Learning about Learning Disabilities. Part One

Perhaps you sense that your child is not performing up to her potential. Perhaps she is struggling academically or doesn’t show the same mastery of age-expected skills as older siblings.  Could she have a learning disability?


For reasons not well understood, learning disabilities are fairly common these days.  This has led to increased interest into the relationship between brain functioning and a child’s ability to cope with school demands.  As a result of many studies, we now know that a child who finds schoolwork hard is not ‘naughty’, lazy or stupid.  We know that even exceptionally intelligent children and those who have the privilege of attending the best schools can still show problems with learning.  But we also know that children with a learning disability are not doomed to lifelong failure.


As a parent, the more you know about learning disabilities the earlier you’ll be able to recognise the symptoms.  This is important because timing can be crucial to addressing and perhaps resolving a problem before school going age, when children begin to find learning hard, lose interest, develop a lack of confidence and even develop unhealthy coping techniques to compensate.


But there is a difference between recognising symptoms of a learning disability and being able to identify and define its nature.  This is where you need a specialist to help you correctly identify the source of the difficulty and know what to do to eliminate it.  Remember that sometimes the symptoms of a difficulty may have no clear connection to the underlying cause.   Steven might have problems with mathematics but hiring a tutor or remedial teacher to help him with his computational problems may not be the solution.  If he has a language processing problem, for example, he may not understand the problems presented to him as ‘story sums’ (e.g. ‘If Betty has seven Rand and loses five ….).  Trying to ‘fix’ a symptom without addressing its source can only lead to frustration and a loss of time (and money).  To the child, such efforts can compound the problem because in spite of trying, they don’t show improvement.  They become discouraged, frustrated and even angry.  Some might begin to act out or withdraw, but either way, the family experiences a deluge of emotions which affects all members.


As a parent, you feel responsible for finding the best solution possible for your child.  But before you seek out the help of professionals, you could try to understand more about learning disabilities so that you can speak to professionals on a more equal footing.  It is also important to project confidence to your child.  If you display anxiety and become stressed because of your concerns, your child will also begin to feel more anxious.  Remember that there is help out there, and you’ll be doing all you can to help in the most effective way possible.


As a start, these articles will give some answers to frequently asked questions. Then I’ll try to outline some of the more commonly encountered causes of various learning difficulties. 


If you miss one of these articles, don’t despair because they are all published on the blog on the Integrated Learning Therapy website.  So visit the website – www.ilt.co.za – to read more about our ILT approach and also to check on any blogs that you might have missed.


We also offer courses to parents, teachers and helping professionals and those are listed on the website as well.


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Raising kids with high self-esteem


Having confidence and faith in oneself is something we all acknowledge to be a positive trait. Success is so often accompanied by self-confidence, a good self-concept and self-esteem.  We visualise those with high self-esteem as walking tall, being able to socialise easily, share their opinions with assurance, ready to assume leadership roles and take necessary risks in life.  They stand up for themselves, are independent enough to resist peer pressure and even escape bullying.  Good reasons for us to consider how children may be helped to develop high regard for themselves.


It starts with the formation of identities.  We have many different identities that we form throughout our lives.  These identities are linked to the roles we have in life as we experience ourselves in different stages and situations. For example, we have all been in the role of a child, a brother or sister, a preschooler, a primary school learner, a soccer or netball player, a reader, and later a boy or girlfriend, wife or husband, mother or father, employee or employer, grandparent, retiree, and so on and on.


As we take on different identities, we evaluate them.  We assess ourselves in relative terms – using others as a comparison.  For example, we compare ourselves to others in the classroom and may conclude that we cannot read as well as most.  That may lead to a negative image of our identity as a reader.  On the other hand, we may compare ourselves favourably in another situation, for example, in art class.  Our identity as someone who draws and paints will be positive.  And we also evaluate ourselves according to how others rate us.  If we hear (or see) approval of some aspect of ourselves from others, we will judge ourselves accordingly.


