From Parenting New Mexico September 1999

ARTICLE ONE OF FOUR ARTICLES ON
LEARNING DISABILITIES

Learning Disabilities:
What Are They?

Simply put, a learning disability is a neurologically-based dysfunction which impairs performance in readin', writin', and 'rithmatic.

Unfortunately, things aren't that simple when it comes to accurately diagnosing learning disabilities (LD) or providing help for them. For starters, learning problems, like many difficulties in life, come on a continuum from having just a little to a lot. A child or adult can have a touch of a reading problem (Dyslexia) or a profound case of Dyslexia. Where to say a personal weakness ends and a true disability begins is a matter of much professional debate. Next, learning disabilities are a collection of problems as described below. Many who have learning problems have impairments in more than one area, although one area is often the predominant source of concern. Lastly, professionals disagree about which problems should be categorized under LD and which belong under some other classification. While what you call a problem or how it's classified doesn't change the problem, it certainly can change the help available. Definitions, labels, and classifications are what determine an individual's eligibility for remedial programs such as special education in the public schools.

Formal LD definitions vary among the many professional groups who work with children and adults having LD; educators, speech and language pathologists, occupational therapists, physicians, and psychologists. However, the single most important definition is that contained in the Individuals with Disabilities Education Act (IDEA). This is the newly-revised federal law which guides all states in the provision of special education services through the public schools. IDEA defines a learning disability as "a disorder in one or more of the basic psychological processes involved in understanding or in using spoken or written language, which may manifest itself in an imperfect ability to listen, think, speak, read, write, spell or to do mathematical calculations." The law goes on to specifically exclude learning problems that are primarily the result of visual, hearing, or motor disabilities; mental retardation; or environmental, cultural, or economic disadvantage. Perfectly clear, right? Diagnosing LD is far from simple and precise.

An important distinction the law does make is that mental retardation is not included. The importance is that this by default defines LD as a difficulty of individuals with average or higher IQ. Since children and adults with LD are always people with average to superior general intellectual functioning, LD has often been called the "Hidden Disability." You can meet someone with a severe LD in a store or on the street and have no idea of their problem unless you observe them perform an academic task (such as reading or writing) which is impacted by their disability.

The Basic Psychological Processes Involved

The IDEA definition includes "a disorder in one or more of the basic psychological processes involved in understanding or in using spoken or written language." There are many complex processes performed by the brain during any cognitive task such as speaking, reading, writing, or doing math. The processes begin with input ­ recognizing and decoding (like seeing the letters in the word "enough" and knowing to pronounce the word as "ee-nuff"). Then comes encoding, using the information (like knowing what "enough" means in the context of the sentence). Lastly, there is output - some verbal statement, writing, or action in response. See the schematic describing Information Processing.

For learning-disabled individuals, certain information processing skills needed in common school type tasks are frequently the source of impairment. Some of the most commonly seen psychological and neurological processing problems are:

• Visual-Spatial Skills - These are the skills used to correctly perceive and produce shapes and graphical representations - like letters. When there is a problem here, difficulties occur such as reversing letters (d and b, or p and q), slowed handwriting due to the extra effort needed to form the letters correctly, and mistakes in identifying common words (seeing "then" but perceiving the word as "them," for example).
• Phonological Skills - Think phonics, like how you were taught to read. Words are made up of sound bits (called phonemes) and most English words (about 70%) can be "decoded" by making the sound of each phoneme as represented by one to three letters (sch, oo, l, for example) and then putting the sound bits together (sch-oo-l). This isn't easy for LD individuals with Dyslexia. Often these children and adults struggled to break words into sound bits and then recombine them. We will talk more about this in a future article specifically on reading and Dyslexia.
• Memory Abilities - As shown in the Information Processing graphic, the input and decoding phases involve recognition and recall, functions of memory. Memory is also involved in the interpretation part of encoding, and learned (remembered) responses come in at the output stage. Unfortunately, many LD problems stem from breakdowns in either short-term memory (I remember the word I just saw) or long-term memory (I've seen the word "Teletubbies" before).

