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Sheldon Horowitz, Ed.D.

Sheldon Horowitz, Ed.D., is the Director of Professional Services at the National Center for Learning Disabilities (NCLD). Prior to his arrival at NCLD, he directed hospital-based evaluation and treatment programs in psychiatry and developmental pediatrics as well as taught at the primary, secondary, and college levels, and he served as a consultant to school districts throughout the New York City metropolitan region. He has published in the areas of fetal alcohol effects in children, language-based learning disabilities, disorders of hyperactivity and attention, and has authored a number of Web sites in the area of learning disabilities. Dr. Horowitz is a regular presenter at professional conferences and is frequently cited in the popular press on topics including parenting children with learning disabilities and other special needs, attention deficit disorder, assessment and evaluation, research-based interventions, parent advocacy and special education policy reform, and learning disability throughout the life span. He spoke with us in June, 2003.

• What is a learning disability? What are the different types of learning disabilities?
• What causes learning disabilities?
• What, if any, connections exist between learning disabilities? Do they have anything in common?
• Don't all people have some form of learning difficulty? Aren't learning disabilities simply a matter of degree?
• How can a parent determine if a child has a learning disability?
• What can parents do once their child is diagnosed? Where can they go for help?
• What kinds of medical, behavioral, and holistic treatments are available? What are the pros and cons of each type?
• What kinds of financial costs might parents face as they seek help for a child?
• What if parents live far away from the care their child needs? What can they do?
• What is an IEP, and what can parents expect from the IEP process?
• What can parents do if they feel a school system is not following their child's IEP?
• What can parents do when they believe their child is struggling in school but have been told the child does not qualify for special education?
• What are the pros and cons of having children repeat grades? Who is responsible for the decision to hold a child back?
• What should parents keep in mind when talking with a child about his or her learning disability?
• How might a parent's own learning disability impact how he or she responds to their child?
• What kinds of assistive technologies are available?
• What are researchers learning about the nature and treatment of learning disabilities? What research looks most promising?

What is a learning disability? What are the different types of learning disabilities?

Sheldon Horowitz, Ed.D.: A learning disability is a neurological disorder that affects the brain's ability to receive, process, store, and respond to information. The term "learning disability" is used to describe the seeming unexplained and unexpected difficulty a person has in acquiring basic academic skills. These skills are essential for success at school and work, and for coping with life in general. A learning disability is not a single disorder. It is a term that refers to a group of disorders.

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What causes learning disabilities?

Sheldon Horowitz, Ed.D.: Experts aren't exactly sure what causes learning disabilities. Some possibilities include:

• Heredity: Often, learning disabilities run in the family, so it's not uncommon to find that people with learning disabilities have parents or other relatives with similar difficulties.
• Problems during pregnancy and birth: Learning disabilities may be caused by illness or injury during or before birth. It may also be caused by low birth weight, lack of oxygen, drug and alcohol use during pregnancy, and premature or prolonged labor.
• Incidents after birth: Head injuries, nutritional deprivation, and exposure to toxic substances (i.e. lead) can contribute to learning disabilities. Learning disabilities are NOT caused by economic disadvantage, environmental factors, or cultural differences. In fact, there is frequently no apparent cause for learning disabilities.

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What, if any, connections exist between learning disabilities? Do they have anything in common?

Sheldon Horowitz, Ed.D.: It is estimated that 80% of individuals with learning disabilities have their primary area of difficulty in reading. Sometimes people have more than one learning disability. In addition, approximately one-third of people with learning disabilities also have attentional problems —attention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHD) which makes it difficult for them to concentrate, stay focused, or manage their attention to specific tasks.

The National Institutes of Mental Health has estimated that approximately 3% to 5% of school-aged children have ADHD. ADHD often occurs in combination with learning disabilities —reading, spelling, writing, arithmetic, and language problems, as well as social and emotional problems.

According to the National Institutes of Health, up to 15% of the US population has significant difficulty learning to read. Dyslexia can have different effects on different people, depending on the severity of the learning disability and the success of efforts to develop alternate learning methods. Traditionally, dyslexia causes problems with reading, writing, and spelling and those problems manifest themselves differently in each person.

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Don't all people have some form of learning difficulty? Aren't learning disabilities simply a matter of degree?

Sheldon Horowitz, Ed.D.: No. A learning disability is a neurological disorder that affects the brain's ability to receive, process, store, and respond to information. A person can be of average or above-average intelligence, not have any major sensory problems (like blindness or hearing impairment), and yet struggle to keep up with people of the same age in learning and social situations.

Learning disabilities are characterized by a gap between the level of achievement that is expected and what is actually being achieved. They become apparent in different ways with different people and manifest themselves differently during different stages of development. They can also affect social-emotional skills and behavior.

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How can a parent determine if a child has a learning disability?

