School Failure—Evaluation and Treatment

Abstract

A comprehensive multidisciplinary team approach to the diagnosis and management of school failure, with the pediatrician knowledgeable in the field of behavioral and learning disorders serving as coordinator, is outlined in terms of actual office procedures. An integral part of the expanded neurological examination is an empirically evolved diagnostic screening test for developmental dyslexia which identifies three atypical reading-spelling patterns on the basis of which dyslexic children can be classified into three main subtypes: dysphonetic, dyseidetic, and mixed dysphonetic-dyseidetic, each with its own therapeutic and prognostic implications. The approach outlined here is designed to identify not only the specific educational needs of a given child but all of the causative and contributory factors, physical, emotional, and sociocultural, that may impinge on the child's ability to learn. Though necessarily time-consuming, the team approach appears in our present state of knowledge to be the most practical and reliable way to get at the roots of the child's multifaceted problem and to develop a coordinated program of treatment—simultaneous insofar as feasible, and sequential when required. A child referred for school failure is a child in crisis. The challenge to the pediatrician to whom the parents turn for a solution is to find ways as promptly as possible to help the child improve in his school adjustment and self-esteem. It is recognized that special education has a primary and ultimate responsibility for remediating specific learning disabilities. Nevertheless, the complexity of the problem of school failure requires that overall diagnosis and management be a multidisciplinary venture, in which the professionals involved are committed to working together to ensure that the whole child is taken into account.

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