Do I talk to my child's pediatrician about learning problems?

**If you would prefer this content in video form, click here: Should I Ask My Pediatrician About Dyslexia?

I’m a pediatrician.  I’m the person that most parents turn to when something, ANYTHING, is going on with their child. If your child is hurt, sick, or sad, your pediatrician is often the first professional you will call.  What about if your child is struggling with learning?  Is it appropriate to call the pediatrician? YES!

In my office, it is my job to think of everything that could make it hard  for your child to learn.  The list includes:

Vision problems

Hearing problem

Learning disability

ADHD

Anxiety or depression

Inadequate sleep

Social issues like being bullied

Poor nutrition or food insecurity

As you can imagine, sorting through all of these possibilities means I need to ask a lot of questions and really listen carefully to the information being shared.  I may also need call to the teacher to better understand what’s happening before making any recommendations.

SLEEP

When it comes to a child's sleep, I try to get a sense of how many hours of sleep they and also the quality of their sleep.  Children ages 5-10 need about 10-12 hours per night. If they are getting enough hours of sleep but are still tired all the time, I might think about sleep disorders like sleep apnea that would affect how restful their sleep actually is. 

EMOTIONS & BEHAVIOR

I need to hear all about their behaviors in and out of school.  Are they enjoying time with friends?  Are they eager to play when they have the time? Have they lost interest in doing things?  Are they struggling to separate from their parents?  Do they try to avoid going to school or other activities?  Are they having more outbursts or tantrums then we might expect? All of these might help gauge if a child is anxious or depressed or struggling socially in some way.  But remember that being anxious or depressed wouldn’t rule out a learning disability or dyslexia, because sometimes the struggle to keep up in school CAUSES the stress or sadness or tantrums. Children may also misbehave in school or around schoolwork as a way to detract attention from their inability to understand the work because they are afraid of looking “dumb” or “stupid”.

TIME FOR THE CHECK-UP

Next steps in my office would be an exam, a vision and a hearing test.  All can be done in the office that day.  If a child passes the in-office vision or hearing screen, but there are ongoing concerns about either one of these, then a referral to an ophthalmologist or audiologist should be made for more in-depth testing.  Many kids with dyslexia might talk about “letters moving” on the page which would understandably worry a parent that something is wrong with their eyes.  However, in dyslexia this is due to how the brain is processing the letters on the page.  With that said, it’s still a good idea to get confirmation from a pediatric ophthalmologist that the eyes are working just fine. 

MAKING A PLAN

The last part of the visit is discussing the next steps. These may include:

1. Referral to eye doctor
2. Referral to audiologist
3. Being given a survey to complete about ADHD (usually one is given to each parent and teacher - more about this another time)
4. Suggestion to request PPT and guidance on how to go about that.
5. Referral for private psychoeducational testing or to a pediatrician specializing in behavior and development.
6. Reassurance!  Sometimes you bring a concern to a pediatrician and are simply reassured that everything sounds appropriate for age and suggestions of what to watch for in the coming months that would be signs of a problem.  

The Bottom Line:  Your pediatrician is a member of your child’s learning team.  If you have concerns about your child’s progress in reading or in school or in social development, please let us know!