| Learning disability | |
|---|---|
| Classification and external resources | |
| ICD-10 | F81.9 |
| ICD-9 | 315.0-315.3 |
| DiseasesDB | 4509 |
| eMedicine | article/1835801 article/1835883 article/915176 |
| MeSH | D007859 |
Learning disability (LD, sometimes called a learning difference, learning disorder,[1] or learning difficulty) is a classification including several disorders in which a person has difficulty learning in a typical manner, usually caused by an unknown factor or factors. The unknown factor is the disorder that affects the brain's ability to receive and process information. This disorder can make it problematic for a person to learn as quickly or in the same way as someone who is not affected by a learning disability. People with a learning disability have trouble performing specific types of skills or completing tasks if left to figure things out by themselves or if taught in conventional ways.
Some forms of learning disability are incurable. However, with appropriate cognitive/academic interventions, many can be overcome. Individuals with learning disabilities can face unique challenges that are often pervasive throughout the lifespan. Depending on the type and severity of the disability, interventions may be used to help the individual learn strategies that will foster future success. Some interventions can be quite simplistic, while others are intricate and complex. Teachers and parents will be a part of the intervention in terms of how they aid the individual in successfully completing different tasks. School psychologists quite often help to design the intervention, and coordinate the execution of the intervention with teachers and parents. Social support improves the learning for students with learning disabilities.
In the 1980s, the National Joint Committee on Learning Disabilities (NJCLD) defines the term learning disability as:
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 and presumed to be due to Central Nervous System Dysfunction. Even though a learning disability may occur concomitantly with other handicapping conditions (e.g. sensory impairment, mental retardation, social and emotional disturbance) or environmental influences (e.g. cultural differences, insufficient/inappropriate instruction, psychogenic factors) it is not the direct result of those conditions or influences.
The NJCLD used the term to indicate a discrepancy between a child’s apparent capacity to learn and his or her level of achievement.[2]
The 2002 LD Roundtable produced the following definition:
The term "learning disability" does not exist in DSM-IV, but it has been proposed that it be added to DSM-5, and incorporate the conditions learning disorder not otherwise specified and disorder of written expression.[5]
Learning disabilities can be categorized either by the type of information processing that is affected or by the specific difficulties caused by a processing deficit.
Learning disabilities fall into broad categories based on the four stages of information processing used in learning: input, integration, storage, and output.[6]
Deficits in any area of information processing can manifest in a variety of specific learning disabilities. It is possible for an individual to have more than one of these difficulties. This is referred to as comorbidity or co-occurrence of learning disabilities.[7] In the UK, the term dual diagnosis is often used to refer to co-occurrence of learning difficulties.
The most common learning disability. Of all students with specific learning disabilities, 70%-80% have deficits in reading. The term "Developmental Dyslexia" is often used as a synonym for reading disability; however, many researchers assert that there are different types of reading disabilities, of which dyslexia is one. A reading disability can affect any part of the reading process, including difficulty with accurate or fluent word recognition, or both, word decoding, reading rate, prosody (oral reading with expression), and reading comprehension. Before the term "dyslexia" came to prominence, this learning disability used to be known as "word blindness."
Common indicators of reading disability include difficulty with phonemic awareness—the ability to break up words into their component sounds, and difficulty with matching letter combinations to specific sounds (sound-symbol correspondence).
Speech and language disorders can also be called Dysphasia/Aphasia (coded F80.0-F80.2/315.31 in ICD-10 and DSM-IV).
Impaired written language ability may include impairments in handwriting, spelling, organization of ideas, and composition. The term "dysgraphia" is often used as an overarching term for all disorders of written expression. Others, such as the International Dyslexia Association, use the term "dysgraphia" exclusively to refer to difficulties with handwriting.
Sometimes called dyscalculia, a math disability can cause such difficulties as learning math concepts (such as quantity, place value, and time), difficulty memorizing math facts, difficulty organizing numbers, and understanding how problems are organized on the page. Dyscalculics are often referred to as having poor "number sense".[8]
Learning disabilities are often identified by school psychologists, clinical psychologists, and neuropsychologists through a combination of intelligence testing, academic achievement testing, classroom performance, and social interaction and aptitude. Other areas of assessment may include perception, cognition, memory, attention, and language abilities. The resulting information is used to determine whether a child's academic performance is commensurate with his or her cognitive ability. If a child's cognitive ability is much higher than his or her academic performance, the student is often diagnosed with a learning disability. The DSM-IV and many school systems and government programs diagnose learning disabilities in this way (DSM-IV uses the term "disorder" rather than "disability".)
