LEARNING DISABILITY

Language and Speech Disabilities

These are among the most common learning problems and can be quite sig­nificant, because most learning is dependent on language. If your child has such a disability, it can affect his reading, spelling, writing, speech, and ability to understand what he hears or reads. It may also affect his memory or com­prehension—that is, the ability to recall or understand information previously heard or read. Your child may have difficulty following instructions, under­standing explanations, or expressing himself. These problems can not only af­fect his learning but also may impede his social interactions, which require good listening and speaking skills. As a result he may become embarrassed, confused, or quiet and withdrawn. He might even resort to acting out his feelings, thoughts, or frustrations with inappropriate behavior.

Writing Difficulties

Like children with other types of learning disabilities, children with writing problems may be bright and creative but may have difficulty expressing them­selves on paper in a coherent manner. This may cause frustration or even a writing phobia. Since any written document is a semipublic, permanent dis­play of one’s work, these children sometimes feel extremely embarrassed or self-conscious and often try to avoid writing assignments or don’t make much of an effort when doing them. Writing is a complex task that requires the si­multaneous use of many skills, including letter formation, grammar, vocabu­lary, spelling, the mechanics of writing (punctuation, capitalization), and organizing ideas into sentences and paragraphs. While some children may master each of these skills separately, carrying all of them out at the same time may prove difficult. Writing problems are complex and may have several causes, including visual, fine motor, language, and/or memory difficulties.

Visual Learning Difficulties

When youngsters have a weakness or disability in understanding visually pre­sented information, it may affect their ability to read, spell, interpret, or re­member the printed word, graphs, tables, illustrations, and maps. These are learning problems; the children’s vision is normal and unrelated to the specific problem.

Sometimes visual learning difficulties occur along with another weakness— for example, in conjunction with fine motor difficulties—which can affect handwriting. When that happens, the child’s writing may be illegible. He may have difficulty forming letters or numbers, or keeping numbers properly aligned in columns. He may write letters or numbers backward. This can affect not only his writing ability (including legibility and speed) but also his profi­ciency in mathematics, causing him to make miscalculations.

Memory and Other Thinking Difficulties

As children move through elementary school, they are increasingly asked to remember, retrieve, and use more and more information rapidly. They need to recall specific information in a very detailed manner, as well as to recall and assemble information in a creative and open-ended way. The first, more spe­cific memory (called convergent) is useful in short answers or multiple-choice tests and in analytical, fact-oriented reasoning. The second, more general memory (divergent) is useful in essay writing, retelling a story, interpreting a poem, or describing a character in one’s own way.

Memory involves taking in information, classifying it, associating it with pre­viously learned information, and consolidating it. Many children understand what they read or are taught but can’t remember it later on, perhaps for a test, or they can’t recall it in a different context. While a memory problem can be subtle and difficult to assess, you should suspect this type of difficulty if your child is underachieving.

Some youngsters have particular trouble remembering several pieces of se­quential information, such as multiple instructions or a series of words or numbers (like a telephone number). As a result, a school-age child may have difficulty doing a three-step math problem, organizing events, learning the al­phabet, remembering multiplication tables, or recounting a story in the proper sequence. Even learning the days of the week, months of the year, and class schedules can be hard.

A number of factors can make memory problems even worse. These include too much or too complex information being presented at one time, or an ex­cessively rapid rate of incoming information. Attention problems, emotional disorders (depression, anxiety), boredom, loss of motivation, and fatigue (poor nutrition, inadequate sleep, mental exertion) can also contribute to memory difficulties.

Difficulties can occur with other higher-level thinking as well. Some children have problems with a skill called abstract reasoning, meaning that they are un­able to determine the general meaning of a particular word or symbol—per­haps the symbol for an unknown quantity in a math problem. They also cannot make inferences by going from a specific, concrete fact to a more general type of thinking.

Youngsters may also have difficulty with organization and thus be unable to assemble information into a usable form. Good organizational skills can also help children associate newly learned information with their existing knowl­edge, making it fit in with something familiar so it can be more easily retrieved and utilized.

Summarizing skills are another possible problem area. Children may have trouble taking a large amount of information and condensing it to a more man­ageable size so it is easier to remember and use. Youngsters with this skill are able to separate major facts and concepts from lesser ones, ascertaining which ones are most worthwhile.

Inadequate Social Skills

These often occur in conjunction with learning disabilities and usually result in difficulties interacting with other children or adults. Children with this prob­lem may have trouble interpreting the messages or intentions of others and re­sponding appropriately to others, even to parents and teachers who are trying to be helpful. Recognizing and alleviating these difficulties are critical, be­cause peer acceptance and a successful social life are extremely important to the youngster in middle childhood and greatly affect his self-image and self-esteem

Diagnosing a Learning Disability

Learning disabilities are traditionally diagnosed by conducting two tests and noticing a significant discrepancy between their scores. These tests are an in­telligence (or IQ) test and a standardized achievement (reading, writing, arith­metic) test. Most children found to have a learning disability have normal or above-normal intelligence but do not fully demonstrate that potential on achievement tests. For example, a youngster might score 112 on the full-scale IQ test, but her math score might be 90; this discrepancy of 22 points between her potential ability (IQ) and actual achievement (in math) might qualify her for special services at her school. Some states, for example, define a learning disability as a difference of 15 points, but the criteria for services vary from one part of the country to another. As a result, state-mandated definitions sometimes exclude a range of learning difficulties that do not produce wide discrepancies.

When a learning disability is not detected early, diagnosed correctly, and treated effectively, it can cause a number of other problems. These additional difficulties may be emotional, and a child can show signs of sadness, frustra­tion, or disappointment. Behavior problems like acting out might occur. Or the learning problems may show up within the family, causing, for example, mis­understandings, increased stress, or blaming others. Studies show that among children whose families seek professional help for emotional or behavioral problems, 30 to 50 percent of them have learning disabilities.

About Dr. Jayaprakash

Asst. Prof. of Pediatrics, ICH. Institute of Child Health. Gov. Medical College Kottayam. Kerala, India.

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