LEARNING DISABILITES IN

SCHOOL – GOING CHILDREN

Common Difficulties

Learning Disorder

• Difficulty in reading, writing, arithmetic

Behavioral Disorder

• Disorder of attention

• Disorder of conduct

Emotional Disorder

• Anxiety• Depressio

n

LEARNING DISORDER

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Learning Disability: Symptoms

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Difficulty learning phonetics Poor grades Poor memory Poor comprehension- not able to

understand written text Discrepancy between oral and written

language Avoidance/reluctance to study

Causes of Learning Disabilities

Heredity Problems during pregnancy and

birth: An illness or injury during or before birth

Incidents after birth: Serious illness, head injuries, poor nutrition and exposure to toxins such as lead can contribute to LD

This difficulty in not due to

Low IQ “Slow learners” (IQ 71 to 80) Mental retardation (IQ ≤ 70)

Language barrier Visual handicap (>60% disability) Hearing handicap (> 60% disability) Physical handicap (e.g. cerebral palsy) Psychiatric disorder Poor motivation/attitude difficulties

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Reading

“Late starter” compared with others of his/her age

Puts sounds in wrong order or reverses words; e.g., was/saw; slit/silt; skates/sticks

Difficulty in following line, uses finger Reads slowly, word by word, ignores full stops Confuses words which look similar; e.g.,

look/took May not recognise “easy” words

he learned long ago Leaves words out; also puts extra words in Difficulty in breaking words into syllables

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Spelling

Confuses letters that look alike, especially b/d Confuses letters that sound alike, e.g., n, m, ng Puts letters in the wrong order;

e.g., gril, frist, bersa, saduh Spelling can be bizarre, with no relation to

real wordse.g., Htit, Brail, spirn, sighnt, niegteet, xqatk, tesbogjapApe (The last example is supposed to be “This dog jumped up!”)

Mirror writing; e.g., tac, tnew. (may also reverse letters)

Writing

Holds pencil awkardly; words often don’t sit on lines

Forgets letter shapes, relative heights, positions on line

Difficulty copying from the board Punctuation - omits capitals and full-stops Difficulty getting sentences and stories

down on paper Writing “stories” is generally a slow,

painful procedure

Number Confuses signs (+, -) and

symbols (6,9 8,3)

Reverses digits,

e.g., 12 and 21

(In English) Confuses number names

which sound alike,

e.g., fifty/fifteen

Impact on affected child

Boredom and carelessness; Disinterest in school & studies Withdrawal in class; Disorganization, inattention; Sloppy or poorly done work Slow to respond to questions Learned helplessness Aggressive behavior/behavior

problems

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Impact on teacher & parents

Confusion due to lack of awareness

Lack of acceptance in parents Feel that the child can do; but

“does not want to do” Feel the child is “dumb” Blame the child Blame teachers/parents Undue pressure on child

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Identifying LD in Classrooms

Learning Disability Checklist Informal measure Meant for screening only Not enough for diagnosis While rating keep in mind if

behavior to be rated in both inappropriate to age and interfering in performance

No checklist should be regarded as a 100% reliable “measure” of dyslexia

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Indian Scenario & Educational Policies

Prevalence rate of dyslexia in India- 9.87% among Indian School Children

Since early 1990’s, National Educational Boards (ICSE & CBSE), State Governments of Maharashtra, Tamil Nadu and Karnataka provide accommodations from standard I to XII

Children identified with dyslexia and receiving exam provisions show 22% improvement in scores.

Roadmap for helping child with

LD Screen children failing in 3 or more subjects in two consecutive tests

Look for signs of SLD- apply

checklist

If child meets criteria- refer for

evaluation

If child is diagnosed to have

SLD

CBSE ExemptionsClassroom Management

Special Education

CBSE Exemptions

Exemptions from third language Extra time during examinations Option of studying one compulsory language

as against two Besides one language any four of the

following subjects can be offered: Mathematics, Science, Social Science, another language, Music, Painting, and Home Science.

Classroom Management Strategies

Make the child sit away from doors / windows and close to the teacher.

Don’t criticize or reprimand the child in front of others.

