Child and adolescent psychiatrists in schools: practical issues related to communication and learning deficits

Language disorders and deficits and related learning disabilities (LaDs/LDs) in students ages 11 to 18 years frequently go undetected. Understanding associations between communication and learning disorders informed by research, and comprehending relevant federal categories of eligibility for school assessment and services for effective treatment planning, is essential for health promotion and prevention, treatment, parent guidance efforts, and advocacy for many students. Likewise, child and adolescent psychiatrists working in schools have the opportunity to positively mitigate the impact of LaD/LDs on affected youth and to feel competent in their roles in schools and school systems to identify and address needs related to student with LaD/LDs. An overview considers LaDs and LD comorbidity, and school-based services based on federal categories by relevant special education and disability law. The prevalence of LaDs and LDs in school populations, along with advances made in their identification, assessment, and treatment, and the role of child and adolescent psychiatrists in mitigating the problem are presented. Results and implications of 500 youth ages 11 to 18 years by their self-report of language deficits, related frustration, and the extent of past, current, and desired services for their LaD/LDs are reported. Research to inform child and adolescent psychiatrists functioning to assist in developing individualized education programs (IEPs) and consulting on problematic students is synthesized for practical application in working with teachers and school staff. Child and adolescent psychiatrists have improved insight into the impact of LaD/LDs on students and the roles they may play in schools and school systems to identify, case-formulate more effectively, and optimize school services for affected youth. Their competence and comfort level are increased in guiding interventions for this difficult-to-treat population, particularly those diverse from the mainstream. LaD/LDs are significant problems in school settings. Child and adolescent psychiatrists have the unique opportunity to provide care in the environment where they routinely function.