Dyslexia and the other learning disabilities are appearing more to be diagnoses of exclusion. Many conditions can mask or mimic dyslexia, and these should be identified and treated adequately prior to the assessment of the dyslexic. Counseling should be the first line therapy, but one should not be reluctant to accept medical intervention. Some of the medical therapies suggested in this paper have not received indication from the FDA for the condition or age group, but they have been successfully used by primary care physicians, psychiatrists and neurologists. We have divided these conditions into two lists, Acquired and developmental. The Acquired conditions are conditions that could be circumvented by early intervention. The Developmental conditions are considered to be inherent.
Table # 9 provides a list of the acquired conditions. The approach in treating some of these conditions is sometimes controversial.
This condition can be crippling for individuals without a learning disorder, but really has an impact on students with learning disorders. An area in which the child excels should be identified. Every effort should be made to facilitate success in that area. Positive re-enforcement can also be of benefit, along with having the child accept his condition, and accept that it is OK to be different. It is a good practice not to discuss a child's failures with others in the student's presence.
Although pharmaceutical intervention has been used for this condition, it has been shown that Cognitive Behavior therapy has been the most efficacious. See Table # 10 for a list of medications, doses and most prominent side effects.
|ODD of CHILDHOOD|
|Initial dose||0.1-6mg tid||0.1-0.2mg bid||5-20mg tid|
The literature does not make any distinction in the therapy of the etiology of depression. Table #11 provides a list of medications that have been used.
|Initial dose||25mg/day||100mg bid||37.5mg bid||25mg/day|
|Side effects||EKG, changes,
There is no therapy that is specifically efficacious in these conditions, but the drugs listed in Table # 12 have been used. Both of these conditions are thought to be of the same path, therefore they can be treated the same.
|Initial dose||5-20mg tid||0.1-0.2mg bid||25mg/day|
It is thought that these children possess the propensity to develop these conditions, and that the environment has little influence. What are not clear, however, are these conditions due to genetics, in utero insults, or perinatal insults. We do know that ADHD are more prevalent in the urban areas, which leads me to believe that the environment has to make a contribution. But to what degree and in which of the conditions is not known. More studies are needed in this area.
Attention Deficit and Hyperactivity Disorder with and without hyperactivity and impulsivity responds to the same pharmacologic intervention. Those with Attention Deficit only seem to respond to a lower dose. The FDA approves all on the list in Table # 13.
|ADHD WITH & WITHOUT|
|Initial dose||5-20mg tid||2.5-15mg tid||18.75-25mg tid||5mg/day|
Central Auditory Processing Deficit has not been shown to be responsive to pharmaceutics. Cognitive management has been shown to be the most efficacious. The Easy Listening Device should be used when communication is necessary in a noisy background. Earplugs are helpful during reading or when auditory communication is not necessary. Parents and teachers should give instructions to students in a quiet surroundings and encourage the student to paraphrase these instructions. Information on intervention can be obtained from the speech pathologist and audiologist.
Helpful suggestions have also been added to this site under the following topics:
Suggestions for Home and School
Strategies to Facilitate Organization
Direction Following Tips
Obsessive Compulsive Disorder can now be treated very successfully with the advent of recent pharmaceutics. See Table # 14 for a partial list of suitable medications.
|Initial dose||25-300mg/day||25mg/day||100mg bid||25mg/day|
|Max. dose||300mg/day||3mg/kg or 100mg/day||300mg/day||200mg/day|
dizziness, dry mouth
|Nausea, dry mouth,
Absence Seizures are being treated effectively with Valproic Acid, which is the drug of choice, but Clonazepam, and Carbamazepine has also been used successfully.
|Initial dose||0.1-6mg tid||15mg/kg/day in
2-3 divided doses
Schizophrenia is not one of the conditions you look for in your student or child; it usually does not become recognizable until in adolescence. It is, however, one of the Inattentive Disorders and needs to be treated. There are several drugs on the market, four of which are listed in table #16. The extrapyramidal side effect is the most feared but there needs to be a balance between this and sedation.
|Initial dose||0.5mg bid||10mg bid||10mg bid|
|Max. dose||5mg bid||50mg qid||75mg tid|
|Side effects||Extrapyramidal effects,
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