As we live our lives, it is, of course, impossible to have high regard for every single identity we form.  The important thing is that we have more positive self-identities than negative – especially if the areas in which we score ourselves positively are deemed significant by our particular culture and society.


For this reason, the attitude of significant others to who we are and what we do plays an important role in the formation of high self-esteem.  If we constantly meet with criticism or negative comments regarding ourselves, we don’t have a chance to evaluate any of our identities positively.  This results in the formation of a negative self-concept and low self-esteem with a resulting lack of confidence in our abilities and value.


Young children tend to be naturally confident about themselves but this can quite quickly be undermined by criticism or ridicule from family and teachers.  Sometimes, in the hurly burly of our daily lives, we don’t have time to stop and consider their good behaviours; we only notice when they misbehave, quarrel, make mistakes at school, fail to do their chores, can’t get ready on time and so on.  We react very quickly to annoying behaviours.  What we should be doing is watching out for positive behaviours, successes and achievements no matter how small. Those create opportunities to acknowledge a child and by acknowledging them, we increase their confidence and reinforce their self-worth.


Part of growing up should include opportunities for children to consider their own good points and also hear about these from others.  We can’t all be top of the class, a whizz chess player, the best cricketer and so on and seeming to never shine at anything can be detrimental to the forming of a high self-esteem. But we certainly do all have things we are good at – and every child should be able to name those.


This doesn’t mean that parents should continually give children positive messages to the point of being dishonest.  A healthy self-esteem is realistic.  Children need to be helped to evaluate their identities accurately.  Telling children they are ‘so clever’ when they actually lack academic talent is not helpful.  Rather give them praise for things that they really do well, and support lesser abilities by modelling helpful acceptance of one’s limitations.  A child who accepts that he isn’t able to read as well as others but takes comfort from the fact that he copes well in maths class or is good at making friends on the playground is well on the way to a realistic, positive self-esteem.


Integrated Learning Therapy (ILT)  focuses on unravelling the underlying causes of a child’s failure to thrive at school.  Visit our website www.ilt.co.za to read more about our approach. We also offer courses for parents, teachers and other helping professionals.


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Antibiotics: the good, the bad and the ugly

Antibiotics: the good, the bad and the ugly[1]


A question that interests some health professionals these days is why so many parents worry about vaccines and ponder whether they should be vaccinating their children yet are not at all concerned about giving their children antibiotics. In fact, a number of parents will visit a doctor with the aim of getting a prescription for antibiotics to treat their child’s complaint.   Vaccines are effective in preventing many diseases but antibiotics are becoming less effective – mainly because of their misuse and overuse. 


Apart from antibiotic resistant bacteria growing rapidly and reducing the disease-fighting properties of antibiotics, the use of antibiotics depletes the population of important, ‘good’ gut bacteria in our bodies.  The huge number of beneficial bacteria that we have on our bodies and in our gut is commonly referred to as our microbiota.  The microbiota is essential for our physical and mental health, so destroying large numbers with antibiotics is not good news.


Especially concerning is what antibiotics do to an infant’s microbiota.  Some bacteria in a baby play a critical role in the development of a child’s immune system.  Antibiotic use early in life may raise the risks of allergies and allergic asthma because it reduces the beneficial effects of microbial exposure.  One large study found a link between antibiotic use in the first year of life and symptoms of asthma, hay fever and eczema in children aged between 6 and 7 years.  Early exposure to antibiotics could play a role in the ever increasing rates of food allergies as well.  A study by the University of Chicago recently showed that young mice treated with antibiotics are more likely to develop a peanut-allergy-like condition. Dosing these mice with a certain microbe (called Clostridia) relieved them – seemingly by preventing the peanut proteins from getting into the bloodstream.


One of the biggest problems with antibiotics is that they often bring about almost instant improvements to a state of ill-health.  A child suffering from a painful ear infection will very quickly start to feel better after antibiotic use.  Why is this a problem?  Because when you start feeling better, there are usually a lot of ‘bad’ bacteria still in your system. If you stop taking the antibiotic as soon as you’re feeling better, it gives the bacteria that were able to survive the early doses a chance to go on and develop a full resistance to that antibiotic.  This means the same antibiotic won’t work for you next time. This is why doctors advise you to finish a course of antibiotics.


