May 27, 2009

Jeremy--Teacher says he doesn't pay attention

Jeremy’s mother called me today and said that his school requested an ADHD evaluation because he wasn’t paying attention. He just turned 10, and was struggling in school.

Several years ago, his mother told me that his school wanted to ‘retain’ him, which used to be called getting left back when I was a child. At that time, I told her in clear terms what I thought of ‘retention,’ which is a common suggestion for elementary school kids. This will be a topic of its own series of posts. I suggested she request an IEP, which I attended with her. They didn’t retain him, and he was given some special help in a couple of subjects. Since that time, he has kept up with his grade until now.

Jeremy has never been in trouble. He’s kind and polite to everyone. But there’s something different about him. When he speaks, the words make sense but the rhythm of his speech is off. Often, he will sound a little like a computer speaking, with flat intonation that masks emotional content. This speech issue is just one aspect of some social difficulties. He likes most other kids, but seems to have a lot of trouble reading and reacting to them in a typical way. He does have a breaking point, where frustration and loneliness make him sad and upset. He is a bully magnet.

He also has never been given a diagnosis. His parents can’t afford several thousand dollars to get him tested for all kinds of learning disabilities, and he might have some. The school and school district (and state, for that matter) have no money and are cutting some of these special ed and tutorial programs.

His teacher told mom that he couldn’t concentrate in class and he has requested being allowed to sit in the hall and do his required work in a more quiet environment. The teacher took this as oppositional and sent him to detention, where he had never been before. That afternoon, he told his mom that he loved detention since it was really quiet and he could really focus on his schoolwork. He accomplished several days of homework assignments in 1 hour of detention, completely without direction or supervision.

A picture was emerging. I asked more questions about all kinds of sensory input. Mom said that he was indeed sensitive to ambient noise and found it hard to concentrate in noisy environments. He also was very sensitive to smells, tastes, and the textures of his clothes. He was always cautious about people touching him.

So I could see that he did have an attention problem. But it sure didn’t smell like ADHD to me. He had no attention problem at home or anywhere else except for the classroom. He didn’t have this problem last year, with the teacher who adored him. He didn’t have it in my office, where he would sit and look through a book as his mother and I talked. People who have ADHD have it everywhere they go. They have it on weekends and weekdays, at school, at home, at work, in their conversations and their personal relationships.

I had suspected a diagnosis for Jeremy for years, but what good would a label do for him? I decided to broach this topic with his mother.

I told her about the things I had noticed: the speech issue, the social stuff, the sensory sensitivities. These all could be minor features of autism. But clearly, there were many features of severe autism he didn’t have. He spoke appropriately for his age. He didn’t seem to have any hand-flapping or other repetitive movements, and he was definitely interested in making connections with others. This was an autistic spectrum disorder. There just aren’t enough specific diagnoses to fit everybody on the autistic spectrum. The official ones are Autistic Disorder and Asperger’s Disorder. He didn’t have either of these. Everybody else, pretty much, gets lumped into Pervasive Developmental Disorder--Not Otherwise Specified.

The reason I brought this up with his mother was the result of a 2004 California Law called the Individuals with Disabilities Education Improvement Act [IDEA]. (Other states also have special education laws, and this link has links to the laws in other states.) If a child is diagnosed with dyslexia, for example, the school may get them reading help, if the school can afford it. But the law is explicit for the diagnosis of Autism--the state must provide the needed services. It's possible that if he were diagnosed with autism, that might open up opportunities for him to receive services his family might not afford. But will teachers expect less of him? Will he expect less from himself?

I hate assigning labels. They pigeonhole our children in ways that are convenient only for the industrial institutional system of education and the cultural biases of limited expectations. I am truly fortunate to have learned from and worked with creative teachers, fabulous professors, and brilliant colleagues with inept social skills, inarticulate conversation, or quirky nonconformist interests. Maybe they, too, met the criteria for PDD-NOS. I'm sure that the list of Nobel Prize winners includes a lot of people with these traits.

1 comment:

  1. Thank you for the post. I don't want to label my son as I feel the same way.


Please let me know what you think. Do you know a child or situation like this?