Use a lot of praise. Studies show that it takes ten positive comments to counteract one negative one

Seat the student with good role models Use peer tutors when appropriate

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Avoid making the child read in front of the class

Avoid criticisms for sloppiness or illegibility

Have students complete writing activities in small steps

Give the child extra time to complete his/her work

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BEHAVIORAL DISORDERS

Attention Deficit Hyperactivity

Disorder (ADHD) Brain dysfunction disorder Onset before 7 years More frequent in boys than girls Affects 4-6 percent of school-age children Has a genetic component Life-long; can be managed, not cured

Defining ADHD: Symptoms

Easily distracted Fidgeting and squirming in seat Talking out of turn Leaving seat in the classroom Shifting rapidly from one task to another without

completing first one Unable to play quietly Talking excessively Interrupting or intruding others Disorganized: loses books, notebooks, pencils Unaware of consequences and engages in potentially

dangerous behavior Associated problems: speech delay, problems in

sleeping

Diagnosis

IQ must be within normal / average range

Onset of symptoms must be before 6 years of age

Symptoms must be present at least in 2 settings

Causes of ADHD

Neurotransmittor dysfunction Pre-frontal cortex deficits

Not due to… Poor parenting Family problems Bad teachers / ineffective schools Too much television

Neurotransmittor dysfuntion

ADHD is thought to be caused by a neurotransmitter malfunction

Dopamine is a neurotransmitter that plays a large role in learning, memory and focus

Impact on child

Behavioral problems (not listening, answering back, disruptive behavior)

Low self-esteem Poor motivation Academic decline (50%

comorbidity of LD)

Helping a child with ADHD

Screenin

g

Assessmen

t

Managemen

t

Management

Medication Behavioral Therapy Parent Management Training Combining behavior therapy, parent

management training and behavior management in school is most effective as per research

Behavioral Treatment

Psycho-education about ADHD Structure/routines Clear rules/expectations Attending/rewards Planned ignoring Effective commands Time out/loss of privileges Point/token systems Daily school-home report card Intensive summer treatment programs

Classroom Management

Use clear communication, and give one direction at a time with eye contact

Give ample warning before you expect the child to change activities

Using novelty helps Offer love and support as the child

tries to meet expectations

Oppositional Defiant Disorder

(ODD)Recurrent pattern of behavior that is:

Negativistic Defiant Disobedient Hostile behavior toward authority figures Externalizing blame, Vindictive Temper tantrums Arguing

Conduct Disorder

Aggression against people or animals

Frequent bullying or threatening Often starts fights Used a weapon that could cause

serious injury Physical cruelty to people Physical cruelty to animals

Associations with ODD and CD

Intelligence and underachievement in school

Lack of emotional intelligence Personality factors: impulsive, callous,

unemotional Multiple problems in relationships: peers,

family, teachers, authority figures. Co-occurring Disorders: ADHD, anxiety,

depression, substance abuse.

Management

Medication for aggressive behavior

Parent management training Cognitive behavior therapy Behavior modification Learning support Management of co-morbid

conditions

EMOTIONAL DISORDERS

Emotional disorders

Children with these disorders internalize their pangs and pains which then manifest as Anxiety or Depression. Most Emotional Disorders are stress related.

Somatization, stuttering, stammering, also fall in this category

CASE STUDIES

Case Study - I

Name: Aashi Age: 6 year /FChief complaints Inability to study or sit in class. Cannot recognize alphabets Writes with mirror images Restless Doe not listen Defying instructions Hitting and throwing things at others No effect of scolding or hitting by parents

Analysis

Diagnosis: ADHD Assessment:

IQ (104) ADHD Ratings- Criteria met for

inattention & hyperactivity Pre-Academic Skills- poor verbal &

performance skills

Recommendations

Identifying data

T.C. 11 years Male 6th grade First Born Nuclear family

Presenting Complaints

Aggressive behavior Defiant Answering back Avoids studies Can not concentrate Gets up frequently while

studying Careless about belongings

presenting complaints, contd.

Does not get along with children of his age

Avoids writing Slow handwriting Not able to complete class work Forgets easily Silly mistakes Study-related lying

Assessment

• Intellectual Assessment• Full scale IQ = 94• Verbal Quotient =

104• Performance

Quotient = 82• ADHD

Assessment• No ADHD features

Attention: Impaired Perceptual-Motor

Abilities: Impaired Memory

Visual: Impaired Auditory: Impaired

Language Reading : Grade 3,

read word by word Writing: Slow, poor

spatial relations, missed letters

Comprehension : Grade 2

Spellings: Grade 3 Arithmetic: Adequate

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