Producer: All right, welcome back to Full PreFrontal where we are exposing the mysteries of executive function. I am here with our host Sucheta Kamath. Sucheta is about to have her second conversation with Dr. Judy Wolman, but before we go there, we are going to talk about a gentleman named Peter Rahal who’s actually from my neck of the woods here in Chicago and is the founder of the RXBar.

Sucheta Kamath: Yes, Todd, I am going to talk about Peter Rahal and his story. So, if you’re a parent, teacher, psychologist, or an SLP like me and you heard someone stay, “School was hell for me. I grew up thinking I was stupid,” how would you feel? And that’s what Peter Rahal, the founder of RXBar whose company is not worth $600 million has said about his childhood experiences, and that breaks my heart. School was never easy for Peter. Noticing his struggles early on in elementary school, Peter’s mother took him to a psychologist and he was diagnosed with a sever case of dyslexia. I’m not really sure; I didn’t come across anything that describes what treatment or intervention he received, but it goes on, all the readings and his interviews I saw, I heard him say that he compensated for the lack of success in the classroom with his talent for sports and in fact, by taking risks and being dashing and bold. Interestingly, later on, his own father, Norman Rahal in his 50s discovered that he too had dyslexia but was never diagnosed. So, college journey was also not very easy for Peter. He did not get in his first choice, Denison University, in spite of being a legacy there, and he was left to that go with the next choice. I think he went to Wittenberg which also was a liberal arts college in the same state which is Ohio, and the article that I read in Chicago magazine, the author writes that it forced him to make it on his own, and he, Rahal found that his dyslexia actually give them some advantages and the top of the list, he is self-aware. So, I think one of the interesting things that Peter talked about in many of his interviews, that because school was challenging, because he never had success or ease with which she learned, he considered himself stupid, and that, considering himself stupid was always a record that played in his head and any failure that came his way became a failure that he met with two mindsets, I think. One is to fight it and rebel against it, or just have this negative record play in his head. After college, he tried to job, he tried to make it out there, he wasn’t successful, he came back. What strikes me about his story, that he had undying passion and a desire to make something and make a difference, and that is what I found that he channeled it and landed up putting together this incredibly innovative product which was a bar, a healthy bar that was not existent and he offered it to a fitness club that he used to go, and from there on, his journey began.

All I’m trying to say is we have people will look back at their lives and they’ve described to being in classrooms and they were not understood or they had failures, and they describe those failures to have a long-lasting impact, and the story ends there – they just don’t seem to have even the diagnosis, for example, for Peter of dyslexia and did not lead to have a successful understanding of self. So, how do we change that? How do we bring a sense of ease and comfort in spite of challenges you experience? How do we provide information? How do we empower students with the right information about the nature of their own brains and its functioning, and its capacity for learning and in what ways can we modify curriculum so that everybody gets a chance to learn? And, that’s what we’re going to talk about. We’re going to talk to Judy again. This is my second episode with Judy and here is a little background about Judy.

Judy Wolman is a psychologist in Sandy Springs area which is here in Atlanta. She specializes in psychoeducational evaluation, family therapy regarding child related issues, and psychotherapy for children and adolescents. She received her PhD in Developmental School Psychology from Georgia State in December 1984. Prior to that, she received her Master’s in Learning Disabilities, and she has a Bachelor of Science in Special Education and Elementary Education from University of Maryland. Judy has been in practice in this area. In fact, her building is right next to mine for almost 30 years. She was previously with the Dekalb County School System for 10 years as a school psychologist as part of a preschool assessment team and as a learning disability resource room teacher. Judy is often invited to speak to many schools and community groups on topics such as behavioral management of preschool and elementary aged children, living happily with preadolescent, building self-esteem, identifying attention deficit and hyperactivity disorder, and learning disabilities, and other topics related to successful parenting. She is an actively involved member of many professional organizations. She is married and has two grown up children, and in fact, she is a proud grandmother as well, it’s a personal connection, as I mentioned in my earlier episodes, is she has been one of my ardent referral sources. She has referred a lot of clients to me and I have referred them back. We have a collegial relationship and a friendship, that is, I have tremendous respect for the work she does in her deep understanding of complexities of learning and educational demands that collectively formulate a child’s journey into their educational life, and she is an integral part of that and I’m very, very happy to know her as a friend.

Producer: Yeah, well, and since last week’s conversation with Judy, had been very much looking forward to today’s conversation. So, let’s get to it. Here is Sucheta’s second conversation with Dr. Judy Wolman.

