1. Introduction to the Learning Disorders

Learning Disabilities are a general term that a specific type of learning problem. The formal definition of learning disabilities comes from the Individuals with Disabilities Act (IDEA). The IDEA is a federal law that regulates how schools provide special education and related services to children with disabilities or learning disabilities. Their definition is "a disorder in one or more of the basic psychological processes involved in understanding or using language, spoken or written, that may manifest itself in an imperfect ability to speak, read, write, think, spell, or do mathmatical calculations, including conditions such as perceptual disabilities, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia. Learning disorders do not include learning problems that are primarily the result of hearing, visual, or motor disabilities, of mental retardation, of mental disturbance, or emotional disturbance, or of environmental, cultural, or economic disadvantage."

As many as 1 out of every 5 people in the United States have a learning disability. In an effort to provide and early diagnosis for children, experts look for how a child is doing in school compared to how well a child could do according to his or her level of intelligence. A few other signs to look for are: difficulty learning the alphabet, ryming words, connecting letters to their sounds, repeat and pause often when reading, messy handwriting, struggle with idea expression when writing, limited vocabulary, math number confusion and reversal, and a difficulty in re-telling a story in sequential order. A learning disability can cause a person to experience difficulty in learning, processing information, and to use certain skills. The skills that are most commonly affected are: reading, writing, listening, speaking, mathematics, and reasoning. Learning disorders vary from person to person. For example, a person with a diffieciency in math may not experience one with reading and writing and vice versa.

There is no "cure" for learning disabilities. People who experience them, though, can learn ways to process the information they intake by using the methods that work for them. If people receive early intervention and assistance in diagnosing and treating their learning disorders, they can be high achievers and highly successful as adults. In assessing intelligence levels in children, researchers believe that learning disorders are caused by individual differences in the way in which the brain functions and processes information. This is due to the fact that children with learning disabilities have average or above average intelligence levels. to a diagnosed when an individual's achievement on individually administered,standardize tests in reading, mathematics, or written expression is substantially below (discrepancy of more than 2 standard deviations between achievement and IQ) that expected for age, schooling, and level of intelligence. Generally, children diagnosed with a learning disability usually do not reveal serious psychological or sensory impairment. Learning disabilities may carry with them demoralization, low self-esteem, and social skills deficits.

Learning disabilities are often co-morbid with Oppositional Defiant Disorder, Conduct Disorder, Dysthymic Disorder, and Attention-Deficit/Hyperactivity Disorder. When working with learning Disabilities, it is important to bear in mind that, while all children with learning disabilities have learning problems, not all children with learning problems will have a learning disability. Children and adults with a learning disorder have trouble processing sensory information which interferes in their daily activities at school and work. One should note that cultural and ethnic backgrounds should be taken into account.The DSM-IV-TR definition of learning disabilities has been criticized for being too narrow in considering only three academically oriented disorders. The exclusive orientation implies that a learning disorder cannot exist in a comorbid relationship with another disorder.

2. Reading Disorder (315)

    • DSM-IV-TR criteria
      • A. Reading achievement, as measured by individually administered standardized tests of reading accuracy or comprehension, is substantially below that expected given the person's chronological age, measured intelligence, and age-appropriate education.
      • B. The disturbance in Criterion A significantly interferes with academic achievement or activities of daily living that require reading skills.
      • C. If a sensory deficit is present, the reading difficulties are in excess of those usually associated with it.
Coding Note: If a general medical (e.g., neurological) condition or sensory deficit is present, the condition code on Axis III.

