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Learning disabilities are neurological disorders that affect how children receive and process information. They are not due to lack of intelligence or motivation. Common learning disabilities involve problems with reading, writing, math, reasoning, listening, and speaking. A learning disability is diagnosed through evaluating a child's medical history, development, and testing for difficulties in specific academic skills despite receiving appropriate instruction. The most frequent types of learning disabilities are dyslexia, dyscalculia, dysgraphia, dyspraxia, and auditory/visual processing disorders.
Learning disabilities are neurological disorders that affect how children receive and process information. They are not due to lack of intelligence or motivation. Common learning disabilities involve problems with reading, writing, math, reasoning, listening, and speaking. A learning disability is diagnosed through evaluating a child's medical history, development, and testing for difficulties in specific academic skills despite receiving appropriate instruction. The most frequent types of learning disabilities are dyslexia, dyscalculia, dysgraphia, dyspraxia, and auditory/visual processing disorders.
Learning disabilities are neurological disorders that affect how children receive and process information. They are not due to lack of intelligence or motivation. Common learning disabilities involve problems with reading, writing, math, reasoning, listening, and speaking. A learning disability is diagnosed through evaluating a child's medical history, development, and testing for difficulties in specific academic skills despite receiving appropriate instruction. The most frequent types of learning disabilities are dyslexia, dyscalculia, dysgraphia, dyspraxia, and auditory/visual processing disorders.
Introduction Learning disabilities, or learning disorders, are an umbrella term for a wide variety of learning problems. A learning disability is not a problem with intelligence or motivation. Kids with learning disabilities arent lazy or dumb. In fact, most are just as smart as everyone else. Their brains are simply wired differently. This difference affects how they receive and process information. Simply put, children and adults with learning disabilities see, hear, and understand things differently. This can lead to trouble with learning new information and skills, and putting them to use. The most common types of learning disabilities involve problems with reading, writing, math, reasoning, listening, and speaking. Definition Learning disabilities is defined as 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 listen, speak, read, write, spell, or to do mathematical calculations. Etiology of learning disorder 1. Neurobiologic or other intrinsic factors are often implicated in etiology 2. It is not caused primarily by culture, educational and socio-economic factors or by other disabilities (mental deficiency, visual or hearing impairment, or emotional disturbance). 3. Factors associated with increased risk for learning disabilities include a) First degree relative with dyslexia b) PEM c) Lead exposure d) Prenatal cigarette exposure Using a telephone analogy, faulty wiring in the brain disrupts normal lines of communication and makes it difficult to process information easily. If service was down in a certain area of the city, the phone company might fix the problem by re- wiring the connections. 2
Similarly, under the right learning conditions, the brain has the ability to reorganize itself by forming new neural connections. These new connections facilitate skills like reading and writing that were difficult using the old connections. Other disorders that make learning difficult Difficulty in school doesnt always stem from a learning disability. Anxiety, depression, stressful events, emotional trauma, and other conditions affecting concentration make learning more of a challenge. In addition, ADHD and autism sometimes co-occur or are confused with learning disabilities. ADHD Attention deficit hyperactivity disorder (ADHD), while not considered a learning disability, can certainly disrupt learning. Children with ADHD often have problems sitting still, staying focused, following instructions, staying organized, and completing homework. Autism Difficulty mastering certain academic skills can stem from pervasive developmental disorders such as autism and Aspergers syndrome. Children with autism spectrum disorders may have trouble communicating, reading body language, learning basic skills, making friends, and making eye contact.
