Guide Outline:

1. A Look at Learning Disabilities in Children and Youth
   
   1. Types of Learning Disabilities
      
   2. Detecting a Learning Disability in Children
      
   3. Treatment of Learning Disabilities in Children
2. Help Your Child Learn: Some Suggestions for Parents
   
   1. Accommodation in the Classroom
      
   2. Hints for Parents
3. Adults with Reading or Learning Problems
4. Adults with Learning Disabilities: Assessing the Problem
   
   1. What is the Diagnostic Process for Adults?
      
   2. Questions to Ask Evaluators

A Look at Learning Disabilities in Children and Youth
by Larry B. Silver, M.D.
Reprinted with permission from the Learning Disabilities Association of Montgomery County, Inc., Maryland
Ph: 301/933-1076 Email: LDAMCInfo@aol.com

Children and adolescents perform poorly in school for various reasons. Some have emotional or family problems; for others, the source of trouble is the community, the school, or peers; and some are simply below average intellectually. But 10 to 20 percent have a neurologically-based disorder of the type called a learning disability. According to the definition used by the federal government, these children are of at least average intelligence (many are far above average), and their academic problems are not caused by an emotional disturbance, by social or cultural conditions, or by a primary visual, hearing, or motor disability. Instead, the reason for their learning problems seems to be that their brains are "wired" in a way slightly different from the average person's. About 20 percent of children with learning disabilities also have a related problem, attention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHD). Its symptoms include hyperactivity, distractibility, and impulsiveness. ADD or ADHD must be evaluated and treated separately from the learning disability.

Learning disabilities are lifelong conditions that may require special understanding and help throughout grade school, high school, and beyond. They are also life disabilities that have important effects outside of the classroom, interfering not only with academic work but also with children's games, daily activities, and even friendships. Therefore, help for these children means more than classroom special education.

Types of Learning Disabilities

By the late 1960s, the present model of learning disabilities was established. This model distinguishes four stages of information processing used in learning: input, integration, memory, and output. Input is the process of recording in the brain information that comes from the senses. Integration is the process of interpreting this information. Memory is its storage for later retrieval. Output of information is achieved through language or motor (muscular) activity. Learning disabilities can be classified by their effects at one or more of these stages. Each child has individual strengths and weaknesses at each stage.

Input

The first major type of problem at the input stage is a visual perception disability. Some students have difficulty in recognizing the position and shape of what they see. Letters may be reversed or rotated; for example, the letters d, b, p, q, and g might be confused. The child might also have difficulty distinguishing a significant form from its background. People with this disability often have reading problems. They may jump over words, read the same line twice, or skip lines. Other students have poor depth perception or poor distance judgment. They might bump into things, fall over chairs, or knock over drinks.

The other major input disability is in auditory perception. Students may have difficulty understanding because they do not distinguish subtle differences in sounds. They confuse words and phrases that sound alike -- for example, "blue" with "blow" or "ball" with "bell." Some children find it hard to pick out an auditory figure from its background; they may not respond to the sound of a parent's or teacher's voice, and it may seem that they are not listening or paying attention. Others process sound slowly and therefore cannot keep up with the flow of conversation, inside or outside the classroom. Suppose a parent says, "It's getting late. Go upstairs, wash your face, and get into your pajamas. Then come back down for a snack." A child with this disability might hear only the first part and stay upstairs.

Integration

Integration disabilities take several forms, corresponding to the three stages of sequencing, abstraction, and organization.

A student with a sequencing disability might recount a story by starting in the middle, going to the beginning, and then proceeding to the end. The child might also reverse the order of letters in words, seeing "dog" and reading "god." Such children are often unable to use single units of a memorized sequence correctly. If asked what comes after Wednesday, they have to start counting from Sunday to get the answer. In using a dictionary, they must start with "A" each time.

The second type of integration disability involves abstraction. Students with this problem have difficulty in inferring meaning. They may read a story but not be able to generalize from it. They may confuse different meanings of the same word used in different ways. They find it difficult to understand jokes, puns, or idioms.

Once recorded, sequenced, and understood, information must be organized -- integrated into a constant flow and related to what has previously been learned. Students with an organization disability find it difficult to make bits of information cohere into concepts. They may learn a series of facts without being able to answer general questions that require the use of these facts. Their lives in and outside of the classroom reflect this disorganization.