Sucheta: Welcome back, Judy, it’s such a delight to have you. Let me start with this question: in your experience, what are some of the roadblocks in learning and teaching that have become self-evident in the 21st century?

Dr. Judy Wolman: So, I think that sometimes, parents are hoping that teachers are going to handle the whole educational part of their child’s life, and I think it’s just very important for parents to remain very active in the education of their child so that they can advocate for their child. Sometimes, within the school system, there is a perspective that we can’t test a child when they are young because you won’t be able to diagnose learning disability, and I actually spent 10 years in the school system and now, I’ve been in private practice for a long time, but I do know, I have a foot in both worlds, and because the services that are offered in the public schools are federal dollars, those services are held for students to have a moderate to severe issues, and so children with mild issues don’t get that intervention, and they will be doing things in the classroom to do some modifications in the classroom, but they’re not going to pull a child out for special education services until it is moderate to severe, but as a parent, we are concerned if our child’s issues are mild, and we want to get working on those issues. We don’t want to wait until they become bigger issues. So, often in the school system, they will wait to test a child formally. First of all, until they have tried things on what they call the ‘tier system’ where they put the child through a process of some interventions, but time is going by, and what we now know is that if we get going earlier and intervene sooner when the problem is smaller, they may not qualify for public assistance, but they certainly can respond to private tutoring, and maybe we can make the issue go away sooner. So, I always have to say to parents, if your gut says to you that your child is not reading well, and you see frustration, just that parent gut and go ahead if you can possibly manage it and get testing for your child to find out what is really going on.

Sucheta: And, does that mean that, like you mentioned, mild problems don’t get attention because there are more children with severe disabilities, severe roadblocks have greater needs, and so they get more attention for it is self-evident. Does mild problem – because often in my practice, what I see is people come from two schools of thought. One is, kids will get over it or they will eventually catch up because it’s just they’re kids, they are learning, so why bother? Or, second is, the mild signs are not creating formal roadblocks in learning; they are just oopsies and kind of faux pas, and if you kind of look back, that’s why earlier, you said we take a detailed history. The history is very evident about these problems starting as a young as three years old, so somehow, somebody kind of ignores them. Well, what are your thoughts about how should one think about these problems? When is a good time to start doing something about child’s difficulties?

Dr. Wolman: Yeah, I’m a real proponent and sooner is better. I was getting my hair done the other day and the hairstylist was talking about the grandchild and said that this grandchild does not have many words at age two, and I quickly googled and I said, “This is how many words there should be at age two,” and the person was sort of shocked and said, “Well, they are nowhere near the,” and I said, “There’s programs like Babies Can’t Wait and you can get over –“ the person did not have a lot of funding, but “You can get over to Children’s Healthcare Atlanta,” and they are not going to turn away a child that needs that assessment. So, I’m a big proponent and please don’t wait, please get going. If there’s any little concern in your gut that something is not right, don’t just take one person saying it’s fine. Go ahead and be very sure that you have done what you need to do because we can really make a difference if we get involved with kids and remediation early.

Sucheta: So, when you look at a child and you evaluate their complaints, so to speak, do you then pull out certain test battery or tests that are more appropriate, or does every child who comes for this kind of evaluation gets a standardized selection of test material?

Dr. Wolman: So, it does vary depending on the issue. There are certain things that are standard, so every assessment is going to have a measure of cognitive or intellectual functioning, and every battery is going to have a measure of reading and math, and spelling and writing, but for example, if I’m working with a youngster and I began to question that there may be dyslexia and they are six, seven, eight years old, I’m going to want a very robust measure of their oral reading fluency and accuracy in contrast if I’m working with a youngster and their reading is great that is not the issue, I’m going to spend my time on the issue whether it’s more writing or more math, or perhaps it’s going to be a child where sometimes, it’s social emotional. I’m going to spend more time in that area or more time in attention concentration tasks. So, we start with some of the same critical pieces but then we start taking avenues that look further at the area that is starting to be the area of concern.

Sucheta: So, quickly, can you tell us, if some of these I think social emotional challenges or have early signs of Asperger’s or autism, is there [0:12:35] test that they will receive?

