Also called: Learning Disability, Reading Disability
Learning disorders are conditions that cause patients to have difficulty with reading, writing or mathematics. They result from neurological problems that prevent the brain from properly processing information related to spoken or written language, mathematical calculations, movement coordination or direct attention. Between 2 and 10 percent of the general population has a learning disorder, according to the American Psychiatric Association (APA).
There are three major types of learning disorders. They include:
- Reading disorder. Also known as dyslexia, this condition prevents a person from correctly processing written words and other images from the eyes to the brain.
- Mathmatics disorder. Also known as dyscalculia, this condition involves difficulty performing mathematical calculations.
- Disorder of written expression. Also known as dysgraphia, this condition involves difficulty with both the physical act of writing and the intellectual task of composing text.
The cause of learning disorders is not fully understood. Deficits in visual perception, linguistic processes, ability to pay attention or memory may cause the difficulties that prevent the brain from learning. Medical conditions such as lead poisoning, fetal alcohol syndrome and fragile X syndrome (damage in the X chromosome that leads to mental retardation) have been associated with learning disorders. Heredity also plays a role, as many patients with learning disabilities have family members with similar problems.
Learning disorders can be difficult to diagnose. However, it is crucial that they do not go undetected because they are treatable. Left untreated, learning disorders can be demoralizing, impact a patient’s self-esteem and trigger various behavioral problems. Various standardized tests typically are used to diagnose a learning disorder.
Once the disorder has been pinpointed, appropriate treatment will follow. Special education techniques can help patients of all age groups and levels of impairment improve their ability to read, write or perform mathematics.
About learning disorders
Learning disorders result from a neurological malfunction that prevents the brain from properly processing information related to spoken or written language and mathematical calculations. Patients with learning disorders may have difficulty with reading, writing or mathematics. Their ability to listen or speak may also be impacted, and they may have difficulty coordinating movements or paying attention to stimuli. Between 2 and 10 percent of the general population has a learning disorder, according to the American Psychiatric Association (APA).
Learning involves four major processes. Problems with any of these processes can result in a learning disorder:
- Input. Information is brought to the brain primarily through the eyes and ears. Problems with visual or auditory perception can cause a learning disorder.
- Integration. Once the information has entered the brain, it must be placed in the right order (sequenced), understood beyond its literal meaning (abstraction) and integrated into complete thought concepts (organization). A failure in any of these processes can result in a learning disorder.
- Memory. Learning depends on three types of memory: holding onto pieces of information until they are properly integrated into a full thought or concept (working memory), storing and retaining information for a short period of time (short-term memory) and storing and retaining information for a long period of time (long-term memory). Damage to either auditory memory or visual memory can cause learning disorders.
- Output. The ability to communicate information through words (language output) or muscle activity, such as writing, drawing or gesturing (motor output). A language disability or motor disability can contribute to learning problems.
People with learning disorders often have average to above-average intelligence as measured by standardized testing. It typically is not apparent that a child has a learning disorder until the child begins school and achieves at a lower-than-expected level. Some students with learning disorders do not struggle until lessons become more difficult and sophisticated in the advanced grades.
Learning disorders are diagnosed when results of standardized testing show that an individual is below ability in reading, mathematics or writing when measured against expected levels given their age, schooling and intelligence level.
A person’s learning disorder cannot be cured, but can often be treated with specialized learning methods. These special education techniques can help patients to improve their ability to complete tasks in areas affected by the disorder. It is crucial that learning disorders are detected early so that a child can get help before the disorder begins to have a negative effect on the child’s development or self esteem.
Types and differences of learning disorders
The American Psychiatric Association (APA) recognizes three major types of learning disorders. They are:
- Reading disorder. Also known as dyslexia, this condition prevents a person from correctly processing written words and other images from the eyes to the brain. Patients with dyslexia may have trouble reading and writing. In some cases, patients may have problems with speech. Dyslexia is one of the most common learning disorders, affecting an estimated 4 to 15 percent of the population. This disorder affects males and females equally, and it affects all ethnic and socio-economic groups in equal proportions.