Memory

Disabilities also develop at the third stage of information processing, memory. Short-term memory retains information briefly while we attend to it or concentrate upon it. For example, most of us can retain the 10 digits of a long distance telephone number long enough to dial, but we forget it if we are interrupted. When information is repeated often enough, it enters long- term memory, where it is stored and can be retrieved later. Most memory disabilities affect short-term memory only; students with these disabilities need many more repetitions than usual to retain information.

Output

At the fourth stage, output, there are both language and motor disabilities. Language disabilities almost always involve what is called "demand language" rather than spontaneous language. Spontaneous language occurs when we initiate speaking -- select the subject, organize our thoughts, and find the correct words before opening our mouths. Demand language occurs when someone else creates the circumstances in which communication is required. A question is asked, and we must simultaneously organize our thoughts, find the right words, and answer. A child with a language disability may speak normally when initiating conversation but respond hesitantly in demand situations -- pause, ask for the question to be repeated, give a confused answer, or fail to find the right words.

Motor disabilities are of two types: poor coordination of large muscle groups, which is called gross motor disability; and poor coordination of small muscle groups, which is called fine motor disability. Gross motor disabilities make children clumsy. They stumble, fall, and bump into things; they may have difficulty in running, climbing, riding a bicycle, buttoning shirts, or tying shoelaces. The most common type of fine motor disability is difficulty in coordinating the muscles needed for writing. Children with this problem write slowly, and their handwriting is often unreadable. They may also make spelling, grammar, and punctuation errors.

Detecting a Learning Disability in Children

There are several early clues to the presence of a learning disability. In preschool children we look for failure to use language in communication by age three, or inadequate motor skills (buttoning, tying, climbing) by age five. In school-age children, we observe whether they are learning the skills appropriate to their grade. Schools and families should always consider the possibility of a learning disability before assuming that a child who has been doing poorly in school is lazy or emotionally disturbed. The Individuals with Disabilities Education Act (IDEA), Public Law (P.L.) 102-119 -- formerly known as the Education for All Handicapped Children Act (EHA), P.L. 94-142 -- requires public school systems to evaluate children who are at risk for a learning disability. Evaluations can also be performed by professionals in private practice, beginning with family doctors. Attention deficit disorder (ADD), attention deficit hyperactivity disorder (ADHD), and other problems should always be considered as well and evaluated by qualified professionals with expertise with these conditions. It is important to distinguish between emotional, social, and family problems that are causes and those that are consequences of academic difficulties, because they require different treatments.

The psychological assessment may include a neuropsychological or a clinical psychological evaluation. The intelligence of the child should be determined to learn whether the child is performing below potential. Discrepancies in performance between different sections of the IQ (intelligence quotient) test will help to clarify learning strengths and weaknesses. Other tests may be used to assess perception, cognition, memory, and language abilities. Current academic skills are judged by achievement tests. Both IQ and achievement tests help to clarify discrepancies between potential and actual ability. There are also specific tests that help to uncover learning disabilities. A speech pathologist,occupational therapist, or other professional may contribute further information, as can parents.

Treatment of Learning Disabilities in Children

Special education is the treatment of choice for learning disabilities in school. The Individuals with Disabilities Education Act requires that the school, in conjunction with the parents and relevant professionals, develop an individualized education plan (IEP) for each student with learning disabilities. This plan is revised every year to take into account each eligible student's present skills and learning disabilities and abilities. The specific instruction students receive will vary depending upon their needs and capabilities. Some students attend special education classes full time. Others spend most of their time in a regular class and go to a resource room for part of each day, or spend most of the day in special education and the rest in a regular class. The regular classroom teacher must build on the child's strengths while helping to compensate for weaknesses. The special education teacher consults with the classroom teacher and provides specific interventions, called academic therapy, to overcome or compensate for learning disabilities. Some children need remedial work to learn basic skills such as reading, writing, and arithmetic. Others also need special intervention to fill gaps; for example, students might have difficulty writing a composition in high school because they did not learn punctuation in an earlier grade. Strategies for learning appropriate to a given student's strengths and weaknesses can be taught. Some children need specific related services: a notetaker (for a student with a fine motor disability), word processors, laptop computers, books on tape, or extra time for tests. The IDEA requires schools to provide these special education and related services at no cost to families.

