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Updated 13 February 2013

Learning disabilities

Children, adolescents and adults who experience learning disabilities usually function on an average to above average intellectual level.

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Summary

  • The term learning disability encompasses a wide range of specific learning difficulties.
  • Individuals with learning disabilities are usually of average to above average intelligence, but struggle with a specific aspect of learning and do not learn effectively through conventional methods.
  • Some individuals present with only one particular difficulty. while others present with a combination of difficulties.
  • It is important to distinguish learning disabilities from academic difficulties, which are due to lack of opportunity, poor teaching, inadequate curriculum, physical disabilities, emotional problems and/or family problems.
  • Children with learning disabilities require support and intervention from a wide range of professionals, and a proper diagnostic process and team approach is necessary. 

Description

Learning disability, also referred to as learning difficulty or learning disorder, is an umbrella term used to refer to children or adolescents who, despite average or above average intelligence or cognitive potential, struggle with one or more areas of learning.  Learning is an extremely complex function, and children with learning difficulties experience problems in the brain’s capacity to process, interpret and store information.  These aspects are all imperative to successful learning. These difficulties can manifest in a number of different ways, and can cause problems in a variety of different learning areas. 

While various factors can influence learning, a child with a learning disability must be distinguished from a child who struggles to learn because of a lack of stimulation or environmental problems, as a result of emotional problems or mental illness, a lack of cognitive or intellectual potential, or physical disability, such as impaired hearing or sight. While all of these factors can influence learning, these children are generally not considered to have a definable learning disability.

A learning disability can become apparent at any time after a child starts formal schooling. Because such children have average or above average intelligence, they are often able to compensate for their difficulties during their early school years. As the work load at school increases and the demands of the higher grades become more complex, their learning disabilities often become more apparent.  The manifestations of learning disabilities change with the demands at school as the need for more independent work arises. As these demands change, the severity of the problem also changes.  They are often detected when a child’s output at school doesn’t seem to match his or her potential, despite hard work on the part of the child. 

Without help, nearly 40 percent of children and adolescents with learning problems drop out of school. Learning difficulties also often have an impact on a child’s self-esteem and, if left unsupported, can lead tobehavioural and emotional problems. 

Types of learning disabilities

Although intelligence can be defined and assessed in many different ways – the determination of learning disabilities intelligence is divided broadly into two different areas:  verbal intelligence, and non-verbal intelligence.  Children’s success at school will depend on their skills in both of these areas of intelligence. It therefore follows that we can divide learning disabilities very broadly into these two areas. 

Verbal learning disabilities

A child who experiences an overall verbal learning disability usually shows a significantly lower verbal intelligence score, relative to his or her non-verbal learning potential. Verbal learning refers to the skills needed to listen to information, interpret this information, process, comprehend and understand this information, as well as the skills necessary to express ideas verbally, and certain skills necessary to express ideas in a written format. Children with learning disabilities may have specific deficits within their verbal skills, and some of the disabilities which can present are as follows:

  • Auditory Processing Problem: involves a difficulty processing and/or understanding information that is orally given and perceived aurally (heard). The deficit does not involve physical hearing problems such as deafness, but does affect how the brain interprets auditory information. This disability impacts on a child’s ability to understand and carry out instructions, and causes difficulties in the child’s ability to learn to read and spell. Auditory processing problems include, among other difficulties, auditory discrimination difficulties, where a child struggles to discriminate between similar sounds, as well as auditory sequencing problems, where a child struggles to hear sounds in the correct sequence. 

