Some History About Learning Disabilities
- The first written case about an LD child was in 1896, 14 yr old boy “bright and intelligent… quick at games and in no way inferior to others of his age [except for] his inability to learn to read”
- The phrase “learning disability” was coined here in Chicago in 1963 by Kirk
Old Ideas About Learning Disability
Children with Learning Disabilities used to be diagnosed with “minimal brain dysfunction.” Testing could indicate that children showed some neurological difficulties, but they varied from child to child in unpredictable ways. Differences in the sizes of the two halves of the brain, in the patterns of blood flow to the brain, and in the nerve impulses to the brain were often seen. Sometimes children were diagnosed as having “Perceptual Deficits”. However, efforts to increase hand-eye coordination and visual scanning skills did not work.
Newer Ideas About Learning Disability
The term Learning Disability actually was coined in 1963 here in Chicago by Dr. Samuel Kirk. He was a psychologist who had worked extensively with parents of children who had “minimal brain dysfunction,” or “strephosymbolia” (they reversed and made other errors in their letters). He suggested to parents that they should throw out these unwieldy terms and start referring to their children as having a Learning Disability. This term was very useful for a number of reasons:
- It focused attention on the language, reading, and processing of information, and caused people to think about learning disabilities in new ways.
- It implied that special education techniques were really needed.
- It moved Learning Disabilities out of the exclusive domain of neurology and medicine, and made it a term parents, teachers, and educators could understand.
Rates of LD have varied across the years:
- In 1973, it was estimated that 1-3% of children had an LD.
- In 1994, it was estimated that 4-5% were LD, and 60% of those children had a reading disability.
- Today, Geary and colleagues report that 7% (actually 4% to 14%, depending on the study) of children have a learning disability in mathematics, and another 10% have some generalized (verbal or nonverbal) learning disability (Geary, Hoard, Nugent, and Bailey, 2011).
For children, Learning Disabilities today are seen as an information processing problem.
- They have difficulty processing the basic units of symbols (letters and numbers), sound, syllables, and words. That means some difficulties encoding or learning them (such as remembering the sound that a certain letter makes), recalling or remembering them (such as recalling multiplication tables incorrectly), and producing them (such as in writing numbers and letters in the orientation and order the belong).
- Some studies have shown that LD children fail to pick up on social and implicit cues that other children notice, which impairs their ability to “pick up” what’s happening in social settings as quickly as do other children (Jiménez-Fernández, Vaquero, Jiménez, and Defior, 2011).
- LDs can also result in greater frustration, more experiences of failure, and a lower chance of graduating high school. LDs are associated with clinical anxiety and depression as a result (Willcutt, Boada, Riddle, Chhabildas, and DeFries, 2011).
- LDs are also very correlated with Attention Deficit-Hyperactivity Disorder (Willcutt, Boada, Riddle, Chhabildas, and DeFries, 2011). In fact, one study showed that among 5 to 7 year old children, those scoring the highest on a measure of hyperactivity had reading scores that were 40% lower than those children scoring the lowest (McGee, Prior, Williams, Smart, and Sanson, 2002).
- There is also some evidence that reading disabilities in particular may have a genetic cause (Lim, Ho, Chou, and Waye, 2011).
We may be overdiagnosing LD, but it is also possible that we are simply more aware of it when we see it, better able to test and assess for it, and have better attitudes toward it, so that parents of LD children and the children themselves no longer have to try and hide it.
Definitions of LD
- Definition of the National Advisory Committee of Handicapped Children, headed by S. A. Kirk (1968):
“Children with special learning disabilities exhibit a disorder in one or more of the basic psychological processes involved in understanding or in using spoken or written language. These may be manifested in disorders of listening, thinking, talking, reading, writing, spelling, or arithmetic. They include conditions which have been referred to as perceptual handicaps, brain injury, minimal brain dysfunction, dyslexia, developmental aphasia, etc… they do not include learning problems which are due primarily to visual, hearing, or motor handicaps, to mental retardation, emotional disturbance or to environmental deprivation.”
- Definition of the National Joint Committee on Learning Disabilities (1989):
“Learning disabilities 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, presumed to be due to central nervous system dysfunction, and may occur across the life span. Problems in self-regulatory behaviors, social perception, and social interaction may exist with learning disabilities but do not by themselves constitute a learning disability. Although a learning disability may occur concomitantly with other handicapping conditions (for example, sensory impairment, mental retardation, serious emotional disturbance) or with extrinsic factors (such as cultural differences, insufficient or inappropriate instruction), they are not the result of those conditions or influences.”
- Definition of the U.S. Office of Special Education Programs (2002)
“The central concept of SLD (Specific Learning Disability) involves disorders of learning and cognition that are intrinsic to the individual. SLD are specific in the sense that these disorders each significantly affect a relatively narrow range of academic and performance outcomes. SLD may occur in combination with other disabling conditions, but they are not due primarily to other conditions, such as mental retardation, behavioral disturbance, lack of opportunities to learn, or primary sensory deficits.”
