Jun 17, 2008
When should my child be tested?
Parents often ask us when is the right time for a child to receive testing or therapy services. They may have heard people tell them to wait until third grade, or until a child is 7, or even “Don’t worry, he’ll grow out of it.” There is no magic age for testing and therapy, and if your instinct as a parent is telling you that something is not right, its time to act. Time is one of our most valuable assets in helping children. Most problems that took a while to develop take a while to improve, and when better to make changes than at a time in life when the brain is most adaptable? Early intervention is vital if you have concerns about a very young child (under 5) or if things have been getting steadily worse and worse for your child over time.
For children with ADHD and learning disabilities (as many as half of all children with ADHD also have learning disabilities), testing is critical as soon as problems are noted at school and home. Children with average intelligence can usually cope with the demands of the first grade curriculum, at least for the first part of the year. First grade is a time when the basic skills are introduced. Each task is short, involving only a few steps to complete. First grade work is highly structured, and most things the child reads will have helpful pictures. Homework can usually be completed in a half-hour. If your child is having learning problems in kindergarten or first grade, this can mean that the problems are particularly important to address. If the first year of school is unsuccessful, children may become convinced that they will never be able to do well. Feelings of frustration can lead to school avoidance or disruptive behaviors. As a former special education teacher, I have observed that some children quickly get a reputation among teachers for being 'trouble.' Once it sticks, the label is one that follows the child from year to year. It is much harder to develop a working partnership with school staff when everyone in the school has decided that your child is a 'problem.'
Many of the children I see come during the third grade. The reason for this is simple if you are aware of the scope and sequence of the elementary school curriculum. Third grade is when academic tasks require sustained attention to detail. Almost everything takes more time to complete and involves more steps. Instead of taking five seconds to complete a math problem, it can now take a few minutes to complete each problem (e.g. borrowing and carrying operations). Instead of writing a single word or sentence, the child must do a book report. Children with reading comprehension problems have an exceedingly difficult time understanding chapter books and text books. The helpful pictures they depended on are gone. Projects can take a week or more of planning, which is the downfall of a child with executive functioning impairment. These changes in the curriculum can cause child's academic progress to stall. Children who can not sustain attention or understand most of what they read fall behind their classmates very quickly. This can be a disheartening event for the child. Some develop anxious fears that they are not smart enough to learn. Many cope by convincing themselves that they don't care anyway, that school is stupid or that all teachers are against them. This state of affairs should be a thing of the past now that we have so many treatments and educational interventions, yet I still see children who have gone for years without receiving the help they need.
When deciding whether or not to test, it is important to understand that troubling symptoms can happen for a lot of different reasons. Symptoms like irritability can indicate conditions such as ADHD, depression, anxiety, obsessive compulsive disorder, sensory integration disorder, or even a medical problem like a sleep or elimination disorder. Children are complex beings who, unfortunately, do not often know how to tell us what is wrong. When we ask a child questions like "Why aren't you doing your work?" or "Why can't you sit still?" we get answers like "I don't know." Testing can give us the answers the children can not. I have yet to meet a child who is unsuccessful because he chooses to be. I believe that all children want very badly to make their parents and teachers proud. Research has shown that when children can not meet adult expectations at school and home, they are at-risk for secondary mental health problems like depression or anxiety. Children with undiagnosed disabilities often feel terrible. When kids feel terrible they may become disruptive, avoidant, or even aggressive. It makes sense if you think about it from the child's perspective, who can be happy spending six hours a day feeling like a failure or getting punished? As adults, we would quit a job like that, but kids don't have that option. Children are stuck with school, whether it goes well or not. Children who feel chronically frustrated, irritated, stupid or disliked need help before they become so discouraged that they give up school, or worse, on themselves.
Rebecca Resnik, PsyD, Licensed Clinical Psychologist and Former Special Education Teacher