1. Learning disabilities
Julie Dockrell
Conceptualising learning difficulties

2. Aims Consider alternative conceptualisations of learning difficulties
Focus on language learning difficulties
Consider the impact of co-occuring difficulties in the social-emotional domain
Examine how studies of children with language difficulties can support theory and conceptualisation
Writing as the example
Focus on key experimental studies

3. Workshop
Examine how the complexity of language problems impacts on decisions about assessment and intervention

4. Familiarisation session
To ask questions about developmental disorders
Challenges current wisdom
Per favore domande se qualcosa non sia chiaro o non sei d’accordo

5. Neurodevelopmental disorders
Neurotypical
Neurodiversity
Neurodivergent
No valid scientific evidence
Premised on the categorisation of disorders
Vast majority done a behavioural not neurological bases

6. Specific V. general neurodevelopmental disorders
but even here we have a tremendous reaction range
SOME BACKGROUND
General learning disabilities/ difficulties
level of intellectual development is significantly below average (as assessed by an intelligence test)
perform less well than age matched peers on a range of intellectual tasks.
'slow learners', and in more severe cases ‘intellectual disability'.
Some of these neurodevelopmental disorders can be traced to specific genetic factors – Down syndrome
Specific
intellectual development is normal but have specific difficulty with some particular task
performance profile gap between their level of achievement in their area of specific difficulty and their levels of achievement in other areas of cognitive functioning …discrepancy between achievement and their aptitude
UK- specific learning difficulty/ USA learning disability
Attempts to identify genetic factors but no clear success
Check they know what a reaction range is.

7. Primary diagnostic model DSM-5™ (American Psychiatric Association, 2013)
Specific learning disorder –
developmental disorder that begins by school-age, although it may not be recognized until later
- involves ongoing problems learning key academic skills, including reading, writing and math
Communication Disorders – independent of modality (oral, written, sign)
Language Disorder and Mixed Receptive-Expressive Language Disorder (LD),
Social (Pragmatic) Communication Disorder (SCD),
Speech sound disorder (SSD)
Childhood onset fluency disorder (stuttering)

8. A learning disability (LD)
A learning disability (LD)
affects the brain's ability to receive, process, store and respond to information. The term learning disability is used to describe the seeming unexplained difficulty a person of at least average intelligence has in acquiring basic academic skills. These skills are essential for success at school and work, and for coping with life in general. LD is not a single disorder.

9. History of the term Samuel Kirk 1962 coined term learning disabilities
“ a retardation, disorder or delayed development in one or more of the processes of speech, language, reading, spelling, writing or arithmetic resulting from a possible cerebral dysfunction and not from a mental retardation, sensory deprivation or cultural or instructural factors”
Kirk 1963 LD discrepancy between a child’s achievement and ability to learn
Amalgam of disabilities all grouped under a single label

10. Validity rarely examined!
Assumptions
Validity rarely examined!
Child internal
Cognitively determined
Based on Information Processing Perspective with an emphasis on subskill breakdowns/faults
Discrepancy between learning potential and achievement
Exclusion of cultural, educational, environmental and economic factors or other disabilities
FACTORS
Age determined
Context determined
Heterogeneous group
CRITICAL

11. Some caveats
No objective way to assess putative brain dysfunction + new studies suggest interaction between environment (including instruction) and brain circuitry
IQ scores reflect a gross estimate of current general cognitive functioning should not be used as a measure of learning potential (Thorndike, 1963)
Discrepancy means implementing the wait to fail model!
Interaction is the key

12. Neural systems supporting reading may not be fixed, but develop if challenged. Image of a 10-year-old with severe reading disabilities before and after 60 hours of intensive instruction, during which the child rose into the average range in word-reading ability. The “before” image captures a brain exhibiting the standard activity pattern of children with reading disabilities. The “after” image shows increased activity in the left hemisphere, a pattern common to nonimpaired readers From F=G. Reid Lyon and J. Fletcher

13. Focus is learning What impacts on learning Child Task
general (processing) or specific structures (phonology)
Task
task analysis to identify key components
writing
reading
Environment (particularly vulnerable)
Bronfenbrenner’s analyses

14. Over time

15. Primary language problem?
Problems in the acquisition and development of oral language.
Language difficulties without any obvious aetiological causes e.g. hearing
Range of different terms used to describe these children - often reflecting theoretical background
Estimated 10% of pupils in Year 1 (age 6)
Majority will be in mainstream classes
More prevalent in lower SES & EAL pop (Dockrell et al, 2014)
Specific language impairment Meet Seb
The children and their difficulties have been described in a variety of ways. This confusion is reflected in the variety of terms that have been used to describe the children. These include as developmental aphasia, specific language impairment, and developmental disorders of language. This list is not all inclusive and more recently new terms have been added to describe particular types of problem. New, more specific, descriptions have begun to emerge, including specific grammatical language impairment or word-finding difficulties. Unfortunately, little consensus exists about the appropriate terminology. In this chapter we use the term specific speech and language difficulty to describe children who have primary 2

16. SPECIFIC CRITERIA used in the past
'specific developmental disorders of speech and language' ICD 10
'developmental language disorder'. DSM IV
The criteria to make these specific diagnoses centred on three issues:
Performance on a language test below the child's chronological age
A discrepancy between the child's language skills and their non-verbal abilities
Language abilities that cannot be attributed to any other cause
the norm itself is not easy to characterize. There is considerable diversity in the rate at which children acquire language, especially in the pre-school period. Thus, there is no exact point that divides normal development from that which should cause concern. 3

17. Many challenges What is a discrepancy?
When is performance below expectation?
Which aspect of language?

18. Language disorders Language disorders ? Language learning disabilities
Specific language impairment
Range of other terms
Terminological confusion
Professional challenges
Lack of specificity in looking at co-morbidity
Causal models

19. Developmental language Disorder (Catalise project)
Bishop, D. V. M., Snowling, M. J., Thompson, P. A., Greenhalgh, T., & Consortium, C. (2016). CATALISE: A Multinational and Multidisciplinary Delphi Consensus Study. Identifying Language Impairments in Children. Plos One, 11(7). doi: /journal.pone