UNDERSTANDING LEARNING DISABILITIES: INTERVENTION AND PREVENTION STRATEGIES

PAPER PRESENTED BY

PSYCHOLOGIST NWOKOLO OKEY-MARTINS

PROGRAMME SUPERVISOR ACCELERATON THERAPY, LAGOS

Graduate fellow Department of Psychology,

 University of Lagos

E-mail: izuogu44@yahoo.co.uk

Tel: 08039112839

AT THE 2ND ANNUAL NATIONAL CONFERENCE ON LEARNING DISABILITIES ORGANISED BY THE CENTRE FOR LEARNING         DISABILITIES AND AUDIOLOGY, ABUJA.

                              

                            OCTOBER 31^ST - NOVEMBER 2^ND 2006.

UNDERSTANDING LEARNING DISABILITIES.

The term Learning Disabilities (LD) was first used by Dr. Samuel Kirk in 1963 to describe children who have serious learning problem in school but no other obvious “handicap”. Today, learning disabilities is widely recognized as a separate category or condition. However, Sam Kirk and Barbara Bateman actually used the term in 1962, a year earlier in print, but Kirk’s speech to a group of concerned parents in 1963 is often cited as the basis for using the term to describe these children. Nevertheless, the difficulties that students faced due to LD were not new (Currie and Wadlington, 2000).

What is a Learning Disability?

Although the sub-field of learning disabilities is now 43 years old, it has no clear, universally agreed –upon definition. There is ongoing debate on the issue of definition, and there are more than 10 definitions that appear in the professional literature. Perhaps, this is as a result of the multidisciplinary nature of the field. However, most definitions incorporate 3 (three) criteria that must be met for a child to be labeled learning disabled.

Learning disabled children must have a severe discrepancy between potential or ability and actual achieving.

1.     Learning disabled children must have learning problems that cannot be attributed to other handicapping conditions such as blindness, mental retardation, and emotional disturbance, environmental, economic or cultural disadvantage.

2.     Learning disabled children must need intervention and special educational services (not needed by their well peers) to succeed.

The Learning Disabilities Association of America defines learning disability as a neurological disorder that affects one or more of the basic psychological processes involved in understanding or in using spoken or written language. The disability may manifest itself in an imperfect ability to listen, think, speak, read, write spell or to do mathematical calculations. (LDA, 2005).

It should be noted that there are individual differences in the type, severity and symptoms manifested by persons with LD. Every individual with a learning disability is unique and shows a different combination and degree of difficulties. The implication is that one person with LD may not have the same kind of learning challenges as another person.

For instance, a child with LD may have problem with doing math; another may have challenges with motor co-ordination or listening.

Majority of people with learning disabilities are of average or above average intelligence. Usually there seems to be a gap between the person’s potential and actual achievement. This is why LD are referred to as “hidden disabilities” the individual looks very “normal” and seems to be a very bright and intelligent person yet may be unable to perform the skill expected from someone of a similar age.

Children with LD can achieve success in school, relationships and at work if they receive appropriate support and early intervention. There is no “cure” for learning disabilities. Researchers think that LD is life-long. 

What causes Learning Disabilities?

Learning Disability is a general term that describes specific kinds of learning problems. The causes are complex and not well understood. Researches on the causes of learning disabilities suggest that they may be as diverse as the types of LD. None of the available evidences is conclusive on the exact cause(s) of LD. Nevertheless, certain observations and pointers have emerged and include:

v Learning Disabilities appear to have a genetic component. LD tends to run in families, so some learning disabilities may be inherited.

v Teratogenic causes: e.g., alcohol, lead, cocaine and (recently the suspicious) mercury (Lerner, 2000).

v Medical causes: e.g., premature birth, diabetics, meningitis Injuries before birth or in early childhood probably account for some later learning problems .Children born prematurely and children who had medical problems soon after birth sometimes have learning disabilities.

v Environmental causes: e.g., malnutrition and poor prenatal healthcare.

v Some children develop and mature at a slower rate than others in the same age group. As a result, they may not be able to do the expected school work.. This kind of learning disability is called “ Maturational lag”

According to Heward and Orlansky (2002), Learning Disabilities may be caused by brain:

                               i.            Brain damage

                             ii.            Biochemical imbalances

                          iii.            Environment (e.g. quality of teaching)

v Some learning disabilities appear to be linked to the irregular spelling, pronunciation, and structure of the English language. The incidence of learning disabilities is lower in Spanish or Italian speaking countries.

v Delayed onset of Intervention may also result to LD. The definition of LD often requires the child to have a discrepancy i.e. a difference between ability and achievement. This works against giving special instructional services to very young children; if the services could be provided when they are young, then the problems might be prevented.

v Teaching impaired or teaching disabled teachers. There is a possibility that poor quality of instruction may result in LD. However, research on this factor has not been successful (Slavin  et al,1991).

