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In early December PEN hosted two speakers from the Abbey Neuropsychology Clinic, Richard D. Abbey, Ph.D., Clinical Neuropsychologist and Diana Barrett, Ph.D., Clinical Psychologist who addressed the complex topic, Depression, Anxiety and Learning. I was impressed with the ease with which these two specialists shared the podium, addressing these issues from their own perspectives.  A more detailed background on both speakers can be found at the conclusion of this blog post.

They began their morning talk with a focus on depression, advising us that it appears differently with children and adults.   For a child, irritability is a key element.  They become very edgy and display a lack of interest in something that they previously very much enjoyed, walking away from any involvement with it or others. Whereas a tip they provided which indicates that an adolescent might be in a depressed state is when they begin sleeping till noon or complaining about a tummy ache. These are safer ways to express depression.  If a preoccupation evolves with poetry on life-threatening topics, it could mean the adolescent is exploring the possibility. The challenge for a parent is discovering whether the symptoms express simply anxiety, which interferes with a child's functioning, or whether the issue comes from a depressed state. 

Often depression arises when a problem with learning causes emotional issues. Ask yourself the question: are the emotional issues out of control, or is depression causing a learning problem? It is clear that when a child, adolescent or adult is depressed, this state interferes with other and important daily functions. 

The frontal lobe of the brain is where Executive Functioning occurs. It can be one of the first segments of the brain affected by depression or anxiety. Kids who can't keep information being taught in their mind are offering a good clue that this skill is not working well.  Perhaps the school teachers are unable to track the child's reading skills which can result in their teaching approach not matching the way the child learns.  When a student hears from a teacher:  "try a little harder"  or, "we just told you" when they are not doing what is being asked, more than likely the child/adolescent internalizes, "I am stupid."  This can lead to depression.

There is another clue:  Is the student taking a long time to accomplish a task, especially if there is sequence of tasks to accomplish with the project. This inability can lead to the student getting caught up in right and wrong.  And, then they begin to say to themselves if I can't do it perfectly I am not going to do it at all.  Their anxiety becomes dominant. 

These are some questions the speakers provided to begin assessing whether your child/adolescent is experiencing anxiety or depression.   

• Is anything significantly different in any domain of your child's life?
  
• Is their day to day functioning different from the norm?
  
• In their academic life, does the child have a problem reading aloud. Do they lose their place, skipping words or replacing words? 
  
• With Executive Functioning: is there a switching of letters and numbers? Can they sort out a lot of information being taught? does their attention keep varying?
  
• Are you concerned that your child may not be safe?
  

There are solutions/interventions to these tell tale signs:  A few are listed below.

• Professional emotional and learning assessments to diagnose what is happening with your child. 
• Cognitive Behavior Therapy. The process focuses on solving problems concerning dysfunctional emotions, behaviors and cognitions:  I looked up the word "cognitive" on Wikipedia for a definition. It refers to the following skills: attention, remembering, producing and understanding language, solving problems, and making decisions. The speakers had some good news about the effectiveness of Cognitive Behavior Therapy confirming that 75% of the time there is some kind of improvement with anxiety and depression.
• Medications:  The speakers did not spend much time on this topic. They did comment that kids on medication do seem to have a working memory problem.  This is a controversial issue which has been discussed at PEN many times.  See former PEN blogs for more information. 
• Reading interventions.  The speakers caution parents to undertake due diligence before taking action.  Some therapies only look at a part of the problem - which may or may not be appropriate for your child.  For an overview the speakers recommend using the National Reading Panel. http://www.nationalreadingpanel.org. 
• Executive Functioning Coaching.  The need for this skill may not present itself until college level.  When it does, coaching is very important.  Each person needs to learn how to plan, how to live with goal oriented behavior.
• Software:  These speakers were promoting the use of a Pulse Pen.   It records what is being said and relieves the need for the listener to take notes.  They also mentioned the Intel Reader which was discussed in more detail in the previous PEN blog.
  Cogmed:  This process helps improve working memory, expand attention and executive functioning. http://www.cogmed.com/about-working-memory
• What to do at home: Adjust expectations of your child:  Set realistic goals. schedule free time along with time with you, the parent.  Have a listening ear, find a way to bring up the topic you want to discuss or to hear more about from them.  
  
• School:  School placement is very important.  See previous PEN blogs on this topic.

These speakers gave me a giggle when they said:  We have never spoken to a parent who didn't think that they were right.  A part of me, Ann, who is writing this blog and is not a parent, sees that part of needing to be right in myself.  It takes time to undo that belief. If you, as parent are so challenged, give yourself time to learn more about the topic. Yes, I know sometimes that's a difficult step for a parent to take. Our ego can make it difficult for us to accept there is a learning challenge. Your goal is to keep the best interests of the child to the fore. Here's a sobering comment made by the speakers. There is evidence now that if one parent experiences depression, the risk for the child developing depression goes up. So, if you as parent experience the same issues as the child, the speakers said it helps the child if the parents also do the interventions. 

The speakers urged the parents to go to gatherings, like EdRev in San Francisco, a yearly event produced by PEN which occurs at the Giants baseball park (AT&T Park).  Here parents can intermingle with hundreds of other parents and learning specialists and discover ways to increase their knowledge base on the issues facing their child.

Remember, the brain is neuroplastic, it can and does change! 

