I am currently working with a student diagnosed with White Matter Disease. Very little information is available on this condition, and I cannot find any information about what educational strategies may be effective to help a child with this condition. First, in layman's terms can you give an explanation of White Matter Disease. What is it and how does it affect a child. Second, can you provide any guidance to help the educational staff to know what accomodations and modifications may be helpful. For example, what learning challenges might this disease create, how should information be presented, and what demands should be avoided?

Thank you for your help

Answer:

Unfortunately, this is a very non-specific term that can cover a variety of central nervous system problems and therefore present in a huge variety of ways. The White Matter is one of the two main substances that make up the brain. It is composed of the matter that connects brain cells (in the grey matter) to other brain cells. This is similarly true in the spinal cord.
Please see:http://en.wikipedia.org/wiki/White_matter

I had not heard the term used in this way before. It is like saying that an individual has “bone disease”, covering all the diseases that can occur in bone. Presumably, the physician did an MRI and discovered that the child had an abnormality in the white matter of the brain. The substance that is white is the myelin, a sheath that covers the “connecting nerve material” of the brain and insulates it so that it will not short circuit. The Myelin coating also provides a path that an injured nerve can follow to regenerate. See: http://en.wikipedia.org/wiki/Myelin

There are diseases associated with the Myelin sheath being progressively destroyed that are involved with the production and quality of the Myelin. There are others that are infectious and cause damage to the white matter of the brain, Encephomyelitis (a viral infection of the brain). There are others such as multiple sclerosis that causes injury to different areas of the white matter of the brain. Prematurity can also be associated non-specific abnormalities of the white matter and can be very mild or severe depending on the extent of the nerve damage and the brain areas that are dysfunctional. See:http://www.mcw.edu/chorus/doc/00423.html

It would be helpful to know if the process is progressive because that would mean that the child’s neurological functioning would worsen over time, eventually leading to death. That child will need frequent retesting to determine their current level of functioning and areas of weakness, neurodevelopmental lags.

Though it might be interesting to know where in the brain the white matter abnormality is, it is far more helpful to know the status of the child’s neurological system. Vision and hearing would need to be carefully assessed as well as other senses and motor functioning and learning abilities. There needs to be a team approach as with a child study team, to look at the child’s learning strengths and weaknesses and cognitive capabilities.

Such disease can sometimes be associated with seizures and this also is important information to have. It is important to know if the child is taking any medications for a neurological condition, including medications for seizures, anticonvulsants. Such medications can have side effects of depressing neurological functioning and interfering with the child’s availability to learn.

I would start by asking the parent about the causes for the child’s neurological disease and if he/she has lost functioning over time. You could also ask if the child is taking any medications and potential side effects. Perhaps there is more specific information in the child’s files as well.

If you get more specific information, I would be glad to talk with you again. However, the child’s parent, pediatrician or neurologist are much more likely to already have that information and be able to share it with you.

Good luck in the school year,

Kay S. Browne MD