Definition
Learning disorders are academic difficulties experienced by children and adults of average to above-average intelligence. People with learning disorders have difficulty with reading, writing, mathematics, or a combination of the three. These difficulties significantly interfere with academic achievement or daily living.
Description
Learning disorders, or disabilities, affect approximately 2 million children between the ages of six and 17 (5% of public school children), although some experts think the figure may be as high as 15%. These children have specific impairments in acquiring, retaining, and processing information. Standardized tests place them well below their IQ range in their area of difficulty. The three main types of learning disorders are reading disorders, mathematics disorders, and disorders of written expression. The male: female ratio for learning disorders is about 5: 1.
Reading Disorders
Reading disorders are the most common type of learning disorder. Children with reading disorders have difficulty recognizing and interpreting letters and words (dyslexia). They are not able to recognize and decode the sounds and syllables (phonetic structure) behind written words and language in general. This condition lowers accuracy and comprehension in reading.
Mathematic Disorders
Children with mathematics disorders (dyscalculia) have problems recognizing and counting numbers correctly. They have difficulty using numbers in everyday settings. Mathematics disorders are typically diagnosed in the first few years of elementary school when formal teaching of numbers and basic math concepts begins. Children with mathematics disorders usually have a coexisting reading disorder, a disorder of written expression, or both.
Disorders of Written Expression
Disorders of written expression typically occur in combination with reading disorders or mathematics disorders or both. The condition is characterized by difficulty with written compositions (dysgraphia). Children with this type of learning disorder have problems with spelling, punctuation, grammar, and organizing their thoughts in writing.
Causes & Symptoms
Learning disorders are thought to be caused by neurological abnormalities that trigger impairments in the regions of the brain that control visual and language processing and attention and planning. These traits may be genetically linked. Children from families with a history of learning disorders are more likely to develop disorders themselves. In 2003 a team of Finnish researchers reported finding a candidate gene for developmental dyslexia on human chromosome 15q21.
Learning difficulties may also be caused by such medical conditions as a traumatic brain injury or brain infections such as encephalitis or meningitis.
The defining symptom of a learning disorder is academic performance that is markedly below a child's age, grade capabilities, and measured IQ. Children with a reading disorder may confuse or transpose words or letters and omit or add syllables to words. The written homework of children with disorders of written expression is filled with grammatical, spelling, punctuation, and organizational errors. The child's handwriting is often extremely poor. Children with mathematical disorders are often unable to count in the correct sequence, to name numbers, and to understand numerical concepts.
Diagnosis
Problems with vision or hearing, mental disorders (depression, attention-deficit/hyperactivity disorder), mental retardation, cultural and language differences, and inadequate teaching may be mistaken for learning disorders or complicate a diagnosis. A comprehensive medical, psychological, and educational assessment is critical to making a clear and correct diagnosis.
A child thought to have a learning disorder should undergo a complete medical examination to rule out an organic cause. If one is not found, a psychoeducational assessment should be performed by a psychologist, psychiatrist, neurologist, neuropsychologist, or learning specialist. A complete medical, family, social, and educational history is compiled from existing medical and school records and from interviews with the child and the child's parents and teachers. A series of written and verbal tests are then given to the child to evaluate his or her cognitive and intellectual functioning. Commonly used tests include the Wechsler Intelligence Scale for Children (WISC-III), the Woodcock-Johnson Psychoeducational Battery, the Peabody Individual Achievement Test-Revised (PIAT-R), and the California Verbal Learning Test (CVLT). Federal legislation mandates that this testing is free of charge within the public school system.
Treatment
Once a learning disorder has been diagnosed, an individual education plan (IEP) is developed for the child in question. IEPs are based on psychoeducational test findings. They provide for annual testing to measure a child's progress. Students with learning disorders may receive special instruction within a regular general education class or they may be taught in a special education or learning center for a portion of the day.
Common strategies for the treatment of reading disorders focus first on improving a child's recognition of the sounds of letters and language through phonics training. Later strategies focus on comprehension, retention, and study skills. Students with disorders of written expression are often encouraged to keep journals and to write with a computer keyboard instead of a pencil. Instruction for students with mathematical disorders emphasizes real-world uses of math, such as balancing a checkbook or comparing prices.
