Research shows that children and adolescents with learning disabilities (LD) may experience increased levels of anxiety compared to young people without LD. To date, research findings on this topic are not conclusive because there haven't yet been enough data collected from comparable studies.
Clearly, not every child with LD will automatically experience anxiety. However, common sense would tell us that children who may face daily frustrations, failures, and embarrassment at school would be more likely to worry excessively about academic performance, social status, and prospects for future success than would peers without LD.
What types of situations are likely to evoke anxiety in children with learning difficulties? What kinds of symptoms might signal a parent to seek a professional assessment of a child who is anxious? In this interview three clinical psychologists from the Frostig Center in Pasadena, CA: Drs. Roberta Goldberg, Ken Herman, and Bruce Hirsch, explain these issues. The Frostig Center conducts research, provides professional development, and operates a day school for children from first through 12th grades with learning and attention problems. Among them, these three psychologists have more than 60 years of clinical experience assessing and counseling children with learning and attention problems.
The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders™, text revision, (DSM-IV-TR) devotes more than 50 pages to various kinds of anxiety disorders. For the purposes of this interview, we adopted a working definition of anxiety as: Excessive worry that is interfering with a child's daily activities and/or his enjoyment of life. In this article, practical descriptions of excessive worry in children are provided as examples only, not as a means to diagnose an anxiety disorder in your child.
This is the first of two articles on this topic. The second article focuses on approaches parents can use to help their children with LD who are experiencing anxiety.
Roberta Goldberg: I think all kindergartners and their parents start the school year happy and confident, expecting to be capable and successful. But for children growing up with learning disabilities, that attitude is short-lived, as the first reading readiness activities are introduced into the curriculum. In my intake interviews at the Frostig Center, in my private practice, and certainly in our longitudinal study of children growing up with learning disabilities,1 we note that this is the time that the first signs of anxiety emerge for youngsters with a learning disability. I think I'd call it "the anxiety of not being able to keep up."
As these children enter later elementary grades, the anxiety of not being able to keep up just worsens because the skill gaps widen. The teacher notices, the parents notice, the siblings notice, and of course the child himself starts to notice. This is usually the period of identification of the learning disability, and I think the anxiety of this period is "the anxiety of feeling different." Our study participants reported feeling "stupid," "retarded," or like "damaged goods" about this time.
Ken Herman: Up until a child starts school, he is certainly "the sparkle in his parents' eyes." Then he gets into school and he starts comparing himself with others and, all of a sudden, he starts to realize he's struggling. Early in the elementary years the stress really rises for children with learning disabilities. And developmentally they don't have a whole lot of coping skills, so they have very limited means of dealing with the stress. Typically, parents don't suspect a learning disability yet, so they think the child just isn't trying hard enough.
The children themselves can't tolerate the fact that they can't do something that they think they should be able to do. They know they saw it done in class that day where it was discussed at length. If they're older they maybe took a note or two, but they can't read their notes very well. They can't take the information from school to home and duplicate it. As soon as the external structure of the teacher's words leave, the child can't retain that structure, and it just crumbles.
Bruce Hirsch: For many of the kids I see, anxiety is probably part of their temperament, part of what they were born with. The anxiety may wax and wane some, but these kids tend to be anxious by nature. When you have a kid who has always been anxious, if he has been coping with that and he's used to that, I would probably wait longer before bringing him in for treatment. But, where anxiety comes on suddenly and unexpectedly, I would want to know what's going on here, what's causing this?
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