1. Outline – Lecture 5 [Oct. 14, 2003] Ch
Outline – Lecture 5 [Oct. 14, 2003] Ch. 5: Children with Learning Disabilities
Learning Disorders [LD]
Definition & criteria
DSM criteria
Dyslexia, Dyscalculia, Dysgraphia
Prevalence
Cognitive, Social, & Motivation deficits
Developmental course & outcome
Etiology
Brain abnormalities, genetic & environmental factors
Assessment & Treatment
Comorbid Disorders - ADHD

2. Chronology 1877 Kussmaul described congenital word blindness
1896 Cases of word blindness reported
1917 Hinshelwood published: “Congenital Word Blindness”
1927 Orton coins strephosymbolia
1940s Strauss & Werner work with brain-injured children
1963 Kirk uses term learning disabilities ACLD formed
1970s Rapid expansion of the field

3. Generic Definition of LD
A disorder in one or more of the basic psychological processes involved in understanding/using language, [spoken or written]
General LD – performance lags in most academic areas
Specific LD – difficulties lie in specific areas

4. Criteria
performance is below expected grade or age level in at least one academic area or
there is a discrepancy between intellectual ability and achievement level
Problem:
How much of a discrepancy?
IQ & achievement are not independent

5. Common Elements of Accepted Definitions
Average or above average intelligence
Discrepancy between Potential &Performance
Exclusion of other causes
Difficulty in academic tasks
Neurological dysfunction
Uneven growth pattern

6. Learning Disorders: problems in reading, arithmetic, writing, and spelling [DSM-IV Criteria]
Achievement substantially below that expected for age, IQ, and education
Significant interference with academic achievement or activities of daily living
If sensory deficit present, difficulties are in excess of those expected

7. DYSLEXIA [Disorders of Reading]
[1] Deficits in language skills - phonological processing is implicated
[2] Deficits in visuospatial skills - may cause reading problems for some but not central in most cases
Dyslexia characterized by:
- poor decoding & word recognition skills
-problems with phonological processing
-language difficulties
-problems in short-term memory

8. DYSCALCULIA [Disorders of Arithmetic]
[Often co-exists with reading or spelling disorders]
characterized by:
-deficits in computational arithmetic
-deficits in fine-motor and visual-spatial abilities
-deficits in nonverbal concept formation
- may have age-appropriate language & auditory perceptual abilities
-don’t use efficient & effective memory strategies

9. DYSGRAPHIA [Disorders of Writing]
Appear to be 3 types:
[1] deficits in language development [phonetic-analytic skills]
[2] poor visuospatial and constructive skills
[3] deficits in written language only [not in reading or arithmetic]

10. Prevalence
Difficult to determine – varies with how LD is defined and with sociopolitical factors
5 to10 or 15% of school age children
Boys: 3 to 5 times more than girls but can see reports of 4:1 to 10:1

11. Steps Involved in Learning
Input – the process of recording information in the brain. Refers to how one sees, hears, or perceives the world. Term used for this central process is perception.
Integration – the process of interpreting input information. Information has to be placed in right order and understood.
Memory – storage of input for later retrieval.
Output – achieved through through language or motor activity
Malfunctions can occur at any of the steps.

12. Possible Underlying Cognitive Deficits
Attention deficits
Deficits in Language learning
Deficits in listening
Misperception of phonemes
semantics
Perceptual & perceptual-motor problems
Auditory information processing
Visual information processing
Motor coordination
Deficits in Memory, cognitive strategies
May not be able to hold information in memory
Metacognition problems

13. Effects on Social Competence
Relationship problems - may be due to:
Behavioural Deficits:
-lower in verbal skills
-deficit in motor skills
-nonverbal behaviour problems
Social Cognitive deficits:
-less accurate in predicting appropriate emotions
-less accurate in identifying emotional expressions
-attribute negative bias to neutral interactions
-lower in social perspective taking ability
-have trouble comprehending instructions
-goals for social interaction are different

14. Effects on Motivation
Vicious cycle of academic failure & low motivation
-self-perceptions [external locus of control]
-problems with academic self-perceptions
-more pessimistic about future performance
-less personal credit for success
-attribute failure to lack of ability
-attribution retraining has shown some success

15. Effects on the Family stress resources sibling competition
finding special education opportunities
dealing with stigma

16. Developmental Course and Outcome
Language disorders
Receptive-Expressive: do not easily remit
Expressive: children may only be delayed
Reading disorders
Problems tend to persist
Adjustment is variable

17. Familial-genetic factors Brain abnormalities
Etiology
Familial-genetic factors
Brain abnormalities
hemispheric specialization
structural abnormalities
Environmental factors
Gerald Coles [1987] ‘The Learning Mystique’
dyspedagogia

18. Assessment Importance of assessment identify, plan, and evaluate
Formal assessments
-Standardized tests e.g. IQ tests
-Specific tests
-processing tests [e.g. auditory, sequential]
-achievement tests [e.g. math, reading]
-indicate current level of achievement
-highlight ability-achievement discrepancies
Informal assessments e.g.teacher observations
Assessment must be comprehensive in order to understand child’s deficits
See Table 5-1 in text for common characteristics

19. Modes of Treatment Early process approaches
Perceptual-motor training
Visual-perception training
Provide missed motor and sensory experiences
Visual or visual-motor training
Multisensory experiences targeting language
Current Approaches [Educational]
Direct instruction
Behavioural approach
Cognitive and cognitive-behavioural model

20. Common Co-Morbid Disorders
Learning disabilities &ADHD are often co-morbid
why?
[1] LD may create an inattentive, impulsive behaviour style that is diagnosed as ADHD.
[2] primary deficits of ADHD may interfere with learning to degree that LD label is warranted
[3] some common biological/environmental factors can cause both
[4] each has distinct biological/environmental cause but these are related
[5] could build on each other

21. Core Characteristics of ADHD
Inattention
difficulty attending to relevant, ignoring irrelevant stimuli
difficulty maintaining attention over time
Impulsivity
Difficulty inhibiting behaviour [act without thinking]
Hyperactivity
Excessive activity and restlessness [unable to sit still]
Must appear before age 7. Must be severe and persistent.
Must impair child in at least two environments