Dr. Wolman: Yes. That would be one of the things I would try to grasp in terms of the original phone contact, and if I’m beginning to hear that there are some concerns in those areas, there are specific tasks. There is one called the ADOS, the Autism Diagnostic Observation System. I’m actually not scale to give it but there is someone else in the practice who isn’t going to probably direct that referral to that person, or if the referral comes in and it’s someone where it’s an older student and there is a sentence that social emotional functioning is the issue, not spectrum, but anxiety, depression, I’m going to sort of shift that referral again to the person in the practice who is more skilled with projective testing. So, part of the important piece is that initial phone call. It’s interesting – I actually make all of my own return phone calls. I’ve been doing that my whole professional career, and part of the reason is I feel like on that phone contact, I’m getting a lot of information and giving a lot of information that needs to be expressed before the testing to make the decisions for that child. So, I just, sometimes, someone is going to say, “Why are you spending all that time on the phone?” I just think it makes a difference in what I do.

Sucheta: Yeah, that makes perfect sense, and so it sounds like this logic will also apply to those kids who are showing tendencies towards giftedness, and so you will do some specialized evaluation for that as well?

Dr. Wolman: Yes, and being attuned – sometimes, highly gifted children can look quirky. We sometimes think, oh, how lucky to be highly gifted, but I always say to the parents of those kids, remember that when a child is two, three standard deviations above the mean, we do so much focus on children who are two and three standard deviations below the mean, who are below a 70 IQ but we kind of think, oh, how lucky for the child with a 130 or a 145 IQ, but they really do sometimes struggle because they don’t necessarily easily find a peer that has some of the same interests. They are sometimes not crawling out of their skin when they have to sit through very mundane instruction. Sometimes, they want only to the interesting things, but they do have to do – you do have to fit and learn to form the letters, and you do have to sit and work on some of the basic phonics even though you can read, you still need to know a few of the phonics rules so that there is some underpinning to that natural ability, and so sometimes, being a highly gifted child is very tough. I always try to educate parents for them to read some things on highly gifted children.

I’ll tell you what is really tough to distinguish, it’s with highly gifted kids, there is something called hyper excitabilities. I’ve had some of these kids flipping cartwheels while we are doing therapy practically, and how to separate that from what is ADHD is it really tough, and if someone takes a little while of really watching it play out because they are busy, but sometimes, they are busy because their brain is going in a productive way rapidly, not in an aimless sort of distractible way.

Sucheta: Got it. So, one more question regarding testing, so why do I find that many students who have had previously been evaluated have not received any measures of executive function as part of their test battery, so academically, they look fine but their complaints have been in the area of executive proficiency, and that doesn’t give any information to the parents or the child, or to the teacher, so it looks like he doesn’t have a challenge but he has executive dysfunction when I evaluate them?

Dr. Wolman: Interesting. You know, it’s there and everything that people are doing, but it’s a matter of sometimes looking at not the product, not the number, but the process that the student went through to be able to say, “I see some difficulty inhibiting impulses or I see some lack of flexibility, or I see that they are disorganized in a way they do a task.” So, it is all there in I think the testing that is being done, but I think you have to be attuned to what you are looking for. It’s interesting – there are many people that don’t diagnose dyslexia because they don’t know. There’s this sort of fallacy that you can’t do it in the public schools, that it’s not, I don’t know, called the D-word, but there are a lot of states now, there’s a lot of federal focus and states are beginning to make sure that that is in fact in the state regulations. Our state right now in Georgia is working very hard to get that word in the material about special education. So, some of the executive functioning is you have got to know what it is to be able to call it, so sometimes, it’s in the test results, just like dyslexia is in the test results but no one knew to call it that, since then the parent isn’t getting that information.

Sucheta: So, that brings me to this question that typically, those that are not familiar with the report from a clinical psychologist or educational psychologist is maybe 16 to 18 pages long, it is dense with amazing fabulous information –

Dr. Wolman: 25 to 30 pages long.

Sucheta: Oh! 25 to 30, yes, I was just being very, very modest, and people don’t know what to do with it. So, what is your expectation when you provide a report, what’s the best way to utilize what you have captured and what advice do you have as to how to read this report?

Dr. Wolman: Hopefully, the conference which is so important will help parents really understand what all those numbers mean. It’s the kind of overwhelming because there’s a lot and while they are sitting in the conference – I remember, even as a mother, the first time the pediatrician said, “Your child has an ear infection,” I went into nonfunctioning status. So, I know that it is stressful. But I think parents, please feel comfortable to make a list of questions once you have been through the conference, and then you have read the report and it’s like, something is not making sense, they need to be able to feel like that document’s content. We don’t want it to be a document it just goes and sits in a file somewhere and does not do anything productive, and hopefully, at the end of every psychologist report are some very clear bulleted recommendations and diagnoses so that it is very clear that they could almost go through that last part of the report and speak with teachers and talk about what it is that they had been told that their child needs, and make it a working document, not just something that kind of gets filed.

