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  Name Learning Disability
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  MeshID D007859


In the United States and Canada , the term learning disability (LD) refers to a group of disorders that affect a broad range of academic and functional skills including the ability to Speak , Listen , Read , Write , Spell , Reason and organize Information .

A learning disability is not indicative of low Intelligence . People with learning disabilities sometimes have difficulty achieving at his or her intellectual level because of a deficit in one or more of the ways the brain processes information.


OVERVIEW

The National Joint Committee for Learning Disabilities (NJCLD)1981; 1985 defines the term learning disability as "... a heterogeneous group of disorders manifested by significant difficulties in the acquisition and use of listening, speaking, reading, writing, reasoning or mathematical abilities. These disorders are intrinsic to the individual and presumed to be due to Central Nervous System Dysfunction. Even though a learning disability may occur concomitantly with other handicapping conditions (e.g. sensory impairment, mental retardation, social and emotional disturbance) or environmental influences (e.g. cultural differences, insufficient/inappropriate instruction, psychogenic factors) it is not the direct result of those conditions or influences."

The term “learning disability” was apparently first used and defined by Kirk 1962, cited in Streissguth, Bookstein, Sampson, & Barr, 1993, p.144. The term referred to a discrepancy between a child’s apparent capacity to learn and his or her level of achievement.


TYPES OF LEARNING DISABILITIES


Learning disabilities can be categorized either by the type of information processing that is affected or by the specific difficulties caused by a processing deficit.


Information Processing Deficits

The National Dissemination Center for Children with Disabilities (NICHY)
National Dissemination Center for Children with Disabilities (NICHY), 2004. {Link without Title} . Accessed May 11, 2007. states that learning disabilities fall into broad categories based on the four stages of information processing used in learning: input, integration, storage, and output.
  • Input

  • :This is the information perceived through the senses, such as visual and auditory perception. Difficulties with visual perception can cause problems with recognizing the shape, position and size of items seen. There can be problems with sequencing, which can relate to deficits with processing time intervals or temporal perception. Difficulties with auditory perception can make it difficult to screen out competing sounds in order to focus on one of them, such as the sound of the teacher's voice. Some children appear to be unable to process tactile input. For example, they may seem insensitive to pain or dislike being touched.

  • Integration

  • :This is the stage during which perceived input is interpreted, categorized, placed in a sequence, or related to previous learning. Students with problems in these areas may be unable to tell a story in the correct sequence, unable to memorize sequences of information such as the days of the week, able to understand a new concept but be unable to generalize it to other areas of learning, or able to learn facts but be unable to put the facts together to see the "big picture." A poor vocabulary may contribute to problems with comprehension.

  • Storage

  • :Problems with memory can occur with short-term or working memory, or with long-term memory. Most memory difficulties occur in the area of short-term memory, which can make it difficult to learn new material without many more repetitions than is usual. Difficulties with visual memory can impede learning to spell.

  • Output

  • :Information comes out of the brain either through words, that is, language output, or through muscle activity, such as gesturing, writing or drawing. Difficulties with language output can create problems with spoken language, for example, answering a question on demand, in which one must retrieve information from storage, organize our thoughts, and put the thoughts into words before we speak. It can also cause trouble with written language for the same reasons. Difficulties with motor abilities can cause problems with gross and fine motor skills. People with gross motor difficulties may be clumsy, that is, they may be prone to stumbling, falling, or bumping into things. They may also have trouble running, climbing, or learning to ride a bicycle. People with small motor difficulties may have trouble buttoning shirts, tying shoelaces, or with handwriting.



Specific learning disabilities


Deficits in any area of information processing can manifest in a variety of specific learning disabilities.
  • Reading disability (ICD-10 and DSM-IV codes: F81.0/315.00)

  • :The most common learning disability. Of all students with specific learning disabilities, 70%-80% have deficits in reading. The term " Dyslexia " is often used as a synonym for reading disability; however, many researchers assert that there are different types of reading disabilities, of which dyslexia is one. A reading disability can affect any part of the reading process, including difficulty with accurate and/or fluent word recognition, word decoding, reading rate, prosody (oral reading with expression), and reading comprehension.

:Common indicators of reading disability include difficulty with phonemic awareness -- the ability to blend sounds into words or break up words into their component sounds, and difficulty with matching letters or letter combinations to specific sounds (sound-symbol correspondence).
  • Writing disability (ICD-10 and DSM-IV codes F81.1/315.2)

  • :Speech and language disorders can also be called Dysphasia / Aphasia (coded F80.0-F80.2/315.31 in ICD-10 and DSM-IV).

