Understanding Dyslexia: A Comprehensive Guide

September 3, 2024 Vanessa Scarborough

Dyslexia is a common but often misunderstood learning disability that affects reading and language processing. This blog post aims to shed light on what dyslexia is, how it impacts individuals, and effective strategies for managing it. We will also explore some reputable sources for further reading and support.

What is Dyslexia?

Dyslexia is a neurological condition that affects the way the brain processes written and spoken language. It is characterized by difficulties with accurate and/or fluent word recognition and by poor spelling and decoding abilities. According to the International Dyslexia Association (IDA), dyslexia is not related to intelligence or vision problems, but rather to how the brain processes language.

Key Characteristics

Individuals with dyslexia may experience:

Difficulty reading fluently: Reading slowly and with many errors.
Struggles with spelling and writing: Spelling words incorrectly and having poor handwriting.
Problems with phonemic awareness: Difficulty recognizing and manipulating sounds in words.

Causes and Risk Factors

Dyslexia is believed to have a genetic component, meaning it often runs in families. The exact neurological basis is still being studied, but researchers believe that differences in brain structure and function play a role. According to the National Institute of Neurological Disorders and Stroke (NINDS), studies using brain imaging techniques have shown that people with dyslexia have differences in the areas of the brain involved in reading.

Diagnosis and Assessment

Early diagnosis is crucial for effective intervention. The process typically involves:

Educational assessment: Evaluating reading skills, language processing, and academic performance.
Psychological evaluation: Identifying any co-occurring conditions, such as ADHD or anxiety, which may affect learning.

The IDA emphasizes the importance of using a comprehensive assessment to determine the presence of dyslexia and tailor interventions accordingly.

Intervention and Support

Effective interventions for dyslexia often include:

Structured literacy programs: These programs, such as Orton-Gillingham and Wilson Reading System, focus on explicit, systematic instruction in phonics and other reading skills.
Accommodations: Such as extra time on tests, audiobooks, and assistive technology.
Support from educators and specialists: Working with teachers who are trained in dyslexia can make a significant difference.

The National Center for Learning Disabilities (NCLD) provides numerous resources and guides for both educators and parents to help support students with dyslexia.

Coping Strategies

For individuals with dyslexia, coping strategies can include:

Using technology: Tools like text-to-speech software and electronic organizers.
Developing strong study habits: Breaking tasks into smaller chunks and using multisensory learning techniques.
Seeking support groups: Connecting with others who understand the challenges can be very beneficial.

Conclusion

Dyslexia is a complex condition, but with early diagnosis and appropriate intervention, individuals with dyslexia can achieve success in reading and other areas of life. By understanding dyslexia and utilizing available resources, we can better support those who live with it and help them unlock their full potential.

Feel free to reach out at drvscarborough@gmail.com or (410)343-9704 if you have any questions or need further information regarding dyslexia.

IMPACT OF SOCIAL MEDIA

March 20, 2024 Vanessa Scarborough

Highlights from Dr. Jonathan Haidt regarding social media use:

Members of Generation Z are suffering from anxiety, depression, self-harm, and related disorders at levels higher than any other generation for which data is available. Recommended new norms include the following-

No smartphones before high school
- A norm of delaying constant internet access until ninth grade would help to protect adolescents during the very vulnerable first few years of puberty.
No social media before 16
- If the majority of adolescents were not on these accounts until they are 16, families and adolescents could more easily resist the peer pressure of opening accounts so they can keep up with posts and gossip.
Phone-free schools
- Schools that have gone phone-free always seem to report that is has improved the culture, making students more attentive in class and more interactive with one another. Published studies back them up.
More independence, free play, and responsibility in the real world
- Parents are encouraged to replace screen time with real-world experiences involving friends and independent activity.

OUT-OF-NETWORK BENEFITS: What are they and how to use them

January 12, 2022 Vanessa Scarborough

1. Check your out-of-network benefits

These can typically be found in the Summary of Benefits, included in a member information packet or on your insurance company website. Keep an eye out for these terms:

Out-of-network deductible: This is the amount of money you have to pay before you are eligible for reimbursement.

Let’s say your out-of-network deductible is $1,000, and your insurance company pays for 100% of services after you meet that amount. That means you’ll have to pay $1,000 out of pocket, after which you’ll have “met your deductible.”

In this scenario, if you spend $2,500 on services, you’ll have to pay $1,000 out of pocket, but a portion of the remaining $1,500 will be reimbursed to you in the form of a check (mailed to you after you submit your claim). Deductibles reset every calendar year, and any health expense you pay out-of-pocket contributes to meeting it.