The problem is made worse because some doctors may use unreliable methods to decide which antibiotic to prescribe. Different bacteria need different antibiotics.  Lab tests should actually be done to ensure the correct antibiotic use.  Even worse than ‘guessing’ is the use of broad-spectrum antibiotics, which target wide ranges of bacterial species, resulting in damage to our entire microbiome and not just the ‘bad’ bacteria we need to get rid of.


Probiotic use in animals


Once upon a time, sick animals used to be treated with antibiotics in the same way as they are used to treat people.  Then, way back in the 1950’s, it was noticed that low doses of antibiotics caused weight gain in livestock.  Increased size means increased value so low doses of antibiotics has become virtually the norm in animal farming. 


This is a practice that is spreading antibiotic resistance.  While high doses of antibiotics kill virtually any bacteria, low doses allow changes that make bacteria a little more resistant so that when the time comes that a particular bacteria is indeed life threatening, we’ve provided it with a means to protect itself and survive. In addition, the surviving bacteria spread throughout the agricultural industry, can jump between one species and another and infect humans.  That’s why the European Union banned low-dose antibacterial use for fattening livestock in 2006.  In South Africa, we can benefit from limiting our meat intake to sources that are farmed free-range and certified to be free of antibiotics.


And lastly, if low doses of antibiotics fatten up our livestock, do they fatten us up as well?  It seems that the answer, although not yet conclusively proven, might well be yes!


Please be cautious about running to the doctor for that ‘quick-fix’ medication.  In the long run, the benefits might be fewer than you think.


Integrated Learning Therapy (ILT) tries to unravel all underlying causes of children’s learning and behaviour problems.  Visit our website to learn more about our approach and find a practitioner near you to help.  We also offer courses to parents and teachers to better understand why children behave in the ways they do.


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[1][1] Most of this content is extracted from the book Follow your gut, by Rob Knight. Published as a TED Book in 2015 by Simon and Schuster.  It is highly recommended reading! If you would like to hear more, you can listen to Rob Knight’s TED Talk, available online at www.TED.com.

Sound safety

Sound and hearing are vital aspects of being human, learning and functioning optimally in the world.  If our ability to hear is hampered, the effects are widespread. A weakened auditory system may result in auditory sequential processing problems. This affects short-term memory – the important ability to link pieces of auditory information.  Auditory processing can also lead to difficulties focusing listening – another symptom of auditory dysfunction.  These weaknesses negatively affect communication, language learning and attention skills.  It seems reasonable, in the light of this, to ensure that your child is ‘sound safe’.


There are two primary forms of hearing and listening impairment[1].  Noise-induced hearing loss (NIHL) occurs when protracted loud sounds damage the inner ear.  The delicate cilia hair cells in the inner ear are destroyed and cannot be repaired.


In addition, stress can interfere with the way we absorb sound. This is called Stress-induced auditory dysfunction (SIAD).  An expert in auditory impairment claims that “Poor listening can begin at any age and for any number of reasons. “It might result from a health problem, an accident, a major lifestyle disruption or from stress.”


Hearing loss, be it noise or stress induced, with the addition of auditory dysfunction, can result in muddled thinking and out-of-balance emotions.  For this reason, we need to become more sound aware.  Sound can be healing, comforting and an aid to learning. In the form of noise, it can also disturb us and negatively affect our functioning. We need to help our children take precautions to protect their ears.


The word noise comes from the Latin nausea meaning seasickness.  Noise generally refers to any loud, unmusical or disagreeable sound.  Your classification of noise will, of course, depend on your subjective opinion.  What you call loud and noisy may reflect your audiological health and personal taste.  What I call unmusical and disagreeable depends entirely on my taste in music; one person’s noise is another’s delight.


