Lebanon-Based Program Eyes Learning Challenges Through Health Care’s Lens

  • Elaina Cooper, 11, of Grantham, N.H., explains her drawing illustrating how panic takes over when she procrastinates on her school work during a coaching session with behavioral health specialist Dr. Linda Addante at the Alice Peck Day Multi-Specialty Clinic in Lebanon, N.H., Thursday, Nov. 30, 2017. The session was part of the Rx for School Success program which identifies patients whose academic difficulties may be impacting their health, and vice versa, through a questionaire during their well-child visit. Those individuals are then given the option to meet with a coach to identify the patients strengths and challenges and help them self-advocate. (Valley News - James M. Patterson) Copyright Valley News. May not be reprinted or used online without permission. Send requests to permission@vnews.com.

  • A basket of stress toys is available as Elaina Cooper, 11, talks with behavioral health specialist Dr. Linda Addante in the Rx for School Success program at Alice Peck Day's Multi-Specialty Clinic in Lebanon, N.H., Thursday, Nov. 30, 2017. During their coaching sessions, Addante helps Cooper make plans to overcome the challenges of being a student.(Valley News - James M. Patterson) Copyright Valley News. May not be reprinted or used online without permission. Send requests to permission@vnews.com.

Valley News Staff Writer
Monday, December 04, 2017

Elaina Cooper, 11, of Grantham, stood at the front of a small room on Thursday and introduced her mom to a cast of characters who started out as amorphous shapes on a whiteboard. Over the course of the previous hour or so, Elaina had taken it upon herself to bring those shapes to life, giving them faces and names that represented her difficulty completing schoolwork.

This difficulty is part of what brought her to Rx for School Success, a program for students whose learning challenges may be affecting their mental and physical health. Now in its second year at Alice Peck Day Memorial Hospital in Lebanon, the program connects struggling learners with a team of experts from the hospital and from the Lebanon-based education nonprofit Center for School Success, which partnered with the hospital to create the program.

An information session and discussion about Rx for School Success will take place Thursday evening at Alice Peck Day, from 5:30 to 7.

At the center of Elaina’s drawing was a steering wheel — symbolizing her desire to do what was expected of her — whose course had been hijacked by a character called the Party Monkey.

“Party Monkey comes along and has an idea of something more fun to do,” Elaina explained. Soon enough though, the “Panic Monster” barges in, scares the monkey into a tree and takes the wheel into its own hands. That, Elaina said, is when “you start panicking, because you only have a short time to do (your work).”

Watching Elaina name and verbalize her frustrations that day was a big deal to her mom, Debbie Cooper, who started noticing a difference in Elaina around the time she started fourth grade last year.

“She didn’t always have a hard time. She kind of breezed through the early grades,” but hit a wall once schoolwork called for more and more memorization, Cooper said during an interview in the waiting room, while Elaina was in her coaching session with behavioral specialist Dr. Linda Addante.

Elaina was having an especially hard time with her math facts and spelling words, and her self-esteem started to plummet. Meanwhile, Cooper’s confusion about what was going on led to friction at home.

“Lainey was at a point where she would say ‘Mom, I’m just dumb,’ ” Cooper recalled. “Just feeling really bad about herself. And then I was on her case so much because I didn’t know what was wrong, either. Homework was a nightmare. We were arguing. It was a bad dynamic.”

Eventually, Cooper brought Elaina to her pediatrician at Alice Peck Day, who thought Elaina might be a good fit for Rx for School Success, then in its pilot year. The doctor explained that the program takes a holistic approach to students’ well-being, and provides 30- to 45-minute coaching sessions to help them understand and advocate for their own learning needs before their concerns spin out of control.

Elaina completed a questionnaire about the academic, social, psychological and biological spheres of her life, which indicated that her learning challenges placed her at-risk for health problems.

She’s not alone. Many students become so distressed about their performance in school that they experience sleep disturbances and anxiety-related aches and pains, said Dr. Doug Williamson, a pediatrician at Alice Peck Day and the medical director of Rx for School Success, in an interview at the hospital. For example, headaches and stomach upsets that “mysteriously disappear on the weekends” could stem from school-related stress, he said — and such symptoms are on the rise.

