CONCEPT OF LEARNING DISABILITY

The term "Learning Disability" (LD) was first used by Kirk in 1962 to describe that group of children who had disorders in the development of language, speech, reading and associated communication skills needed for social interaction. Visually impaired, hearing impaired, mentally retarded and emotionally disturbed children were excluded from this group. The term was seldom heard before 1960’s but by 2000 it has captured the interest and attention of all professionals directly or indirectly related to the field of special education i.e. Educators, Physical Educators, Neurologists, Pediatricians, occupational Therapists, Psychologists, Psychiatrists, Rehabilitation Workers, Speech Therapists, Ophthalmologists, Social Workers and other medical specialists.

In fact the concepts behind Learning Disability are not recent invention but the term itself and popular interest therein are comparatively new. The subjects recognized as Learning Disabled were previously, more or less referred to as children with Minimal Brain Dysfunction, Minimal Brain Injured, Minimal Neurological Handicap, Perceptual Handicap, Cognitive Defects, Hyperactive child, children with language disorders or Dyslexia etc.

DEFINITION & INCIDENCE

Learning Disability is a term used by educators and pediatricians, to denote a group of conditions that interfere with person’s learning & functioning. Learning Disability refers to a disorder that interferes with one’s ability to store, process and produce information. Dr. Samuel Kirk was the first to use the term learning disabilities (LD) in 1963. Prior to this time, terms such as minimal brain damage (MBD) and minimal brain dysfunction had been used.

The term learning disabled is a label, which implies a condition, which cannot be overcome, and this is not true. Learning disabled, today, can compensate their deficits areas and make significant contributions to society. Further, early intervention may prevent learning difficulties becoming learning disabilities. Some of the most worthwhile people were learning disabled – Winston Churchill, Thomas Edison and George Bernard Shaw to name only a few. Learning disabilities are the most prevalent of developmental disabilities.

Incidence: Overall learning disabilities are present in 10% of school age children, though the estimates range from 2% to 20% of population. Boys are affected to about twice as frequently as girls.

Incidence in India is not exactly well known, as many children do not reach school and a significant number of children drop out of school.

Definition:

National Joint Committee for learning Disabilities (NJCLD) 1988. Learning disabilities is a generic term that refers to a heterogeneous group of disorders manifested by significant difficulties in acquisition and use of skills such as listening, speaking, reading, reasoning or mathematical abilities. These disorders are intrinsic to an individual and are presumed to be due to central nervous system dysfunction and may occur across the lifespan of the individual. Problems in self-regulatory behaviour, social perception and social interaction may exist with learning disabilities and do not by themselves constitute a learning disability. Although learning disability may occur with other handicaps or with other extrinsic influences, they are not the result of these conditions or influences.

There are three types of learning disabilities that are commonly described: Dyslexia: derived from the Greek word “dys” meaning difficult and "lexia" meaning words. Commonly interpreted as difficulty in reading. Dyslexia denotes a language disorder affecting reading, spelling, speaking and listening. This is the commonest of learning disabilities.

Dysgraphia:-

the term refers to a difficulty in learning to write.

Dyscalculia:-

The term refers to a disorder affecting mathematical reasoning and calculations. Dyscalculia is rarely the principal cause for referral. Most often it is seen in conjunction with Dyslexia or Dysgraphia.

Facts about LD:

The term does not include children who have learning problems which are primarily the result of visual, hearing, or motor handicaps, of intellectual deficiency, of emotional disturbance, or of environmental, cultural or economic disadvantage.

• There is no intellectual deficiency.
• Discovery of the disability comes only after the child has entered school. Before the school entrance, he appears "normal" when compared with other children of the same age.
• Dyslexic conditions occur more frequently in boys than in girls, with an approximate ratio of 4:1. The difficulty is supposed to be sex-linked genetically.
• General confusion in orientation can be noticed even before the child enters school. He may confuse days of the months, time, distance, size, or left-right directions.
• Motor coordination is frequently poor.
• Speech delays and speech difficulties may also occur, but the child’s speech may also be perfectly normal.
• Health is usually unimpaired in general. Upon neurological examination, milder forms of neurological dysfunction are sometimes discovered, but no gross pathology exists.
• The child feels more and more inadequate as he encounters reading and spelling failure. He feels dumb and stupid and develops emotional reactions in response to his failures.
• Poor schoolwork. Tuitions have not helped the child.
• Short attention span and distractibility. Impulsive.

CAUSES

The exact causes of LD are unknown. The following observations have been made in cases of LD

• There is a strong familial factor. Genetics plays a role. Often several members of the family have LD. It is believed that a single major gene locus could account for all learning disabilities of subtype Dyslexia.
• The studies conducted by Herman (1959) and Bakwin (1973) showed that there was higher incidence of LD in monozygotic twins when compared to dizygotic twins.
• Pre maturity and Low birth weight babies tend to develop LD. In a study conducted by Davie et al (1972) appropriate for gestational age (AGA) children fared better academically than small for gestational age babies. Thus prematurity and LBW are important contributing factors in the development of LD.
• Perninatal Asphyxia-Prolonged labour, malpresentation, cord around the neck leading to hypoxic ischemic injury to brain were responsible for development of LD
• Children with certain X chromosome syndromes (girls with Turner Syndrome or fragile X Syndrome and boys with Klinefelter Syndrome) have a greatly increased risk of LD
• Neuronal migration defects and corpus callosum abnormality are associated with LD
• Association of symmetrical temporal lobes in Dyslexia (Non dyslexics have asymmetrical temporal lobes). Thus there is a lack of the normal asymmetry in the area of plandin temporal of the temporal lobes.

Screening and testing for difficulties/ disabilities

When a learning difficulty is suspected in a child, screenings are highly recommended. Screenings can be short and online assessment tool that can indicate the level of risk and also can recommend for further comprehensive testing if required. If dyslexia, dysgraphia, ADHD or dyscalculia are suspected, comprehensive testing can be performed by a certified psychologist.

This is must to understand that two people with a learning difficulty/disability struggle with the same set or severity of symptoms and thus it’s important to understand where strengths and areas of need lie in order to provide the best strategy training and accommodations.

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