Learning Disabilities (Final)

8/14/2019 Learning Disabilities (Final)

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What is a learning disability?

Interestingly, there is no clear and widely accepted definition of "learning disabilities." Currentlyat least 12 definitions appear in the professional literature. These disparate definitions do agreeon certain factors:

1. The learning disabled have difficulties with academic achievement and progress.Discrepancies exist between a person's potential for learning and what he actually learns.

2. The learning disabled show an uneven pattern of development (language development, physical development, academic development and/or perceptual development).

3. Learning problems are not due to environmental disadvantage. 4. Learning problems are not due to mental retardation or emotional disturbance.

How prevalent are learning disabilities?

Experts estimate that 6 to 10 percent of the school-aged population in the United States islearning disabled.

In India around 13-14% of all school children suffer from learning disorders.

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What causes learning disabilities?

i. Little is currently known about the causes of learning disabilities. However, some generalobservations can be made:

ii. Some children develop and mature at a slower rate than others in the same age group. Asa result, they may not be able to do the expected school work. This kind of learningdisability is called "maturational lag."

iii. Some children with normal vision and hearing may misinterpret everyday sights andsounds because of some unexplained disorder of the nervous system.

iv. Injuries before birth or in early childhood probably account for some later learning problems.

v. Children born prematurely and children who had medical problems soon after birthsometimes have learning disabilities.

vi. Learning disabilities tend to run in families, so some learning disabilities may be

inherited. vii. Learning disabilities are more common in boys than girls, possibly because boys tend to

mature more slowly. viii. Some learning disabilities appear to be linked to the irregular spelling, pronunciation, and

structure of the English language. The incidence of learning disabilities is lower inSpanish or Italian speaking countries.

What are the "early warning signs" of learning disabilities?Children with learning disabilities exhibit a wide range of symptoms. These include problemswith reading, mathematics, comprehension, writing, spoken language, or reasoning abilities.Hyperactivity, inattention and perceptual coordination may also be associated with learningdisabilities but are not learning disabilities themselves. The primary characteristic of a learningdisability is a significant difference between a child's achievement in some areas and his or her overall intelligence. Learning disabilities typically affect five general areas:

1. Spoken language: delays, disorders, and deviations in listening and speaking. 2. Written language: difficulties with reading, writing and spelling. 3. Arithmetic: difficulty in performing arithmetic operations or in understanding basic

concepts. 4. Reasoning: difficulty in organizing and integrating thoughts. 5. Memory: difficulty in remembering information and instructions.

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Among the symptoms commonly related to learning disabilities are:

poor performance on group tests difficulty discriminating size, shape, color difficulty with temporal (time) concepts distorted concept of body image reversals in writing and reading general awkwardness poor visual-motor coordination hyperactivity difficulty copying accurately from a model

slowness in completing work poor organizational skills easily confused by instructions difficulty with abstract reasoning and/or problem solving disorganized thinking often obsesses on one topic or idea poor short-term or long-term memory impulsive behavior; lack of reflective thought prior to action

low tolerance for frustration excessive movement during sleep poor peer relationships overly excitable during group play poor social judgment inappropriate, unselective, and often excessive display of affection lags in developmental milestones (e.g. motor, language) behavior often inappropriate for situation failure to see consequences for his actions overly gullible; easily led by peers excessive variation in mood and responsiveness poor adjustment to environmental changes

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overly distractible; difficulty concentrating difficulty making decisions lack of hand preference or mixed dominance

difficulty with tasks requiring sequencing

When considering these symptoms, it is important to remain mindful of the following:

1. No one will have all these symptoms. 2. Among LD populations, some symptoms are more common than others. 3. All people have at least two or three of these problems to some degree. 4.

The number of symptoms seen in a particular child does not give an indication as whether the disability is mild or severe. It is important to consider if the behaviors are chronic andappear in clusters.

How does a learning disability affect the parents of the child?

A parent may move from stage-to-stage in random. Some parents skip over stages while othersremain in one stage for an extended period. These stages are as follows:

DENIAL: "There is really nothing wrong!" "That's the way I was as a child--not to worry!""He'll grow out of it!"

BLAME: "You baby him!" "You expect too much of him." "It's not from my side of the family."

FEAR: "Maybe they're not telling me the real problem!" "Is it worse than they say?" "Will heever marry? go to college? graduate?"

ENVY: "Why can't he be like his sister or his cousins?"

MOURNING: "He could have been such a success, if not for the learning disability!"

BARGAINING: "Wait 'till next year!" "Maybe the problem will improve if we move! (or hegoes to camp, etc.)."

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ANGER: "The teachers don't know anything." "I hate this neighborhood, this school...thisteacher."

GUILT: "My mother was right; I should have used cloth diapers when he was a baby." "Ishouldn't have worked during his first year." "I am being punished for something and my child issuffering as a result."

ISOLATION: "Nobody else knows or cares about my child." "You and I against the world. Noone else understands."

FLIGHT: "Let's try this new therapy--Donahue says it works!" "We are going to go from clinicto clinic until somebody tells me what I want to hear.!"

Again, the pattern of these reactions is totally unpredictable. This situation is worsened by thefact that frequently the mother and father may be involved in different and conflicting stages atthe same time (e.g., blame vs. denial; anger vs. guilt). This can make communication verydifficult.

Common types of learning disabilities :

Common Types of Learning Disabilities

Dyslexia Difficulty processing language Problems reading, writing, spelling,speaking

Dyscalculia Difficulty with math Problems doing math problems,understanding time, using money

Dysgraphia Difficulty with writing Problems with handwriting, spelling,organizing ideas

Dyspraxia (SensoryIntegration Disorder)

Difficulty with fine motor skills

Problems with handeye coordination, balance, manual dexterity

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Common Types of Learning Disabilities

Auditory ProcessingDisorder

Difficulty hearing differences between sounds

Problems with reading, comprehension,language

Visual ProcessingDisorder

Difficulty interpreting visualinformation

Problems with reading, math, maps, charts,symbols, pictures

ARTICULATION AND PHONOLOGICAL DISORDERS

Both articulation and phonology refer to the physiological production of speech sounds,ie. the individual sounds in speech, not the meaning and content of speech. When a child

presents with either an articulation disorder or a phonological disorder they are oftendifficult to understand.

