Too little too late -- small garden hose for a big fire!

So much of what we do in special education has to do with being timely. The earlier we detect the learning problems, the earlier we can do something about it.

Unfortunately, early identification and intervention is much talked about and not practiced enough. A non-intrusive and fun screening done at our office which takes less than thirty minutes will often do the trick in detecting “at-risk” young children. This is why we offer School Readiness Screening so parents with young children entering kindergarten can have a chance to be alerted for possible learning problems.

The cost of the early screening is negligible when one considers how expensive LD intervention services can be. If parents allow learning problems to go unchecked, the cost at the end will be far greater. And I am talking about the social-emotional cost which cannot always be measured in financial terms. Many LD individuals suffer from having a low self-esteem as well as other social adjustment problems.

The earlier the LD student receives attention, the more likely the learning problems can be reduced so that they will not suffer unnecessarily.

The logical thing for us to do was to arrange for a full scale assessment by a registered psychologist. If it was purely an academic concern such as reading and/or math, I could have easily done a screening in my office, but the “problem” that was being described had a “behavioral” dimension. So, I called up our trusted psychologist friend who agreed to help me out on short notice. Most psychologists would make you wait for a long time, so I did my prospective client a big favor by lining up an assessment for her immediately!

Unfortunately, all my efforts came to naught. In the course of our first meeting with the prospective client, it became apparent that this mom was not looking for a diagnosis — she was looking for a confirmation from us that her son is, indeed, an “angel” and that the problems were, in fact, the teachers’!

Sorry! I am not “Dr. Feel Good.” So I insisted: the first step to take was to have the boy go for an assessment by our psychologist friend. If the mother’s certainty of her boy’s “angelic” status was valid, then the psychologist’s report would more or less confirm that.

In today’s China, many couples only have one child…and, it is usually a son. This has created a host of societal problems in China. Unfortunately, when people emigrate to Canada, they also take their social problems with them.

The story of “sunshine boy” will surely not end here. More drama will likely follow, featuring irate teachers and a defensive mom and dad.

Ah, what can I say? May God bless the hardworking teachers in Vancouver! Defend them, I plead. Amen.

Posted by Dr. Winnifred Tang

Don’t get me wrong: I love my physician-clients because they are smart and educated and we can communicate on a similar wave length. The problem is that sometimes they hide behind Google and refuse to face the real diagnosis. They just keep “googling” on for an alternative explanation instead of accepting my advice, for which they have paid.

One of the examples that stands out the most from memory is the case of a family with three boys. It was a most unfortunate case: two out of three of the boys had problems. One of the boys had a case of “classic dyslexia” — he was a bright and verbal boy, smart and witty, but once he had to deal with reading text or producing it, he would be extremely anxious. This boy did very well shortly after I took over his case and his parents couldn’t believe their child was able to improve so quickly. However…

The other boy, his older brother, did not have dyslexia, although the parents wished he had. If it was just dyslexia, it would have been a lot easier to deal with compared to what I had suspected he had. The reason? The older brother had what I believed was some sort of child psychiatric issue. This was clearly outside my area of competence and I had advised the parents to arrange for a child psychiatric assessment as soon as possible. “No! Not possible.” was the response. The father, who was a GP, “googled” and “googled” (and that was in 2003, when the web was really dumb and not as intuitive as it is now). One day his diagnosis was autism and another day his diagnosis would be some other big medical term. The problem? Unfortunately, mental illness carries a stigma and the parents did not want to face the possibility that their child might have problems of a psychiatric nature.

It was sad, but a few years later, I saw the boys’ mom and she told me that, finally, they were lining up for a child psychiatric assessment. Less sophisticated clients would have simply taken my advice and sought a medical professional for help.

The problem was: indeed the father was a medical professional, but his specialty was not child psychiatry!

Posted by Dr. Winnifred Tang

Given such an impressive bio, one would expect “big fees” for his services. I was pleasantly surprised! The fee was half of what most providers of psycho-educational assessments would charge. The reason for charging less was simply: why make the children “antsy” and the parents pay more when the job can be done within three hours of testing!

I thought, now here is a person who makes sense.

For my clients with LD children, getting the educational psychologist’s assessment is more a formality than a necessity. As someone with academic credentials at the Ph.D. level, specializing in learning disabilities, I am qualified to diagnose a child for learning disabilities.  When I send a client’s child to the educational psychologist, I have done the diagnosis already and know exactly what to expect. In fact, for my Ph.D. dissertation, I was diagnosing LD children using the low achievement approach to identifying learning disabilities. Unfortunately, in British Columbia, as in many places around the world, there is still a great deal of entrenched thinking regarding the definition of LD: an outdated IQ-achievement discrepancy formula is still widely used.  When the assessment has an IQ component, we must have an educational psychologist to do the IQ testing.

As my Ph.D. supervisor, Dr. Linda Siegel, used to say, excessive testing for children is not good for them: do only what is necessary and leave it at that! Thus, I try to satisfy the school’s requirement for a psycho-educational assessment through exposing the child to the least testing possible while getting the job done.

So, it was. By chance, while having a conversation with my Italian hairstylist at her salon, the topic of psycho-educational assessments came up and she told me of a client that she has who seems to fit the profile of the psychologist I have been so impressed with. At an instant, both our eyes met, and we blurted out in unison the same name. “By George, it is Dr. ____!”

I guess birds of a feather do flock together!

Out here in the “real” world, “end users” such as parents and educators are concerned about “funding” and “labeling.” If there is a name for the problem, there is the possibility for accessing “funding” and getting additional educational support for the child. I can’t blame them for being practical and so, I’ve decided to try and make myself useful by doing a little “Adult Education” here.

Here is a simple “memory aid” for all you confused folks: ☺

1. Educational Psychologists are supposed to be “experts” in testing. They know what tests screen what. They test everything from “depression” to “dyslexia”.
2. Dr. Winnifred Tang, yours truly, has a Ph.D. from UBC in Special Education dealing with learning disabilities. Her doctoral research examined the cognitive profiles of learning disabled children from an ESL (English as a Second Language) background. These are the children with reading disability (dyslexia) and arithmetic disability (dyscalculia).

Simply put: the Educational Psychologists find the problem and I fix it.  That is, if it belongs to my area of specialty, which is dyslexia and language-based learning disabilities.

Dyslexia and dyscalculia are terms used by researchers, academics, and the medical professionals. Educators like to use a broad term, “learning disability”, to describe a range of learning problems ranging from poor reading to poor calculation skills. Note that a learning disability refers only to academic-related skills in the language and numerical domain. A child who cannot do gymnastics is not “learning disabled” nor is the child who cannot sing and dance.

Do I know how to diagnose dyslexia? Of course I can! This is what I was trained to do. And not only that, I can fix the learning problem through educational intervention. Hence my background in Language Education-my master’s research dealt with reading acquisition and the development of writing skills in ESL students- and my interest in using technology in education come in handy.

The disclaimer I have to make here is this: I only diagnose dyslexia and related learning disabilities and I set certain boundaries in my private practice. For example, autism and ADHD are two areas which I am hesitant to venture into and I would accept dyslexia cases with these accompanying co-morbidities on a case-to-case basis.  Also, I diagnose by clinical observation and criterion-based tests. For parents requiring “a piece of paper” with an Educational Psychologist’s signature on it so that they can access services from the school,  I am not the person to see. However, for parents interested in “fixing” the problem, regardless of who pays for what, I may be the person of interest to them.

Now that I have cleared the air, I look forward to working with my colleagues in the school system to help dyslexic children ridden with language-based learning problems to receive timely and appropriate educational support.