Introduction to learning disabilities

Learning disability ICD-10 F80-F81 ICD-9 315.0-315.2 OMIM {{{OMIM}}} DiseasesDB {{{DiseasesDB}}} MedlinePlus {{{MedlinePlus}}} eMedicine {{{eMedicineSubj}}}/{{{eMedicineTopic}}} MeSH {{{MeshNumber}}}

In the United States, the term learning disability is used to refer to socio-biological conditions that affect a persons communicative capacities and potential to learn. The term includes conditions such as perceptual disability, brain injury, minimal brain dysfunction, autism, dyslexia, and developmental aphasia. In the United Kingdom, the term learning disability is used more generally to refer to developmental disability.

Someone with a learning disability does not necessarily have low or high intelligence, it just means this individual is working far below their ability due to a processing disorder, such as auditory processing or visual processing. Learning disabilities are usually identified by school psychologists through testing of intelligence, academics and processes of learning.

Official definitions

The term “learning disability” was apparently first used and defined by Kirk (1962, cited in Streissguth, Bookstein, Sampson, & Barr, 1993, p.144). The term referred to a discrepancy between a child’s apparent capacity to learn and his or her level of achievement. A review of the LD classifications for 49 of 50 states revealed that 28 of the states included IQ/Achievement discrepancy criteria in their LD guidelines (Ibid., citing Frankenberger & Harper, 1987). However, the National Joint Committee for Learning Disabilities (NJCLD)(1981; 1985) preferred a slightly different definition:

"Learning Disability" is a generic term that refers to a heterogeneous group of disorders manifested by significant difficulties in the acquisition and use of listening, speaking, reading, writing, reasoning or mathematical abilities. These disorders are intrinsic to the individual and presumed to be due to Central Nervous System Dysfunction. Even though a learning disability may occur concomitantly with other handicapping conditions (e.g. sensory impairment, mental retardation, social and emotional disturbance) or environmental influences (e.g. cultural differences, insufficient/inappropriate instruction, psychogenic factors) it is not the direct result of those conditions or influences.

The Individuals with Disabilities Education Act (United States) defines a learning disability this way:

. . .[a] disorder in one or more of the basic psychological processes involved in understanding or in using spoken or written language, which may manifest itself in an imperfect ability to listen, think, speak, read, write, spell, or to do mathematical calculations. . . .Learning disabilities include such conditions as perceptual disabilities, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia.

correct coding = F70 -79

Alternative definition - Resistance to Intervention

Although the discrepancy model has dominated the school system for many years, there has been substantial criticism of this approach (eg, Aaron, 1995, Flanagan and Mascolo, 2005) among researchers. One reason for this has been that diagnosing on the basis of the discrepancy does not predict the effectiveness of treatment. Low academic achievers who do not have a discrepancy with IQ (ie their IQ scores are also low) appear to benefit from treatment just as much as low academic achievers who do have a discrepancy with IQ. An alternative approach has been proposed, which is known as Resistance to Intervention (Gresham 2001). Under this model, children who are having difficulties in school are identified early - in their first or second year after starting school. They then receive additional assistance such as participating in a reading remediation program. Those few who still have trouble may then receive designation and further assistance.

Sternberg (1999) has argued that early remediation can greatly reduce the number of children meeting diagnostic criteria for learning disabilities. He has also suggested that the focus on learning disabilities and the provision of accommodations in school fails to acknowledge that people have a range of strengths and weaknesses and places undue emphasis on academics by insisting that people should be propped up in this arena and not in music or sports.

Contrast with other conditions

People with an IQ lower than 70 are usually characterised as having mental retardation (MR), mental deficiency, or cognitive impairment and are not included under most definitions of learning disabilities, because their learning difficulties are related directly to their low IQ scores. In contrast, learning disabled individuals have the potential to learn as much as other people of average intelligence, but something is preventing them from reaching that potential.

Attention-deficit hyperactivity disorder (ADHD) is often studied in connection with learning disabilities, but it is not actually included in the standard definitions of learning disabilities. It is true that a person with ADHD struggles with learning, but he can often learn adequately once he or she is successfully treated for the ADHD. A person can have ADHD but not be learning disabled or be learning disabled without having ADHD.

