Learning Disabilities (final)

What is a learning disability? Interestingly, there is no clear and widely accepted definition of "learning disabilities." Currently at least 12 definitions appear in the professional literature. These disparate definitions do agree on certain factors: 1. The learning disabled have difficulties with academic achievement and progress.

Discrepancies exist between a person's potential for learning and what he actually learns. 2. The learning disabled show an uneven pattern of development (language development, physical development, academic development and/or perceptual development). 3. Learning problems are not due to environmental disadvantage.

4. Learning problems are not due to mental retardation or emotional disturbance.

How prevalent are learning disabilities? • •

Experts estimate that 6 to 10 percent of the school-aged population in the United States is learning disabled. In India around 13-14% of all school children suffer from learning disorders.

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What causes learning disabilities? i. ii.

iii. iv. v. vi. vii. viii.

Little is currently known about the causes of learning disabilities. However, some general observations can be made: Some children develop and mature at a slower rate than others in the same age group. As a result, they may not be able to do the expected school work. This kind of learning disability is called "maturational lag." Some children with normal vision and hearing may misinterpret everyday sights and sounds because of some unexplained disorder of the nervous system. Injuries before birth or in early childhood probably account for some later learning problems. Children born prematurely and children who had medical problems soon after birth sometimes have learning disabilities. Learning disabilities tend to run in families, so some learning disabilities may be inherited. Learning disabilities are more common in boys than girls, possibly because boys tend to mature more slowly. Some learning disabilities appear to be linked to the irregular spelling, pronunciation, and structure of the English language. The incidence of learning disabilities is lower in Spanish or Italian speaking countries.

What are the "early warning signs" of learning disabilities? Children with learning disabilities exhibit a wide range of symptoms. These include problems with reading, mathematics, comprehension, writing, spoken language, or reasoning abilities. Hyperactivity, inattention and perceptual coordination may also be associated with learning disabilities but are not learning disabilities themselves. The primary characteristic of a learning disability is a significant difference between a child's achievement in some areas and his or her overall intelligence. Learning disabilities typically affect five general areas: 1. Spoken language: delays, disorders, and deviations in listening and speaking. 2. Written language: difficulties with reading, writing and spelling. 3. Arithmetic: difficulty in performing arithmetic operations or in understanding basic

concepts. 4. Reasoning: difficulty in organizing and integrating thoughts. 5. Memory: difficulty in remembering information and instructions. 2

Among the symptoms commonly related to learning disabilities are: •

poor performance on group tests

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difficulty discriminating size, shape, color

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difficulty with temporal (time) concepts

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distorted concept of body image

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reversals in writing and reading

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general awkwardness

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poor visual-motor coordination

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hyperactivity

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difficulty copying accurately from a model

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slowness in completing work

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poor organizational skills

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easily confused by instructions

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difficulty with abstract reasoning and/or problem solving

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disorganized thinking

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often obsesses on one topic or idea

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poor short-term or long-term memory

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impulsive behavior; lack of reflective thought prior to action

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low tolerance for frustration

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excessive movement during sleep

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poor peer relationships

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overly excitable during group play

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poor social judgment

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inappropriate, unselective, and often excessive display of affection

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lags in developmental milestones (e.g. motor, language)

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behavior often inappropriate for situation

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failure to see consequences for his actions

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overly gullible; easily led by peers

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excessive variation in mood and responsiveness

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poor adjustment to environmental changes 3

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overly distractible; difficulty concentrating

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difficulty making decisions

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lack of hand preference or mixed dominance

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difficulty with tasks requiring sequencing

When considering these symptoms, it is important to remain mindful of the following: 1. No one will have all these symptoms. 2. Among LD populations, some symptoms are more common than others. 3. All people have at least two or three of these problems to some degree. 4. The number of symptoms seen in a particular child does not give an indication as whether

the disability is mild or severe. It is important to consider if the behaviors are chronic and appear in clusters.

How does a learning disability affect the parents of the child? A parent may move from stage-to-stage in random. Some parents skip over stages while others remain in one stage for an extended period. These stages are as follows: DENIAL: "There is really nothing wrong!" "That's the way I was as a child--not to worry!" "He'll grow out of it!" BLAME: "You baby him!" "You expect too much of him." "It's not from my side of the family." FEAR: "Maybe they're not telling me the real problem!" "Is it worse than they say?" "Will he ever marry? go to college? graduate?" ENVY: "Why can't he be like his sister or his cousins?" MOURNING: "He could have been such a success, if not for the learning disability!" BARGAINING: "Wait 'till next year!" "Maybe the problem will improve if we move! (or he goes to camp, etc.)."

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ANGER: "The teachers don't know anything." "I hate this neighborhood, this school...this teacher." GUILT: "My mother was right; I should have used cloth diapers when he was a baby." "I shouldn't have worked during his first year." "I am being punished for something and my child is suffering as a result." ISOLATION: "Nobody else knows or cares about my child." "You and I against the world. No one else understands." FLIGHT: "Let's try this new therapy--Donahue says it works!" "We are going to go from clinic to clinic until somebody tells me what I want to hear.!" Again, the pattern of these reactions is totally unpredictable. This situation is worsened by the fact that frequently the mother and father may be involved in different and conflicting stages at the same time (e.g., blame vs. denial; anger vs. guilt). This can make communication very difficult.

Common types of learning disabilities : Common Types of Learning Disabilities Dyslexia

Difficulty processing language 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 Difficulty with fine motor Integration Disorder) skills

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Problems with hand–eye coordination, balance, manual dexterity

Common Types of Learning Disabilities Auditory Processing Disorder

Difficulty hearing differences Problems with reading, comprehension, between sounds language

Visual Processing Disorder

Difficulty interpreting visual information

Problems with reading, math, maps, charts, symbols, pictures

ARTICULATION AND PHONOLOGICAL DISORDERS  Both articulation and phonology refer to the physiological production of speech sounds, ie. the individual sounds in speech, not the meaning and content of speech. When a child presents with either an articulation disorder or a phonological disorder they are often difficult to understand.

Articulation •

Articulation is a general term which refers to the production of individual sounds. The production of sounds involves the coordinated movements of the lips, tongue, teeth & palate and respiratory system. This includes a variety of nerves and muscles used for speech production. All speech sounds (phonemes) are acquired in a predictable developmental order.

•

An articulation disorder refers to a child who has difficulty producing and forming particular speech sounds correctly eg. lisping or not being able to produce a particular sound eg. "r". These disorders are generally very specific in nature and require therapy from a trained speech pathologist.