Articulation

Articulation is a general term which refers to the production of individual sounds. The production of sounds involves the coordinated movements of the lips, tongue, teeth & palate and respiratory system. This includes a variety of nerves and muscles used for speech production.

All speech sounds (phonemes) are acquired in a predictable developmental order.

An articulation disorder refers to a child who has difficulty producing and forming particular speech sounds correctly eg. lisping or not being able to produce a particular sound eg. "r". These disorders are generally very specific in nature and require therapyfrom a trained speech pathologist.

Phonology / Phonological disorders

Phonology refers to the pattern in which sounds are strung together to produce words.This means that a child can produce a sound correctly but may use it in the incorrect

position in a word eg. a child always use "d" sound for the "g" sound ie. "doe" for "go".Phonological processes generally simplify sounds or sound sequences such as syllablesand words. There are many types of phonological disorders and these area generallyeffected by three primary areas, including:

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i. Phonological disorders may have a far greater impact on a child's intelligibility than purearticulation disorders as the child may confuse several phonological rules.

ii. Phonological disorders and phonemic awareness disorders (the understanding of soundsand sound rules in words) have been linked to on - going language and literacydifficulties. It is therefore important to correctly assess a child's speech difficulties so thatthe correct intervention can be arranged.

Who should assess and treat the child?

A qualified speech pathologist should assess a child if there are any concerns regardingthe quality, intelligibility or production of a child's speech.

Pure articulation or phonological difficulties are generally not a direct symptom of braininjury. In most cases a child may have had some underlying difficulties prior to the braininjury occurring.

Children with an acquired brain injury may however have difficulties with their speech patterns and these are generally caused by dyspraxia or dysarthria . Some children withacquired brain injuries may have difficulties with literacy acquisition and language, thesechildren generally present with specific phonological awareness disorders.

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ATTENTION DEFICIT / HYPERACTIVITY DISORDER (AD/HD)

Attention-Deficit/Hyperactivity Disorder (AD/HD) is a condition that can make it hardfor a person to sit still, control behavior, and pay attention. These difficulties usually

begin before the person is 7 years old. However, these behaviors may not be noticed untilthe child is older.

Doctors do not know just what causes AD/HD. However, researchers who study the brainare coming closer to understanding what may cause AD/HD. They believe that some

people with AD/HD do not have enough of certain chemicals (called neurotransmitters )in their brain. These chemicals help the brain control behavior.

Causes of ADHD

ADHD is not caused by poor parenting, too much sugar, or vaccines.

ADHD has biological origins that aren't yet clearly understood. No single cause has beenidentified, but researchers are exploring a number of possible genetic and environmentallinks. Studies have shown that many kids with ADHD have a close relative who also hasthe disorder.

Although experts are unsure whether this is a cause of the disorder, they have found thatcertain areas of the brain are about 5% to 10% smaller in size and activity in kids withADHD. Chemical changes in the brain also have been found.

Recent research also links smoking during pregnancy to later ADHD in a child. Other risk factors may include premature delivery , very low birth weight, and injuries to the

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Some studies have even suggested a link between excessive early television watching andfuture attention problems. Parents should follow the American Academy of Pediatrics'(AAP) guidelines, which say that children under 2 years old should not have any "screentime" (TV, DVDs or videotapes, computers, or video games) and that kids 2 years andolder should be limited to 1 to 2 hours per day, or less, of quality television

programming.

How Common is AD/HD?

As many as 5 out of every 100 children in school may have AD/HD.

Boys are three times more likely than girls to have AD/HD.

What Are the Signs of AD/HD?

There are three main signs, or symptoms, of AD/HD. These are:

problems with paying attention,

being very active (called hyperactivity), and

acting before thinking (called impulsivity).

1) Inattentive type .

Many children with AD/HD have problems paying attention. Children with the inattentive typeof AD/HD often:

do not pay close attention to details;

cant stay focused on play or school work;

dont follow through on instructions or finish school work or chores;

cant seem to organize tasks and activities; get distracted easily; and

lose things such as toys, school work, and books. (APA, 2000, pp. 85-86)

2) Hyperactive-impulsive type .

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Being too active is probably the most visible sign of AD/HD. The hyperactive child is alwayson the go. (As he or she gets older, the level of activity may go down.) These children also act

before thinking (called impulsivity ). For example, they may run across the road without lookingor climb to the top of very tall trees. They may be surprised to find themselves in a dangeroussituation. They may have no idea of how to get out of the situation.

Hyperactivity and impulsivity tend to go together. Children with the hyperactive-impulsive typeof AD/HD often may:

fidget and squirm;

get out of their chairs when theyre not supposed to;

run around or climb constantly;

have trouble playing quietly;

talk too much; blurt out answers before questions have been completed;

have trouble waiting for their turn;

interrupt others when theyre talking; and

butt in on the games others are playing. (APA, 2000, p. 86)

3) Combined type .

Children with the combined type of AD/HD have symptoms of both of the typesdescribed above. They have problems with paying attention, with hyperactivity, and withcontrolling their impulses.

Of course, from time to time, all children are inattentive, impulsive, and too active. Withchildren who have AD/HD, these behaviors are the rule, not the exception .

These behaviors can cause a child to have real problems at home, at school, and withfriends. As a result, many children with AD/HD will feel anxious, unsure of themselves,and depressed. These feelings are not symptoms of AD/HD. They come from having

problems again and again at home and in school.

