO WHICH DR.'S THAT I CAN TAKE HER TO. PLEASE ANY ADVICE THAT YOU MAY HAVE SHARE WITH ME. I KNOW IN MY HEART AS SOON AS SHE CAN SHE WILL DROP OUT OF SCHOOL!!

                                        TAMMY IN ALABAMA

[Dee]

Allow me to put my two cents in.  I am concerned about the allergies and the "zoning out" and the hearing.  Yes, allergies can be the cause of all his symptoms.  They can affect his mood, thoughts and overall well-being.  Stay on top of getting him tested.  The circles around his eyes, sniffing, coughing and rubbing his nose sure sounds like he's suffering from allergies.  They can make you feel so miserable.  Just for the record, my husband and two sons have suffered tremendously from allergies all their lives.  We tried everything thrown at us, even Claritan.  Nothing made much difference.  Finally, we had a new family doctor and he put my then five year old on Rhinocort Nasal Inhaler (Spray) and all I can say is it is a miracle drug for our family.  It doesn't work right away, but after about three days I had a new child.  He used to get up every morning sneezing so much junk out I didn't know how he was breathing.  I practically had to wear a rain coat!  After the Rhinocort took effect the first thing I noticed was he got up and didn't go through a box of tissues and the circles under his eyes improved.  It was a difference of daylight and dark.  My husband then was put on it and for the first time in 40 years he too stopped blowing the daylights out of his nose.  Allergies can make you very, very tired, as was told to me by my son's allergist.  It's really hard to function when you feel like that.  But also, I'm concerned about the long-time fluid in your son's ears.  My son also had fluid for the first year and a  half of his life and was missing the critical hearing required to learn how to talk.  He eventually had tubes put in, but was behind in speech.  He couldn't blend certain sounds and had trouble repeating sounds because of the way he learned to hear those first months of life with fluid in his ears.  He learned to repeat sounds the way he heard them - garbled.  He required speech therapy in Kindergarten to help him learn how to process sounds and very quickly caught up with the other children.  This also affected his learning in that his audiologist said he was processing sounds differently, but that too would resolve with therapy and as he got older.  He's in first grade and talks beautifully.  The Kg. teacher had tremendous trouble getting his attention and getting him to follow through on tasks the way she asked.  He was not hyperactive and not typically ADD - just different than the other kids.  But what concerns me most about your son is when you said he "zones out".  Even though you say it's not like a seizure, you would be surprised.  Yes, my son also has Epilepsy we discovered.  Depending on the kind of seizure the child has depends on the kind of zoning out you might see.  Sometimes the child can look like they're deep in thought and you can't get their attention for a few seconds, so the teacher may think they're attention deficit.  But, if the child is having a certain kind of seizure, like the absence seizure, they can zone out as much as 100 times a day - which means a loss in learning for the child.  Once the seizure begins they can be looking at anything and just "not be there" for a few seconds and then return to what they were doing as if nothing happened.  Usually only a trained professional can spot this, or parents who eventually learn about it because they have a child with epilepsy.  Some seizures can cause the same symptoms, but instead of returning to the activity that they were doing they can forget what they were doing and the teacher will have to remind them of the task at hand.  Again, this can appear to be ADD to a teacher if she/he is not familiar with the different kinds of epilepsy.  I would most certainly have this investigated by a pediatric neurologist who specializes in epilepsy.  My 6 yr. old son has faced all the obstacles you've mentioned and this hit home for me.  My son was not diagnosed with epilepsy until this past summer, after he finished kindergarten, but it all makes sense now.  His EEG's confirm what we see symptom-wise and if I had known in kindergarten what I know now I would have been to a neurologist in a heartbeat.  But the teacher and I just thought he had trouble processing direction.  He did become frustrated and wanted so hard to please us, but he was unsure of himself because in actuality he was missing out on the direction given him and missed key learning in the process.  His EEG showed he was having over 100 seizures a day, which surprised me, but when I learned they were brief then I learned to recognize he wasn't just blowing me off sometimes when I would try to get his attention.  This teacher this year had to learn to recognize that also since he is not yet controlled with medication.  He was diagnosed with complex partial seizures at first, but now is diagnosed with primary generalized.  For whatever reason his seizures have changed and when he has one it's like he suddenly doesn't know where he's at, just looks around with a blank look, almost a frightened look, forgets what he was doing and sometimes mumbles incoherently.  Afterwards he usually has a headache and is sleepy.  This is the post-ictal state.  So please, don't rule out seizures, allergies and hearing difficulties and related learning difficulties.  Our sons sound too similar.  I know this is long, but I hope this will be of some benefit to you.  

Sincerely,
Dee

[Kevin Kennedy, Ph.D.]

Dear Brandy,

Nothing in the information you conveyed is suggestive of Attention Deficit/Hyperactivit Disorder as a primary condition. However, it can be comsidered as part of a more general evaluation of his medical, learning and social-emotional status.

[Brandy]

Thank you so much for your professional input!!
I called today for my son to have an appointment to be tested for ADD by a psychologist, which if there are no answers there he will go further checking for learning disorders also.  I decided to go this step after talking with a co-worker whose child has ADD and the behaviors were so alike.  I also have him an appointment with an Allergist so that he can be tested.
Do you feel the ADD may be appropriate?  Thank you again!!

[Kevin Kennedy, Ph.D.]

Dear Brandy,

There's no doubt that your son is hampered by some sort of physical condition; he is not displaying the sort of energy and vigor that one would expect of a child who is six years old.

Discuss this with his pediatrician to figure out what course to follow. Certainly allergy testing is one possibility. Your doctor will very likely order some lab work in any case.

Relative to the possibility of learning disorder/disability, it also is worth investigating. At his age, kindergarten-level work should not be a challenge if all is normal. Now, he may simply be showing some developmental lag in acquiring some early learning skills, but only testing will determine this. Because he is already six years old, a wait-and-see approach would not be wise. There's no need to confine yourself to concern about any one type of learning disability - learning disability screening can be done to cover an array of possibilities and help focus the investigation.