ABSTRACT
The reasons some children perform at a lower academic level than intelligence and educational opportunity predict are still under study. We reference the relevant and conflicting research later, but clinically it is clear that learning disorders are associated with disturbed behavior and with psychiatric symptoms. It is our contention that youngsters with this group of difficulties require dynamically informed psychotherapeutic help if they are to utilize any academic approach. Without psychotherapy, they are often unmotivated and tend to avoid academics, using other techniques—often maladaptive—to maintain self-esteem. This tendency accelerates as they move into and through adolescence. It is also important to remember that some academic problems are primarily psychological inhibitions of curiosity (Blanchard, 1946; Buxbaum, 1964) or performance (Berger and Kennedy, 1975), and it is crucial that these are not confused with learning problems that have a cognitive origin. In addition, even in those instances in which there are cognitive problems, the final presentation is a complex interaction between neuropsychological deficits and emotional factors (Rothstein et al., 1988; Swanson, Harris, and Graham, 2003). In brief, learning problems can be the result of psychological conflict, or psychological conflict can occur secondary to neuropsychiatric deficiencies. Two of our case examples will illustrate these two possibilities, whereas the third will show how difficult it can be to make that differentiation with some adolescents.
