Many, many people with ADHD and learning disabilities have difficulty reading. This newsletter takes an in-depth look at reading issues and what can be done about them. One article explores the differences between ADHD reading issues and dyslexia (and their overlaps) while another interviews a doctor in a relatively new area of optometry - behavioral optometry.
I was inspired to focus on reading after the surprise of learning this fall that my 18 year old daughter, who has ADD and has always been a very slow reader, has eye tracking issues. In other words, her eyes don't physically follow words on a page well. She was relieved to learn that she could do therapy to help her read better and faster (or as she said "finally, Mom, something we can do something about!"). It seems, as you'll read in Rebecca Shafir's article, A Reading Problem, or ADHD? that there is significant potential to help many who struggle in school and suffer from reading issues that normal optometrist appointments and school screenings don't pick up. In fact, it seems that at least some people are incorrectly diagnosed with ADHD when what they really have is "convergence insufficiency".
Just as reading is an issue for many with LD, so are finances. Dr. Hallowell weighs in on how to improve financial management skills this month. And, in another piece of exciting news, he and his wife Sue will be hosting a very special couples workshop weekend in June. You all are the first to find out about it.
Spring is in the air, and we hope that you all are finding ways to keep healthy and happy in today's somewhat oppressive environment.
Melissa Orlov, editor
Q: Our son was diagnosed in junior year of high school. After he started medications his grade point average went from 2.7 to 3.7 - a dramatic improvement that got him into college. But now that he's at college he can't start papers, doesn't remember to turn in his homework - other words many of the old habits are back. He's a great kid but really struggling. What can we do?
Editor's note: The mother who sent this in wrote back to us after she consulted with Renee Goldberg, an educational coach with the Hallowell Center. Renee gave this couple specific advice: Go to the Academic Achievement Center on campus. Their son was able to meet with the LD/ADHD counselor there and he and the school counselor they created a "to do" list together. She also recommended that the student get a face-to-face educational coach, and that the parents get longer distance coaching on how to support their son. Finally, the mother read Chapter 9 of Delivered from Distraction, which she found to be "spot on". (for more info on colleges - see the resource section of this newsletter for a list of colleges that are ADHD friendly.
Q: I'm pretty sure my husband has ADHD, but he refuses to go to see a doctor about it. He claims it's just "made up by the medical companies". Help!
A: Your husband is not alone - many adults who might have ADHD resist getting a diagnosis. Some are afraid that a diagnosis might label them as "defective" or fear that they will be forced to take medications. In addition, some fear that a positive diagnosis will position them to be blamed for problems they have in their marriage or business - something they would rather avoid.
Assure your husband that you do not equate getting a diagnosis with needing to take medications...he can make a decision about that later after he has more information. And it is very clear that ADHD is not just a trick of the medical companies. Lots of scientific research shows unequivocally that ADD is real.
Finally, please try to be particularly sensitive about how you approach him. Sensitivity to being vulnerable to blame over past events once ADD has been diagnosed is very real. It would probably help him if you could let him know you love him regardless of whether he has ADD.
Q: We have trouble at the dinner table with our 4 year old grandson whom we suspect has ADHD. He can't sit still, hates veggies, gets bored, makes incessant noise - in short bugs everyone. Furthermore he dawdles until we can no longer stand it. Any suggestions?
A: (from Melissa) When my ADHD daughter used to dawdle at the table we would take turns staying with her until she finished...else move her and her remaining meal into the kitchen to eat at the counter while others did dishes and cleaned up. Your grandson isn't dawdling to annoy you, he just runs on a different clock. Likewise if he talks and talks and doesn't seem to remember being chided about it (or interrupts a lot) this could be ADD symptoms (poor impulse control).
My approach was to be indulgent where it made sense (extra time to run around at the playground if needed, extra time to eat, allow the verbal interruptions as best you can while he is little, and try to be patient) and set down rules where it's important (issues of safety, getting enough sleep, being respectful, not throwing tantrums) and then stick to them.
As for veggies, that's a health issue. Mine had to eat at least a small portion even if it meant they stayed at the table for two hours (we would not stay with them in this case, just nearby). If you stick to this, pretty soon they decide it's more fun to be playing and they get over it and start eating veggies.
Dr. H has a new book out about parenting kids with ADHD called SuperParenting for ADD which will probably help you. In general, try to err on the side of thinking your grandson doesn't mean to be disruptive.