:Impaired written language ability may include impairments in handwriting, spelling, organization of ideas, and composition. The term " Dysgraphia " is often used as an overarching term for all disorders of written expression. Others, such as the International Dyslexia Association, use the term "dysgraphia" exclusively to refer to difficulties with handwriting.
  • Math disability (ICD-10 and DSM-IV codes F81.2-3/315.1)

  • :Sometimes called Dyscalculia , a math disability can cause such difficulties as learning math concepts (such as quantity, place value, and time), difficulty memorizing math facts, difficulty organizing numbers, and understanding how problems are organized on the page.

  • Nonverbal Learning Disability disorder is not listed in the ICD-10

  • :Nonverbal learning disabilities often manifest in motor clumsiness, poor visual-spatial skills, problematic social relationships, difficulty with math, and poor organizational skills. These indivduals often have specific strengths in the verbal domains, including early speech, large vocabulary, early reading and spelling skills, excellent rote-memory and auditory retention, and eloquent self-expression. Lerner, Janet (2000). Learning Disabilities: Theories, Diagnosis and Teaching Strategies. Eighth edition. Houghton Mifflin.

  • Dyspraxia

  • :Sometimes called motor planning, dyspraxia refers to a variety of difficulties with motor skills. Dyspraxia can cause difficulty with single step tasks such as combing hair or waving goodbye, multi-step tasks like brushing teeth or getting dressed, or with establishing spatial relationships such as being able to accurately position one object in relation to another.

  • Disorders of speaking and listening

  • Difficulties that often co-occur with learning disabilities include difficulty with memory, social skills and executive functions (such as organizational skills and time management).



DIAGNOSIS


The presence of a learning disability is sometimes suspected by a child's parents long before problems are seen at school. However, the issues typically become visible when a child begins having difficulty at school. Difficulty learning to read is often one of the first signs that a learning disability is present.

Learning disabilities are often identified by school Psychologist s, Clinical Psychologist s, and Neuropsychologist s through a combination of Intelligence Test ing, academic achievement testing, classroom performance, and social interaction and aptitude. Other areas of assessment may include perception, cognition, memory, attention, and language abilities. The resulting information is used to determine whether a child is achieving at his or her potential.

The DSM-IV, and many school systems and government programs have defined learning disabilities on the basis of a discrepancy between IQ scores and achievement scores. Although the discrepancy model has dominated the school system for many years, there has been substantial criticism of this approach (eg, Aaron, 1995, Flanagan and Mascolo, 2005) among researchers. Recent research has provided little evidence that a discrepancy between formally-measured IQ and achievement is a clear indicator of LD (Fletcher, 2003). Furthermore, diagnosing on the basis of a discrepancy does not predict the effectiveness of treatment. Low academic achievers who do not have a discrepancy with IQ (ie their IQ scores are also low) appear to benefit from treatment just as much as low academic achievers who do have a discrepancy with IQ (ie their IQ scores are higher).

Much current research has focused on a treatment-oriented diagnostic process known as Response To Intervention (RTI). Researcher recommendations for implementing such a model include early screening for all students, placing students having difficulty in research-based early intervention programs, and closely monitoring the progress of identified students to determine whether increasingly intense intervention results in adequate progress (Fletcher, 2003). Those who do not respond adequately to intervention can then be referred for further assistance through special education. A primary benefit of such a model is that it would not be necessary to wait for a child to be sufficiently far behind to qualify for assistance (Lyon, et al, 2001). This may enable more children to receive assistance before experiencing significant failure, which may in turn result in fewer children who need intensive and expensive special education services.


TREATMENT AND INTERVENTION


Poor academic achievement can be addressed with a variety of interventions. Although the underlying processing difficulty is usually considered to be a lifelong disorder, academic skills themselves can be improved with targeted interventions. Some (adjustments, equipment and assistants) are designed to accommodate or help compensate for the disabilities while others (specialized instruction) are intended to make improvements in the weak areas. Practice is a particularly important component in developing competence, regardless of the starting point. Children who start out with a weakness in a basic skill, such as reading, may miss out on the necessary practice because of the need to catch up with their chronological age peers. Thus a small weakness can snowball into a larger problem.

Interventions include:

  • Mastery Model:

  • ---Learners work at their own level of mastery.

  • ---Practice

  • ---Gain fundamental skills before moving onto the next level


  • --Note: this approach is most likely to be used with adult learners or outside the mainstream school system.


