by Psychology Today © 2018 Sussex Publishers, LLC
Learning disabilities, such as dyslexia, affect a person's ability to understand or use language, to do math calculations, to coordinate movements, or to direct attention. They are usually diagnosed in children once they start school.
Learning disabilities are disorders that affect one's ability to understand or use spoken or written language, do mathematical calculations, coordinate movements, or direct attention. Although learning disabilities occur in very young children, disorders are usually not recognized until a child reaches school age. Research shows that 8 to 10 percent of American children under the age of 18 have some type of learning disability.
Learning disabilities affect one's ability to interpret what one sees and hears or to link information from different parts of the brain. These limitations can show up as specific difficulties with spoken and written language, coordination, self-control, or attention. Such difficulties extend to schoolwork and can impede learning to read or write or to do math. Learning disabilities do not reflect IQ (intelligence quotient), or how smart a person is.
Learning disabilities can be lifelong conditions that, in some cases, affect many parts of a person's existence: school or work, daily routines, family situations, and, sometimes, even friendships and play. In some people, many overlapping learning disabilities may be apparent. Others may have a single, isolated learning problem that has little impact on other areas of their lives.
Not all learning problems fall into the category of learning disabilities. Many children are simply slower in developing certain skills. Because children show natural differences in their rate of development, sometimes what seems to be a learning disability may simply be a delay in maturation
To be diagnosed as a learning disability, a child's condition must meet specific criteria.
Dyslexia is a reading and language-based learning disability. With this problem, a child may not understand letters, groups of letters, sentences, or paragraphs. For example, at the beginning of first grade, children may occasionally reverse and rotate the letters they read and write. This may be normal when they are first learning to read. By the middle of first grade (and with maturity) these problems should disappear. However, a young student with dyslexia may not overcome these problems. The difficulty can continue as the student grows. To him, a b may look like a d. She may write on when she really means no. Your child may reverse a 6 to make 9. Additionally, a child with dyslexia can sometimes see sentences, words, or letters hovering, moving (sometimes called "dancing"), or disappearing off of the page. These are not vision problems, rather they are problems with how the brain interprets the information it "sees."
Dysgraphia is a term for problems with writing. An older child may not form letters correctly and have difficulty writing within a certain space. Writing neatly takes time and effort; yet despite the extra effort, the handwriting still may be hard to read. A teacher may say that a learning-disabled student can't finish written tests and assignments on time, and supervisors may find that written tasks are always late or incomplete.
Dyscalculia is a term for problems concerning math. A child may do well in history and language, but fail tests involving fractions and percentages. Math is difficult for many students, but those with dyscalculia may have much more difficulty than others their age. Dyscalculia may prevent your child from solving basic math problems that others the same age complete with no difficulty.
Information-processing disorders are learning disorders related to people's ability to use the information that they take in through their senses: seeing, hearing, tasting, smelling, and touching. These problems are not related to an inability to see or hear. Instead, the conditions affect the way the brain recognizes, responds to, retrieves, and stores sensory information.
Language-related learning disabilities are problems that interfere with age-appropriate communication, including speaking, listening, reading, spelling, and writing.
The criteria and characteristics for diagnosing learning disabilities appear in a reference book called The Diagnostic and Statistical Manual of Mental Disorders (DSM). The DSM diagnosis is commonly used when applying for health insurance coverage of diagnostic and treatment services.
Specific Learning Disorders (SLDs)
Students with academic-skills disorders are often years behind their classmates in developing reading, writing, or arithmetic skills.
A. Over the past six months they have had learning difficulties with at least one of the following symptoms:
- Slow, inaccurate reading or reading that requires excessive effort
- When reading, difficulty or inability to understand the meaning of words
- Poor or inaccurate spelling
- Written expression with grammatical or punctuation errors, lack of clarity in ideas, and poor paragraph organization
- Difficulties in understanding the magnitude or relationship of numbers or difficulties with calculations that are abnormal for that age group
- Difficulties in solving quantitative problems due to poor mathematical reasoning
B. Their difficulties or problems with academic skills are greater than expected of typical development at the individual's age, and they cause significant academic or occupational performance problems.
C. Signs of problems with academic skills are seen during school-age years.
D. There are no other explanations that better account for these difficulties.
Reading disabilities (in Specific Learning Disorders), commonly known as dyslexia, are quite widespread. They affect 2 to 8 percent of elementary school children. Reading, writing, and mathematics disabilities affect 5 to 15 percent of all school-age children and 4 percent of adults.