Dyslexia may be defined as difficulty learning to read
and spell that can't be explained by lack of education,
poor eyesight, or deficient mental capacity. If your child
has dyslexia, learning to read is possible, but the
struggle is to develop fluency. Like riding a bike, good
readers find reading smooth and automatic; those with
dyslexia work very hard to maintain their balance. For
the dyslexic, fluency is tough to acquire. He can read,
but only slowly and only with effort and concentration.
Reading and writing letters in the wrong order is only
one manifestation of dyslexia, and it doesn't occur in all
cases. Other problems experienced by dyslexics
Dyslexia affects 15-20% of the U.S. population. It's common in people with ADHD. Research suggests that at least 20% of those with ADHD also have dyslexia. Sometimes people confuse ADHD with dyslexia, but they are different disabilities. Dyslexia is a language-based learning disability; ADHD is a deficiency or an overabundance of attention. When you treat ADHD, the symptoms of dyslexia may improve; the new-found capability for paying attention helps in reading. While medication may be an effective ADHD treatment, there is no medication that helps dyslexia.
The first step in identifying one's problem with reading
is to consult a neuropsychologist or a reading
specialist for a differential diagnosis. If you are in the
Boston or New York areas the Hallowell Center can
provide these. Contact Saumya Sharma,
neuropsychologist at the Hallowell Center in Sudbury
(978) 287-0810 ext.113 for more information on
The Dore Program In the '80's there were over one hundred research projects across the US and UK regarding the cerebellum and connections were found to reading, writing, verbal fluency executive functions, directional sense, coordination, fine motor development and much more. Further SPECT and PET scanning have shown that people who have dyslexia (as well as ADD/ADHD, dyspraxia and Aspergers) have an underdeveloped cerebellum. Specific exercises develop the cerebellum and improve its functioning thus affecting all the areas that are impaired. The Dore program begins with an assessment that includes a Dyslexic Screening test and an Ocular Motor test. An exercise regimen is assigned based on the testing results. The exercises are upgraded periodically as the individual's skills advance. Olga Soler of the Dore Program at the Hallowell Center in Sudbury sees non- readers and non-writers become readers and writers over the course of the program and improve in ways that educational interventions alone could not have accomplished. For more information on The Dore Program at the Hallowell Center, contact Olga Soler at (978) 287-0810 x126.
My Sensory Solutions is for reading, attention
and processing difficulties. The pioneer of "listening
therapy," Dr. Alfred Tomatis's research showed that
reading is a process of connecting a series of letters
representing sounds to form words and groups of
words that have meaning, in other words both the ears
and the eyes are needed for reading. My Sensory
Solutions is a program of listening to specially treated
classical music, delivered via an 80GB iPod, through
stimulating bone-conduction headphones. Combining
a Tomatis-based auditory/vestibular program with
visual and proprioceptive (muscle and joint)
stimulation, pitch discrimination is corrected and
neurological pathways can be strengthened resulting
in improvements in the ability to learn as well as
process information such as reading, writing, and
Specialized reading tutoring can help a student develop phonic awareness, the ability to break down words into their component sounds - symbolized by the letters of the alphabet. Sally Shaywitz, one of the pioneers in dyslexia studies [and author of Overcoming Dyslexia], calls this "breaking the code." Some of the most successful traditional reading programs are the Wilson program, Orton Gillingham or Lindamood Bell Reading programs. Google search these programs for a provider near you.
Behavioral optometrists can assess and treat eye motor issues that may contribute to slow reading or comprehension. See the next article in the newsletter for full information on this.
by Rebecca Shafir M.A. CCC
Dr. John Abbondanza's waiting room at Vision Care Specialists in Southborough MA was bright and cheerful, just like the faces of his patients I met as I passed leaving his office. As I waited to interview Dr. A, I perused a thick book of thank you letters from the children and young adults he's treated. After a quick a tour of his little store of beautiful glasses and frames typical of an upscale optometrist office, Dr. A. hastened me to the back where "the really exciting work takes place." After showing me a couple rooms with state-of-the art testing equipment, we went into another sunny room, classroom-like, with charts and various gadgets in the corners, including a balance beam, where he and his staff do vision therapy with patients.
Dr. A commented that we all know that people pick certain sports or careers over others based on their specific talents and tendencies. A visual problem alone, for example, may prevent a very talented person from pursuing a particular sport or career for which he or she is otherwise well suited. Therefore, a student may have a talent for law, but will end up becoming a mechanic or ski teacher because of a visual problem that inhibits the reading needed for law. Dr. A's passion is fueled by the possibility that if a visual problem is correctly diagnosed and treated, it could change one's life and make them successful at what they choose to do rather than letting a visual problem choose for them.
