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Authors: Mary MacCracken

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It wasn’t only letters and numbers that Joey mixed up. He jumbled his own thoughts as well. I asked him to write a few sentences about whatever interested him. He thought hard and then took a long time to write. “I’m going to make this neat,” he told me as he worked.

When I asked him to read out loud what he had written, he read, “I like to go fishing because we always win.”

“Wait a minute here,” he interrupted himself. “That’s not right. See, I began about fishing, but then somewhere, about here” – Joey put a line after fishing, which was written “fsihign” – “I must’ve begun thinking about soccer.”

I didn’t have a test to measure the restlessness inside Joey. But observation made it clear that he was much more active, tense, and distractible than the usual seven-year-old.
I even wondered if the neurologist’s decision against medication was correct.

I had worked with other children who were labeled hyperactive or as having a “hyperkinetic syndrome” – and I had seen medication such as Ritalin work for some, although not for all. Originally, the thought of medication of any kind repelled me, but I learned that it did work for some children as long as it was
carefully monitored by a pediatric neurologist or experienced pediatrician. Often hyperactivity and learning disabilities are considered one and the same, but they are actually two separate conditions. When they occur together I think of it as “dyslexia plus,” the plus being hyperactivity. Both teaching and rearing these children takes a great deal of energy and love. Just to get them to tune in so
that they can hear what you are saying is a big job in itself – to sustain their attention minute after minute so that they can learn is a tremendously difficult task. These are vulnerable children – their sensations heightened, their motors always running a little too fast, never quite in time with the rest of the world. They are exhausting children. They need more supervision than most. They need
more loving. They also give it back in quantum measure.

The Stones arrived at the same time but in different cars, coming straight from work to my office. Mr. Stone was well over six feet tall, lean, with hair just slightly darker than Joey’s.

“Did you get a sitter?” Mr. Stone asked his wife.

She shrugged, a small frown crinkling her forehead. “I tried three, but no luck. I think
they were making excuses.” She turned to me. “Ours isn’t the easiest house to baby-sit. When I went back to work last year I tried to make arrangements to have someone there when the boys got home from school. Nobody lasted longer than a week. They all said they couldn’t take Joey. They never knew where he was or what he was up to – and if he was there, he was into something he shouldn’t have
been into. So now the boys look after themselves. Joey, and Bill, he’s our eleven-year-old, fight constantly, but Richard, the oldest, is thirteen and responsible, and he can handle Joey better than most. My parents live across town, so Rich can call them if anything serious comes up. My mother is ill, but my father can drive over.”

“Which usually makes things worse rather than better,”
Mr. Stone added.

Mrs. Stone turned her head toward her husband. “Don’t start,” she warned.

“Shall we begin, then?” I asked, wanting to interrupt the tension that was building between them. “I’ve read everything you sent,” I continued. “The Child Study Team reports, the teacher’s comments, the neurologist’s report, the background information form that I asked you to fill out. I’ve scored
the dozen tests that I gave Joey, and I’ve reviewed them with Dr. Golden, the psychologist and learning disabilities professor I mentioned.

“Now, I’d like to go over it all with you and see if we can pull it together and come up with a plan of action. Let’s begin at the beginning.”

I began to summarize. “Joey was a full-term baby, born October twenty-ninth with a birth weight of six
pounds, ten ounces. The pregnancy was a difficult one in contrast to earlier pregnancies with Joey’s brothers. Toward the end of the third month staining was severe enough for the doctor to advise complete bed rest for several weeks …”

For the next hour we went over each of the tests. I read them Joey’s intelligent, sophisticated answers, and they were surprised and pleased at how much he
had learned about his world in spite of all his troubles. One by one I showed them the intelligence tests, academic tests, visual and auditory processing tests, puzzles, drawings, and Dr. Golden’s comments.

I summed up Joey’s strengths: his intelligence; his excellent verbal skills, including both word knowledge and speech; his love of people and ability to make friends; his excellent physical
coordination; and his intelligent, supportive family.

I also went over Joey’s weaknesses: the large gap between his intelligence and his achievement in academic areas; his difficulty in “sitting still”; the sleep disturbances that Mrs. Stone mentioned; his difficulties with spatial relationships; his reversals in both reading and writing; his left-right confusion; his inability to sequence
digits, letters, days of the week, months of the year; his difficulty with all forms of writing; his lack of understanding of decoding skills, which resulted in wild guessing; his pattern of disorganization; his lack of confidence in his ability to learn; and an overriding factor of distractibility and frustration.

“Joey has various learning disabilities and also a certain amount of hyperactivity,”
I said. “It’s possible to have either of these conditions without the other, but in Joey’s case both are present, each compounding the other.

“From reading his report it seems there may have been some tiny damage to neurological pathways before Joey was born,” I continued.

Mr. Stone looked at his watch and cleared his throat. “All right, I can accept that. The neurologist said the
same thing, and also my brother claims he has dyslexia himself – but the main thing is, what are we going to do about it?” He looked directly at me.

“Tell me the two things about Joey that are causing the most trouble,” I said.

They both spoke at once. Mrs. Stone said, “I don’t want him to go to a special school. Everyone will think he’s retarded.”

“I don’t care what other people
think,” Mr. Stone said. “But Joey is sure to get even more down on himself than he already is if he isn’t allowed to go to the school where his brothers went.”

“How about his teacher? What do you think she finds most difficult about Joey?” I asked.

“He disrupts the class. She also said he acts like he’s not aware of what’s going on,” Mrs. Stone replied. “I think what started the talk
about a special class is that he falls out of his chair all the time now. She thinks maybe he’s having fits.”

