Teaching Students with Learning Disabilities
and Physical Impairments

Attitudes About Learning-Disabled Students

You may be surprised at who in your studio has a learning disability. I know it's happened to me! Several times! For example, one child I taught for six years was dyslexic, and I never knew it until the mother casually commented early one September that they were so proud that their daughter was "finally in a regular reading group." When I expressed befuddlement, she said the child had a learning disability. That was news to me! I had never been aware of it.

I have a son who has learning disabilities, and I've done my share of home tutoring and reading about problems associated with learning disabilities and coping strategies for dealing with them. Should I have recognized my student's learning disability?

Maybe, maybe not. I think a lot depends on the type of the learning disability. To some extent, perhaps the severity also impacts whether a studio teacher recognizes it in a music teaching situation.

The most important thing to remember is that a learning-disabled student does not lack intelligence.

In fact, these students are most commonly above average in IQ. What makes them different is the way they learn. That's all!

The way they learn. Period. There's nothing deficient about their intelligence.

If "normal" teaching were geared to the learning-disabled student, then everyone else would be "learning-disabled!"

True, there are some learning-disabled people who also have low IQ, but then there are some non-learning-disabled people who have low IQ. Learning disabilities and low IQ do not go hand in hand, and that misconception is the stigma attached to having a learning disability.

The One-on-One of Music Study is the Great Leveler
Among All Students

Over the years, I have had at least a dozen learning-disabled students (that I have found out about, that is; doubtless I have had twice or three times as many, including adults). Probably the main reason learning disabilities do not show themselves readily to the studio teacher is that piano study is one-on-one, and this type of learning situation tends to negate problems which are more obvious in a group learning situation.

One of the most common strategies for learning-disabled children in the school system is one-on-one instruction. It helps the child stay focused and allows the child's normal learning pace to govern what is accomplished and how fast. Private piano lessons are by definition one-on-one experiences.

In piano study, the one-on-one technique also tends to mask any disorder since the student progresses at a rate which is normal for him. The teacher accepts this as an individual variant, making no comment on how fast or slow that is (unless the teacher knows from past experience with the child that he can accomplish more and now is being lazy).

Another reason learning disabilities (especially dyslexia) perhaps are not as obvious is that there is not a lot of word reading in piano study. And, could it be that music notation is easier to process for dyslexics than the written word? I don't know, but maybe. Or maybe the one-on-one situation and the individual pace cancel out the manifestation of dyslexia? Much more research needs to be done in this area.

Dyscalcula (arithmetic) and dysgraphia (writing on paper) do not greatly influence piano study since calculation and written work are not used extensively in it. Students with these learning disabilities, then, may have no particular disadvantages learning to play the piano.

Difficulty with auditory processing is another disability (also called low auditory discrimination). This manifests itself as difficulty following verbal directions. If you have a student with this difficulty, speak somewhat more slowly (but not more loudly) and enunciate very clearly. Ask the student to repeat your directions or to write them himself in his assignment pad. If he cannot repeat or write it all, ask him to go as far as he can. Repeat directions as needed. Unless it is unusually long, I repeat the entire direction so the student learns to pick up where he left off.

Often the student has more than one disability, or one disability may be quite strong and thus mask one or more others. This is a very difficult area and one that professional educators and psychologists are just beginning to penetrate.

Attention Deficit Disorder

It is estimated that 5% of children/adults have this disorder.

Generally this disability is more common in males than females (four times more common in males), but the symptoms and behaviors are approximately the same. Sometimes, however, boys with ADD are aggressive and physically punitive, whereas girls tend not to react so strongly, although they will be "more aggressive" or "more physical" than the "average girl."

Adults with this disorder generally have formulated adaptive behaviors to compensate, although I am sure that many adults in the population go undiagnosed. Adults who are "unable to keep a job," are "lazy," and so on may simply have this disorder, don't know it, and thus do not know what modification techniques they might use to help them live productively with it. I wonder what percentage of prison inmates, children in juvenile facilities, and "habitually homeless" adults have ADD and are undiagnosed?

You may find helpful information at this website sponsored by Eli Lilly, the drug company. There's a radio-button "self-test" that lists some symptoms of how the condition presents in adults and other information.

Attention Deficit Disorder and Piano Study

For students with attention deficit disorder, one-on-one instruction is critical. And often, as above, ADD is masked by the one-on-one situation because an child with ADD does best when he is working alone with a teacher, has her full attention, and can give her his attention without distractions from classmates.

