Behavioral and Emotional Challenges for Students with Language

Behavioral and Emotional Challenges for Students with Language Based Learning Disabilities June 2016 Interventions in School, in Therapy, and at Home

PRESENTERS ● Marla Dennehy, M. S. Ed. Landmark Academic Advisor, Teacher ● Hélène Dionne, Ph. D. Landmark Director of Counseling Services ● Ana Laguarda, M. A. , C. A. G. S. Landmark Counselor ● Laura Sherman, LICSW Landmark Counselor

PRESENTATION OVERVIEW 1. Definition of Language Based Learning Disability (LBLD) 2. Prevalence 3. Risk factors 4. Other challenges frequently associated with LBLD a. cognitive challenges b. behavior and emotional challenges c. social challenges 5. Intervention a. in school b. in therapy/ counseling c. at home

IN THEIR OWN WORDS Students’ early memories of having LBLD

LBLD DEFINITION A language based learning disability is a neurodevelopmental condition affecting how individuals of average to above average intelligence receive, process, or express information conveyed through words. A person may have one, or several, of the following challenges: Written word • Input (Dyslexia): reading & processing written material Output (Dysgraphia): spelling & poor handwriting, difficulty expressing thoughts in writing Spoken word • Input: processing oral information • Output: expressing oral information Mathematics (Dyscalculia) • Reading numbers sequentially and mastering number sense, learning time tables, solving word problems, telling time

PREVALENCE • 1 in 7 Americans have a learning disability (LD) • 30 -50% of those are undiagnosed • 85% of people with LD struggle with reading • 20 % of students with LD dropout (vs. national avg of 8%) • 5 -15% of school-age children across different languages and cultures have a specific learning disorder Source: http: //www. landmarkschool. org/infographic; DSM-V

IMPACT ON SOCIETY: Supporting those with LBLD About 70% of individuals incarcerated in the US are functionally illiterate • Cost of incarceration in the USA: $15, 000 (Kentucky) - $60, 000 (New York) as of 2010 Schooling is less expensive! • Cost: $10, 700 on average ($8, 000 -16, 000) per student as of 2013 Sources: • http: //www. vera. org/sites/default/files/resources/downloads/the-price-of-prisons-40 -fact-sheets-updated-072012. pdf • http: //www. governing. com/gov-data/education-data/state-education-spending-per-pupil-data. html

RISK FACTORS FOR LBLD Environmental: prematurity/very low birth weight, prenatal exposure to nicotine Genetics: Increased risk if a first-degree relative has a LD • 4 -8 times higher for reading disability • 5 -10 times higher for math disability Gender: LDs are more common in males • 2: 1 or 3: 1, study dependent LDs are found across languages, cultures, races and socio -economic levels, but vary in manifestation. Source: American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders- 5 th Edition- DSM-5. American Psychiatric Publishing, Washington DC. P. 72

PRESENTATION OVERVIEW 1. ☑Definition of Language Based Learning Disability (LBLD) 2. ☑Prevalence 3. ☑Risk factors 4. Other challenges frequently associated with LBLD a. cognitive challenges b. behavior and emotional challenges c. social challenges 5. Intervention a. in school b. in therapy/ counseling c. at home

RELATED COGNITIVE CHALLENGES • Working Memory • Inconsistencies in performance • Executive Function • Attention (with or without impulsivity) • Spatial difficulties

BEHAVIORAL & EMOTIONAL CHALLENGES Children with LBLD present with higher rates of: • Anxiety (video: anxiety) • Depression • Symptoms of PTSD, even if they may not meet all criteria to actually diagnose the disorder (video: labels)

OTHER BEHAVIORAL AND EMOTIONAL CHALLENGES • Impact on self-esteem or sense of self as a capable learner • Motivation • Learned helplessness • Emotional self-regulation • Difference between chronological & social/emotional development • Stamina

ADAPTIVE AND MALADAPTIVE COPING STRATEGIES • School phobia • Shutdown, refusal to work • Task avoidance • Oppositional behavior, argumentative • Meltdowns, temper tantrums • Class Clown • Ability to hide when they don’t understand • Examples of other creative coping strategies

SOCIAL CHALLENGES Difficulty processing/expressing oral information may impact social interactions • Difficulty reading social cues • Difficulty interpreting spoken language • Difficulty finding the right word • Difficulty understanding sarcasm and humor Difficulty recalling sequence of events when reviewing interactions

SOCIAL EXPERIENCE Video: peer relationships • Excluded/isolated (spending time in SPED classes) • Feeling different/treated as different because learning style is misunderstood • Bullied by their peers

