Hearing a diagnosis that your child has a disability can feel overwhelming. Toledo Parent talked to local experts about the most common disabilities seen in children, what they mean and how parents and loved ones can understand and accomodate special needs.
Attention Deficit Hyperactivity Disorder Linell Weinberg Autism Spectrum Disorder Autism Society of NWO Lon Mitchell Developmental Disabilities Lucas County Board of Developmental Disabilities
Attention Deficit Hyperactivity Disorder (ADHD) is a “child’s inability to focus that is interfering with his/her learning. That difficulty focusing may or may not have the hyperactive piece,” clarifies Susan Santoro, retired director of Student Services at Springfield Local Schools with 32 years in the education field. ADHD is a medical condition, which means the diagnosis must come from a doctor. However, the diagnosis is typically based on teacher input, evaluation, and a checklist.
“It’s harder to diagnosis ADHD in younger children because younger kids have fleeting attention spans,” explains Santoro. “Around preschool age, if they can’t focus, and that impairs what they are trying to do, even if that means playing common household games or eating a meal, then parents may want to consider asking their doctor.” Santoro emphasizes that ADHD does not always include hyperactivity. A child may appear to be focusing because s/he is sitting calmly, but if that child fails to focus on the task at hand, and this occurs on a regular basis, then the s/he may have attention deficit disorder.
Some doctor-parent teams decide to use medication to treat ADHD, but Santoro explains there are options, including short-term medication trials or medicating only Monday through Friday for school purposes. Santoro says there are also many non-medication strategies. For example, some children have success with “heavy work,” which includes children pulling or carrying heavy objects before sitting down to focus. “Deep pressure also works on many children. Many schools are turning to lap blankets. Many kids need movement, so they will do jumping jacks, but every child is different. Wearing noise-canceling headsets is another great strategy for when children need to focus on reading or working quietly.”
“Autism Spectrum Disorder is a brain-based developmental disorder that usually appears during the first three years of life,” explains Linell Weinberg, executive director of the Autism Society of Northwest Ohio. “It causes difficulty with understanding and using language; relating to people, events and objects in the environment; dealing with sensory stimuli such as pain, sounds, smells, visual input, etc.; exhibiting repetitive behaviors and interests, and in addition, individuals with autism exhibit a large range of cognitive abilities.”
Weinberg lists the signs of autism in young children: “No big smiles or joyful expressions, especially to parent or caregiver, by age 6 months. No back and forth sharing of sounds or smiles by 9 months. The child does not respond to name by 10 months. No back and forth gestures such as pointing (to share enjoyment), reaching up to the caregiver, or waving by 12 months. No babbling by 12 months and no words by 16 months. Not initiating two-word phrases such as “want juice” or “go bye-bye” by 24 months (imitation and repetition do not count). ANY loss of speech or social skills at any age.”
An informative website that parents can use to track their child’s milestones is www.cdc.gov/ncbddd/actearly/milestones/index.html. Parents can click on their child’s age and compare where they are with typical milestones for that age. Additionally, Weinberg notes, “The average age of diagnosis across the country is 4 years old; however, autism can be diagnosed at age two or even earlier. If parents have concerns, they should not wait. They should talk to their child’s pediatrician and ask for a developmental evaluation and a referral. It is recommended that a child who is even suspected of having autism receive a minimum of 25 hours a week, intensive (one-on-one), individualized services year round.”
6629 W. Central Ave., Ste 1, Toledo
Children with developmental disabilities have a wide range of abilities and struggles, but according to Lon Mitchell, public information manager at Lucas County Board of Developmental Disabilities, there are classifications that make children eligible for program services. The most common classifications include individuals with an intellectual disability, spina bifida, epilepsy, autism, cerebral palsy, Tourette’s, and Down syndrome.
Many of these developmental disabilities can be diagnosed at birth, but some disabilities do not manifest until a bit later. Mitchell says, “We encourage genetic counseling before a woman becomes pregnant, but if there are two things I would emphasize to all parents, it would be that early intervention is key, and 50 percent of developmental disabilities could be prevented if women did not drink during pregnancy.” Mitchell encourages parents to download the developmental checklist at lucascountyei.org if any issues are suspected. The online checklist can help parents to evaluate if there might, indeed, be a problem by comparing their child’s development to typical milestones achieved by other children of the same age.
Parents can complete the online checklist and/or directly call Lucas County DD to schedule an appointment at 419-381-8320. The board is a resource, and it doesn’t cost anything for a child to be assessed. There are numerous programs for young children, ages birth to two, with developmental disabilities. Mitchell explains, “Once a child/adult is enrolled, we create an individualized program about what we can do, what a parent should be doing to measure success, and we create a budget to make those programs a reality.” Their website also has an extensive library with many articles and links to services, as well as the aforementioned developmental checklist.
1154 Larc Lane, Toledo
Attention Deficit Hyperactivity Disorder
Autism Spectrum Disorder
Autism Society of NWO
Lucas County Board of Developmental Disabilities
Down Syndrome Down Syndrome Association of Greater Toledo
“Down syndrome is a genetic disorder that occurs during the development process of the embryo,” describes Richard Harris, executive director of Down Syndrome Association of Greater Toledo. “A small amount of excess genetic material gets placed on ßChromosome 21, resulting in the child being born with Down syndrome.”