Although the discrepancy model has dominated the school system for many years, there has been substantial criticism of this approach among researchers.[10][11] Recent research has provided little evidence that a discrepancy between formally measured IQ and achievement is a clear indicator of LD.[12] Furthermore, diagnosing on the basis of a discrepancy does not predict the effectiveness of treatment. Low academic achievers who do not have a discrepancy with IQ (i.e. their IQ scores are also low) appear to benefit from treatment just as much as low academic achievers who do have a discrepancy with IQ (i.e. their IQ scores are higher than their academic performance would suggest).
Much current research has focused on a treatment-oriented diagnostic process known as response to intervention (RTI). Researcher recommendations for implementing such a model include early screening for all students, placing those students who are having difficulty into research-based early intervention programs, rather than waiting until they meet diagnostic criteria. Their performance can be closely monitored to determine whether increasingly intense intervention results in adequate progress.[12] Those who respond will not require further intervention. Those who do not respond adequately to regular classroom instruction (often called "Tier 1 instruction") and a more intensive intervention (often called "Tier 2" intervention) are considered "nonresponders." These students can then be referred for further assistance through special education, in which case they are often identified with a learning disability. Some models of RTI include a third tier of intervention before a child is identified as having a learning disability.
A primary benefit of such a model is that it would not be necessary to wait for a child to be sufficiently far behind to qualify for assistance.[13] This may enable more children to receive assistance before experiencing significant failure, which may in turn result in fewer children who need intensive and expensive special education services. In the United States, the 2004 reauthorization of the Individuals with Disabilities Education Act permitted states and school districts to use RTI as a method of identifying students with learning disabilities. RTI is now the primary means of identification of learning disabilities in Florida.
The process does not take into account children's individual neuropsychological factors such as phonological awareness and memory, that can help design instruction.[14] Second, RTI by design takes considerably longer than established techniques, often many months to find an appropriate tier of intervention. Third, it requires a strong intervention program before students can be identified with a learning disability. Lastly, RTI is considered a regular education initiative and is not driven by psychologists, reading specialists, or special educators.
Many normed assessments can be used in evaluating skills in the primary academic domains: reading, including word recognition, fluency, and comprehension; mathematics, including computation and problem solving; and written expression, including handwriting, spelling and composition.
The most commonly used comprehensive achievement tests include the Woodcock-Johnson III (WJ III), Weschler Individual Achievement Test II (WIAT II), the Wide Range Achievement Test III (WRAT III), and the Stanford Achievement Test–10th edition. These tests include measures of many academic domains that are reliable in identifying areas of difficulty.[12]
In the reading domain, there are also specialized tests that can be used to obtain details about specific reading deficits. Assessments that measure multiple domains of reading include Gray's Diagnostic Reading Tests–2nd edition (GDRT II) and the Stanford Diagnostic Reading Assessment. Assessments that measure reading subskills include the Gray Oral Reading Test IV – Fourth Edition (GORT IV), Gray Silent Reading Test, Comprehensive Test of Phonological Processing (CTOPP), Tests of Oral Reading and Comprehension Skills (TORCS), Test of Reading Comprehension 3 (TORC-3), Test of Word Reading Efficiency (TOWRE), and the Test of Reading Fluency. A more comprehensive list of reading assessments may be obtained from the Southwest Educational Development Laboratory.[15]
The purpose of assessment is to determine what is needed for intervention, which also requires consideration of contextual variables and whether there are comorbid disorders that must also be identified and treated, such as behavioural issues or language delays.[12]
Interventions include:
Sternberg[18] has argued that early remediation can greatly reduce the number of children meeting diagnostic criteria for learning disabilities. He has also suggested that the focus on learning disabilities and the provision of accommodations in school fails to acknowledge that people have a range of strengths and weaknesses, and places undue emphasis on academic success by insisting that people should receive additional support in this arena but not in music or sports. Other research has pinpointed the use of resource rooms as an important—yet often politicized component of educating students with learning disabilities.[19]
The causes for learning disabilities are not well understood, and sometimes there is no apparent cause for a learning disability. However, some causes of neurological impairments include:
Neuropsychological differences can impact the accurate perception of social cues with peers.[20] A diagnosis of a learning disability can be potentially devastating to an individual and their family. Both the individual and their family will need to learn methods of coping with the effects of the disorder; they will also need to learn how to cope with the disorder emotionally. Stress related to the disorder can accumulate, making the coping process difficult. Stigmas that friends/family/peers have about the learning disorder can also contribute to the stress level the individual feels. Learning disabilities are often present throughout the lifespan, so learning appropriate and effective methods of coping are essential to successful management of the disorder.