Types of learning disabilities

Areas of perception involved

Learning disabilities involve many areas of perception, which include:

• Visual or Auditory Discrimination
  • perceiving differences in either sights or sounds
• Visual or Auditory Closure
  • filling in missing parts of sights or sounds
• Visual or Auditory Figure-ground Discrimination
  • focusing on an object and disregarding its background
• Visual or Auditory Memory, either short-term or long-term
• Visual or Auditory Sequencing
  • putting what is seen or heard in the right order
• Auditory Association and Comprehension
  • relating what is heard to other things, including definitions of words and meanings of sentences
• Spatial Perception
  • laterality (above vs. below, between, inside vs. outside) and one's position in space
• Temporal Perception
  • processing time intervals in the range of milliseconds, critical to the development of speech processing
• Nonverbal Learning Disability
  • Processing nonverbal cues in social interactions

Terminology and classification

Various terms are used to describe particular learning disabilities. A person can have one of them or more than one of them.

• (F80.0-F80.2/315.31) Dysphasia/aphasia - Speech and language disorders
  • difficulty producing speech sounds (articulation disorder)
  • difficulty putting ideas into spoken form (expressive disorder)
  • difficulty perceiving or understanding what other people say (receptive disorder)
• (F81.0/315.02) Dyslexia - the general term for a disability in the area of reading.
  • difficulty in phonetic mapping, where sufferers have difficulty with matching various orthographic representations to specific sounds
  • Some claim that dyslexia involves a difficulty with spatial orientation, which is stereotyped in the confusion of the letters b and d, as well as other pairs. In its most severe form, b, d, p and q, all distinguished primarily by orientation in handwriting, look identical to the dyslexic. However, there is no scientific evidence that dyslexia, or other learning difficulties, are related to vision or can be alleviated with visual exercises or coloured glasses. See ^[1] for more details.
  • Some claim that dyslexia involves a difficulty with sequential ordering, such that a person can see a combination of letters but not perceive them in the correct order. However, as with spatial orientation, there is no scientific evidence that dyslexia involves a visual problem^[2].
• (F81.1/315.2) Dysgraphia - the general term for a disability in the area of physical writing. It is usually linked to problems with visual-motor integration or fine motor skills.
• (F81.2-3/315.1) Dyscalculia - the general term for a disability in the area of math.

An accepted way of referring to these people as "special" is due to their special circumstances. In modern times it is generally regarded as insensitive and rude to deride or make fun of someone for such a disability.

Possible causes

Various theories have been posited for the cause or causes of learning disabilities. They are thought to involve the brain in some fashion. The most common causes are thought to be:

• defects or errors in brain structure
• drug abuse
• poor nutrition
• passed on in parents' genes
• lack of parental involvement during early development stages in the infant
• lack of communication between various parts of the brain
• incorrect quantities of various neurotransmitters, or problems in the brain's use of these transmitters
  • common neurotransmitter problems include insufficient dopamine, improper serotonin regulation, and excessive dopamine reuptake where emitting neurons reabsorb too much dopamine after releasing them to communicate with other neurons (also implicated in depression).

Treatment

Learning disabilities may be treated with a variety of methods but are usually considered to be lifelong disorders. Some (adjustments, equipment and assistants) are designed to accommodate or help compensate for the disabilities while others (Special Education) are intended to make improvements in the weak areas. Treatments include:

• Classroom adjustments:
  • special seating assignments
  • alternative or modified assignments
  • modified testing procedures

• Special equipment:
  • electronic spellers and dictionaries
  • word processors
  • talking calculators
  • books on tape

• Classroom assistants:
  • note-takers
  • readers
  • proofreaders

• Special Education:
  • prescribed hours in a special class
  • placement in a special class
  • enrollment in a special school for learning disabled students

See also

• Special education
• Specific developmental disorder
• Landmark East School

External links

• TeachingLD
• LD Online
• Mental Health Matters: Learning Disorders
• Schwab Learning
• National Institute for Learning Disabilities
• LD Resources
• LD of children, age 8 - 12 (requires Flash)

References

1. ^  Learning Disabilities, Dyslexia, and Vision: A Subject Review A report from American Academy Of Pediatrics reporting the complete lack of evidence for a link between visual problems and learning difficulties.
2. Flanagan, D.P., & Mascolo, J.T. (2005). Pyschoeducational Assessment and Learning Disability Diagnosis. In D.P. Flanagan & P.L. Harrison (Eds). Contemporary Intellectual Assessment: Theories, Tests, and Issues. New York: The Guildford Press.
3. Aaron, P.G., (1995) Differential diagnosis of reading disabilities. School Psychology Review 24(3), 345-360.

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