Group lessons are not a good idea for students with ADD. Not only will they be unable to absorb much of anything at a group lesson, but they will be a distraction to others and a general disruption. Group classes should be omitted for these students until they learn appropriate coping mechanisms, which is usually in junior high or after.

Similarly, ADD students work better if the parent is not observing the lesson (at least, not on a regular basis). Another person in the studio will divert the ADD student's attention, even if the person is simply sitting still. And siblings are a definite no!

Sometimes during the private lesson I may have to use a physical gesture to gain the attention of an student with ADD. If a student becomes too "active" or is interrupting what we were doing by an unrelated comment, I will often put my hands on her shoulders and "restrain" her, saying, "Look at me in the eyeballs." Eventually, only one hand on her forearm is enough to get attention.

Breaking the lesson activities into smaller "type" segments is also helpful, I've found. Again, music study lends itself very well to this. There's a technique segment, a theory segment, a sight-reading segment, and so on. If the child seems overly impulsive and wants to change topics so soon that one segment cannot be completed with his undivided attention (a classic manifestation of ADD), taking him by the hand and turning him to face me so he can look at my eyes, I say, "Just a little while longer on this, ok? I know you can do it." Often just calling the child's attention to the fact that he is not attending any more is adequate, especially after he is aware of his diagnosis -and is willing- to try to improve. Sometimes this readiness does not come until late junior high or later, along with greater physical and emotional maturity.

Home practice should be broken into segments, too, for most ADD students, especially those at the elementary school level. Since my students and I together arrive at a practice plan, it is very easy for the student with ADD to divide home practice into segments. If the assignment says "chromatic scale, contrary motion, MM=200, 3x," the student can do that and then leave the piano for a while if that is all he can handle at one time. Of course, the parent will need to understand what is going on and help the child remember to go -back- to the piano!

In such a situation, setting a timer for the "rest period" is a good idea. Letting the child watch a half-hour of TV and then go back and do another element of the assignment does not work too well. It will take forever to get through the assignment -and- (I believe) the on-again/off-again flickering images of the TV screen reinforce lack of sustained attention. (Any of you female readers will appreciate this remark if you've ever had the "pleasure" of watching TV with one of the male persuasion when -he- is holding the clicker!) A 5-minute "rest" is about right.

If the student is having a difficulty with something during the lesson, reassure the student that there is plenty of time:

It's important that the student really -knows- that you are well-content with his learning pace and that the two of you don't have to please anyone else.

Reinforce positive behaviors with praise ("I'm very pleased to see that you played your entire set of scales without stopping once to talk to me!"). Reassurance is in order, right along with praise ("I have every confidence in you," "I know you can do this"). Sometimes pet names can be used to good advantage ("Ok, champ, let's hear your Christmas song."). Of course, these techniques to build confidence are recommended for all students!

Routine can be a great aid for students with ADD. You probably already have set up the order in which you approach the different "segments" of the lesson. Ask your student to practice at home in this same order. Stick strictly to this order at lessons (unless she comes bounding in dying to start the lesson with something). Knowing "what comes next" can be a great comfort to a child whose organizations skills are sorely lacking.

Often music teachers spot the ADD disorder when a classroom teacher can't. The classroom teacher is beleaguered with responsibility for 30 or more students and cannot devote a lot of extra time to any one student without the others suffering unduly. Some tell-tale markers that a student might have ADD include:

There are other flags, as well, but these are the ones music teachers might encounter most often.

Suggesting an evaluation for ADD is best done face-to-face with the parent and without the student's being present (ask the student to look at a book in the waiting area). Try to talk to the parent before or after the lesson (on the child's time, however, not the next student's) and say you've notice that the child is distractible and impulsive at his lesson. Perhaps the child's school or Sunday School teacher or scout leader has mentioned this? Perhaps the parent has noticed it at home?

A personal touch is helpful to "soften the news." I am in the position to add, "My son has ADD, so I'm wondering if perhaps your child does, too." If you don't have a learning-disabled child or family member or friend, but have had such a student, state that. If none of the above, state that you have been reading up on ADD and the child's behavior rang a bell with you.

Despite trying to soften your comment, the parent still will be aghast at the very idea of ADD. Immediately, he will think there is something wrong with -his- genes, and therefore he personally feels threatened by your suggestion.

