More and more parents are seeking help from the psychiatric clinic after their children's grades have problems
Wen / Xin Ying Cao Yujie
Editor/Wang Xiao
Photo / Dr. Zhang Lili of the Children's Research Institute "chatting" with the children attending the clinic / Xin Ying
Every Tuesday afternoon, parents with children are waiting outside the "Learning Difficulties" special outpatient clinic of the Children's Hospital Affiliated to the Capital Institute of Pediatrics (hereinafter referred to as the "Children's Research Institute").
Since May, the Children's Research Institute opened a "learning difficulty" special outpatient clinic, it is difficult to find, the attending physician Zhang Lili overtime has become the norm, and at the end of the consultation, often the entire floor is only the light of this room is still on.
The "learning difficulty" here is not a specific disease. Zhang Lili, who specializes in child psychology, found that more and more parents choose to go to the hospital for treatment when their children are not studying well, but they do not know which department to see. Therefore, the hospital added a special outpatient clinic and arranged for three doctors to take turns to visit the clinic.
"Two-thirds of the children don't actually have medical illnesses and just need to adjust some study habits, but some parents are too worried that the children can't meet their parents' expectations." Zhang Lishun pointed to a thick pile of consultation records next to the computer, "This situation occurs more concentrated in the families of children with high IQs, many of whom have IQs above 109."
After more concentrated contact with children with "learning difficulties", Zhang Lili also felt the anxiety of parents in their children's learning more intensively, because there are many cases of corporal punishment of children because of learning, "whether the child really has a mental illness that affects learning, I hope that parents can adjust their mentality and treat it correctly."
Most of them are not children who are sick, but the "grades" anxiety of parents
After the start of the school year, the number of consultations per Tuesday afternoon in the special outpatient clinic for learning difficulties, which mainly treats primary school students, is already less than that in the summer vacation. However, it was also 7 o'clock that the assistant informed that there were no patients outside the door. Zhang Lili, who did not stop for a moment throughout the afternoon, took off her mask, drank two sips of water, and went to the bathroom.
More than 20 groups of patients are the limit of Zhang Lili.
If you are in the general internal medicine clinic, a patient can read 50 numbers in one afternoon in three or five minutes. However, the psychological clinic is different, each first-time family has a consultation time of at least 20 minutes, and the hospital only has 15 numbers open in half a day. The first patient this afternoon was 40 minutes long, considering that there were too many people waiting behind, Zhang Lili had to interrupt the parents, prescribe the examination plan, and read the results before communicating.
Most of the plus signs are follow-up patients. Due to the difficulty of number grabbing, the solution negotiated in the department is that the follow-up patient hangs up the ordinary health department number and goes to the learning difficulty clinic to follow-up the clinic. As a result, work is overdone almost every week.
Photo / Parents and children waiting at the entrance of the pediatric research institute with learning difficulties / Xin Ying
Xiao Le (pseudonym) in the fifth grade of primary school, in the process of "chatting" with him easily, Zhang Lili initially learned about Xiao Le's learning status, living habits, expression ability, interpersonal relationships, and family environment, including observing whether his expression squeezed his eyebrows, whether his attention was not easy to concentrate, and whether he had a tendency to be hyperactive.
The child's and the parent's consultation is carried out separately, and the concern revealed in the parent's words is a different situation compared to the child's carefreeness.
Xiaole's father did not know about the learning difficulty clinic before, and the teacher did not feedback that the child had such problems, but Xiaole's parents felt that the child's attention was not concentrated, and after hearing about this department, they came to see.
Grades have been eliminated in elementary schools, but parents' focus on grades has not diminished in the slightest. Although Xiao Le's score fluctuated, but there was no failure in Zhang Lili's consultation standards, the score of more than 70 points was low in Dad's view, "There are still a lot of homework errors, the content of the first grade is simple, and it is not easy to see the impact, but the content behind is more difficult, and the impact of poor attention is more obvious."
Zhang Lili's preliminary judgment after the consultation was that the problem was not big, "The child is fine except for the special ability to speak." But if you are not at ease, you can do a concentration test."
In addition to routine questionnaire tests such as intelligence, attention, and emotional behavior, electroencephalogram testing may be required, and magnetic resonance imaging may be required for individuals.
About two-thirds of the children are disease-free after the test. Parents are too worried, and it is easier to appear in the families of high-IQ children. "Smart children are more likely to be questioned, parents hope to get 100 points, test to 98 points, dad feels that they can't accept it", every week Zhang Lili can receive one or two such families.
A mother who came to the clinic asked her to concentrate for 40 minutes every time she accompanied her third-grade daughter to do homework. Zhang Lili smiled and said that children of this age, the level of concentration is 15 minutes - 20 minutes, can not be too strict.
However, Zhang Lili still reminded that if problems are found, it is recommended that parents come to the hospital in time to identify and identify to see if there is a problem with attention. For example, the incidence of ADHD in children is on the rise. According to international statistics, the incidence of ADHD has risen from 3% to 5% to 7%.
ADHD is a neurodevelopmental disorder that easily affects the grades of school-age children, which in turn leads to inferiority complex, interpersonal skills, and personality will be more withdrawn and irritable. Compared with the liveliness of normal children, children with ADHD will be "naughty" regardless of the occasion, lack of self-control, mainly manifested in inattention, hyperactivity, impulsivity.
For mild ADHD, it can be improved by strengthening cognitive training, exercise intensity, psychological intervention, family education, but for undesirable situations, it is necessary to cooperate with drug treatment, because it is a chronic disease, the treatment cycle of ADHD is in years as a unit, and it is necessary to take drugs for at least one or two years.