Sucheta: I love it. I will tell you a story, you will get a kick out of this. I saw a young man after he bombed his sophomore year, and that he was eventually referred to me, and when I started talking with him, apparently, his first neuropsychological evaluation was done when he was in third grade at by the time he came to see me, he had six or seven evaluations but he had not read a single one because he was never made aware of it, and that is, kind of to me is a terrible disservice. So, what is at the Golden rule?

Dr. Wolman: You know what, when children are in high school, I actually have the conference with Dan and I have the parents function as the peanut gallery, so I literally even structure it so that the student is sitting to my side going through the results and I focus on them, but I will kind of include the parents. So, to me, high school has got to have the data and I say to them, the purpose of this is not to bore you to death. It so that you can learn what you need to do to self-advocate with your teachers and let them know how you learned and what you need. Middle schoolers, I will sometimes have parents say, after I had had the parents through the conference, I’d love for my student to get this information. I will absolutely have them back in for a short session and go through it with them in a less detailed way. The younger kids, I have kind of counted on the parents to pass it forward to their children in terms of what they need, but I would be open to having any child come in and just bring it down to their level in terms of how they learn. Some kids need to know, you learn so well by breaking information on paper and know the laptop computer does not seem to quite do it the same as writing it on paper, or you learn by really repeating this information inside your head again and again, and again, and sometimes, students need to move around the room and talk to themselves while they are putting that information to their mind. So, I think it’s really helpful to help them understand their best way to learn.

Sucheta: You are basically talking about best practices. Every clinician should be really living by this golden standard, I feel, and sometimes, I don’t know what the reasons are, but some people are held back and not comfortable. So, this brings me to two important questions, if one, I have met so many – and you and I live in plant and you are familiar with the cultural private schools here, but I think that a lot of parents who are extremely afraid of this information getting out, so they almost become the gatekeeper of this information and I’m always discouraging them, and I remind them that this is a partnership with your school. What are the reasons you see the character has to share this important valuable information about the child’s learning profile?

Dr. Wolman: I think some people are fearful that their child is going to be labeled, but as I always say to them, you know what, without the document, your child is who is struggling in a certain area of school is actually already labeled. Everyone really knows it isn’t it better if we give them the right information and we give them some direction on what to do about it instead of sticking it into a locked file somewhere away from the school, not wanting them to have that information, and I have to say that a fear in a place where you can’t trust the people that are working with your child to educate them, you are not in the right place.

Sucheta: Great.

Dr. Wolman: I just think it’s critical to be – I think you are right to be a team together. However, I always say to the parents, it is a very private document and you have the right to say to your school, tell me where this document goes, who has access to it? How is it kept private? Because it should be sitting at a teacher’s desk, it should be in a locked file, it should be in a situation where the teacher goes to a set place to sit and look at it. Many of the schools, what I have observed, have a point person who reads it thoroughly, reads the document thoroughly, and that puts together a sort of a working document for the teachers, so that is the piece that is floating around, not the full psychoeducational evaluation, and I think that is a wise way to handle it.

Sucheta: I just love that. I think that is such an empowering way you are educating them to extend that partnership, but also, it is becoming more about the process, and these processes, you don’t get any manuals for parenting and particularly. In the child with any special needs. Another question I have about recommendations, one of my pet peeves, and tell me what you think about this recommendation – is the extended time, but only referring that in the context of children with executive dysfunction who have ADHD, don’t have any learning disabilities or language-based learning disability, or dyslexia, given this extended time which under the umbrella and the child was actually take advantage of the extended time and use that it is time to not get distracted but to read and process information carefully, and it never works. I think there’s a lot of problems in implementation of this suggestion. What is the logic that the psychologists have been right giving extended time?

