Of Learning Disabilities

Learning Disabilities (LD) are the largest category of exceptionalities representing 40% of all disabilities.  An invisible handicap impacting the processing of information, by definition LD impacts students with an IQ of 85+ (e.g. average intelligence).  LD is generally seen as a neurological problem that affects how the brain perceives and processes information.

A computer analogy provided by Dr. K. Heikilla may help here.  LD occurs beyond the input stage of information at the processing, storage and output stages.

A) Characteristics of LD students


There are 7 academic/ language impacts (Smith, 2009):

1. Reading Skills
2. Reading Comprehension
3. Mathematical Calculations
4. Mathematical Reasoning
5. Written Expression
6. Oral Expression
7. Listening Comprehension

Other common characteristics of LD include:

• Socio-emotional problems
• Attention difficulties and hyperactivity
• Memory, cognition, metacognition difficulties
• Motor skills or perceptual ability difficulties 

B) Identifying LD students
The main criterion for identifying learning disabilities is a "severe discrepancy between ability and achievement that cannot be explained by another disabling condition or lack of learning opportunity." (Polloway, Smith et al. (2009). Teaching Students with Learning Disabilities.)

The main perceptual skills an LD student may be impacted by are:

1. Identification - Dyslexia - learning limited by numbers and letters being jumbled, e.g. not related to spatial orientation (More on dyslexia at BC Health Link).
2. Discrimination - Ability to notice increasingly subtle likeness and differences of items
3. Sequencing - Ability to recognize meaningful order and item position (spelling/math)
4. Closure - Ability to fill in gaps by activating prior learning to create meaningful whole (humour/sarcasm)
5. Figure-Ground - Ability to priortize items, to focus on relevant, ignore the relevant

Here is a video, My Life with a Learning Disability, where Andrew tells of his experience and how he wishes that learning in school had no time limit.
Check the sidebar for more LD resources and links.   I hope these resources will help students and parents understand the experience of having LD as told by students who have it.

Teachers should also ensure that other factors are not the primary cause for the behaviour or outcomes.  They should screen for cultural and linguistic differences and ensure that the indicators are not just unco-operative behaviour.

Teachers should also use assessment tools as a diagnostic on the correct identification of LD and to identify the type of perceptual skill that is affected so they can intervene appropriately.

Parents and students should be assured that no single cause is usually identifiable for their child.  Pinpointing the cause is not critical to developing effective plans and strategies for assisting LD.

C) Classroom modifications and adaptations 


At the secondary level, students with LD continue to need basic skill assistance as well as strategies that make them more efficient learners.  Application of Life skills is also recommended.

Other adaptations include:

• Use of graphical organizers (tables, fishbone diagrams, webs, event maps or story maps)
• Accessing less advanced texts from publishers
• Highlighting and summarizing key ideas
• Text to voice programs like Read Please
• Voice to text programs like Dragon Speaking
• Seating and physical accomodations
• Incorporation of Educational Assistants where possible

A Learning Disability Case Study completed by this blog author and colleagues can be found in this post.  A series of websites, tapes, books and audio are suggested as well as classroom accommodations.

Of Attention Deficit Hyperactivity Disorder (ADHD)

ADHD is a complex condition with no visible physical characteristics and a huge social and ethical debate around appropriate intervention.  Dr. K. Heikilla describes the condition as a neurological one impacting the brain's attention centres as the brain lacks beta waves that focus attention.

Healthlink BC defines ADHD as follows: Attention deficit hyperactivity disorder (ADHD) is a condition in which a person has trouble paying attention and focusing on tasks, tends to act without thinking, and has trouble sitting still. It may begin in early childhood and can continue into adulthood. Without treatment, ADHD can cause problems at home, school, work, and with relationships. In the past, ADHD was called attention deficit disorder (ADD).










