“We would drill words again and again and again. After the fifth time my daughter had seen the word, it was like she was seeing it again for the first time. And I realized that working harder wasn’t necessarily better, but working smarter was what we should be focusing on.”—Dr. Travis Harker, family physician in New Hampshire
Children with dyslexia^, ADHD^ and other kinds of learning and attention issues are as smart as their peers. But without the right support, many fall behind academically and struggle socially. They’re more likely to repeat a grade, get in trouble at school or with the law, drop out and struggle as adults to find work. But this downward spiral can be prevented.
This data-intensive report provides insights into the challenges facing the 1 in 5 as well as specifics on how to improve outcomes in school, work and the community. We start with a snapshot of learning and attention issues—focusing on the costs to society when these issues remain unaddressed.
Learning and attention issues are brain-based difficulties in reading, writing, math, organization, focus, listening comprehension, social skills, motor skills or a combination of these. Learning and attention issues are not the result of low intelligence, poor vision or hearing, or lack of access to quality instruction.
|OTHER DIFFICULTIES THAT AFFECT LEARNING AND BEHAVIOR
- Executive function deficits
- Nonverbal learning disabilities
|Learning and attention issues can look like laziness or lack of intelligence, but with the right support, children can achieve at high levels. Less stigma and high expectations are key.
|With major changes ahead in education policy, it has never been more important to empower parents with information and help them be effective advocates for their children.
|Most students with SLD or OHI spend 80% or more of the school day in general education classrooms, and all educators need more resources and strategies to meet the needs of diverse learners.
|If a child is struggling with academics or behavior, it’s imperative to find out why and to provide targeted, evidence-based instruction and intervention as early as possible.
|Aligning learning with each student’s interests, strengths and needs—as well as rigorous standards—helps all children, especially those with learning and attention issues.
|INCORPORATE SOCIAL AND EMOTIONAL LEARNING (SEL)
|Embedding SEL instruction into the curriculum and tailoring it for students with learning and attention issues can help develop important skills such as managing emotions and persevering.
|BUILD SELF-ADVOCACY SKILLS
|Helping students understand how they learn and practicing how to ask for accommodations are essential for success and can be fostered through mentoring.
|FOCUS EARLIER ON POSTSECONDARY TRANSITIONS
|Helping high-schoolers adjust to changing expectations can promote resilience as they transition to college or the workplace.
|ADVOCATE FOR INCREASED FUNDING
|Education laws offer protections and can be powerful tools for change, but implementing them requires adequate, steady funding to provide supports and services.
Sources listed at the bottom of this page.1
Converging epidemiological evidence indicates at least 1 in 5 children in the U.S. have learning and attention issues. Prevalence estimates vary for conditions such as dyslexia because different studies use different definitions. There is no blood test or other quick way to tell if a child has a learning or attention issue. An accurate diagnosis involves comprehensive assessment protocols that look at many kinds of behaviors and skills.
*Also known as developmental coordination disorder
It’s important to keep in mind that many children have more than one learning or attention issue. For example, researchers have found that dyslexia and dyscalculia^ co-occur in 30% to 70% of children who have either disorder.2 Studies also indicate as many as 45% of children with ADHD also have alearning disability^.3
Despite how common learning and attention issues are, there is still widespread confusion among the public about the nature and impact of these issues. Recent surveys, detailed below, highlight the perceptions of three key groups: parents, educators and healthcare professionals who work with children between the ages of 3 and 20. These surveys are consistent with previous research on public perceptions4 and underscore the ongoing need to:
- Raise awareness and reduce stigma among parents, 43% of whom say that they wouldn’t want other parents to know if their child had a learning disability.
- Clear up misconceptions among educators—a third of whom believe that sometimes what people call learning or attention issues is really just laziness.
- Keep learning and attention issues top of mind among healthcare professionals, only a fifth of whom say they almost always ask parents and children about symptoms of learning and attention issues.
New research in the fields of neuroscience and neurogenetics is deepening our understanding of the differences in brain structure and function in children with learning and attention issues. Brain scans and other tools are also helping researchers measure the biological impact that instructional interventions have on children with dyslexia and other issues.