Related Problems

One of the difficulties in diagnosing ADHD is that it's often found in conjunction with other problems. These are called coexisting conditions, and about two thirds of kids with ADHD haveone. The most common coexisting conditions are:

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At least 35% of kids with ADHD also have oppositional defiant disorder, which ischaracterized by stubbornness, outbursts of temper, and acts of defiance and rule

breaking. Conduct disorder is similar but features more severe hostility and aggression.Kids who have conduct disorder are more likely to get in trouble with authority figuresand, later, possibly with the law. Oppositional defiant disorder and conduct disorder areseen most commonly with the hyperactive and combined subtypes of ADHD.

b) Mood Disorders

About 18% of kids with ADHD, particularly the inattentive subtype, also experiencedepression. They may feel inadequate, isolated, frustrated by school failures and social

problems, and have low self-esteem .

c) Anxiety Disorders

Anxiety disorders affect about 25% of kids with ADHD. Symptoms include excessiveworry, fear, or panic, which can also lead to physical symptoms such as a racing heart,sweating, stomach pains, and diarrhea. Other forms of anxiety that can accompanyADHD are obsessive-compulsive disorder as well as motor or vocal tics (movements or sounds that are repeated over and over). A child who has symptoms of these other conditions should be evaluated by a specialist.

d) Learning Disabilities

About half of all kids with ADHD also have a specific learning disability. The mostcommon learning problems are with reading ( dyslexia ) and handwriting . AlthoughADHD isn't categorized as a learning disability, its interference with concentration andattention can make it even more difficult for a child to perform well in school.

If your child has ADHD and a coexisting condition, the doctor will carefully consider that when developing a treatment plan. Some treatments are better than others ataddressing specific combinations of symptoms.

Treating AD/HD

ADHD can't be cured, but it can be successfully managed. Your child's doctor will work with you to develop an individualized, long-term plan. The goal is to help a child learn to

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control his or her own behavior and to help families create an atmosphere in which this ismost likely to happen.

In most cases, ADHD is best treated with a combination of medication and behavior therapy. Any good treatment plan will require close follow-up and monitoring, and your doctor may make adjustments along the way. Because it's important for parents toactively participate in their child's treatment plan, parent education is also considered animportant part of ADHD management.

Medications

Several different types of medications may be used to treat ADHD:

i. Stimulants are the best-known treatments they've been used for more than 50 years inthe treatment of ADHD. Some require several doses per day, each lasting about 4 hours;some last up to 12 hours. Possible side effects include decreased appetite, stomachache,irritability, and insomnia. There's currently no evidence of long-term side effects.

ii. Nonstimulants were approved for treating ADHD in 2003. These appear to have fewer side effects than stimulants and can last up to 24 hours.

iii. Antidepressants are sometimes a treatment option; however, in 2004 the U.S. Food andDrug Administration (FDA) issued a warning that these drugs may lead to a rareincreased risk of suicide in children and teens. If an antidepressant is recommended for your child, be sure to discuss these risks with your doctor.

Medications can affect kids differently, and a child may respond well to one but not another.When determining the correct treatment, the doctor might try various medications in variousdoses, especially if your child is being treated for ADHD along with another disorder.

Behavioral Therapy

Research has shown that medications used to help curb impulsive behavior and attentiondifficulties are more effective when combined with behavioral therapy.

Behavioral therapy attempts to change behavior patterns by:

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ii. giving clear directions and commandsiii. setting up a system of consistent rewards for appropriate behaviors and negative

consequences for inappropriate ones

Here are examples of behavioral strategies that may help a child with ADHD:

i. Create a routine. Try to follow the same schedule every day, from wake-up time to bedtime. Post the schedule in a prominent place, so your child can see what's expectedthroughout the day and when it's time for homework, play, and chores.

ii. Get organized . Put schoolbags, clothing, and toys in the same place every day so your child will be less likely to lose them.

iii. Avoid distractions. Turn off the TV, radio, and computer games, especially when your

child is doing homework.

iv. Limit choices. Offer a choice between two things (this outfit, meal, toy, etc., or that one)so that your child isn't overwhelmed and overstimulated.

v. Change your interactions with your child. Instead of long-winded explanations andcajoling, use clear, brief directions to remind your child of responsibilities.

vi. Use goals and rewards. Use a chart to list goals and track positive behaviors, then

reward your child's efforts. Be sure the goals are realistic (think baby steps rather thanovernight success).

vii. Discipline effectively. Instead of yelling or spanking, use timeouts or removal of privileges as consequences for inappropriate behavior. Younger kids may simply need to be distracted or ignored until they display better behavior.

viii. Help your child discover a talent. All kids need to experience success to feel goodabout themselves. Finding out what your child does well whether it's sports, art, or music can boost social skills and self-esteem.

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AUDITORY PROCESSING DISORDER

Auditory processing disorder (APD), also known as central auditory processing disorder (CAPD), is a complex problem affecting about 5% of school-aged children.

These kids can't process the information they hear in the same way as others becausetheir ears and brain don't fully coordinate. Something adversely affects the way the brainrecognizes and interprets sounds, most notably the sounds composing speech.

Kids with APD often do not recognize subtle differences between sounds in words, evenwhen the sounds are loud and clear enough to be heard. These kinds of problemstypically occur in background noise, which is a natural listening environment.

So kids with APD have the basic difficulty of understanding any speech signal presentedunder less than optimal conditions.

Causes

The many possible causes of APD include:

i. head trauma

ii. lead poisoning

iii. chronic ear infections.

Sometimes the cause is unknown. Because there are many different possibilities evencombinations of causes each child must be assessed individually.

Problem Areas for Kids With CAPD

The five main problem areas that can affect both home and school activities in kids with APD

are:

1. Auditory Figure-Ground Problems: This is when the child can't pay attentionwhen there's noise in the background. Noisy, low-structured classrooms could be veryfrustrating.

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2. Auditory Memory Problems: This is when the child has difficulty rememberinginformation such as directions, lists, or study materials. It can be immediate (i.e., "Ican't remember it now") and/or delayed (i.e., "I can't remember it when I need it for later").

3. Auditory Discrimination Problems: This is when the child has difficultyhearing the difference between sounds or words that are similar (COAT/BOAT or CH/SH). This problem can affect following directions, reading, spelling, and writingskills, among others.

4. Auditory Attention Problems: This is when the child can't maintain focus for listening long enough to complete a task or requirement (such as listening to a lecturein school). Although health, motivation, and attitude might also affect attention,among other factors, a child with CAPD cannot (not will not ) maintain attention.

5. Auditory Cohesion Problems: This is when higher-level listening tasks aredifficult. Auditory cohesion skills drawing inferences from conversations,understanding riddles, or comprehending verbal math problems require heightenedauditory processing and language levels. They develop best when all the other skills(levels 1 through 4 above) are intact.