"Many of the symptoms of AD/HD listed in the DSM IV are symptoms of kids with vision and learning issues; they are almost exactly the same," says Dr. A. How do you know if you really have ADD or if there are these underlying visual issues that are contributing to the symptoms? What does the data show? According to Dr. A, if you look at a bright kid struggling in school, in the absence of any abuse issues, there's a 60-70% chance that child has a visual problem that's at least contributing to the learning problem. For example, the relationship between AD/HD and convergence insufficiency or CI (an eye-teaming problem) published in 2005 found the prevalence of CI to be 300% higher in kids with AD/HD. CI is the most common binocular problem and it can co-exist with AD/HD. Regular optometry appointments don't cover the mechanics of how eyes converge when reading and so would not "uncover" CI.
Also common are kids who lose their place, skip over words, skip over lines; they read better if they use their finger to read. The finger is telling the eyes where to point. The child who reads better with the finger is saying I don't have control over my eyes to read, so I need to help my eyes, and therefore I use my finger - I have a tracking problem.
Dr A claims that the first three steps of reading have
nothing to do with phonics. These steps
You may have 20/20 vision and pass all the screenings at school and at the eye doctor's office, but you may still have difficulty tracking, eye teaming, focusing and re- focusing over time, creating, maintaining, recognizing and recalling words. All of these difficulties slow down reading. These visual problems can cause loss of place, skipping over words or lines when reading, headaches and eye strain when reading or doing close work, or double vision. What to do? Sometimes a slight eye prescription can make all the difference.
Dr. A played a video of such a child singled out with "a learning disability" reading aloud unaided, then aided with the new prescription. When he put on the glasses his reading picked up measurably -it was his visual perceptual problem that made him read like a child with a significant "reading problem."
Another approach is "vision therapy" - a series of exercises designed to improve the functioning and efficiency of the mechanical visual system. Vision therapy may be very helpful in a child who is struggling with school with slow reading and who can't seem to keep his attention on a page. In addition, vision therapy may be used to treat patients with brain injury due to trauma or disease that have visual problems such as double vision, reading problems, and difficulty focusing, all of which can be helped by vision therapy.
Vision therapy exercises start with fairly simple tasks and gradually progress to more and more complex exercises as new skills are learned. The therapy is individually tailored to the needs of each patient. Often it takes only weeks to a few months to notice the changes. In addition, many parents report that they see improved attention as visual skills are developed in their children. Behavioral optometry/vision therapy is just one approach to consider if your child has reading problems that have not been satisfactorily addressed by more traditional means.
Though most of Dr. A's patients are children, teens and adults can also be treated by a behavioral optometrist to improve reading skills.
Behavioral optometry is a fledgling field within optometry and there are fewer specialists in this field compared with traditional optometry. Dr. A suggests you visit these resources for FAQs, articles, and research information: His own website at www.greatvision care.com (or call 508-481-8558 with specific questions): to find a certified behavioral optometrist in your area go to the licensing organization's website at www.covd.org For educational papers and the like, try www.oepf.org
Dr. Hallowell and his wife, Sue are going to be hosting a special weekend experience for couples in which one or both partners has ADHD this June. Dr. Hallowell has ADD himself. Sue is an experienced couples therapist. Together they will team up to both teach, as well as coach, couples through the issues presented by ADHD in a relationship.
This very special experience takes place June 20 and 21 in Boston. Participants will stay at the Hyatt Regency Boston and work interactively with Ned and Sue Hallowell from noon on Saturday until 6:30, then again from 8:30 am on Sunday to 1:30pm.
Dr. Hallowell said of the event, "The tone of the weekend will be upbeat, informal, positive, often humorous, but also seriously committed to helping bring about desired change. I know that this one weekend can change these couples' marriages for the better!"
The weekend will be limited to 25 couples, and will consist of teaching, coaching and sharing. As an added benefit, participants can take advantage of all Boston has to offer on Saturday night...or stay at the hotel's health club, pool or spa if they prefer.
For complete details and to register, please go to the link below.
We recently received a wonderful question from a concerned grandmother who wishes to help her granddaughter learn the financial management skills she'll need to have in order to get along in her life. Briefly, she wrote:
My granddaughter, who is a sophomore in college, has both ADD and a learning disability. She seems to be doing well in all areas of her life except for managing her finances and this is a continual problem.
Her father covers her school tuition, board and room and fees. She has a job which pays for gas for her car, cell phone, and spending money but she is often overdrawn. I wonder if you can suggest any tools that might help her keep track of her expenses so this does not continue to happen? She wants to learn to keep her expenses in check but her ability to do that is inconsistent.