Causes of Learning Disabilities

The causes of LD are mixed and have been elusive from science. What is known is that learning disabilities stem from subtle differences in the anatomy and function of the brain. But exactly what causes the neurological disturbances is not clear. It appears that there are multiple causes.

We do know that LD run in families and have a genetic connection. Very frequently someone with a learning problem has a parent, grandparent, aunt, or uncle with some similar form of the problem. Despite significant research, science has yet to fully identify the genetic process.

A sizable portion of LD individuals, however, have no family history of the problem. Among these individuals, many but certainly not all, had medical problems during pregnancy or birth which are suspect for being the cause. Some of the commonly associated prenatal and neonatal difficulties are: extremely long labor, complicated deliveries, having the umbilical cord wrapped around the neck, premature birth, and serious infections as a young infant.

Frequency of Learning Disabilities

Any measurement of prevalence in the population is highly dependent on how minimal the problem can be and still be labeled as LD. Nationally, about four percent of elementary school children receive some special assistance for a LD. Very serious LD problems affect about one percent of the population. Mild to severe problems affect five to ten percent of school children.

Developmental Progression

LD certainly impact the entire life span. However, with good remedial instruction and time for neurological development most have major improvements. Kindergarten through third grade are crucial. But many also have substantial achievement gains between the middle elementary grades and high school. For example, my good friend. He could hardly read at all until seventh grade. As a young teen reading began to "make sense" to him for the first time, and by high school he was nearly at grade level in reading ability. I met him in graduate school where he earned nearly straight A's - as long as he had a typist to help him spell and keep his grammar straight. Today he is a successful psychologist, author on LD, and a past president of the Michigan Branch of the International Dyslexia Association. But I still get Christmas cards from him with my name misspelled, and often misspelled differently from year to year.

Types of Learning Disabilities

There are several common LD patterns. These include:
Dysgraphia - a writing problem characterized by difficulty forming letters and fitting writing onto a page with appropriate spacing.
Dyscalculia - impaired ability to grasp mathematical
concepts.
Dyslexia - problems with reading, and usually also with spelling. A special note is needed here about the meaning of the word Dyslexia. In common usage it is often used to mean reversing letters, like writing "d" when a "b" was intended. Among LD professionals, Dyslexia means a reading disorder and not a visual spatial problem, although many people with a reading problem did reverse letters when they were young. Dyslexia will be the subject of a future article in this series.
Written Expression Disorder - a disability in writing characterized by problems with grammar and sentence construction.
Nonverbal Learning Disabilities - a distinctly different group of problems from the others. Nonverbal LD are problems in the processing and storage of visual or auditory information. Nonverbal LD will also be the subject of a future article.

Association with Other Problems

Approximately, one quarter to one third of all LD children also have ADHD. The relationship appears to be distinctly physical since the known causes of LD and ADHD are quite similar. When a child has both, efforts to provide remedial help for the LD problem are often negatively impacted by the symptoms of ADHD. Treatments for ADHD often provide some improvement in the neurological processing difficulties experienced with LD.

Individuals with learning disabilities are also at a greater risk for developing behavior problems and low-level depression than are non-LD kids. However, it is unclear if the association is physical or solely relates to the frustration experienced by LD individuals as they struggle to fit in at school. Maintaining good behavior and social functioning in school is one of the best predictors of good adult adjustment in overcoming the effects of LD.

Future Topics

As already stated, future articles in this series will address Dyslexia and Nonverbal Learning Disabilities. Additionally, we will explore the process of diagnosing LD, how parents can spot LD problems early, and useful strategies for providing help to those with a LD problem.

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Dr. Zieman is an Albuquerque psychologist who specializes in the evaluation of child and adolescent disorders. He also works with people having ADHD.

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Learning Disability Articles
Part 2 | Part 3 | Part 4

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Copyright by Parenting New Mexico and Gayle L Zieman PhD. This article may not be published in part or in its entirety in any medium without written permission from Gayle L Zieman PhD or Parenting New Mexico magazine. Links to this page are welcome.