Phonology / Phonological disorders •

Phonology refers to the pattern in which sounds are strung together to produce words. This means that a child can produce a sound correctly but may use it in the incorrect position in a word eg. a child always use "d" sound for the "g" sound ie. "doe" for "go". Phonological processes generally simplify sounds or sound sequences such as syllables and words. There are many types of phonological disorders and these area generally effected by three primary areas, including: 6

i.

Phonological disorders may have a far greater impact on a child's intelligibility than pure articulation disorders as the child may confuse several phonological rules. Phonological disorders and phonemic awareness disorders (the understanding of sounds and sound rules in words) have been linked to on - going language and literacy difficulties. It is therefore important to correctly assess a child's speech difficulties so that the correct intervention can be arranged.

ii.

Who should assess and treat the child? • •

•

A qualified speech pathologist should assess a child if there are any concerns regarding the quality, intelligibility or production of a child's speech. Pure articulation or phonological difficulties are generally not a direct symptom of brain injury. In most cases a child may have had some underlying difficulties prior to the brain injury occurring. Children with an acquired brain injury may however have difficulties with their speech patterns and these are generally caused by dyspraxia or dysarthria. Some children with acquired brain injuries may have difficulties with literacy acquisition and language, these children generally present with specific phonological awareness disorders.

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ATTENTION DEFICIT / HYPERACTIVITY DISORDER (AD/HD)

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Attention-Deficit/Hyperactivity Disorder (AD/HD) is a condition that can make it hard for a person to sit still, control behavior, and pay attention. These difficulties usually begin before the person is 7 years old. However, these behaviors may not be noticed until the child is older. Doctors do not know just what causes AD/HD. However, researchers who study the brain are coming closer to understanding what may cause AD/HD. They believe that some people with AD/HD do not have enough of certain chemicals (called neurotransmitters) in their brain. These chemicals help the brain control behavior.

Causes of ADHD •

ADHD is not caused by poor parenting, too much sugar, or vaccines.

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ADHD has biological origins that aren't yet clearly understood. No single cause has been identified, but researchers are exploring a number of possible genetic and environmental links. Studies have shown that many kids with ADHD have a close relative who also has the disorder.

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Although experts are unsure whether this is a cause of the disorder, they have found that certain areas of the brain are about 5% to 10% smaller in size and activity in kids with ADHD. Chemical changes in the brain also have been found.

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Recent research also links smoking during pregnancy to later ADHD in a child. Other risk factors may include premature delivery, very low birth weight, and injuries to the brain at birth. 8

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Some studies have even suggested a link between excessive early television watching and future attention problems. Parents should follow the American Academy of Pediatrics' (AAP) guidelines, which say that children under 2 years old should not have any "screen time" (TV, DVDs or videotapes, computers, or video games) and that kids 2 years and older should be limited to 1 to 2 hours per day, or less, of quality television programming.

How Common is AD/HD? As many as 5 out of every 100 children in school may have AD/HD. Boys are three times more likely than girls to have AD/HD.

What Are the Signs of AD/HD? There are three main signs, or symptoms, of AD/HD. These are: •

problems with paying attention,

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being very active (called hyperactivity), and

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acting before thinking (called impulsivity).

1) Inattentive type. Many children with AD/HD have problems paying attention. Children with the inattentive type of AD/HD often: •

do not pay close attention to details;

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can’t stay focused on play or school work;

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don’t follow through on instructions or finish school work or chores;

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can’t seem to organize tasks and activities;

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get distracted easily; and

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lose things such as toys, school work, and books. (APA, 2000, pp. 85-86)

2) Hyperactive-impulsive type. 9

Being too active is probably the most visible sign of AD/HD. The hyperactive child is “always on the go.” (As he or she gets older, the level of activity may go down.) These children also act before thinking (called impulsivity). For example, they may run across the road without looking or climb to the top of very tall trees. They may be surprised to find themselves in a dangerous situation. They may have no idea of how to get out of the situation. Hyperactivity and impulsivity tend to go together. Children with the hyperactive-impulsive type of AD/HD often may: •

fidget and squirm;

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get out of their chairs when they’re not supposed to;

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run around or climb constantly;

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have trouble playing quietly;

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talk too much;

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blurt out answers before questions have been completed;

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have trouble waiting for their turn;

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interrupt others when they’re talking; and

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butt in on the games others are playing. (APA, 2000, p. 86)

3) Combined type. •

• •

Children with the combined type of AD/HD have symptoms of both of the types described above. They have problems with paying attention, with hyperactivity, and with controlling their impulses. Of course, from time to time, all children are inattentive, impulsive, and too active. With children who have AD/HD, these behaviors are the rule, not the exception. These behaviors can cause a child to have real problems at home, at school, and with friends. As a result, many children with AD/HD will feel anxious, unsure of themselves, and depressed. These feelings are not symptoms of AD/HD. They come from having problems again and again at home and in school.

Related Problems One of the difficulties in diagnosing ADHD is that it's often found in conjunction with other problems. These are called coexisting conditions, and about two thirds of kids with ADHD have one. The most common coexisting conditions are: a) Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) 10

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At least 35% of kids with ADHD also have oppositional defiant disorder, which is characterized by stubbornness, outbursts of temper, and acts of defiance and rule breaking. Conduct disorder is similar but features more severe hostility and aggression. Kids who have conduct disorder are more likely to get in trouble with authority figures and, later, possibly with the law. Oppositional defiant disorder and conduct disorder are seen most commonly with the hyperactive and combined subtypes of ADHD.

b) Mood Disorders •

About 18% of kids with ADHD, particularly the inattentive subtype, also experience depression. They may feel inadequate, isolated, frustrated by school failures and social problems, and have low self-esteem.

c) Anxiety Disorders •

Anxiety disorders affect about 25% of kids with ADHD. Symptoms include excessive worry, fear, or panic, which can also lead to physical symptoms such as a racing heart, sweating, stomach pains, and diarrhea. Other forms of anxiety that can accompany ADHD are obsessive-compulsive disorder as well as motor or vocal tics (movements or sounds that are repeated over and over). A child who has symptoms of these other conditions should be evaluated by a specialist.

d) Learning Disabilities •

About half of all kids with ADHD also have a specific learning disability. The most common learning problems are with reading (dyslexia) and handwriting. Although ADHD isn't categorized as a learning disability, its interference with concentration and attention can make it even more difficult for a child to perform well in school.

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If your child has ADHD and a coexisting condition, the doctor will carefully consider that when developing a treatment plan. Some treatments are better than others at addressing specific combinations of symptoms.