Sheldon Horowitz, Ed.D.: A critical first step is to gather information about your concerns and share them with others. Teachers, physicians, tutors and even other family members can be invaluable sources of information about your child's areas of strength and weakness. Once you can share your concerns (and give examples whenever possible), help is not far away.

Parents as well as teachers and other professionals can recommend that your child be evaluated, and the school must get your explicit written consent before an evaluation can happen. If school personnel do not feel that testing is warranted, they must inform parents in writing and explain their reasons. Parents who disagree can request a due process hearing and present their case to an impartial hearing officer.

Once it is decided that your child needs to undergo a formal evaluation, the Individuals with Disabilities Education Act (IDEA) ensures that your child can be evaluated (at no cost to you, if you chose to have the school district take the lead) to determine if he or she is eligible for special education and related services. The evaluation must take into account the information you have gathered, including feedback from teachers, and is comprised of a number of different tests and screening measures that sample skills and behaviors in all the areas that may be affected by the suspected disability. Once the evaluation is done, a meeting is held to share all the findings and to recommend a plan of support, which may or may not include special educational services.

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What can parents do once their child is diagnosed? Where can they go for help?

Sheldon Horowitz, Ed.D.: At the post-evaluation meeting (sometimes called a CSE —"Committee on Special Education"— meeting) parents and school personnel create an Individualized Education Program (IEP) that details reasonable learning and behavioral goals for your child and states the services that the school district will provide and how attainment of these goals will be measured. This meeting must be held within thirty school days after your child is found eligible for special education services.

You and your child have the right to participate in the development of the IEP, along with your child's teachers, a representative from the school administration who is qualified to recommend and supervise special programs and services, representatives from other agencies that may be involved in your child's transition services (if your child is age 16 or older), and a parent of a child receiving special education support. You are also free to invite other people to this meeting if you think they can be helpful.

Think of this meeting as an opportunity to get your child the help he or she needs to succeed in school, and know that services must be provided in the least restrictive environment possible. This means that, to the fullest extent possible, your child should receive instruction and support with classmates who do not have disabilities. Also be aware that your child is entitled to special education services or supports to help them participate in extracurricular activities such as clubs and sports.

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What kinds of medical, behavioral, and holistic treatments are available? What are the pros and cons of each type?

Sheldon Horowitz, Ed.D.: There are no known medical treatments for reading, writing, and math related learning disabilities, and when it comes to "alternative" types of therapies, consumers beware! The best way to understand and treat learning disabilities is head on, with targeted screenings and assessments, and focused, intensive, and explicit instruction. There are many different treatments that are being advertised as "effective," and it's best to consider each one carefully before investing time and expense. If in doubt, ask for help from an expert at either a university or hospital-based evaluation and treatment center or through a national organization like the National Center for Learning Disabilities, the International Dyslexia Association, or the Learning Disabilities Association of America.

If you think your child may have an attention deficit disorder, you should contact your child's physician and ask for help. ADD and ADHD cannot be "cured" but can be controlled, often with medication and even more effectively with a combination of medicine, behavioral therapy, and educational support. For more information, visit the National Resource Center on ADHD Web site.

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What kinds of financial costs might parents face as they seek help for a child?

Sheldon Horowitz, Ed.D.: Special education services, if delivered through the public schools, are "free" to parents and children (our tax dollars hard at work). Parents who choose to enroll their children in private schools will have to bear the burden of tuition but should inquire about financial assistance, as many will offer some level of scholarship based on financial need. Parents may also arrange for out-of-school tutoring, counseling, or therapy and will need to bear these related services costs as well. It would be wise to check with your medical insurance carrier, as a number of companies provide some limited coverage for these services.

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What if parents live far away from the care their child needs? What can they do?

Sheldon Horowitz, Ed.D.: Finding the right kind of help can be the single most challenging hurdle a parent needs to overcome. Parents should talk to their child's teachers and to others (e.g., psychologist, social worker, speech/language therapist) in the school district as well as to their child's physician and others who have worked with this child. The "Resource Locator" on the National Center for Learning Disabilities (NCLD) Web site offers an efficient way to search for resources in your area as well as state agencies and national organization with state and local chapters.

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What is an IEP, and what can parents expect from the IEP process?

Sheldon Horowitz, Ed.D.: Children with disabilities have the right to receive instruction and support designed to meet their specific needs. In the case of infants and toddlers, these needs are documented in an Individualized Family Services Plan (IFSP) and focus on the early developmental growth of the child; for children age three and older, service and support plans are stated in an Individualized Education Program (IEP). These plans outline:

• The child's current levels of development
• The outcomes expected to be achieved for the child over a specified period of time
• The services that will be provided to support this growth
• When and where these services and supports will be provided
• When the plan will be reviewed and updated

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What can parents do if they feel a school system is not following their child's IEP?

Sheldon Horowitz, Ed.D.: Parents or guardians have the right to be included in making any decisions about their child's educational needs and services. This includes appealing or consenting to any decisions made through the evaluation and assessment process.

