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Sunday, August 14, 2005


How Do You Know If Your Child
Might Have a Learning Disability?


Larry B. Silver, M.D.
LD OnLine exclusive

Many of the questions I receive from parents describe their child's
learning problems and then ask if he or she might have a Learning
Disability (LD). I receive similar questions about Attention-
deficit/Hyperactivity Disorder (ADHD). These are two separate and
very different problems. Students with ADHD might show
hyperactive/fidgety behaviors, inattention/distractibility problems,
and/or impulsivity. These behaviors, present for years, can be seen
at school, at home, and with peers. Students with LD have a
neurologically-based processing problem that interferes with the
ability to master specific learning skills. Between 30 and 50
percent of children with LD will also have ADHD. The reverse is also
true, between 30 and 50 percent of children with ADHD will also have
LD. So, it is wise to look for both possibilities.

So, how would you know to suspect that your child or adolescent has
a learning disability?

Students with LD have difficulty processing information in one or
more of several areas of learning. They may have problems getting
information into the brain (called an input problem). They may have
difficulty with sound input (called an auditory perception or
auditory processing disorder) or with visual input (called a visual
perception disorder). This student may have difficulty integrating
information once it is received in the brain. These problems may
include the ability to sequence information, to infer meaning
(abstract), or to organize information. Some may have problems with
the storage and retrieval of information or memory. The memory
problem might involve information still in the process of being
learned (short-term memory) or material that has been learned but
not retained (long-term memory). Finally, students may have
difficulty getting information out of the brain (called an output
problem). This problem may impact the ability to send information to
their muscles. For example, a student with this problem may have
difficulty coordinating the muscles of the hand and have slow,
tedious and awkward handwriting (called a grapho-motor problem).
Additionally, this student may have difficulty getting thoughts onto
paper (reflected by problems with spelling, grammar, punctuation,
capitalization, or organization of the thoughts).

There is no one definitive characteristic found in a child or
adolescent with learning disabilities. The student may show
characteristics of one or more of the areas described. In fact, it
is very uncommon to have only one area of difficulty. Also, how a
learning disability manifests in school is based on the student's
grade level and the demands for that grade level.

What are the clues of a learning disability?
In preschoolers, look for:
Communication delays, such as slow language development or
difficulty with speech. Problems understanding what is being said or
problems communicating thoughts.

Poor coordination and uneven motor development, such as delays in
learning to sit, walk, color, and using scissors. Later watch for
problems forming letters and numbers.

Problems with memory and routine; for example, not remembering
specifics of daily activities and not understanding instructions.
Possibly, problems remembering multiple instructions.

Delays in socialization including playing and relating interactively
with other children.

In elementary school, look for:
Problems learning phonemes (individual units of sound) and graphemes
(letters, numbers). Problems learning how to blend sounds and
letters to sound out words. Problems remembering familiar words by
sight. Later, difficulty with reading comprehension.

Problems forming letters and numbers. Later, problems with basic
spelling and grammar.

Difficulties learning math skills and doing math calculations.

Difficulty with remembering facts.

Difficulty organizing materials (notebook, binder, papers),
information, and/or concepts.

Not understanding oral instructions and an inability to express
oneself verbally. Some types of LD are not apparent until middle
school or high school. With increased responsibilities and more
complex work, new areas of weakness may become apparent.

Losing or forgetting materials, or doing work and forgetting to turn
it into the teacher.

An inability to plan out the steps and time lines for completing
projects, especially long-term projects.

Difficulty organizing thoughts for written reports or public
speaking.
If you see these clues and believe your pre-school or elementary-
school aged son or daughter might have LD, it is important to find
out if you are correct. The diagnostic process is called a "psycho-
educational" evaluation. Under education law, public schools must
provide this evaluation if requested to do so and when problems are
apparent. (This is true if the child is in private school as well.
As tax payers, you can go to your public school to request such an
assessment.) There are three parts to this evaluation. The tests
used may vary with each school system:

An assessment of potential. Usually this is done through an IQ test.
A battery of achievement tests to assess skills in reading, writing,
and math. A battery of tests to assess processing skills. These
tests examine possible problems with input, integration, and output
of information.

The results of these tests should clarify if the student has a
learning disability. Identifying processing problems may not qualify
the student for services. Most school systems use what is called
a "discrepancy formula" to decide if an individual is eligible for
services. That is, there must be a specific degree of difference
between the student potential (IQ) and performance. Your son or
daughter might have significant processing problems but not be far
enough behind to qualify for services. This is the reason that many
schools will not identify a child with LD until third grade or
later.

Larry B. Silver, M.D.

http://www.ldonline.org/article.php?
max=20&special_grouping=&id=408&loc=68

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