Treating AD/HD •

ADHD can't be cured, but it can be successfully managed. Your child's doctor will work with you to develop an individualized, long-term plan. The goal is to help a child learn to 11

control his or her own behavior and to help families create an atmosphere in which this is most likely to happen. •

In most cases, ADHD is best treated with a combination of medication and behavior therapy. Any good treatment plan will require close follow-up and monitoring, and your doctor may make adjustments along the way. Because it's important for parents to actively participate in their child's treatment plan, parent education is also considered an important part of ADHD management.

Medications Several different types of medications may be used to treat ADHD: i.

Stimulants are the best-known treatments — they've been used for more than 50 years in the treatment of ADHD. Some require several doses per day, each lasting about 4 hours; some last up to 12 hours. Possible side effects include decreased appetite, stomachache, irritability, and insomnia. There's currently no evidence of long-term side effects.

ii.

Nonstimulants were approved for treating ADHD in 2003. These appear to have fewer side effects than stimulants and can last up to 24 hours.

iii.

Antidepressants are sometimes a treatment option; however, in 2004 the U.S. Food and Drug Administration (FDA) issued a warning that these drugs may lead to a rare increased risk of suicide in children and teens. If an antidepressant is recommended for your child, be sure to discuss these risks with your doctor.

Medications can affect kids differently, and a child may respond well to one but not another. When determining the correct treatment, the doctor might try various medications in various doses, especially if your child is being treated for ADHD along with another disorder.

Behavioral Therapy Research has shown that medications used to help curb impulsive behavior and attention difficulties are more effective when combined with behavioral therapy.

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Behavioral therapy attempts to change behavior patterns by:

i.

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reorganizing a child's home and school environment 12

giving clear directions and commands setting up a system of consistent rewards for appropriate behaviors and negative consequences for inappropriate ones

ii. iii.

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Here are examples of behavioral strategies that may help a child with ADHD:

i.

Create a routine. Try to follow the same schedule every day, from wake-up time to bedtime. Post the schedule in a prominent place, so your child can see what's expected throughout the day and when it's time for homework, play, and chores.

ii.

Get organized. Put schoolbags, clothing, and toys in the same place every day so your child will be less likely to lose them.

iii.

Avoid distractions. Turn off the TV, radio, and computer games, especially when your child is doing homework.

iv.

Limit choices. Offer a choice between two things (this outfit, meal, toy, etc., or that one) so that your child isn't overwhelmed and overstimulated.

v.

Change your interactions with your child. Instead of long-winded explanations and cajoling, use clear, brief directions to remind your child of responsibilities.

vi.

Use goals and rewards. Use a chart to list goals and track positive behaviors, then reward your child's efforts. Be sure the goals are realistic (think baby steps rather than overnight success).

vii.

Discipline effectively. Instead of yelling or spanking, use timeouts or removal of privileges as consequences for inappropriate behavior. Younger kids may simply need to be distracted or ignored until they display better behavior.

viii.

Help your child discover a talent. All kids need to experience success to feel good about themselves. Finding out what your child does well — whether it's sports, art, or music — can boost social skills and self-esteem.

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AUDITORY PROCESSING DISORDER •

Auditory processing disorder (APD), also known as central auditory processing disorder (CAPD), is a complex problem affecting about 5% of school-aged children.

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These kids can't process the information they hear in the same way as others because their ears and brain don't fully coordinate. Something adversely affects the way the brain recognizes and interprets sounds, most notably the sounds composing speech.

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Kids with APD often do not recognize subtle differences between sounds in words, even when the sounds are loud and clear enough to be heard. These kinds of problems typically occur in background noise, which is a natural listening environment.

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So kids with APD have the basic difficulty of understanding any speech signal presented under less than optimal conditions.

Causes •

The many possible causes of APD include:

i.

head trauma

ii.

lead poisoning

iii.

chronic ear infections. •

Sometimes the cause is unknown. Because there are many different possibilities — even combinations of causes — each child must be assessed individually.

Problem Areas for Kids With CAPD The five main problem areas that can affect both home and school activities in kids with APD are: 1. Auditory Figure-Ground Problems: This is when the child can't pay attention

when there's noise in the background. Noisy, low-structured classrooms could be very frustrating.

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2. Auditory Memory Problems: This is when the child has difficulty remembering

information such as directions, lists, or study materials. It can be immediate (i.e., "I can't remember it now") and/or delayed (i.e., "I can't remember it when I need it for later"). 3. Auditory Discrimination Problems: This is when the child has difficulty

hearing the difference between sounds or words that are similar (COAT/BOAT or CH/SH). This problem can affect following directions, reading, spelling, and writing skills, among others. 4. Auditory Attention Problems: This is when the child can't maintain focus for

listening long enough to complete a task or requirement (such as listening to a lecture in school). Although health, motivation, and attitude might also affect attention, among other factors, a child with CAPD cannot (not will not) maintain attention. 5. Auditory Cohesion Problems: This is when higher-level listening tasks are

difficult. Auditory cohesion skills — drawing inferences from conversations, understanding riddles, or comprehending verbal math problems — require heightened auditory processing and language levels. They develop best when all the other skills (levels 1 through 4 above) are intact.

Detecting APD  Symptoms of APD can range from mild to severe and can take many different forms. If you think your child might have a problem with how he or she processes sounds, consider these questions: i.

Is your child easily distracted or unusually bothered by loud or sudden noises?

ii.

Are noisy environments upsetting to your child?

iii.

Does your child's behavior and performance improve in quieter settings?

iv.

Does your child have difficulty following directions, whether simple or complicated?

v.

Does your child have reading, spelling, writing, or other speech-language difficulties?

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vi.

Is abstract information difficult for your child to comprehend?

vii.

Are verbal (word) math problems difficult for your child?

viii.

Is your child disorganized and forgetful?

ix.

Are conversations hard for your child to follow?  APD is an often misunderstood problem because many of the behaviors noted above can also appear in other conditions like learning disabilities, attention deficit hyperactivity disorder (ADHD), and even depression. Although APD is often confused with ADHD, it is possible to have both. It is also possible to have APD and specific language impairment or learning disabilities

Diagnosis •

Audiologists (hearing specialists) can determine if a child has APD. Although speechlanguage pathologists can get an idea by interacting with the child, only audiologists can perform auditory processing testing and determine if there really is a problem.

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However, some of the skills a child needs to be evaluated for auditory processing disorder don't develop until age 8 or 9. Younger kids' brains just haven't matured enough to accept and process a lot of information. Therefore, many children diagnosed with APD can develop better skills with time.

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Once diagnosed, kids with APD usually work with a speech therapist. The audiologist will also recommend that they return for yearly follow-up evaluations.

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Strategies at home and school  Strategies applied at home and school can alleviate some of the problem behaviors associated with APD. Because it's common for kids with CAPD to have difficulty following directions, for example, these tactics might help: i.