Parents must also try to understand the nature of their children's problems. Like classroomteachers, they must build on the child's strengths while compensating for or adjusting to the weaknesses without exposing them unnecessarily. A child with a visual motor disability, for example, might find it hard to load a dishwasher but could carry out the trash. The same child might have difficulty catching or throwing a ball, but no trouble swimming. Parents must think ahead about these matters to minimize their child's stress and to maximize his or her chance to experience success, make friends, and develop self-esteem. Treatment that affects only school work will not succeed, because learning disabilities are life disabilities. It is essential to recognize learning disabilities and related problems as early as possible. Without recognition and help, children may become increasingly frustrated and distressed as they persistently fail. By the time they reach high school, they may give up. On the other hand, children whose problems are recognized early and treated appropriately can overcome or learn to compensate for their disabilities.

NICHCY thanks Dr. Larry Silver and the Learning Disability Association of Montgomery County, Inc., for permission to reprint Dr. Silver's article, which appeared in their November 1991 newsletter. The Learning Disability Association of Montgomery County, Inc., is a local chapter of the Learning Disabilities Association of America. You can contact LDAMC, Inc. by writing P.O. Box 623, Rockville, MD 20848-0623.)

Helping Your Child Learn: Some Suggestions for Parents

If you suspect that your child is having trouble learning to read, or trouble with learning in general, there is help available. For parents of school-age children, the first source of help should be the public school serving your area. Contact your child's school principal, express your concerns, and ask to have your child evaluated. The school system is required by federal and state law to evaluate your child at no cost to you or your family. The results of the evaluation will show whether or not your child has a problem with reading or learning and, if so, the nature of the problem. You may be told that your child has dyslexia or another type of learning disability. If the evaluation shows that your child does have a learning disability, the school is required by federal and state law to provide special education for your child -- also at no cost to you or your family. Suppose, however, that the results of the evaluation show that your child does not have a disability. In this case, there are a number of actions you can take. If you think that the school's evaluation of your child was not appropriate -- for example, only one test was administered or the evaluation was based solely upon observation of your child -- you can ask the school system to pay for what is known as an Independent Educational Evaluation (IEE). There are usually strict guidelines for obtaining an IEE at the school's expense. Ask the school about its IEE policy. Of course, you can always have your child evaluated independently and pay for the evaluation yourself. Whether the school pays for the IEE or whether you do, the results of this second evaluation must be taken into account in determining whether or not your child has a disability and, thus, is eligible for special education services through the school. If evaluation results still indicate that your child's problems in learning to read are not caused by a disability, your child will not be eligible for special education services through the public school. However, most schools have services available for students who are having trouble reading. Your child may be enrolled in a remedial reading program or work with a reading resource teacher to improve his or her skills. You may also wish to contact some of the organizations dealing with literacy (see Organizational Resources at the end of this Briefing Paper). Suppose, however, that the results of testing show that your child does have a learning disability. In this case, your child will be eligible to receive special education services. Parents and school personnel then meet to discuss the results of the evaluation and to develop what is known as an Individualized Education Program (IEP). The IEP will describe the level at which your child is currently performing, as well as identify the specific services or instruction your child will receive to address his or her specific needs. (More information about special education and the IEP process is available by contacting NICHCY.) Classroom accommodations are also possible and can help a student compensate for his or her learning disability.

Accommodations in the classroom can include:

• Taped textbooks available through Recording for the Blind (see the description of RFB under "Organizations" at the end of this briefing paper);
• Extended time on tests;
• Tutoring;
• Use of a notetaker, for students who have trouble listening in class and taking notes;
• Use of a scribe during test taking, for students who have trouble writing but who can express their answers verbally to the scribe, who writes down the responses;
• Use of a reader during test taking, for students who have trouble reading test questions;
• Tape recording of class lectures; and
• Testing in a quiet place, for students who are easily distracted. The suggestions presented in the remainder of this article focus upon what parents can do to help a child with a learning disability learn and function within the home.

