Ramon is an 18-year-old male who identifies as Latino and African American. He is in
his senior year of high school and lives with his parents and two sisters.
Ramon has been diagnosed with an intellectual disability and with moderate hearing
loss in his right ear. His mother, Angela, reached out to me, the school social worker.
Background and History
After gaining consent, I met with Angela and Ramon for background and history. I asked
about Ramon’s early history, and she reported that as a baby, Ramon had multiple ear
infections as well as . He was hospitalized and put on medication to control the
seizures, though nothing was done for the ears. At 5 years old, he became very sick,
and it was discovered that his Eustachian tubes were bent, which had resulted in
muffled hearing on the right side. Angela reported that if the doctor, who was White, had
noticed the issue when he’d been a baby, Ramon could have gotten tubes placed in his
ears and would not need a hearing aid. Angela reported skepticism and distrust of the
medical community based on this experience.
Angela reported that Ramon adapted over time to a hearing aid. He remained
somewhat removed in social situations and was overwhelmed when he entered school.
Because of his initial struggle in academics, his IQ was assessed and determined to be
below average; throughout the duration of his public schooling, Ramon had an
Individualized Education Plan (IEP) based on this identified intellectual disability.
Once I had this background from Angela, I asked what brought them here. Angela
mentioned that the college and career counselor at the high school had implied that
college was not in Ramon’s future. Angela was furious and did not feel heard by the
school administration when she brought up the incident with them. She would like
Ramon’s IQ to be reassessed. She felt that the original practitioner who performed the
IQ assessment “did not get it right” and that “Ramon has grown so much.”
Session With Ramon
I then met with Ramon individually. During the meeting, I observed that he fidgeted and
appeared anxious, occasionally biting his fingernails. “How long is this going to take?”
he asked, while looking at the time. Ramon reported that he didn’t want to be late for
gym class. He hung his head and talked in a low voice but responded to all of my
questions appropriately. When I asked how he felt about college, he said he wanted to
“go to LSU” and that the college and career counselor had started showing him job
listings instead. “Now my mom’s all mad,” he said and rolled his eyes. “Are you mad?” I
asked. Ramon said, “I don’t think that was fair of him to do. I’m not dumb.”
I asked Ramon how high school had been for him. And he responded that he didn’t
wear his hearing aid because it made him self-conscious around his peers. He sat on
the right side of the classroom so he could hear clearly from his left ear. This provoked
some anxiety prior to each class about whether he would be able to find a seat that
would position him well to hear. In cases where he could not hear, Ramon could not
fully participate in class; teachers interpreted this lack of engagement as part of him
being “slow.” Ramon also reported fear and anxiety around test-taking and social
interactions. Other than that, he explained that he generally did okay in school, and his
grades back up this statement.
Based on my recommendation, the school supported carrying out another assessment
for both IQ and mental health. The findings were that Ramon does not have a low IQ
but rather generalized and social anxiety disorders. These mental health issues were
contributing to Ramon’s social isolation and feelings of extreme worry, which in turn
impacted his performance on both the IQ assessment and school tests.
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