Detecting APDSymptoms of APD can range from mild to severe and can take many different forms. If you think your child might have a problem with how he or she processes sounds, consider these questions:

i. Is your child easily distracted or unusually bothered by loud or sudden noises?

ii. Are noisy environments upsetting to your child?

iii. Does your child's behavior and performance improve in quieter settings?

iv. Does your child have difficulty following directions, whether simple or complicated?

v. Does your child have reading, spelling, writing, or other speech-language difficulties?

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vi. Is abstract information difficult for your child to comprehend?

vii. Are verbal (word) math problems difficult for your child?

viii. Is your child disorganized and forgetful?

ix. Are conversations hard for your child to follow?

APD is an often misunderstood problem because many of the behaviors noted above canalso appear in other conditions like learning disabilities, attention deficit hyperactivitydisorder (ADHD), and even depression. Although APD is often confused with ADHD, itis possible to have both. It is also possible to have APD and specific language impairmentor learning disabilities

Diagnosis

Audiologists (hearing specialists) can determine if a child has APD. Although speech-language pathologists can get an idea by interacting with the child, only audiologists can

perform auditory processing testing and determine if there really is a problem.

However, some of the skills a child needs to be evaluated for auditory processingdisorder don't develop until age 8 or 9. Younger kids' brains just haven't matured enoughto accept and process a lot of information. Therefore, many children diagnosed with APDcan develop better skills with time.

Once diagnosed, kids with APD usually work with a speech therapist. The audiologistwill also recommend that they return for yearly follow-up evaluations.

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Strategies at home and school

Strategies applied at home and school can alleviate some of the problem behaviorsassociated with APD. Because it's common for kids with CAPD to have difficulty

following directions, for example, these tactics might help:

i. Since most kids with APD have difficulty hearing amid noise, it's very important toreduce the background noise at home and at school.

ii. Have your child look at you when you're speaking.

iii. Use simple, expressive sentences.

iv. Speak at a slightly slower rate and at a mildly increased volume.

v. Ask your child to repeat the directions back to you and to keep repeating them aloud (toyou or to himself or herself) until the directions are completed.

vi. For directions that are to be completed at a later time, writing notes, wearing a watch, andmaintaining a household routine also help. General organization and scheduling also can

be beneficial.

vii. It's especially important to teach your child to notice noisy environments, for example,and move to quieter places when listening is necessary.

Other strategies that might help:

i. Provide your child with a quiet study place (not the kitchen table).

ii. Maintain a peaceful, organized lifestyle.

iii. Encourage good eating and sleeping habits.

iv. Assign regular and realistic chores, including keeping a neat room and desk.

v. Build your child's self-esteem.

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Be sure to keep in regular contact with school officials about your child's progress. Kidswith APD aren't typically put in special education programs. Instead, teachers can make iteasier for kids by altering seating plans so the child can sit in the front of the room or with the back to the window, or providing additional aids for study, like an assignment

pad or a tape recorder.

One of the most important things that both parents and teachers can do is to acknowledgethat CAPD is real. Symptoms and behaviors are not within the child's control. What iswithin the child's control is recognizing the problems associated with APD and applyingthe strategies recommended both at home and school.

A positive, realistic attitude and healthy self-esteem in a child with APD can work wonders. And kids with APD can go on to be just as successful as other classmates.Although some children do, however, grow up to be adults with APD, with coping

strategies and by using techniques taught to them in speech therapy, they can be verysuccessful adults.

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VISUAL PROCESSING DISORDER

A visual processing, or perceptual, disorder refers to a hindered ability to make sense of

information taken in through the eyes. This is different from problems involving sight or sharpness of vision. Difficulties with

visual processing affect how visual information is interpreted, or processed by the brain.

Common areas of difficulty and some educational implications :

1) Spatial relation

This refers to the position of objects in space. It also refers to the ability toaccurately perceive objects in space with reference to other objects. Reading and math are two subjects where accurate perception and understandingof spatial relationships are very important. Both of these subjects rely heavily on the useof symbols (letters, numbers, punctuation, math signs). Examples of how difficulty mayinterfere with learning are in being able to perceive words and numbers as separate units,directionality problems in reading and math, confusion of similarly shaped letters, such as

b/d/p/q. The importance of being able to perceive objects in relation to other objects isoften seen in math problems. To be successful, the person must be able to associate thatcertain digits go together to make a single number (i.e., 14), that others are single digitnumbers, that the operational signs (+, x,=) are distinct from the numbers, but

demonstrate a relationship between them. The only cues to such math problems are thespacing and order between the symbols. These activities presuppose an ability andunderstanding of spatial relationships.

2) Visual discrimination

This is the ability to differentiate objects based on their individual characteristics.Visual discrimination is vital in the recognition of common objects and symbols.Attributes which children use to identify different objects include: color, form, shape,

pattern, size, and position. Visual discrimination also refers to the ability to recognize an

object as distinct from its surrounding environment. In terms of reading and mathematics, visual discrimination difficulties caninterfere with the ability to accurately identify symbols, gain information from pictures,charts, or graphs, or be able to use visually presented material in a productive way. Oneexample is being able to distinguish between an /nl and an Imp, where the onlydistinguishing feature is the number of humps in the letter. The ability to recognize

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distinct shapes from their background, such as objects in a picture, or letters on achalkboard is largely a function of visual discrimination.

3) Visual closure

Visual closure is often considered to be a function of visual discrimination. This isthe ability to identify or recognize a symbol or object when the entire object is notvisible. Difficulties in visual closure can be seen in such school activities as when theyoung child is asked to identify, or complete a drawing of, a human face. This difficultycan be so extreme that even a single missing facial feature (a nose, eye, mouth) couldrender the face unrecognizable by the child.

4) Object recognition (Visual Agnosia)

Many children are unable to visually recognize objects, which are familiar tothem, or even objects, which they can recognize through their other senses, such as, touchor smell. One school of thought about this difficulty is that it is based upon an inability tointegrate or synthesize visual stimuli into a recognizable whole. Another school of thought attributes this difficulty to a visual memory problem, whereby the person cannotretrieve the mental representation of the object being viewed or make the connection

between the mental representation and the object itself.