The essential feature of a reading disorder, or dyslexia, is reading achievement (reading accuracy, speed, or comprehension as measured by individually administered standardized tests) that falls substantially below the expected level given the individual's chronological age, measured intelligence, and age-appropriate education. The disturbances in reading significantly interfere with academic achievement or with activities of daily living that require reading skills. If a sensory deficit is present, the reading difficulties are in excess of those usually associated with it. If a neurological or other general medical condition or sensory deficit is present, it should be categorized as that. In individuals with a reading disorder, reading aloud is characterized by distortions, substitutions, or omissions. Reading out loud and silently are both characterized by slowness and errors in comprehension.
In the disorder of written expression, or dysgraphia, writing skills (as measured by an individually administered standardized test or functional assessment of writing skills) fall substantially below the expected skills for the individual's chronological age, measured intelligence, and education. The disturbance significantly interferes with academic achievement or certain daily living experiences. If a sensory deficit is present, the difficulties in writing skills are in excess of those usually associated with it. There is generally a combination of difficulties in the individual's ability to compose written tests, which tend to be full of grammar, spelling, and punctuation mistakes, poor paragraph organization, and poor handwriting.
The essential feature of the mathematics disorder, or dyscalculia, is a lack of mathematical ability (as measured by individually administered standardized tests of mathematical calculation or reasoning) that falls substantially below the expectation for the individual's age, measured intelligence, and age-appropriate education. The disturbance in mathematics strongly interferes with academic achievement or activities of daily living. A number of different skills may be impaired in a mathematics disorder, including "linguistic" skills (understanding or naming mathematical terms, operations, or concepts and decoding written problems into mathematical symbols), "perceptual" skills (recognizing or reading numerical symbols or arithmetic signs and clustering objects into groups), "attention" skills (copying numbers or figures correctly, remembering to add in "carried" numbers, and observing operational signs), and "mathematical" skills (following the sequence of mathematical steps, counting objects, and learning multiplication tables).
Formally, previous versions of the DSM specified the type of learning disorder (reading, writing, or arithmetic) for a diagnosis. Those who did not meet the criteria for any specific learning disorder would be diagnosed with "learning disorders not otherwise specified" (LDNOS). A primary reason for a diagnosis of LDNOS was an individual's having problems in all three areas (reading, mathematics, and written expression) that, together, significantly interfered with academic achievement, even though performance on tests measuring each individual skill was not substantially below that expected, given the person's chronological age, measured intelligence, and age-appropriate education. This is no longer a problem with the way SLDs are diagnosed, and therefore there is no longer a need for an LDNOS diagnosis.
Not all individuals get diagnosed with SLDs in childhood. Some get diagnosed in adulthood when they realize similarities between their children's symptoms and their own when they were in school. This adult-age diagnosis is not unique to SLDs but is also common for families where ADHD is hereditary.
Mental-health professionals stress that since no one knows what causes learning disabilities, it doesn't help parents to look backward to search for reasons. There are too many possibilities to pin down the cause, and it is more important for the family to move forward with getting help.
While learning disabilities were thought to be caused by a single neurological problem, researchers now say that the causes are more diverse and complex. New evidence seems to show that most learning disabilities do not start in a single, specific area of the brain, but from difficulties in bringing together information from various brain regions.
A leading theory is that learning disabilities stem from subtle disturbances in brain structure and function that may begin before birth. Other possibilities include: • Genetic predisposition • Tobacco, alcohol, or substance abuse by the mother prior to, during, and after pregnancy • Problems during pregnancy or delivery, such as low birth weight, prematurity, and birth trauma or distress • Environmental toxins, such as lead poisoning • Central nervous system Infections • Severe head trauma
Identification of Learning Disabilities
Evaluation, the process for determining whether a child has a disability and needs special education and services, is the first step in developing a helpful educational program. A full and individual initial evaluation must be done before the initial provision of any special education or related services to a child with a disability. In addition, a student must be re-evaluated at least once every three years. Evaluation involves gathering information from a variety of sources, including the parent, about a child's functioning and development in all areas of suspected disability. The evaluation may look at cognitive, behavioral, physical, and developmental factors, as well as other areas.
Under the 2004 reauthorization of the Individuals with Disabilities Education Improvement Act, legislators made significant changes in how people with learning disabilities could be identified as eligible for special education services. This reauthorization allows for the optional use of the Response to Intervention (RTI) approach to determine whether a child has a specific learning disability and may receive special education services. There is evidence that the IQ-discrepancy model normally used is ineffective in identifying all students with learning disabilities; therefore, many schools are implementing an RTI approach.