As studies expand how we think about and address learning and attention issues, it’s important to note that the science is still emerging and that studies need to be replicated to confirm these findings.
|A groundbreaking study used brain imaging to show that, when repeatedly presented with certain stimuli, the brain’s responses are different in people with dyslexia when compared to typical readers. This difference was apparent when the study’s participants heard or looked at words as well as when they were presented with pictures of objects and faces.
|If neurons have trouble adapting to repeated stimuli, it may be harder to learn new information. And if weaker neural adaptation is the core difference in the brains of people with dyslexia, these findings could lead researchers to investigate the underlying mechanism and find ways to address it.
|Another new study points to structural and functional differences between the brains of children with dyslexia and the brains of children with dysgraphia when compared to neurotypical children. Children with dyslexia or dysgraphia have less white matter (which connects different parts of the brain and relays information quickly), but more functional connections in their gray matter (where thinking and language processing take place). The study also shows there are brain-based differences between children with dyslexia and dysgraphia.
|These findings indicate that brains of children with dyslexia or dysgraphia have to work harder to complete written-language tasks as compared to the brains of neurotypical children. And because the spelling problems associated with both of these learning disabilities appear to have different brain bases, they may require different kinds of interventions. (It’s also important to keep in mind that children with co-occurring issues may need several types of interventions.)
|Functional connections within and betweencertain brain networks take longer to mature in children with ADHD. These networks are associated with paying attention, staying on task and other executive functions.
|This study helps explain why children with ADHD struggle with executive functioning. Providing direct instruction and support could help nurture the formation of neural connections needed to improve performance.
|A longitudinal study looked at the role neurochemistry plays in the process of learning toread and found that young children’s reading ability can be predicted by glutamate and choline levels in their brains. Children with higher levels of these metabolites tended to have lower scores for reading and language.
|These findings point to new directions for research on dyslexia, including the possibility of one day, perhaps, developing medication that could help children who struggle to develop early reading skills.
|A study of more than 5,000 children offers insights into the complex role genes play in dyslexia. Children who have variants of two genes associated with dyslexia (DCDC2 and KIAA0319) have a much greater risk of developing dyslexia or language impairment than if they only have variants of one gene or the other.
|The more we understand how genes interact with each other or how they’re affected by environmental factors, the sooner we may be able to use this information alongside screening and progress monitoring to identify children at risk and intervene before they fall behind in school.
|An imaging study showed how learning to read changes the way the brain’s visual system functions. Researchers compared children with dyslexia to typically developing readers who were the same age as well as to younger, less experienced readers. The findings indicate thatdifferences in processing visual stimuli is not a cause of dyslexia but instead is a consequence of less reading. The study also observed that after children with dyslexia received intensive phonological tutoring to address the core deficit of this reading disorder, they made significant gains in reading, and their brains boosted their response to certain kinds of visual stimuli.
|These findings indicate that when researchers observe differences in visual processing in children with dyslexia, it may be because they are being compared to more skilled readers whose brains have undergone more of this change. The findings also further demonstrate that phonological training can improve reading and reinforce the notion that identification and treatment of dyslexia should not revolve around deficits in visual processing.
|A study of children with dyscalculia identified changes in brain function after the children received effective tutoring. Eight weeks of one-on-one cognitive tutoring not only improved math performance, but also led to widespread changes in brain activity in networks associated with numerical problem-solving.
|These findings may provide new ways to understand and measure how children respond to different kinds of math interventions.
|New research shows that dyslexia affects brain structure in males in different ways than it affects brain structure in females. Sex-specific differences were observed in areas that process language as well as in regions of the brain that process sensory and motor information.
|Because more boys than girls tend to be identified as having dyslexia, our understanding of the brain basis of dyslexia has developed primarily through the study of males. More research is needed to determine whether different approaches are needed to identify and treat dyslexia in girls.
In the field of learning and attention issues, brain imaging technology is still considered to be only a research tool. No brain imaging technology has been validated by the research community for clinical use in lieu of behavioral evaluations to diagnose either ADHD or dyslexia.
There is tremendous variability from one person to the next in terms of brain anatomy and brain function. (The same is also true when it comes to people’s genomes—even identical twins don’t have identical DNA!) Any differences that might serve as diagnostic markers need to be tested in large-scale studies and replicated by other researchers before brain scans can be used to reliably identify dyslexia in clinical settings.
