Dealing with LDs: Does your child have a Learning Disability?
This is the first of a series of four articles on children with Learning Disabilities
By Dr Meghna Singhal
Rukmini, an otherwise cheerful 5th grader, dreaded going to school. She particularly hated the English class, where sometimes the teacher would ask students to take turns to read aloud from the textbook. When Rukmini read aloud she stumbled and made mistakes. She felt anxious. Her heart would pound.
In order to make it easier for herself, Rukmini would count the students ahead of her and figure out which paragraph she would have to read. Then she’d try and memorise it. She always hoped for a short paragraph. Sometimes she’d even plan toilet breaks so she could avoid her turn altogether.
Rukmini’s parents had no idea what she was going through. It wasn’t until she reached 11th grade that was she diagnosed as having dyslexia, a type of learning disability.
What is a Learning Disability?
Learning disability (LD) or Specific Learning Disability (SLD) is a disorder that interferes with a child’s ability to read, write, listen, think, spell, speak, or do mathematical calculations. Thus, LD refers to ongoing problems in three areas: reading, writing, and math, which are the foundations of learning.
LD is fairly common, with research reports indicating that up to 19% of school-going children in India suffer from it.
LD is frequently taken to mean dyslexia, but dyslexia is only one type of LD. Learning Disability is an umbrella term that is used to describe many different types of learning disorders. Three of the most common LDs are:
A specific disability in reading is called dyslexia. This includes difficulty in noticing, thinking about, and working with individual sounds in words, difficulty in detecting and discriminating among different speech sounds (e.g., the sound of ‘d’ could sound like ‘g’) and difficulties with the rate of reading, rhyming, spelling, vocabulary, and comprehension.
Dyslexia is the most prevalent and well-recognised of the subtypes of LD, accounting for an estimated 80% of the cases of LD. The popular Bollywood movie Taare Zameen Par showcases the struggles of a child with dyslexia.
A specific learning disability in math is called dyscalculia. This includes difficulties with counting, learning number facts and doing math calculations, difficulties with measurement, telling time, counting money and estimating number quantities, and trouble with mental math and problem-solving strategies.
A specific learning disability in writing is called dysgraphia. This includes both the physical act of writing and the quality of written expression. It is expressed through a tight, awkward pencil grip and body position, tiring quickly while writing, trouble forming letter shapes, and inconsistent spacing between letters or words. It could also include trouble organising thoughts on paper, trouble keeping track of thoughts already written, and difficulty with grammar.
A child may have one or a combination of these learning disabilities. SLD can also vary in severity:
- Mild: Indicates some difficulties in learning in one or two academic areas, and can be compensated with adequate support
- Moderate: Indicates significant difficulties with learning, requiring special education and accommodation
- Severe: Indicates severe difficulties in learning, impacting most academic areas, and requiring intensive specialised instruction
LD terminology decoded
The terms ‘learning disorders’, ‘learning disability’, ‘learning difficulty’ and ‘slow learner’ are often used interchangeably but differ in many ways.
- Learning Disorder is a medical term and is used by mental health professionals the world over.
- Learning Disability is a legal term that is mentioned in the Right of Persons with Disabilities Act (RPWD Act), which was enforced by the Government of India in 2016.
- Learning Difficulty is a term used to refer to those children who underachieve academically for a variety of reasons, such as behavioural, psychological and emotional issues, English being their second language but the medium of instruction in school, ineffective instruction, high absenteeism or inadequate curricula. These children have the potential to achieve age-appropriate levels once they are provided support.
- Slow Learner is a term used to refer to those children whose intellectual abilities are below average but who are capable of achieving a moderate degree of academic success. Slow learning is not to be confused with ‘mental retardation’.
Causes of Learning Disabilities in Children
A number of possible risk factors for LDs have been identified in research:
- Genetic: LDs tend to run in families. Children who have a parent with an LD are more likely to develop an LD themselves.
- Biological: LDs arise from neurological differences in brain structure and function, which affect the brain’s ability to receive and process information.
- Pre- or peri-natal: Factors that affect a developing foetus in the womb, such as alcohol or drug use, maternal malnutrition, or significant maternal illness or injury can put a child at higher risk for an LD. Lack of oxygen to the brain during birth, premature or prolonged labour, and low birth weight have also been associated with LD.
- Environmental: There is a high incidence of LDs among people living in poverty, perhaps due to poor nutrition and ingested and environmental toxins (such as lead, tobacco, and alcohol) during early and critical stages of development. LDs are not caused by intellectual disabilities, emotional disturbance, inadequate instruction, or limited English proficiency.
Learning Disabilities do not become evident till the child starts formal schooling, because that’s when challenges with reading or writing or doing mathematical calculations become apparent. However, many individuals do not receive a diagnosis until late adolescence (when they reach high school or pre-university college) or until adulthood (when they join the workforce). Others with LD may never receive an evaluation and go through life never knowing why they have difficulties in academics, or why they have problems in their jobs or relationships.
There are many factors that hinder the detection of LD, some of which include lack of awareness, dearth of trained teachers in school, myths regarding LD, and confusion with other conditions, most notably learning difficulty and slow learning.
Research shows that the earlier an LD is diagnosed and the child given appropriate help, the more successful the outcome.