- Mathematics disorder. Also known as dyscalculia, this condition involves difficulty performing math and manifests in many different forms. Patients with mathematics disorder may struggle with various concepts, such as linguistic skills (e.g., understanding and naming mathematical terms, operations and concepts), perceptual skills (e.g., grouping objects), attention-based skills (e.g., remembering to add “carried” numbers) and mathematical skills (e.g., following the right sequence of steps to arrive at a correct answer). Mathematics disorder is believed to affect about 1 percent of school-aged children, according to the APA. Because children do not begin substantial mathematics study until the end of first grade, it is typical for this disorder to go undiagnosed until second or third grade or later.
- Disorder of written expression. Also known as dysgraphia, this condition involves difficulty in both the physical act of writing and the intellectual task of composing text. Patients with this disorder have difficulty writing without grammatical and punctuation errors, poor paragraph structure and multiple spelling errors. Patients also often have extremely poor handwriting. In most cases, poor spelling and handwriting is not sufficient to warrant a diagnosis of this condition. This condition is less understood than other learning disorders and is not typically diagnosed until the second grade. Relatively little is known about the prognosis of those diagnosed with this disorder.
A fourth type of learning disorder called dyspraxia is recognized by many experts. Patients with this disorder have trouble planning and completing tasks that require the use of fine motor skills. It can impact everything from brushing one’s teeth to simply waving goodbye. About 2 percent of the general population has dyspraxia, and 70 percent of those with the condition are male, according to the National Center for Learning Disabilities.
Potential causes of learning disorders
The exact cause of learning disorders remains unknown. It is believed that disorders are most often caused by a malfunction in cognitive processing that affects receiving, processing and communicating information.
There are many potential causes of cognitive malfunctioning. These may include deficits in visual perception, language processes, ability to pay attention or memory. Various medical conditions can also cause learning disorders to develop. These include lead poisoning, fetal alcohol syndrome and fragile X syndrome (damage to the X chromosome that leads to mental retardation). Heredity also plays a role, as many patients with learning disabilities have family members with similar problems.
Perinatal injuries (such as in the months prior to or just after birth) are sometimes factors in learning disorders. In addition, women who use drugs and alcohol during pregnancy increase the risk of having children with learning disorders. Low birth weight, premature or prolonged labor and nutritional deficiencies are also associated with these disorders.
People of all ages, socioeconomic backgrounds and ethnic groups may develop learning disorders.
Signs and symptoms of learning disorders
It is often difficult to recognize learning disorders in children before they begin school. However, there are several symptoms that might indicate the development of a learning disorder. It is important to note that many of these symptoms are normal occurrences during childhood. A learning disorder should only be suspected if these symptoms do not fade as the child gets older:
- Difficulty following directions
- Difficulty distinguishing letters, numerals or sounds
- Difficulty with sequencing
- Disorganization and other sensory difficulties
- Poor coordination
- Poor reading and/or writing ability
- Poor memory
- Short attention span
People with learning disorders often display many other traits. They are often restless and impulsive, do not respond well to change and may perform differently from day to day. They may have a tendency to reverse letters or words, seeing the letter “b” as a “d” or seeing words such as “dog” as “god.” Lack of physical coordination during activities ranging from athletics to holding a pen is associated with certain learning disorders.
Patients who exhibit symptoms of one learning disorder also often have symptoms associated with other learning disorders. In other cases, a person who has a learning disorder in one area – such as reading – may have exceptional abilities in another area, such as math.
According the American Psychiatric Association (APA) , about one-quarter of patients with learning disorders also have an associated mental health disorder such as conduct disorder, oppositional defiant disorder, attention deficit hyperactivity disorder, major depressive disorder or dysthymic disorder.
Diagnosis methods for learning disorders
Learning disorders can be difficult to diagnose, but it is crucial that they do not go undetected. Learning disorders need to be distinguished from inadequate schooling and normal variation in academic abilities among children. Left untreated, learning disorders can impact a patient’s self-esteem, trigger various behavioral problems and cause poor academic achievement that tends to compound over the years as the child grows older. About 40 percent of children with learning disorders eventually drop out of school, according to the American Psychiatric Association (APA).
There are several warning signs that can help parents or teachers recognize a learning disorder in preschool-aged children. These include:
- Delays in language. The child is unable to form sentences after age 2.
- Trouble with speech. The child’s speech is not understandable more than half of the time after age 3.