Then, he will think that his child is "dumb." That's when you assure him that a learning disability - - of which ADD is only one - - has nothing to do with intelligence: "Rob is -so- smart and -so- talented, and I can't help but think he'd -really- be a superior piano student if we could control his distractibility. Please talk to your wife [husband] and maybe to Rob's school teacher about whether anyone else has noted this in his behavior and about whether an evaluation might be warranted. You probably will want to chat with the school counselor, too. It may just be his age and he'll eventually grow out of it, but it may be something that can be addressed right away."

At all times, stress how well the child is doing and how you enjoy teaching him. Reassure the parent that ADD does -not- have anything to do with lack of intelligence.

Sometimes the child is put on medication (Ritalin is often used). Sometimes the child simply has a "dose" of caffeine in the form of a cola or a cup of coffee/tea. If behavior improves via these methods or by the child's force of will (usually with a junior high student or older), be sure to compliment the student -on his behavior-. Let him know you noticed a difference, however slight. ("Thank you such good concentration during your lesson today. I'm so proud of you! How difficult was that? Do you think you can do it again next week?")

Be in close and continued contact with the parents and ask them to inquire specifically of the psychologist or other professional whom the child is seeing what you, as the piano teacher, can do to help this child.

Let me note here that most children who are overly active at lessons do -not- have ADD. They are simply immature.

Usually this is a child from ages three to five, but as late as age seven or even eight. By age eight, a child without ADD should have been acclimated enough to following expected procedures simply by attending school and taking part in normal elementary-level enrichment activities (church classes, sports, scout groups, etc.). Therefore, he should adapt quickly to your lesson behavior requirements and lesson routine. With an "overly-active" child such as this, you should see improvement within a month or two of starting lessons and good conformity to your demands by the six-month point. Be sure to insist the child hew whatever line you have set, no matter if she asks several times to change activities ("No, we are going to finish this entire song before we play a game. I know you can do this, sweetpea."). Reassurance (see below) helps a lot. If necessary, put your hands on the child's shoulders (see above) to obtain the child's attention and/or quiet her down.

An immature child, of course, is not ready for group lessons. When the distractibility goes on and on - - beyond say, six months - - and the child doesn't seem to be adapting to the regimen of piano study, then you would begin to look at possible ADD or some other underlying problem.

Adults have ADD, too, as mentioned. Usually -you- will not know this, however. Often they have been on medication for many, many years -and- have learned successful coping strategies. (This may be why many adults drink a lot of coffee!)

Maturity and the attendant self-control also help mitigate ADD's interference with learning. This is why you might never pick up on ADD in an adult or teen student.

One way, however, ADD might manifest itself in an teen/adult student is if the student has more than normal difficulty matching his playing to the metronome. The student might say something like, "There's just too much going on. I can't pay attention to all of it." If repeated efforts do not make this skill easier to master, do not press. Simply drop it. The student is not likely to get better with repetition, just more frustrated. (I use diatonic and chromatic scales, all 48 hand-over-hand triads, and other such technical exercises as metronome exercises, too. Often my teen/adult ADD students will get to a certain speed and simply cannot go any faster, accompanied with a comment such as the one above. I then say, "Ok, that's as fast as we'll go with this. No problem.")

For more information about ADD, you can contact CHADD (Children and Adults with Attention Deficit Disorder) at 800-233-4050.

Also search the Web in general for the latest medical news in this area. For example, a study at UCLA, reported in November, 2003, found thru MRI that some structural differences in the brains of children with ADD. One area, in particular, seemed linked to impulsive behavior. Note: The study sample was not large - - 27 children with and 46 without ADD - - and all research needs replication several times over, so this study should not be taken as definitive.

Physical Impairments

What about physical impairments? I have taught students with physical impairments without any great changes in my normal routine. I simply adjust the pace of study to the student. (I do this for for each one, anyway, so this isn't a big change.) It's important that the teacher give the student a feeling of confidence and not that the teacher doubts the student will be able to cope with his physical limitations well enough to learn to play the piano.

For the hearing impaired, enunciate carefully (you don't have to speak louder!) and avoid sitting or standing where you are back-lit (that is, the light is coming from behind you). Backlighting and sloppy enunciation make lip reading difficult. If the student hears from one ear better than the other, sit/stand on the "good side."

For the visually impaired, try enlarged notation and be extra sensitive as to whether there is enough light. Sigma Alpha Iota, a women's music fraternity, has a special big-note program for visually-impaired music students. Use opaqueing fluid to paint out irrelevant notation on the page. Excess notation is particularly common in beginner music.

