What is a learning disability? Even the experts can’t always agree. An important definition is found in the American Psychiatry Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM), the main reference book physicians rely on to help them diagnose these conditions. The most recent edition, the DSM IV, identifies three types of learning disabilities: dyslexia, the inability to read, spell and write words, but not as a result of faulty eyesight; dysgraphia, the inability to write properly; and dyscalculia, the inability to perform mathematical calculations.
Definition of “Learning Disabilities”
The federal government takes a broader view. Under the Individuals with Disabilities Education Act (IDEA), all eligible children between the ages of three and twenty-one are guaranteed free and appropriate special education and related services in the public schools. IDEA defines “learning disabilities” as follows:
A disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, which may manifest itself in an imperfect ability to think, speak, read, write, spell, or to do mathematical calculations. The term includes such conditions as perceptual handicaps, brain injury, minimal brain dysfunctions, dyslexia, and developmental aphasia.
That encompasses not only the trio of disorders mentioned above, but also attention deficit hyperactivity disorder (ADHD) and pervasive developmental disorders, including autism and Asperger’s syndrome. Although the law expressly does not include intellectual disabilities, states and individual school districts are free to modify the guidelines. Some do classify an intellectual disability as a learning disability; others may provide special-education services for students whose academic achievement falls well short of their potential, as measured by test scores.
To add to the confusion, you may hear the same learning problem referred to as a learning disability, a developmental disability or yet another term. Ultimately, how these disorders are classified isn’t as important as recognizing that each one can seriously interfere with a youngster’s ability to learn.
All learning impairments share one thing in common: deviations in processing in one or more locations of the brain. Several studies employing sophisticated brain-imaging technology have been able to observe the workings of brains with learning problems. At Yale University School of Medicine, for example, patients with dyslexia were asked to read while they underwent a magnetic resonance imaging scan. The researchers clearly observed a difference in the parts of the brain that normally handle reading.
Similarly, imaging studies of people with ADHD have found decreased functioning in the areas that enable us to concentrate; and scans of people with autism reveal abnormalities in brain structure, particularly within the shellshaped cerebellum nestled at the base of the brain. Impaired brain development from a variety of causes is also at the root of an intellectual disability. (These imaging procedures were employed strictly for research purposes, incidentally; they are not part of a routine diagnostic workup.) Learning difficulties are diagnosed in at least four times as many boys as girls. This may be due in part to the fact that boys who have problems academically are more prone to disruptive behavior and to resisting reading and other challenging tasks in school. Therefore they tend to be referred more to specialists and subsequently diagnosed.
Many of these disorders may weave their way through family trees. According to the National Institute of Mental Health, children with ADHD usually have at least one close relative who also has the disorder. Frequently it’s the father; at least one in three who have ADHD themselves pass it on genetically to their offspring.
Typically, a learning deficit becomes apparent early in childhood, though not always. If the problems are subtle, a child may compensate sufficiently for quite a while; in fact, some of these boys and girls happen to be extremely bright. It’s only after the work in school becomes more complex, beginning around third or fourth grade, that they start to struggle. “This is the time when the curriculum begins to shift from ‘learning to read,’ to ‘reading to learn,’ ” explains Dr. Mark L. Wolraich, a specialist in learning disabilities. Of the more than 2.4 million children with learning disorders in U.S. schools, about four in five encounter problems with reading and language.
Several of these conditions have overlapping features; consequently, misdiagnoses are not uncommon. For instance: Difficulty concentrating in school characterizes ADHD, but is also a hallmark of Asperger’s syndrome, intellectual disabilities or depression. Furthermore, learning difficulties are typically accompanied by secondary problems.
Let’s return to the example of ADHD. Some of these children are additionally diagnosed with another learning problem, such as dyslexia. A number develop the behavioral disorder oppositional defiant disorder. Their belligerence and fits of temper can be attributed partly to their lack of success in school and other circumstances. “But some of the misconduct,” says Dr. Wolraich, “is due to the fact that the two conditions tend to occur together.” Less commonly, adolescents or young adults with an attention deficit have or will develop bipolar disorder, a serious mood disturbance also referred to as manic depression.
Learning Problem? It’s That and More
Rarely are the effects of a learning problem confined solely to the classroom. They frequently spill over to other areas of daily life. Making friends can be especially difficult for many of these youngsters, some of whom lack fundamental social skills, such as the ability to understand nuances of language and read facial expressions. A joke that sends others into hysterics may sail right by them. Of course, many boys and girls with learning difficulties get along splendidly with their peers, but for those who are socially awkward, adolescence can be a painful time. Adolescents with learning problems can be screened by their pediatrician or other health professional for other difficulties, such as anxiety or depression.
A child’s diagnosis thrusts parents into the role of advocate: the person(s) charged with getting her whatever educational, psychological and rehabilitative services she needs. Mothers and fathers are also advocates in the sense of providing constant love and encouragement. Keeping self-esteem aloft and promoting a positive self-image vie in importance with helping a child with a learning problem academically. In short, be your child’s number-one fan. Remember: No one will love and support him or her more than you.
If you suspect your teenager might have a learning problem of some kind, consult his pediatrician, who can outline a plan of action. Don’t deny your instincts, as parents sometimes do, largely out of fear that a finding of ADHD, or autism or another problem will permanently stigmatize him.
Stigmatize him? With whom? Between increased public awareness and 120,000 new cases of learning disorders among students every year, a learning problem no longer carries the stigma it once did. But, frankly, what other people might think shouldn’t even cross a parent’s mind. When mothers and fathers ignore the reality of the situation, in a well-intentioned but misguided attempt to protect their child, they are depriving him of the help he needs in learning to live with his disorder. Until then, his schoolwork is likely to suffer, reinforcing a destructive pattern of failure. And without therapy to show him ways to control any alienating behaviors, the more likely it is that he will suffer the rejection of his peers.
Approximately two in five boys and girls with ADHD aren’t diagnosed until they reach junior high or high school—sometimes not until college. Imagine what it must be like to spend years not understanding why you can’t seem to do better in school. How many teens conclude it must be because they’re “stupid”? Or “lazy,” a frequent accusation. To receive an explanation for why learning has always been hard usually comes as a relief. Although it is preferable for learning problems to be picked up early in childhood, know it is never too late to help a youngster turn things around.
Initials, Initials, and More Initials
|ADHD||attention deficit hyperactivity disorder|
|ASD||autism spectrum disorder|
|CAPD||central auditory processing disorder|
|PDD||pervasive developmental disorder|
|PDD-NOS||pervasive developmental disorder not otherwise specified|