“Perhaps one day imaging will play a role in identifying individuals with dyslexia. Until then, parents and educators need to use traditional options, such as a neuropsychological evaluation and other behavior measures proven effective in identifying struggling readers and very young children at risk for reading difficulties, even before they learn to read.”
—Guinevere Eden, Ph.D.,
Director of Georgetown University’s Center for the Study of Learning and former president of the International Dyslexia Association
Several long-standing legal protections as well as some newer laws protect the rights of children and adults with disabilities, including learning disabilities and disorders such as ADHD.
|Section 504 of the Rehabilitation Act
- Prohibits discrimination against students with disabilities in programs or activities that receive federal funding
- Requires school districts to provide accommodations, supports and services to remove barriers and “level the playing field” for general education students with disabilities
- Includes some procedural safeguards to ensure that children with 504 plans receive a free and appropriate public education
- Protects college students with disabilities from discrimination and offers accommodations
- Does not give schools additional funding for eligible students
|Individuals with Disabilities Education Act (IDEA)
|1990 (and updated in 1997 and 2004)
- Replaced the Education for All Handicapped Children Act, which was signed into law in 1975
- Requires school districts to find and evaluate—at no cost to parents—children suspected of having disabilities
- Provides special education, accommodations, modifications and related services (such as speech therapy and counseling) through Individualized Education Programs (IEPs) that are tailored to meet the needs of each child with a qualifying disability to enable the child to be involved in and make progress in the general education curriculum
- Provides early intervention from birth up to age 3 and special education from age 3 to 21
- Includes many procedural safeguards to ensure that children with disabilities receive a free and appropriate public education
- Gives schools additional funding for eligible students
|Americans with Disabilities Act (ADA)
- Protects individuals with disabilities from discrimination in any public place, including schools and the workplace
- Protects students with disabilities from discrimination at private schools (including colleges and universities)
- Ensures that individuals with disabilities have equal access to compete for educational and workplace opportunities and receive necessary accommodations on standardized testing, licensing and other types of assessments
- Requires workplaces with 15 or more employees to provide reasonable accommodations to employees with disabilities
|Workforce Innovation and Opportunity Act (WIOA)
- Improves access to job training, education and employment services for young adults with learning disabilities and other people who have traditionally faced barriers to employment
- Expands some services to high school dropouts ages 14 to 24 who are eligible under IDEA or Section 504
- Requires states to coordinate services, including those for youth transitioning from high school to postsecondary education
|Every Student Succeeds Act (ESSA)
- Replaced No Child Left Behind as the main federal law for K–12 general education
- Requires states to establish standards from kindergarten through grade 12 to help ensure that students graduate from high school prepared for college or career
- Requires states to establish assessments aligned to the standards in English and math for grades 3 through 8 and at least once in high school; also requires assessments in science at least once in high school
- Requires states to evaluate schools using academic factors including reading and math scores, English language proficiency test scores and high school graduation rates and another factor related to school quality or student success—to be chosen by states—such as chronic absenteeism or access to advanced coursework
- Requires schools to set ambitious goals for all groups of students, such as those in special education, and to use evidence-based methods to help close achievement gaps
- Encourages states to use Universal Design for Learning (UDL), a multi-tier system of supports (MTSS) and personalized learning to help meet the needs of all students
- Calls for the creation of a national center focused on reading issues for children with disabilities such as dyslexia that will serve as an information clearinghouse for teachers and parents
|Research Excellence and Advancements for Dyslexia Act (READ)
- Requires the National Science Foundation (NSF) to provide $5 million every year for research on the science of learning disabilities, of which at least $2.5 million per year shall support research focusing specifically on dyslexia
- May cover research topics such as:
- Early identification of children with learning disabilities
- Professional development for teachers
- Curricula and tools to help children with learning disabilities
- Implementation of successful interventions
Over the last decade, 38 states have passed laws that require schools to monitor students’ progress in reading between kindergarten and grade 3. These laws emphasize the importance of early screening to help find struggling students before they fall far behind. These laws are often referred to as third-grade reading laws or third-grade retention laws because they require students who can’t read at a certain level to repeat grade 3. Some of these laws allow exceptions for students with anIEP^ or 504 plan^.
In addition, 26 states have passed dyslexia laws to help identify and provide early intervention for students with a reading disability. These laws provide funding and require intervention and services for students who are struggling with reading. Many states with these early screening and literacy laws also provide funding for teacher professional development.