The term learning disability (LD) is used to refer to a range of neurological conditions that affect one or more of the ways that a person takes in, stores, or uses information. Learning disabilities are specific, not global, impairments. For example, a person could have a learning problem which inhibits her ability to understand written information though the same information, delivered orally, might present no problem.
Signs and Symptoms
Teachers are often the first to notice that "something doesn't seem right." Most parents will, from time to time, see one or more of these warning signs in their children. However, if you see several of the below mentioned characteristics over a significantly long period of time, then your child is possibly at the risk of having a learning disability.
- Speaks later than most children
- Pronunciation problems
- Slow vocabulary growth (number of words learned as the child grows), often unable to find the right word.
- Difficulty rhyming words
- Trouble learning numbers, alphabet, days of the week, colors, shapes
- Extremely restless and easily distracted
- Trouble interacting with peers
- Difficulty following directions or routines
- Slow to develop fine motor skills
- Slow to learn the connection between letters and sounds
- Confuses basic words ( run , eat , want )
- Makes consistent reading and spelling errors including letter reversals ( b / d ), inversions ( m / w ), transpositions ( felt / left ), and substitutions ( house / home )
- Interchanges number sequences and confuses arithmetic signs (+, -, x, /, =)
- Slow to remember facts
- Slow to learn new skills, relies heavily on memorization
- Impulsive, difficulty planning
- Unstable pencil grip
- Trouble learning about time
- Poor coordination, unaware of objects around, prone to accidents
- Reverses letter sequences ( soiled / solid , left / felt )
- Slow to learn prefixes (group of letters added before a word, eg, re-), suffixes (group of letters added after a word, eg, -ment), root words (a real word from which new words can be made by adding prefixes and suffixes. eg, pay), and other spelling strategies
- Avoids reading aloud
- Trouble with word problems
- Difficulty with handwriting
- Awkward, fist-like, or tight pencil grip
- Avoids writing assignments
- Slow or poor recall of facts
- Difficulty making friends
- Trouble understanding body language and facial expressions
- Continues to spell incorrectly, frequently spells the same word differently in a single piece of writing
- Avoids reading and writing tasks
- Trouble summarizing
- Trouble with questions that requires an answer greater than a single word or two on tests
- Weak memory skills
- Difficulty adjusting to new settings
- Works slowly
- Poor grasp of abstract concepts
- Either pays too little attention to details or focuses on them too much
- Misreads information
The child may not have Learning Disorder if he/she has any of the following:
- Low intelligence.
- Physical difficulties such as poor vision or hearing problems.
- Insufficient knowledge of a language, as in the case of an individual whose native language is not English.
- Inadequate development of pre-reading skills (e.g., letter knowledge, letter sound association) prior to entering school.
A language-based disability in which a person has trouble understanding written words. It may also be referred to as reading disability or reading disorder.
Dyslexia is a specific learning disability that is neurological in origin. It is characterized by difficulty in learning to read in spite of average or above average intelligence and regular exposure to reading instruction. Often children with dyslexia also have difficulties in areas of speed of processing, short term memory, organization, sequencing, and spoken language and motor skills. They typically have trouble making the connection between the sound and the corresponding letter and difficulty blending those sounds to form words. If it takes too long to sound out the word, then the child will have a hard time reading through sentences and understanding them. A child with dyslexia often forgets the word and its meaning in the larger context of the sentence or paragraph.
A mathematical disability in which a person has difficulty in solving arithmetic problems and grasping math concepts. Dyscalculia can also be characterized by having difficulties both with reading and with math. Children with dyscalculia often require a long time to carry out even simple arithmetic tasks. They might count on their fingers until far into the upper grades. Such difficulties are termed as Automatization difficulties. Another problem area is linguistic difficulties which can manifest as difficulties in understanding numbers as concepts. Although often of high intelligence, such a child may have only a limited understanding of either numbers or even numerical symbols. Another form is planning difficulties that lead to the child's failure to carry out computations effectively. This child may have difficulties in following even an obvious strategy in solving arithmetic problems, losing track of where he/she is at, use complicated/time-taking strategies. Dyscalculia may also be based on problems in visual perception that lead to difficulties at tasks involving logical thinking as well as in carrying out computations. This is often encountered in children who have difficulties in learning to read an ordinary clock and understand how the position of the hands is to be interpreted.
