1. Learning Disability A way forward…. Learning Disability Clinic L.T.M.G.Hospital & Tata Interactive Systems Mumbai

2. Specific Learning Disability Generic term that refers to a heterogeneous group of disorders manifested by significant unexpected, specific and persistent difficulties in the acquisition and use of reading (dyslexia), writing (dysgraphia) or mathematical (dyscalculia) abilities despite conventional instruction, normal intelligence, proper motivation and adequate socio-cultural opportunity.

3. Learning Disability Common neuro-developmental disorder Prevalence 5% to 15 % Equal male : female distribution Most likely to be familial

4. Contd..... Across all socio economic classes May occur along with other handicapping conditions. Problems in learning to read,write, spell or do mathematics. Presumed to be due to CNS Dysfunction.

5. What is not L.D.? Mental Retardation Borderline I.Q. Sensory deficits: Vision, Hearing Emotional disturbances Attention deficits Late maturation

6. Why early diagnosis ? Early acceptance Early intervention Reduction in emotional problems Effective main-streaming Optimum development

7. Steps in Assessment Multi-disciplinary Approach Medical history and examination School history Vision and Hearing tests Psychological assessment Educational assessment Review of school reports Counselor’s evaluation Psychiatry evaluation Case conference

8. Management Remedial Education Counseling Treatment of co-morbidities School Responsibilities Encouraging Talents Facilities / Accommodation

9. Challenges Early Detection Standardized Tests in regional languages LD-friendly schools Language barrier Education Boards Legal issues Parents’ reactions

10. What can we do ? Create Awareness Organize Assessment Guidance for management Arrange Counseling Support the family Network

11. Awareness

12. Assessment Whose? When? Where? Who? How?

13. Quantum Population in general Child population School-going population Children with suspected L.D.

14. Maharashtra Edu. board SSC Exam. March 2007 No. Registered No. Appeared Percent passed Fresh1326077131528777.17 Repeater33589732859944.24 Total1661974164388660.70

15. Region-wise DivisionNo. Regi No. Appear. Pass % Pune20067119936580.63 Nagpur16912416722059.19 Aurangabad13936713793380.53 Mumbai24935724785784.57 Kolhapur16608916461378.66 Amaravati15116714979173.12 Nasik15616315538277.17 Latur941399312680.81

16. Repeaters Division No. Regi No. Appear. Pass % Pune525385097545.41 Nagpur607305993437.26 Aurangabad180551760537.15 Mumbai886278628147.60 Kolhapur382953740547.21 Amaravati369053647246.39 Nasik304502987644.79 Latur102871005142.89

17. When? Referral Stage a) Pre-referral screening b) School committee review Assessment Stage a) Multidisciplinary evaluation b) Case conference, team meeting c) Writing of IEP Intervention Stage a) Implementation of IEP b) Monitoring student progress

18. By whom? Multi-disciplinary Approach

19. Team School teacher Pediatrician/Pediatric Neurologist Clinical Psychologist Special educator Counselor ENT, Ophthalmologist Psychiatrist

20. Management Issues Trained remedial teachers Counselors Support from Government departments Curriculum for teachers’ training Courses for special educators/ counselors/ psychologists Curriculum for medical professionals

21. Key Messages L.D.commonly present as school problems Early detection :Early intervention L.D. initiative in schools Multi-disciplinary approach for diagnosis Remedial Education Provisions Parent Support

22. Acknowledgement All Deans – L.T.M.G.Hospital Dr. Karande, Dr. Thadhani, Dr. Naik Ms. Sholapurwala, Ms. Chitre Ms. Shiledar, Ms. Vinita, Ms. Pethe Ms. Jaheeda, Ms. Rohini Staff of Dept. of Pediatrics All children and their Parent

23. Thank you !