Coinsurance: This is the percentage of the service fee that you’re ultimately responsible for paying.

If the evaluation costs $2,500 and your coinsurance is 25%, you are responsible for paying $625. Just remember that this comes in the form of a reimbursement: you’ll need to pay the full $2,500 upfront, then your insurance will send you a check for $1,875 , once you have met the deductible and submitted a claim.

Some insurance companies determine an “allowed amount,” which caps the evaluation fee that they will cover. If your insurance has determined $1,500 is their “allowed amount” per session, at a 25% coinsurance rate, your insurance company will still only reimburse you up to $1,500, no matter what the evaluation fees are. In other words, if your insurance has an allowed amount of $1,500 but your evaluation fee is $1875, you will not get reimbursed more; you will still be reimbursed $1,500, and will be ultimately responsible for $1,000.

2. Call your insurance company to verify your benefits

The best way to be sure of your benefits is to clarify with your insurance company member services line. You can find this phone number on the back of your insurance card or through your online insurance platform.

Ask these questions when speaking to your insurance company about benefits:

How much of my deductible has been met this year?
What is my out-of-network deductible for outpatient mental health services? (Outpatient means treatment outside a hospital.)
What is my out-of-network coinsurance for outpatient mental health?
Do I need a referral from an in-network provider to see someone out-of-network?
How do I submit claim forms for reimbursement? (Claims are forms that are sent to your insurance company to receive reimbursement for sessions you paid for out of pocket.)

3. Ask your provider for a Superbill

After making your payment you can ask your provider for a document called a Superbill. This document will include the codes and fees for services rendered and should be sent directly to your insurance company in order to receive reimbursement.

What is executive functioning?

February 7, 2020 Vanessa Scarborough

You may have heard of the term “executive functioning” and wondered what that meant. Executive functioning refers to a broad group of mental skills that enable people to complete tasks and interact with others. These skills include working memory, planning, organization, problem solving, shifting, controlling emotions and behavior, and response inhibition. Essentially they refer to an individual’s “doing skills”. These are skills that we use everyday such as:

Making plans
Keep tracking of time and finish work on time
Keeping track of more than one thing at once
Evaluating ideas and reflecting on one’s own work
Asking for help or seeking more information when needed
Making mid-course corrections while thinking, reading or writing

These skills are typically more difficult for a child, adolescent or adult with ADHD who usually already struggles with forgetfulness, losing things or an inability to focus. Therefore, carrying out executive functioning skills can be very challenging for those with ADHD. In addition to individuals with ADHD, executive functioning challenges are also common in other mental health disorders such as obsessive-compulsive disorder (OCD) and Autism Spectrum Disorders (ASD).

So how can executive functioning skills be improved? There are many strategies that can be implemented to help improve difficulties experienced due to weaknesses in executive functioning. Some of these include:

Using visuals (e.g., white erase board) to jot down morning routines/chores/etc.
Utilizing simple planners to keep track of assignments/due dates/deadline
Setting timers to assist with time-management
Setting alarms to hep with remembering daily activities (e.g., taking medication, getting up in the morning, etc.)

How can a neuropsychological/psychological evaluation help if I think that I/my child has executive functioning difficulties? An evaluation can help identify executive functioning weaknesses through formal assessment of these skills using neuropsychological tests created to measure executive functions (e.g., working memory, cognitive flexibility, planning/organization, etc.). Additionally, individuals, parents/caregivers, and/or teachers are also asked to complete rating scales to assess the individual’s executive functioning skills. Lastly, careful observation of executive functioning skills (e.g., approach to a task) is also conducted throughout the evaluation process. All of this information is collected and analyzed to determine if there are weaknesses in executive functioning and more importantly what specific areas of executive functioning are impacted. Given the complexity of executive functioning, it is not uncommon for an individual to have weaknesses in only some executive functions.

IF YOU BELIEVe THAt you/YOUR CHILD IS STRUGGLING WITH executive functioning CONTACT DR. SCARBOROUGH Today TO DISCUSS YOUR CONCERNS.

ADHD Testing-What is included in an evaluation to determine if someone has ADHD?