Dysgraphia is a writing disability in which a person finds it hard to form letters or write within a defined space. These children usually will have extremely poor handwriting. Children with dysgraphia often have sequencing problems. What usually appears to be a perceptual problem (reversing letters/numbers, writing words backwards, writing letters out of order, and very sloppy handwriting) is often directly related to sequential/rational information processing difficulty. These children have difficulty with the sequence of letters and words as they write. As a result, they either need to slow down in order to write accurately, or experience difficulty with writing (spelling, punctuation, etc). And when they do slow down they often tend to lose the thoughts that they are trying to write about.
Sensory Processing Disorders
It is a sensory disability wherein a person has difficulty in understanding language despite normal hearing and vision due to deficiency in the processes of recognizing and interpreting information taken in through the senses. The two most common areas of processing difficulty associated with learning disabilities are visual and auditory perception (understanding what they see and hear).
Central Auditory Processing Disorder (CAPD)
CAPD is a condition in which one has difficulty processing or interpreting information heard when in a noisy environment. Typically, individuals with CAPD have normal hearing when taking a traditional pure tone and speech-hearing test but are unable to interpret or process speech when in an environment which is not quiet. Environments such as a classroom and public gatherings can be disturbing because of this processing difficulty. Children with CAPD often perform below their potential in school and are often classified as "underachievers" by their teachers and parents. A psychological evaluation will most typically reveal that the child's aptitude is superior to or better than the child's actual performance or achievement in school. Some children with CAPD exhibit lower-than-normal activity levels (hypoactivity). These children do not act up in the classroom; in fact, they appear to be lazy, not active, or not social. Often parents report that these children are very tired after school. They are probably spending a lot of energy just trying to receive information heard in a meaningful manner.
Checklist of common features of CAPD
- Hears better when watching the speaker.
- Talks or likes T. V. louder than normal.
- Interprets words for exactly what they mean, i.e. does not understand metaphors.
- Often needs remarks repeated.
- Difficulty reading words by the sound of individual letters or group of letters.
- "Ignores" people, especially if engaged.
- Unusually sensitive to sounds.
- Asks many extra informational questions.
- Confuses similar-sounding words.
- Difficulty following directions in a series.
- Speech developed late or unclearly.
- Poor "communicator" (terse, telegraphic).
- Memorizes poorly.
- Problems with rapid speech.
- Difficulty hearing in noisy situations
- Difficulty following long conversations
- Difficulty hearing conversations on the telephone
- Difficulty learning a foreign language or challenging vocabulary words
- Difficulty remembering spoken information (i.e., auditory memory deficits)
- Difficulty taking notes
- Difficulty maintaining focus on an activity if other sounds are present i.e. child is
- easilydistracted by other sounds in the environment
- Difficulty with organizational skills
- Difficulty following multi-step directions
- Difficulty in directing, sustaining, or dividing attention
- Difficulty with reading and/or spelling
- Difficulty processing nonverbal information (e.g., lack of music appreciation)
Nonverbal Learning Disabilities (NLD)
Children with this disorder are unable to recognize and translate nonverbal cues, such as facial expressions or tone of voice, into meaningful information. This cause the children to be mislabeled as emotionally disturbed because of their inappropriate responses to nonverbal stimuli. It is a neurological disorder, which originates in the right hemisphere of the brain, causing problems with visual-spatial, intuitive, organizational, evaluative, and holistic processing functions. Nonverbal learning disabilities can be tricky to recognize and diagnose. The neuropsychological characteristics of individuals with the NLD profile include deficits in tactile perception, psychomotor coordination, visual-spatial organization, nonverbal problem solving, and appreciation of inconsistencies and humor. Children with NLD also show memorizing through repetition (rote) and verbal memory skills. They however face difficulty in adapting to new and complex situations, and rely much on rote behaviors in such situations, deficiencies in addition and subtraction (mechanical arithmetic) as compared to proficiencies in single word reading, poor pragmatics and prosody in speech, and significant deficits in social perception, social judgment, and social interaction skills. There are marked deficits in the appreciation of subtle and even fairly obvious nonverbal aspects of communication, that often result in other person's social disdain and rejection. As a result, NLD individuals show a marked tendency toward social withdrawal and are at risk for development of serious mood disorders.
