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Health: the Whole Child

Good health is important to all children if they are to perform well at school. For a child with learning difficulties, it may be necessary to look beyond routine health checks to arrive at the root of a problem, but it is essential to correct any focusing deficit, hearing loss and dietary deficiencies first.

A learning-disabled child may present many other symptoms. Dyslexia is frequently associated with deficits in concentration, memory, co-ordination, dexterity, eye control, listening and difficulties in balancing. It is therefore preferable to take a holistic approach when assessing the child.

Vision: optometry
Optometry is the treatment offered by an optometrist to improve ocular processing. The optometrist identifies the areas of weakness by administering a series of tests and taking a detailed history. Difficulties include:

• difficulty with holding a fixed image so that blurring, double vision and merging of images occurs
• poor tracking or following a moving object, with consequent poor ball-game skills
• poor saccades (alternating jumps and fixations) essential for reading
• inability to alter the focal length from near to far vision rapidly, which leads to poor copying skills
• aberrations of depth perception and spatial arrangement, with poor copying, poor layout technique, poor drawing and clumsiness
• aberrations of peripheral vision, either increased (causing them to be easily of distracted and to have difficulty with central focusing) or decreased, when the visual field is reduced.

Treatment consists of teaching a series of exercises, which are practised over a period of some weeks, to stimulate the ocular motor nerves (the nerves on the outside of the eye that control eye position and movement rather than the visual pathways).

Some optometrists may also test for colour sensitivity and prescribe coloured lenses to reduce colour sensitivity. Lens prescription must only be made up by specialist optometrists or opticians. Most European countries have institutes of optometry which keep lists of practitioners and are happy to refer patients.

Hearing problems
Dyslexic children often have a history of repeated ear infections, sometimes resulting in ‘glue ear,’ and fluctuating hearing loss. This condition contributes to problems with spelling, listening comprehension and short-term auditory memory. Glue ear itself is treated by inserting tiny tubes, or grommets, into the ear to drain away the tenacious fluid which has collected there because of repeated infections. Sometimes there are sound-frequency losses, and distorted vowel perception will cause listening comprehension, speech and spelling difficulties.

Speech and language weakness
The child with aural impairment may be slow in speech and language development and will benefit from speech therapy and tutoring from a language development specialist.

Auto-immune system
Weak auto-immunity which causes allergies is another problem increasingly associated with learning-disabled children. Allergy testing is available from specialist doctors. Common allergies are to wheat, dairy products, caffeine and food additives, especially colourings and preservatives. Treatment usually consists of excluding the offending foods from the diet, or controlling the home environment as much as possible in the case of an environmental allergy.

Nutrition
A balanced, healthy diet made up as much as possible of fresh, whole foods will benefit most children. This may well be of particular importance to a child with specific learning difficulties. Minerals, especially zinc, magnesium, manganese and calcium, are all important for proper brain cell function and many specialists prescribe supplements to good effect when analysis shows children to be deficient. Fatty acids, important for nerve cell function, are sometimes not produced by the body and may also need to be given as supplements.

Movement
There is a range of therapies available throughout the European Union using movement exercises designed to improve co-ordination, spatial awareness and treat developmental delays and learning disabilities. These include educational, neuro-developmental therapy, neurological organisation training, sensory integration and vestibular stimulation.

Counselling
As screening for specific learning difficulties becomes more widespread, early intervention should reduce the incidence of associated psychological problems. With increased understanding of the experience of the child with specific learning difficulties and a broad view of how his well-being can be looked after on all fronts, fewer children will be demoralised by their experiences at school to the extent that they need professional counselling to regain their confidence and self-esteem.