Types of learning disabilities Problems with reading, writing, and math Learning disabilities are often grouped by school-area skill set. If child is in school, the types of learning disorders that are most conspicuous usually revolve around reading, writing, or math. Learning disabilities in reading (dyslexia) There are two types of learning disabilities in reading. Basic reading problems occur when there is difficulty understanding the relationship between sounds, letters and words. Reading comprehension problems occur when there is an inability to grasp the meaning of words, phrases, and paragraphs. 3
Signs of reading difficulty include problems with: letter and word recognition understanding words and ideas reading speed and fluency general vocabulary skills Learning disabilities in math (dyscalculia) Learning disabilities in math vary greatly depending on the childs other strengths and weaknesses. A childs ability to do math will be affected differently by a language learning disability, or a visual disorder or a difficulty with sequencing, memory or organization. A child with a mathbased learning disorder may struggle with memorization and organization of numbers, operation signs, and number facts (like 5+5=10 or 5x5=25). Children with math learning disorders might also have trouble with counting principles (such as counting by 2s or counting by 5s) or have difficulty telling time. Learning disabilities in writing (dysgraphia) Learning disabilities in writing can involve the physical act of writing or the mental activity of comprehending and synthesizing information. Basic writing disorder refers to physical difficulty forming words and letters. Expressive writing disability indicates a struggle to organize thoughts on paper. Symptoms of a written language learning disability revolve around the act of writing. They include problems with: neatness and consistency of writing accurately copying letters and words spelling consistency writing organization and coherence Other types of learning disabilities and disorders Reading, writing, and math arent the only skills impacted by learning disorders. Other types of learning disabilities involve difficulties with motor skills (movement and coordination), understanding spoken language, distinguishing between sounds, and interpreting visual information. 4
Learning disabilities in motor skills (dyspraxia) Motor difficulty refers to problems with movement and coordination whether it is with fine motor skills (cutting, writing) or gross motor skills (running, jumping). A motor disability is sometimes referred to as an output activity meaning that it relates to the output of information from the brain. In order to run, jump, write or cut something, the brain must be able to communicate with the necessary limbs to complete the action. Signs that child might have a motor coordination disability include problems with physical abilities that require hand-eye coordination, like holding a pencil or buttoning a shirt. Learning disabilities in language (aphasia/dysphasia) Language and communication learning disabilities involve the ability to understand or produce spoken language. Language is also considered an output activity because it requires organizing thoughts in the brain and calling upon the right words to verbally explain something or communicate with someone else. Signs of a language-based learning disorder involve problems with verbal language skills, such as the ability to retell a story and the fluency of speech, as well as the ability to understand the meaning of words, parts of speech, directions, etc. Auditory and visual processing problems: the importance of the ears and eyes The eyes and the ears are the primary means of delivering information to the brain, a process sometimes called input. If either the eyes or the ears arent working properly, learning can suffer. Auditory processing disorder Professionals may refer to the ability to hear well as auditory processing skills or receptive language. The ability to hear things correctly greatly impacts the ability to read, write and spell. An inability to distinguish subtle differences in sound, or hearing sounds at the wrong speed make it difficult to sound out words and understand the basic concepts of reading and writing. Visual processing disorder Problems in visual perception include missing subtle differences in shapes, reversing letters or numbers, skipping words, skipping lines, misperceiving depth or distance, or having problems with eyehand coordination. Professionals may refer to the work of the eyes as 5
visual processing. Visual perception can affect gross and fine motor skills, reading comprehension, and math. Common types of learning disabilities Dyslexia Difficulty reading Problems reading, writing, spelling, speaking Dyscalculia Difficulty with math Problems doing math problems, understanding time, using money Dysgraphia Difficulty with writing Problems with handwriting, spelling, organizing ideas Dyspraxia (sensory integration disorder) Difficulty with fine motor skills Problems with hand-eye coordination, balance, manual dexterity Dysphasia/Aphasia Difficulty with language Problems understanding spoken language, poor reading comprehension Auditory processing disorder Difficulty hearing differences between sounds Problems with reading, comprehension language Visual processing disorder Difficulty interpreting visual information Problems with reading, math, maps, charts, symbols, pictures
Diagnostic evaluation of learning disabilities Screening for learning disabilities includes a detailed history, physical and neurological examination, ancillary diagnostic studies, psychologic evaluation, informed perceptive interaction with the child, and observation of the child during interactions with others. 1. Medical and developmental history 6
The medical history include information on Genetic and familial traits Pregnancy and delivery Trauma the infant sustained Acute and chronic illnesses and other disorders The developmental history includes Survey of the childs attainment of the normal development milestone Any behavioral difficulties the child has had during preschool or school age
2. The physical and neurologic examinations in most children who are learning disabled are usually normal. A neurologic assessment of the mental status, cranial nerve functioning, cerebellar functioning, gait, muscle tone and strength and tendon reflexes is done to detect any associated neurologic problems.