As you can see, the definitions have changed over time but aren’t all that different. Typically, several factors are required to diagnose an LD:
- The child must have average intelligence or better, and achievement scores that are significantly (generally one standard deviation) lower. In some states, specific tests must be given because the laws regarding funding for educational services requires them.
- This is a debated point, however, as IQ and achievement test scores are not independent. Sternberg points out that the using this discrepancy is pointless, as the required difference varies from one state and county to another. He reports that in Connecticut, LD rates ranged from 7.2% of children in one district to 16.2% in another. Both were higher SES districts, and all that varied was the definition of LD. In the lower SES districts, rates range from 12.9% to 23.8%, again largely due to definitions of LD. As a result, the Office of Special Education Programs recommends testing several methods for instructing LD children and assessing how well the child responds to these methods as part of the diagnostic process (think about a medical doctor confirming the diagnosis of an infection after seeing that antibiotics cured the problem).
- Interviewing with the parent(s) and teacher(s) is also very important. There are parenting questionnaires (see for example the Colorado Learning Difficulties Questionnaire by Willcutt et al, 2011) which ask the parent to report what they have observed in their child’s learning in five areas (reading, math, social cognition, social anxiety, and spatial difficulties). Understanding the child’s learning in more than one setting is important.
- Last, ruling out issues such as visual problems that could be corrected with glasses, auditory problems that could be corrected with hearing aids, and any medical issues (for example, asthma medication can cause a child to appear hyperactive) that could complicate a child’s learning.
It’s worth noting that Sternberg strongly disagrees with such definitions. He offers that we assume an LD is an “internal” condition, when the reality is that it is socially constructed. He points out that there were no reading disabilities in preliterate societies, but any of us could show “hunting disabilities” which would make us disabled in those societies. Likewise, different languages use different ways of communicating – tones, words, gestures – with different kinds of irregularities – letters with multiple sounds, verbs that are conjugated in illogical ways – and so a child lacking in some skilled might be seriously disadvantaged in one place and not at all in another.
What Makes Learning So Hard?
Think about the process of reading. The smallest unit of speech sound we process is called a phoneme. The word “TALE” has three phonemes; T A and L, so three sounds. Reading the word “tale” requires two steps, and then four more:
- Breaking up the word into syllables
- Breaking up syllables into letters
- Previously learning the possible sounds that each of the letters makes and storing that information in memory
- Being able to on-the-spot pull the sound from memory that goes with the presented letter and store it in the brain’s “work space”
- Rapidly reprocess, or make the links between letters and sound quickly and holding them in memory long enough to put them back together into a word
- Keep in mind that the correct sound for the A could be long A as in TABLE or a short A as in TALENT, or the altered A as in TALL. When you think about it, not knowing how the A is supposed to sound until you get to the end of the word makes it more difficult, as it means you have to go through several possibilities:
- TALE with a long A and E (rhymes with “Hailey”)
- TALE with a short A and silent E (rhymes with “Hal”)
- TALE with a long A and no sound from the E (the correct one).
This also means there are three areas of phonemic processing that could be flawed too:
- phoneme awareness (knowing the letters and sounds)
- phoneme memory (accessing the sound and letter pairings)
- speed of phoneme access (doing all this work quickly)
This is a lot of work to be doing on-the-spot, especially if those around you do it faster and without even thinking about it.
Individual Education Program (IEP)
IDEA stands for Individuals with Disabilities Education Act. Children, teens, and young adults 3-21 are entitled by Federal law to special educational considerations as needed. This is determined through an Individualized Education Program or IEP. It is a special plan for that child which takes into account their own unique strengths, weaknesses, and educational needs. Section 614(d) of IDEA defines “Individualized Education Program” as “a written statement for each child with a disability that is developed, reviewed, and revised in accordance with this section” which includes the following:
- present levels of education performance (current test results)
- annual goals (benchmarks or short objectives addressing where they need improvement and what they can reasonably be expected to achieve in the next year)
- special education and related services needed (specified in writing as to where, when, how much, and how long they last, ranging from regular classroom placement, additional tutoring or resource room time, special class placement, special school placement, or institutional placement)
- explanation of non-participation in regular classes (least restrictive environment)
- participation of the child and the parent too in the IEP meeting
- transition services (at age 14 the child should be slated for vocational or college track)
- clear measurement of progress and report regularly to the parents
How Can You Spot An LD?
LD children do not show the behavioral and adjustment extremes that Emotionally Disturbed children do, and likely learn more and improve after educational interventions.