Since most kids with APD have difficulty hearing amid noise, it's very important to reduce the background noise at home and at school.

ii.

Have your child look at you when you're speaking.

iii.

Use simple, expressive sentences.

iv.

Speak at a slightly slower rate and at a mildly increased volume.

v.

Ask your child to repeat the directions back to you and to keep repeating them aloud (to you or to himself or herself) until the directions are completed.

vi.

For directions that are to be completed at a later time, writing notes, wearing a watch, and maintaining a household routine also help. General organization and scheduling also can be beneficial.

vii.

It's especially important to teach your child to notice noisy environments, for example, and move to quieter places when listening is necessary.  Other strategies that might help:

i.

Provide your child with a quiet study place (not the kitchen table).

ii.

Maintain a peaceful, organized lifestyle.

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Encourage good eating and sleeping habits.

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Assign regular and realistic chores, including keeping a neat room and desk.

v.

Build your child's self-esteem.

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 Be sure to keep in regular contact with school officials about your child's progress. Kids with APD aren't typically put in special education programs. Instead, teachers can make it easier for kids by altering seating plans so the child can sit in the front of the room or with the back to the window, or providing additional aids for study, like an assignment pad or a tape recorder.  One of the most important things that both parents and teachers can do is to acknowledge

that CAPD is real. Symptoms and behaviors are not within the child's control. What is within the child's control is recognizing the problems associated with APD and applying the strategies recommended both at home and school.  A positive, realistic attitude and healthy self-esteem in a child with APD can work wonders. And kids with APD can go on to be just as successful as other classmates. Although some children do, however, grow up to be adults with APD, with coping strategies and by using techniques taught to them in speech therapy, they can be very successful adults.

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VISUAL PROCESSING DISORDER • •

A visual processing, or perceptual, disorder refers to a hindered ability to make sense of information taken in through the eyes. This is different from problems involving sight or sharpness of vision. Difficulties with visual processing affect how visual information is interpreted, or processed by the brain.

Common areas of difficulty and some educational implications: 1) Spatial relation • This refers to the position of objects in space. It also refers to the ability to accurately perceive objects in space with reference to other objects. • Reading and math are two subjects where accurate perception and understanding of spatial relationships are very important. Both of these subjects rely heavily on the use of symbols (letters, numbers, punctuation, math signs). Examples of how difficulty may interfere with learning are in being able to perceive words and numbers as separate units, directionality problems in reading and math, confusion of similarly shaped letters, such as b/d/p/q. The importance of being able to perceive objects in relation to other objects is often seen in math problems. To be successful, the person must be able to associate that certain digits go together to make a single number (i.e., 14), that others are single digit numbers, that the operational signs (+, x,=) are distinct from the numbers, but demonstrate a relationship between them. The only cues to such math problems are the spacing and order between the symbols. These activities presuppose an ability and understanding of spatial relationships. 2) Visual discrimination • This is the ability to differentiate objects based on their individual characteristics. Visual discrimination is vital in the recognition of common objects and symbols. Attributes which children use to identify different objects include: color, form, shape, pattern, size, and position. Visual discrimination also refers to the ability to recognize an object as distinct from its surrounding environment. • In terms of reading and mathematics, visual discrimination difficulties can interfere with the ability to accurately identify symbols, gain information from pictures, charts, or graphs, or be able to use visually presented material in a productive way. One example is being able to distinguish between an /nl and an Imp, where the only distinguishing feature is the number of humps in the letter. The ability to recognize 19

distinct shapes from their background, such as objects in a picture, or letters on a chalkboard is largely a function of visual discrimination.

3) Visual closure • Visual closure is often considered to be a function of visual discrimination. This is the ability to identify or recognize a symbol or object when the entire object is not visible. • Difficulties in visual closure can be seen in such school activities as when the young child is asked to identify, or complete a drawing of, a human face. This difficulty can be so extreme that even a single missing facial feature (a nose, eye, mouth) could render the face unrecognizable by the child. 4) Object recognition (Visual Agnosia) • Many children are unable to visually recognize objects, which are familiar to them, or even objects, which they can recognize through their other senses, such as, touch or smell. One school of thought about this difficulty is that it is based upon an inability to integrate or synthesize visual stimuli into a recognizable whole. Another school of thought attributes this difficulty to a visual memory problem, whereby the person cannot retrieve the mental representation of the object being viewed or make the connection between the mental representation and the object itself. • Educationally, this can interfere with the child's ability to consistently recognize letters, numbers, symbols, words, or pictures. This can obviously frustrate the learning process, as what is learned on one day may not be there, or not be available to the child, the next. In cases of partial agnosia, what is learned on day one, "forgotten" on day two, may be remembered again without difficulty, on day three. 5) Whole/part relationships • Some children have a difficulty perceiving or integrating the relationship between an object and symbol in its entirety and the component parts, which make it up. Some children may only perceive the pieces, while others are only able to see the whole. The common analogy is not being able to see the forest for the trees and conversely, being able to recognize a forest but not the individual trees, which make it up. • In school, children are required to continuously transition from the whole to the parts and back again. A "whole perceiver", for example, might be very adept at recognizing complicated words, but would have difficulty naming the letters within it. On the other hand, "part perceivers" might be able to name the letters, or some of the letters 20

within a word, but have great difficulty integrating them to make up a whole, intact word. In creating artwork or looking at pictures, the "part perceivers" often pay great attention to details, but lack the ability to see the relationship between the details. "Whole perceivers", on the other hand, might only be able to describe a piece of artwork in very general terms, or lack the ability to assimilate the pieces to make any sense of it at all. As with all abilities and disabilities, there is a wide range in the functioning of different children. 6) Interaction with other areas of development •

•

•

A common area of difficulty is visual motor integration. This is the ability to use visual cues (sight) to guide the child's movements. This refers to both gross motor and fine motor tasks. Often children with difficulty in this area have a tough time orienting themselves in space, especially in relation to other people and objects. These are the children who are often called "clumsy" because they bump into things, place things on the edges of tables or counters where they fall off, "miss" their seats when they sit down, etc. This can interfere with virtually all areas of the child's life: social, academic, athletic, pragmatic. Difficulty with fine motor integration affects a child's writing, organization on paper, and ability to transition between a worksheet or keyboard and other necessary information, which is in a book, on a number line, graph, chart, or computer screen.

Diagnosis The key to having a visual processing disorder detected is to see a specialist, an expert in central visual impairments, or a neurologist because an eye doctor can often miss signs like visual tracking, crossing the midline (with the eyes), fluidity, and may not even test your child’s reading or writing ability and may miss the flipping of letters such as b’s and d’s, p’s and q’s, and the also common 3 and E.