“He’s not having fits,” I said. “You’ve already had him examined by a neurologist who found no sign of convulsive activity. I’d be willing to bet that Joey is falling out of his chair because he’s not successful when he’s in it.

“What he needs to know,” I continued, “is that
he’s smart and can learn and doesn’t have to act like a fool. I think Joey would rather have the kids in his class think he’s a clown than think he’s dumb. Joey himself is pretty sure he actually is stupid, but at the same time he’s smart enough not to want anyone else to think so.”

“How can Joey ever feel good about himself when he has so many problems?” Mrs. Stone asked. “His teacher says
he can’t read or write like the others – now a special class …”

“I’ll tell you honestly that I don’t think that Joey belongs in special education,” I said. “I taught in special ed for many years, and it’s the right answer for some children. But I don’t think Joey’s problems are that severe, and his intelligence and social abilities outside of school say to me that he belongs in a regular
classroom. I think he’s smart enough to learn to use his strengths to bring his academic skills up to grade level. You’ve had top medical advice that his hyperactivity is not severe enough to warrant medication at this time, and I think maybe Joey can learn to control his impulsive behavior if it doesn’t pay off. We just have to try to convince the school to let him have a little more time, in a
regular class.”

“That will be a miracle in itself,” Mrs. Stone said. “I think they’ve already made up their minds.”

“There’s one thing I want to get straight before we go any further,” Mr. Stone said. “Are you going to help? Are you going to work with Joey? Or are you just telling us this so we’ll tell somebody else?”

It was a fair question, and I knew what my answer should be.
There were so many children now who needed help that I often didn’t finish in my office until seven thirty or eight o’clock; understandably, Cal would not be eager for me to take on another child. Still, there was something about Joey …

I returned Mr. Stone’s steady gaze and then turned to Mrs. Stone as well. “Yes. I want to help. I’d like to work with Joey, but I can’t do it alone. I’ll
need a lot of help from both of you and from Joey and his school. I’d like to talk with his teacher every week or so. It’s important to know how he’s doing in the classroom, because no matter how well he does here with me, if there isn’t carryover into his classroom it isn’t going to help Joey stay in a regular class.

“I have two things I’d like you to do. I’d like you to have a pediatric
audiologist check Joey – just to cover all bases and make sure there is no physical cause for the low scores in auditory processing. Second, I’d like you to try to see that he eats well, with an emphasis on fruits and vegetables rather than sweets and junk food. I don’t think there’s a diet in the world that will teach him to read, but it may cut down the hyperactivity.

“The main thing will
be to get Joey to believe in himself and take responsibility for his learning and behavior.

“I tell you what. Let me try over the summer – and also talk to the Child Study Team and see if they will agree to take another look at Joey at the end of August. If there’s been enough improvement, maybe they’ll let him start in second grade.”

We went over schedules – Joey’s and mine. School
closed for summer vacation the following week, so Joey and I would both have more time. Somehow we’d have to work it out in the fall, but for now I’d see him from a quarter past nine to ten o’clock on Tuesday and Thursday mornings.

Joey arrived Tuesday morning still steeped in sleep. Hair uncombed, eyes half shut, shirttail out, shoes untied. He plopped himself onto the chair behind the
desk.

“Well,” he began, laying his head on the desk, “the good news is that school’s over. The bad news is that I had to get up to come here.”

“Would you rather come in the afternoon?”

“No. I got to swim in the afternoon. That’s how come we’re not going up to the lake till August. I got to be in about a hundred dozen swim meets.” Joey had opened the middle desk drawer and was
fiddling around inside.

“Close the drawer, please, Joey.” He had already explored it several times on other visits. I wanted his complete attention now.

Some part of Joey was always in motion, touching this and opening that. He did it unconsciously, not really aware of what he was doing. He had no real concept of what belonged to him and what didn’t. Whatever was in reach was fair
game. Before he could change, he would have to become aware of what he was doing.

Joey replaced the box of rubber bands he’d been playing with, and I said, “Good. Pay yourself twenty, that’s two blues or one red chip, for following directions so quickly.

“Now let me show you what we’re going to do today. This is your notebook; this is your bin. This is where we’ll keep the things you’re
working on. Would you please write your name on the notebook?”

“Can I use the Magic Marker you got in the drawer?”

I laughed. This was the child that was reported to be unaware of his surroundings? “Sure,” I said. “It doesn’t erase, though.”

Joey got out the pen and then looked through the black and white marbleized notebook, blank except for the first page, where I’d made out
our schedule for the day. He turned back to the cover.

“Maybe I’ll just do it in pencil first. In case. You know?”

“Good thinking, Joey – pay another twenty.”

Joey’s turn to laugh. “Twenty for just thinking? Thinking’s easy.”

“Maybe,” I said, “but it’s the most important part. You’re lucky you’re good at it.”

“Yeah,” Joey answered, writing his
J
backward with his
left hand and then scrubbing it out with his eraser and making it correctly. The
o
came out fine, but somehow when he made the
e
it overlapped the
o
. Joey attacked it with the eraser again.

As he rubbed away, Joey looked over at me, grinned, and said, “This old eraser sure does have a hard life, doesn’t it?”

How could I have missed having Joey in my life?

After Joey had written
his name in pencil and gone over it with the black marker, I took his folder from his bin and showed him how he’d done on each test.

Joey was only mildly interested, and I decided to be clearer. “The main thing is,” I said, “I want you to know you’re smart, so you don’t have to go around shouting ’bout how dumb you are and falling out of your chair.”

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