PRESENTATION OVERVIEW 1. ☑Definition of Language Based Learning Disability (LBLD) 2. ☑Prevalence 3. ☑Risk factors 4. ☑Other challenges frequently associated with LBLD a. ☑cognitive challenges b. ☑behavior and emotional challenges c. ☑social challenges 5. Intervention a. in school b. in therapy/ counseling c. at home

INTERVENTION

AT SCHOOL

TEACHING STRATEGIES Specific teaching strategies (video: Adam & Peter) • Avoid, or minimize, multi-steps directions • Making expectations clear (Write agenda daily) • Think to paper • Mid-point check in-in/out circle • Pass out of class

TEACHING STRATEGIES • Use multiple modalities • Micro-unit and structure tasks • Insure automatization through practice and review • Provide models • Include student in learning practice • Provide opportunities for success

What is happening here? This is Stupid! I am not reading this! www. . Splitsider. com

CLASSROOM MANAGEMENT • • • Video: classroom management LBLD vs. willful behavior Balance of support and maintaining expectations Anxious kids feel out of control • need for boundaries, structure, stability Give students a structured choice, do not argue with them • Limit time/set options/done Student should have techniques to self-soothe • Breathing, space, self talk etc. Students should identify safe adults for support

SPORTS Video: coaching kids with LBLD • Coach using previously described teaching strategies • Do not assume that vocabulary specific to that sport is known/understood • Present plays and techniques in micro units, ideally with visual aids • Confirm understanding • Give athletes opportunity to practice organization skills • Set athlete up for success first • Maintain longview perspective

PRESENTATION OVERVIEW 1. ☑Definition of Language Based Learning Disability (LBLD) 2. ☑Prevalence 3. ☑Risk factors 4. ☑Other challenges frequently associated with LBLD a. ☑cognitive challenges b. ☑behavior and emotional challenges c. ☑social challenges 5. Intervention a. ☑in school b. in therapy/ counseling c. at home

THERAPY: THE BIG PICTURE • If client is diagnosed: read the report, talk to the psychologist • If client is not diagnosed yet: is LD part of the picture? • Support parents in their role as advocates • Provide psycho-ed to the family and child about LBLD • School: truly ask about school experience (not just generalities about likes/dislikes of class, friends. . . ) • Ask how client understands difficulties (possibility of trauma)

THERAPY Islands of Competency • Important for all children - Essential for children with LBLD • Encourage explorations of areas other than academics: performance and visual arts, music, sports, leadership, community service, games • Sports: individual sports are often best, such as wrestling, track, swimming, tennis

STRATEGIES FOR EFFECTIVE COMMUNICATION If your client processes or expresses oral information more slowly: • Be aware of the language you use. Avoid double negatives • Give time for response from your client • Do not assume. Check if your client understands by asking for restatements • Slow down your speech

MORE STRATEGIES • Use rating scales (ask if they prefer you to read it to them) • Use concrete examples • Use humor wisely - sarcasm may be misinterpreted • Use visual material, ex. a whiteboard in your office • Use different words to present the same concepts • Go over the information more than once • When explaining, break it down

DO ALL OF THIS WITHOUT PATRONIZING YOUR CLIENT!

PRESENTATION OVERVIEW 1. ☑Definition of Language Based Learning Disability (LBLD) 2. ☑Prevalence 3. ☑Risk factors 4. ☑Other challenges frequently associated with LBLD a. ☑cognitive challenges b. ☑behavior and emotional challenges c. ☑social challenges 5. Intervention a. ☑in school b. in therapy/ counseling - groups c. at home

INTEGRATION OF DIFFERENT TREATMENT MODALITIES • Relaxation response for decrease in anxiety and increase in attention and focus • CBT & DBT to counter recurrent negative thoughts and help facing challenges • Strategies for ADHD at home and school

GROUPS • Social Thinking & Zones of Regulation • Bullying Prevention - Bystander, bully, upstander • Healthy Relationships • Self-advocacy - disability awareness • Drugs/Alcohol & decision making skills • Value of social skills groups - lunch bunch • Mediation

GROUP PROCESS • Develop routine • Repeat content (review, restate) • Provide templates for work (feelings and images) • Give concrete strategies • Role play situations • Support perspective taking • Clarify sequencing of events

PRESENTATION OVERVIEW 1. ☑Definition of Language Based Learning Disability (LBLD) 2. ☑Prevalence 3. ☑Risk factors 4. ☑Other challenges frequently associated with LBLD a. ☑cognitive challenges b. ☑behavior and emotional challenges c. ☑social challenges 5. Intervention a. ☑in school b. ☑in therapy/ counseling c. at home

LBLD AT HOME • Stress experienced around homework Video: Homework • Anger and frustration expressed at home after “keeping it together” at school • Desire for increased autonomy is not matched by ability at times; they may always require help in certain areas