Dr. Wolman: So, when there is a learning disability and especially when a student has received some remediation and they are trying to use those remedial strategies, the extended time can be tremendous assistance for them, and I always say that it doesn’t help – extended time does not help a student who does not have a learning disability. They are just sitting there for longer, but if the student really got a dyslexic profile, for example, or some sort of a language learning disability, that extra time resulting in a completely different set of scores, and the parents are sometimes nervous about extended time and I go, “Listen, at Harvard, people who are learning-disabled extended time,” and they are probably people who are going to make huge discoveries and make our world a better place. I want them to be able to share what they know, and they may end up working at their lab if they end up going into something in science, they may be there until midnight because they work slower but they might discover a good cure to cancer, so that is where extended time is exactly what the student needs. There are students who it is not that they work slowly and in fact, they are flying through things, and so sitting there twice as long just makes them crawled the wall and it is not the right intervention. We have to help them to learn to be more thoughtful and more reflective. Their strategy is different than just sitting in the room for twice as much time, but if it is the right accommodation for a student, it totally will transform the information that.

Sucheta: Yeah, and I think, I don’t know if this is a confident the level of spirits wanting extended private psychologist is like, “Okay, fine, I see that having value,” I find a disconnect between the student not really recognizing how to utilize that extended time for self. My other question was, some of these – and again, I’m using executive function as a lens – some of the recommendations that I see is when you have a student with difficulty connecting to – organizing work managing themselves. A lot of psychological recommendations are on paper that require implementation were coaching, or implementation of process, but that they don’t receive it because that is not the purpose of the evaluator process, so for example, if the psychologist recommends to take notes in the class will prepare a study guide for yourself or one of the results – I mean, report that everything have John’s create a mental image visualization about the information to be learned. It is a great, but the student doesn’t know how to.

Dr. Wolman: They are going to need a coach.

Sucheta: Yeah, yeah, so what is what to do with this kind of recommendation? And I’m assuming psychologist as you said is provided you that information during that interview.

Dr. Wolman: I would hope that if there is a recommendation, that it is not something that a student is going to be able to implement on their own, that there needs to be a professional recommended to that student who is to be able to teach them how to do it, and because it can be a wonderful strategy but somebody’s going to have to teach them how to do that just the way we teach reading, math, spelling, writing. It’s not something that you can just say, oh, do this. They would have done that if they could’ve figured out how to do it on their own, so you’ve got to find some personnel to implement with the student.

Sucheta: Yeah, and I just find, again some of these poor practices that parents even are involved with words they take the child to the psychologist, they get the report, give it to the school, and they hope that their accommodations are put in place, but they kind of glaze over the rest of the accommodations which is that process specific learning and they never go to the right person to receive that coaching which is kind of [0:28:38].

Dr. Wolman: I think we need more people. I mean, I can’t tell you how often during the week people say, I’d love somebody to work on executive functioning. I mean, how many people can use SERF, we need more people coming out trained in that field. And, not just children, we have adults who need that support too.

Sucheta: So, how do you see, in closing, the work that I do has complemented the work you do, or what, as you just mentioned, there is such a need to teach this, in what ways do you have seen that work for students to develop these abilities outside the classroom or outside the formal educational learning?

Dr. Wolman: I think we need more of it. First of all, I think – and you have that some of these two – I think we need to educate teachers and how to implement executive function organizational strategy, teaching explicitly in the classroom. There are some teachers that know how to explicitly teach something that requires organizational. Let us say writing a term paper and they will do it didn’t very broken to pieces, but the others really haven’t learned how to teach that very explicitly, so I think number one, we need to get educators to know how to implement that, and then I think we need to support people out there that parents can call upon when a child is struggling to not – I’d say it’s not give the fish but to teach the child how to fish, that is the important piece, so that they can go forward in life with this strategy, with the scale, and be independent.

Sucheta: Well, thank you, Judy, so much for what you do and of the way you have explained, and I really appreciate our friendship, and it has been such a joy to have collaborated with you for over 17 years now.

Dr. Wolman: Wow! That’s a long time.

Sucheta: I just can’t believe it!

Dr. Wolman: That’s a long time, Sucheta.

Sucheta: And truly, I’m so grateful for your time and it has been phenomenal to talk with you.

Dr. Wolman: Oh, it’s a pleasure. I just want more of you.

Sucheta: Thank you so much and have a fabulous day.

Dr. Wolman: You too, bye-bye.

Producer: All right, that was Dr. Judy Wolman, yet another great conversation with her, Sucheta. Kick us off with some initial thoughts please.