Interventions The following represent a number of common interventions and accommodations used with children in their regular classroom: 1) For readings 21

Enlarged print for books, papers, worksheets or other materials which the child is expected to use can often make tasks much more manageable. Some books and other materials are commercially available; other materials will need to be enlarged using a photocopier or computer, when possible. There are a number of ways to help a child keep focused and not become overwhelmed when using painted information. For many children, a "window" made from cutting a rectangle in an index card helps keep the relevant numbers, words, sentences, etc. in clear focus while blocking out much of the peripheral material which can become distracting. As the child's tracking improves, the prompt can be reduced. For example, after a period of time, one might replace the "window" with a ruler or other straightedge, thus increasing the task demands while still providing additional structure. This can then be reduced to, perhaps, having the child point to the word s/he is reading with only a finger. 2) For writing Adding more structure to the paper a child is using can often help him/her use the paper more effectively. This can be done in a number of ways. For example, lines can be made darker and more distinct. Paper with raised lines to provide kinesthetic feedback is available. Worksheets can be simplified in their structure and the amount of material, which is contained per worksheet, can be controlled. Using paper, which is divided, into large and distinct sections can often help with math problems. 3) Teaching Style Being aware and monitoring progress of the child's skills and abilities will help dictate what accommodations in classroom structure and/or materials are appropriate and feasible. In addition, the teacher can help by ensuring the child is never relying solely on an area of weakness, unless that is the specific purpose of the activity. For example, if the teacher is referring to writing on a chalkboard or chart paper, s/he can read aloud what is being read or written, providing an additional means for obtaining the information.

EXPRESSIVE LANGUAGE DISORDER

Definition 22

Expressive language disorder occurs when an individual has problems expressing him or herself using spoken language.

Types • • • •

Expressive language disorder is generally a childhood disorder. There are two types of expressive language disorder: the developmental type and the acquired type. Developmental expressive language disorder does not have a known cause and generally appears at the time a child is learning to talk. Acquired expressive language disorder is caused by damage to the brain. It occurs suddenly after events such as stroke or traumatic head injury. The acquired type can occur at any age.

Causes • •

There is no known cause of developmental expressive language disorder. Research is ongoing to determine which biological or environmental factors may be the cause. Acquired expressive language disorder is caused by damage to the brain. Damage can be sustained during a stroke, or as the result of traumatic head injury, seizures , or other medical conditions. The way in which acquired expressive language disorder manifests itself in a specific person depends on which parts of the brain are injured and how badly they are damaged.

Symptoms 1. Expressive language disorder is characterized by a child having difficulty expressing him- or herself using speech. The signs and symptoms vary drastically from child to child. The child does not have problems with the pronunciation of words, as occurs in phonological disorder . 2. The child does have problems putting sentences together coherently, using proper grammar, recalling the appropriate word to use, or other similar problems. 3. A child with expressive language disorder is not able to communicate thoughts, needs, or wants at the same level or with the same complexity as his or her peers. 4. The child often has a smaller vocabulary than his or her peers. 5. Children with expressive language disorder have the same ability to understand speech as their peers, and have the same level of intelligence. Therefore, a child with this disorder may understand words that he or she cannot use in sentences. The child may understand complex spoken sentences and be able to carry out intricate instructions, although he or she cannot form complex sentences. 23

6. There are many different ways in which expressive language disorder can manifest itself. Some children do not properly use pronouns, or leave out functional words such as "is" or "the." 7. Other children cannot recall words that they want to use in the sentence and substitute general words such as "thing" or "stuff." 8. Some children cannot organize their sentences so that the sentences are easy to understand. These children do comprehend the material they are trying to express—they just cannot create the appropriate sentences with which to express their thoughts.

Diagnosis •

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To diagnose expressive language disorder, children must be performing below their peers at tasks that require communication in the form of speech. This can be hard to determine because it must be shown that an individual understands the material, but cannot express that comprehension. Therefore, non-verbal tests must be used in addition to tests that require spoken answers. Hearing should also be evaluated, because children who do not hear well may have problems putting together sentences similar to children with expressive language disorder. In children who are mildly hearing impaired, the problem can often be resolved by using hearing aids to enhance the child's hearing. Also, children who speak a language other than English (or the dominant language of their society) in the home should be tested in that language if possible. The child's ability to communicate in English may be the problem, not the child's ability to communicate in general. The Diagnostic and Statistical Manual of Mental Disorders , fourth edition, text revised (known as the DSM-IV-TR ), states that there are four general criteria for diagnosing expressive language disorder. The first is that the child communicates using speech at a level that is less developed than expected for his or her intelligence and ability to understand spoken language. This problem with communication using speech must create difficulties for the child in everyday life or in achieving goals. The child must understand what is being said at a level that is age-appropriate, or at a developmental level consistent with the child's. Otherwise the diagnoses should be mixed receptive-expressive language disorder . If the child has mental retardation , poor hearing, or other problems, the difficulties with speech must be greater than is generally associated with the handicaps that the child has.

Treatment 24

• • • •

There are two types of treatment used for expressive language disorder. The first involves the child working one-on-one with a speech therapist on a regular schedule and practicing speech and communication skills. The second type of treatment involves the child's parents and teachers working together to incorporate spoken language that the child needs into everyday activities and play. Both of these kinds of treatment can be effective, and are often used together.

RECEPTIVE LANGUAGE DISORDER

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Receptive language disorder means the child has difficulties with understanding what is said to them. The symptoms vary between individuals but, generally, problems with language comprehension usually begin before the age of four years. 25

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Children need to understand language before they can use language effectively. In most cases, the child with a receptive language problem also has an expressive language disorder, which means they have trouble using spoken language.

Causes •

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The cause of receptive language disorder is often unknown, but is thought to consist of a number of factors working in combination, such as the child’s genetic susceptibility, the child’s exposure to language, and their general developmental and cognitive (thought and understanding) abilities. Receptive language disorder is often associated with developmental disorders such as autism. In other cases, receptive language disorder is caused by brain injury such as trauma, tumour or disease.

The process of understanding spoken language Understanding spoken language is a complicated process. The child may have problems with one or more of the following skills: • •

• • •

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Hearing - a hearing loss can be the cause of language problems. Vision - understanding language involves visual cues, such as facial expression and gestures. A child with vision loss won’t have these additional cues, and may experience language problems. Attention - the child’s ability to pay attention and concentrate on what’s being said may be impaired. Speech sounds - there may be problems distinguishing between similar speech sounds. Memory - the brain has to remember all the words in a sentence in order to make sense of what has been said. The child may have difficulties with remembering the string of sounds that make up a sentence. Word and grammar knowledge - the child may not understand the meaning of words or sentence structure. Word processing - the child may have problems with processing or understanding what has been said to them.