Hints for Parents:

• Learn more about learning disabilities. This information can help you understand that your child does not learn in the same way as other people do. Find out as much as you can about the problems your child has with learning, what types of learning tasks will be hard for your child, what sources of help are available, and what you can do to make life and learning easier for your child. You can find the information you need by reading many of the publications listed at the end of this document, or by contacting the national organizations that are listed.
• Become an unobtrusive detective. Look for clues that can tell you how your child learns best. Does he or she learn best through looking, listening, or touching? What is your child's weakest approach to learning? Also pay attention to your child's interests, talents, and skills. All this information can be of great help in motivating and fostering your child's learning.
• Teach through your child's areas of strength. For example, he or she may have great difficulty reading for information but readily understand when listening. Take advantage of that strength. Rather than force reading, which will present your child with a "failure" situation, let your child learn new information by listening to a book on tape or watching a videotape.
• Respect and challenge your child's natural intelligence. He or she may have trouble reading or writing, but that doesn't mean learning can't take place in many other ways. Most children with learning disabilities have average or above average intelligence that can be engaged and challenged through using a multisensory approach. Taste, touch, seeing, hearing, and moving are valuable ways of gathering information.
• Remember that mistakes don't equal failure. Your child will have the tendency to see his or her mistakes as huge failures. You can model, through good-humored acceptance of your own mistakes, that mistakes can be useful. They can lead to new solutions. They are not the end of the world. When your child sees you taking this approach to mistakes -- your own and the mistakes of others -- he or she can learn to view his or her mistakes in the same light.
• Recognize that there may be some things your child won't be able to do or will have lifelong trouble doing. Help your child to understand that this doesn't mean he or she is a failure. After all, everyone has something they can't do. Capitalize on the things your child can do.
• Be aware that struggling with your child over reading, writing, and homework can draw you into an adversarial position with your child. The two of you will end up angry and frustrated with each other, which sends the message to your child that, yet again, he or she has failed. You can contribute positively to your child's schooling by participating actively in the development of your child's Individualized Education Program (IEP) and by sharing with the school the special insights about your child that only you as a parent have.
• Use television creatively. Television, or videos, can be a good medium for learning. If the child is helped to use it properly, it is not a waste of time. For example, your child can learn to focus, sustain attention, listen carefully, increase vocabulary, and see how the parts fit together to make a whole. You can augment learning by asking questions about what was seen. What happened first? Then what happened? How did the story end? Such questions encourage learning of sequence, an area that causes trouble for many LD children. Be patient, though. Because your child does not see or interpret the world in the same way you do, progress may be slow.
• Make sure books are at your child's reading level. Most children with learning disabilities will be reading below grade level. To experience success at reading, then, it's important that they have books to read that are on their reading level (rather than their age level). Foster reading by finding books on topics of interest to your child or by reading to him. Also let your child choose his or her own books to read.
• Encourage your child to develop his or her special talent. What is your child good at? What does he or she especially enjoy? Encouraging your child to pursue areas of talent lets him or her experience success and discover a place to shine.

Adults with Reading or Learning Problems
Sally Smith

Adults who have trouble reading or learning usually have had these problems since they were children. Their problems may stem from having a learning disability that went undetected or untreated as a child. If an adult has a learning disability, he or she will experience many of the difficulties described in Dr. Larry Silver's article about learning disabilities in children. The difference for adults who have learning problems is that they no longer spend their day in school and cannot turn to the public school system for evaluation and special instruction. They may not know why they have trouble learning, and don't know where to go to find out. Help is available. It's important, however, to know what is causing the adult's problem with reading or learning. Knowing the reason makes it possible for the individual to get the kind of help he or she needs. The problem may arise because the person has a learning disability. If so, then the person needs to work with instructors who know about learning disabilities. He or she needs to receive instruction designed for individuals with learning disabilities. But not all reading or learning problems are caused by learning disabilities. Perhaps as a child the person did not get enough basic instruction to build the foundation that leads to skilled reading and learning. Becoming involved in a literacy program might meet this person's needs. The first step, then, is to find out if the learning problems are caused by the presence of a learning disability. A thorough assessment can give clues as to whether or not a learning disability exists and can pinpoint areas of strength and difficulty. An overview of the diagnostic process is given on the next page. This overview is adapted from the HEATH Resource Center's publication called Resources for Adults with Learning Disabilities. "The child with learning disabilities feels isolated from the parent's culture and learns to hide her "shameful secret." And, of course, as the child carries this secret into adulthood and begins to face adult responsibilities, the burden of it grows and grows. Surprisingly, when the secret is finally revealed, it turns out not to be shameful at all. Once a person openly acknowledges having a learning disability, she finds it possible to relax and request help and support. Only after openly acknowledging the learning disability is the person free to work on improving her ability to learn."

