Specific Learning Disorder (SLD) and School Failure in a 12- Year- Old Girl Suffering from Type 1 Diabetes (T1DM): Interdisciplinary Therapeutic Approach

Abstract

Introduction: School performance, especially in children with SLD (SLD), is adversely affected by the coexistence of a chronic physical illness, such as Type 1 Diabetes (T1DM) (previously called juvenile diabetes or insulin-dependent diabetes). Being diagnosed with a chronic illness can be overwhelming; especially at the start it can be stressful for the child and its family. We are conscious that living with T1DM can be really challenging for children and adolescents in terms of complexity of treatment and the required level of family involvement for a successful management. Aim: This article proposes a different approach to the phenomenon of learning difficulties and poor school performance in children who confront a major chronic physical condition, such as T1DM. We report the case of a 12-year-old girl who experienced SLD and school failure, while managing to adjust with T1DM. The purpose of this article is to highlight T1DM impact on psychological well-being and school performance in children and adolescents with SLD, presenting their experiences of their condition and treatment and those of their careers. Case Report: A 12-year-old girl being diagnosed with SLD and T1DM came to our hospital for examination, feeling particularly vulnerable and anxious. The Child and Adolescent Psychiatric Assessment (CAPA), which usually takes place in our medical setting, in collaboration between Outpatient State Certified Diagnostic Department for Learning Difficulties and Child Psychiatry, highlighted a range of psychological symptoms that were common in PTSD and depression. A two-year follow-up revealed the challenge of patient adherence in managing T1DM but also highlighted the disease’s impact on the psychological well-being and school performing. The main need was to shape an integrated intervention program consisting of two major areas: (1) appropriate teaching methods and curricula designed to respond to the child’s particular needs (2) an environment that creates need for structural change. Integrating these two areas and building them into a simultaneously functioning integral system ensured that the needs of our patient with SLD were met. Conclusion: Early interdisciplinary intervention is key for people with learning disorder and chronic disease. If problems are identified early, intervention can be more effective, and children can avoid going through extended problems with schoolwork and related low self-esteem. Overall, experience and research seem to indicate that the best preventive approach in T1DM patients who experience educational and psychological problems is a strong, supportive family who is able to follow health professionals’ instructions.