VIDEO FROM PARENTS: IMPACT ON HOME LIFE

WORKING WITH FAMILIES • Parental/Familial impact of raising a child with LBLD • Toll on parents • Dyslexia runs in families • parents have similar challenges? • Importance of psychoeducation about LBLD • Importance of seeing child’s perspective • Impact of LBLD in conflicts • Interpretation of child’s “refusal” to answer questions

TAKEAWAYS Write at least 3 strategies/ideas you learned today Then with a partner discuss: • What will be helpful in supporting someone with LBLD (in school, in therapy, and at home? (Think, Pair, Share)

ENDING NOTE Video: students give advice and share their view of their LBLD

RESOURCES • Bourne, E. J. (2010) The Anxiety and Phobia Workbook, 5 th Edition. New Harbinger Publications, Oakland, California • Cooper, B. Widdows, N. (2008) The Social Success Workbook for Teens. Instant Help Books A Division of New Harbinger Publications, Inc. Oakland, California • Biegel, GM (2009) The Stress Reduction Workbook for Teens. Instant Help Books, a Division of New Harbinger Publications, Inc. Oakland, CA • Hallowell, E. M. , Jensen, P. S. (2010). Super-parenting for ADD: an Innovative Approach to Raising your Distracted Child. Ballantine Books Paperback Ed. • Huebner, D. (2006) What to Do When You Worry Too Much: A Kid's Guide to Overcoming Anxiety. Magination Press, American Psychological Association. Washington, D. C.

RESOURCES (con’t) • • Mc. Kay M. , Wood J. C. , Brantley J. (2007) The Dialectical Behavior Therapy Skills Workbook: Practical DBT Exercises for Learning Mindfulness, Interpersonal Effectiveness, Emotion Regulation & Distress Tolerance. New Harbinger Publications. Newhall, P. W. (2013) Making sense of language-based learning disabilities. Prides Crossing, MA: Landmark School Outreach Program Schab, L. M. (2008) The Anxiety Workbook for Teens. Instant Help Books A Division of New Harbinger Publications, Inc. Oakland, California Thompson-Silver, D. (2012). Fall Down 7 Times Get Up 8: Teaching Kids to Succeed. Corwin, Sage Cie. Thousand Oaks, CA. Wagner, A. P. (2013). Worried No More: Teaching Tools and Forms. Lighthouse Press, Inc. Wilcher , M. , Chudnofsky, R. , Malloy, L. , Melachrinou, AM. (2102). Education Manual Initiative. Benson Henry Institute for Mind Body Medicine. Massachusetts General Hospital. www. landmarkoutreach. org Relaxation resources: http: //www. stopbreathethink. org/ or https: //www. headspace. com/

GRATITUDE • To all members of the Landmark School Counseling Department for their essential contribution to the development of this presentation • Special thanks to Andrew Gruden for his technical assistance • To parents, teachers, coaches and students for sharing their experience and giving us a better understanding of life with LBLD Students: Haley, Josh, Mc. Kenna, Philip, Ryan Parents: Kathleen Mac. Mannis, Kristin Walsh Teachers: Peter Harris, Adam Hickey, Thomas O’Riordan

BIBLIOGRAPHY 1. 2. http: //www. landmarkschool. org/infographic American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders: DSM-5. Washington, D. C: American Psychiatric Association 3. Du. Paul, Gormley, Laracy. (2012). Comorbidity of LD and ADHD: Implications of DSM-5 for Assessment and Treatment, J Learn Disabil, January/February 2013; vol. 46, 1: pp. 43 -51. 4. http: //www. landmarkschool. org/infographic 5. http: //www. vera. org/ 6. http: //www. vera. org/sites/default/files/resources/downloads/the-price-of-prisons-40 -fact-sheetsupdated-072012. pdf 7. http: //www. governing. com/gov-data/education-data/state-education-spending-per-pupil-data. html 8. Ryan, M. (2000) “The Other Sixteen Hours: the social and emotional problems of dyslexia. The International Dyslexia Association (IDA) 9. Sexton, C. , Gelhorn, H. , Bell, J. , and Classi, P. (2011). The Co-occurrence of Reading Disorder and ADHD: Epidemiology, Treatment, Psychosocial Impact, and Economic Burden, J Learn Disabil, November/December 2012; vol. 45, 6: pp. 538 -564. 10. S. Shaywitz, M. D. (2005). Overcoming Dyslexia. Vintage Books, A Division of Random House, INc. , NY, 2203 11. S. Shaywitz, R. Morris, & B. A. Shaywitz. (2008). The Education of Dyslexic Children from Childhood to Young Adulthood, Annu. Rev Psychol. 59: 451 -75. Online 12. Nelson, J and Harwood, H. (2010). Learning Disabilities and Anxiety: A Meta-Analysis, J Learn Disabil, January/February 2011; vol 44, 1: pp. 3 -17.