NICHCY thanks Sally L. Smith for her permission to reprint this quote from her (1991) book, Succeeding Against the Odds: Strategies and Insights from the Learning Disabled (p. 20).)

Adults with Learning Disabilities: Assessing the Problem
Adapted with permission from the HEATH Resource Center

When adults suspect they may have a learning disability, they often begin a search for solutions. They may have difficulty in locating resources to diagnose the disability. For many individuals, obtaining a diagnosis can involve locating one or more professionals to select, perform, and interpret diagnostic tests.

Why is Diagnostic Testing Necessary?

These tests are needed because:

• Obtaining accurate diagnostics is the first step in overcoming the effects of a learning disability.
• Learning with a learning disability requires different strategies.

What is the Diagnostic Process for Adults?

The diagnostic process for adults with learning disabilities is different from diagnosis and testing for children. While diagnosis for children and youth is tied to the education process, diagnosis for adults is more directly related to problems in employment, life situations, and education. An adult will need to find a diagnostician experienced in working with adults and who is oriented to adult school- and work-related learning needs. The assessment process will include a diagnosis and an evaluation to decide on possible choices for treatment. The diagnosis identifies the type of specific learning disability by showing strengths and weaknesses in the way an individual learns and uses information. Both informal and formal activities are used in this process. For example, information may be collected about the person's life and academic history and why there is a need for the testing. More formal activities would include measuring learning/work style, such as visual memory or memory for numbers. An evaluation can then be offered, suggesting ways to overcome some of the effects of the disability. This may include strengthening skills by working with someone who takes into account the way the individual learns best. Until recently, it was not widely recognized that learning disabilities have influenced the lives of adults, especially those whose conditions were not diagnosed during school years. It is now clear that adults should be evaluated in a manner related to their age, experience, and career objectives. How Do You Find Someone to Perform the Testing? You may be wondering how to find a professional qualified to conduct adult assessments. Several local agencies can either perform the tests or refer you to diagnosticians for adults within the community. Agencies to contact for information include:

• The public school system - Ask about Adult Education programs conducted through the school system and the availability of testing;
• Adult Literacy Programs or Literacy Councils - These may be listed in your local telephone book. If not, call the national literacy organizations listed under Organizational Resources at the end of this briefing paper and ask what programs are available in your community;
• Learning Disability Association in your area, often listed in the telephone book with the name of the city or county first;
• Counseling or Study Skills Centers at a local community college;
• Guidance Counselors in high school;
• Orton Dyslexia Society (see description listed under Organizational Resources);
• Special Education Programs at a local public school or university; and
• Vocational Rehabilitation Agency in your state or county.

These organizations or individuals may also be able to put you in touch with an educational therapist or learning specialist in private practice who can perform and interpret the tests you need.

Questions to Ask Evaluators

• Have you tested many adults with learning disabilities?
• What is the cost of the testing? What does this cost cover?
• Can insurance cover the costs? Are there other funding sources? Can a payment program be worked out?
• How long does the testing take?
• Will there be a written report of the assessment? Will I be able to meet with you to discuss the results?
• Will our discussion give me information regarding why I am having trouble with my school, job, or life at home?
• Will you also give me ideas on how to improve (remediate) my areas of disability and how to get around (compensate for) my disabilities?
• Will the report make recommendations about where to go for immediate help?
• If there are additional questions, are you available for more consultation? If so, what are the charges?

This overview of the diagnostic process has been adapted from the HEATH Resource Center's publication called Resources for Adults with Learning Disabilities (1989; 1991). You can obtain a free copy of this publication by contacting the HEATH Resource Center, American Council on Education, One Dupont Circle, Suite 800, Washington, DC 20036-1192. NICHCY thanks Rhona Hartman, Director of HEATH, for her permission to adapt and reprint this material.)

Project Director: Suzanne Ripley
Editor: Lisa Kupper

Permission Statement

This fact sheet is made possible through Cooperative Agreement #H030A30003 between the Academy for Educational Development and the Office of Special Education Programs. The contents of this publication do not necessarily reflect the views or policies of the Department of Education, nor does mention of trade names, commercial products or organizations imply endorsement by the U. S. Government.

This article is provided as a service of the Davidson Institute for Talent Development, a 501(c)3 nonprofit dedicated to supporting profoundly gifted young people under 18. To learn more about the Davidson Institute’s programs, please visit www.DavidsonGifted.org.