  • Specific reading disorder: occurs when a child struggles to learn to read, despite good performance in other learning areas, and is generally considered to be the most common type of learning disorder. The problem may be with the child’s ability to decode words (see the individual sounds or letters) or with the child’s ability to put letters together to make meaningful words. Dyslexia forms part of this reading disorder and involves problems in the sequencing of letters or groups of letters which makes reading words very difficult.
  • Specific spelling disorder: occurs when a child struggles to learn to spell, despite adequate verbal skills in other areas. 
  • Expressive communication disorder: refers to problems with the production of speech and language. Speech and language disorders are vast and varied and can affect the pronunciation of words, the ability to put words together to form sentences, the ability to plan an utterance so that the words are in the correct order, and the ability to formulate an idea and put this into words.
  • Receptive communication disorder: encompasses problems with a child’s ability to understand spoken language. Because the process of receptive language is internal, it is often difficult to detect such problems. However, they manifest as problems understanding instructions, problems comprehending reading passages, frequent requests to repeat information and generally a slower grasping of new concepts.

Non-verbal learning disabilities

Non-verbal learning disorder (NLD) is a neurological syndrome affecting the right hemisphere of the brain. Children with NLD usually have much lower non-verbal intelligence relative to their verbal skills.  NLD affects a number of areas of functioning, including gross motor development such as balance and coordination, fine motor development, visual-spatial skills, and certain social skills, which rely on right-brain functioning such as reading facial features or body language. 

As with verbal learning disabilities, a non-verbal learning disorder can also be more specific and can affect particular areas of functioning.  Some of the specific disorders which may present are:

  • Visual perceptual disability: involves difficulty in processing and interpreting visually perceived information. This is not due to a physical problem with sight, but rather has to do with how the brain interprets and makes sense of visual information.  Visual perceptual disabilities can cause problems with figure-ground discrimination where there is difficulty distinguishing between a specific image and a competing background, with visual sequencing or seeing things in the correct order; visual discrimination or seeing the differences between similar representations; or problems perceiving distance. 
  • Dysgraphia: is an inability to produce legible handwriting in an appropriate length of time. This term is sometimes used to refer to more general problems with written language, but generally refers specifically to a child’s handwriting.
  • Motor planning problems or dyspraxia: refers to children who have difficulty planning motor movements.  This can be evident in their gross motor movements such as running, climbing, and navigating around objects, but can also be evident in their fine motor movements and can manifest as problems initiating tasks.  Depending on the specific type of planning problems, as well as their severity, this disorder is sometimes referred to as dyspraxia. 

Scholastic disorders

In addition to verbal and non-verbal disabilities, there are other learning disabilities which affect both of these areas and have an impact on a child’s overall scholastic skills. Some of these include:

  •  Problems with attention and concentration: are common in children with learning disabilities and affect a child’s ability to attend to relevant information, as well as a child’s ability to control his or her level of activity. However, concentration difficulties can also present in isolation in children who otherwise have good learning potential, such as in the case of children with Attention-Deficit / Hyperactivity Disorder. There are two main types of ADHD. In the first case, children are considered to have mainly hyperactive or impulsive type ADHD. These children are often overly active, are often noisy or have a “soundtrack”, tend to move from task to task without finishing an activity, are impulsive in their functioning and tend to rush their work, and are generally “busy”.  In the second case, children may have predominately inattentive type ADHD.  These children tend to day-dream, take a long time to finish tasks, are easily distracted, and generally struggle to keep their attention on the task at hand.  
  • Dyscalculia: refers to a problem understanding or using mathematical concepts and symbols. People with dyscalculia may have difficulty performing even the simplest mathematical calculations.
  • Memory disabilities: involve problems recalling and repeating information and can affect either visual memory or auditory memory. These memory difficulties present significant problems in academic study. A child may listen attentively during a class or lecture, or study hard for a test, but cannot remember the information learnt. Some children have an intact long-term memory, but a poor short-term memory, and are thus able to benefit from repeated teaching and learning of concepts.  
  • Planning and organisational disabilities: refer to problems in devising a plan to carry out a task or organising a task in such a way that it can be easily completed.  This disability includes problems with organising time and thus completing tasks within a given time; dividing tasks into smaller parts and prioritising these; and problems organising space and thus difficulty orientating a task on a page.   

Associated problems

10 to 25 percent of individuals with learning disabilities have associated problems such as conduct disorder, oppositional defiant disorder, or major depressive disorder. In addition, learning disabilities, if not identified and treated correctly can have a significant impact on a child’s self-esteem which may in turn lead to behavioural and social problems. 