Even though I know I am a prejudiced grandmother, others also see what a delightful and charming young lady she is with many strong points and a fine future. She is majoring in Social Work, her grades are good, papers in on time, active in student government and has many friends. She has good values and a positive outlook. Any suggestions or advice would be most welcome.
Dr. Hallowell responded with advice that is relevant for
more than just college age people:
Money management is challenge in the world of ADD. It is common for people with ADD never to balance their checkbooks, overdraw regularly, have no idea what their balance is, recoil at attempts to help them organize their finances, and in general avoid the topic of money management as if it were the plague. They simply do not have a head for money management, as it were, and they live in hope they others will take care of it for them.
These people are typically gifted in the ways people with ADD so often are: warm, creative, intuitive, charismatic, hard-working, devoted to friends, caring, responsible (in most ways), and bright. But, they have the devil of a time when it comes to running their financial lives.
I would suggest seeing this as you might see a reading problem. Your granddaughter needs a tutor. Regular sessions over time. Regular check-ins about money. Show her how to balance her checkbook. In the meantime, deal only in cash. Send her $100 per week, or whatever her allowance is, and let her know that is all she will get. Close out her checking account if she keeps overdrawing. Let her know this is not a punishment, but a safeguard against herself. You do not want to drive a car until you can drive it without getting into an accident every drive. You do not want to have a checking account until you can manage it without overdrawing regularly. Work on the issue with a sense of humor, but also with the realistic knowledge that money management is an important life skill, a skill that you, or whoever tutors her, intends to work on with her until she is able to handle it on her own.
This may take a year or two. Don't worry, she will get there. Don't give up, and above all, don't turn it into a struggle full of anger and reproach. Think of it as a problem you can solve together, which you can!!!
January and February were big months for us - readers sent us lots of information about their favorite resources. Here are a few:
Youth and PTSD: Kerri G recommends "a fantastic book called Finding My Way, written by Dr. Michelle D. Sherman and DeAnne M. Sherman, that addresses how youth are affected when parents struggle with PTSD."
Emergency Contacts in Your Cell Phone: Christine S. sent us information about a new movement that the BBC is advertising - putting an emergency contact name under "ICE" in your cell phone contacts. ICE stands for "In Case of Emergency".
Clarifying Tips for Teachers: Carolyn K, a middle school counselor, suggested "sitting students in the front of the classroom should be more specific. Students with ADD should sit at the center of the activity and at the focus of instruction. Not all teaching takes place at the front of the classroom."
ADHD Friendly Colleges: Jean M. forwards this list "for folks who are looking for a LD-service-oriented college. This page includes live links to LD programs all over the USA. (Editor's note: It's not all-inclusive, so don't assume a college doesn't have LD support if it's not on the list) It's a huge time saver during the college search." In addition, she suggests that residents of Massachusetts look into a special summer program on college transition just for MA residents at this link.
ADHD Help Down Under: Diane Wellacott wants to let those in New Zealand know about the ADHD Association there. Email her at firstname.lastname@example.org. Also, they can help Americans moving to New Zealand find a good school system etc. They also have support groups, a newsletter, and the like.
Dyslexia Information: Debbie H. says "There is much snake oil out there about Dyslexia. As the mother of 2 sons whoare both ADD and dyslexic, I know the frustration of trying to find the right help. I suggest your readers go to www.brightsolutio ns.us for information I've found helpful."
LOTS is going on this month and next. Dr. Hallowell is speaking all over the U.S. and in the U.K. plus offering some special seminars in June and July. The Centers have multiple groups going on. Please go to the links for more information (rather than emailing me!)
Dr. Hallowell's Speeches and Workshops Open to
Public (more details at this link):
Cape Cod Institute - Strengths based approach to ADHD across the lifespan from June 29 to July 3.
Ned Hallowell ADHD Summer Enrichment Camp at The Leelanau School - July 13 - 24. Two one- week sessions, one for returning families and one for new families with students entering grades 5-12 (both adults and kids attend). Go to this link.
Special Meditation Class Starting at New York
Hallowell Center on April 6th:
Because of the structure of the class, it may be covered under individual insurance plans as group psychotherapy. An initial phone consult with Dr. Neale is required for admittance and to tailor the class to meet specific personal needs.
The New York Center offers an array of support and therapy groups to address the challenges of ADHD. All groups are held at our West 72nd street location - a warm and inviting setting. There are groups for adolescents, young women (18-30), adults, women, parents and spouses. Please contact the Center to sign-up for the meditation class or any of the groups! (212-799-7777)