Learning Disabilities Case Study 1

Pearl
Learning Disability, 15y F

Rae Tattenbaum, MSW, CSW

The Director of Educational Services objected to Pearl’s mothers request for an educational evaluation because she her attentiveness and test taking ability were improving. Although Pearl received some tutorial help, she was not securing the necessary remedial services to address specific educational deficits. The following is the story of an attractive, energetic 15 year old who has been alternately placed in special services and mainstreamed. Her mother was frustrated by Pearl’s mysterious inability to learn and retain information.

Six months ago, Pearl’s mother picked up an Inner Act brochure at a local library. Her mother told me that she “was hyperactive from an early age, running around until she passed out under the dining room table.” In kindergarten, she was initially diagnosed as learning disabled, however, there never seemed to be a plan which helped her learn. During the assessment process some of the identified symptoms were, inattention, inability to complete tasks, boredom and she was frequently in trouble.

Some of the other issues were:

Difficulty understanding age appropriate directions.
Oppositional and disrespectful.
Argumentative.
Blames others for her mistakes or behaviors.
Short fuse and extreme irritability.
Periods of rage with little provocation.
Often misinterprets comments as negative when they are not.
Periods of spaciness, or confusion, or forgetfulness, or memory problems
Periods of panic or fear for no reason.
Frequent periods of deja-vu
I evaluated her as having an attentional issue, a left hemisphere processing problem and most probably a temporal lobe disorder with possible seizures. Arrangements were made for her to have a consultation with a psychiatrist who agreed and suggested a trial of Neurontin. The treatment included EEG Neurotherapy two to three times a week using T3 with FP1 and T4 with FP1 with a 2-6 inhibit. Subsequently, after the initial round of sessions, the protocol became C3-FP1 and C4-FP1 with an alpha inhibit.

In addition, I used hypnosis to help Pearl explore issues around when she first had difficulty learning. She is an excellent regression subject and was able to describe her childhood frustration with her efforts to learn and her inability to understand the lesson. During one session, I asked her to look around and see if there was a part of her hiding in that first grade room. “Of course, she responded there is a smaller me hiding in the desk. As I had thought, she had become so discouraged by the negativity that a shadow of herself was hiding. Hypnosis was also utilized to help her prepare for tests and to discover a future self capable of learning. Sound Therapy based on the Tomatis principles was utilized for 6 weeks, off for 2 and then another six weeks of listening anywhere from one to three hours a night. By the time the school met with her mother, Pearl was improving and it was more evident that she had a left hemisphere processing problem.

With much reluctance the school decided to evaluate her and learned that academically she was performing at a primary grade level in reading and math. They evaluate her IQ as low normal. The team found this difficult to believe because Pearl is so verbal and engaging. Arrangements were made for her to be tutored three hours a day.

Today, Pearl continues with her remediation program, plays softball and is planning on attending college.

The Visual TOVA and Behavioral Changes.
This is a visual computerized continuous performance test for the diagnosis of attentional disorders. The patient is given a practice period followed by a 22 minute test which uses non language based, non sequential stimuli with both vigilance and disinhibition subtests to measure: Inattention (Errors of Omission), Impulsivity (Errors of Commission), Response Time, and Variability of Response.

10/14/97
1/09/98
3/98
Inattention
108
108
108
Impulsivity
100
99
99
Response
112
118
125
Variability
100
115
123

Initially, on the Oct. test, the results of quarter 2 ,specifically variability, were not within normal limits. and are suggestive of an attentional disorder. The second test demonstrate the impact of the 20 or more sessions and the medication. The most recent test demonstrates the steady improvement on Pearl’s part which is seen in significant improvement in her behavior.

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