Symptoms

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There is no standard set of symptoms that indicates receptive language disorder, since it varies from one child to the next. However, symptoms may include: • • • • • •

Not seeming to listen when they are spoken to Lack of interest when story books are read to them Inability to understand complicated sentences Inability to follow verbal instructions Parroting words or phrases (echolalia) Language skills below the expected level for their age.

Diagnosis methods Assessment needs to pinpoint the child’s particular areas of difficulty, especially when they do not respond to spoken language. Diagnosis may include: •

•

• • •

Hearing tests by an audiologist to make sure the language problems aren’t caused by hearing loss and to establish whether or not the child is able to pay attention to sound and language (auditory processing assessment). Testing the child’s comprehension (by a speech pathologist) and comparing the results to the expected skill level for the child’s age. If the child is from a non-English speaking home, assessment of comprehension should be performed in their first language as well as in English, using culturally appropriate materials. Close observation of the child in a variety of different settings while they interact with a range of people. Assessment by a neuropsychologist to help identify any associated cognitive problems. Vision tests to check for vision loss.

Treatment options The child’s progress depends on a range of individual factors, such as whether or not brain injury is present. Treatment options can include: • • • •

Speech-language therapy One-on-one therapy as well as group therapy, depending on the needs of the child Special education classes at school Integration support at preschool or school in cases of severe difficulty 27

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Referral to a mental health service for treatment (if there are also significant behavioural problems).

DYSLEXIA

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There are several kinds of learning disabilities; dyslexia is the term used when people have difficulty learning to read, even though they are smart enough and are motivated to learn.

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Dyslexia is not a disease. It's a condition that you are born with, and it often runs in families. People with dyslexia are not stupid or lazy. Most have average or above-average intelligence, and they work very hard to overcome their learning problems.

Causes •

Research has shown that dyslexia happens because of the way the brain processes information. Pictures of the brain, taken with modern imaging tools, have shown that when people with dyslexia read, they use different parts of the brain than people without dyslexia. These pictures also show that the brains of people with dyslexia don't work efficiently during reading. So that's why reading seems like such slow, hard work.

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Most people think that dyslexia causes people to reverse letters and numbers and see words backwards. But reversals occur as a normal part of development, and are seen in many kids until first or second grade. The main problem in dyslexia is trouble recognizing phonemes which are the basic sounds of speech (the "b" sound in "bat" is a phoneme, for example). Therefore, it's a struggle to make the connection between the sound and the letter symbol for that sound, and to blend sounds into words.

•

This makes it hard to recognize short, familiar words or to sound out longer words. It takes a lot of time for a person with dyslexia to sound out a word. The meaning of the word is often lost, and reading comprehension is poor. It is not surprising that people with dyslexia have trouble spelling. They may also have trouble expressing themselves in writing and even speaking. Dyslexia is a language processing disorder, so it can affect all forms of language, either spoken or written.

•

Some people have milder forms of dyslexia, so they may have less trouble in these other areas of spoken and written language. Some people work around their dyslexia, but it takes a lot of effort and extra work. Dyslexia isn't something that goes away on its own or that a person outgrows. Fortunately, with proper help, most people with dyslexia learn to read. They often find different ways to learn and use those strategies all their lives.

What's It Like to Have Dyslexia? •

If you have dyslexia, you might have trouble reading even simple words you've seen many times. You probably will read slowly and feel that you have to work extra-hard when reading. You might mix up the letters in a word, for example, reading the word "now" as "won" or "left" as "felt." Words may blend together and spaces are lost. Phrases might appear like this: 29

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You might have trouble remembering what you've read. You may remember more easily when the same information is read to you or heard on tape. Word problems in math may be especially hard, even if you've mastered the basics of arithmetic. If you're doing a presentation in front of the class, you might have trouble finding the right words or names for various objects. Spelling and writing usually are very hard for people with dyslexia.

Diagnosis A teen's parents or teachers might suspect dyslexia if they notice these problems: 1. 2. 3. 4. 5. 6.

poor reading skills, despite having normal intelligence poor spelling and writing skills difficulty finishing assignments and tests within time limits difficulty remembering the right names for things difficulty memorizing written lists and phone numbers difficulty with directions (telling right from left or up from down) or reading maps

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If someone has one of these problems it doesn't mean he or she has dyslexia, but someone who shows several of these signs should be tested for the condition.

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A physical exam should be done to rule out any medical problems, including hearing and vision tests. Then a school psychologist or learning specialist should give several

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standardized tests to measure language, reading, spelling, and writing abilities. Sometimes a test of thinking ability (IQ test) is given. Some people with dyslexia have trouble in other school skills, like handwriting and math, or they may have trouble paying attention or remembering things. If this is the case, more testing will be done.

Dealing With Dyslexia •

Although dealing with dyslexia can be tough, help is available. A child or teen with dyslexia usually needs to work with a specially trained teacher, tutor, or reading specialist to learn how to read and spell better. The best type of help teaches awareness of speech sounds in words and letter-sound correspondences (called phonics). The teacher or tutor should use special learning and practice activities for dyslexia. 30

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A student with dyslexia may get more time to complete assignments or tests, permission to tape class lectures, or copies of lecture notes. Using a computer with spelling checkers can be helpful for written assignments. For older students in challenging classes, services are available that provide any book on tape, even textbooks. Computer software is also available that "reads" printed material aloud. Ask your parent, teacher, or learning disability services coordinator how to get these services if you need them.

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Treatment with eye exercises or glasses with tinted lenses will not help a person with dyslexia. It's not an eye problem, it's a language processing problem, so teaching language processing skills is the most important part of treatment.

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Emotional support for people with dyslexia is very important. They often get frustrated because no matter how hard they try, they can't seem to keep up with other students. They often feel that they are stupid or worthless, and may cover up their difficulties by acting up in class or by becoming the class clown. They may try to get other students to do their work for them. They may pretend that they don't care about their grades or that they think school is dumb.

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Family and friends can help people with dyslexia by understanding that they aren't stupid or lazy, and that they are trying as hard as they can. It's important to recognize and appreciate each person's strengths, whether they're in sports, drama, art, creative problem solving, or something else.

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People with dyslexia shouldn't feel limited in their academic or career choices. Most colleges make special accommodations for students with dyslexia, offering them trained tutors, learning aids, computer software, reading assignments on tape, and special arrangements for exams. People with dyslexia can become doctors, politicians, corporate executives, actors, artists, teachers, or whatever else they choose.

