Clinics and Departments
Everyone agreed Billy was ready for kindergarten. All through his preschool years, nursery school teachers, parents, relatives and friends described him as a bright, curious, and creative child. Billy had acquired a wealth of knowledge about the world around him, and was particularly interested in the workings of electronic devices. At the age of four he could disassemble a radio or watch and could reassemble it with no difficulty. He also was a mild-mannered, well-behaved child, and his parents’ expectations for his school performance were indeed very high. Their comment to family and friends was “this is a child who will thrive in school.”
However, after several months of direct instruction in readiness skills—such as learning the letters of the alphabet or learning numbers—Billy began to struggle. Sometimes he could not recall the exact names of the letters or numbers, and sometimes he could not recall the sounds the letters made. Sometimes he printed letters or numbers backward, and sometimes they were inverted. When it came to remembering actual words, he was at a loss.
At the spring parent conference, teachers voiced concerns over Billy’s academic achievement, but assured parents this was probably a matter of maturation, and he would “catch up in first grade.” As many parents would feel, Billy’s parents were concerned but did not want to “overreact.” They began to ask pertinent questions, and began to wonder whether their son was “at risk” for having learning disabilities.
What is a learning disability? Is it easy to identify?
These two questions must be asked simultaneously. There are “indicators” of potential learning disabilities. On the other hand, all children are unique, differing from one another intellectually, emotionally, socially and physically. Given this uniqueness, however, most students learn in regular classrooms and are taught successfully with traditional methods of instruction.
However, all children do not follow this pattern. Some children struggle due to specific “learning disabilities,” and require individualized instruction. These children, known as children with “learning disabilities,” may have problems in one or several of the academic areas (such as reading, arithmetic, language or spelling). Often their estimated intellectual ability differs markedly from their actual achievement. Some of these students may exhibit wide spans between the skills they excel in and those that are problem areas. Some may have only one problem area, such as reading comprehension, whereas others may have a combination of learning problems.
Therefore, to diagnose a learning disability, it is important to consider the following:
After addressing these questions, keep in mind that learning disabilities are not diagnosed in the same sense as “chickenpox.” There is no absolute or predictable set of symptoms. Parents and pre-school teachers may suspect a potential learning disability by observing of development. But children differ in their rate of development, and sometimes what seems to be a potential learning disability may simply be a delay in maturation. Not all learning problems are necessarily learning disabilities.
Proper diagnosis is crucial. Making a diagnosis is a complex task. There are “red flags” for potential learning disabilities, and research has stressed the importance of early identification of children who are “at risk” for learning disabilities. On the other hand, children develop at various rates, so parents are encouraged to “not over-react.
Risk factors to monitor
There may be a learning disability if this child:
These and other risk factors should be closely monitored during the beginning elementary years, as early identification of difficulties has significant implications for long-term outcomes.
Moving from observations to formal assessments
While children can be informally identified as being “at risk” for having learning disabilities, actual diagnosis is made using standardized tests that compare the child’s level of ability to what is considered normal development for a person of that age and intelligence.
In other words, specific criteria must be met to be diagnosed with a learning disability. The Diagnostic and Statistical Manual of Mental Disorders—Fourth Edition (DSM-IV) contains the criteria and characteristics for diagnosing learning disabilities. The manual provides specific criteria professionals use to determine whether a formal diagnosis of a learning disability can be made. For example, the diagnostic criteria from the DSM-IV identify a learning disability in the area of reading based on the following:
1. Reading achievement, as measured by individually administered standardized tests of reading accuracy or comprehension, is substantially below that expected given the person’s chronological age, measured intelligence, and age-appropriate education.
2. The disturbance in Criterion 1 significantly interferes with academic achievement or activities of daily living that require reading skills.
3. If a sensory deficit is present, the reading difficulties are in excess of those usually associated with it.
Assessments for possible learning disabilities are completed by professionals such as School Psychologists, Clinical Psychologists and/or Educational Specialists, and teachers certified in Special Education.
Federal definition of a learning disability
The federal definition of a learning disability comes into play if the need for Special Education is a possibility. This definition is more precise than the DSM-IV definition, and it is the one schools and Special Education personnel most often use. It is as follows:
Treatment for learning disabilities
It is important to get help once a learning disability has been diagnosed. In order to receive Special Education services through the public school system, specific criteria must be met to qualify for various services. As suggested previously, the following steps must be completed in order to receive Special Education services for a learning disability.
What are alternatives to special education services?
Children may obtain scores indicating they are struggling with academic skill development, but the scores are not discrepant enough for them to receive Special Education services. In these cases it is sometimes possible to qualify for other sources of support, such as Title I, Chapter I or Assurance of Mastery, which are federally funded programs for children in regular education who do not qualify for Special Education in the public schools.
In addition to these services, parents sometimes hire tutors to work with their children to strengthen skills and to provide support with work completion. This is not an optimal solution, however, as the cost of tutoring is not covered by insurance, nor is it compensated by the school.
What causes learning disabilities?
Often one of the first questions parents ask when they learn their child has a learning disability is “Why? How did this happen?” In spite of years of research, professionals have made few gains in answering this question. Recent studies suggest that learning disabilities appear to run in families and therefore, the possibility of a genetic link has been explored. In addition, with the development of Positron Emission Topography, or PET scans, it has been possible to compare brain structures of people with and without learning disabilities. In these studies, results have identified tiny differences in brain structures and functioning. This has led to further research into the physiological aspect of learning disabilities.
Other “causes” of learning disabilities are more related to factors in the environment. Problems during pregnancy or delivery, effects of tobacco, alcohol and other drug use, and toxins in the child’s environment also are contributory factors.
Can learning disabilities be outgrown?
Perhaps the best answer is to re-phrase the question, and ask, “Can learning disabilities be managed?” Can a person develop strategies to work around the disability and acquire skills needed for a successful and productive life? The answer to these questions is certainly “yes.” In fact, countless individuals across cultures with reported learning disabilities, have made enormous achievements in science, politics, athletics, and the arts. speak for themselves. It is thought that Albert Einstein, Thomas Edison, Winston Churchill, Nelson Rockefeller, George Patton, Walt Disney, Tom Cruise, and Cher have had some form of learning disability.
How to “work around” a learning disability
What interventions or accommodations help? The professionals working with individuals with learning disabilities have found that a multi-sensory, structured, systematic, and repetitious instructional approach has been most effective. There are dozens of publications based on the studies and writings of Dr. Samuel T. Orton and Psychologist Anna Gillingham. In the 1920’s the two collaborated to develop an effective approach for teaching reading and written language skills to people with learning disabilities. Today, this approach is viewed as the most effective in working with individuals with these difficulties. The purpose of the Orton-Gillingham approach and related materials is to remediate skills.
In addition to remediation of skills, however, it is necessary to make accommodations. The following are commonly used and accepted by professionals and educators:
Sources of information and support
Learning Disabilities Association of America
Library of Congress
Talking Books and Reading Disabilities, a fact sheet outlining eligibility requirements for borrowing talking books.
National Information Center for Children and Youth with Disabilities
National Institute of Mental Health
International Dyslexia Association
To arrange for special college entrance testing for LD adults, contact:
ACT Special Testing (319) 337-1332