“Each person born with DS is uniquely special in their own way, just like every other child,” Harris clarifies. Children with DS are identified from birth, and sometimes even within the womb, so diagnosis and developmental expectations can be discussed from infancy. “That being said, parents should expect longer than average periods for their child with DS to reach certain milestones in the development phases of their growth. Due to lower muscle tone, some children with DS don’t learn to sit up, crawl, or walk at the same ages as their typical peers. Many of our parents are still waiting for their child with DS to be potty trained at four, five, or six years old.”
Ideally, a child with DS should be individually assessed by a team of family doctors, parents, teachers, and various other educators to compile an Individual Education Program (IEP). Each county has various programs for children with DS, and families then decide which programs are right for their child. Harris explains that the DSAGT is launching the Smart Start Program, which is a program that targets the parents of pre-kindergarten age children with DS. The program includes numerous tools to assist parents with student readiness (potty training, expectations, following rules/directions, handling schedule changes) and parent/school relations (communicating effectively, common mistakes, informing teachers).
P.O. Box 298, Sylvania
Down Syndrome Association of Greater Toledo
Dr. Rodney Gabel
Speech/Language Disabilities NWO Stuttering Clinic, University of Toledo Diane McCreery Dyslexia Children’s Dyslexia Center
“Stuttering is actually a neurological condition that leads to a breakdown in speech fluency, which manifests in the repetition of parts of words or getting stuck on a sound.” According to Dr. Rodney Gabel, a certified and licensed speech-language pathologist and a board-recognized specialist in fluency and fluency disorders, “Stuttering is not related to anxiety; it’s a developmental problem. It’s also genetic in nature and appears to run in families.”
Stuttering typically starts in children between the ages of 24 and 48 months with the repetition of vowels and/or consonants, but approximately 80 percent of children who stutter “grow out of it.” Dr. Gabel clarifies, “The earlier you start treatment, the more likely the child will end up in that 80 percent range. Around two to four years of age is when children learn to talk in longer utterances, in phrases and sentences, so early intervention is key. The longer they stutter, the more likely they will continue.”
Dr. Gabel encourages parents to contact a speech language pathologist if they suspect abnormal speech behavior. The first step is a speech, language, and hearing evaluation. “That includes taking speech samples, analyzing the child’s speech, talking to the family about the child’s language, and completing an observation, either a video recording or direct observation in the home.” Once a child is diagnosed, there are a variety of treatment options based on age at the Northwest Ohio Stuttering Clinic at The University of Toledo. The clinic currently has 30 individuals who stutter, and the ages range from three years to adult.
“Dyslexia is difficulty communicating verbally and on paper,” summarizes Diane McCreery, director of The Children’s Dyslexia Center. “Children with dyslexia don’t see the letters backwards; they just don’t process the letters correctly.”
According to McCreery, the telltale sign of dyslexia is when a child cannot remember the letters of the alphabet or the sounds the letters make. McCreery elaborates, “Even if you go over and over the alphabet, it just doesn’t stick. Then maybe you think they got it one day, but when you do the same activity the next day, they don’t have a clue.” If a child has difficulty rhyming, that’s another sign that s/he may have dyslexia. Children can be diagnosed with dyslexia as early as five or six, and as many as 15-20 percent of children are dyslexic.
McCreery assures, “You can retrain the brain. It’s been proven by Dr. Sally Shaywitz from Harvard; she wrote a book called Overcoming Dyslexia. What we do at The Children’s Dyslexia Center is retrain the brain through giving the kids Orton-Gillingham training.” As for practical, everyday tools, McCreery suggests asking a child to spell out a word when s/he is having difficulty deciphering the word. She also advises calling vowel sounds “sound” and “name” instead of “short” and “long.” She has found that works much better for children with dyslexia. Lastly, she recommends creativity when addressing a child’s specific struggle. For example, she had someone who had trouble with the sound of the letter “M.” McCreery pulled out a bag of M&M’s, and they traced the letter and made the “M” sound.
102 E. Broadway, Ste 301, Maumee
NWO Stuttering Clinic, University of Toledo
Children’s Dyslexia Center
Where do you go to start an evaluation to assess special needs?
If a parent or caregiver suspects a child may have a developmental disability, the key is not to wait, as early intervention will help them succeed. Maumee City School’s Director of Special Education Carole Burnworth suggests parents with children younger than three years of age seek out Help Me Grow, a program designed to ensure a healthy and productive start to school. For children older than three years, discussing concerns with a pediatrician and teacher or principal will solidify a plan of action. Parents of homeschooled children should consult the principal from the school district they are living in for evaluation and resources as well as The Lucas County Board of Developmental Disabilities.
Help Me Grow
Lucas County Board of Developmental Disabilities
Special Education 101
How many Lucas County K-12 students receive Special Needs services?
11,691 out of 62,868 students
Based on 2012-2013 school year data compiled by the Ohio Department of Education
Ohio Standards of Teacher/student Ratio in Special Needs Classrooms:
1 teacher 16 students
1 teacher 24 students