Identifying Learning Problems Early

By Dr. Jan Hittelman

We all learn differently and we all have strengths and weaknesses in terms of our learning processes. There are also many different explanations for why students do not achieve at a level that is expected. For some students it’s about motivation. For other students it can also be a function of difficulties with speech, language processing, auditory and visual processing, written expression, emotional/behavioral factors, as well as overall intelligence.

The earlier these learning challenges are identified, the sooner children can receive help to improve and/or compensate for these difficulties. When early identification does not occur, these problems tend to get worse as does the child’s attitude towards school. In some cases, these challenges are identified in preschool and, through proper remediation, addressed. In many cases these challenges become more apparent in elementary school. For the child’s academic success as well as positive sense of self, it is important to identify and attempt remediate these difficulties as early as possible. Children spend most of their waking hours in school and if they experience a high degree of failure, the damage to their self-esteem can be significant. This is why early intervention is key.

If you suspect that your child is having difficulties in school, the right place to start is with their classroom teacher. Request an opportunity to meet with the teacher and discuss your concerns and get their feedback as well. In addition, the teacher may recommend additional services within the school. In some cases additional evaluations by school specialists may be necessary. A private evaluation by a licensed psychologist is another option. Through the use of psychological, academic, speech/language and learning processing testing, it is possible to get a more detailed and clear picture of a child’s strengths and weakness relative to other children of the same age. Depending on the severity of the areas of weakness additional services at the school may be available.

If your gut tells you that your child is not learning as he or she should be, seek out the guidance of school staff and make your concerns known. The longer you wait the more difficult it will be for your child to get back on track.

Language Development and School Success

By Dr. Jan Hittelman

One of the most amazing experiences as a parent is witnessing language development in our young children. From no language, to first words (“no” usually being one of the first!), to sentences, all in a relatively short time, typically within the first three years of life. The onset and development of language is a complex combination of neurological development and environmental factors.

Parents can make a significant contribution to their children’s language development by enriching their language opportunities. Examples of this would include: reading together, playing word games, stimulating discussions through a variety of new experiences, being a good listener, asking questions, providing writing opportunities, and modeling good language usage.
Language development is a critical precursor to school success. A child with significant language delays will inevitably struggle with academic activities. This is because the vast majority of school tasks are language-based. In addition to reading, tasks that involve spelling, oral and written expression are all language-based.

Language skills are typically divided into two categories: expressive language and receptive language. Expressive language is how we express our thoughts and feelings, while receptive language is our understanding of information that is shared by others. In addition there is speech development, which involves the physical act of speech and includes skills like enunciation and articulation.

Because of the profound impacts of language development on school success, most school districts provide early speech/language screenings to identify those that require corrective services. The good news is that Speech and Language Pathologists can often reduce these deficits quite effectively. The earlier these problems are identified, the easier and faster they typically are to remediate.

If you have concerns about your child’s speech/language development, consider having an assessment by a Speech and Language Pathologist. Through using standardized speech/language testing materials, strengths and weaknesses can be pinpointed to help determine if remediation is needed.

Importance of Early Intervention

By Dr. Jan Hittelman

We all know that long-term habits are hard to break. That’s why addressing our children’s learning, language, emotional, and behavioral challenges early on is so important. If your child is struggling at home, in school and/or with peers, it is important to first understand where these challenges are emanating from. And that’s not always so easy to do. A child who “is not listening” in class may have a language-processing problem. Someone who bullies others may be struggling with self-image issues. Temper tantrums may be a desperate cry for attention. While its every parent’s hope that our children are simply going through a phase (and sometimes they are), if these challenges continue consider the following steps:

1. Get Other’s Feedback: Check in with other adults in your child’s life (teachers, other parents, relatives, etc.) and get their feedback as well. If these issues are occurring in other settings then it may be an issue unique to your child. If it’s only happening in one setting then the dynamics of that setting may play a role.
2. Talk to Your Child: On a good day at a positive moment discuss your concerns with your child in an open, supportive, non-threatening way. Try to elicit your child’s viewpoints and feelings about your concerns. Ask what you can do to help.
3. Consider an Assessment: There are excellent learning, language and behavioral experts who are trained to assess children and provide valuable feedback regarding their challenges. Ask your child’s teacher and/or principal for recommendations.
4. Develop an Action Plan: Once you’re clear about the type of issues that your child is struggling with, develop a plan of action to ensure that your child’s difficulties are being addressed.

