How To Help Your Child Learn To Read

“My son’s teacher wants to refer him to the school’s psychologist. What does this mean? Should I say yes? We’re both terrified.”

Today I’m talking with Jane Gartland (Child Psychologist), in response to this question.

Ali: Welcome Jane. Thanks for coming today to discuss this situation.

Do State primary school teachers refer to other educational and health professionals and, if so, how often?

Jane: Yes, state primary school teachers are professionally obliged to refer to other educational professionals, as well as health professionals, when they see the need for other people to be involved/when it’s outside their area of expertise. Your family doctor, dentist, chiropractor, whatever, does exactly the same thing. [There’s a question mark over professionals who don’t consult with other professionals].

If a teacher sees a student experience failure in learning then they try to work out what is going wrong… thinking, thinking, thinking… “why doesn’t this student seen to be moving through learning?” They observe this student more closely over time, and teachers can make really good guesses at what might be going wrong for the student. [Don’t forget, primary teachers go to uni for 4 or 5 years to study how a child develops socially, emotionally, behaviourally and intellectually. That’s got to be a head-start over us parents.]

Teachers tend to look at problems in two ways:

(i) Is this a problem with the senses (seeing, hearing, tasting, touching, smelling)?

or

(ii) Is this a problem with perception (how we interpret the senses: language, behaviour, emotion, intelligence)?

Here’s two examples of sensory problems:

Example 1: And then she said: “Yes I did do the “p” with a stick going down, so I don’t know why its sticking up like that”, and she got a bit upset and said: “ I hate writing”. It’s a bugger-of-a-job getting her to hold a pen, and usually a melt-down at the end of it.

Example 2: And so he said… “But if I don’t put my finger on the line I’m reading and the other finger under the words I’m sounding out then they’ll move, so I’ve got to hold them down”. It came straight from the heart. He really sees it that way.

[This primary teacher would have referred the stick p student to our occupational therapist, and the moving lines and words student to a developmental optometrist.]

Here’s two examples of perceptual problems:

Example 1: You can freak this chap by just moving his pencil. No way do I collect-up the math toys from his table. We just leave him there holding on to the math toys, and the rest of the class moves-on with the next activity. He joins us in his own time.

Example 2: He’s got the gift-of-the-gab; a real charmer with words, and one of my best readers. Really low on writing and maths. Wouldn’t know: “the next one, up/down/over/under, left/right, north/south, tomorrow, next week, base 10, basic number skills, nothing.”

[This primary teacher would have referred the easily freaked student to a psychologist, and the smart and charming, but spatially unaware student to a psychologist.]

State primary school teachers refer approximately 8 – 15% of their classroom to other educational and health professionals. The younger the child is, the better the referral is more likely to be successful. It’s more like 15% of Kindy to Year Two students get referred, and 6 – 8% of Year Three to Year Seven students get referred. Teachers know that there’s a better chance of success if changes can be made when a child is 4 – 8 years old.

Ali: What might a school’s psychologist do and say with my child? How many sessions would the psych need, and does the teacher/parent get feedback?

Jane: If you don’t know the answers to these questions before the psych sees your child, then something is very wrong. The psych is not allowed to be alone with your child before it’s made clear to you:

(a)    why the psych is involved

(b)   what the psych is going to do or say

(c)    how long the psych thinks this will take, and

(d)   how the psych is going to consult with you all after the event.

The old “just sign this psych referral and we’ll sort-it-out” days are long gone. If you’re extremely unlucky and find this happening to you by school administration, then you’re forced to dig-your-heels-in and say: “I’d like an appointment with the teacher and the psychologist together before I sign anything.” No one likes to be pushed to have to be that assertive, but sometimes a responsible parent has to do this.

Let’s go back to the primary teacher … thinking, thinking, thinking… “why doesn’t this child seem to be learning as well as they could?” The teacher makes guesses about what might be going wrong, and she runs with it.

Example 1: She thinks: “It’s a language and hearing problem”, and so makes changes to her teaching as if it was a language and hearing problem. She very carefully observes how the student responds to these changes to teaching. [In teacher-talk (pedagogy), this is called “making teaching and learning adjustments”.]

If things aren’t going well with all this guessing and adjusting, then the teacher might think that the problem is beyond her range of expertise. The teacher thinks that it would be helpful to seek-out consultation with a speech pathologist, because a speechie has more expertise in language and hearing problems. She talks things through with the speechie – who reckons it seems more like a comprehension/ understanding words problem, and less like a hearing problem. The speechie can give the teacher some tips for making changes/adjustments to help develop comprehension. The speechie won’t know for sure, and would need to spend about 90 minutes doing testing activities with the student in order to know exactly what kind of language development is happening for this student. The teacher may need to negotiate a referral to the speech pathologist with the student’s parents.

