Learning Disability

Definition

Learning disabilities are disorders that affect one's ability to understand or use spoken or written language, do mathematical calculations, coordinate movements or direct attention. Although learning disabilities occur in very young children, disorders are usually not recognized until a child reaches school age.

Learning disabilities affect one's ability to interpret what one sees and hears, or to link information from different parts of the brain. These limitations can show up as specific difficulties with spoken and written language, coordination, self-control or attention. Such difficulties extend to schoolwork and can impede learning to read or write, or to do math.

Learning disabilities can be lifelong conditions that, in some cases, affect many parts of a person's existence: school or work, daily routines, family situations and, sometimes, even friendships and play. In some people, many overlapping learning disabilities may be apparent. Others may have a single, isolated learning problem that has little impact on other areas of their lives.

Not all learning problems fall into the category of learning disabilities. Many children are simply slower in developing certain skills. Because children show natural differences in their rate of development, sometimes what seems to be a learning disability may simply be a delay in maturation.

To be diagnosed as a learning disability, a child's condition must meet specific criteria.

Dyslexia is a term that describes serious problems with reading. With this problem, a child may not understand letters, groups of letters, sentences or paragraphs. At the beginning of first grade, children may occasionally reverse and rotate the letters they read and write. This may be normal when he or she is first learning to read. By the middle of first grade (and with maturity) these problems should disappear. However, a young student with dyslexia may not overcome these problems. The difficulty can continue as the student grows. To him, a "b" may look like a "d." He may write on when he really means no. Your child may reverse a 6 to make 9. This is not a vision problem, rather it is a problem with how the brain interprets the information it "sees."

Dysgraphia is a term for problems with writing. An older child may not form letters correctly, and there is difficulty writing within a certain space. Writing neatly takes time and effort; yet despite the extra effort, handwriting still may be hard to read. A teacher may say that a learning-disabled student can't finish written tests and assignments on time, and supervisors may find that written tasks are always late or incomplete.

Dyscalculia is a term for problems concerning math. A child may do well in history and language, but he may fail tests involving fractions and percentages. Math is difficult for many students, but with dyscalculia, a child may have much more difficulty than others his age. Dyscalculia may prevent your child from solving basic math problems that others his age complete with no difficulty.

Auditory memory and processing disabilities is a term for problems with understanding and remembering words or sounds. A child may hear normally, but he or she may not remember key facts because his or her memory does not correctly store and interpret facts. This is not caused by a hearing problem—it happens when the brain fails to understand words or sounds the right way.


Symptoms

The criteria and characteristics for diagnosing learning disabilities appear in a reference book called the Diagnostic and Statistical Manual of Mental Disorders (DSM). The DSM diagnosis is commonly used when applying for health insurance coverage of diagnostic and treatment services.

Learning Disorders
Students with academic-skills disorders are often years behind their classmates in developing reading, writing or arithmetic skills. The diagnoses in this category include:

Reading disorder
Disorder of written expression
Mathematics disorder
Learning disorder not otherwise specified
The reading disorder, also known as dyslexia, is quite widespread. Reading disabilities affect 2 to 8 percent of elementary school children.

The essential feature of a reading disorder is reading achievement (reading accuracy, speed or comprehension as measured by individually administered standardized tests) that falls substantially below the expected level given the individual's chronological age, measured intelligence and age-appropriate education. The disturbances in reading significantly interfere with academic achievement or with activities of daily living that require reading skills. If a sensory deficit is present, the reading difficulties are in excess of those usually associated with it. If a neurological or other general medical condition or sensory deficit is present, it should be categorized as that. In individuals with a reading disorder, reading aloud is characterized by distortions, substitutions or omissions. Both reading out loud and silently are characterized by slowness and errors in comprehension.

In the disorder of written expression, writing skills (as measured by an individually administered standardized test or functional assessment of writing skills) fall substantially below the expected skills for the individual's chronological age, measured intelligence and education. The disturbance significantly interferes with academic achievement or certain daily living experiences. If a sensory deficit is present, the difficulties in writing skills are in excess of those usually associated with it. There is generally a combination of difficulties in the individual's ability to compose written tests, which tend to be full of grammar, spelling and punctuation mistakes, poor paragraph organization and poor handwriting.

The essential feature of the mathematics disorder is a lack of mathematical ability (as measured by individually administered standardized tests of mathematical calculation or reasoning) that falls substantially below the expectation for the individual's age, measured intelligence and age-appropriate education. The disturbance in mathematics strongly interferes with academic achievement or activities of daily living. A number of different skills may be impaired in a mathematics disorder, including "linguistic" skills (understanding or naming mathematical terms, operations or concepts, and decoding written problems into mathematical symbols), "perceptual" skills (recognizing or reading numerical symbols or arithmetic signs and clustering objects into groups), "attention" skills (copying numbers or figures correctly, remembering to add in "carried" numbers and observing operational signs) and "mathematical" skills (following sequences of mathematical steps, counting objects and learning multiplication tables).

