What is a learning disability (LD)?
A learning disability is a neurological condition which affects the brain's ability to send, receive, and process information. A child with a learning disability may have difficulties in reading, writing, speaking, listening, understanding mathematical concepts, and with general comprehension. Learning disabilities include a group of disorders such as dyslexia, dyspraxia, dyscalculia and dysgraphia. Each type of disorder may coexist with another.
Definition of learning disabilities
The federal definition of learning disabilities, laid down by the US Government in Public Law 94-142, has been adopted in India:
“Specific learning disability means a disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, which may manifest itself in an imperfect ability to listen, speak, read, spell or to do mathematical calculations.
The term includes such conditions as perceptual handicaps, brain injury, minimal brain dysfunction, dyslexia and developmental aphasia.
The term does not include children who have learning problems which are primarily the result of visual, hearing or motor handicaps, or mental retardation, emotional disturbance or environmental, cultural or economic disadvantages."
Courtesy: (Federal Register, 1977, p. 65083) (Karanth, 2002)
What learning disabilities are not?
Some children begin as slow learners but are eventually able to learn and cope with their studies and other activities. Some children may not be interested in specific types of learning (learning a new language, a specific activity or skill, or academic subject), or may not be interested in sports or other outdoor activities. These attributes indicate the child's interests and are not indicative of a learning disability.
James H. Wendorf, Executive Director, National Center for Learning Disability
What causes learning disabilities?
Experts say that there is no single, specific cause for learning disabilities. However, there are some factors that could cause a learning disability:
Heredity: It is observed that a child, whose parents have had a learning disability, is likely to develop the same disorder.
Illness during and after birth: An illness or injury during or after birth may cause learning disabilities. Other possible factors could be drug or alcohol consumption during pregnancy, physical trauma, poor growth in the uterus, low birth weight, and premature or prolonged labor.
Stress during infancy: A stressful incident after birth such as high fever, head injury, or poor nutrition.
Environment: Increased exposure to toxins such as lead (in paint, ceramics, toys, etc.)
Comorbidity: Children with learning disabilities are at a higher-than-average risk for attention problems or disruptive behavior disorders. Up to 25 percent of children with reading disorder also have ADHD. Conversely, it is estimated that between 15 and 30 percent of children diagnosed with ADHD have a learning disorder.
What are the signs of learning disabilities?
In the normal physiological development, the child is expected to acquire a certain set of basic cognition and motor skills. Any significant delay or gap in this development could be a sign of learning disability. A series of well-researched and proven tests and assessments have to be conducted before diagnosing the condition.
The signs of LD may vary slightly during each stage of childhood.
Preschool: The child may have some of these difficulties in preschool.
Developing speaking skills at normal age (15-18 months) when speech typically develops in children
Pronouncing simple words
Recognizing letters and words
Learning numbers, rhymes or songs
Concentrating on tasks
Following rules and directions
Using fine/gross motor skills to do physical tasks.
Primary School: The child may have difficulty in:
Connecting letters and sounds
Differentiating between similar sounding words or rhyming words
Reading, spelling, or writing accurately
Distinguishing right from left, for example, confusing 25 with 52, “b” with “d,” “on” with “no,” “s” with “5”
Recognizing letters of the alphabet
Using correct mathematical symbols for doing maths problems
Remembering numbers or facts
Learning new skills; the child may be slower than other children of his or her age
Memorizing poems or answers
Understanding the concept of time
Hand-to-eye coordination, being unable to gauge the distance or speed, thus leading to accidents
Tasks involving fine motor skills: holding pencil, tying shoe lace, buttoning shirt and so on
Keeping track of own possessions like stationery items
Middle School: The child may have difficulty in:
Spelling similar words (sea/see, week/weak), usage of prefixes, suffixes
Reading aloud, writing assignments, solving word problems in maths (the child may avoid doing tasks involving these skills)
Handwriting (child may grip the pencil tightly)
Memorizing or recalling facts
Understanding body language and facial expressions
Showing appropriate emotional reactions in a learning environment (the child may behave in an aggressive or rebellious way, and react with an excess of emotion)
High School: The child may have difficulty in:
Spelling words accurately (the child may write the same word with different spellings in a single writing assignment)
Reading and writing tasks
Summarizing, paraphrasing, answering application problems or questions in tests
Adjusting to new surroundings
Understanding abstract concepts
Focusing consistently: the child may lack concentration on some tasks, while focusing excessively on others
How is a learning disability identified?
Identifying a learning disability is a complex process. The first step is to rule out vision, hearing, and developmental issues that can overshadow the underlying learning disability. Once these tests are completed, a learning disability is identified using psycho educational assessment, which includes academic achievement testing along with a measure of intellectual capability. This test helps determine if there is any significant discrepancy between a child's potential and performance capability (IQ) and the child's academic achievement (school performance).
What are the intervention and support options for learning disabilities?
A learning disability cannot be cured. However with timely intervention and support, children with learning disabilities can be successful in school. Parents and teachers are the first persons to notice that the child is finding it difficult to read, write or learn. If you think that your child may have a learning disability, seek help from a mental health expert or other trained specialists for the required intervention program or therapy.
If your child has a learning disorder, your child's doctor or school might recommend:
Extra help: A reading specialist or other trained professional can teach your child techniques to improve his or her academic skills. Tutors can also teach children organizational and study skills.
Individualized Education Program (IEP): Your child's school or a special educator might develop an IEP that will describe how a child can best learn in school.
Therapy: Depending on the learning disorder, some children might benefit from therapy. For example, speech therapy can help children who have language disabilities. Occupational therapy might help improve the motor skills of a child who has writing problems.
Complimentary/alternative therapy: Research shows that alternative therapies like music, art, dance can benefit children with learning disabilities.
Parents and experts need to set goals and assess if the child is improving with the selected mode of intervention and support. If not, alternative methods can be chosen to help the child.
What experts to approach for the treatment of learning disabilities?
LD is identified after a series of tests conducted by a team of specialists. The following specialists may work together to help diagnose and treat a child’s LD.
Clinical Psychologist : Preferably a psychologist with a specialization in education. The Clinical Psychologist conducts specific intelligence test (such as Wechsler Intelligence Scale for Children test) to determine whether the child’s intellectual functioning is normal. This helps to exclude borderline intellectual functioning and mild mental retardation, both of which may affect academic performance.
Special Educator assesses the child’s academic achievement by administering standard educational tests (Wide Range Achievement Test, Peabody Individual Achievement Test, Woodcock-Johnson Tests of Achievement, Schonnel Attainment Test, Curriculum Based Test) to assess the child’s performance in areas like reading, spelling, written language, and mathematics. An academic achievement of two years below the child’s actual school grade or chronological age may indicate that the child has a specific learning disability.
Counselor helps in understanding behavior, checks for any behavioral issues, and for any problems that may exist due to poor home or school environment, or any emotional problems that may be the reason for the child's poor performance at school.
Pediatrician/ Pediatric Neurologist: If a learning disability is suspected, The pediatrician needs to enquire about the child's performance in school and guide the parents to get their child's psycho-educational assessment done. The pediatrician may also counsel the parents and class teacher about the usefulness of remedial education. A pediatric neurologist records detailed clinical history and does a thorough physical examination to exclude medical ailments like hypothyroidism, chronic lead poisoning; and neurological disorders such as cerebral palsy, Wilson’s disease, ADHD. Checks for behavioral issues at school and at home.
Child Psychiatrist : Checks if there are symptoms of ADHD because it may coexist with any type of learning disability. The psychiatrist also checks for other disorders which may be the cause for poor academic performance.