Dear Dr. Sylvia

Ill Child Has No Obvious Disabling Problems

July, 2013

QOur 14-year-old daughter has numerous disabilities. One is a medical diagnosis of encephalopathy. She is an extremely intelligent child who gets great grades; and, because of this, her school district, teachers, and staff refuse to accept that anything is wrong with her. All they want to talk about is her excellent grades.




Encephalopathy is a very complicated brain disorder. According to Wikipedia, “common neurological symptoms are loss of cognitive function, subtle personality changes, inability to concentrate, lethargy and depressed consciousness.” There is a long list of other potential symptoms, none of which are likely to be obvious to your daughter’s teachers. Your daughter may also be masking some of the stresses she feels related to her diagnosis since teachers report only good progress and excellent grades.

If you believe your daughter requires a special education program based on her very real health problem, you should request that. A team will meet and will even involve your daughter’s physician in order to understand how the school can best help her. Schools are only required to provide help to students where health impairments are adversely affecting learning. The struggle the teachers no doubt have is recognizing the effect of your daughter’s impairment on her academic or social-emotional success.

If you believe your daughter is underachieving or is likely to begin underachieving as her symptoms get worse, you should not hesitate to request an Individual Educational Program (IEP) for her. Even very observant high school teachers may miss symptoms of unfamiliar disorders they haven’t been trained to spot, especially if they haven’t been alerted to your concerns. Also, high school schedules don’t give teachers a full day with the same students. Your daughter may begin her morning feeling well, but be in a fogbank after lunch. The seven or more teachers who each see her for only 50 minutes daily have no point of reference. Utilizing your district’s special education program should ensure that a qualified professional is monitoring how the encephalopathy and other medical concerns are affecting your daughter’s school experience.

Dr Sylvia RimmDr. Sylvia Rimm is a child psychologist and clinical professor at Case University School of Medicine, author, newspaper and magazine columnist, and radio/TV personality. For free newsletters about raising boys and growing up too fast in high school, send a self-addressed, stamped envelope for each newsletter to P.O. Box 32, Watertown, WI, 53094. Read Dr. Rimm’s Articles for Parents and Teachers and submit family questions online at All questions are answered.

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