Definition

Learning disorders are academic difficulties experi-enced by children and adults of average to above-average intelligence. People with learning disorders have diffi-culty with reading, writing, mathematics, or a combina-tion of the three. These difficulties significantly interfere with academic achievement or daily living.

Description

Learning disorders, or disabilities, affect approxi-mately 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 disor-ders, mathematics disorders, and disorders of written ex-pression. 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 cor-rectly. 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 co-existing reading disorder, a disorder of written expres-sion, or both.

Disorders of written expression

Disorders of written expression typically occur in combination with reading disorders or mathematics dis-orders 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 neu-rological 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 re-ported 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 aca-demic 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 let-ters and omit or add syllables to words. The written homework of children with disorders of written expres-sion is filled with grammatical, spelling, punctuation, and organizational errors. The child’s handwriting is often extremely poor. Children with mathematical disor-ders 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, psy-chiatrist, neurologist, neuropsychologist, or learning spe-cialist. A complete medical, family, social, and educa-tional 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 Psychoed-ucational 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 in-dividual 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 edu¬cation 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 dis¬orders focus first on improving a child’s recognition of the sounds of letters and language through phonics train¬ing. Later strategies focus on comprehension, retention, and study skills. Students with disorders of written ex¬pression are often encouraged to keep journals and to write with a computer keyboard instead of a pencil. In¬struction for students with mathematical disorders em¬phasizes 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 re¬ceive 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, prim¬rose oil, and omega-3 fatty acids. Eliminating food addi¬tives, 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 at-tention-deficit hyperactivity disorder (ADHD). Gink¬go 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 learn¬ing 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 prob¬lems 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 per¬centage of children with reading disorders that are iden¬tified 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.” Sci¬ence. 273 (August 1996): 867-868.
Galaburda, D. M., and B. C. Duchaine. “Developmental Disor¬ders 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 Candi¬date Gene for Developmental Dyslexia Encodes a Nuclear Tetratricopeptide Repeat Domain Protein Dynamically Regulated in Brain.” Proceedings of the National Acade¬my 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 Function¬al Status, Family Stressors, and Psychosocial Adjustment Among School-Aged Children with Disabilities in the United States.” Archives of Pediatric and Adolescent Med¬icine 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.

Paula Ford-Martin
Rebecca J. Frey, PhD

KEY TERMS
 
Dyslexia—An inability to read, write, or spell words in spite of the ability to see and recognize letters. Dyslexia is an autosomal dominant disorder thst occurs more frequently in males.

IQ—Intelligence quotient; a measure of intellectual functioning determined by performance on standardized intelligence tests.

Phonics—A system to teach reading by teaching the speech sounds associated with single letters, letter combinations, and syllables.