For those who do not meet the criteria for any specific learning disorder discussed so far, there is the category of learning disorders not otherwise specified. This might include problems in all three areas (reading, mathematics and written expression) that, together, significantly interfere with academic achievement, even though performance on tests measuring each individual skill is not substantially below that expected given the person's chronological age, measured intelligence and age-appropriate education.


Causes

Mental-health professionals stress that since no one knows what causes learning disabilities, it doesn't help parents to look backward to search for reasons. There are too many possibilities to pin down the cause, and it is more important for the family to move forward with getting help.

While learning disabilities were thought to be caused by a single neurological problem, researchers now say that the causes are more diverse and complex. New evidence seems to show that most learning disabilities do not start in a single, specific area of the brain, but from difficulties in bringing together information from various brain regions.

A leading theory is that learning disabilities stem from subtle disturbances in brain structure and function that may begin before birth. Other possibilities include:

Genetic predisposition
Tobacco, alcohol or substance abuse by the mother prior to, during, and after pregnancy
Problems during pregnancy or delivery
Environment—both emotional and physical

Treatment

Identification of Learning Disabilities

Evaluation, the process for determining whether a child has a disability and needs special education and services, is the first step in developing a helpful educational program. A full and individual initial evaluation must be done before the initial provision of any special education or related services to a child with a disability. In addition, a student must be reevaluated at least once every three years. Evaluation involves gathering information from a variety of sources about a child's functioning and development in all areas of suspected disability, including information provided by the parent. The evaluation may look at cognitive, behavioral, physical and developmental factors, as well as other areas.

It can identify children who have delays or learning problems and may need special education and related services as a result.

Eligibility. It can determine whether a child has a disability under the Individuals with Disabilities Education Act (IDEA) and qualifies for special education and services.
Planning an Individualized Education Program (IEP). It provides information that can help parents and the school develop an appropriate IEP for a child.
Instructional strategies. It can help determine what tactics may be most effective in helping a child learn.
Measuring progress. It establishes a baseline for measuring a child's educational progress. The evaluation process establishes a foundation for developing an appropriate educational program. The public agency must provide a copy of the evaluation report and the documentation of determination of eligibility to the parent. Even if the evaluation shows that a child does not need special education, the information may still be used to help that child in a regular education program.
After a child's evaluation is complete, parents will meet with a group of qualified professionals to determine whether their child has a disability under IDEA. The school must provide the parents with a copy of the evaluation report and a written determination of eligibility.

If the team determines that a child is eligible for special education and related services, the next step is to develop an IEP to meet the child's needs.

The goals and objectives the IEP team develops relate directly to the strengths and needs that were identified through evaluation.

It's important for parents to understand the results of their child's evaluation before beginning to develop an IEP, and they should ask to have the evaluation explained in plain language by a qualified professional.

Parents will want to request the evaluation summary report before meeting with other members of the team to develop the IEP. Reviewing the results in a comfortable environment before developing the IEP can reduce parents' stress and provide time to consider whether the results fit their own observations and experiences with their child.

The most common treatment for learning disabilities is special education. Trained educators may perform a diagnostic educational evaluation assessing a child's academic and intellectual potential in addition to his or her level of academic performance. Once the evaluation is complete, the basic approach is to teach learning skills by building on the child's abilities and strengths, while correcting and compensating for disabilities and weaknesses. Other professionals such as speech and language therapists also may be involved. Some medications may be effective in helping the child learn by enhancing attention and concentration. Psychological therapies may also be used.

Learning disabilities can be lifelong conditions. In some people, several overlapping learning disabilities may be apparent. Others may have a single, isolated learning problem that has little impact on their lives.

Dyslexia

Recognizing dyslexia early is a key factor in how much the learning disability will affect a person's development. Unfortunately, adults with unidentified dyslexia often work in jobs below their intellectual capacity. But with help of a tutor, teacher or other trained professional, almost all people with dyslexia can become good readers and writers. Incorporating the following strategies into the learning process can help overcome the difficulties of dyslexia:

Early exposure to oral reading, writing and drawing, and encouraging development of print knowledge, linguistic awareness (the relationship between sound and meaning), basic letter formation and recognition skills
Practice reading different kinds of texts (books, magazines, advertisements, comics)
Multi-sensory, structured language instruction and practice using sight, sound and touch when introducing new ideas
Modifying classroom procedures to allow for extra time to complete assignments, help with note-taking, oral testing and other means of assessment
Using books-on-tape and assistive technology such as screen readers and voice-recognition computer software
Help with the emotional issues that arise from struggling to overcome academic difficulties
Reading and writing are fundamental skills for daily living; however, it is important to emphasize other aspects of learning and expression. Like all people, those with dyslexia enjoy activities that tap into their strengths and interests. As multidimensional thinkers, visual fields such as design, art, architecture, engineering and surgery, which do not emphasize language skills, may appeal to them.