Causes

There is still some confusion about what causes a learning disability.  However, most experts agree that learning disabilities are caused by a difference in how the brain works and how it processes information. Some of the factors which are considered to influence the development of a learning disability include: 

  •  Hereditary factors: often other family members have learning disabilities
  • Poor maternal health during pregnancy, including the use of drugs and alcohol. and illness in a mother during pregnancy
  • Complications at birth: such as low birth weight; cord around the neck; prolonged labour; use of medication
  • Minor brain injuries in early development
  • Environmental factors: exposure to toxins; poor nutrition in early development.

Prevalence

There are no clear statistics on learning disabilities. However, it is believed that approximately 10 – 30 percent of children have learning difficulties. Most learning disabilities, including reading disorders, concentration difficulties and language difficulties are more prevalent in boys than in girls. 

Diagnosis

Although a possible learning disability can be detected during a child’s early development, a learning disability is usually only identified when a child enters formal schooling. When a child’s achievement in reading, mathematics or written expression is substantially below what is expected in relation to his or her age, schooling and level of intelligence, a learning disorder may be present.

When a learning disorder is suspected, it is imperative that a complete diagnostic evaluation of skills be completed which can provide the basis forindividualised treatment strategies for schools and families. A psychologist who hasspecialised in the field of learning disabilities usually conducts such an evaluation, also called a psycho-educational assessment. However, there is often a team of professionals involved in the assessment and identification of learning difficulties which may include Occupational Therapists, Physiotherapists, Speech and Language Therapists, Remedial Teachers, Neuro-developmentalPaediatricians, Psychologists, and the class teacher. Co-operation among the family, the school and the professionals involved is crucial.

The signs indicative of a learning disability are vast. However, below are some of thebehaviours which parents and teachers need to look out for in detecting the possible presence of a learning disability. A complete diagnostic evaluation must be completed before any intervention is undertaken. 

During early development, the following signs and symptoms may be observed in a child with a learning difficulty:

  • Slower than average developmental milestones (sitting, walking, speaking)
  • Difficulty communicating needs and desires
  • Difficulty following instructions
  • Poor attention span

At school-going level, the following signs andbehaviours may be indicative of a learning disability:

  • Difficulty following verbal instructions
  • Repetition of the same question or asking seemingly simple questions or self-explanatory questions
  • Repeated asking of questions about work already explained
  • Losing their place when reading or copying
  • Erratic spelling or no set pattern to spelling mistakes
  • Difficulty working from written instructions
  • Difficulty copying
  • An awareness of a mistake, but difficulty correcting that mistake
  • Difficulty distinguishing main ideas from details
  • Difficulty adjusting to change in routine
  • Difficulty making choices, identifying priorities and initiating tasks
  • Forgetting assignments or homework
  • Difficulty completing tasks within a given time
  • Difficulty in putting ideas to paper even when verbal answers given are correct
  • Difficulty remembering information from one day to the next
  • Inconsistent performance in school work (“up and down days”)
  • Ability to complete difficult examples of work, but difficulty with simpler examples
  • Poor handwriting
  • Clumsiness
  • Difficulty sustaining attention

Intervention

With early identification and intervention along with a cooperative attitude between school and parents, the prognosis for a child with a learning disability is positive in a significant percentage of cases. Early identification (pre-puberty) can prevent or limit frustration and failure in school, as well as associated emotional, social or behavioural problems. Intervention usually includes one or more of the following:

  • Individual or group remedial lessons by a trained remedial teacher
  • Occupational therapy for children with NLD, motor disabilities and visual perception disabilities
  • Physiotherapy for NLD and motor disabilities
  • Speech and language therapy for children with specific language difficulties and auditory perception disabilities
  • Social skills groups and behavioural management for children to help them to cope with the social and emotional difficulties which may arise from a learning disability
  • Education for family members on the ramifications of learning disabilities and the effect on family functioning
  • Homework tutors to assist with individual homework sessions

