Hello, Dr.T speaking...

fion7889

Hi , Dr. T,

我係一個在職媽媽, 我仔仔剛剛三歲, 醫生診斷仔仔有自閉症徵狀, 其實我而家可以做到d乜....

A1

test

ALAL

Dr T,
My son (7 years old) has undergone a dylexsia test in Yaumeiti government clinic. There are about 10 items for test for Chinese, and for English just spelling and word recognition. The psychologist (student) said my son's dictation result for chinese is 6 marks out of full marks 10 and for English only get 2 marks. But for word recognition in Chinese my son is above standard and for English is okay.

Her comment is that my son doesn't have dylexsia, but would not have good mark in dictation. She also comment that he is not attentive in doing the assessment.

What is your comment on the assessment result ? Is the assessment similar to what you done to your client?

I will met the psychologist in Yaumeti clinic coming Tuesday. Just wish to listen to your opinion first. Thanks.

Dr.T

直覺上他做的測驗似乎不是正式的"香港讀寫障礙測驗"...最好問一問...因為應該不只10題...很大可能是一個初檢的測試而已 如果是的話那有可能根本未看清楚事情的全部...

這是我覺得藍醫生的文章有點諷刺的原因,因為"彊化和官僚的指引"好像是指他們多一些,又或者她是指教統局???

***什麼是「邊緣讀寫障礙」？
兒童體能智力測驗服務部 藍芷芊醫生

讀寫困難可以劃分由輕度至嚴重狀況，假若某人的嚴重的困難沒有被評估出來或得到適當的支援，可以嚴重地影響他日常的生活。那麼，我們在什麼情況下，需要對讀寫困難作出特別的支援呢?

邊緣讀寫障礙又是什麼呢?

今天，除了不少學童被評定讀寫障礙，也不少學童被介定有邊緣讀寫障礙。這些學童往往在學習上面對不斷的困難，卻得不到適當的支援。「香港讀寫障礙測驗」是一個標準的測驗，讓專業人員能夠較準確地掌握學童的問題所在。在測驗結果中，當某部份能力測驗的得分「不是太低」，但同時在其他能力測驗的得分又低於標準時，這類情況，可能被評定為「邊緣讀寫障礙」。然而，面對這些學童，我們如何評定他們在學習過程中，是否需要協助？

事實上，以失明學童為例，他們是不會被要求通過一般閱讀而學習，但是對於一些邊緣視障學童，當他們也不能正常地通過閱讀書寫而學習，相信專業的醫療人員及教育工作者都不會因為視障的標準化定義，而否定這類學童是需要協助的。

對於讀寫障礙的學童，支援是否有效是受到兩個基本因素影響，一是學童何時得到支援，二是學童的支援量。由於兒童的腦部發展在幼時其可塑性較高，因此當他們逐漸成長，其可塑性便相對減低。另外，若學童需要追趕大量的知識及課程以達至一般水平時，也會直接影響支援的效果。世界上所有讀寫障礙的測驗，都是一個參考工具，使用者必須將資料演譯及理解到學童的學習層面，加以運用。如果等到邊緣讀寫障礙學童出現明顯問題時才作出支援，這樣對他們的成長會造成不必和可能嚴重的傷害。

彊化和官僚的指引，對成熟的教育工作者並無實際效用。當政府要求前線教育工作者為有特殊學習需要學童進行評估時，她們假定教育工作者已有足夠的專業知識及技巧去評定個別學童的學習需要，而不需依靠測驗的結果。假如我們的教育工作者都認為在未有足夠確認學童確實情況前，而一律不提供支援給邊緣讀障礙的學童，那就會再一次證明目前的教育系統還未準備好透過「教學診斷及協助學童」的教育模式。

有邊緣讀寫障礙子女的父母應該努力向學校爭取為學童提供適切的支援，你們應該要尋求為什麼有一般智力、學習機會及家庭支持的學童，不能更有效地在香港的教育制度下獲益。

ALAL 寫道:
Dr T,
My son (7 years old) has undergone a dylexsia test in Yaumeiti government clinic. There are about 10 items for test for Chinese, and for English just spelling and word recognition. The psychologist (student) said my son's dictation result for chinese is 6 marks out of full marks 10 and for English only get 2 marks. But for word recognition in Chinese my son is above standard and for English is okay.

Her comment is that my son doesn't have dylexsia, but would not have good mark in dictation. She also comment that he is not attentive in doing the assessment.

What is your comment on the assessment result ? Is the assessment similar to what you done to your client?

I will met the psychologist in Yaumeti clinic coming Tuesday. Just wish to listen to your opinion first. Thanks.

Dr.T

造成小朋友不專注的原因很多,我會覺得只有透過詳細觀察及評估才可以分清不專心的源頭.例如他上課不專心,不跟指示但又可以專注彈琴2小時可能代表他對某一個資訊的來源吸收得較好.

可以先考慮政府的服務(醫生寫紙轉介)...聯絡資料請check pm

...What can I do to help him improving his self-control/social skill?  and, If I want to bring him for some assessment, can you PM me your contact details?

Dr.T

盡快排政府服務的隊(要經社工);向家長資源中心(如協康會屬下的數間)查詢有關的家長講座/輔導;如經濟許可的話安排私人的訓練...

抱歉好像講得很簡單,但直接面對問題,尋找解決方法是最重要...

fion7889 寫道:
我係一個在職媽媽, 我仔仔剛剛三歲, 醫生診斷仔仔有自閉症徵狀, 其實我而家可以做到d乜....

