We are all familiar with visible disabilities: missing limbs, order profound retardation, blindness, deafness, cerebral palsy, speech handicaps and so on. Children with such disabilities will be provided with special education that addresses their special needs. The community will be understanding and supportive of parents who are raising special children; everyone will try to help.
However, many children are suffering from “invisible disabilities.” These are emotional, physical and behavioural conditions that range from the most mild of dysfunctions to serious handicaps. Teachers may confront these conditions in their classrooms and parents may deal with them at home, without knowing that a disability even exists. Adults may see a child who is “difficult” or “uncooperative” or “unmotivated.” They may see a child who is “inflexible” or “spaced-out” or “over-sensitive.” What they don’t know is what to do about it. Parents raising such children tend to receive criticism rather than support; others assume that poor parenting is the culprit. In fact, various underlying, often genetic conditions, create invisible disabilites.
There are young children who function just a bit behind their age or grade level and who have nothing more seriously wrong with them than immaturity. Their social skills may be lacking and/or their academic performance may be weak. Sometimes social skills counselling can help, but often finding alternate areas of activity and competency can bolster flailing self-esteem. For instance, a socially immature child who receives lessons in art, music, sports, computer programming, cooking, sewing, or any other extracurricular activity, can grow in confidence and self-respect, despite social frustration in the classroom.
Some additional individual attention in academic subjects will often bring immature children to an appropriate level of functioning within a matter of months or a couple of years. Providing this extra help thereby completely removes the “disability.” However, failure to provide the help, can cause the child to remain permanently disadvantaged in the classroom. Not only will his academic performance lag (and thus threaten his adolescent schooling opportunities), but his frustration and boredom may also lead to behavioural and emotional difficulties, actually creating a psychological handicap when there was none to begin with. Similarly, there are some immature adolescents who may need temporary extra help and/or guidance in order to function successfully at the high school level. With such help, they may go on to be outstanding members of the class, and eventually, of the community.
Minimal Brain Dysfunction
An early term used to describe a cluster of behavioural, emotional and intellectual deficits was “minimal brain dysfunction.” The syndrome referred to unexplainable gaps in academic functioning in otherwise normal children. Dylexia (reading disability), discalculaia (arithmetic disability), dysgraphia (handwriting disabilities) and other academic weaknesses were found to exist on their own or in combination with any number of neurological “soft signs” such as fine or gross motor deficits, eye-hand coordination problems, information processing weaknesses, mixed laterality, poor directionality, poor social perception and other symptoms. Today, the term “minimal brain dysfunction” has been replaced with other diagnostic categories such as “learning disabilities,” “auditory processing deficits,” “ADD,” and “ADHD.” In recent times, the nomenclature has included Tourette’s Syndrome with all of its variants of Tic Disorders, Obsessive-Compulsive Disorders, Depression and various other complex disorders of social and cognitive functioning. The field is still evolving and new understandings and categorizations of these dysfunctions will emerge.
Mild and moderate cases of these disorders present themselves as “invisible disabilities.” A child is clearly not functioning up to par. Psycho-educational assessment will often reveal the criteria for a diagnosis of one of the above-named syndromes. Sometimes, a “sub-syndrome” may be postulated – some symptoms exist, but not enough to meet criteria for a formal diagnostic label. In either case, treating the symptoms with appropriate interventions usually yields excellent results. Extra academic support, alternative teaching strategies and occasionally, behaviour modification programmes, can allow the child to prosper within his normal classroom setting. With such help, the child progresses normally and may be able to integrate into the mainstream without further intervention. In more serious cases, the child may require a slightly modified curriculum in addition to the special educational interventions already described. With such help, the child is able to stay within his regular school setting and develop normally along with his peers. Sometimes, psychological support given to the parents and medication or naturopathic treatment given to the child, provides further assistance and ensures the best prognosis. Often, where the child has received appropriate support, the disability becomes a non-issue by the period of adolescence or adulthood. In other cases, the disability remains, but the child has acquired many coping skills and alternate areas of successful functioning that allow him to succeed in life. Only in the most extreme cases of such disabilities, is special schooling required, taking this category completely out of the “invisible handicap” designation.
