Leading Life with Learning Disabilities

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Despite having a healthy home atmosphere, availability of competitive teachers and student friendly curriculum, if your child still has issues with learning in at least one subject, then you need to get your child assessed for the presence of a learning disability

By Wasim Kakroo

IN the wildly popular movie, Taare Zameen Par (2007), the child protagonist Ishaan Awasthi’s struggle with dyslexia is captured with precision. We may have snippets from the movie still etched in our memory even now with visual recollections of his struggle with “d” and “b” and his encounter with reading disabilities in a conventional school setup. While movies may fall short of actually capturing issues in totality, they’re often good wakeup calls for the general population which may have otherwise been in denial about certain childhood issues.

Learning disabilities is one such disorder that needs parents and society to stay vigilant and prepared to tackle it.

A learning disability is a neurological disorder that impairs the ability of the brain to send, receive, and process information. A young child with a learning disability may struggle with reading, writing, speaking, listening, comprehending mathematical concepts, and general comprehension. Dyslexia, dyspraxia (inability to read), dysgraphia (inability to write) and dyscalculia (inability to calculate) are all examples of learning disabilities. Each of these conditions can coexist with another. Learning disabilities are not caused by physical or mental disease, economic circumstance, or cultural background; the presence of such conditions also does not suggest that the child is weak or lazy.

“A specific learning disability is defined as a disorder in one or more of the underlying psychological processes involved in understanding or using spoken or written language, which may present itself as an imperfect capacity to listen, talk, read, spell, or perform mathematical calculations.”

What learning disabilities are not?

Some children are slow learners at first, but they gradually learn and can deal with the issues in their studies and other activities. Some children may not be interested in certain sorts of learning (for example, learning a new language, a specialised activity or skill, or an academic subject), or in sports or other outside activities. These characteristics reflect the child's interests and do not indicate a learning disability.

What factors contribute to learning disabilities?

According to experts, there is no single cause of learning disabilities. However, the following factors may contribute to a learning disability:

Heredity: It is noted that a child, whose parents have had a learning disability, is likely to inherit it from them.

Illness during and after birth: Learning disabilities may be caused by an illness or injury during or after birth. Other potential risk factors include drug or alcohol use by mother of such children during pregnancy, physical trauma, poor uterine growth, low birth weight, and early or prolonged labour.

Stress in infancy: A stressful event that occurs after delivery, such as a high fever, a head injury, or insufficient nourishment.

Environment: Increased contact with toxins such as lead (in paint, ceramics, toys, etc.)

Co-morbidity: Children with learning disabilities are more prone than the general population to have attention problems or disruptive behavior disorders. E.g., up to 25% of children having a reading disorder also have Attention Deficit Hyperactivity Disorder (ADHD). In contrast, it is estimated that between 15% and 30% of children diagnosed with ADHD have a learning disorder.

What are the indications of learning disabilities?

The child is supposed to learn a certain set of basic cognition and motor skills during normal physiological development. Any major delay or gap in development may indicate the presence of learning disability. Before diagnosing this mental health condition, a set of well-researched and verified assessments must be performed.

The symptoms of LD may differ slightly at each stage of childhood.

Preschool: The child may experience difficulties in some of these areas in preschool: Speaking skills at a normal age (15-18 months), when children's speech normally develops. Issue with simple word pronunciations,identifying letters and words, learning numbers, rhymes, or songs. They also struggle with keeping focus on tasks, observing rules and directions and performing physical tasks by using fine/gross motor abilities.

Primary School: At this level The child may have difficulty in connecting letters with sounds, differentiating between words that sound or rhyme similar and accurately reading, spelling, and writing. They may also have problems and confuse 25 with 52, “b” with “d,” “on” with “no,” and “s” with “5.”. They will also struggle with recognizing alphabetical letters, using the proper mathematical symbols while solving math problems and memorizing numbers or facts.The child may be slower than other children his or her age when learning new skills, remembering poems or responses and understanding the concept of time. Hand-to-eye coordination, inability to judge distance or speed, resulting in accidents are some likely fallouts of learning disabilities. Tasks involving fine motor skills such as holding a pencil, tying a shoelace, buttoning a shirt, and so on are also likely outcomes. Additionally, they may also find it difficult to keep track of personal belongings such as stationery.

Middle school: At this level, the child may struggle with spelling similar words (e.g., sea/see, week/weak), use of prefixes and suffixes. The child may also avoid tasks involving reading aloud, writing activities, and math word problems. With respect to writing and handwriting a  child may hold the pencil tightly. They will also struggle with memorizing or recalling information and interpreting body language and facial expressions.

High school: At this stage, a child may struggle with correctly spelling words. For instance, in a single writing assignment, the child may write the same word with different spellings. They will also have difficulty reading, writing assignments, summarizing, paraphrasing, and responding to application questions in tests and will often have memory lapses. It is often also difficult for them to get used to unfamiliar surroundings and comprehending abstract ideas. The child may also struggle to concentrate on some tasks while being hyperfocused on some other tasks.