Dr.T

如果問題比較輕微的話,那早些安排入學,讓他有多一些語言刺激,和單對單見治療師可能效果不會相差很遠(尤其是當經濟是一個主要考慮點時).

但當然你要密切留意小朋友的進展,如果過了一段時間依然發展緩慢的話那又另作考慮了

...我個仔2歲5個月大,剛讀幼兒班,已做語言評估, 言語治療教師說他的認知能力已達標, 語言能力有1歲8個月,他說只是語言輕微遲緩了小小,他建議我去上堂學如何在家教他語言就可以了,未須要為小朋友報私人的言語治療班(其實我家的經濟緊拙),他亦為我們安排政府早期訓練,但要到2008年2月才有位上,請問他的建議是否真的可以嗎?

Dr.T

多謝你的回應...

我總是覺得錢不是沒有,問題是用不得其所...總是想走捷徑,但基本的又未必已經做好.

正如日前看到"施政報告"話會花2億發展資優教育時心中不禁冷笑 --如果那2億只是用來錦上添花,只是選那些本身成績已甚佳的學生加以培訓,而非雪中送炭,針對那些資優但因行為情緒問題成績無甚表現,甚至差的學生,那多多錢也沒有用,得益的永遠只是那些只懂得拿Renzulli的三層架構出來"嚇"人的技術官僚...

抱歉,借題發揮了

rachaelmum 寫道:
好同意您的看法! 囡囡現在正是面對同樣的困難, 渴望和同儕建立友誼卻沒有技巧, 在學校遇到社交的問題, 老師只叫我們多在家裏提點女兒。

學校是學習社交的最好環境, 偏偏卻沒有投放資源和人手, 唉 :cry:  :cry:

Dr.T

早前做了嬰幼兒評估試測的家長十萬分不好意思---其實結果早已處理好,但未有時間打好再寄出...今個星期一定,一定寄出     

A1

Dr. T,
Thanks for your advice.  

gigi2

   Same thought and agreed with you!

Dr T: 只是選那些本身成績已甚佳的學生加以培訓,而非雪中送炭,針對那些資優但因行為情緒問題成績無甚表現,甚至差的學生,那多多錢也沒有用,得益的永遠只是那些只懂得拿Renzulli的三層架構出來"嚇"人的技術官僚...

linglam

Hello Dr. T,

我都想請教下, 我個女兩個多月, 但係仲唔係好識望實我,成日周圍望, 叫佢同佢玩,佢都好似唔識. 佢會否有問題? 我真的很擔心 !!

gigi2

Dr T,

Any idea to those child who knows herself behave badly in class but she does not scare the scolds from teachers (teachers will scold her or give her less chips to eat etc but will not punish her by ruler, standing alone in front of blackboard etc.)

As you know, this is my girl's case.  :evil:

linglam

Dr. T,

唔好意思, 唔記得話你知佢一右眼矢明, 所以我好擔心佢左眼視力, 同腦部有問題!!我真的很擔心

gigi2

Dr T,

再補充一下,我現在初試行獎勵計劃。課堂行為乖的那天有她喜愛的玩意或遊戲，否則便罰停不准玩，例如玩电腦錄音等等。雖然她好想玩，但返咗学又唔記得守規舉，幸好罰她無得玩時她又從不發脾氣死要得到，最多有時會不停問我仲有無得玩，成日好似博大霧咁！唉！我真係比呢個女激到要吹BB！正所謂，見她蠢又蠢唔晒，但精又精唔哂，都唔知係乜人嚟！

JeffeChan

Hello Dr T,

My son is six years old.  He was found to be late developed when he was 22 months old.  He was well trained in school by different therapists.  He was assessed in the Government Testing Centre again last summer.  He was concluded that he could go to normal school for P1.  But I am very concerned since he is slow in everything and his concentration is relatively lower than the same aged children.  We need to repeat two to three times for any instruction or any speech for him because his understanding is no good too.  

Recently I found he wrote the word "drawing" reversed.  Sometimes pronouce "d" to "t" or "t" to "d".  Do you suggest me to get a private testing centre to assess if he has the problem??

Thanks for your advice.

leeamy

Hello Dr. Tang,
之前你講在某報有關"韋氏"測驗的訪問,裡面詳細描述智力測驗的內容及作用,不知道你還有沒有keep住,我非常之有興趣,請email 有關資料給我. Email address如下：
[email protected]
多謝晒。

Dr.T

1. 最重要的是將來那一間學校會不會有支援,因為如果根據你的描述小朋友上課可能會有問題 :-|

2. 其實你是擔心甚麼問題...是否需要再評估視乎上次的評估是否詳盡,因為很大可能是需要再跟進,如果只是一個簡單的分級那作用不大.

JeffeChan 寫道:
1...He was concluded that he could go to normal school for P1.  But I am very concerned since he is slow in everything and his concentration is relatively lower than the same aged children.  We need to repeat two to three times for any instruction or any speech for him because his understanding is no good too.  

2...Do you suggest me to get a private testing centre to assess if he has the problem??

Dr.T

老實說兩個多月大的小小朋友可測到的不太多,主要是一些身體肌能表現,現時唯有可以做的持續觀察 只要你有帶她去做應做的檢查,那就不要太擔心.

linglam 寫道:
唔好意思, 唔記得話你知佢一右眼矢明, 所以我好擔心佢左眼視力, 同腦部有問題!!我真的很擔心