“In the past 20 years, there’s been a big pop in learning challenges,” he said, though he was hesitant to ascribe an exact cause, since there is likely a variety of factors that differ from student to student. But he did acknowledge that many school systems are demanding more from students than they used to, and that genetics and home life can play a role in determining how a child will navigate an increasingly benchmark-driven academic environment.

Attention deficits, like the ones Elaina ultimately realized she experiences, are among the most common learning challenges Dr. Williamson sees in his patients. But many children also find it hard to express themselves through language, or have difficulty holding short-term information in their working memory, or struggle to connect their thoughts to the physical act of writing, said Leslie Williamson, executive director of the Center for Success and School. (She and Dr. Williamson are married, and Rx for School Success arose in part from long conversations they’d have with each other at the end of the day, they said.)

“These kids are capable, and they have promising futures if they can get out of their own way,” said Dr. Williamson. “What we don’t want is for them to go the other way, which is when they get discouraged and eventually depressed and drop out.”

He and Leslie Williamson said that these difficulties often become noticeable during transition periods, such as entering middle or high school. This doesn’t, however, mean that students weren’t suffering before.

“In the literature,” said Leslie Williamson, “it’s suggested that there can be two-plus years between the time when children start feeling difficulties, to when these difficulties manifest,” often in the form of behavioral or emotional problems related to low self-esteem. “That’s a long time for a child to feel that way.”

She added that Rx for School Success is a way to give those children a sense of agency over their own learning: It’s always the student’s decision to start, continue with or leave the program, because “what we’ve found,” she said, “is that children are accurate reporters of their own experiences.”

If the student decides to give Rx for School Success a try, he or she will work with a team of experts — Doug and Leslie Williamson, program coordinator Nancee Tracy, a behavioral or learning specialist, such as Addante, and the child’s primary care provider — to figure out what the student’s main challenges are, and develop strategies to make school less stressful.

For example, a student might have every intention of focusing on a lesson, but then when the bell rings at the end of class, they realize they’ve been staring out the window for some time, without knowing when or how they departed on what Leslie Williamson called a “mind trip.”

These students might benefit from using a chart to track their awareness throughout the school day, which can help them catch their mind early on in a trip, and reel it back in. They might also explain to their teachers that certain things help them focus, such as doodling or sitting at the front of the classroom.

Levi Smith, a third-grader from East Thetford, has now gone through a couple of coaching sessions with behavioral specialist Dr. Steven Atkins. His mom, Sarah Smith, feels the results so far are promising.

“He is really into certain things. He loves science,” Smith said in a phone interview. “But he was struggling with writing — not focusing on writing and just not being interested in writing at all. I didn’t know if it was a focus issue or a stubbornness issue or what was going on with that.”

She likes Rx for School Success because she doesn’t like the idea of putting Levi on medication — not that it isn’t an option in the program, but it’s not the first option — and because Levi’s team has created a “safe environment” for both of them.

“I don’t know if this is kind of weird to say, but they’ve really treated us like family,” she said in a phone interview. “Leslie and Nancee have been really nurturing and helpful, and answering all my questions with more information than I know what to do with. … They’re incredibly attentive to what we need.”

So far, Levi’s team has discovered that he’s a visual learner, meaning that “if people can work with him on creating pictures in his head, instead of only telling him verbally, he crystallizes that information much better,” Smith said, adding that this may shed light on Levi’s reluctance to write. She thinks the next step might be trying to figure out how much of an issue focusing is for Levi.

“Hopefully we’ll get more information. But the insight that he’s a visual learner is huge,” she said. “Things like that they can just tell, because they do this all the time, figuring kids out by doing little activities with them.”

That Rx for School Success is free is crucial for Cooper and Smith, who said their children might not be able to participate in the program otherwise. So far, the program has been funded by philanthropic donations, “but it won’t always be,” said Leslie Williamson. She said she’s looking into ways for the coaching sessions to be covered by some insurance plans.

“The ability to figure out this much stuff about my kid, it’s incredible to me,” Smith said. “It’s only the beginning of the process, but I feel like at the end, we’ll have a really good picture of the best things to do.”

An information session about Rx for School Success will take place on Thursday evening from 5:30 to 7, in the Dwinell Room at Alice Peck Day Memorial Hospital. For more information, contact program coordinator Peggy Cooper at cooperm@apdmh.org or 603-448-7456.

EmmaJean Holley can be reached at ejholley@vnews.com or 603-727-3216.