The longer we wait to address these issues the more challenging they are to remediate and the more damage they are likely to cause.

Early Identification of Depression

 By Dr. Jan Hittelman

It is not well known, but one of the fastest growing age groups for suicide are children 10-14 years of age. Given that Colorado ranks first among all states for teen depression, it is important for parents of elementary-age youth to be more aware of the warning signs in order to identify these concerns as early as possible.

Nationally suicide is the third leading cause of death among youth ages 15-24, while in Colorado it is the second leading cause of death. As disturbing as these statistics are, it is widely believed that they are underestimated since many suicides and attempts go unreported. Fortunately for most, depression is a very treatable disorder. Depending on the particular individual, talk therapy, medication, or a combination of the two, has been shown to be highly effective in treating depression. Unfortunately, it is estimated nationally that only 30% of adolescents with depression receive treatment. Surprisingly, research shows that many of these youth are from families with good communication. The challenge is that, in addition to the general signs of depression in adults (i.e. feelings of sadness, changes in eating and sleeping patterns, loss of interest in once enjoyed activities, loss of energy, feelings of worthlessness or guilt, difficulty concentrating), the more subtle warning signs unique to children and adolescents are often missed. These include:

• Irritability, anger, hostility
• Frequent absences from school or poor school performance
• Lack of interest in spending time with friends or family
• Talk of or efforts to run away from home
• Social isolation, poor communication
• Extreme sensitivity to rejection or failure
• Reckless behavior
• Neglect of clothes and appearance

The good news is depression can be identified and treated, if the right resources and information are in place.

Understanding ADHD

By Dr. Jan Hittelman

Attention Deficit Hyperactivity Disorder (ADHD) is estimated to affect 3-7% of school-age children. For many, these challenges continue into adulthood. There are three types of ADHD; “Predominantly Inattentive”, “Predominantly Hyperactive-Impulsive”, and a combination of the two (“Combined Type”).

Over the years there have been valid concerns that many children are inaccurately diagnosed as having ADHD. This is problematic in part because medication is often prescribed to treat the disorder. It has been shown that some children, who were initially diagnosed as ADHD, were actually in the early stages of having Bipolar disorder and the ADHD symptoms were a function of the manic component. In these cases, prescribing stimulant medication can actually trigger manic episodes. There have also been instances where children were initially diagnosed with ADHD and it later was determined that their concentration problems were actually a symptom of depression. Finally, there are large numbers of children that were simply misdiagnosed and did not need to be put on medication at all.

To accurately diagnose ADHD there need to be several indicators that together confirm the diagnosis. These would include: feedback from parents, teachers and children themselves; objective evidence based on standardized psychometric tests constructed to assess for ADHD; and meeting the specific criteria developed by the American Psychiatric Association. Too often these critical steps are skipped and medication is prescribed.

Referral Assessment

Everything about the design of our treatment services is focused on effectiveness.

Before a client is matched to a therapist, an assessment is available that is completed by a member of our assessment team trained by Dr. Jan Hittelman, a licensed Psychologist and Director of Boulder Psychological Services.

During the assessment process a detailed summary of the client’s background information is obtained. The client is empowered with feedback during this process and works in collaboration with the assessor in developing a comprehensive treatment plan.

Based on the specific counseling issues requiring treatment, clients are matched with mental health and/or other professionals who not only have experience addressing the specific issues identified during the assessment process but are also a good personality match, which can help maximize treatment success.

The fee for the 1.5-2 hour assessment for children and adolescents is $250. The fee for the 1-1.5 hour adult assessment is $175. Unfortunately, we cannot accept insurance for the assessment but can provide a paid in full invoice for clients, which can be submitted to their insurance company for out of network benefit.

To schedule an assessment, please fill out the form below or call 720-217-3270.


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