An IEP meeting must be held once a year, and a comprehensive re-evaluation must be done every three years. However, you may request an IEP meeting at any time. Be sure to attend these meetings, and be prepared to be an active participant. In the event that your school district fails to follow the IEP developed for your child and is resistant to working with you toward a speedy resolution of your concerns, you may choose to seek legal advice. Options include mediation with an impartial third person, a more formal due process hearing, or a formal hearing in a court of law.

Most states have legal services specializing in disabilities advocacy. To find assistance in your state, visit the "Resource Locator" on the National Center for Learning Disabilities (NCLD) Web site.

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What can parents do when they believe their child is struggling in school but have been told the child does not qualify for special education?

Sheldon Horowitz, Ed.D.: This can be a very frustrating situation for parents and for the school. Everyone wants the child to succeed, but sometimes, people's best intentions fall short of taking steps to address the child's needs. Perhaps due to a lack of resources, a system that doesn't allow for flexibility in classroom instruction, or because the child's evaluation scores do not meet the threshold for special education classification, the trajectory toward help shifts into idle, or worse, grinds to a halt. Parents could explore a number of options:

• If the school district is reluctant to conduct an initial evaluation, don't take "no" for an answer. Parents cannot be denied access to having their child evaluated for suspected learning disabilities.
• If you disagree with the school district's evaluation, consider having an outside evaluation at private expense. (Note: If this outside evaluation provides new information to the school that now makes the child eligible for services, the parents should be reimbursed the expense of this testing.)
• Look for alternate ways to get your child the needed help. For example, consider setting up a schedule of in-school help with teachers or peer tutors, or having teachers provide you with a structured program of materials to review at home.
• Be sure to discuss what kind of assistive technology devices -- such as speech recognition software, electronic organizers or books on tape -- could help your child. Assistive technology services include evaluating your child for specific devices, providing the device, and training your child to use the device.

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What are the pros and cons of having children repeat grades? Who is responsible for the decision to hold a child back?

Sheldon Horowitz, Ed.D.: There are different schools of thought on this topic, and there is no single way to generalize when repeating a grade is the right or wrong thing to do. The decision must be made only after considerable discussion and the gathering of different kinds of information, including the child's overall cognitive and emotional development, rate of learning, language skill, prior experience, home environment, and previous school profile. As a general rule of thumb, efforts should be made to keep children with their age- and grade-appropriate peers. The decision to recommend grade retention should always be child-specific and so should always be made on an individual basis.

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What should parents keep in mind when talking with a child about his or her learning disability?

Sheldon Horowitz, Ed.D.: Parents should help children overcome their fear of being "discovered" (a process that parents need to undergo themselves) and work with them to see their areas of strength and talent, not focus on the aspects of their lives that are filled with challenges and frustration. Parents should help open lines of communication with and for their children so they can communicate freely at home and with school personnel. Also important is to keep expectations realistic but high, to provide encouragement and positive and constructive feedback, and to set goals that are attainable and can help their child experience and measure progress, even if this is only in small steps along the path to larger accomplishments.

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How might a parent's own learning disability impact how he or she responds to their child?

Sheldon Horowitz, Ed.D.: Imagine what a relief it could be for a child to realize that their parent knows exactly how they feel because they struggled in school too! All parents, including those with a learning disability, can help their children feel special and can pave the way for them to be effective self-advocates in school and in the community at large. Research has shown that successful adults with learning disabilities are those who were able to talk about their disability and explain the kinds of supports and services they needed to succeed. It turns out that they are also individuals who were able to create a network of support around them so they could turn quickly and efficiently for help with challenges in a variety of settings including home, school, and on the job. It's never too early to start developing these attributes for success. Parents, as their child's first and most important teachers, are in the unique position to help start their children off on this path to independence.

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What kinds of assistive technologies are available?

Sheldon Horowitz, Ed.D.: "Assistive technology" is a term used to describe different devices — such as speech recognition software, electronic organizers or books on tape — that are often helpful to children with learning disabilities. Be sure that, if these types of supports are offered to your child, there is a trial period of training and support. The last thing you want to do is arrange for your child to have a tool or system that supports learning, only to find that it is more annoying than helpful or is helpful only in certain ways and at certain times.

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What are researchers learning about the nature and treatment of learning disabilities? What research looks most promising?

Sheldon Horowitz, Ed.D.: Some of the most exciting current research is not so much in the area of learning disabilities per se but in the area of learning in general. Ongoing work through the US Department of Education, Office of Special Educational Programs (OSEP) and the National Institute of Child Health and Human Development (NICHD) has made available a growing body of information about reading, math, classroom grouping, peer learning strategies and other ways to deliver research-based instruction in classrooms. These findings will certainly have a positive impact on all students in general and hold enormous promise for students with learning disabilities and others who struggle to learn. Our challenge is to find ways to "close the gap" and to create (and support) the systems and conditions that will enable these research findings to become part of every teacher preparation program and every classroom curriculum.

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