Ask Dr. Amy: How to choose an intervention AFTER your child’s learning disability diagnosis

Has your child or teen recently received a learning disabilities diagnosis? For many parents, there’s an immediate sense of overwhelm. What interventions are right for my child based on their specific diagnosis? How do I know what’s truly effective in strengthening their specific cognitive deficits vs. just a blanket, one-size-fits all intervention? On this mini-episode, Dr. Amy and Sandy discuss next steps for parents and how to evaluate different interventions that can be helpful based on the particular learning disability. 

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Transcript

DR. AMY: Hi listeners, this is Dr. Amy Moore and I'm here with my co-host, Sandy Zamalis, and we are just going to have a brainy moment.   

SANDY: So we had a question from one of our listeners and they reached out to us. They recently received a learning disabilities diagnosis for their child, but they're really overwhelmed with all of their options. So we thought we might talk about where to start and what to do and what to look for.   

DR. AMY: Yeah, I think that's a great question, Sandy, and probably one that lots of parents have when they have a child who's struggling, you know, particularly in the classroom. So, I think that as parents, our first inclination is to consider hiring a tutor, right? I mean, that's just been the standard for so long: your child is struggling; let's get a tutor to help them. And so I think tutors can be beneficial in several scenarios. One, if your child has been absent due to illness or injury and needs to catch up, a tutor can help with those assignments or lessons that they missed and need to catch up on. I also think tutors can be beneficial for subjects like algebra that are sometimes hard to understand as the teacher is going quickly through the concepts. And so a tutor can come in and again, reteach that content, that the child isn't quite grasping in the classroom. So those are really the two scenarios in which a tutor would be beneficial. But I think that it's important to look at the underlying cause of the learning struggle, because we can't just reteach content over and over and over again and watch our child continue to struggle if we don't focus on what's causing that struggle. And we know that most struggles with learning are the result of a deficit in one or more cognitive skills. And cognitive skills are those underlying learning skills that we use for thinking and learning things like: working memory and long-term memory; processing speed, how quickly we can process incoming information; auditory processing, you know, how well we can manipulate sounds in our languages; visual processing, that ability to visualize and manipulate images; reasoning skills, right? We use those all day every day as we problem solve and use logic. And of course, attention and focus. So those are cognitive skills. And if you have a deficit or a weakness in one or more of those, then learning is going to be difficult. And so I think it's important to look at interventions that can remediate those deficits or weaknesses in those cognitive skills. And then once they're remediated, right? Once that underlying problem is addressed, then you go, “Okay, do I need a tutor to help my child catch up now?” Right? Because if they're struggling for a long time, then they might need a tutor for a little bit just to catch up. So they could go hand in hand, right? An intervention to target those skills, plus a tutor, or maybe once you remediate those skills, you don't need a tutor, right? Because learning becomes easier.   

SANDY: So I think I felt that question from that particular mom because there's so many interventions out there. How does a parent kind of siphon through those? How do they choose? What should they look for?   

DR. AMY: Yeah, that's a great question, Sandy, because it can be overwhelming when you're looking for something and it's an investment. It's an investment in time. You know, interventions can be costly. And so you want to choose wisely. You want to have the most information that you can in order to make an informed decision. So my first suggestion is to look at the research and so that's the question that I would ask as you're looking for interventions. What does the research show on your particular intervention? Right? And so many times what we see are, you know, interventions or companies that say, “This is research based.” Right? And so they'll take that logic that if A equals B and B equals C, then A equals C. And so sometimes that works. But most of the time, that's a little squishy. And so what they'll say is, you know, “This is based on neuroplasticity.” Okay, well, most learning is based on neuroplasticity, right? Like, neuroplasticity is the brain's ability to change with experience. And so that's a squishy support for an intervention. You want to ask for research on that particular intervention, right? Has a research study or studies been conducted on your intervention that you're trying to tell me is good for my child? So that is absolutely the first question that I would ask.   

SANDY: That's a great question. Although I think research is intimidating. Can you share from a research, because you're a researcher, from a researcher's perspective and you're a mom, you would know what you're looking for in research. What should a parent be looking for even in something that seems as simple as “read the research”? There's probably things that a parent should be able to glean from what they're reading or seeing in that research that would be really helpful for them.   

DR. AMY: Yeah, that is a great question. There, for example, there's an intervention out there called Cogmed, and there are lots of studies on Cogmed, like lots of research studies on Cogmed, but many of those studies show that it didn't work. And so just because you have research doesn't mean that the results were significant, right? Now, they do have some studies that show that it did work, right? So it's kind of iffy. And I'm not, I'm not slamming Cogmed, please hear me, right? But they're, it's just a good example. So what you want to look for is the results section that says there were statistically significant changes, or statistically significant gains, or statistically significant improvements. So that word “significant” is what we're looking for. And if you don't see that, right, then that particular research study probably showed that that intervention was not effective. That's the simplest way to look at it. There are nuances that kind of muddy the waters, right? So you might see something that says, “the results were nearly significant,” right? And that's the researcher's way of saying, “Well, it wasn't significant, but it was close,” right? Well, that's like saying you're a little bit pregnant, right? Right. Either you are or you're not pregnant, right? So the results are either significant or they're not. So that whole language of trying to spin it, “it's nearly significant,” I would probably just shake my head and go, “No, I'm not convinced.” The other thing is, it would be my hope that companies or interventions have distilled all that research down for the parent or the client, right? Like they have some sort of client outcomes or research results guide with visuals that they can share with you, right, that distill that down already, right? “Hey, this was the research study that was conducted. This is who conducted it. This is how many people were in it. This was the diagnosis of the people in it. And here were the results right there on a beautiful page for you.” And then if you want to go dig into the actual study, then you can. But at least the intervention or company has done that for you. I would think that's a company that you would want to meet with, right? That you would want to work with, right? Because they care enough about you to distill that down for you.   