When remediation isn’t possible or the problem cannot be overcome, supportive measures can be put in place to assist children to work around these problems and reach their potential despite these learning problems.  In South Africa, the Department of Education offers special dispensations for Learners with Special Educational Needs. These must be applied for by the school and may include:

  •  Extra time for exams
  • Spelling concession
  • Handwriting dispensation
  • Oral exams
  • A planning aid for exam writing
  • Questions on tape
  • Use of a computer during exams
  • A scribe during exams

In addition to formal intervention and support measures, it is imperative that children with learning disabilities also receive support at home and in the classroom. The following are some ideas of how teachers and parents can assist children with learning disabilities:  

  • Ensure that learning occurs in a relatively distraction-free environment.  If possible, seat the child in the front of the class, or in a position where he or she will be exposed to fewer distractions. A single desk is often preferable. Some sort of shelving for the storage of books, worksheets and stationary often ensures an organised desk space.
  • Provide a calendar with a weekly plan, homework, assignments and tests to help the child structure his or her time.  If possible, supervise the recording of homework to ensure that the child knows what needs to be done and when.
  • Repeat instructions and provide these in a structured, simple and clear way.  Provide both written and oral instructions and, if possible, ask the child to repeat the instructions to you in their own words to ensure that they have understood these. Make sure that the child is paying attention before instructions are given, and make eye-contact with the child to monitor whether they understand the instructions.
  • Provide a checklist of features that can help learners to plan and evaluate their own work, such as use of paragraphs, style, punctuation, and headings.
  • Break assignments up into small tasks and be available to check assignments in the planning stages and provide support and suggestions.
  • Reduce volume of work, presenting only essential information and reducing the number of practice examples required of the child.
  • Underline important facts in passages and help the child to recognise important information and summarise.
  • Give specific questions to guide reading and understanding.
  • Allow work to be done on a computer if necessary.
  • Don’t penalise poor spelling, just correct it.
  • Provide a key with word definitions and ask the child to start his or her own dictionary where new words can be written down and used in future assignments.
  • Enlarge reading texts, maps and diagrams for easier reference.
  • Use visual aids such as charts and graphs, and teach and present work in different ways.
  • Give extra time to complete tasks if necessary, but also help the child to plan and use their time effectively.
  • Minimise the amount of work copied from the board, as this is time-consuming and takes energy from the child.
  • Use concrete examples to explain new concepts.
  • Provide the learner with strategies such as acronyms or mnemonics to remember information.
  • A quick recap of the previous day’s work is beneficial.  Don’t assume that the child with a learning disability remembers or can build on what was learnt the previous day.
  • Children with a learning disability need organised teachers and parents. Ensure that the worksheets or notes that are given to the child are well set-up. 
  • Remember that producing good work takes a great deal of effort from children with learning disabilities.  Make sure that you provide lots of positive reinforcement and help to boost the child’s self-esteem. 
  • A “homework buddy” or “classroom buddy” (a strong and organised classmate) can be used to keep an eye on the child with a learning disability to ensure that they stay organised in class and have someone whom they can ask for help if necessary. 
  • Any child can only learn if they are properly fed and rested, and the same is true of a child with a learning disability. Because children with learning disabilities take so much longer to complete homework and learn, it often becomes the sole focus in a family.  While too many extra-mural activities can be exhausting and distracting for a child with a learning disability, it is imperative that these children be allowed to participate in activities which they enjoy, and that they are given sufficient leisure time. It is particularly important to find something that the child feels positive about in order to boost his or her self-esteem. 

It is imperative that the treatment and support plan for a child with a learning disability be updated often to ensure that he or she receives the most beneficial support. While many of these measures take effort and time from teachers, employing some of the above suggestions in the classroom context would benefit all learners, not only those with special educational needs.

Previously reviewed by Dr P. Normand, clinical psychologist

Reviewed by Carey-Lee Vermoter, Counselling Psychologist, January 2011

 

 
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