RTI is a tiered approach to educational intervention; the most common is a 3-tier model. The first tier provides high quality reading instruction to all students, with careful progress monitoring by teachers in the classrooms. Tier 2 is the same high quality instruction but with increased intensity for those not progressing well enough. If students do not progress with this more intensive instruction, they are identified for Tier 3, which is targeted special education intervention. Tier 3 students have full evaluations and the establishment of an Individualized Education Program (IEP).
This approach can identify children who have delays or learning problems and may need special education and related services as a result.
- Eligibility. It can determine whether a child has a disability under the Individuals with Disabilities Education Act (IDEA) and qualifies for special education and services.
- Planning an Individualized Education Program (IEP). It provides information that can help parents and the school develop an appropriate IEP for a child.
- Instructional strategies. It can help determine what tactics may be most effective in helping a child learn.
- Measuring progress. It establishes a baseline for measuring a child's educational progress. The evaluation process establishes a foundation for developing an appropriate educational program. The public agency must provide a copy of the evaluation report and the documentation of determination of eligibility to the parent. Even if the evaluation shows that a child does not need special education, the information may still be used to help that child in a regular education program.
After a child's evaluation is complete, parents meet with a group of qualified professionals to determine whether their child has a disability under IDEA. The school must provide the parents with a copy of the evaluation report and a written determination of eligibility.
If the team determines that a child is eligible for special education and related services, the next step is to develop an IEP to meet the child's needs.
The goals and objectives the IEP team develops relate directly to the strengths and needs that were identified through evaluation.
It's important for parents to understand the results of their child's evaluation before beginning to develop an IEP, and they should ask to have the evaluation explained in plain language by a qualified professional.
Parents will want to request the evaluation summary report before meeting with other members of the team to develop the IEP. Reviewing the results in a comfortable environment before developing the IEP can reduce parents' stress and provide time to consider whether the results fit their own observations and experiences with their child.
The most common treatment for learning disabilities is special education. Trained educators may perform a diagnostic educational evaluation assessing a child's academic and intellectual potential in addition to his or her level of academic performance. Once the evaluation is complete, the basic approach is to teach learning skills by building on the child's abilities and strengths, while correcting and compensating for disabilities and weaknesses. Other professionals such as speech and language therapists also may be involved. Some medications may be effective in helping the child learn by enhancing attention and concentration. Psychological therapies may also be used.
Learning disabilities can be lifelong conditions. In some people, several overlapping learning disabilities may be apparent. Others may have a single, isolated learning problem that has little impact on their lives.
Recognizing dyslexia early is a key factor in how much the learning disability will affect a person's development. Unfortunately, adults with unidentified dyslexia often work in jobs below their intellectual capacity. But with help of a tutor, teacher, or other trained professional, almost all people with dyslexia can become good readers and writers. Incorporating the following strategies into the learning process can help overcome the difficulties of dyslexia:
- Early exposure to oral reading, writing, and drawing and encouraging development of print knowledge, linguistic awareness (the relationship between sound and meaning), basic letter formation, and recognition skills
- Practicing reading different kinds of texts (books, magazines, advertisements, comics)
- Multisensory, structured language instruction and practice using sight, sound, and touch when introducing new ideas
- Modifying classroom procedures to allow for extra time to complete assignments, help with note-taking, oral testing, and other means of assessment
- Using books-on-tape and assistive technology, such as screen readers and voice-recognition computer software
- Getting help for the emotional issues that arise from struggling to overcome academic difficulties
Reading and writing are fundamental skills for daily living; however, it is important to emphasize other aspects of learning and expression. Like all people, those with dyslexia enjoy activities that tap into their strengths and interests. As multidimensional thinkers, visual fields like design, art, architecture, engineering, and surgery, which do not emphasize language skills, may appeal to them.
Helping a student identify his or her strengths and weaknesses is the first step in moving ahead. Following identification, parents, teachers, and other educators can work together to establish strategies that will aid the student in learning math more effectively. Help outside the classroom lets a student and tutor focus specifically on the difficulties that student is having, taking pressure off moving to new topics too quickly. Repeated reinforcement and specific practice of straightforward ideas can make understanding easier. Other strategies include:
- Using graph paper for students who have difficulty organizing ideas on paper
- Working on finding different ways to approach math facts; instead of just memorizing the multiplication tables, explain that since 8 x 2 = 16, if 16 is doubled, 8 x 4 must = 32
- Practicing estimating as a way to begin solving math problems
- Introducing new skills, beginning with concrete examples and later moving to more abstract applications
- For language difficulties, explaining ideas and problems clearly, and encouraging students to ask questions
- Providing a place to work with few distractions, and having pencils, erasers, and other tools on hand as needed
- Helping students become aware of their strengths and weaknesses; when a child understands how he or she learns best, he or she takes a big step toward achieving academic success and confidence
There are many ways to help a person with dysgraphia achieve success. Generally, strategies fall into three categories:
- Accommodations: Providing alternatives to written expression
- Modifications: Changing expectations or tasks to minimize or avoid the area of weakness
- Remediation: Providing instruction for improving handwriting and writing skills
Each type of strategy should be considered when planning instruction and support. A person with dysgraphia will benefit from help from both specialists and those who are closest to the person. Finding the most beneficial type of support is a process of trying different ideas and openly exchanging thoughts on what works best.