Nevertheless, noise damages ears.  Acoustic trauma happens when an extremely loud sound strikes in an instant.  One blast from an explosion can rip apart the ears’ inner tissues, leaving scars that cause permanent damage.  Noise-induced hearing loss (NIHL) develops more insidiously over a period of time.  Repeated or extended exposure to dangerous noise levels attacks the delicate sensory cells in the ear.  Their function is to transport airborne vibrations from the inner ear to the brain.  Without them, hearing is inefficient.  In addition, loud sounds cause constriction of blood vessels in the cochlea, which is the hearing organ in the inner ear.  A lack of a proper blood supply may result in damaging changes in the inner ear.


For these reasons, workplaces try to protect workers from hazardous noise levels, but what is being done to protect children?


In human adults, 80 dB is the maximum sound intensity that will not produce hearing loss.  Above 85 dB, you run a risk of damage which worsens with length of exposure and higher dB levels.


Here is a table showing the decibel levels of common noises:


Watch ticking – 20 decibels

Whisper – 30 decibels

Average conversation – 40 decibels

Dishwasher, microwave – 60 decibels

City traffic – 70 decibels

Noisy restaurant – 70 decibels

Vacuum cleaner – 80 decibels

Busy city pavement – 80 decibels


Then we move into danger zones:


Lawn mower – 90 decibels

Screaming child – 90 decibels

Power drill or chain saw – 100 decibels

Blow dryer – 100 decibels

Car hooter – 110 decibels

Noisy video arcade – 110 decibels

Rock concert – 100–130 decibels

Jet engine at 40 metres – 140 decibels

Jackhammer – 180 decibels


While we can cope with a certain amount of noise (if our auditory system is healthy), we should avoid prolonged exposure.  The next table shows a 1984 standard of noise-level safety based on decibels and time-exposure levels.  It was created for the workplace and the duration per day may be higher than what is truly healthy for your children’s ears.


90 decibels – not more than 8 hours

92 decibels – not more than 6 hours

100 decibels – not more than 2 hours

102 decibels – not more than 1.5 hours

115 decibels – not more than 0.25 or less hours


So how do you teach your children sound safety?   You don’t want to be paranoid but neither do you want them to innocently damage their wonderful auditory systems.  The result of damage is not always hearing loss; sometimes damage substitutes sounds for others and they are replaced with tinnitus, or ringing or buzzing sounds in the head.  Hearing damage is not something to take lightly.


Here are some precautionary measures:


  • Limit exposure to sounds over 85 decibels. If you have to be exposed for longer, wear ear protection. Ear plugs must be worn to really noisy events such as rock concerts or firework displays. Earplugs are made of foam, silicone or wax and are designed to reduce noise levels from between 20 to 30 dB.  Cotton wool doesn’t effectively diminish excessive sound waves.
  • When using headphones, do the following: Keep the volume down. If your child listens with headphones to music with a ten-digit volume wheel set at 4 or higher, hearing loss may result. Limit listening to one hour at a time and let the ears rest. Be very careful if using headphones when exercising.
  • Give the ears a rest. Alternate quiet and noisy activities. Don’t go to a noisy party or club after a loud sports event.


Our ears don’t actually bleed after a blast of fireworks or a rock concert.  That doesn’t mean that we have incurred self-inflicted damage.  Our society is an increasingly noisy one.  Sound pollution means that we have to teach our children to be aware of sound and to practice sound safety.


Integrated Learning Therapy (ILT) practitioners take a keen interest in auditory functioning. If you would like to read more about our approach, visit our website www.ilt.co.za.  We also have a list of practitioners around this country and others.


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[1] Joshua Leeds. 2001. The power of sound. Vermont: Healing Arts Press

Why does my child get carsick?

Why does my child get carsick?


Road trips are great ways to explore and teach children about their country.  Booking family holidays in faraway places is exciting, especially for inland families who look forward all year to joining the exodus to the sea.  But these trips become a nightmare if one of the family is prone to carsickness. In some cases, even a drive to the supermarket is something to avoid. Why do some children suffer from this unpleasant condition? Is it just a passing phase or could it be a sign of something else?


