My son has been labeled everything from "hyperactive" and "learning disabled" to "above average but unable to read". This is all very confusing. He is a wonderful kid but he does have real problems. What does it all mean?
Brain-injured children have been given literally hundreds of labels that describe their symptoms but do not identify the cause of the problems they are having. When treatment or therapy is prescribed it is also directed at symptoms and therefore does not solve the problem. These are all symptoms of brain injury. When a good brain is mildly or moderately injured the result can be mild to severe learning problems. These are neurological problems that can only be solved with a good neurological treatment program that is directed at the brain itself. A proper diagnosis for such a child is "brain-injured," not a label that describes one of his many symptoms.
No one has ever said my child was brain-injured. He has been tested repeatedly and everything comes up normal on brain scans, genetic screenings, etc. When and how does such a brain injury occur?
No matter where the path begins that may ultimately lead to a brain injury, the most common end result is a decrease of oxygen to the brain. This can occur from any number of traumatic events during pregnancy, delivery, or through illness or injury during childhood. The developmental histories of children with learning problems show babies who were premature or postmature with delayed or prolonged labors, to children who experienced high fevers or falls during their infancy.
Sometimes the cause of injury is painfully obvious and at other times (especially when it occurs in utero) it may be more difficult to discover. Brain scans are a wonderful tool to locate tumors or cysts or other gross abnormalities, but they do not give a complete picture of the brain and how it is functioning. There are many brain-injured children with very serious problems whose brain scans look relatively normal.
Doesn't the term "brain-injured" refer to children who are mentally retarded or physically disabled? What does that have to do with my bright and active child who is having problems in school?
Brain injury is a matter of degree in all human beings. A child who is severely brain-injured may have significant problems both intellectually and physically. In fact, a child who is only mildly brain-injured may also have coordination problems and learning problems, but these problems will be to a much milder degree. Such a child may appear to be as capable as the next child, but he cannot actually perform as well in life even though he is trying very hard to keep up with his peers.
Both the severe child and the mild child are brain-injured, but neither child is hopeless. Both need an effective neurological program to treat the brain.
Brain development can be slowed or even stopped by brain injury, but it also can be speeded by stimulation so that the child can catch up to his well peers. All of us are on a continuum of brain function, beginning with the baby who is just developing and proceeding to a mature adult who continues to experience brain growth and development until death. We proceed up this continuum of neurological development at varying rates of speed, depending on how much or how little stimulation we receive. We can also move down this continuum at any point if our brain is injured through trauma or illness.
How is it possible for my son to be so bright in so many ways but not be able to read? It doesn't make sense.
Reading is not an academic subject but rather a neurological function. The ability to read is unique to human beings. It is one of the most sophisticated abilities of the human brain. Only the human brain is able to decode visual symbols called words and grasp their meaning. We also decode words in the exact same way through the auditory pathway. Whether we hear a word or see a word, both of these abilities are a function of the brain. In order for us to hear and decode a word it is necessary for us to hear that word properly. In order for us to see and read a word it is necessary for us to see the word properly.
When a child is having difficulty reading it is because he has visual problems. In most cases these problems are problems of convergence. In order to be able to read one must be able to converge one's vision at near point consistently. (Near point is defined as the distance from one's outstretched arm inward to the tip of one's nose. Anything beyond three feet is considered far point.) The child with reading problems is not using both eyes together perfectly at near point.
This problem does not exist in the eye itself but rather in the brain's ability to take two distinct visual pictures of the world–one from the right eye and the other from the left eye–and place one picture over the other perfectly. When the brain is not injured it places the image from the right eye perfectly over the image from the left eye, and the result is perfect convergence and depth perception.
When the brain is injured it may not be able to do this at all or it may do this very inconsistently, and this creates visual chaos. Words on the page of a book appear double, disappear, or blur. Under these trying circumstances, the child with reading problems has difficulty making sense of the printed page. These problems slow him down tremendously and this, in turn, greatly reduces his comprehension.
To his teachers and parents he behaves as if he is slow and unintelligent when he is, in all likelihood, as smart as any child in the classroom and sometimes considerably smarter. He simply has visual problems as a result of his brain injury and these visual problems need to be addressed. Once he has had the neurological program that he needs he will be able to see the words just like everyone else in the classroom does, and he will read just as well.
If my child has visual problems as a result of brain injury and those visual problems are causing him to be a very poor reader, doesn't he need glasses?
Convergence problems originate in the brain, not the eye, and so this problem can not be corrected by glasses. Glasses prescribed for children who have convergence problems only make the problem worse.
My child has severely crossed eyes. Will surgery help?
Often surgery is recommended for children who have a severe strabismus (eyes that cross or diverge). When a strabotomy is performed, the muscles of the eye are cut in order to pull in an eye that turns out or pull out an eye that turns in. This purely symptomatic treatment seems to work for a little while, but usually within six months to a year the eyes go back to where they were before the surgery. This is simply because the problem is not in the muscles. The muscles of the eye are completely normal.
The problem is in the brain, which controls the muscles. We have seen children who have had this procedure as many as a half dozen times or more in the hope that the continued chopping of the eye muscles will correct the problem. When the problem exists in the brain it is simply not possible to bypass the brain in order to solve the problem. Repeated attempts to do so will result in failure and make an already complicated problem even worse.
Are there any other kinds of visual problems that can cause reading or learning problems?
Yes. Although convergence problems are more common, we also see children who have laterality problems. These problems can effect reading, auditory competence, mobility, language, and manual ability, especially writing. Children should develop hemispheric dominance by the time they are six years of age, which is to say a child should be clearly right-sided or left-sided by then.