Educationally, this can interfere with the child's ability to consistently recognizeletters, numbers, symbols, words, or pictures. This can obviously frustrate the learning

process, as what is learned on one day may not be there, or not be available to the child,the next. In cases of partial agnosia, what is learned on day one, "forgotten" on day two,may be remembered again without difficulty, on day three.

5) Whole/part relationships

Some children have a difficulty perceiving or integrating the relationship betweenan object and symbol in its entirety and the component parts, which make it up. Some

children may only perceive the pieces, while others are only able to see the whole. Thecommon analogy is not being able to see the forest for the trees and conversely, beingable to recognize a forest but not the individual trees, which make it up. In school, children are required to continuously transition from the whole to the

parts and back again. A "whole perceiver", for example, might be very adept atrecognizing complicated words, but would have difficulty naming the letters within it. Onthe other hand, "part perceivers" might be able to name the letters, or some of the letters

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within a word, but have great difficulty integrating them to make up a whole, intact word.In creating artwork or looking at pictures, the "part perceivers" often pay great attentionto details, but lack the ability to see the relationship between the details. "Whole

perceivers", on the other hand, might only be able to describe a piece of artwork in verygeneral terms, or lack the ability to assimilate the pieces to make any sense of it at all. Aswith all abilities and disabilities, there is a wide range in the functioning of differentchildren.

6) Interaction with other areas of development

A common area of difficulty is visual motor integration. This is the ability to use visualcues (sight) to guide the child's movements. This refers to both gross motor and finemotor tasks.

Often children with difficulty in this area have a tough time orienting themselves in

space, especially in relation to other people and objects. These are the children who areoften called "clumsy" because they bump into things, place things on the edges of tablesor counters where they fall off, "miss" their seats when they sit down, etc.

This can interfere with virtually all areas of the child's life: social, academic, athletic, pragmatic. Difficulty with fine motor integration affects a child's writing, organization on paper, and ability to transition between a worksheet or keyboard and other necessaryinformation, which is in a book, on a number line, graph, chart, or computer screen.

Diagnosis

The key to having a visual processing disorder detected is to see a specialist, an expert in centralvisual impairments, or a neurologist because an eye doctor can often miss signs like visualtracking, crossing the midline (with the eyes), fluidity, and may not even test your childsreading or writing ability and may miss the flipping of letters such as bs and ds, ps and qs,and the also common 3 and E.

Interventions

The following represent a number of common interventions and accommodations used withchildren in their regular classroom:

1) For readings

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Enlarged print for books, papers, worksheets or other materials which the child is expected to usecan often make tasks much more manageable. Some books and other materials are commerciallyavailable; other materials will need to be enlarged using a photocopier or computer, when

possible.

There are a number of ways to help a child keep focused and not become overwhelmed whenusing painted information. For many children, a "window" made from cutting a rectangle in anindex card helps keep the relevant numbers, words, sentences, etc. in clear focus while blockingout much of the peripheral material which can become distracting. As the child's trackingimproves, the prompt can be reduced. For example, after a period of time, one might replace the"window" with a ruler or other straightedge, thus increasing the task demands while still

providing additional structure. This can then be reduced to, perhaps, having the child point to theword s/he is reading with only a finger.

2) For writing

Adding more structure to the paper a child is using can often help him/her use the paper moreeffectively. This can be done in a number of ways. For example, lines can be made darker andmore distinct. Paper with raised lines to provide kinesthetic feedback is available. Worksheetscan be simplified in their structure and the amount of material, which is contained per worksheet,can be controlled. Using paper, which is divided, into large and distinct sections can often helpwith math problems.

3) Teaching Style

Being aware and monitoring progress of the child's skills and abilities will help dictate whataccommodations in classroom structure and/or materials are appropriate and feasible. Inaddition, the teacher can help by ensuring the child is never relying solely on an area of weakness, unless that is the specific purpose of the activity. For example, if the teacher isreferring to writing on a chalkboard or chart paper, s/he can read aloud what is being read or written, providing an additional means for obtaining the information.

EXPRESSIVE LANGUAGE DISORDER

Definition

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Children need to understand language before they can use language effectively. In mostcases, the child with a receptive language problem also has an expressive languagedisorder, which means they have trouble using spoken language.

Causes

The cause of receptive language disorder is often unknown, but is thought to consist of anumber of factors working in combination, such as the childs genetic susceptibility, thechilds exposure to language, and their general developmental and cognitive (thought andunderstanding) abilities.

Receptive language disorder is often associated with developmental disorders such asautism.

In other cases, receptive language disorder is caused by brain injury such as trauma,tumour or disease.

The process of understanding spoken language

Understanding spoken language is a complicated process. The child may have problems with oneor more of the following skills:

Hearing - a hearing loss can be the cause of language problems. Vision - understanding language involves visual cues, such as facial expression and

gestures. A child with vision loss wont have these additional cues, and may experiencelanguage problems.

Attention - the childs ability to pay attention and concentrate on whats being said may be impaired.

Speech sounds - there may be problems distinguishing between similar speech sounds. Memory - the brain has to remember all the words in a sentence in order to make sense

of what has been said. The child may have difficulties with remembering the string of sounds that make up a sentence.

Word and grammar knowledge - the child may not understand the meaning of words or sentence structure.

Word processing - the child may have problems with processing or understanding whathas been said to them.

Symptoms

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There is no standard set of symptoms that indicates receptive language disorder, since it variesfrom one child to the next. However, symptoms may include:

Not seeming to listen when they are spoken to Lack of interest when story books are read to them Inability to understand complicated sentences Inability to follow verbal instructions Parroting words or phrases (echolalia) Language skills below the expected level for their age.

Diagnosis methods

Assessment needs to pinpoint the childs particular areas of difficulty, especially when they donot respond to spoken language. Diagnosis may include:

Hearing tests by an audiologist to make sure the language problems arent caused byhearing loss and to establish whether or not the child is able to pay attention to sound andlanguage (auditory processing assessment).

Testing the childs comprehension (by a speech pathologist) and comparing the results tothe expected skill level for the childs age. If the child is from a non-English speakinghome, assessment of comprehension should be performed in their first language as wellas in English, using culturally appropriate materials.