Learning disability theory is founded in a medical model, in that disability is perceived as an individual deficit that is biological in origin.[21][22] Researchers working within a social model of disability assert that there are social or structural causes of disability and/or the assignation of the label of disability, and even that disability is entirely socially constructed.[22][23][24][25][26] Since the turn of the 19th century, education in the United States has been geared toward producing citizens who can effectively contribute to a capitalistic society, with a cultural premium on efficiency and science.[27][28] More agrarian cultures, for example, don’t even use learning ability as a measure of adult adequacy,[29][30] whereas learning disabilities are prevalent in Western capitalistic societies because of the high value placed on speed, literacy, and numeracy in both the labor force and school system.[31][32][33] The notion of learning disabilities has been described as evidence of America’s individualistic obsession with self-reliance.[34] In the bigger picture, these points demonstrate how the label of disability is socially constructed and represents a lack of fit between Western conceptions of educational institutions and proper students.
One of the most clear indications of the social roots of learning disabilities is the disproportionate identification of racial and ethnic minorities and students who have low socioeconomic status (SES). While some attribute the disproportionate identification of racial/ethnic minorities to racist practices or cultural misunderstanding,[35][36] others have argued that racial/ethnic minorities are overidentified because of their lower average SES.[37][38] Similarities were noted between the behaviors of “brain-injured” and lower class students as early as the 1960s.[23] The distinction between race/ethnicity and SES is important to the extent that these considerations contribute to the provision of services to children in need. While many studies have considered only one characteristic of the student at a time,[39] or used district- or school-level data to examine this issue, more recent studies have used large national student-level datasets and sophisticated methodology to find that the disproportionate identification of African American students with learning disabilities can be attributed to their average lower SES, while the disproportionate identification of Latino youth seems to be attributable to difficulties in distinguishing between linguistic proficiency and learning ability.[40][41] Although the contributing factors are complicated and interrelated, it is possible to discern which factors really drive disproportionate identification by considering a multitude of student characteristics simultaneously. For instance, if high SES minorities have rates of identification that are similar to the rates among high SES whites, and low SES minorities have rates of identification that are similar to the rates among low SES whites, we can know that the seemingly higher rates of identification among minorities result from their greater likelihood to have low SES. Summarily, because the risk of identification for white students who have low SES is similar to that of black students who have low SES, future research and policy reform should focus on identifying the shared qualities or experiences of low SES youth that lead to their disproportionate identification, rather than focusing exclusively on racial/ethnic minorities.[40][41] It remains to be determined why lower SES youth are at higher risk of incidence, or possibly just of identification, with learning disabilities.
People with an IQ lower than 70 are usually characterized as having mental retardation (MR), mental deficiency, or cognitive impairment and are not included under most definitions of learning disabilities, because their learning difficulties are considered to be related directly to their low IQ scores.
Attention-deficit hyperactivity disorder (ADHD) is often studied in connection with learning disabilities, but it is not actually included in the standard definitions of learning disabilities. An individual with ADHD may struggle with learning, but he or she can often learn adequately once successfully treated for the ADHD. A person can have ADHD but not learning disabilities or have learning disabilities without having ADHD. The conditions can co-occur.
Some research is beginning to make a case for ADHD being included in the definition of LDs, since it is being shown to have a strong impact on "executive functions" required for learning. This has not as yet affected any official definitions.
Rick Lavoie is an advocate, author, special education teacher, and writer of learning disabilities. He started a school in Massachusetts specifically targeted towards learning disabled children. Rick Lavoie has written several books on the subject of learning disabilities and their impact on children. The F.A.T. City Project (1989) was a documentary that created a mock environment where everyday people could experience the Frustration, Anxiety, and Tension of being a learning disabled child. [42]
In the United States and Canada, the terms learning disability and learning disorder (LD) refer to a group of disorders that affect a broad range of academic and functional skills including the ability to speak, listen, read, write, spell, reason, organize information, and do math. A person's IQ must be average or above to have a learning disability or learning disorder.
The Section 504 of the Rehabilitation Act 1973 was taken in effect in May 1977, this American legislation guarantees certain rights to people with disabilities, especially in the cases of education and work, such being in schools, colleges and university settings.
The Individuals with Disabilities Education Act, formerly known as the Education for All Handicapped Children Act, is a United States federal law that governs how states and public agencies provide early intervention, special education and related services to children with disabilities. It addresses the educational needs of children with disabilities from birth to the age of 21.[43] Considered as a civil rights law, states are not required to participate.
In the UK, terms such as specific learning difficulty (SpLD), Developmental Dyslexia, dyspraxia and dyscalculia are used to cover the range of learning difficulties referred to in the United States as "learning disabilities". In the UK, the term "learning disability" refers to a range of developmental disabilities or conditions that are almost invariably associated with more severe generalized cognitive impairment.
|
|||||||||||||||||||||||||||