Handedness is the most obvious sign of a child's laterality. In order to achieve complete neurological organization a child must have complete hemispheric dominance in all areas of function. This means that the child must not only use the same hand consistently but that this hand should match his eyedness, earedness, and leggedness. If a child is right-handed, he should also be right-eyed not only at far point but, what is more important, at near point.
For example, if a child is right-sided (right-handed, eared, and legged) but is using his left eye as the dominant eye instead of his right eye, this can cause problems when he begins to read or write. Words will often reverse so that "saw" looks like "was" to him. When he wants to write "d" he will write "b" no matter how many times he is corrected. He will continue to make such mistakes because "b" actually looks like "d" and "d" actually looks like "b". Even the most patient and loving people who try to help this child will unwittingly cause him great frustration because they mistakenly think he does not know the difference between "saw" and "was" or "d" and "b".
This child does not have an intellectual problem–he has a very real and very complicated visual problem. A child with extreme laterality problems will actually draw and write upside-down and backwards. Children with laterality problems have great difficulties spelling. They often write words without any vowels at all. These words are very hard to read, not only for parents and teachers but the children themselves often have no idea what they wrote yesterday because they can not decipher the strange words any better than anyone else. When they write they flip their three-ring notebook paper over so that the ring holes and margin are on the wrong side. They often leave a very wide margin of half a page on the left side of the paper.
Such a child needs a neurological program that will help to establish which side should be dominant (this is a genetically determined factor). Once the correct side is determined, a program of neurological organization will help him to become one-sided in all areas. When this is handled he will be able to read, write, and learn as easily as anyone else.
How can I help my daughter choose a dominant side? How do I know if she should be right-sided or left-sided? Does it matter?
Eighty-five percent of us are right-sided, and the remaining fifteen percent of us are left-sided. The genetic predisposition for one side or the other comes from our parents. Some children show an early preference for one side over the other and continue this preference throughout childhood. Others switch back and forth in the early years. It is best to observe carefully without interfering with the process or imposing one side or the other. Problems occur when a child who is really meant to be one side is encouraged to use the opposite side. This is much more likely to occur in children who are naturally left-sided. Sometimes parents or teachers force these children to use their right hand in the mistaken belief that this will "make life easier" for them. This will create a laterality problem where one would not have existed if the child had been permitted to use his left hand.
As an infant we put our child in a walker and he learned to walk very early. I barely remember whether he crawled on his belly or crept on his hands and knees at all. He was up walking and nearly running before his first birthday. At first I thought this was a good thing, now I'm not so sure.
Those early developmental stages of crawling and creeping are absolutely essential for good neurological growth in every infant. Not only do these stages provide the foundation for physical coordination and balance in later years, but they also promote the development of convergence, which results in depth perception. Children who may have already experienced some oxygen deprivation in utero may not have enough opportunity to crawl and creep or may not use what opportunity they do have effectively. They may spend their infancy rolling instead of crawling, or scooting instead of creeping. This is because they do not have the coordination to perform these more sophisticated functions. Later, when we evaluate these children as eight- or ten- or fifteen-year-olds with reading or learning problems, we find that although they may walk and run well they can not crawl or creep correctly. Incredibly, some of these youngsters do not know how to crawl at all.
If missing the early stages of crawling and creeping, or not doing enough of either, helps to explain my son's present learning problems, what should he do now?
Crawl and creep. Fortunately the brain is so constructed that it is possible to go back to vital stages that were missed in development and make them up by accomplishing them now. In the past forty years, thousands of school-age children have gone back to crawling and creeping. Equipped with knee pads and the determination to get well, they have logged miles of both crawling and creeping. By doing so, they have improved their visual convergence and their laterality. Their reading often improves dramatically, as does their writing. Their coordination, balance, speech, and manual function often change markedly as well.
My husband and I have been asked to consider giving my child drugs to help with the learning and behavior problems he is having in school. This is the last thing we wish to do. Is there any way we can avoid this?
There is no such thing as a drug that treats a learning problem. Tranquilizers, amphetamines, and psychiatric drugs are completely inappropriate for children who are brain-injured. These drugs have a very negative effect on the central nervous system. Children with learning problems need a good neurological treatment program to solve their problems, not medication.
A good neurological treatment program includes the opportunity to use developmental stages missed or done incompletely, an excellent diet free of refined sugars and chemical preservatives, a careful monitoring of liquid balance, techniques which enhance oxygen delivery to the brain, and an intellectual program that provides appropriate and challenging reading, writing, math and general knowledge programs.
My child is hyperactive. He has recently been diagnosed as having Attention Deficit Disorder. What does this mean?
Hyperactivity is actually a normal stage in the early development of a child. Every child between two and three is naturally "hyperactive". However, when that same level of activity is seen in a six-, ten-, or fifteen-year-old child it appears very abnormal indeed. The label Attention Deficit Disorder (ADD) is the new label for the hyperactive child at the moment. Both of these terms are simply describing one symptom of a brain-injured child.
Tragically many of these children are placed on amphetamines that suppress the function of the brain. The child does slow down when he is medicated, but the price he pays is large. The child's hyperactivity should be a call to action to treat the neurological problem rather than taking the simple expedient of drugging the child and hoping the problem will go away. It is a lot simpler and kinder to treat the problem as early as possible than to wait until the child has made the weary and degrading rounds of special education or barely surviving at the bottom of his class for years. When this happens the child has two problems with which he must deal: his neurological problem and the problem of years of being treated as if he is lazy, crazy, or stupid.