Zhang Lili introduced, "The current drug treatment is relatively mature, and some parents are not at ease before, and they have prescribed medicine to go back to eat for a week before giving their children food." ”
A peaceful view of "learning difficulties"
In the medical profession, "learning difficulty" in the narrow sense is actually a kind of learning skill development disorder. Mathematical learning disabilities are a typical example of this. "The same question, taught 10 times, 20 times or not, this may be a disease." Zhang Lili said.
In addition, there are dyslexia, dyslexia, such as children jumping when reading, missing words, disordered order, etc. Learning skills impairment may also be complicated by conditions such as ADHD and Asperger.
"There are actually relatively few such patients, but the treatment is very difficult." Zhang Lili introduced that due to the limited treatment methods, long-term correction is the mainstay, and it needs to be found as soon as possible.
Photo/Waiting at the entrance of the pediatric research institute for learning difficulties / Xin Ying
When a mother from another province found Zhang Lili, her son was in middle school, and because of her poor math scores, both mother and son had anxiety disorders.
My son's grades are often compared because his older brother, who is already in college, has excellent grades. Three years ago, my brother was diagnosed with ADHD in the local area.
In order to improve her brother's math scores, not only to enroll in extracurricular classes, but also to ask one-on-one tutoring, and even tried some drug treatment programs, the mother always insisted, hoping that through hard work, can improve the child's grades.
After the examination at the Institute of Pediatrics, it was diagnosed with learning skills disorder, "the intellectual structure does not match, and there is a problem with logical thinking ability". Zhang Lili introduced that at present, there is basically no drug to treat the learning skills disorder, and it mainly relies on intensive training. Taking writing difficulties as an example, if the child always writes the opposite word (the left and right structure is written backwards), you can use the touch class bypass, choose a simple word that is not easy to write incorrectly, and group words, first let the child slowly remember what the word is in this word, and then gradually associate and apply it to other contexts.
A number of social institutions have also introduced various training programmes. In response to dyscalculia, the State Key Laboratory of Cognitive Neuroscience and Learning at Beijing Normal University has also launched a study. After the intervention, the accuracy of the questions was significantly improved by those who had difficulty with calculations compared with the students who did not intervene. In another brain cognitive function training, Jiangsu has 6-12 classes participated in experimental research, and 6 classes have been trained for 2-3 years using abacus methods. The other 6 classes are taught in the traditional way. In the regular class, the incidence of dyscalculia was found to be 6% through assessments, and after the implementation of abacus education, the incidence of dyscalculia was 0.
"It's hard to say how much the training can be strengthened for different cases." In most of the patients Zhang Lili has contacted, the help is limited.
With all the efforts, no effect was seen, and the mother was particularly hit, and at the same time, the pressure on the younger brother was also increased. Zhang Lili suggested that parents try to adjust their mentality, "excessive training, children have not improved, their frustration will be stronger." To see the child's shining point, you can't have to take the child's shortcomings and compare it with the advantages of others, so that the child's pressure will become more and more intense. The motivation to learn is getting worse and worse, resulting in a feeling of boredom towards school, and incorporating more psychological problems."
Don't let parents' emotions increase "learning difficulties"
After several months of continuous online classes, as long as her mother saw Xiaofeng (pseudonym) studying at home, a nameless fire rose in her heart.
"She couldn't control her emotions anymore, and that's when she realized she had a problem," Jia Xiaoying, a community worker at a social psychological service center in Beijing's Changping District, met Xiaofeng's mother when she went to the community to provide mental health service publicity.
Xiaofeng began to attend primary school in 2020, and due to the impact of the new crown epidemic, intermittent online classes and school learning alternately. This is not a case encountered by Jia Xiaoying, "School life is actually an important part of cultivating children's learning habits, which is irreplaceable by online classes, and even adults are not so focused when they hold online meetings." ”
According to the State of the World's Children 2021 report, more than 1.6 billion adolescents worldwide have been affected by the COVID-19 pandemic in their studies. More than 13 percent of adolescents aged 10-19 have a mental disorder as defined by the World Health Organization.
More importantly, after asking professional psychological counselors to intervene, it was found that Xiaofeng's mother's emotions did not come entirely from the child's learning, but also had the impact of many aspects of work and life, but the contradiction eventually broke out on the issue of children's education, which aggravated the child's fear of difficulties, and the vicious circle of "learning difficulties".
"Sometimes, it's harder than accepting that there is a problem with a child's ability to learn, and there's a problem getting parents to accept that they are raising their children." Among the "learning difficulties" children treated by Liu Nan, deputy chief physician of Beijing Puren Hospital, a considerable number of them are resistant to learning due to emotional problems, "such as parents always quarreling in front of their children, teachers in the school often counting children, and the tension between parents and children during adolescence."
Some parents even say "How can there be a child like you because their children are reluctant to go to school?" Your good homes have been ruined by you." Liu Nan is because the child is tired of school, the results are not good to receive the family to this family, parents think that either the child has a problem with intelligence, or the child is disobedient, the doctor to do ideological work, the child's academic performance can be good, but did not realize that the problem of education has led to the child's depressive symptoms.
Liu Nan suggested that for every child with "learning difficulties", parents should first pay attention to their children's emotions and be vigilant against the psychological problems behind learning difficulties. At the same time, you must also pay attention to your emotions, learn to regulate emotions, and do not simply vent emotional pressure on children.
In the past ten years of practice, Zhang Lili feels that parents attach higher importance to children's mental health, but to improve children's "learning difficulties", parents and schools still need to cooperate at the same time.