Many researchers suggest that rather than determining the cause of student’s problems, it is more important to determine the individual’s unique educational needs and design instruction that has the best chance of helping him or her to meet those needs.

SOME EARLY SIGNS OF LEARNING DISABILITIES

Children with LD may manifest an array of symptoms which includes difficulties in math, reading, writing, spelling, comprehension, and memory and reasoning skills. Hyperactivity, inattention and perceptual coordination may also be associated with learning disabilities but are not learning disabilities themselves.

Ø Reversals in writing or reading

Ø Difficulty discriminating size,  shape, colour

Ø Poor performance on group tests

Ø Difficulty with temporal (time) concepts

Ø Poor visual – motor coordination

Ø Difficulty copying accurately from model

Ø Difficulty with tasks requiring sequencing

Ø Overly distractible, difficultly concentrating

Ø Slowness in completing work

Ø Poor organizational skills.

Ø Easily confused by instructions

Ø Often obsesses on one topic or idea

Ø Poor short-term or long-term memory

Ø Impulsive behaviour, lack of reflective thought prior to action.

Ø Low tolerance for frustration

Ø Poor peer relations

Ø Poor social judgment

Ø Lags in developmental milestones (e.g. motor, language)

Ø Behavior often inappropriate for situation

Ø Overly excited during play

Ø Failure to see consequences for action

Ø Lack of hand preference or mixed dominance

Ø Disorganized thinking

Ø Overly gullible; easily led by peers

According to the Division for Learning Disabilities of the council for Exceptional Children (2006), characteristics of LD vary with age. They categorized the characteristics of LD into Preschool, Elementary and Adolescence/Adulthood.

PRESCHOOL 

Check if child has difficulties in:

·        Learning the alphabet

·        Rhyming words

·        Counting and learning numbers

·        Pronouncing words

·        Connecting spoken sounds with letters

·        Using crayons, paints, playdough

·        Remembering names of colours

·        Walking forward or up and down stairs

·        Dressing self without assistance

ELEMENTARY SCHOOL

·        Speaking in full sentences

·        Reading accurately

·        Retelling stories

·        Following rules of conversation

·        Remembering routines

·        Following directions

·        Holding pencils

·        Playing with peers

·        Moving from one activity to another

·        Writing letters and numerals by hand

·        Expressing thoughts verbally or in writing

·        Computing math problem at his or her class level

·        Reciting times table, counting numbers

·        Learning new skills

·        Keeping materials neat and assignments organized

·        Modulating voice (does he speak too loudly or in a monotone?)

·        Playing age appropriate games 

ADOLESCENCE AND ADULTHOOD

Check if the person has difficulties in:

·         Staying organized

·        Remembering newly learned information

·        Understanding what he or she reads

·        Remembering and sticking to deadlines

·        Getting along with peers or coworkers

·        Following directions

·        Using basic skills (reading, writing, spelling, math)

·        Using proper grammar in spoken or written communication

SPECIFIC LEARNING DISABILITIES

Some of the symptoms described above may indicate:

Dyslexia:              A language and reading disability

Dyscalculia:         Problems with math concepts and calculation

Dysgraphia:        A writing disorder resulting in poor handwriting and illegibility

Dyspraxia:           A sensory integration disorder resulting in problem with motor coordination.

Central Auditory Processing Disorder: Difficulty processing and remembering language – related tasks

Non Verbal Learning Disorders: Problems with nonverbal cues e.g body language

Visual Perceptual / Visual Motor Deficit:           Reverses letters; inability to copy accurately, hurting and itchy eyes, problems with cutting.

Language Disorders (Aphasia / Dysphasia): Difficulty understanding spoken language; poor reading comprehension.

TYPES OF LEARNING DISABILITIES

Generally speaking, LD are brain–based processing problems (LDA, 2006). There processing problems interfere with the learning of basic skills (e.g. reading, writing math) and higher level skills, (e.g. abstract reasoning, time, organization and planning).

To identify the type of learning disabilities therefore we would consider the specific processing problem-in terms of:

Input:                  How information gets into the brain

Organization:      Making sense of this information

Memory:              Storing and   retrieving this information

Output:                Getting this information back out.

INPUT FACTOR: The brain receives information primarily through the eyes (visual perception) and ears (auditory perception). A person may have difficulty in one or both areas.

Auditory Perception: The person may not be able to differentiate between subtle differences in sounds (called phonemes) or may not be able to distinguish individual sounds as quickly as normal. They may have difficulty with auditory figure-ground. They have difficulty identifying what sound(s) to listen to when there is more than one sound.