Identifying learning challenges in the early years of life are based on clinical observation and the emerging research on the developmental pathways involved in early learning and eventual mastery of reading, math, writing and organizing ( Diagnostic Manual for Infancy and Early Childhood (2005). "These early learning challenges involve emotional and social capacities, auditory processing and language (including memory and retrieval), visuo-spatial processing, perceptual motor and motor planning (including visual memory, sequencing, and what is often referred to as nonverbal learning) capacities and sensory modulation." (ICDL-DMIC page. 168).
The identification of a learning disorder involves the examination of two kinds of evidence.
1. A detailed case history: It is important to collect detailed information regarding the child's birth, development, familial status, learning environment, medical history, and social-emotional adjustments. This is done by interviewing the parents/care-givers and often provides reasonably good insight into the issues underlying the learning problem.
2. Evaluation of the child: Information regarding the child's functional skills can only be gained by directly assessing him/her using informal and formal testing procedures. The child is tested in the areas of motor, speech-language, sensory, cognitive-perceptual and academic skills. Psychological tests are often carried out to identify and rule out associated features such as Intelligence levels, ADHD/ADD, Behavioural, and Social-Emotional issues.
Neither source of evidence by itself is conclusive. However, a comprehensive profile of the child can be drawn from both the case history and results of the direct testing, which will also help determine the source of the learning problem. Analysis of the pattern of performance is a very powerful tool that helps identify a variety of academic problems that range from a general poor reading skill to inconsistent writing to attention deficit problems. It is also very essential to assess the child's learning potential rather than just labeling his/her deficits.
Role of professionals in Diagnosis
Clinical Psychologist : Provide assessment of intellectual and emotional functioning.
Educational Psychologist: Assess learning and behaviour in children along with evaluating their educational setting. A small number are trained to assess cognitive, intellectual functioning as well.
Special Educator : Assess the academic skills and learning potential in children.
Speech and Language Pathologist: Assess and diagnose speech and language difficulties, which is often a significant component of most learning disabilities.
Occupational Therapist: Assess the motor and visual-motor, cognitive-perceptual, sensory and everyday functional skills of the child. Assessing issues in Handwriting is often the role of the occupational therapist. All these have a direct and/or indirect effect on the child's learning process.
Neurologist : Identify if there is a possible damage to brain functions.
Psychiatrist: Diagnose and treat severe behavioural and emotional problems and will sometimes prescribe medication.
Pediatrician: Provide medical services to infants, children, and adolescents; trained in overall growth and development of children.
If parents, teachers, and other professionals discover a child's learning disability early and provide the right kind of support, the child's chance to develop positive skills needed to lead a successful and productive life is higher. Early identification is possible if we are more alert to the way the child is developing during the early years and adapting to the environment as he/she grows older. It begins from birth or first diagnosis, and continues through school age.
Early intervention involves identifying the problem areas and designing a program to suit the child's needs. Specialized education program, therapy services for the child along with support for the family and school is an integral part of intervention. Early Childhood Intervention has several goals. Firstly, it is provided to support families to support their child's development. Secondly, it is to promote the child's development in key domains such as learning, communication or mobility. Thirdly, it is to promote the child's coping confidence, and finally it is to prevent the emergence of future problems.
The child should be provided with the required services in an inter-disciplinary setting. An ideal Intervention team generally consists of Special Educators, Speech and Language pathologists, Occupational therapists, Physiotherapists, and counselors. A key feature of an "interdisciplinary model" is where staff members discuss together and work on goals as a team. This approach would be more beneficial to the child as well as the family. Look for a centre which has a team comprising people with varied expertise.
Special Education describes an educational alternative that focuses on the teaching of students with academic, behavioral, health, or physical needs that cannot sufficiently be met using traditional educational programs or techniques. Children who have special learning needs which arise out of sensory, intellectual, psychological or socio-cultural deficits often face difficulty in facing the challenges of mainstream education. They might need special inputs to perceive and comprehend the vast information presented to them using special instructional methodology and instructional material, learning aids and equipment specific to each individual's learning needs. This puts an additional demand on the mainstream teacher. These needs therefore have given rise to the component of education known as Special Education.
A Speech-Language Pathologist/Speech Therapist performs a comprehensive evaluation of language-base learning skills that helps identify strengths and weaknesses in the following skills:
- Auditory comprehension
- Expressive language ability
- Phonemic awareness (ability to process speech sounds)
- Current reading level (decoding and comprehension)
- Processing of higher-level language (inferences, idioms, etc.)
