Learning Disability

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)

• 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.

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

• Poor memory

• Adjusting to new surroundings

• Understanding abstract concepts

• Focusing consistently: the child may lack concentration on some tasks, while focusing excessively on others

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.

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.