A) Characteristics of ADHD students

1. Limited sustained attention 
2. Reduced impulse control
3. Excessive task-irrelevant activity
4. Deficient rule following
5. Greater than normal task variability during task performance

One very interesting aspect that has been published is the similarity between ADHD "symptoms" and the "traits" of gifted people.  In his book Engaging Minds and his lectures, Dr. Brent Davis frames this as a question of "Are we ritalinizing our geniuses?"  A difficult consideration for any parent.

Here is what we do know medically about ADHD based on research.  The condition is attributed to neurological causes including anatomical, chemical, physiological and pyshcological including reduced brain activity, lesser neurotransmitter activity and dysfunction or differences in the frontal lobes affecting "executive function." Still, much more research is needed on these models.  See CHADD for more.   (image credit: www.scienceblogs.com - The Neuroscience of ADHD)

B) Identifying ADHD
Incidence estimates vary but ADHD is the most common child psychiatric disorder with the Canadian Pedriatric Society states 3-7% amongst school age children.

ADHD has a genetic thread as it often runs in families which can be a helpful reference during diagnosis.

The identification process usually involves referral by a teacher or parent to the school team or school psychologist based on concerns over attention problems.  The teacher will use assessment measures and document behaviour over time in different settings.  Ultimately, a physician or psychiatrist involvement is required as ADHD is not an exceptionality category in the Canadian education system.

The assessments and documentation should help identify the type of ADHD and identify other factors that may exist which can include aggression, LD, Giftedness and Developmental Disabilities.  This process is critical to the right plan and adaptations.

The major strategies for intervention are medication and structural adaptations (covered in the next section).  The medical aspects are briefly touched on here since stimulant and anti-depressant medications are often prescribed including Ritalin, Adderal and Concerta.

So how does a parent decide whether to try medication?   Only after considerable thought and exploration of other interventions.  Significant school and home disruptions by the child's behaviour may indicate a stronger case for medication.  Side effects versus the benefits from addressing the impairment the child faces should be considered.  Will they suffer worse outcomes without the medication?
Other considerations include the child's age, supervision ability, costs, past interventions, the child's concerns and feelings and even competitive sports performance.

If a course of medication is decided upon, then the school team and parents need to monitor the behaviour impacts and any side effects like appetite loss.  Dosages or types of medication may need to be adjusted to find the right mix and substance abuse monitored.   Strong communication lines need to be in place with the physician as results are monitored.  Barkley (1999-2000) reports a 90% success rate for individuals that continue to try different stimulants after one fails.

It is important for parents to educate themselves and for those involved to be aware that the presence of ADHD may not necessarily be proven by positive response to the medication and that some children with ADHD may show no response at all.

C) Classroom adaptations and modifications
The literature related to ADHD generally suggests some of these approaches:

• Proactive classroom management around groups, physical management and behaviour
• Mutual rules development (5-6 maximum) and consistent rules application and consequences
• Positive language, patience, periodic review, positive reinforcement for abiding
• Spending time to develop relationship and teaching to their strengths and interests
• Routines, clear rules and choices during free times, flexible pacing and workload
• Respectful treatment of students
• Teaching cognitive strategies like note-taking, Power Point etc and apply skills to real world
• "Grandma's Law" - A clear reward following a desired behaviour
• Negative reinforcement - removing an aversive stimulus like homework for desired behaviour

As featured in the Parent Resource post, an excellent resource on classroom strategy for boy-centric problems is Barry Macdonald's Mentoring Boys.  Tips include:  consideration of the active learner style of many boys through physical environment, activity centres, novelty, fun, encouraging mistakes and calculated risks, clear goals and enabling boys to take on responsiblity and give input on school tasks.

As well the incorporation of Tactile-Kinesthetic Activities including:  role-play, performances, manipulatives, picture-taking for projects, note-taking strategies, field trips, models and dioramas, artifacts or foods related to theme and means of allowing students to get in touch with their feelings and gut reactions (journals).

More on Gardner's Multiple Intelligences can be viewed here.