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DYSPRAXIA •

A person with dyspraxia has problems with movement and coordination. It is also known as "motor learning disability". Somebody with dyspraxia finds it hard to carry out smooth and coordinated movements. Dyspraxia often comes with language problems, and sometimes a degree of difficulty with perception and thought. Dyspraxia does not affect a person's intelligence, but it can cause learning difficulties, especially for children.

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Dyspraxia is also known as Developmental Co-ordination Disorder (DCD), PerceptuoMotor Dysfunction, and Motor Learning Difficulties. The terms Clumsy Child Syndrome or Minimal Brain Damage are no longer used.

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Developmental dyspraxia is an immaturity of the organization of movement. The brain does not process information in a way that allows for a full transmission of neural messages. A person with dyspraxia finds it hard to plan what to do, and how to do it.

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Experts say that about 10% of people have some degree of dyspraxia, while approximately 2% have it severely. Four out of every 5 children with evident dyspraxia are boys. If the average classroom has 30 children, there is probably one child with dyspraxia in almost each classroom.

Causes •

Scientists do not know what causes it. Experts believe the person's nerve cells that control muscles (motor neurons) are not developing correctly. If motor neurons cannot form proper connections, for whatever reasons, the brain will take much longer to process data.

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In some cases dyspraxia can be inherited .

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One study carried out at Children's Hospital Boston, USA, found that when there was injury to the cerebrum among premature babies; the cerebellum failed to grow to a normal size. The cerebellum grows rapidly late in gestation - much faster than the cerebral hemispheres - premature birth arrests this surge in development. Premature babies with cerebellum problems are likely to have deficits that extend beyond motor, and may benefit from early intervention.

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A study by scientists at the Universite Laval, Canada found that mothers who take omega-3 during the last months of pregnancy will boost their child's motor and cognitive development.

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A study carried out at Johns Hopkins Bloomberg School of Public Health found that fetal heart rates give clues to children's later development during toddler years.

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If a person develops dyspraxia later in life it is usually due to traumas suffered by the brain after a stroke, accident or illness. If a person is born with dyspraxia, it is also known as Developmental Dyspraxia.

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Unfortunately, for many sufferers, there is no obvious cause.

Symptoms

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Very early childhood The child may take longer than other children to: • • • • • • • •

Sit Crawl (some never go through crawling stage) Walk Speak Stand Become potty trained (get out of diapers/nappies) Build up vocabulary Speak in a clear and articulate way. Many parents of very young children with dyspraxia say they cannot understand what they are trying to say a lot of the time

Early childhood Later on the following difficulties may become apparent: • • • • • • • • • • • •

Problems performing subtle movements, such as tying shoelaces, doing up buttons and zips, using cutlery, handwriting. Many will have difficulties getting dressed. Problems carrying out playground movements, such as jumping, playing hopscotch, catching a ball, kicking a ball, hopping, and skipping. Problems with classroom movements, such as using scissors, coloring, drawing, playing jig-saw games. Problems processing thoughts. Difficulties with concentration. Children with dyspraxia commonly find it hard to focus on one thing for long. The child finds it harder than other kids to join in playground games. The child will fidget more than other children. Some find it hard to go up and down stairs. A higher tendency to bump into things, to fall over, and to drop things. Difficulty in learning new skills - while other children may do this automatically, a child with dyspraxia takes longer. Encouragement and practice help enormously. Writing stories can be much more challenging for a child with dyspraxia, as can copying from a blackboard.

The following are also common at pre-school age: • •

Finds it hard to keep friends Behavior when in the company of others may seem unusual 34

• • •

Hesitates in most actions, seems slow Does not hold a pencil with a good grip Such concepts as in, out, in front of are hard to handle automatically

Later on in Childhood • • • • • • • • •

Many of the challenges listed above do not improve, or do so very slightly Tries to avoid sports and PE Learns well on a one-on-one basis, but nowhere near as well in class with other kids around Reacts to all stimuli equally (not filtering out irrelevant stimuli automatically) Mathematics and writing are difficult Spends a long time getting writing done Does not follow instructions Does not remember instructions Is badly organized

Diagnosis A diagnosis of dyspraxia can be made by a clinical psychologist, an educational psychologist, a pediatrician, or an occupational therapist. Any parent who suspects their child may have dyspraxia should see their GP (general practitioner, primary care physician), or a special needs coordinator first. When carrying out an assessment, details will be required regarding the child's developmental history, intellectual ability, and gross and fine motor skills: Gross motor skills - this refers to how well the child uses his/her large muscles that coordinate body movement. This includes jumping, throwing, walking, running, and maintaining balance. • Fine motor skills - this refers to how well the child can use his/her smaller muscles. Activities which require fine motor skills include tying shoelaces, doing up buttons, cutting out shapes with a pair of scissors, and writing.  The assessor will need to know when and how developmental milestones, such as walking, crawling, speaking were reached. The child will be screened for balance, touch sensitivity, and variations on walking activities.  If the assessor, or GP, does not have the necessary training, dyspraxia could be missed altogether and the child will not be referred to a specialist. Training on identifying dyspraxia can be patchy, depending on which part of the world you live in, and also •

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which part of specific countries. The same applies to teachers - in some places they are well trained at identifying potential dyspraxia among their pupils, while in others they are not.  A new coordination and handwriting test that identifies Developmental Coordination Disorder may identify teenagers who need extra help at secondary school and college.

Treatment Although dyspraxia is not curable, with time the child can improve. However, the earlier a child is diagnosed, the better and faster his/her improvement will be. The following specialists most commonly help people with dyspraxia: •

Occupational therapy

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An occupational therapist will first observe how the child manages with everyday functions both at home and at school. He/she will then help the child develop skills specific to activities which may be troublesome. Speech and language therapy

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The speech and language therapist will first carry out an assessment of the child's speech, and then help him/her communicate more effectively. Perceptual motor training This involves improving the child's language, visual, movement, and auditory skills. A series of tasks, which gradually becoming more advanced, are set - the aim is to challenge the child so that he/she improves, but not so much that it becomes frustrating or stressful.