While children with learning disabilities may struggle in some areas of learning, they often possess exceptional ability, skill, and talent in some other areas such as sketching, drawing, poem writing etc. We often concentrate on the issue and overlook the child's strengths or abilities. Parents and instructors must help children to recognize this latent potential in their children and encourage them to pursue it so that they have a solid foundation for their sense of self esteem and self worth.

How can we know if a child has a learning disability?

Finding out if a child has a learning handicap is a complex task. The first step is to rule out any vision, hearing, or developmental problems that could mask a learning disability. Following the completion of these tests, a learning disability is diagnosed utilising psycho educational assessment, which involves academic success testing as well as an assessment of intellectual quotient (IQ). This test determines whether there is a large gap between a child's potential and IQ and academic attainment (school performance).

Can undetected and untreated learning disability lead to abuse and bullying experiences at home and/or at school?

Students with LD are at risk of poor academic performance and failure due to their academic deficits and thus such children are very vulnerable to physical and emotional abuse by parents as well by teachers at school. They are also more likely to be bullied by their peers. Bullying can have both distinct and additive impacts, significantly increasing such children’s likelihood of developing social and emotional issues.

What interventions are available for people with learning disabilities?

A learning disability is incurable. Children with learning difficulties, however, can be successful in school if they receive timely intervention and assistance. Parents and teachers are often the first to discover that the child is struggling to read, write, or learn. If you suspect your child has a learning disability, get assistance from a mental health professional or other qualified specialists for the necessary intervention programme or therapy.

Early diagnosis can help the child to get the treatment or therapy he or she needs and benefit from it. Neglecting the condition may have an impact on the child's ability to cope with it and may impact their sense of self esteem and self confidence and they may remain behind in their studies despite having potential to excel.

If your child has a learning disability, they may benefit from:

  • Additional assistance: A reading expert or another trained professional can teach your child ways to help him or her enhance his or her academic skills. Tutors can also educate such a child study and organizational skills.
  • Individualized Education Program (IEP): Your child's school or a special educator may create an IEP that explains how he or she can learn best in school.
  • Psychotherapy: Some children may benefit from psychotherapy, depending on the type of learning disorder they have. Speech therapy, for example, can benefit children with language disabilities. Occupational therapy can assist a child to improve his or her motor skills which may lead to resolution of writing problems.
  • Alternative therapy: Alternative therapies such as music, art, and dance, have been found to help children with learning disabilities.

What specialists should you consult for the treatment of learning disabilities?

A team of mental health specialists conducts a battery of tests to determine if your child has LD. The specialists listed below may collaborate to assist identify and treat a child's LD.

  • Clinical Psychologist: Ideally, a psychologist with an expertise in education or an experience of working in a child and adolescent mental health facility. To evaluate whether the child's intellectual functioning is normal, the Clinical Psychologist administers particular intelligence tests (such as the Malin's Intelligence Scale for Indian Children (MISIC) test). This helps to rule out borderline cognitive functioning and mild mental retardation, both of which may impact academic achievement. They may also formulate a psychotherapeutic plan to address self esteem and self confidence issues as well as comorbid conditions such as anxiety, depression etc.
  • Special educator: This mental health professional assesses the child's academic achievement by administering standard educational tests (Wide Range Achievement Test, Peabody Individual Achievement Test, Woodcock-Johnson Tests of Achievement, Schonnel Attainment Test, Curriculum Based Test) to assess performance in areas such as reading, spelling, written language, and mathematics. If a child's academic achievement is two years behind his or her actual school grade or chronological age, it may indicate the presence of a specific learning disability. They use Individualized Education Program (IEP) through which they develop strategies about how he or she can learn best in school.
  • Counselors: They assist in understanding behaviour and checking for any behavioural issues as well as any problems that may arise due to a poor home or school environment, or any emotional problems that may be the cause of the child's poor academic performance.
  • Pediatrician/Pediatric Neurologist: The Paediatrician should inquire about the child's academic achievement and advise parents to get their child's psycho-educational assessment done, if they suspect a learning disability in then child. The paediatrician may also advise the parents and teacher on the importance of remedial education. A paediatric neurologist takes a full clinical history and performs a an in-depth physical examination to rule out medical conditions such as hypothyroidism and chronic lead poisoning, as well as neurological problems such as cerebral palsy, Wilson's disease, and ADHD.
  • Child Psychiatrist: Checks whether there are symptoms of ADHD, which can coexist with any form of learning disability. The psychiatrist also looks for other mental health conditions such as anxiety, depression that could be causing low academic performance.

In conclusion, learning disability needs to be understood as a serious mental health issue that affects child and adolescent population and can cause severe deficits in the academic, social and emotional abilities of an affected child. Educationists, mental health professionals as well as policy makers need to join their hands to develop effective strategies to help such children realize their true potential so that they are able to live a respectful and successful life.

The author is a licensed clinical psychologist (alumni of Govt. Medical College Srinagar) and is currently working as a child and adolescent mental health therapist at Child Guidance and Well-Being Centre at Institute of Mental Health And Neurosciences-Kashmir (IMHANS). Author can be reached at [email protected]

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