How common are Learning Disabilities?
Learning concerns are one the most common neurological issues that children and adolescents present with. It has been estimated that approximately 20% of the general population in the prevalence rates indicate that 6% of the general population meet the necessary diagnostic criteria for a diagnosis of a specific learning disorder.
How are Learning Disabilities Defined?
There is great debate regarding how to accurate define, classify, and diagnosis learning disorders. Traditionally, it was assumed that a specific learning disorder exists when there is a significant discrepancy between a child’s ability (IQ, cognitive functioning) and achievement (performance on standardized reading, mathematics, and written expression tasks). However, there have been recent changes within the USA regarding how to classify and diagnosis learning disabilities. Currently, categorization of a child’s learning disability is based upon a multi-tiered process involving early identification and intervention. This multi-tiered process based approach is labeled Response to Intervention (RTI).
What are the Pros and Cons of RTI?
Researchers who are in favor of the RTI Model of learning disabilities argue that a combination of interviewing and behavioral observations are sufficient for identification of problems as well as to determine appropriate interventions. The RTI Model is most beneficial for children who have emotional or behavioral disorders that result secondary from a defined environmental factor, such as: inappropriate or inconsistent reinforcement or punishment.
Individuals who are against the RTI Model argue that the screening measures to be used to diagnosis learning disabilities are not defined or explained. Additionally, many researchers state that identification of actual learning disabilities may not occur for some children until they have failed. Teachers and academic staff who follow the RTI Model strictly may lead to a denial of services for some children who are at risk for a learning disorder.
What is the Difference Between and IEP and a 504 Plan?
An Individual Education Plan (IEP) is a document that is based upon federal legislation, “Individual with Disabilities Education Act (IDEA).” IDEA provides specific federal guidelines for the diagnosis of a specific learning disability, as well as criteria for establishing special education programming. Children with an IEP have a documented medical or psychological condition which leads to significant impairment within the school setting. These children require specific, out of the classroom intervention and services (such as working with a learning resource teacher, occupational therapy, speech/language therapy, or social work support).
A 504 Plan is based upon Section 504 of the Rehabilitation Act of 1973. Essentially, a 504 Plan offers minimal classroom accommodations and interventions that help a child perform to ability. Children with 504 Plans usually do not receive out of classroom support and services. These children typically are offered a variety of accommodations and interventions within the classroom that are designed and implemented based upon their specific concerns.
The important thing about both the IEP and the 504 Plan is that it is individually based. The child’s academic team, parents, and outside representatives work collaboratively as a team in order to define what specific accommodations a child needs as well as how to implement the accommodations in the least restrictive environment possible.
What are the Different Learning Disabilities that Child May be Diagnosed With?
The Diagnostic Statistical Manual, Fourth Edition, Text Revised (DSM-IV-TR), which is the guidebook that psychologists, psychiatrists, and other mental health professionals use to identify and diagnosis a variety of conditions (from learning disabilities, ADHD, to pathological gambling)., reveals four possible learning disabilities a child may be diagnosed with (Reading Disorder, Mathematics Disorder, Disorder of Written Expression, and a Learning Disorder Not Otherwise Specified).
What is a Reading Disorder?
Reading Disorders are the most common form of learning disorders in children in the United States. It has been estimated that anywhere between 5-15% of the general population meet necessary criteria for a diagnosis of a Reading Disorder. There is strong evidence that Reading Disorders are substantially more common in boys than girls.
There are four components associated with a child’s reading ability: phonological processing/awareness, word identification, reading fluency, and reading comprehension. Phonological processing and awareness is the child’s ability to decode, combine, and break apart basic sound units. Children with primary phonological processing deficits are often unable to combine sound units (pen –cil makes pencil) or break apart words based upon sounds (say tiger without the ‘g’ sound). Word identification is the child’s ability to sight read a list of words. Children with adequate vocabulary base and a good phonological processing ability should be readily able to read a list of words. Reading fluency is the ability to read at a rapid and accurate rate. Children who have difficulty with their reading fluency often read at a pace that is much slower than expected of them or would often read at a rapid rate; however, make many errors with reading (either misreading words or adding words). Comprehension is the child’s ability to answer literal and inferential questions about what he or she read.
What is a Mathematics Disorder?
This is not an easy question to answer. Mathematics is much more than adding and subtracting. Instead, there are several factors that makeup a child’s mathematics achievement. It is important to recognize how mathematics skills develop in children. There exists a hierarchical manner. The first stage is observed in young children and consists of skills such as understanding of one-to-one correspondence, classification, seriation, and conservation. Once these skills are established, children are able to learn addition, subtraction, multiplication, and division. Next, advanced skills such as algebra and geometry are taught as children enter adolescence; when mastery of higher order reasoning capacities has occurred.
When a child is identified as having a Mathematics Disorder, one or more of the following skill areas are likely the primary factors to address: visualspatial skills, linguistic abilities, and working memory. Visualspatial skills are necessary for aligning numerals in columns for calculation problems, understanding the base ten system, interpreting maps, and understanding geometry. Linguistic abilities are needed when performing word problems, following procedures of how to carry out operations, understanding math syntax, knowledge of math facts, and relationships between numbers. Working memory capabilities are used for the active manipulation of numbers and their operations.
What is a Disorder of Written Expression?
It has often been thought that gaining proficiency in written expression skills is the culmination of a child’s education. The ability to express oneself in written form is required for academic progress. Despite the fact that written expression is the most difficult academic skill to master, it is the least researched of all the learning disorders.
Written language involves several cognitive processes, including the ability to spell and write words, formulate and express ideas into a combination of sentences and paragraphs, evaluate and edit the finished product, and use ones words as a way of communicating meaning and connecting ideas. A Disorder of Written Expression can manifest itself as a result of impairment with any of the above skills.
Can a Child Have More than One Learning Disorder?
Yes, it is quite common for a child to simultaneously experience multiple learning disorders. We often see children with reading disorders struggle with their mathematics achievement and with their written expression.
What is the Role of a Neuropsychologist in Diagnosing Learning Disorders?
A neuropsychological evaluation can offer informative data and information regarding a child’s specific problems; in addition to the pattern of strengths, which can aid and guide the development of an effective, empirically based intervention plan. A comprehensive neuropsychological evaluation can help provide information about underlying causes of the problems at hand. As described above, reading, mathematics, and written expression are more comprised of much more than the academic skills. An evaluation needs to provide information not only about the child’s cognitive ability and academic achievement, but also about a variety of other factors that impact the day-to-day achievement (working memory, visualspatial skills, language processing, attention, executive functioning)
In addition, the evaluation should provide information about the child’s social and emotional functioning which can lead to impairment within the academic setting.In addition, it is quite common for a child with a learning disorder to experience co-existing psychological and neurodevelopmental concerns including: Attention Deficit Hyperactivity Disorder, Tourettes Disorder, Oppositional Defiant Disorder, Anxiety, and Depression.