Scientists from the University of Leeds, England, developed a set of practical guidelines for use by teachers, childcare professionals and parents that will help pre-school children with coordination difficulties, to improve their dexterity. Active Play • Experts say that active play - any play that involves physical activity - which can be outdoors or inside the home, gets the motor activity going in children. Play is a way children learn about the environment and about themselves, and particularly for children aged 3 to 5; it is a crucial part of their learning. • Active play is where a very young child's physical and emotional learning, their development of language, their special awareness, the development of what their senses are, all come together. 36

• •

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The more children are involved in active play, the better they will become at interacting with other children successfully. Parents, uncles and aunts, and other adults can also become involved with a child's active play - however, sometimes they should take a step back and let the children really explore so they can try out their own understanding of the world. The risk of negative things happening to children if they play outside are far smaller than the risks of negative things happening to them if they don't, such as obesity, poor socialization with other children, and having less fun. It is only by taking risks that children learn the importance of, say, holding on tight, and correcting themselves. Parents who have a child with dyspraxia need to balance the risks of negative things happening outside, with the enormous benefits that active play has to offer. Deciding what this balance is depends on many factors, such as the severity of the child's dyspraxia, the outside environment, etc.

DYSCALCULIA

Dyscalculia is a specific learning disability in the area of mathematics. It has also been termed number blindness. This, much like dyslexia, is a neurological problem.

Causes •

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In children with dyscalculia, the cause is usually that the child does not have the proper level of development in number sense. They have great difficulty in connecting numbers with quantity. For example, such a child would have difficulty in determining that the number 5 relates to 5 objects and would not be able to count them out if asked to do so. Experts believe that dyscalculia is caused by a difference in the brain structure as it applies to carrying out mathematical calculations. This is a relatively new field of research in the area of learning disabilities and the research that exists has been carried out among populations that have other conditions as well, such as Fetal Alcohol Syndrome. 37

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All of the studies on these children show that there are less brain cells in the area of the brain dealing with mathematical skill than there are with those of normal ability. The causes of dyscalculia are believed to be both genetic and environmental. Alcohol consumption by the mother during pregnancy and premature birth are two of the environmental factors attributed to this learning disability.

Symptoms • • • • • • • • • •

Difficulty working with numbers Confused by math symbols Difficulty with basic facts (adding, subtracting, multiplying and dividing) Often will reverse or transpose numbers (36: 63) Difficulty with mental math Difficulty telling time Difficulty with directions (as for playing a game) Difficulty grasping and remembering math concepts Poor memory for layout of things (for example, numbers on a clock) Limited strategic planning skills (like used in chess)

A child with dyscalculia will have average or above average intelligence but cannot achieve to that degree in the area of mathematics.

Diagnosis • • •

An awareness of the problem by either the teacher or parent brings this disability to light. The family physician will likely refer the child to a specialist. This specialist will administer a battery of tests to determine the presence of a disability. Often a special educator and a school psychologist will also be involved in the testing and diagnosis.

Treatment •

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There is no cure for Dyscalculia, but with intervention, a child with discalculia can learn math and can function in the world. Typically instruction involves multi-sensory methods and other alternate methods of teaching any given math skill. Repetitive practice does not generally aid a child with dyscalculia. A child diagnosed with dyscalculia will typically receive an IEP (Individualized Education Plan) to guide instruction. Play math games that practice and review concepts. Touch math is an excellent way to teach children their basic facts, and is a strategy that students with no math disability can learn and benefit from as well. Basically touch math 38

•

•

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uses a multi-sensory approach to learning math, where students physically touch points on each number with their pencil point. Work to help the student visualize math problems. This includes simple things like drawing a picture or chart. Have the child look at pictures charts or graphs provided in the math book, and spend the time to really explain the graphs before moving on to solving the problem. Try having the child read the problem aloud, and see if that helps. Give him an example of the problem worked out or think about a real life example of the problem. Use graph paper to help keep the numbers lined up correctly, and un-clutter the worksheets that will go home to prevent too much visual information from being distracting. The most important thing a teacher or parent can do for a child with dyscalculia is to never give up. Each child can learn; some just learn differently. It may take a bit of extra effort, and some creative teaching methods, to help the child with dyscalculia be successful in math class.

DYSGRAPHIA Dysgraphia is a type of learning disability affecting the ability to recognize forms in letters, to write letters and words on paper and to understand the relationship between sounds, spoken words and written letters.

Causes •

Dysgraphia is believed to involve difficulty with fine motor skills such as motor memory, muscle coordination, and movement in writing.

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Language, visual, perceptual, and motor centers of the brain are also believed to play a role.

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Evidence suggests it may be hereditary.

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People who have suffered brain injuries or strokes may also show signs of Dysgraphia.

Characteristics of Dysgraphia 39

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People with dysgraphia, have substantial difficulty with written language despite having formal instruction.

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Their handwriting may include reversals, spelling errors, and may be illegible.

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Some students with dysgraphia may also have difficulty with language processing and the connection between words and ideas they represent.

Testing for Dysgraphia •

Dysgraphia - Comprehensive psychological and educational evaluations can assist in the diagnosis of Dysgraphia.

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Diagnostic writing tests can be used to determine if the learner's writing skills are normal for his age. They can also provide information on his writing processing.

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Through observations, analyzing student work, cognitive assessment, and occupational therapy evaluations, educators can develop comprehensive, individualized treatment plans.

Treatment •

Dysgraphia - Educators use a variety of methods to develop the student's individual education program (IEP).

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Typical programs focus on developing fine motor skills such as pencil grip, hand coordination, and developing motor-muscular memory.

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Language therapy and occupational therapy help the learner develop the important connections between letters, sounds, and words.

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Some students work best with keyboarding or speech recognition programs.

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REFERENCES

1. http://www.childdevelopmentinfo.com/learning/learning_disabilities.shtml 2. http://www.childdevelopmentinfo.com/learning/teacher.shtml 3. http://www.chw.edu.au/prof/services/rehab/brain_injury/information_sheets/communicati

on/articulation_and_phonology.htm 4. http://www.nichcy.org/Disabilities/Specific/Pages/ADHD.aspx 5. The National Center for Learning Disabilities New York (http://www.incrediblehorizons.com/visual-processing.htm#Smart%20Driver)

6. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. text revised. Washington DC: American Psychiatric Association, 2000. 7. Sadock, Benjamin J. and Virginia A. Sadock, eds. Comprehensive Textbook of Psychiatry. 7th ed. Philadelphia: Lippincott Williams and Wilkins, 2000. 8. Stein, Martin T., Steven Parker, James Coplan, Heidi Feldman. "Expressive Language Delay in a Toddler." Journal of Developmental & Behavioral Pediatrics 22 no. 2 (April 2001): 99. 9. http://www.disability.vic.gov.au/dsonline/dsarticles.nsf/pages/Receptive_language_disor der?OpenDocument 41

10. http://kidshealth.org/teen/school_jobs/school/dyslexia.html 11. http://learningdisabilities.about.com/od/learningdisabilitybasics/p/dysgraphia.htm 12. http://www.medicalnewstoday.com/articles/151951.php 13. http://specialneedseducation.suite101.com/article.cfm/diagnosing_treating_dyscalculia

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