3 questions for… Dr. med. Ute Mendes, doctor for child and adolescent psychiatry and psychotherapy at the Social Pediatric Center, Vivantes Clinic in Friedrichshain, Berlin
What is particularly important when working with the affected children and their families? Ute Mendes: Comprehensive diagnostics are required before any funding starts. In addition to intelligence and partial performance diagnostics (reading and spelling tests), this includes the exclusion of organic causes. In addition, comorbid (e.g. ADHD) or secondary psychological disorders (e.g. anxiety disorders) must be clarified. The treatment of children with LRS requires close, substantively coordinated cooperation between school, parents and, if necessary, learning therapists, child and youth psychiatrists or psychologists. What happens if an LRS is not recognized? Mendes: Children whose LRS is not recognized (in school) often suffer from psychosomatic complaints, anxiety or depressive moods. They often show great sensitivity to failure and low self-esteem. At school, there is risk of cross-disciplinary reduction in performance (despite sufficient intelligence) up to general failure. The diagnosis and education of the parents, the teacher and the child often lead to decrease in secondary disorders, especially if the children are then also specifically supported and relieved (for example by protecting them from grades). It is important to consider the presence of an LRS even if another problem is first described. For example, children are presented with suspected ADHD in whom the overwork resulting from an LRS proves to be the cause of the lack of concentration. How do you advise the children and their parents? Mendes: The children often think they are stupid. They find it relieving when someone sees their capabilities in other areas and recognizes their great efforts. The path ahead of the parents is usually difficult. They have to learn to make appropriate demands on their child and to see individual progress. Special school funding measures are not always available in sufficient quality and quantity. However, extra-curricular learning therapy incurs costs that are not covered by health insurance, although LRS is diagnosis according to the ICD-10. Financing according to the Child and Youth Welfare Act (35 SGB VIII) is possible if the child is threatened with mental disability or this has already occurred as result of the LRS and their participation in life in society is impaired. Parents have to fight for the rights of their children and are dependent on support.