Close observation of the child in a variety of different settings while they interact with arange of people.

Assessment by a neuropsychologist to help identify any associated cognitive problems. Vision tests to check for vision loss.

Treatment options

The childs progress depends on a range of individual factors, such as whether or not brain injuryis present. Treatment options can include:

Speech-language therapy One-on-one therapy as well as group therapy, depending on the needs of the child Special education classes at school Integration support at preschool or school in cases of severe difficulty

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Referral to a mental health service for treatment (if there are also significant behavioural problems).

DYSLEXIA

There are several kinds of learning disabilities; dyslexia is the term used when peoplehave difficulty learning to read, even though they are smart enough and are motivated tolearn.

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Dyslexia is not a disease. It's a condition that you are born with, and it often runs infamilies. People with dyslexia are not stupid or lazy. Most have average or above-averageintelligence, and they work very hard to overcome their learning problems.

Causes

Research has shown that dyslexia happens because of the way the brain processesinformation. Pictures of the brain, taken with modern imaging tools, have shown thatwhen people with dyslexia read, they use different parts of the brain than people withoutdyslexia. These pictures also show that the brains of people with dyslexia don't work efficiently during reading. So that's why reading seems like such slow, hard work.

Most people think that dyslexia causes people to reverse letters and numbers and seewords backwards. But reversals occur as a normal part of development, and are seen inmany kids until first or second grade. The main problem in dyslexia is troublerecognizing phonemes which are the basic sounds of speech (the "b" sound in "bat" is a

phoneme, for example). Therefore, it's a struggle to make the connection between thesound and the letter symbol for that sound, and to blend sounds into words.

This makes it hard to recognize short, familiar words or to sound out longer words. Ittakes a lot of time for a person with dyslexia to sound out a word. The meaning of theword is often lost, and reading comprehension is poor. It is not surprising that peoplewith dyslexia have trouble spelling. They may also have trouble expressing themselves in

writing and even speaking. Dyslexia is a language processing disorder , so it can affectall forms of language, either spoken or written.

Some people have milder forms of dyslexia, so they may have less trouble in these other areas of spoken and written language. Some people work around their dyslexia, but ittakes a lot of effort and extra work. Dyslexia isn't something that goes away on its own or that a person outgrows. Fortunately, with proper help, most people with dyslexia learn toread. They often find different ways to learn and use those strategies all their lives.

What's It Like to Have Dyslexia? If you have dyslexia, you might have trouble reading even simple words you've seen

many times. You probably will read slowly and feel that you have to work extra-hardwhen reading. You might mix up the letters in a word, for example, reading the word"now" as "won" or "left" as "felt." Words may blend together and spaces are lost. Phrasesmight appear like this:

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You might have trouble remembering what you've read. You may remember more easilywhen the same information is read to you or heard on tape. Word problems in math may

be especially hard, even if you've mastered the basics of arithmetic. If you're doing a presentation in front of the class, you might have trouble finding the right words or namesfor various objects. Spelling and writing usually are very hard for people with dyslexia.

Diagnosis

A teen's parents or teachers might suspect dyslexia if they notice these problems:

1. poor reading skills, despite having normal intelligence2. poor spelling and writing skills3. difficulty finishing assignments and tests within time limits4. difficulty remembering the right names for things5. difficulty memorizing written lists and phone numbers6. difficulty with directions (telling right from left or up from down) or reading maps

If someone has one of these problems it doesn't mean he or she has dyslexia, but someonewho shows several of these signs should be tested for the condition.

A physical exam should be done to rule out any medical problems, including hearing andvision tests. Then a school psychologist or learning specialist should give several

standardized tests to measure language, reading, spelling, and writing abilities.Sometimes a test of thinking ability (IQ test) is given. Some people with dyslexia havetrouble in other school skills, like handwriting and math, or they may have trouble payingattention or remembering things. If this is the case, more testing will be done.

Dealing With Dyslexia

Although dealing with dyslexia can be tough, help is available. A child or teen withdyslexia usually needs to work with a specially trained teacher, tutor, or reading specialistto learn how to read and spell better. The best type of help teaches awareness of speechsounds in words and letter-sound correspondences (called phonics ). The teacher or tutor should use special learning and practice activities for dyslexia.

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A student with dyslexia may get more time to complete assignments or tests , permissionto tape class lectures, or copies of lecture notes. Using a computer with spelling checkerscan be helpful for written assignments. For older students in challenging classes, servicesare available that provide any book on tape, even textbooks. Computer software is alsoavailable that "reads" printed material aloud. Ask your parent, teacher, or learningdisability services coordinator how to get these services if you need them.

Treatment with eye exercises or glasses with tinted lenses will not help a person withdyslexia. It's not an eye problem, it's a language processing problem, so teachinglanguage processing skills is the most important part of treatment.

Emotional support for people with dyslexia is very important. They often get frustrated because no matter how hard they try, they can't seem to keep up with other students.They often feel that they are stupid or worthless, and may cover up their difficulties by

acting up in class or by becoming the class clown. They may try to get other students todo their work for them. They may pretend that they don't care about their grades or thatthey think school is dumb.

Family and friends can help people with dyslexia by understanding that they aren't stupidor lazy, and that they are trying as hard as they can. It's important to recognize andappreciate each person's strengths, whether they're in sports, drama, art, creative problemsolving, or something else.

People with dyslexia shouldn't feel limited in their academic or career choices. Mostcolleges make special accommodations for students with dyslexia, offering them trainedtutors, learning aids, computer software, reading assignments on tape, and specialarrangements for exams. People with dyslexia can become doctors, politicians, corporateexecutives, actors, artists, teachers, or whatever else they choose.

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DYSPRAXIA

A person with dyspraxia has problems with movement and coordination. It is alsoknown as "motor learning disability". Somebody with dyspraxia finds it hard to carry outsmooth and coordinated movements. Dyspraxia often comes with language problems, andsometimes a degree of difficulty with perception and thought. Dyspraxia does not affect a

person's intelligence, but it can cause learning difficulties, especially for children.

Dyspraxia is also known as Developmental Co-ordination Disorder (DCD), Perceptuo-Motor Dysfunction, and Motor Learning Difficulties. The terms Clumsy Child Syndromeor Minimal Brain Damage are no longer used.