  • Direct Instruction : National Institute for Direct Instruction www.nifdi.org. Accessed May 23, 2007

  • ---Highly structured, intensive instruction

  • ---Emphasizes carefully planned lessons for small learning increments

  • ---Scripted lesson plans

  • ---Rapid-paced interaction between teacher and students

  • ---Correcting mistakes immediately

  • ---Achievement-based grouping

  • ---Frequent progress assessments


  • Classroom adjustments:

  • ---Special seating assignments

  • ---Alternative or modified assignments

  • ---Modified testing procedures


  • Special equipment:

  • ---Electronic spellers and dictionaries

  • ---Word processors

  • ---Talking calculators

  • ---Books on tape


  • Classroom assistants:

  • ---Note-takers

  • ---Readers

  • ---Proofreaders


  • Special Education:

  • ---Prescribed hours in a special class

  • ---Placement in a special class

  • ---Enrollment in a special school for learning disabled students


Sternberg Sternberg, R. J., & Grigorenko, E. L. (1999). Our labeled children: What every parent and teacher needs to know about learning disabilities. Reading, MA: Perseus Publishing Group has argued that early remediation can greatly reduce the number of children meeting diagnostic criteria for learning disabilities. He has also suggested that the focus on learning disabilities and the provision of accommodations in school fails to acknowledge that people have a range of strengths and weaknesses, and places undue emphasis on academic success by insisting that people should receive additional support in this arena but not in music or sports.


CAUSES AND RISK FACTORS


The causes for learning disabilities are not well understood, and sometimes there is no apparent cause for a learning disability. However, some causes of neurological impairments include:

  • Heredity -- Learning disabilities often run in the family.

  • Problems during pregnancy and birth -- Learning disabilities can result from anomalies in the developing brain, illness or injury, fetal exposure to alcohol or drugs, low birth weight, oxygen deprivation, or by premature or prolonged labor.

  • Accidents after birth -- Learning disabilities can also be caused by head injuries, malnutrition, or by toxic exposure (such as heavy metals or pesticides).



IMPACT ON AFFECTED INDIVIDUALS

Individuals with a learning disability may isolate themselves from society as they may feel:

  • Ashamed of the types of difficulties they struggle with, such as poor literacy skills, attention or memory difficulties

  • Fear of failure, criticism, ridicule or rejection

  • Fear that others may think that they are stupid or incapable

  • Ashamed that they are unable to read or that they have poor handwriting

  • Left out of every day discussions due to lack of understanding

  • Depressed

  • Alone




IMPACT ON SOCIETY

Statistical and demographic studies show that society pays a high cost for untreated learning disabilities because of the disproportionate number of individuals with LD who receive welfare, who commit crimes, who go to juvenile courts, who are held in a juvenile detention facility, and who go to prison.

:Welfare

  • According to a study conducted by the Center for Law and Social Policy, 25%-35% of former participants in a federal welfare-to-work program had learning disabilities, 85% of whom had not been identified as learning disabled by the public schools. Center for Law and Social Policy, 1998


  Last Lyon
  First G Reid
  Last2 Fletcher
  First2 Jack M
  Last3 Shaywitz
  First3 Sally E
  Last4 Shaywitz
  First4 Bennett A
  Last5 Torgesen
  First5 Joseph K
  Last6 Wood
  First6 Frank B
  Last7 Schulte
  First7 Anne
  Last8 Olson
  First8 Richard
  Date 2001
  Contribution Rethinking Learning Disabilities
  Contribution-url http://wwwppionlineorg/ppi_cicfmknlgAreaID=110&subsecID=900030&contentID=3344
  Editor-last Finn
  Editor-first Chester E
  Editor2-last Rotherham
  Editor2-first Andrew
  Editor3-last Hokanson
  Editor3-first Charles R
  Title Rethinking Special Education for a New Century
  Publisher PPI and The Thomas B Fordham Foundation
  Url http://wwwppionlineorg/ppi_cicfmknlgAreaID=110&subsecID=900030&contentID=3344


  Last Moody
  First KC
  Last2 Holzer
  First2 CE III
  Coauthors et al
  Title Prevalence of dyslexia among Texas prison inmates
  Journal Texas Medicine
  Volume 96
  Issue 6
  Pages 69-75
  Date June
  Year 2000
  Url http://wwwncsallnet/id=525
  Accessdate 2007-06-19


  Last Moody
  First KC
  Last2 Holzer
  First2 CE III
  Coauthors et al
  Title Prevalence of dyslexia among Texas prison inmates
  Journal Texas Medicine
  Volume 96
  Issue 6
  Pages 69-75
  Date June
  Year 2000
  Url http://wwwncsallnet/id=525
  Accessdate 2007-06-19


  Last Snow
  First Catherine E
  Last2 Strucker
  First2 John
  Title Lessons from Preventing Reading Difficulties in Young Children for Adult Learning
  Journal National Center for the Study of Adult Learning and Literacy
  Volume 1
  Issue 2
  Year 1999
  Url http://wwwncsallnet/id=525
  Accessdate 2007-06-19