Ensuring that the child has proper nutrition can help in the treatment of learning disorders. Those who do not receive the proper doses that they need may require changes in their diets, or supplements are taken. Supplements that may help with learning disorders are fish oil, flax oil, primrose oil, and omega-3 fatty acids. Eliminating food additives, like colors and preservatives, as well decreasing the child's consumption of refined sugars, can also be helpful.
Meditation is also beneficial. It helps to slow the mind down and take in the surroundings while focusing on the task at hand.
Herbal remedies may also help to focus the mind. St. John's wort and Ginkgo biloba are used to treat attention-deficit hyperactivity disorder (ADHD). Ginkgo is a blood thinner and those considering taking it should consult a doctor beforehand.
Expected Results
The high school dropout rate for children with learning disabilities is almost 40%. Children with learning disabilities that go undiagnosed or are improperly treated may never achieve functional literacy. They often develop serious behavior problems as a result of their frustration with school; in addition, their learning problems are often stressful for other family members and may strain family relationships. The key to helping these students reach their fullest potential is early detection and the implementation of an appropriate individualized education plan. The prognosis is good for a large percentage of children with reading disorders that are identified and treated early. Learning disorders continue into adulthood, but with proper educational and vocational training, an individual can complete college and pursue a challenging career. Studies of the occupational choices of adults with dyslexia indicate that they do particularly well in people-oriented professions and occupations, such as nursing or sales.
Resources
Books
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision. Washington, DC: American Psychiatric Association, 2000.
Church, Robin P., M.E.B. Lewis, and Mark L. Batshaw. "Learning Disabilities." Children with Disabilities. edited by Mark L. Batshaw. 4th ed. Baltimore: Paul H. Brookes, 1997.
"Learning Disorders. " Section 19, Chapter 262 in The Merck Manual of Diagnosis and Therapy, edited by Mark H. Beers, MD, and Robert Berkow, MD. Whitehouse Station, NJ: Merck Research Laboratories, 2002.
Mars, Laura. The Complete Learning Disabilities Directory, 1999/2000. Grey House Publishing, 1999.
Osman, Betty B. Learning Disabilities and ADHD: A Family Guide to Living and Learning Together. New York: John Wiley & Sons, 1997.
Periodicals
Baringa, Marcia. "Learning Defect Identified in Brain." Science. 273 (August 1996): 867–868.
Galaburda, D. M., and B. C. Duchaine. "Developmental Disorders of Vision." Neurologic Clinics 21 (August 2003): 687–707.
Gillberg, C., and H. Soderstrom. "Learning Disability." Lancet 362 (September 6, 2003): 811–821.
Stage, Frances K. and Nancy V. Milne. "Invisible Scholars: Students With Learning Disabilities." Journal of Higher Education. 67 (July–August 1996): 426–45.
Taipale, M., N. Kaminen, J. Nopola-Hemmi, et al. "A Candidate Gene for Developmental Dyslexia Encodes a Nuclear Tetratricopeptide Repeat Domain Protein Dynamically Regulated in Brain." Proceedings of the National Academy of Sciences in the USA 100 (September 30, 2003): 11553–11558.
Taylor, K. E., and J. Walter. "Occupation Choices of Adults With and Without Symptoms of Dyslexia." Dyslexia 9 (August 2003): 177–185.
Witt, W. P., A. W. Riley, and M. J. Coiro. "Childhood Functional Status, Family Stressors, and Psychosocial Adjustment Among School-Aged Children with Disabilities in the United States." Archives of Pediatric and Adolescent Medicine 157 (July 2003): 687–695.
Organizations
The Interactive Guide to Learning Disabilities for Parents, Teachers, and Children. http://www.ldonline.org.
The Learning Disabilities Association of America (LDA). 4156 Library Road, Pittsburgh, PA 15234–1349. (412) 341–1515. http://www.ldanatl.org.
National Center for Learning Disabilities (NCLD). 381 Park Avenue South, Suite 1401, New York, NY 10016. (410) 296–0232. http://www.ncld.org.
[Article by: Paula Ford-Martin; Rebecca J. Frey, PhD]