SANDY: So let's dig a little deeper into actual learning diagnosis a little bit. So, you know, students can struggle for lots of different reasons and like you mentioned, you know, it's helpful for a parent to understand kind of the underlying cause of some of those things. How do they kind of discern or find the interventions that can help. For example, and like reading, there's a ton of reading options out there. And I think what you just shared about the different research is super helpful, but it's still overwhelming. How does a parent choose like, for example, if their child just got diagnosed with dyslexia? There's a lot, especially in the last couple of years, there's been a lot of discussion about the science of reading, but it's, you know, it's, it's overwhelming. There's so much information out there. And even people who talk about science of reading talk about how overwhelming it is. What could you share kind of even in trying to narrow it down to a specific skill area that you're trying to build?   

DR. AMY: Yeah, I think that, well, first of all, there's not a standard way to diagnose dyslexia, right? The field has not landed on, “Hey, here are the specific tests that you give the child to determine if they have dyslexia or not.”   

SANDY: That's really frustrating for parents. We hear that all the time. It's so frustrating.   

DR. AMY: Right. And actually dyslexia is not even an official diagnosis anymore, right? The official diagnosis is specific learning disorder. And then it could say in reading or in math or in writing. Right? Okay, so that's number one that I know how frustrating that can be. But I think it's important for parents to look at the results of the tests to look at the individual skills that led or the deficits in those skills that led to that diagnosis. So you know, were the deficits in visual processing or were the deficits in auditory processing skills such as phonological awareness, word attack? Because then that shapes the type of intervention that you're looking for as well. So, if that diagnosis was received, because there was a visual processing deficit, then a visual processing skills intervention would absolutely be your first stop. You know, those offered by developmental optometrists, for example, vision therapy. But if it's an auditory processing deficit, then you need to pick an intervention that specifically targets, you know, those auditory processing skills.   

SANDY: Yeah, I think that's super helpful because a lot of times when parents, you know, for example, do some of these studies, for their child and they get back this information, it's like a 50-page report that's really hard to understand. But if they can isolate the skill, that will help them kind of address and help on the home front.   

DR. AMY: Absolutely. And then it's, it's also again important to look at the research. You know, there was a meta-analysis. So meta-analysis is when you look at multiple studies that have been conducted on the same intervention and you kind of look at the effect sizes and run the statistics that way and come up with a conclusion. “Hey, based on all of these studies on this intervention, does it work or not?” And so last winter, there was a meta-analysis done on the Orton Gillingham approach to dyslexia or reading disabilities, and they landed on that it was not statistically significant that it wasn't effective. And so does that mean it hasn't been effective for individual children? Absolutely not, right? We've heard stories of children's lives who have been changed by that intervention, probably because it addressed their specific skill deficit in that moment in time. Right? But overall, when you look at the thousands and thousands of children across those studies, it showed that it wasn't effective. So I think that we have to keep up with the research, right? Just because that's the buzzword that's used, just because that's familiar when you look, like you could Google reading intervention, right? And you're going to you're going to find Orton Gillingham interventions all over the internet. Right? So it's important to keep up with that research. You know, we just finished a research study on ReadRx, you know, which is a structured literacy program based on the science of reading, you know, that addresses all of those auditory processing skills. The difference in ReadRx from other structured literacy programs is that it's built on the foundation of remediating those cognitive skills that we just talked about, right? So, you get the benefit of strengthening all of those underlying learning skills that are required for learning to read and learning to read well, as well as learning any other subject, as well as performing in your job when you're an adult, right? Like we use those cognitive skills all day, every day for the rest of our lives. And so that's the difference. And so that study that we just conducted was on over 3,500 children. 3,500 children with a reading struggle, and we found statistically significant gains in all of those reading skills that we tested. And, you know, the average change in phonological awareness was 5.8 years in 24 weeks. A 5.8-year gain in 24 weeks. Show me another program that can do that. I haven't seen one. It's kind of exciting.   

SANDY: It is exciting. So to wrap up, if you're looking, if you've just been, your child's been diagnosed with a learning struggle, first get to the root cause. Figure out what's going on, and then research and search out interventions that tackle the root, get to the root of the problem.   

DR. AMY: Yes.   

SANDY: And look for things like research that shows statistical significance. That's a tongue twister.   

DR. AMY: And research on that intervention, right? Not that they're using the research on similar interventions or on a theory, right? But that researchers have conducted a study or more studies on that specific company or that specific intervention. Yes.  

SANDY: Okay. Well, hopefully that was helpful to our listener who asked the question. Thank you, Amy, for sharing and your guidance and wisdom as usual.