Classroom – Watch for the following:
- Difficulty reading –breaking down and reassembling words, correctly assigning sound to the letter, find reading tiring
- Writing –reversals, substitutions, or inability to spell or check spelling
- Speaking –word finding difficulty, close substitutions
- Motor problems –clumsiness, awkward pencil grip, and poor fine motor coordination
- Math problems –calculating problems, mistaking math signs, and severe problems memorizing times tables
- Speed of responding –slower to answer questions, less likely to give complete answers
Home – Watch for
- Memory problems –recalling, organizing, understanding implications of facts, forgets or loses things
- Time problems –telling time, underestimates how long it will take to do something, how long since or until something
- Social problems –impulsiveness, seems immature for age, difficulty adapting to change, can’t “read” friends and explain their emotional reactions, harder time reading body language, breaks into conversations, asks fewer questions and the ones they ask are more closed-ended, less interesting to peers, loose focus of topic more, less monitoring of others’ understanding of them, less flexibility in the developmental levels of their speech, more likely to read in aggression, less persuasive, but able to behave as other children would if cued to the expected behavior
- self-esteem issues –anxiety when asked to perform, low self-efficacy, classic internal/global/stable attributions for failure (like “I’m stupid”), external/specific/unstable attributions for success (like “the Teacher likes me”) which often leads to a more passive and less assertive style
- problem-solving –less competent solutions (despite understanding more competent ones), less information used to form them, greater inaccurate expectations of success, jump to task before realizing instructions are incomplete
Interventions for LD children
This is a complex area that has been full of false starts and revolutionary interventions that failed miserably. Social deficits are of course sometimes present, sometimes not, sometimes pervasive, sometimes not. Supportive parents, teachers, and mentors can make a big difference for children. Teens can benefit from strategies and metacognitive approaches to help them organize their work and studying, play to their strengths, and specific ways to overcome weaknesses. Integrative learning strategies help learning, as well as self-regulation and control. Adults are more difficult to help. They tend to have found many ways to overcome their weaknesses often, and so finding them is sometimes hard. Of course, others are not successful and have many problems, meaning that their LD may be in plain sight but you don’t see it because they are depressed, unemployed now (and Wong notes that some studies show LD adults are more likely to be “let go” during an economic recession or company financial cuts), and their spouse is mad at them.
Below are some examples of accommodations for students, but they can be applied to work settings for adults in many ways:
- Timing/Scheduling Accommodations
multiple testing sessions with breaks, extra time on or untimed tests
- Setting Accommodations
small groups study, individual tutoring, seated in front of class, with things like extra lighting, magnifiers, laptops, or tape records as needed
- Presentation Accommodations
large print texts and tests, verbal and written instructions, check for student comprehension, reminder prompts, underlining and highlighting to stress key points of questions, practice tests, examiner notes, additional spacing between test items, bigger answer bubbles, cues (e.g., arrows and stop signs) provided on answer form, and quiet and non-distracting place to test, bigger illustrations for tests, graph paper or colored pencils as needed
- Response Accommodations
test booklets, computerized tests, larger lined or more paper, big pencils, dictation, use of things like an abacus or dictionary, typewriter, grammar and spell checking by another student, review of notes by another student
Research on Success
The research is also pretty clear on outcomes for LD children. LD children who were successful showed four qualities in their families:
- Their parents were educated and encouraged learning in the children
- Their parents advocated for the children, and demanded special assessment and tutoring for their children
- Their parents got private tutoring for the children
- Their parents had “connections” and were able to help them obtain employment
Put this way, some of what parents do for their successful LD children has nothing to do with education, and more to do with advocating for the child.
Successful LD children also show several other characteristics:
- They had a positive temperament, a good outlook on life
- They had talents and skills in non-academic areas and used them and enjoyed them
- They had stable homes and effective parents who helped them grow and mature like their peers
- They had a mentor, someone other than the parents, who encouraged them to assume that they could be successful and pushed them to be their best.
Previous research has shown children with LD were more likely to report depression. Stevenson and Romney (1984) found that 14% of LD children age 8 to 13 showed signs of clinical depression. Wright-Strawderman and Watson (1992) obtained a higher estimate of 35.8% of LD children age 8 to 11. The research has been confused in that some LD children do poorly in school, and thus are LD and underachieving, while others do well in school, and thus are only LD and not underachieving. The poor achievement may be the key factor in depression. More modern research shows that LD children who have a strength or skill in a non-academic area develop “non-academic self-esteem.” they feel a sense of pride and accomplishment, and receive the respect of their peers. These children do not show self-esteem and social problems even if they are LD.
Other children show few strengths, and don’t have a non-academic area in which to excel. They show the social problems much of the research has shown. They may cut off peers in conversations, miss turn-taking cues, and have little ability to engage other children in peer-appropriate discussion and play. Often they make poor choices. While they may be able to say which choice is better when the sit and think with you about it, when in the real situation, they act without thinking and only later see they made a mistake. There is some research to indicate that teaching specific problem-solving strategies can help them, as well as articulating social rules for them to follow. In other words, their can develop good social skills, but may need extra time to do so.
For more information, see Resilience Elements in Students with Learning Disabilities 2002, by Miller, published in the Journal of Clinical Psychology, volume 58, issue 3, pages 291-298