- Language formulation in writing
- Auditory and visual memory
- Vocabulary level
- Word-finding abilities
A typical Speech therapy program will involve:
- Phonemic awareness is the ability to separate words into individual sounds, and blend individual sounds into words. Targeted listening activities give a boost to the development of the area of the brain responsible for this skill.
- Phonics is the ability to associate a letter with its given sound(s). Activities at this level focus on decoding nonsense syllables and words in order to learn how to break the reading code.
- Fluency involves reading quickly and accurately. Increasing speed involves repeated oral reading with feedback, sight word instruction, and increasing speed with specific listening activities.
- Vocabulary development is crucial for progressing in reading at an age-appropriate level. Word-finding skills are targeted in activities designed to develop rapid sound and meaning associations between words, such as plant, planting, plantation, planter, and power plant.
- Comprehension focuses on strategies for chunking information, visualizing the picture being painted by the words, and formulating inferences and conclusions. At this level, work focuses on the whole text.
Many children with Central Auditory Processing Disorder will benefit from auditory training procedures and phonological awareness training. Intervention may also involve the identification of (and training in the use of) strategies that can be used to overcome specific auditory, speech and language, or academic difficulties. A number of actions can be taken to improve the quality of the signal reaching the child. Children can be provided personal assistive-listening devices that should serve to enhance the teacher's voice and reduce the competition of other noises and sounds in the classroom. Acoustic modifications can be made to the classroom (e.g., carpeting, acoustic ceiling tiles, window treatments) which should help to minimize the detrimental effects of noise on the child's ability to process speech in the educational setting.
Finally, teachers and parents can assist the child in overcoming his or her auditory deficits by speaking clearly, rephrasing information, providing preferential seating, using visual aids to supplement auditory information, and so forth. The program should be tailored to the child's individual needs, and it should represent an interdisciplinary approach. Parents, teachers, educational specialists, and other professionals, as appropriate, should be involved in the development and implementation of the child's management program.
Occupational Therapists, as part of their training develop the knowledge and skills to also work with people with learning disabilities. They are, therefore, in a position to work with and understand the complex health needs of young people with learning disabilities, and to be an integral part of the holistic and inclusive services. They conduct a holistic assessment, which takes into account the environment in which the young person is living and provide a wide range of services, including issues in health, education, and social-emotional areas. They have a role in promoting and enabling social competence, helping the individual develop a sense of purpose, promote safe and inclusive environments, and provide a range of opportunities to participate in the mainstream community. This often enhances the development of self-esteem and self-purpose, and thus promotes positive mental health.
Parents and professional support groups can increase awareness of the issue, dispel misconceptions, help establish educational systems that provide for the needs of children with learning disabilities, and get support for each other considering that the condition itself is very mentally demanding.
Tips for parents
Work with your child
Parents are a child's first and best teachers. Show your child that reading can be fun. Read to your child every day. Point out words on billboards and traffic signs as you drive, on food labels at the grocery store, on packages, mail, and letters. Play word games.
Tips for helping with schoolwork
- Show an interest in your child's homework. Inquire about the subjects and the work to be done. Ask questions that require answers longer than one or two words and not always involving academics.
- Help your child organize homework materials before beginning.
- Establish a regular time with your child to do homework-developing a schedule helps avoid procrastination.
- Find a specific place for your child to do homework that has lots of light, quiet, and plenty of work space.
- Encourage your child to ask questions and search for answers, taking the time to figure it out on his/her own.
- Make sure your child backs up answers with facts and evidence.
- Practice school-taught skills at home.
- Relate homework to your child's everyday life. For instance, teach fractions and measurements as you prepare a favorite food together.
- Praise your child for both the small steps and big leaps in the right direction.
Help your child become a better reader (for early readers)
- Work on the relationship between letters and words. Teach younger children how to spell a few special words, such as their own names, the names of pets or favorite cartoon characters, or words they see frequently like stop or exit .
- Help your child understand that language is made up of sounds, syllables, and words. Sing songs and read rhyming books. Play word games; for instance, think of words that rhyme with dog or begin with p.
- Teach letter sounds. Sound out letters and words.
- Sound out new words and encourage your child to spell by speaking each sound aloud.
- Notice spelling patterns. Point out similarities between words, such as fall, ball, and hall or cat, fat, and hat.
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