3. On the basis of the findings, ancillary diagnostic test is done. These may include electroencephalogram, if subclinical seizures are suspected.
4. The battery of test used for psychologic evaluation should be suited for the symptoms of the individual child and should sample a broad range of skills. These tests should examine communication ability and perceptual strengths and weaknesses, determine cognitive ability and academic strengths and weaknesses and assess social and emotional adaptation.
5. Direct interaction with the child by the health professional and observation of the child during interactions with others can provide additional information. The children may develop maladaptive behavior patterns that deter the psychosocial adjustment. Types of specialists to diagnose learning disabilities include: Clinical psychologists School psychologists Child psychiatrists Educational psychologists Developmental psychologists Neuropsychologist 7
Occupational therapist (tests sensory disorders that can lead to learning problems) Speech and language therapist Treatment for learning disabilities 1. The most common treatment for learning disabilities is special education. 2. Specially trained educators may perform a diagnostic educational evaluation assessing the child's academic and intellectual potential and level of academic performance. 3. Once the evaluation is complete, the basic approach is to teach learning skills by building on the child's abilities and strengths while correcting and compensating for disabilities and weaknesses. 4. Other professionals such as speech and language therapists also may be involved. 5. Psychological therapies may also be used. 6. Classroom adjustments: a. Special seating assignments b. Alternative or modified assignments c. Modified testing procedures d. Quiet environment 7. Special equipment: a. Word processors with spell checkers and dictionaries b. Text-to-speech and speech-to-text programs c. Talking calculators d. Books on tape e. Computer-based activities
Nursing management of children with learning disabilities The overall goal of nursing management for the family 1. To achieve a comprehensive understanding of the diagnosis and its sequelae 8
2. To be aware of the laws and available community services for children who have learning disabilities 3. To promote coping strategies to deal with life stresses that may be compounded with learning disabilities
For a child 1. To develop internal means of self-control 2. To remain free of insults and injuries from the environment
Praise the child when he or she does well. Children with learning disabilities are often very good at a variety of things. Find out what the child really enjoys doing, such as dancing, playing soccer, or working with computers. Give the child plenty of opportunities to pursue his or her strengths and talents. Find out the ways the child learns best. Does he or she learn by hands-on practice, looking, or listening? Help the child learn through his or her areas of strength. Let the child help with household chores. These can build self-confidence and concrete skills. Keep instructions simple, break down tasks into smaller steps, and reward the child's efforts with praise. Make homework a priority. Read more about how to help the child be a success at homework. Pay attention to the child's mental health. Be open to counseling, which can help the child deal with frustration, feel better about himself or herself, and learn more about social skills. Allow the parents to talk with other parents whose children have learning disabilities. Parents can share practical advice and emotional support. Establish a positive working relationship with child's teacher. Through regular communication, exchange information about child's progress at home and at school.
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Health Education to parents and teachers how to deal with children having learning disabilities 1. Seize the opportunity to make an enormous difference in this student's life! Find out and emphasize what the student's strengths and interests are. Give the student positive feedback and lots of opportunities for practice. 2. Review the student's evaluation records to identify where specifically the student has trouble. Talk to specialists in school (e.g., special education teacher) about methods for teaching this student. Provide instruction and accommodations to address the student's special needs. Examples include: breaking tasks into smaller steps, and giving directions verbally and in writing; giving the student more time to finish schoolwork or take tests; letting the student with reading problems use textbooks-on-tape letting the student with listening difficulties borrow notes from a classmate or use a tape recorder; and letting the student with writing difficulties use a computer with specialized software that spell checks, grammar checks, or recognizes speech. 3. Learn about the different testing modifications that can really help a student with learning disabilities show what he or she has learned. 4. Teach organizational skills, study skills, and learning strategies. These help all students but are particularly helpful to those with learning disabilities. 5. Work with the student's parents to create an educational plan tailored to meet the student's needs. 6. Establish a positive working relationship with the student's parents. Through regular communication, exchange information about the student's progress at school.