Example 2: Same situation for the teacher thinking that it might be a behaviour problem, or an emotional problem, or a social problem. For some unknown reason, a student can’t seem to take turns in speaking and listening, can’t seem to share materials, and is often aggressive and harms others in the classroom and playground. In every other respect, this child is a delightful and intelligent student – a person who desperately seeks affection and friendships. The teacher makes guesses about what might be going wrong, and runs with it. She makes changes to her teaching as if it were a social skills problem.

If things aren’t going well with all this guessing and adjusting, then the teacher might think that the problem is beyond her range of expertise, and seeks-out consultation with a psychologist, because a psych has more expertise in social, emotional, and behavioural problems. The psych reckons that the teacher is on the right track with the social skills guess, but would like to include a basic hands-on friendship skills programme, where students get daily practise and praise for demonstrating specific friendship skills. The psych might give the teachers some other tips for making changes / adjustments to help develop social skills. The psych wont know for sure, and would need to spend  2 x 90 minutes doing testing activities with the student in order to know exactly what kind of behavioural and socioemtional development is happening for this student. The teacher may need to negotiate a referral to the school’s psychologist with the student’s parents.

The ideal situation is that the teacher and parents are communicating all the way, so that there’s no big surprises with the referral to the psychologist. If it does seem like a surprise, then that’s you’re cue to put more effort and time into communicating with the teacher. If it is a surprise, then ask for an appointment with the teacher and the psych. together to discuss this further with you. [Just like any other appointment, both parents might have to get time off work to attend the appointments.]

When you are all communicating together at the same time then you can negotiate:

(a)   why the psych is involved

(b)   whether the psych is going to pursue assessments or therapy programmes, and what the psych. is going to do and say

(c)   how long the psych thinks this will take, and

(d)   how the psych is going to consult with you after the assessments or therapy.

Good communication is everyone’s responsibility. A school-versus-the-parents mentality is, quite frankly, an immature emotional response. Everyone working together, and committed to ongoing communication, is going to have the best result for your child.

Ali: Are there other professionals that can help children through the school system?

Jane:

    * The doctor [four years study and two years hospital rego]

-         can write care plans for your child that include Medicare-covered service providers (eg. OT, psych., etc.)

-         can refer you on to Medicare-covered specialists (eg. ENT, paediatrician, etc.)

    * The paediatrician [six years study and four years hospital rego]

-         can assess neurological, sensory, behavioural, medical, and intellectual problems

    * The psychiatrist [four years study and four years hospital rego]

-         can assess mental health problems, or pathologies

    * The ear/nose/throat specialist (e.g. for hearing problems), the neurological specialist (e.g. for epilepsy problems), and other medical specialists, generally

    * The speech pathologist [four years study and two years rego]

-         can assess and provide therapy programmes; re. language development, verbal reasoning, and speaking

    * The occupational therapist [four years study and two years rego]

-         can assess and provide therapy programmes, re. non-verbal reasoning involving the senses

    * The developmental or behavioural optometrist [four years study]

-         can assess how the eyeball is developing in relation to the brain parts that interpret visual information

    * The school’s registered psychologist [four years study and two years rego.]

-         can assess behavioural, socioemotional, and intellectual development (within the average range)

    * The clinical psychologist [six years study and four years rego.]

-         can assess mental health problems, or pathology (behaviours not in the average range)

Of course there are many other health and educational professionals. It’s a good idea to ask for a brochure or flyer about the professional your child has been referred to.
 

Ali: What’s the difference between a school’s registered psychologist, and the hospital’s registered speech pathologist and registered occupational therapist?

Jane: I’ll tell you first about the same bits for these three types of service providers. The psych, speechie, and OT, will all be accessible to teachers. There’s no one else – no other professionals/service providers who will meet personally with the teacher upon request in order to discuss the learning progress of a student. Even then, a teacher might have to push-and-shove and make noises to organise a consultation with a psych, speechie, or OT.

The teacher, psych, speechie, OT (all us education and health professionals) are taught to understand how a child develops from birth to eighteen years of age.  How they develop their:

-         behaviour

-         emotional and social expression

-         intelligence

The speechies know way more than the psych. when the problem seems to do with making meaning of words (communication):

-         behaviour to do with words being involved / exchanged

-         emotional and social expression (using words)

-         intelligence (using words)

The occupational therapists / OT’s know way more than the psych. when the problem seems to do with not using words, but using the rest of our intelligence and our senses and perceptions through:

-         behaviour to do with our senses (and not words)

-         emotional and social expression using our sensory perceptions / interpretations (and not words)

-         intelligence via perception (and not words)

Psychs, of course, know everything. Some people say that they are “real know-alls”, but in fact, psychs often refer the child on the other health and educational professionals.

[So, if you’re the sort of parent who is “terrified” about the psych referral, then you’ll wet-your-pants on the referral roller-coaster that may follow.  This is all part of being a parent.  You don’t need anxiety medications, but you might need a bit of support.  I often have appointments with a mum or dad, and their “support person” it’s not weird; it’s quite common.  You might need more communication, and you might need to be more assertive about making communication happen.]