Joint efforts tackle child learning difficulties

Viral social media post shines spotlight on topic that was misunderstood, little discussed

The learning difficulties clinic at Children's Hospital of Fudan University in Shanghai has been in existence since September 2020, but few people were aware of it until recently, when a parent noticed the clinic's name on the hospital's electronic notification board.

The parent then took a photo, uploading it to social media platforms with the comment, "Had there been such a clinic during my childhood, I wouldn't have been an underachiever and my life would be completely different."

The post went viral, and Zhu Daqian, director of the hospital's psychology department, who is also in charge of the clinic, has found herself facing numerous interviews and questions related to learning difficulties.

Similar clinics in Shanghai and cities such as Beijing, Nanjing, capital of Jiangsu province, and Wuhan, the Hubei provincial capital, have seen a significant rise in the number of people seeking consultations, according to local media reports.

Zhu said: "We decided to establish this clinic in 2020 because we were receiving a growing number of cases of strained parent-child relationships at our psychology clinic. These cases accounted for nearly 90 percent of the total. Most of them were related to children's less-than-satisfactory academic performances."

Most parents are still quick to associate their child's poor academic results with a lack of motivation or low intellect. They rarely consider the fact that the child might have a learning disability.

Zhu said there are various forms of learning disabilities, including dyslexia, attention deficit hyperactivity disorder, or ADHD, and autistic spectrum disorder. The key to addressing these problems is to identify them early. She added that children with neurodevelopmental disorders often require rehabilitative training, which is most effective when they are still in kindergarten.

"Most children with ADHD see great improvements with the proper medication and behavioral intervention," she said.

Zhu added that most learning difficulties are hard to identify early and can go undetected until a child enters the third or fourth grade, when there is a significant increase in academic workload.

Misconceptions, stigmas

Research worldwide estimates that 10 percent to 17 percent of children experience learning difficulties. Despite this prevalence, the topic is rarely discussed in Chinese society due to misconceptions, ignorance, or the stigma associated with it, Zhu said.

She added that she is surprised and happy to see the sudden surge of public interest in the issue.

Wang Hui, a psychology teacher and counselor at Shanghai Zhabei No 1 Primary School, said many Chinese still do not understand ADHD even though about 15 million children in China－roughly 5.6 percent of the child population－have the condition.

She added that most Chinese consider a child with ADHD to have unusually high levels of energy.

"The fact that most people only associate ADHD with hyperactivity is evidence of the common misunderstanding of the learning disorder," Wang said. "Some ADHD patients experience only serious attention deficit issues. Not all such patients are hyperactive."

Zhu said another common misconception about ADHD is that the condition will disappear when a child grows older. While there have been examples of this happening, such cases are the exception, not the norm, she said.

According to research, about 2.5 percent of adults experience ADHD, meaning that at least 50 percent of children with the condition continue to experience it even after they reach adulthood.

Wang recalled an incident some years ago when she and her colleagues had to go to great lengths to convince a student's family, especially his grandparents with whom the child lived, that the boy had ADHD and needed medication and behavioral intervention.

"Most parents are reluctant to have their child take medication, due to concerns about possible side effects on the child's growth," Wang said.

Zhu Jie, a teacher who is also a psychology counselor at Shanghai Jing'an Foreign Language Primary School affiliated to Shanghai International Studies University, said he constantly encounters such concerns from parents.

"I always tell them that any side effects from medication will have less impact than ADHD might have on the child if left untreated," Zhu said.

Based on what he has learned from books and through experience, Zhu said neurodevelopmental learning disorders such as ADHD can seriously affect a child's learning ability, resulting in low self-esteem and impeded personal development.

"Such problems could leave a student with lifelong trauma, as he or she might experience a sense of helplessness. As such, it is imperative that these issues are addressed early," he said.

Tackling the issue

Zeng Fanlin, an associate professor of special education at East China Normal University, said that in recent years the authorities have taken steps to address such issues. For example, inclusive education has been listed in the nation's 13th (2016-20) and 14th (2021-25) Five-Year Plans.

Schools nationwide have also recruited staff members with special education training to help such children. For instance, since 2012, the authorities in Shanghai have ruled that schools with more than 500 students must hire at least one qualified psychologist.

Long before this, many schools in the city launched efforts to look after the psychological health of their students, including those with specific learning disorders, Wang said. Shanghai No 1 Zhabei Primary School, where Wang works, is one example of such efforts.

Since the 1990s, the school, which was among the first to be named as an example to follow in terms of caring for students' mental health, has had a counselor on campus. Wang, a Chinese-language teacher at the school since 1991, took over the position in 2009, when she qualified as a psychologist. As the on-campus counselor, she is responsible for helping screen students for possible learning disorders.

Team effort

However, schools cannot be overly reliant on counselors to identify children with learning difficulties. Parents and teachers－who spend the most time with the students－should also help, Wang said.

"It's not fair or feasible to rely solely on counselors to address this situation," she said. "There is a growing consensus that inclusive education needs a systemic approach that requires efforts from families, schools and medical institutions."

Wang recalled an example of a student with ADHD experiencing extreme mood swings during class. After consulting the student, his family and doctors, the school drew up a learning schedule that allowed the boy to attend different classes to learn major subjects in the mornings. In the afternoons, he was free to read, exercise, take private tutoring lessons and undergo psychological counseling.

The decision proved highly effective, as the student went on to do well in his studies.

"This would not have been possible without the efforts of all the parties involved," Wang said.

Zhu, from Children's Hospital of Fudan University, said that since 2016 the hospital has contacted primary schools in the city to promote awareness of learning disorders.

"Cooperation between parents, schools and medical institutions is key to early detection," she said.

Although it is encouraging to hear of such children achieving academic success, Zhu Daqian is quick to remind the public that medication and intervention do not guarantee good grades.

"There is no doubt that many patients have improved in their studies after receiving treatment at our clinic. But as psychologists, our top concern is not to help them succeed academically," she said.

"Rather, we focus more on the psychological health of the child and his or her parents. We consider ourselves more a companion to children as they grow up. We are here to relieve them of the pain of not being able to learn in the typical manner, and help them find their own ways to learn."