Different But The Same by David S. Katz, MD

Different But The Same

Recently, Alex Rodriguez, the often injured New York Yankees third baseman, has started working with a new athletic trainer. Instead of focusing on his hip, to the surprise of many fans, Dr. Mike Clark instead treated his whole body. He explained his approach to the problem this way: “We look at the body as an integrated unit…(and) retrain the entire body.”

Children with special needs likewise have to navigate the same broad developmental stages as all children.

A parent of an 18-month-old child with a significant speech delay has recently been getting calls from the daycare teacher, that their previously loving child is now pulling his friends hair, hitting them and then grabbing their toys.

Not infrequently, a distraught mother of a 13 year seventh grade boy with ADHD (Attention Deficit Hyperactivity Disorder) will come to speak with me about his unexpectedly difficult year at school. Her son is forgetting his homework, or books, not completing his work, talking more, becoming the class clown, and talking back to his parents at home. As a result, his grades are dropping and the teachers are frantically contacting the parents about his recent poor overall school performance.

A father of a 15 year old boy, with developmental delays, tells me that his son is telling all his friends at school that he is going to “get someone pregnant”. His father is very upset and embarrassed about this behavior.

The key to understanding these situations was taught to me by one of my mentors in developmental and behavioral pediatrics, Dr. James Kavanaugh child psychiatrist at the University of Virginia. Parents often feel that their child’s behavior is due to their longstanding developmental issues. In reality, however, normal developmental milestones occur in a child with learning differences, just like any child. These developmental paths are shaped by the child’s limited ability to respond to these challenges.

The toddler mentioned above is in the normal stage of increased aggressiveness and attempts to assert himself. Toddlers are well known to hit and bite each other to get what they want. When a child with speech delays reaches this stage, his or her inability to express desire leads to frustration and therefore increasingly aggressive behavior.

All 13 year old boys are a puddle of hormones. Or as one of my pediatric partners has said, their blood flow goes to other areas than the brain. All pubertal preteens and teens struggle to stay focused on their school work, when changes to their bodies and minds serve as major distractions. I refer to the concurrent drop in school performance, maybe less eloquently stated, as an academic brain fart. An older teen, looking back at her early teens, told me, “Our bodies were changing and we didn’t know what to do about it.”

Superimpose this normal development phase onto a 13 year old with ADHD and you can understand why he would be having an extraordinarily difficult year at school.

In high school, sexuality is even more overt. Kids want to be accepted and to be “popular”. A student who is not socially adept will often suffer with issues of low esteem. In an attempt to compensate he might make statements filled with bravado to overstate his acceptability or attractiveness, as the 15 year old teenager mentioned above.

Children with special needs have unique hurdles to surmount, but also experience the same developmental challenges as their peers. It can be a special challenge for parents, teachers and caregivers of these children to resist solely viewing these kids through the “special needs lens.” Rather, one must look at these challenges as the interaction between their special needs and normal stages of development.

Parenting any child is a contact sport!

David S. Katz, MD
Kaplan Barron Pediatric Group

other related sites

Best Buddies Kentucky

The Council on Developmental Disabilities

Kids Center for Pediatrics Therapies

American Academy of Child and Adolescent Psychiatry