November 21, 2019 Vanessa Scarborough

What is included in an evaluation to determine if someone has ADHD? The first step is a clinical interview also referred to as a diagnostic interview. During this appointment the clinician will gather information about your/your child’s family, birth, developmental, school/educational, work and psychosocial history. The individual’s history is important because it can provide information about ADHD risk factors. For example, it is important to gather family history because there is a genetic component to ADHD. Meaning that it often runs in families. (e.g., 30-50% of 1st degree relatives of children with ADHD also have the disorder). Other factors also increase the risk of ADHD including environmental risk factors such as prematurity, birth complications, maternal smoking, lead exposure/toxicity, and moderate to severe brain injury. During the clinical interview information about current concerns /problems are also reviewed. This information along with background history is then used to determine if testing is warranted. The clinician will also request school records, pertinent medical records, and any previous testing to review as part of the evaluation.

After the clinical interview is completed the testing session is scheduled. The testing is scheduled on a separate day and usually takes anywhere from 3-5 hours depending on the individual’s age as well as presenting concerns. As part of the evaluation, parents, other family members, teachers/supervisors may be asked to complete rating scales assessing the individual’s attention and behavioral functioning. It is important to gather information about the individual’s functioning across settings (e.g., home, school, work, etc.) to gain a better understanding of how the attention problems are affecting the individual. Throughout the testing session the clinician is also observing the individual. How someone approaches a task is just as important as how they actual perform on the task! The clinician is also observing other aspects of the individual’s behavior such as distractibility, ability to stay focused, need for redirecting, fidgeting, and restlessness.

The clinician reviews and analyzes the information gathered during the clinical interview, records obtained (e.g., school records, previous testing, etc.), ratings scales, results from tests administered, and observations made throughout the testing session to determine if the individual meets criteria for ADHD. The clinician’s diagnostic impressions are shared with you the day of testing.

Approximately 2 weeks after the evaluation is complete, you will receive a report that includes all of the background information gathered, behavioral observations, test results, diagnostic impressions, and most importantly recommendations. Recommendations are provided to help support the individual in all setting including home, school and/or work (e.g., preferential seating, scheduled breaks, extra time, reduced work load, etc.). Resources including books, workbooks, websites are also provided.

IF YOU ARE/YOUR CHILD IS STRUGGLING WITH ATTENTION PROBLEMS AND/OR HYPERACTIVITY/IMPULSIVITY CONTACT DR. SCARBOROUGH TO DISCUSS YOUR CONCERNS.

Did you know that there are different types of AD/HD?

October 11, 2019 Vanessa Scarborough

Problems with attention including difficulty focusing and concentrating is a common reason people undergo psychological testing or neuropsychological testing. Difficulty with attention is one aspect of AD/HD. Another common problem often found in individuals with AD/HD is hyperactivity/impulsivity. But my child is not hyperactive/impulsive, does this mean they don’t have AD/HD? The answer is no. You do not need to be hyperactive/impulsive to receive a diagnosis of AD/HD. So many people are surprised to learn that there are different types of AD/HD. The Diagnostic and Statistical Manual of Mental Disorder, Fifth Edition (DSM-5) published by the American Psychiatric Association identifies three types of AD/HD:

Inattentive type (predominantly inattentive presentation)
Hyperactive/impulsive type (predominantly hyperactive/impulsive presentation)
Combined type (combined presentation)

Inattentive Symptoms

Does not pay close attention to details or makes careless mistakes in school or job tasks.
Has problems staying focused on tasks or activities, such as during lectures, conversations or long reading.
Does not seem to listen when spoke to (i.e., seems to be elsewhere).
Does not follow through on instructions and does not complete complete school work, chores or job duties (may start task but quickly loses focus).
Has problems organizing tasks and work (e.g., does not manage time well; has messy , disorganized work; misses deadlines).
Avoids or dislikes tasks that require sustained mental effort (e.g., length reading assignments, preparing reports and completing forms).
Often loses things needed for tasks or daily life (e.g., school papers, books, keys, wallet, cell phone, glasses, etc.).
Forgets daily tasks (e.g., chores, running errands, returning phone calls, paying bills).

Hyperactive/Impulsive Symptoms

Fidgets or taps with hand or feet, or squirms in seat.
Not able to stay seated (e.g., classroom, workplace).
Runs about or climbs where it is inappropriate (e.g., library).
Unable to play or do leisure activities quietly.
Always ‘on the go,’ as if driven by a motor.
Talks too much.
Blurts out an answer before a question has been finished (e.g., may finish people’s sentences, cannot wait to speak in conversations).
Has difficulty waiting for turn (e.g., waiting in line).
Interrupts or intrudes on others (e.g., cuts into conversations, games or activities, or starts using other people’s things without permission).

Psychological Testing or Neuropsychological Testing

Psychological/neuropsychological testing can help determine if you have AD/HD as well as what type of AD/HD. This is important because recommendations including what supports will be most helpful will be different depending on the type of AD/HD.