To answer these questions, we need to understand what causes the nausea that characterises carsickness and, of course, seasickness too.  It’s all due to our senses and the fact that the human brain needs input from the sense organs to accurately perceive the world.  Most of our ability to function in the world relies on being able to interpret the messages coming in from our senses.  We are at a distinct disadvantage if our vision, hearing, sense of touch, smell and other sensory organs are faulty, or if our brains are not able to make sense of the messages reaching it from the sensory receptors.


There are, however, more than five senses.  Our sense of balance and movement is vital to being able to operate efficiently in the world.  The receptor for these senses is located in the inner ear and known as the vestibular system.


We don’t use different senses in isolation.  Being able to make accurate perceptions about everything in the world needs cooperation among the senses.  For example, although the vestibular system is able to tell the brain that the head (and of course, the body with it) is moving forward, it uses vision or tactile (touch) information to help confirm how and where the head and body are moving.


This knowledge has led to a theory that has not yet been criticised. It concerns sensory conflict and explains motion sickness as a conflict between the sensory messages coming in from the visual and vestibular systems (and possibly other so called graviceptors of the abdomen) about movements of the head[1].  The symptom of nausea is produced by an incongruity between the messages relayed by the sensors of orientation (position) and those of movement. For example, the visual system of a child sitting in the back seat of a car or a sailor below the deck of a ship detects no movement.  On the other hand, the vestibular system detects movement.  So the brain isn’t able to confirm the acceleration and small shifts in movement detected by the vestibular system and those indicated by vision.  This results in what is caused a lack of coherence between sensory information.


Following conflict in sensory information, central nervous system activity produces successive stages of motion sickness, from drowsiness to nausea.


In the case of children under the age of 8-10 years, the nausea may be as a result of the vestibular system being still underdeveloped.  Although this system is one of the earliest to develop in humans, it continues to develop through early childhood.   For this reason, we don’t need to be too concerned about the possible implications of motion sickness in young children.


If motion sickness continues past early childhood it may signify irregular functioning of the vestibular system (providing there are no visual problems, of course).  This is why carsickness is fairly common in children with learning problems.  The vestibular system is very often implicated in failure to thrive at school.  If vestibular weakness is suspected, there are ways of restoring and improving function.


In the meantime, what to do about the travel sickness?  Vestibular-enhancing medications are available, which are effective in combatting the symptoms.  We also know that reading in a car or on winding roads or when the driver brakes suddenly is not advisable. Rather have the child focus on the distant landscape so the visual system has the same reference as the vestibular system.  This is why sitting in the front seat is often helpful.  When on a boat, make sure the child stays above deck, looking at the horizon. This will ensure that the visual system sees the movement of the horizon which will create the exact same reference as the vestibular system.  Even better, when standing on the deck, make active movements to remain stable, because these motor commands will add their messages to the other sensory information.  When riding in a car, making small movements to coincide with the movement of the car around corners, passing other cars, and so on, will also be helpful.


Hopefully, your child will outgrow car sickness but if not, do consider whether the functioning of his or her balance system might be contributing to the problem.  History tells us that Admiral Nelson was seasick when at sea for his entire life.  I can’t help but wonder about his vestibular system!


Integrated Learning Therapy (ILT) understands the significance of vestibular functioning for successful learning.  If you would like to know more about this approach, visit our website at www.ilt.co.za. We have practitioners listed around this country and others who are able to help you and we offer training to parents, teachers and other professionals to learn more about aspects of our approach.


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[1] Alain Berthoz. 2000. The brain’s sense of movement. Harvard Press.

My anxious child


You may wonder why your child is prone to anxiety. Why she so often resorts to tears, fears and avoidance behaviours. While there are many possible reasons for this, it is sometimes useful to consider the actual development of the brain and how this may contribute to becoming an anxious person.