- Trouble with coordination. The child is unable to tie shoes, button, cut and hop by the time they are ready to enter kindergarten.
- Short attention span. The child is unable to sit still while being read a short story after age 4 or 5 (attention span increases with age during this period).
Before diagnosing a learning disorder, other conditions must be ruled out. A physician will likely perform a complete physical examination of the child and compile a thorough medical history. A child’s vision and hearing will be tested, and testing of the child’s intelligence will be performed using standardized tests to rule out mental retardation or other intelligence deficits.
The child may also undergo psychological testing to detect any social problems, anxiety or depression that may be causing problems. In addition, some academic struggles that appear to be associated with learning disorders are actually the result of lack of opportunity, poor teaching or certain cultural factors (such as children learning in a setting where their primary language is not used).
If a physician suspects a learning order, psychologists or other specialists may be consulted to administer standardized tests that can provide clues about the patient’s disorder. For example, reading disorder can be diagnosed through tests that evaluate the process a child uses to read and the quality of the patient’s reading skills. Meanwhile, a patient with suspected mathematics disorder may take a test that measures the ability to perform basic math skills and to organize objects in a logical way.
In addition, experts recently devised a new neurophysiological test that enables professionals to detect learning disorders in patients as young as 8 years of age. The tool, which is known as the Biological Marker of Auditory Processing (BioMAP), uses noninvasive electrodes placed on the patient’s scalp and an earpiece that delivers carefully calibrated sounds into the patient’s ear. As the patient watches a video, the tester is able to measure the brain’s responses to the sounds and assess whether the patient has sound encoding problems related to a learning disorder.
Disorder of written expression is more difficult to diagnose than other disorders. Standardized testing has not been developed (aside from spelling tests) that can sufficiently and objectively measure the extent of a child’s difficulties in the area of writing. Typically, the child is instead asked to copy, write to dictation and write spontaneously, and the results are analyzed.
A specific learning disorder is diagnosed if the patient’s deficit in a specific area such as reading, writing or mathematics meets the following criteria:
- Levels of reading/writing/mathematics (as measured by standardized testing) are substantially lower than would be expected given the patient’s age, level of intelligence and level of education.
- Level of reading/writing/mathematics significantly interferes with school performance and day-to-day activities that require such skills.
- If the patient has a sensory deficit (impairment of one of the five senses), the reading/writing/mathematics difficulty must be in excess of that typically experienced by others with the same deficit.
In some cases, patients are diagnosed with a level of learning deficiency that does not fit the criteria for any one of the three APA recognized learning disorders. This may include problems in all three areas of learning.
Treatment options for learning disabilities
A learning disorder cannot be cured – the problem in the brain that causes the disorder lasts throughout the patient’s lifetime. However, special education techniques can help patients to improve their ability to read, write or perform mathematics. Many people with learning disorders learn to succeed at school and can become accomplished in areas that require academic excellence.
A specialist in learning disorders can help a patient with new methods of learning that focus on the patient’s learning strengths while compensating for areas of weakness. Federal law in the United States guarantees that children in public schools with learning disabilities receive extra help. Specialists are also available to help treat adults who are diagnosed with learning disorders.
Treatment of disorder of written expression is more difficult, as less is known about the condition than about other learning disorders.
Medications to treat a child’s hyperactivity and individual and family psychotherapy are also sometimes part of a treatment plan.
Questions for your doctor on learning disorders
Preparing questions in advance can help patients to have more meaningful discussions with their physicians regarding their conditions. Patients, or parents of patients, may wish to ask their doctor the following questions related to learning disorders:
- What are the signs and symptoms that might indicate that my child has a learning disorder?
- What tests will my child take to determine if a learning disorder is present?
- What type of learning disorder do you suspect my child may have?
- How can my child better learn to read, write or perform mathematics?
- What types of professionals offer this training?
- How should I work with my child’s school to ensure that my child has the best possible learning conditions?
- Is my child’s school legally obligated to help my child?
- Will my child ever be able to read, write or perform mathematics proficiently?
- What can I do to help my child better cope with his/her learning disorder?
- I have just been diagnosed with learning disorder, but I’m an adult. Is it too late for me to learn techniques that will strengthen my reading, writing or mathematical abilities?