Dear Dr. Linda,

Ethan is in the eighth grade and struggling in almost every subject. He always does his homework and does OK on tests when I work with him. But that means I literally have to repeat myself over and over again for him to understand what I’m saying, and even then he doesn’t always get it. When he does, though, he even remembers things he learned in elementary school. We’ve had him tested and seems his hearing is fine and he doesn’t have ADD. He’s a sweet kid, but I think something is wrong. Do you have any ideas about what could be going on?

Ethan’s mom

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Dear Ethan’s mom,

There are Ethans in every school who are bright children, but who struggle in school because they miss what the teacher is saying. It often begins way back in preschool and kindergarten when, for instance, a teacher tells children to put away what they’re doing, take a mat and come and sit on the floor for story time. When the Ethans don’t immediately end up on the floor sitting on their mats, the teacher reprimands them for not listening and paying attention. The problem, though, is not that they weren’t listening and paying attention—it’s that they didn’t understand or were confused.

It’s frustrating for teachers, I know. It happens so often in elementary school that many teachers have resorted to a rule: “Ask three, then me.” What those teachers mean, of course, is that before they will repeat what they said to the class, s/he must ask three other children what was said or what s/he needs to be doing. (Nevermind that there’s probably also a rule about talking to neighbors in class.)

You said it yourself. One time through isn’t enough for students like Ethan to understand oral directions or new material. And for kids like him, there’s nothing quite as motivation-destroying as hearing things like: “If you were paying attention, you’d know what I said,” or “I just said that,” when you know you were paying attention but just can’t connect the dots. By the time they reach middle or high school, these children often give up and check out.

So, what is going on? If you have to repeat things over and over for Ethan to understand what you’re saying, it may be that he has an auditory processing disorder. That means that he can’t quickly put what he hears together to make sense out of it. (Think of the adults you know who don’t get a joke until someone tells it again or even explains it—it isn’t that they’re not listening to you, is it?) Children and adults with APD don’t process what they hear as quickly as others. Some have trouble recognizing slight differences in the sounds of words, especially if there’s a lot of background noise, as in an elementary school classroom, for instance.

• If you’re a teacher, please throw out the rule “Ask three, then me.” Yes, it’s out of the question if you have 20 to 30 kids to repeat everything to each child individually. But, chances are that it’s not every child—the children who ask you again and again are the same ones most of the time. By telling them to leave you alone and ask other children (who may not understand what you said, either), you are really telling them that they’re not worthy of your attention. Note which children keep asking you what they should be doing, contact their parents and have them make an appointment with an audiologist to make sure it’s not a hearing problem, and if hearing is OK, consult a school or private psychologist for testing. There could be other reasons for the behavior, too—children with ADHD, short-term memory issues, or difficulty hearing specific sounds often exhibit the same symptoms.

• If you’re a parent, as with the teachers, I understand you get frustrated and annoyed, especially when it happens over and over. But a child who keeps asking you to repeat what you’ve said has a problem he isn’t equipped to solve for himself. As his parent, you need to determine the source of the problem. Contact your pediatrician and ask for references so you can have your child evaluated by an audiologist, neurologist and/or psychologist.

In the meantime, Ethan’s mom, when you work with him:

• Remember to show him the same respect that you’d show an adult. If a friend asked you to repeat something you said, would you accuse her of not paying attention?

• Have him explain to you—in his own words—what he thinks he has heard from you or in class. If he doesn’t get it, you’ll know. And remember…just because you say it over and over doesn’t mean he understands a concept or what he’s supposed to do.

• Preview with him what is going to be taught before he hears it in class. If exposed to the terms and material before he hears them when his teacher talks about them in class, he has a better chance of connecting what is said.

A few simple changes may make a world of difference for Ethan.

Dr. Linda

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