Below are some examples of how to teach individuals with dysgraphia to overcome some of their difficulties with written expression.
- Use paper with raised lines for a sensory guide to staying within the lines.
- Try different pens and pencils to find one that's most comfortable.
- Practice writing letters and numbers in the air with expansive arm movements to improve motor memory of these important shapes. Also practice letters and numbers with smaller hand or finger motions.
- Encourage proper grip, posture, and paper positioning for writing; it's important to reinforce this early on as it's difficult for students to unlearn bad habits later.
- Use multisensory techniques for learning letters, shapes, and numbers; for example, speaking through motor sequences, such as b is "big stick down, circle away from my body."
- Introduce a word processor on a computer early; however, do not eliminate handwriting for the child. While typing can make it easier to write by alleviating the frustration of forming letters, handwriting is a vital part of a person's ability to function in the world.
- Be patient and positive; encourage practice and praise effort. Becoming a good writer takes time and practice.
- Allow use of print or cursive, whichever is more comfortable.
- Use large graph paper for math calculations to keep columns and rows organized.
- Allow extra time for writing assignments.
- Begin writing assignments creatively with drawing or by speaking ideas into a tape recorder.
- Alternate focus of writing assignments; put the emphasis on some for neatness and spelling, others for grammar or organization of ideas.
- Explicitly teach different types of writing: expository and personal essays, short stories, poems.
- Do not judge timed assignments on neatness and spelling.
- Have students delay before proofreading their work; it's easier to see mistakes after a break.
- Help students create a checklist for editing work: spelling, neatness, grammar, syntax, and clear progression of ideas.
- Encourage the use of a spell-checker—speaking spell-checkers are available for handwritten work.
- Reduce the amount of copying; instead, focus on writing original answers and ideas
- Have students complete tasks in small steps instead of all at once.
- Find alternative means of assessing knowledge, such as oral reports or visual projects.
- Encourage practice through low-stress opportunities for writing, such as letters, a diary, making household lists, or keeping track of sports teams
Teenagers and Adults
- Provide tape recorders to supplement note taking and to prepare for writing assignments.
- Create a step-by-step plan that breaks writing assignments into small tasks (see below).
- When organizing writing projects, create a list of key words that will be useful.
- Provide clear, constructive feedback on the quality of work, explaining both the strengths and weaknesses of the project and commenting on the structure as well as the information that is included.
- Use assistive technology such as voice-activated software if the mechanical aspects of writing remain a major hurdle.
It is never too early or too late to reinforce the skills needed for proper writing. All age groups can use many of these tips:
Though teachers and employers are required by law to make "reasonable accommodations" for individuals with learning disabilities, they may not be aware of how to help. Speak to them about dysgraphia, and explain the challenges you face as a result of your learning disability.
Although obtaining a diagnosis is important, even more so is creating a plan for getting the right help. Because learning disabilities can affect the child and family in so many ways, help may be needed on a variety of fronts.
Learning Disabilities and the Law
Public Law 105-17, the Individuals with Disabilities Education Act Amendments of 1997, is the federal special education law. IDEA was signed into law in June 1997, with final federal regulations published in March 1999. This law replaces all earlier versions of Public Law 94-142, the Education of All Handicapped Children Act of 1975.
In 2004, there was a reauthorization of the Individuals with Disabilities Education Improvement Act, where significant changes were made as to the identification of individuals with learning disabilities so that they can receive the needed educational services.
IDEA guarantees each child with a disability and need of special education services the right to a free appropriate public education (FAPE) in the least restrictive environment (LRE) appropriate.
- American Academy of Pediatrics
- Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition
- Families and Advocates Partnership for Education
- Learning Disabilities Association of America
- National Center for Learning Disabilities
- National Institute of Health - Eunice Kennedy Shriver National Institute of Child Health and Human Development
- National Institute of Mental Health
- National Institute of Neurological Disorders and Stroke
- University of Maryland Medical Center; Learning Disabilities
- University of Michigan Health System: Learning Disabilities: Your child
- United States Department of Education; Jessup, Maryland: Office of Special Education and Rehabilitative Services
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