The speakers were:

Dr. Richard Abbey is a clinical neuropsychologist who specializes in assessment, diagnosis, and treatment of ADHD, learning disorders, and other neurocognitive and emotional conditions. Prior to opening the Abbey Neuropsychology Clinic in Palo Alto, Dr. Abbey was a clinical faculty member at Stanford University School of Medicine/Lucille Packard Hospital. His areas of specialty include ADHD (and non-medication based interventions for ADHD), learning disorders, pediatric brain tumors, autism, and treatment of neurocognitive deficits.
Diana Marchetti Barret, Ph.D. is a clinical psychologist who assesses and diagnoses learning disorders, developmental disorders (e.g. autism, aspergers), mood disorders, and ADHD. Dr. Barrett completed post-graduate work at the University of Utah Neuropsychiatric Institute and post doctorate training at Stanford University School of Medicine, Child and Adolescent Psychiatry. Dr. Barrett also has specialty training in Motivational Interviewing, Dialectical Behavior Therapy, non-medication treatment for ADHD, and Pivotal Response Training PRT) for Autism Spectrum Disorders.

The speakers can be reached through:  Abbey NeuroPsychology Clinic located in Palo Alto, CA.  They offer comprehensive neuropsychological evaluations for infants, children, and adults.  www.abbeyneuropsychologyclinic.com

This blog is written by Ann Farris who has mastered most of the challenges she faces with dyslexia and hyperlexia.  Learn more at www.dyslexiadiscovery.com.

Learning Coach - Learning Services Program 
Reports to: Director of Learning Services 
F.T.E.: 10-15 Hours per Week

Job Description :

• Collaborates with the director of learning services to clarify philosophy and develop/implement strategies for meeting the learning needs of Bay School students. The learning coach will meet weekly with the director.
• Assists individuals and small groups of students in implementing the strategies and tactics described in individual learning plans, with a particular focus on the areas of planning and organization. Furthermore, the learning coach will track two grade levels of students with identified learning/attention differences throughout the academic year.
• Communicates with parents, teachers, and staff to monitor and support student progress.
• Collaborates with the director of learning services to support teachers in differentiating instruction and supporting individual students.
• Administers, as needed, extended time standardized tests on site at the Bay School.
• Attends/coordinates Bay School Parent Education Network (PEN) meetings/programs as needed.

Responsibilities:

Work with Students:

• Works one-on-one with students having executive functioning challenges and time management difficulties including: prioritizing, planning, and organization.
• Related areas of intervention include:
  Reading and following rubrics and directions
  Tracking assignments and ensuring completed work is handed in
  Getting thoughts down on paper in a clear, sequential and organized manner
  Editing work and study skills
  Developing and using effective learning strategies
  Helping students better understand their learning challenges
  Offering practical advice about how to communicate with teachers: accommodations and strategies
  Refers students to resources available at Bay: faculty, peer tutoring and software
• Maintains records of meetings with students, sharing them with the director.
• Consults with the director of Learning Services to identify students who should be discussed at
  weekly Student Services Team (SST) meetings.

Work with Faculty and Advisors:

• Consults with members of the faculty to understand students' strengths and challenges.
• Achieves an understanding of faculty strategies in order to gauge what has been effective.
• Advises faculty members about strategies taught and reinforced in coaching.
• Maintains regular contact with student advisors.
• Serves as student advocate.

Work with Parents:

• Communicates with parents about the specific challenges and concerns involving their students,
  and to understand types of intervention that have been, or are being tried.
• Provides periodic feedback to parents about work with their student.
• Notifies parents if their student is not following through on scheduled appointments.
• Documents communication with parents and shares it with the director. 

Please send letter of interest and resume to:jobs@bayschoolsf.org, Attention: Director of Learning Services

The Bay School does not discriminate on the basis of an applicant’s race, color, religion, national origin, ancestry, sexual orientation, age, or any other characteristic protected by law.

Hear student Taylor Stommel speak about her experiences with learning differences, and PEN's student group SAFE, at EdRev 2011 in San Francisco:

a) Make a list of the bumpy child's strengths and challenges using the following categories to organize your thoughts: social, emotional,

learning skills, sensory behavior, and physical challenges as well as attributes. One way to assess your child's need, in part, is to watch how your child interacts at a birthday party. Does he or she seek the stimulation or prefer to be quiet?

b) When visiting a potential Preschool use this check list and complete during your visit: 

Environment: If your child is one that needs space, does the preschool offer this? Is there a break area where the child can have his or her own space? Is the environment visually over loaded or very organized? What variety of seats do they offer: comfortable chairs, carpeted floor, colorful balls etc. What does your child respond best to?

Curriculum: Find out what is the curriculum and see what it might mean to your child. If your child is stronger in learning than social interaction, perhaps you want an academic environment.

Structure: How many transitions in a day are there? Is there a warning to the youngsters before the transition? Does your child need breaks? Ms. Roffman has found that bumpy kids usually are best in a consistent environment. 

Philosophy of the school. Is there an overall plan or is the process individualized? Is it okay if the child fidgets? 

Social/emotional curriculum. Is the school only academic or is there a social component? Is it okay to have a learning difference? Is it okay to make a mistake?

What is the school's approach to different learning styles? Do they adapt the curriculum to the learning style?

How does the school work with families? Are they open to this?

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“SAFE Voices’ panel made a huge impact on our students. They felt validated, inspired and supported by what they heard the students share, which they expressed again and again in heartfelt thank you letters. This event helped us realize what a difference it makes for students to hear their peers share about their own LDs and challenges in school, so they realize that they are “not the only one” (a refrain we saw again and again in their thank you letters)! Our teachers have noticed a marked difference in students self-advocating and being open about their learning differences, since the panel. Numerous students have told me that they wish they could have heard a SAFE Voices Panel years ago, because they feel so much better about their LD now, thanks to that experience. We hope to have you back every year!”