Signs of Learning Disabilities in children
Following are among the symptoms of LD but it’s important to remember that no one will have all these symptoms:
- Easily confused by instructions
- Poor performance on written tests
- Reversals in writing and reading
- Poor visual-motor coordination
- Difficulty copying accurately from a model
- Slowness in completing work
- Poor organisational skills
- Difficulty with abstract reasoning and/or problem solving
- Difficulty discriminating size, shape, colour
- Difficulty with temporal (time) concepts
- Difficulty remembering information and instructions
- Impulsive behaviour; lack of reflective thought prior to action
- Low tolerance for frustration
- Lags in developmental milestones (e.g. motor, language)
- Poor adjustment to environmental changes
- Overly distracted; difficulty concentrating
- Difficulty making decisions
- Lack of hand preference or mixed dominance
- Difficulty with tasks requiring sequencing
Learning Disability Diagnosis
Diagnosis of LD can only be made by a mental health professional, such as a clinical psychologist, child psychiatrist, occupational therapist or paediatric neuropsychologist. The diagnosis is made through a combination of interviews, tests, observations, family history and school reports. It includes intelligence testing, academic skill level testing, LD testing and evaluation of classroom performance.
After the evaluation is completed by the professional, the following are specified in the assessment report:
- The specific nature of the child’s LD
- The unique profile of her strengths and weaknesses
- A detailed plan for intervention and remediation of the problems
- The assessor’s opinion on whether the child is eligible for special education
Does your child have LD?
1. Has your child been having difficulties in one of the following areas for at least six months?
- Difficulty reading/ understanding the meaning of what is being read
- Difficulty with spellings
- Difficulty writing/problems with grammar, punctuation or organisation
- Difficulty understanding number concepts, number facts or calculation
- Difficulty with mathematical concepts
2. Are your child’s academic skills significantly lower than what is expected for her age?
3. Does your child’s difficulties in learning cause problems in her school, work, or everyday activities?
If you have answered a definite ‘yes’ to all the questions above, it is a good idea to get your child evaluated by a mental health professional, such as a clinical psychologist.
Busting common myths about LD
Related issues in LD
Living with an LD is not easy. LDs impact not just learning and school work, but every important aspect of the affected person’s life, including work, family, relationships, and even the sense of self.
1. Problems with self
- Low self-esteem: An all-too-common companion of LDs, low self-esteem could show itself in the child putting herself down, thinking that she is stupid, and not even trying.
- Attitude toward failure: Failure is a constant theme in the life of a child with an LD through no fault of his own. When failure becomes recurrent, children with LDs are much more likely to give up trying at school. They begin to assume that no matter how hard they try, failure will be the outcome.
2. Problems with social relationships
- Social relationships: Children with LDs often struggle with social acceptance among their peers. Some may even be bullied by their classmates. Sometimes, they may even bully others to relieve themselves of their inner turmoil.
- Social interactions: A child with an LD may have difficulty comprehending new information or situations, organising the information to give the desired response, and retrieving the language to express that response.
“Children with LDs often end up wondering whether they are intelligent because their intelligence does not reflect in their academic functioning. This can contribute to their feeling low about themselves, which is expressed differently by different children. Some children may withdraw and be unable to take any initiative, some may be extra sensitive to feedback, and others may be intrusive in wanting to show their competence. These patterns also strain their interactions with teachers, peers, and family.”
Dr. Nithya Poornima, Assistant Professor of Clinical Child Psychology, NIMHANS (Bangalore)
3. Problems with behaviour
- Hyperactivity: Attention-deficit/hyperactive disorder (ADHD) is a developmental disorder that often co-occurs with LDs.
- Acting up: Sometimes children would rather be the ‘bad’ rather than the ‘dumb’ kid. So they act up or misbehave to get attention away from their academic struggles, or display an ‘I don’t care’ attitude as a way of saving face.
Barriers to success in LD
1. Being Made to Repeat a Grade
Children with LD don’t often receive early or effective interventions. A third of students with LDs have been held back a year, which increases the risk of their dropping out of school.
2. Coming Under Strict School Discipline
Students with LDs are twice as likely to be suspended as those without LDs, and the loss of instructional time increases the risk of failure and aversion to school.
3. The Tendency To Drop Out
Students with LDs drop out of Grade 12 (or high school) at nearly three times the rate of all students. The top reason students with LDs drop out? As much as 57% cited disliking school or having poor relationships with teachers or peers.
4. Brushes with the Law
Unaddressed learning issues lead to conditions that push students into the school-to-prison pipeline. A wide-ranging study found that half of young adults with LDs had been involved at some point with the justice system.
In a Nutshell
- Learning Disability (LD) is a disorder that interferes with a child’s ability to read, write, listen, think, spell, speak or do mathematical calculations. It also impacts organisation, focus, social skills and motor skills
- Many causes for LD have been identified, including genetic, biological, pre- or peri-natal, and environmental issues
- LDs do not become evident till the child starts formal schooling
- LDs impact not just learning and school work, but every important aspect of the person’s life, including work, family, relationships, and even the sense of self
- Children with LDs need to be identified early, diagnosed accurately, provided appropriate assistive technologies, and given the right targeted interventions to help them become the best learners they can be
What you can do right away…
- If you suspect that your child has a learning disability, take him to a qualified mental health professional such as a clinical psychologist for a thorough assessment
- Don’t stigmatise your child if she has learning difficulties. Don’t blame her; it’s not her fault. Instead, look for ways to support her learning
Read the next article in this series ‘Accepting that your child has a Learning Disability’.
About the Expert
Written by Meghna Singhal, PhD, on 8 July 2019.
Dr. Singhal is a clinical psychologist with a doctorate degree from NIMHANS (Bangalore) and holds a post-doctorate in parenting from the University of Queensland (Australia). She is Head of the Content Solutions Zone at ParentCircle.
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