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Thursday stream 5 Session 16.10 - 17.25 Length 25 minutes
Gwilym Hosking
Integrated Neurocare Ltd, 234 Great Portland Street, London june@opuscommunications.co.uk
Abstract
There are many reasons why a child may fail in school and many ways in which that failure may manifest. The correct diagnosis or recognition of the cause for failure may be a lottery with diagnostic advice being dispensed across dinner party tables, at the school gate or over the garden fence. Frustrated parents may self refer to the 'expert' they think is appropriate to get what they feel is a confirmation of a diagnosis they have already made - or not. Children who are unnecessarily struggling in school may manifest as naughty children - or sad and withdrawn children - or both. A broad diagnostic approach must always be used for all children because of the superficial commonality of symptoms and behavioural changes. Dyslexia can co-exist with attention deficit disorder, and dyspraxia , or if not, may produce a picture that is similar to the classroom observer. There are a number of other situations ranging from superior cognitive ability to significant social and communication dysfunction to social and environmental trauma and to some medical conditions which only emphasizes that children who are failing in school must have access to comprehensive diagnostic services. Gwilym Hosking has been involved in diagnosing and evaluating children with dyslexia and other neurological problems for the past 25 years. He remains concerned that some children are not receiving appropriate treatment due to the confusions in the diagnosis of dyslexia.
Diagnostic confusion frequently occurs when there are questions raised as to whether a child may have a dyslexic condition.
So often the search for diagnosis and an appropriate remedy will start from an informal setting such as a dinner party, the school gate or following a television programme. It is against this background that it is equally likely that the question may be posed as to whether the child in question has a dyslexia, an attention deficit disorder or a dyspraxia. The choice of professional help will be strongly influenced by which of these three major diagnostic questions are in fact first posed. The difficulty can be that in so many children the outward presentation of the three situations described may be very similar.
Presentations of either a dyslexic condition, primary attention deficit disorder or dyspraxia can have a considerable overlap. Furthermore in at least half of the children with attention deficit disorder specific learning difficulties may also be present and in a poorly quantified number so also may be dyspraxia.
Presentation can be in of any of these situations with failure in school or with bad and oppositional behaviour or with social isolation - or all of these.
For failure in school there are also many reasons and many ways in which failure may manifest, these may include developmental, medical, social reasons or all of these. Any number of professionals may be able to help the failing child or be confronted by the failing child. These may include a teacher, doctor, a member of a specific self-help group, a recommended psychologist, a diet expert or some form of alternative practitioner.
The making of a diagnosis in a setting to which this presentation refers can come with considerable problems. A diagnosis can over medicalise a problem area, can insist that the problem is only educational, can insist the problem is only social, can argue that the problem is totally explained by a single impairment or process and sometimes for various professional reasons or excuses information about a child is not shared nor are opinions between professionals.
As a dyslexia is likely to cause at least a failure in school I would like to consider this problem alongside the primary diagnostic one in relation to dyslexia.
In considering who may be best able to help to evaluate the child who is failing in school or may have developmental, learning or attentional difficulties the question as to which professional is best positioned to get to the bottom of matters, is asked
This doctor's rather incomplete list of potential causes of failure in school may include the following:
The answer to the question as to which professional is best positioned to assist will surely be any number of professionals so long as they are prepared to communicate with others.
In preparing a brief audit of patients referred to the Integrated Neurocare service the following were identified.
The diagnostic confusion that can and do surround a child thought to have a dyslexic condition asks for a number of solutions. The solutions may be three fold.
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