Disorders of Mood and Motivation
There are also children with a wide range of emotional and behavioural difficulties that become invisible handicaps. The “unmotivated” child may be a perfectly normal youngster who daydreams or has interests in non-academic endeavors. This can also be the “gifted” child who is not sufficiently challenged within the classroom setting. Without intervention, these children may fall further and further behind in their studies. Eventually, lack of academic success may lead to behavioural difficulties, as described above. However, with minimal intervention such as classroom withdrawal for extra academic attention specifically geared to their unique learning style, these children can be redirected to a successful learning path. Bach Flower Therapy offers many remedies that treat disorders of motivation (you can find more information about Bach Flowers online and on this site). In more persistent cases, psychological counselling may be helpful as well.
The “behaviour problem” child may be suffering from low self-esteem, depression, chemical and brain disorders, family problems, problems of impulse control and/or immaturity, or other physical or emotional challenges. Left unattended, this sort of child may enter a cycle of failure in which teachers give up on him and he gives up on himself. Eventually such a child is at great risk academically, emotionally and spiritually. However, in-school treatment can make a huge difference. Extra attention, opportunities to shine both academically and non-academically, behaviour modification programmes can all be combined with outside-school interventions such as psychological counselling, nutritional and naturopathic interventions, medical interventions and so forth. Often, parent counselling is an invaluable component of the child’s wellness programme, as parents are provided with at-home interventions that can impact powerfully on both family and academic functioning. When the needs of the child are met, the best outcome will be achieved.
Similarly, children who have early-stage mental health disorders such as OCD (obsessive-compulsive disorder), anxiety disorders or depressive mood disorders (which can be expressed both as sadness and as intense irritability in children), can be kept in their school environments while special allowances are made for their unique needs. This may involve arranging exemptions for medical and/or psychological appointments, altering curriculum demands or schedules to reduce pressure, and providing extra academic support as needed. Without such support, these disorders may worsen significantly due to intolerable levels of stress. They then become “obvious handicaps” rather than “invisible” ones. However, with support, many mental health disorders will become less disruptive or even improve significantly, enabling the child to lead a normal life.
Being Singled Out
Some parents are concerned that children will suffer from being singled out for special attention within the school setting. As we have seen, greater suffering may result from leaving minor problems unattended. Moreover, it is important to note that children generally enjoy the special attention that they receive. Most children, for example, look forward to spending time with their tutor, therapist, resource room teacher or guidance counselor. These professionals are all trained to make children feel successful. The withdrawal experience is thus a very positive one for youngsters. With parental endorsement and support, youngsters can actually feel privileged to receive this help. Making extra help a normal and common part of school experience by providing it to more children more frequently, will also help to reduce any sense of embarrassment or discomfort on the part of individuals.
Our attitude as a community is very important. We must become comfortable with the concept of providing educational and emotional support for children as a primary intervention. We must also understand that the emotional and behavioural profile of children changes dramatically from the period of kindergarten to the end of high school and beyond. A “wild” six-year-old can turn out to be a well-functioning adolescent and adult – especially if he has received the help he needed along the way. Providing a child with help does not make the child “sick” – but failing to provide that help might very well do so. Sometimes professional assessment is an important part of a child’s health plan. Having a child assessed and labelled, does not “doom” him; rather, diagnosis and assessment guides parents and educators to choose the best interventions to help the child grow up “normal”! Lack of proper assessment can sometimes cause a child to miss the earliest intervention that would produce the best outcome. Moreover, the delay of professional assessment may result in a child with entrenched negative patterns that are much harder to uproot. Parents who refuse to have their child assessed despite expressed concern from teachers, are sometimes functioning like people who are afraid to go to the doctor when they are experiencing worrying symptoms. If they went to the doctor early enough, their health could probably be saved. Refusing to obtain a diagnosis for fear that something will be found, is understandable – but self-defeating. It is the diagnosis that permits the healing to begin!
Our job as parents and educators is to help children develop to their potential. Meeting their unique needs helps accomplish this goal. The more help we give, the less stigma we experience. The more help we give, the less dysfunction will exist. The more help we give, the more adults we can produce who are healthy, whole human beings – the products of our educational system and our community.