Early Identification of LD: The Pediatrician's Role
by Tamarah Kagan-Kushnir, MD, FRCPC, and Jay Rosenfield, MD, MEd,
FRCPC
As pediatricians our ultimate goal is to optimize the health and
well being of children and facilitate their growth and development.
Learning disabilities threaten a child's quality of life in a variety
of spheres, including educational achievement and social/emotional
development. As such, helping a child and family to recognize and
manage a learning disability as early as possible is an important
part of comprehensive Pediatric care.
In many ways, pediatricians are in a unique position to be able
to identify developmental risk factors which might be the early
precursors of a learning disability. The pediatrician is often the
first person parents consult when they have concerns around their
child's development and learning. Furthermore, pediatricians see
children over time and therefore have the opportunity to make repeated
observations of a child, thus forming a more accurate and complete
picture of their development. This, along with parents', teachers',
and other caregivers' observations, allows for early recognition
of any difficulties. Having knowledge about normal and abnormal
development, the pediatrician can then put these concerns in perspective
and identify what further measures need to be taken.
As pediatricians are often the first professionals to be aware
of a child's difficulties, they are often responsible for selecting
and coordinating a multidisciplinary team to address a child's needs,
including early and accurate diagnosis and intervention. As the
medical professional on the team, ruling out medical problems causing
or contributing to a child's developmental picture is a key role.
This includes deciding what, if any, medical investigations or procedures
are necessary, and whether or not specific treatments, such as medications,
are required.
Moreover, a significant number of children with learning disabilities
have coexisting problems, including attentional and emotional difficulties
such as depression or anxiety, which might benefit from medical
intervention. To enhance communication between team members, pediatricians
often liase with the other professionals involved in the child's
care. As they see the child regularly, they are also in a position
to provide follow up and reassessment of the efficacy of interventions
as well as the need for further evaluations and referrals.
Acting as a support and resource to parents is an integral part
of what a pediatrician does for all children, especially those with
special needs. This includes providing parents with information
and helping them to access resources, not only for assessment and
therapy, but also for further education and support. Pediatricians
can also assist parents in putting together the reports from the
variety of professionals interacting with their child so that they
can develop a comprehensive understanding of their child's strengths
and weaknesses. Ultimately, parents are a child's most important
advocates. Empowering them to do this effectively and helping them
negotiate "the system" is an on-going process between
the family and the pediatrician.
Working together, parents and pediatricians can accomplish a great
deal in helping the young child maximize his/her potential and future
success. Parents will always know their children best, and therefore
often recognize difficulties before any professionals do. To benefit
from their pediatrician's expertise and support in this area, it
is important for parents to discuss their concerns with their pediatrician.
Effective communication is a critical aspect of the care and advocacy
for the learning disabled child, and can be a powerful tool in achieving
early and accurate diagnosis.
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