Dyscalculia

Helping a student identify his or her strengths and weaknesses is the first step in moving ahead. Following identification, parents, teachers and other educators can work together to establish strategies that will aid the student in learning math more effectively. Help outside the classroom lets a student and tutor focus specifically on the difficulties that student is having, taking pressure off moving to new topics too quickly. Repeated reinforcement and specific practice of straightforward ideas can make understanding easier. Other strategies include:

Use graph paper for students who have difficulty organizing ideas on paper
Work on finding different ways to approach math facts; instead of just memorizing the multiplication tables, explain that since 8 x 2 = 16, if 16 is doubled, 8 x 4 must = 32
Practice estimating as a way to begin solving math problems
Introduce new skills, beginning with concrete examples and later moving to more abstract applications
For language difficulties, explain ideas and problems clearly, and encourage students to ask questions
Provide a place to work with few distractions, and have pencils, erasers and other tools on hand as needed
Help students become aware of their strengths and weaknesses; when a child understands how he or she learns best, he or she takes a big step toward achieving academic success and confidence
Dysgraphia

There are many ways to help a person with dysgraphia achieve success. Generally, strategies fall into three categories:

Accommodations: Providing alternatives to written expression
Modifications: Changing expectations or tasks to minimize or avoid the area of weakness
Remediation: Providing instruction for improving handwriting and writing skills
Each type of strategy should be considered when planning instruction and support. A person with dysgraphia will benefit from help from both specialists and those who are closest to the person. Finding the most beneficial type of support is a process of trying different ideas and openly exchanging thoughts on what works best.

Below are some examples of how to teach individuals with dysgraphia to overcome some of their difficulties with written expression.

Early Writers

Use paper with raised lines for a sensory guide to staying within the lines
Try different pens and pencils to find one that's most comfortable
Practice writing letters and numbers in the air with expansive arm movements to improve motor memory of these important shapes. Also practice letters and numbers with smaller hand or finger motions
Encourage proper grip, posture and paper positioning for writing; it's important to reinforce this early on as it's difficult for students to unlearn bad habits later
Use multi-sensory techniques for learning letters, shapes and numbers; for example, speaking through motor sequences, such as b is "big stick down, circle away from my body"
Introduce a word processor on a computer early; however, do not eliminate handwriting for the child. While typing can make it easier to write by alleviating the frustration of forming letters, handwriting is a vital part of a person's ability to function in the world
Be patient and positive; encourage practice and praise effort; becoming a good writer takes time and practice
Young Students

Allow use of print or cursive, whichever is more comfortable
Use large graph paper for math calculations to keep columns and rows organized
Allow extra time for writing assignments
Begin writing assignments creatively with drawing or by speaking ideas into a tape recorder
Alternate focus of writing assignments; put the emphasis on some for neatness and spelling, others for grammar or organization of ideas
Explicitly teach different types of writing: expository and personal essays, short stories, poems
Do not judge timed assignments on neatness and spelling
Have students delay before proofreading their work; it's easier to see mistakes after a break
Help students create a checklist for editing work: spelling, neatness, grammar, syntax, clear progression of ideas
Encourage use of a spell-checker—speaking spell-checkers are available for handwritten work
Reduce the amount of copying; instead, focus on writing original answers and ideas
Have students complete tasks in small steps instead of all at once
Find alternative means of assessing knowledge, such as oral reports or visual projects
Encourage practice through low-stress opportunities for writing, such as letters, a diary, making household lists or keeping track of sports teams
Teenagers and Adults

Provide tape recorders to supplement note-taking and to prepare for writing assignments
Create a step-by-step plan that breaks writing assignments into small tasks (see below)
When organizing writing projects, create a list of key words that will be useful
Provide clear, constructive feedback on the quality of work, explaining both the strengths and weaknesses of the project and commenting on the structure as well as the information that is included
Use assistive technology such as voice-activated software if the mechanical aspects of writing remain a major hurdle
All age groups can use many of these tips; it is never too early or too late to reinforce the skills needed for proper writing

Though teachers and employers are required by law to make "reasonable accommodations" for individuals with learning disabilities, they may not be aware of how to help. Speak to them about dysgraphia, and explain the challenges you face as a result of your learning disability.

Although obtaining a diagnosis is important, even more so is creating a plan for getting the right help. Because learning disabilities can affect the child and family in so many ways, help may be needed on a variety of fronts.

Learning Disabilities and the Law

Public Law 105-17, the Individuals with Disabilities Education Act Amendments of 1997, is the federal special education law. IDEA was signed into law in June 1997, with final federal regulations published in March 1999. This law replaces all earlier versions of Public Law 94-142, the Education of All Handicapped Children Act of 1975.

IDEA guarantees each child with a disability and need of special education services, the right to a free appropriate public education (FAPE) in the least restrictive environment (LRE) appropriate.

Sources:

American Academy of Pediatrics
Diagnostic and Statistical Manual of Mental Disorders
Families and Advocates Partnership for Education
Learning Disabilities Association of America
National Center for Learning Disabilities
National Institute of Mental Health
National Institute of Neurological Disorders and Stroke
University of Maryland Medical Center; Learning Disabilities
United States Department of Education; Jessup, Maryland: Office of Special Education and Rehabilitative Services

By: Laura Stephens