Sucheta: Yeah, so this kind of conversation reminds me about going back to the bigger picture: what is the 21st century education expect from our children? We are expecting children to manage their learning and they are not required to just memorize things anymore because you can Google it, but what they need to do is in fact manage them themselves. They need to self-regulate, they need to kind of find assignments online, they need to make sure that they are ready for soccer practice, they need to – they are highly booked, highly intensely engaged children with so much demand of their time that they need to effectively process information, organize information, and produce all that they need to produce in a timely way, and it if we keep that at the heart of learning expectations, then we need to really kind of contextualize what the learning difficulties may look like, so that teachers are handling the education of a child that the parents are also supporting it, so collectively, there needs to be great advocacy and relationships built between teachers and parent that kind of speaks the same language and is on the same page. Another thing comes to my mind is for milder disabilities, as Judy was mentioning, the federal dollars are held for children with severe disabilities, and those were doing poorly but their poor performance is obvious, they are failing, they are having devastating academic outcome, and/or they behaviorally are disruptive, so much so that they are more stand out. So, such students may be getting a direct and specific identification, but how about the children with milder issues? And, I don’t mean the issues are negligible, but spent issues are more visible. They are likely to not get the help readily because the skills gap is not evidence yet, and also particularly the clientele are the population I serve which is executive dysfunction, their mismanagement can often be misinterpreted as intentional mismanagement or lack of commitment, is considered a trade, a behavioral trait rather that which is a personality trait rather than a skill, and if you have the framework, that those children are less likely to receive any support or diagnoses. So, that leads me to believe that there is a great disadvantage that is created for those students who are smart, capable but are scattered and those whose smarts have allowed them to circumvent some learning challenges when they were younger but suddenly become less effective in their own performance, and so such students are not likely to be on the radar and that’s why we need strong psycho educational and neuropsychological tests done that Identify these subtle nuances of the child’s performance.

Producer: All right, so when a parent sees that comprehensive psychoeducational report on their child, what do they do with that?

Sucheta: Yeah, so that is a great question, isn’t it? So, we spent last week talking about these complex tests that give you lots of findings, but if you ever have taken a look at this psycho educational or neuropsychological report, they are almost like 13 to 20 pages and there is a description of the battery of tests that have been used, and yes, it takes almost half a day to decipher or go through that entire report. So, let us go back to the beginning: a child enters an educational psychologist or neuropsychologist’s office because there is a barrier in learning and for finding is that they have discovered to unfold the students learning profile that can help guide future decisions about many things, particularly school placement, remediation, accommodation, and any additional suggestions. So, parents need to take the time to read the entire neuropsychological test. They should actually get into a habit of discussing with their psychologist and saying, can you give me a condensed version, a one-page summary that I can share with my child and my teachers? Parents also need to kind a shift their mindset a little bit. I find that particularly in private school, parents are very concerned that they don’t want to share the full report because they believe that will influence the teacher is one way or the other, or the children may actually begin to expect less from my child or will have less respect for my child because now, they have clear evidence of what is wrong with my child, and I’d like to defer because I feel that teachers have already noticed a lot of these things so they don’t need the formal report as much as the formal report confirms their observations and gives them a proper guideline as to what is a true inability, what is a true disability, and what is an ability that is under accentuated. So, that kind of differentiation can be really helpful. Most psychologists will review the report in person and explained many times, explained to adolescent – and of course, you need a little bit of intellectual maturity to understand this. So, not saying that you should be explaining to a six-year-old, but a good psychologist with great practice of kind of simplifying the message can do that really well, and finally, I think the psychologists are experts in assessing and recommending how to create the best environment where the child will thrive. So, why don’t you take that suggestion seriously?

Producer: All right. So, the psychoeducational reports that the psychologists provide, and they provide a lot of different information and school placement, remediation, accommodations and other things, I suspect. Can you walk us through some of these, please?

Sucheta: Yeah, and I think this is the advantage of doing the takeaways, right? I get to elaborate on what Judy was talking about, and so let us start with what are really psychologists, experts, that the school placement? So, if a child is experiencing barriers in learning, then the immediate concern is, is my child in the right environment? Here are some thoughts on the school placement of the psychologists are able to shed light on: educational psychologists are experts in school placement as they understand the child and the right environment that proves to be the most nurturing, and they also our community experts so they know, like for example, Judy does so many or most of the private schools in the metro Atlanta area and she has incredible experience with public schools, so she also knows many public schools in a couple of counties that we cover. So, the parents need to engage in the discussion as they carefully consider the right placement based on the recommendations they receive. For example, after reading the report with parents begin to consider various options, I encourage the parents to explore the school settings. For example, I will say, look at the school that you are looking at – considering – and what is the class size? And what is the student to teacher ratio? Does the class allow or facilitate experiential approach? If the child is diagnosed with dyslexia, for example, does the school provide highly structured and systematic instruction in reading and spelling? So, we don’t want just a great ratio but no specific instruction in in learning the skill sets that will compensate for a learning disability because of dyslexia, and another question to think about is, does it offer any type of curriculum along with the support services to the child receives? So, these are some considerations for school placement.