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Developmental dyspraxia is an immaturity of the organization of movement. The braindoes not process information in a way that allows for a full transmission of neuralmessages. A person with dyspraxia finds it hard to plan what to do, and how to do it.

Experts say that about 10% of people have some degree of dyspraxia, whileapproximately 2% have it severely. Four out of every 5 children with evident dyspraxiaare boys. If the average classroom has 30 children, there is probably one child withdyspraxia in almost each classroom .

Causes

Scientists do not know what causes it. Experts believe the person's nerve cells that controlmuscles (motor neurons) are not developing correctly. If motor neurons cannot form

proper connections, for whatever reasons, the brain will take much longer to process data.

In some cases dyspraxia can be inherited .

One study carried out at Children's Hospital Boston, USA , found that when there wasinjury to the cerebrum among premature babies; the cerebellum failed to grow to anormal size. The cerebellum grows rapidly late in gestation - much faster than thecerebral hemispheres - premature birth arrests this surge in development. Premature

babies with cerebellum problems are likely to have deficits that extend beyond motor,and may benefit from early intervention.

A study by scientists at the Universite Laval, Canada found that mothers who takeomega-3 during the last months of pregnancy will boost their child's motor and cognitivedevelopment.

A study carried out at Johns Hopkins Bloomberg School of Public Health found that fetalheart rates give clues to children's later development during toddler years.

If a person develops dyspraxia later in life it is usually due to traumas suffered by the brain after a stroke, accident or illness. If a person is born with dyspraxia, it is also knownas Developmental Dyspraxia.

Unfortunately, for many sufferers, there is no obvious cause.

Symptoms

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Very early childhood

The child may take longer than other children to:

Sit Crawl (some never go through crawling stage) Walk Speak Stand Become potty trained (get out of diapers/nappies) Build up vocabulary Speak in a clear and articulate way. Many parents of very young children with dyspraxia

say they cannot understand what they are trying to say a lot of the time

Early childhood

Later on the following difficulties may become apparent:

Problems performing subtle movements, such as tying shoelaces, doing up buttons andzips, using cutlery, handwriting.

Many will have difficulties getting dressed. Problems carrying out playground movements, such as jumping, playing hopscotch,

catching a ball, kicking a ball, hopping, and skipping. Problems with classroom movements, such as using scissors, coloring, drawing, playing

jig-saw games. Problems processing thoughts. Difficulties with concentration. Children with dyspraxia commonly find it hard to focus

on one thing for long. The child finds it harder than other kids to join in playground games. The child will fidget more than other children. Some find it hard to go up and down stairs. A higher tendency to bump into things, to fall over, and to drop things. Difficulty in learning new skills - while other children may do this automatically, a child

with dyspraxia takes longer. Encouragement and practice help enormously. Writing stories can be much more challenging for a child with dyspraxia, as can copying

from a blackboard.

The following are also common at pre-school age:

Finds it hard to keep friends Behavior when in the company of others may seem unusual

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Hesitates in most actions, seems slow Does not hold a pencil with a good grip Such concepts as in, out, in front of are hard to handle automatically

Later on in Childhood

Many of the challenges listed above do not improve, or do so very slightly Tries to avoid sports and PE Learns well on a one-on-one basis, but nowhere near as well in class with other kids

around Reacts to all stimuli equally (not filtering out irrelevant stimuli automatically) Mathematics and writing are difficult Spends a long time getting writing done Does not follow instructions Does not remember instructions Is badly organized

Diagnosis

A diagnosis of dyspraxia can be made by a clinical psychologist, an educational psychologist, a pediatrician, or an occupational therapist. Any parent who suspects their child may havedyspraxia should see their GP (general practitioner, primary care physician), or a special needs

coordinator first.

When carrying out an assessment, details will be required regarding the child's developmentalhistory, intellectual ability, and gross and fine motor skills:

Gross motor skills - this refers to how well the child uses his/her large muscles thatcoordinate body movement. This includes jumping, throwing, walking, running, andmaintaining balance.

Fine motor skills - this refers to how well the child can use his/her smaller muscles.Activities which require fine motor skills include tying shoelaces, doing up buttons,

cutting out shapes with a pair of scissors, and writing.The assessor will need to know when and how developmental milestones, such aswalking, crawling, speaking were reached. The child will be screened for balance, touchsensitivity, and variations on walking activities.If the assessor, or GP, does not have the necessary training, dyspraxia could be missedaltogether and the child will not be referred to a specialist. Training on identifyingdyspraxia can be patchy, depending on which part of the world you live in, and also

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which part of specific countries. The same applies to teachers - in some places they arewell trained at identifying potential dyspraxia among their pupils, while in others they arenot.A new coordination and handwriting test that identifies Developmental CoordinationDisorder may identify teenagers who need extra help at secondary school and college.

Treatment

Although dyspraxia is not curable, with time the child can improve. However, the earlier a childis diagnosed, the better and faster his/her improvement will be. The following specialists mostcommonly help people with dyspraxia:

Occupational therapy

An occupational therapist will first observe how the child manages with everydayfunctions both at home and at school. He/she will then help the child develop skillsspecific to activities which may be troublesome.

Speech and language therapy

The speech and language therapist will first carry out an assessment of the child's speech,and then help him/her communicate more effectively.

Perceptual motor training

This involves improving the child's language, visual, movement, and auditory skills. Aseries of tasks, which gradually becoming more advanced, are set - the aim is tochallenge the child so that he/she improves, but not so much that it becomes frustrating or stressful.

Scientists from the University of Leeds, England, developed a set of practical guidelines for use by teachers, childcare professionals and parents that will help pre-school children with co-ordination difficulties, to improve their dexterity.

Active Play

Experts say that active play - any play that involves physical activity - which can beoutdoors or inside the home, gets the motor activity going in children. Play is a waychildren learn about the environment and about themselves, and particularly for childrenaged 3 to 5; it is a crucial part of their learning.

Active play is where a very young child's physical and emotional learning, their development of language, their special awareness, the development of what their sensesare, all come together.

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The more children are involved in active play, the better they will become at interactingwith other children successfully.