Visual Perception Disability:  Visual perceptual difficulties may include inability to distinguish subtle differences in shapes (graphemes). They might rotate or reverse letters or numbers e.g. (6, 9, d, p, q, b). This results in misreading symbol. Some might have a figure-ground problem, confusing what figure(s) to focus on from the page covered with many words and lines. They might skip words, skip lines, or read the same line twice. If there is difficulty with visual perception, there could be challenges with tasks that require eye-hand coordination (visual motor skills) such as catching a ball, doing a puzzle, or picking up bottle.

INTEGRATION FACTORS

Once an input is made and the brain records the information, 3 integrative tasks must be carried out to make sense of the information. First the information must be placed in the right order (or sequenced). Then it must be understood beyond the literal meaning (abstraction). Lastly, each unit of information must be integrated into complete thoughts or concepts (organization).

Sequencing:         The person may have difficulty learning information in the proper sequence, e.g. wrong sequencing of numbers, alphabets, months of the year, days of the week etc. 

Abstraction:        One might have difficulties inferring the meaning of individual words or concepts. Jokes, idioms, or riddles are often not understood. They have trouble transferring.

Organization:      The person may have problems organizing materials, losing, forgetting, or misplacing papers, notebooks, or homework assignments. He may have problems with organizing his environment such as his bedroom. Some may have problem organizing time (organization over time is referred to executive function)

Memory:              Problems with working memory (ability to hold on to pieces of information until the pieces blend into full thought or concept. For example, reading each word until the end of a sentence or paragraph and then understanding the full content. “Short-term memory is the active process of storing and retaining information for a limited  period of time. “Long-term memory refers to information that has been stored and is available over a long period of time.

Language Learning Disability: Individuals with LD may have difficulty communicating their thoughts through speech, or may be able to speak but unable to answer specific questions. Some may have problems understanding what others say to them. Part of the problem results from the inability to place information in the correct brain centers and retrieve it when it is needed. It is possible to think of language output as being spontaneous or on demand. Spontaneous means that the person initiates the conversations. Thoughts have been organized and words found before speaking. Demand language means that one is asked or question or asked to explain something. Now, the person must organize his thoughts, find the right words, and speak at the same time.

Perceptual Motor Disability: One might have difficulty coordinating teams of small muscles, called a fine motor disability. For instance, the student might have problems with buttoning, tying shoes, coloring, cutting, writing and pasting.

Hyperactivity:     The individual may find it difficult to settle down, sit quiet, focus and attend. He may flit from task to task without finishing one.

Distractibility:     The person may not be able to distinguish between important and unimportant stimuli. He is disorganized because he can’t follow through on thought processes in an orderly fashion. Their attention is often diverted from the task at hand.

EFFECTIVE INTERVENTION FOR LD

Learning Disabilities vary. Individuals living with the condition also vary. No one will have all the symptoms. Also no two persons will manifest the same symptom in exactly the same way, degree or severity. As a result, no single technique or theory whether social behavioural, psychological or even educational is capable on it own, to explain or remediate Learning Disabilities in all children.

My approach will be to outline some tips and strategies that have proven effective with some LD children. They include.

Ø Design an Individual Education Plan (IEP): This must be done careful using a team approach. There should be a close collaboration among special class teachers, parents, psychologist, occupational therapist, speech-language therapist, regular class teacher and others as need may be

Ø Create learning style compatible conditions. Teach to students’ learning style strengths by involving all parts of the brain in all activities; visualization, musical/auditory, physical movement, rhythm and emotion all help learning.

Ø Capitalize on the student’s strength

Ø Provide high structure and clear expectation

Ø Use short sentences and simple vocabulary

Ø Help build self esteem by providing opportunities for success in a supportive atmosphere

Ø Use computers for drills and practice  teaching word processing

Ø Allows flexibility in classroom procedure (e.g. allowing the use of tape recorders for note-taking and test taking when students have trouble with written language

Ø Give hyperactive children frequent opportunities to move. E.g. have them sharpen pencil for other kids or tap their pen on their leg instead of a desk

Ø Make learning concrete .Majority of persons with LD do quite well when a learning task is something they can get their hands on and when it is connected to something they are curious about.

Ø Children with LD often work better alone or with a partner. Therefore, when possible, find alternatives to large group work.

Ø Encourage the use of assistive technology by making them available – and not waiting until they can do so on their own. Let them use calculators for computation; word processors and spell check programmes for written work.

Ø Children with LD work more enthusiastically on projects than on skill work. They learn better if immersed in one topic for several days, as opposed to moving from topic to topic each day.

Ø Struggling students may take tests in untimed situations – or at least be given more time.

Ø Provide lots of opportunities to practice

Ø Match teaching style to learning style .Visual people learn by seeing; auditory people learn by listening while tactile – kinesthetic people learn by touching and moving so keep that in mind. 

Ø Provide a visual schedule to list all the tasks to be performed each day.

Ø Teach the child how to purposefully relax before beginning school tasks. Ensure that the child is on a calm alert estate (learning – ready state) before commencing.