The second thing you talked about was the remedial services. The report reveals if there is some sort of skills gap, and that it recommends specific remedial services that can bring the skill set at par with their peers where the child is going to operate, so psychologist will recommend something like reading or written language instruction that can be done from outside support. The student – if the student needs a specific multisensory phonetic approach, then the psychologist may say that, you know, why don’t you explore in the mood bell or in Gillingham, or Wilson method? If the student needs explicit systematic instruction in sound-spelling correspondence that compliments the coding instruction, then the psychologist will outline that, and the psychologist not only justice giving these specific types of treatment, but they may give a list of recommended people who provide that as well. So, that is the advantage of getting some specific recommendations about the remedial services. The next thing was accommodation. So, this is an important change that the parents need to understand, that remediation versus modification are two different things, so accommodation is to create an environment which will foster the performance of the child but that is not a skill building necessarily, for example, using a word processor will be a great tool for the child. There are certain schools that are very strict particularly public schools that they don’t allow laptops during test taking, but if the child has specific accommodation, that he can be allowed to use a laptop for typing his papers or answers, and AlphaSmart keyboard is a simple and relatively inexpensive writing tool that can be a great support for keyboarding that can be useful for a child also. There are certain things such as speech recognition software, can be useful as the child goes through rigid work and particularly kind of circumvent the transcription problem that the child often runs into, providing a child books on tape can be a great modification or accommodation. The books on tape can be a great compensation for that child who has tremendous struggles because of dyslexia, and their reading rate may be slow.

So, that’s the kind of modification accommodation we can talk about, and the final thing, the additional services that psychologists look at the bigger picture, so they are not just focused on learning, but what kind of mindset the child has, what kind of social emotional adjustment barriers that these learnings can create, how does the child relate to his peers? So, the psychologist may recommend outside tutor for consistent tutoring at home as the parents are not able to provide for parents and child are running into some conflict because of the way that child thinks the parents are making suggestions about how to study. There can be some things such as [0:41:29] consult for fine motor, for pencil grip, or for things that can help in motor planning that can be improved, or finally, because of the anxiety, isolation, and the distrust the child is feeling, the psychologist can also recommend therapeutic process and give recommendations with counselors that can help remediate that. So, this kind of report is really, really helpful in understanding the big picture of how to go about handling the identified problems.

Producer: Yeah, but as you said earlier, I mean, this is a comprehensive report, lots there. It’s important to be sure you have support and help to help you get through it and understand how to implement all of this because if you don’t, well then, you are not making any improvements in there. That’s a lot to think about. Good stuff.

So, any final thoughts before the wrap this week’s conversation?

Sucheta: Yes, Todd, thank you so much for asking that. Problems are omnipresent and inevitable part of living a full life. Seeing a struggling child or a struggling adult is no picnic. How one moves ahead from there is a real test of personal perseverance. We have come from times or an era where people are expected to pull themselves by the bootstrap, and having challenges was a private and personal matter that induced shame or fear. Things are better now, and they are supposed to get even better. We have neuropsychologists, clinical psychologists, and educational psychologists offering their expertise. The analysis they provide can be of great assets to guide educational decisions and specific and targeted interventions. However, we must be aware of a few systemic challenges. These services are not available to all. In private schools, you have to pay out of pocket and get it done. In public schools, there are protocols and wait time. They are expensive and requires time and eventually may lead to the discovery that there is a lot of work to be done, and more expenses are involved, and so people’s logical brain may want, but their emotional side may prefer not to know. So, that is the tricky balance that one has to strike. So, having information, a report, or a diagnosis is a start and not the end. That is what I would recommend to everybody to be thinking about.

Producer: Good stuff, good, good stuff.

All right, that’s all the time we have for today. On behalf of our host Sucheta Kamath and all of us at Cerebral Matters, thank you for listening today and we look forward to seeing you again right here next week on Full PreFrontal.