Parents, uncles and aunts, and other adults can also become involved with a child's active play - however, sometimes they should take a step back and let the children really exploreso they can try out their own understanding of the world. The risk of negative thingshappening to children if they play outside are far smaller than the risks of negative thingshappening to them if they don't, such as obesity, poor socialization with other children,and having less fun. It is only by taking risks that children learn the importance of, say,holding on tight, and correcting themselves.

Parents who have a child with dyspraxia need to balance the risks of negative thingshappening outside, with the enormous benefits that active play has to offer. Decidingwhat this balance is depends on many factors, such as the severity of the child'sdyspraxia, the outside environment, etc.

DYSCALCULIA

Dyscalculia is a specific learning disability in the area of mathematics. It has also been termednumber blindness. This, much like dyslexia, is a neurological problem.

Causes

In children with dyscalculia, the cause is usually that the child does not have the proper level of development in number sense. They have great difficulty in connecting numberswith quantity.

For example, such a child would have difficulty in determining that the number 5 relates

to 5 objects and would not be able to count them out if asked to do so. Experts believe that dyscalculia is caused by a difference in the brain structure as it

applies to carrying out mathematical calculations. This is a relatively new field of research in the area of learning disabilities and the research that exists has been carriedout among populations that have other conditions as well, such as Fetal AlcoholSyndrome.

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All of the studies on these children show that there are less brain cells in the area of the brain dealing with mathematical skill than there are with those of normal ability.

The causes of dyscalculia are believed to be both genetic and environmental. Alcohol consumption by the mother during pregnancy and premature birth are two of the

environmental factors attributed to this learning disability.

Symptoms

Difficulty working with numbers Confused by math symbols Difficulty with basic facts (adding, subtracting, multiplying and dividing) Often will reverse or transpose numbers (36: 63) Difficulty with mental math Difficulty telling time Difficulty with directions (as for playing a game) Difficulty grasping and remembering math concepts Poor memory for layout of things (for example, numbers on a clock) Limited strategic planning skills (like used in chess)

A child with dyscalculia will have average or above average intelligence but cannot achieve tothat degree in the area of mathematics.

Diagnosis

An awareness of the problem by either the teacher or parent brings this disability to light. The family physician will likely refer the child to a specialist. This specialist will

administer a battery of tests to determine the presence of a disability. Often a special educator and a school psychologist will also be involved in the testing and

diagnosis.

Treatment

There is no cure for Dyscalculia, but with intervention, a child with discalculia can learnmath and can function in the world. Typically instruction involves multi-sensory methods

and other alternate methods of teaching any given math skill. Repetitive practice does not generally aid a child with dyscalculia. A child diagnosed

with dyscalculia will typically receive an IEP (Individualized Education Plan) to guideinstruction.

Play math games that practice and review concepts. Touch math is an excellent way to teach children their basic facts, and is a strategy that

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uses a multi-sensory approach to learning math, where students physically touch pointson each number with their pencil point.

Work to help the student visualize math problems. This includes simple things likedrawing a picture or chart. Have the child look at pictures charts or graphs provided inthe math book, and spend the time to really explain the graphs before moving on tosolving the problem.

Try having the child read the problem aloud, and see if that helps. Give him an exampleof the problem worked out or think about a real life example of the problem. Use graph

paper to help keep the numbers lined up correctly, and un-clutter the worksheets that willgo home to prevent too much visual information from being distracting.

The most important thing a teacher or parent can do for a child with dyscalculia is tonever give up. Each child can learn; some just learn differently. It may take a bit of extraeffort, and some creative teaching methods, to help the child with dyscalculia besuccessful in math class.

DYSGRAPHIA

Dysgraphia is a type of learning disability affecting the ability to recognize forms in letters, towrite letters and words on paper and to understand the relationship between sounds, spokenwords and written letters.

Causes

Dysgraphia is believed to involve difficulty with fine motor skills such as motor memory,muscle coordination, and movement in writing.

Language, visual, perceptual, and motor centers of the brain are also believed to play arole.

Evidence suggests it may be hereditary.

People who have suffered brain injuries or strokes may also show signs of Dysgraphia.

Characteristics of Dysgraphia

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People with dysgraphia, have substantial difficulty with written language despite havingformal instruction.

Their handwriting may include reversals, spelling errors, and may be illegible.

Some students with dysgraphia may also have difficulty with language processing and theconnection between words and ideas they represent.

Testing for Dysgraphia

Dysgraphia - Comprehensive psychological and educational evaluations can assist in thediagnosis of Dysgraphia.

Diagnostic writing tests can be used to determine if the learner's writing skills are normalfor his age. They can also provide information on his writing processing.

Through observations, analyzing student work, cognitive assessment, and occupationaltherapy evaluations, educators can develop comprehensive, individualized treatment

plans.

Treatment

Dysgraphia - Educators use a variety of methods to develop the student's individualeducation program (IEP).

Typical programs focus on developing fine motor skills such as pencil grip, handcoordination, and developing motor-muscular memory.

Language therapy and occupational therapy help the learner develop the importantconnections between letters, sounds, and words.

Some students work best with keyboarding or speech recognition programs.

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on/articulation_and_phonology.htm

4. http://www.nichcy.org/Disabilities/Specific/Pages/ADHD.aspx

5. The National Center for Learning Disabilities New York ( http://www.incrediblehorizons.com/visual-processing.htm#Smart%20Driver )

6. American Psychiatric Association. Diagnostic and Statistical Manual of Mental

Disorders. 4th ed. text revised. Washington DC: American Psychiatric Association, 2000.

7. Sadock, Benjamin J. and Virginia A. Sadock, eds. Comprehensive Textbook of

Psychiatry. 7th ed. Philadelphia: Lippincott Williams and Wilkins, 2000.

8. Stein, Martin T., Steven Parker, James Coplan, Heidi Feldman. "Expressive Language

Delay in a Toddler." Journal of Developmental & Behavioral Pediatrics 22 no. 2 (April

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10. http://kidshealth.org/teen/school_jobs/school/dyslexia.html

11. http://learningdisabilities.about.com/od/learningdisabilitybasics/p/dysgraphia.htm

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Learning Disabilities (Final)

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