I have taught people missing fingers and portions of fingers. Again, the remedy was fairly simple: refingering literature and/or removing notes from chords. One teenaged student I had was congenitally missing both fifth fingers, yet she was easily able to stretch at octave between fingers 1 and 4. We had no more trouble arriving at fingering than we would have, had the student possessed 10 fingers.

Technical exercises may present a special problem (such as Hanon or Schmitt) for the physically challenged. Sometimes I have written special studies for special circumstances, but often judiciously removing notes will work as well. You must see what your student's needs dictate.

Some people have extremely small hands, even after reaching full adult growth. It's not really an impairment, but it does restrict the type of literature they can play. Therefore, a good deal of Liszt and Rachmaninov will not be practical choices for students such as these. Don't offer it and let them stumble. Instead, select something else. Sometimes restructuring large chords (or rolling them, if the style permits) will solve the difficulty. Sometimes strategically fore-shortening a piece will allow the student with ultra-tiny hands to "have a taste" of composers' works which call for huge handfuls of notes and gigantic extensions. For each student, you'll learn how much they can stretch, which pieces can be discreetly reshuffled, and which ones should not be presented at all.

Teaching one-on-one makes it very easy to adjust the curriculum so that these differently-abled students progress as fast their musical ability and amount of practicing allow.

Autism

I have never had an autistic student, so I can offer no help in this area based on experience. A friend of mine knows a family in Australia in which the autistic son has become a concert-caliber pianist, so it can be done. I just can't tell you how. Please consult a music therapist or other professional who is trained to deal with autistic children.

The music therapy web site is http://www.musictherapy.org or call 301-589-3300.

Preparing Yourself to Teach Learning-Disabled Students

During the interview, be sure to ask if there are any learning disabilities. If so, say, "That's good to know. I won't have any trouble with that. I'm sure we'll work just fine together." If you've had learning-disabled students before, you add, "I've taught other learning-disabled students, and it really wasn't a problem. Music study has extra benefits for such kids" (one-on-one teaching, bilaterality training, customized materials, customized teaching pace).

Ask if the student is on any medication, what it is, and when he takes it. If there occasionally is a "bad" lesson, it may be that the dose was forgotten - - commonly at lunch at school. Children who have to take daily medication must go to the office for it and bear the shame of "being different" or "being dumb," therefore, some children actively resist taking the lunchtime dose.

If the child is older (say 5th grade or higher), once lessons have begun, you can speak to him frankly about how he feels about his medication. Assure him that it's no big deal. Many people are on daily medication for lots of different reasons and taking a pill to control some condition is very, very common. If this situation applies to you, tell the student what pills you must take every day. Besides, for every kid who goes into the office for a lunch-time dose, there are two kids who have morning or evening doses; just because no one sees doesn't mean those kids don't take medication. Remind the child that his disability doesn't mean he is stupid; this might elicit some discussion of a recent event at school where he was belittled by his peers (sometimes classroom teachers even do this, as cruel and unthinkable as it seems!). Praise the child's efforts and reassure him that he can be as fine a pianist as he desires to be. All he has to do is try. You'll work together to make sure he reaches his goal.

If you feel you are not ready to "wing it" with a student who has any sort of uncommon learning style, I advise that you contact a music therapist for advice. Other options are to look into music therapy courses at your local university and ask your experienced colleagues how they've handled such problems.

Particularly check the programs at your local, state, and national teachers' groups conventions, as there may be an appropriate session you should attend. If not, suggest the topic to the association president and ask her to pass the request to the appropriate person.

Sometimes a chat with a child's psychologist or school teacher will suggest ways in which you can make your teaching more effective and efficient.

Very rarely there are articles in music and pedagogy journals (not counting music therapy journals, of course), but this aspect of music teaching remains mostly unaddressed, so I wouldn't hope for help from this quarter. If your local university carries music therapy journals, do investigate those, of course. And search the Web. (If you find good sites, please e-mail me so I can add links to this article.) By and large, however, your best source of information is going to be a person.

Whatever you do, don't give up. These students need you! And they need the opportunity to excel, which you can provide through piano study.

Note: See also a response in my pedagogy Q&A file about some techniques for students with dyslexia.

copyright 1997-2003, Martha Beth Lewis, Ph.D.
Contact me for reprint permission.


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