A principle of brain development that was described by the neurologist John MacLean, demonstrates that the brain develops from the bottom to the top and from inside out.  The more primitive systems, being the brainstem, pons and medulla, develop first. This makes sense because they are our survival systems, controlling unconscious functions like heartbeat, breathing and so on. The systems regulating our emotions (the limbic, thalamus, hypothalamus and so on) develop next. Finally, the cortical systems that act as an executive control centre including decision making, problem solving, attending, controlling impulses and more, complete development at about the age of 25 years. These are the ‘smart’ brain systems.


Brain scans and imaging have shown how the primitive brain systems take over higher systems in situations of danger or threat. This is due to the natural need to enhance our survival and explains why when faced with a threatening situation, we cannot think clearly or act rationally.  Oxygen supply to higher brain systems is reduced so that more oxygen can be directed to muscles and other body parts required to protect ourselves by fighting or running away.  When in imminent danger, we don’t need to stop to problem solve – we need to react instinctively to survive. This summarises the stress responses of fight or flight and is a useful mechanism when really needed.


The downside is that if the stress response is activated too much or too intensely at a very early age (within the first twelve months from birth), the development of neural pathways to the brain’s frontal systems becomes compromised.


The reasons for this are threefold. First, the primitive systems are activated very strongly and stronger wiring in the survival brain systems results in weaker wiring in the higher level ‘smarter’ brain systems. This results in the development of the ‘anxious brain’. Secondly, chemicals are produced that are linked to the primitive brain structures. These chemicals (adrenalin, cortisol and others) are geared towards enhancing primitive survival and inhibit chemicals such as serotonin, which is geared towards smart brain development. Thirdly, ongoing electrical activity (firing between neurons) in the primitive systems strengthen the neural connections so a viscous cycle results – with primitive brain areas being gradually more and more in control with less ability to use the higher level smart brain systems.


This is why a well developing brain needs a safe, enriched environment to develop. Secure, enriched environments downregulate the overactivation of primitive systems that result in an anxious brain developing.  If the child’s environment is compromised, it constantly activates threat or risk of not surviving, leading to the protective behaviours that are seen in stress responses.  It is simply devastating for healthy neural development.  Remember too that it isn’t only an emotionally unsafe environment that can predispose a child to becoming anxious.  Physically illnesses also convey a sense of dis-ease and insecurity so even in the most loving and attentive families, a child prone to illnesses may be at risk for developing an anxious brain.


In order to help, what is needed is a bottom-up approach.  It doesn’t help to ‘talk’ a child out of being anxious.  Remember that the higher brain systems aren’t functioning efficiently.   You are not going to want to discuss philosophical matters while a snarling dog is rushing towards you. The child has to be helped to feel safe both physically (including health) and emotionally.  


Some of the basic needs that should be met in order to promote development and wellness are:

  • The need for control (having our survival needs met, such as being fed when hungry, comforted when distressed) and understanding the situation. The latter refers to a child needing help to appraise a situation and to understand why she feels as she does)
  • The need for attachment (closeness of the primary caregiver; trust)
  • The need for distress avoidance and pleasure maximization. (We are all motivated towards pleasant experiences and avoid unpleasant or painful ones. This includes physical, psychological, emotional or social states, which we automatically evaluate as either ‘good’ or ‘bad’.) A child needs more ‘good’ experiences than ‘bad’ in order to develop optimally.
  • The need for self-esteem enhancement and self-esteem protection. A child needs to evaluate her or his worth as a person as valuable and worthy.  Positive feedback from others and unconditional love are important to developing a healthy self-esteem.


 Fortunately, we know that the brain is plastic and can be changed. Neural connections can be established or weakened so by contributing to the child’s sense of security, her brain can reorganize the neural networks and begin to shift the firing of primitive systems to those of the higher level systems.


Stress is a major factor in children with learning difficulties, which is why Integrated Learning Therapy (ILT) practitioners address signs of stress in our clients.  For more information about ILT, visit our website www.ilt.co.za. We also list practitioners around the country and elsewhere if you are looking for help.  


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