Specific Learning Disorder

Patient Story: Specific Learning Disorder

Gina was 12 years old and finishing 6th grade. Her grades had been straight As in all her classes until 5th grade. Then she began struggling with reading and writing assignments and her grades dropped to Bs. In 6th grade her grades declined further to Cs. Her mother had been working with her at home and had noted that Gina was taking much longer to finish her reading assignments.

The teachers had noticed how hard Gina was working, but she continued to struggle with completing class assignments and exams. A referral was made to the school educational diagnostician, who contacted Gina’s parents and obtained permission to evaluate her. After administering educational testing the diagnostician determined that Gina had a reading disorder and difficulties with attention. She recommended classroom accommodations and that Gina’s parents consider an evaluation for attention issues with a child psychiatrist.

Her parents took her to a child psychiatrist. When the psychiatrist asked Gina why she came to see her, she replied “I think it is because I am stupid.” When asked to explain, Gina said that she struggled in school to understand things and she could no longer make good grades, and she was sure it was because she was stupid. “People used to think I was smart, but now they know I am not. I guess I just faked it better when I was little.”

Gina exhibited difficulties with attention and symptoms consistent with mild depressive symptoms during her evaluation. The psychiatrist recommended to her parents that Gina have psychotherapy to help her with the discouragement and low self-esteem she had developed from her academic struggles. She also recommended working together with Gina’s parents to educate Gina about her attention and learning differences but also emphasize her intelligence (which had been revealed in the testing). In addition, the psychiatrist recommended a trial of medication to help Gina with her attention. The psychiatrist met with Gina and her parents and discussed both Gina’s difficulties and the strengths she had shown.

Three months after she had started medication and psychotherapy, and accommodations had been put in place, Gina’s grades had improved to As and Bs. Gina told her psychiatrist, “Guess what, I am not stupid! And my grades show that.”