Ø A quiet soothing music might be helpful for auditory integration

Ø Provide positive reinforcement of appropriate social skills both at home and school.

Ø Break tasks into smaller steps, and giving directions verbally and in writing.

Ø A student with listening difficulties may borrow notes from a classmate or use a tape recorder

Ø Teach organizational skills, study skills and learning strategies. This is particularly helpful for people with LD.

Ø Get the child to help with household chores. Involving him can build self-confidence and concrete skills. Keep instructions simple and reward child’s effort with praise.

Ø Monitor your teaching skills and pursue professional development. Some LDs are said to result from “teaching disabled teachers”.

Ø Talk slowly. Keep conversations brief

Ø Give them advance notice, don’t take them unawares

Ø Establish eye contact while speaking to students. You may however, not insist that they maintain it, if it makes them uncomfortable.

Ø For those who are confused by too much to look at on a page, provide “windows” cut out of paper or cardboard and expose portions of the page at a time.

Ø Never do for your students what they can do for themselves.

Ø Seat students whose behaviours are distracting behind the vision of other children .Surround them with students who can model appropriate behaviours

Ø Routines are useful. Therefore, establish and use predictable routines in class activities and in transitions. Give notice if a routine will be changed or interrupted. Unpredictability throws many struggling students off-balance.

ISSUES OF PREVENTION

There is an interesting and useful debate about special education versus inclusion for children with learning and developmental disabilities.

However, for children at risk of learning disabilities neither special education nor inclusion is the answer. In place of those, we need to focus on effective prevention and early intervention. Why must we allow our children to fall behind and only then provide assistance – when ab initio, we know how to ensure that they don’t fall?  Robber slaving of Johns Hopkins University told a story or parable of the fence and ambulance:

“Once upon a time, there was a town that has in it a playground located at the edge of the cliff. Every so often, a child would fall off the cliff and would be seriously injured. At last the town council decided that something should be done. After much discussion however, the council was deadlocked. Some council members wanted to put a fence at the top of the cliff, but others wanted to put an ambulance at the bottom. “(Slavin, Madden, Karweit, Dolan, Wasik, Shaw, Mainzer, Haxby, 1991).

The question is: which option is better ….the fence or the ambulance?

I think the idea of putting the ambulance is unwise. Waiting for children to be injured and then providing them with help would be both cruel and criminal, if the damage could have been prevented.

There are many professional efforts at Preventing Learning Disabilities some of the notable prevention programmes for LD include:

(a)              Reading Recovery: This is a first-grade tutoring programme originally developed in New Zealand by Marie Clay (Pinnell, Deford and Lyons, 1988). It’s an approach that provides 30 minutes of daily one-to-one tutoring to first graders who score too poorly in diagnostic battery.

(b)             Success for All: This method was popularized by Slavin (1995). It focuses on prevention and early intervention and starts with 4 and 5 year olds.

(c)              PLD: Silver and Hagin (1990) described PLD (Prevention of Learning Disabilities) a one-to-one tutoring that focuses on perceptual skills for first graders.

There are lots of other programmes aiming to prevent learning Disabilities. The General goal is to keep children from ever needing special educational services for the learning disabled. Some common features of these programmes are:

·        There is an emphasis on  early intervention-targeting preschoolers

·        They emphasis one-to-one teacher – learning

·        They design IEP’s – tailored to individual needs.

·        Intensive stimulation

Early intervention is key to preventing and minimizing the impact that LD can have on students. While we are still struggling, in Nigeria, to develop special schools, civilized societies are transitioning from inclusion/mainstreaming to NEVERSTREAMING.

We have an urgent obligation to detect LD and intervene as early as possible. 

Thank you for your attention.

REFERENCE

Curie, P.S. Wadlington, E.M. (2000). The source for learning disabilities. East Moline, IL: LinguiSystems.

(Web: http://www.linguisystem.com)

Division for Learning Disabilities of the Council for exceptional children (2006): Characteristics of Learning Disability.

(Web: http://www.teachingld.org)

LDA, (2005). Learning Disability Association

http://www.idaamerica.org/aboutld/parents/ld-basics/

Lerner, J.W. (2000) Learning Disabilities: Theories, diagnosis, and teaching strategies (8^th ed). Boston, MA: Houghton Mifflin.

(Web: http://college.hinco.com/students/index.html)

Silver, A.A., & Hagin, R.A. (1990). Disorder of Learning in Childhood. New York: Wiley.

Slavin, R.E. (1995). Every Child, Every School: Success for All. Newbury Park, CA: Corwin

Slavin, R.E., Madden, N.A. Karweit, N.L., Dolan, L., Wasik, B.A., Shaw, A., Mainzer, K.L., Haxby, B. (1991). Neverstreming: Prevention and early intervention as alternatives to special education. Journal of Learning Disabilities, 24, 373-378