Unseen and unheard: Student early diagnosis is critical for success

Terry was sitting in his third grade classroom in the Chicago Public Schools system listening to his teacher talk about a noun as a person, place or thing. He had trouble reading the words as she spoke because he had an undiagnosed learning disability. 

For him and others like him, reading is like finding yourself in a foreign country where you do not know or understand the language, cannot read the signs, cannot understand what people are saying and cannot ask for help or directions.

As a pediatric psychologist, I have worked with thousands of children over the past 30 years at Rush University Children’s Hospital, John H. Stroger Hospital of Cook County and in private practice. 

I came to know Terry (not his real name) through the School Obstacles Screening Clinic as he was referred for an evaluation by his pediatrician because of poor performance in fourth grade.  

He is a sweet, polite, quiet student whose learning difference initially slipped through the cracks. He did not communicate his learning difficulties by acting out behaviorally, as some do.

Rather, his abilities to read, write and understand verbally remained at a kindergarten level, even as he was promoted with his peers from kindergarten to first, second, third and fourth grades.

He was elevated even as required elementary school assessments were conducted each year. At the end of third grade last year, Terry was finally evaluated and diagnosed with a specific learning disability. Even then, the support he was given was not enough for him to succeed.

For most schools nationwide, progress reports are scheduled to be distributed within the next few weeks. In the CPS system, first quarter reports are distributed this month. It is usually the first formal communication about the student’s progress, four to six weeks before the official report card.

For parents, it is the time to contact the school, in writing, if concerned about a child’s progress. It is the time for teachers and administrators to identify struggling students with possible learning differences. 

Most schools have 60 school days to respond once a formal request has been made. For instance, if Terry had received services after his first progress report in first grade, following his first set of standardized tests, he would have been referred for additional support.

Hindsight may be 20/20, but these children do not have the luxury or time for hindsight. These children need to be seen and evaluated now. 

Around the country, more than two million children are diagnosed with learning disabilities. And many are not diagnosed until second or third grades. By then they have already fallen behind their peers. 

According to the Learning Disabilities Association of America, 60 percent of adults with literacy problems have undetected or untreated learning disabilities.These undiagnosed students grow up thinking that they unable to learn, when it is the educational system that has failed them. 

The Every Student Success Act was passed in 2015, clarifying the Individuals with Disabilities Education Act and the resources available. Among the diagnosis that are often missed are dyslexia, writing disabilities, dyscalculia, ADHD, autism, social pragmatic communication disorder and language disabilities.  

Many more students who have not been diagnosed, may have poor attendance, change schools multiple times, repeat a grade or even drop out without graduating. Receiving help in early grades improves the chances that they will succeed in school.

Research shows if students receive the appropriate help by the first grade, 90 percent of them will achieve normal reading ability. In the United States, 1.2 million children repeated a grade in 2014-2015, and 76 percent of these students were never evaluated. They failed an end of the year assessment or specific school subjects, and may have gone to summer school, but still were required to repeat a grade. 

These students will not benefit from repeating the grade; they need to repeat it differently. 

In Chicago and across the country, school administrators and teachers have expressed a commitment to working with students with atypical learning styles. Locally and federally, the education system has a goal to meet students where they are educationally. 

Yet across the country, school systems lack the financial resources and personnel to fulfill this goal. In New York, for example, the largest public school system in the country, one in four students don’t get the full services they’re legally entitled to in their Individualized Education Programs, when they are lucky enough to be evaluated. 

As a result, students — and particularly students of low-income families — may be missed, or over-identified and placed in substantially separate classrooms, as the general education systems may not be sufficiently prepared to meet their needs.

Early universal screening would improve the chances to identify students. Even with Required Elementary School Assessments, so many students are promoted with undiagnosed learning disabilities. 

If these assessments are to work, they need to be reviewed carefully, and students identified and evaluated for relative learning strengths and difficulties. Early universal academic screening is a necessary but insufficient remedy to this problem. More needs to be done.  

According to the American Academy of Pediatrics, early universal screening for the risk of learning disabilities leads to better intervention, improved student performance and less money invested in IEP’s. 

The results of each individual screening need to be evaluated, and individual educational plans proposed early. It is every parent’s right to request evaluation for their child. 

If done well, students will have an early diagnosis of learning disabilities, so no child is advanced year after year unseen or unheard. 

Jeannie Aschkenasy, Ph.D., is a pediatric psychologist at Rush University Children’s Hospital and a Public Voices Fellow through The Op-Ed Project.