    • Associated Features
      • A reading disability is a learning disability that involves significant impairment of reading accuracy, speed, to the extent that the impairment interferes with academic achievement or activities of daily life. People with reading disabilities perform reading tasks well below the level one would expect based on their general intelligence, educational opportunities, and physical health.
      • Reading involves several steps, including: pronunciation, phonics, silent letters, word recognition, and so forth. People with reading difficiencies can exhibit difficulties in one or more of these areas. For people who experience a reading difficiency, there is a considerable gap between the actual level of achievement and the expected level of performance. People with reading disabilities might experience the following: slow reading speed, poor comprehension, omission of words, reversal of words or letters, difficulty decoding syllables or single words and associating them with specific sounds (phonics), and limited sight word vocabulary.
      • Children who experience a reading disability tend to experience more negative emotions than children who have typical reading skills. Some negative emotions that have been associated with reading disabilities are: shame, low self-esteem, and lack of motivation. Consequently, this may have a negative effect on their academic work and achievement level, even if they are of average or normal intelligence. The difficiency can also negatively impact a person's motivation to advance in their reading abilities, which in turn leads to a lower self-esteem. Oftentimes, peers make fun of a child's reading ability, or lack thereof, because he/she often reads slowly and often needs help pronouncing what other children view as simple words, which leads to a child's feelings of shame.
      • Teachers can usually identify children with this disorder when doing "popcorn reading," or reading aloud. Children with reading disabilities greatly benefit from a learning environment, in which a teacher has adjusted her curriculum and teaching style to meet their specific needs. Some techniques that teachers can use to help children are: individual reading time, clapping to the rythm of the different phonemes, tutoring, reading shorter passages, pairing with skilled readers on topic tasks, and picture and physical action association. It is very important for parents and teachers to maintain a positive attitude towards the child. Continued reassurance, maintaining frustration levels low, providing flexibility, and providing realistic expectations are critical to reduce negative emotions and provide positive methods for children to cope with their disability. Children who receive early diagnosis and treatment for their reading disorders experience less negative emotions and negative life impacts, such as school drop out, as opposed to children who do not receive early intervention. This rate of improvement is at an astonishingly 90 to 95%.
    • Child vs. Adult Presentation
      • About 4% of school-age children in the United States are diagnosed with reading disability. Children are usually presented with a reading disability when they start kindergarten or first grade, when reading skills are first developed. Since learning disabilities, are life-long, they persist into adulthood. If a person receives adequate intervention and treatment for their disability while in school, they will usually have learned coping skills by the time they enter adulthood. In contrast, if coping skills are not learned, they could continue to struggle as adults and fall into socially unacceptable lifestyles, such as substance abuse or other crimes.
    • Gender and Cultural Differences in Presentation
      • Sixty to 80% of children who are diagnosed with reading disabilities are male. The prevalence in females with the disability may be underestimated, since males tend to be more disruptive in class and referred to special education classes more often. Females, on the other hand, tend to quietly disassociate or daydream in expression of their disability. For the purpose of ruling out cultural differences, a random sample of the population is tested in addition to any individualized testing is performed as a diagnostic tool.
    • Twin Studies
      • Dyslexia was found in 80% or higher of monozygotic twins. The reason the concordance is so high is because monozygotic twins have the same genotype, as opposed to dizygotic twins. In other words, monozygotic twins share the same environment and, therefore, share heritability.
      • Depending on how strict the criteria is in a given country, the incidence and prevalence figures for Reading Disorder may vary from place to place.
    • Epidemiology
      • It is approximated that between five and fifteen percent of the general population has a learning disorder and about eighty percent has a reading disorder. Studies also suggest that about four percent of school-age children have a reading disorder.
      • Symptoms of difficulty in reading can be seen as early as Kindergarten, but they are seldomly diagnosed before the end of Kindergarten or the beginning of first grade, because formal reading instruction does not begin until that time. A reading disorder may go unnoticed for a while for children with a high IQ, because those children might function at or near their appropriate grade level in early grades. Their disorder could become more apparant, however, in fourth grade or later when the mass amount of new information makes it nearly impossible for them to hide their disorder any longer. For cases with early intervention, the prognosis is positive although the reading disorder may persist throughout their adult life.
    • Etiology
      • Reading is an intricate task, that requires eye muscle coordination, spatial orientation, visual memory, sequencing ability, an understanding of sentence structure and grammar, and the skill to categorize and analyze individual letters and a combination of letters. The brain must also be able to incorporate visual cues with memory and associate them with specific sounds. These sounds are then associated with specific meanings which must be retained while a sentence or passage is being read. When any of these processes are disrupted, a reading disorder can occur. Therefore, the cause of reading disorder is difficult to pinpoint. However, research has found that this disorder may be partially inherited. Therefore, reading disorders are more common in children that have a first-degree biological relative with a learning disability. By evaluating the reading and writing abilities of about 80 family members across four generations,researchers were able to isolate mutations in specific genes that were associated with reading and writing short comes (Davidson). Other theories suggest that problems in certain locations of the brain may cause a reading disorder. Studies have shown that the left-hemisphere posterior brain system does not respond correctly when people with the disorder are reading. Also two different systems function to develop a reading ability; an initial system that recognizes phonetics located in the parieto-temporal region and a decoding system used by more skilled readers in the occipito-temporal region that recognizes sight vocabulary. People with a reading disorder demonstrate a low activation of both these areas and an increased activation of the frontal gyrus which causes letter to sound decoding. There may also be a visual or auditory processing deficit, such as having problems moving the eyes to follow text and moving the eyes back and forth across a line. This would not be a problem in seeing, but in processing information from the eyes and in using the eyes to get information.
      • Reading Disordera aggregate familiarly and is more prevalent among first-degree biological relatives of individuals with Learning Disorders.
    • Empirically supported treatments
      • Early intervention is essential to the individuals well being. Customized education plans that has a cross-disciplinary educational approach is a treatment option. Many of the successful programs all use systems that are sound or symbol based, which breaks down the words into letters and sounds. Also, they attempt to build and reinforce mental associations using visual, auditory, and kinesthetic channels of stimulation. They simultaneously see, feel, and say the sound-symbol association by tracing the letters with their finger while pronouncing a word out loud for example. The programs are also highly structured, beginning with the sound of a single letter, working up to a pair of letters, then syllables, and then into words and sentences. By doing repetitive drill and practice, they will be able to form essential associations between sounds and symbols which may help them overcome their reading disorder (Davidson). Also, graphic organizers have a beneficial effect and are more beneficial when created bythe student. These graphic organizers are visual methods of highlighting imprtant information. They link what the student already knows with what they are trying to learn. For those with dyslexia, reading with an index card with a window cut in it is also helpful, as is reading with special colored filters.


3. Mathematics Disorder (315.1)

    • DSM-IV-TR criteria
      • A. Considered a disorder in 1937. Formerly known as developmental arithmetic disorder, developmental acalculia, or dyscalculia. This is a learning disorder in which a person's mathematical ability is substantially lower than the expected base for age, intelligence levels, life experiences, educational background, and physical impairments.
      • B. Mathematical ability, as measured by individually administered standardized tests, is substantially below that expected given the person's chronological age, measured intelligence, and age appropriate education.
      • C. The disturbance in Criterion A significantly interferes with academic achievement or activities of daily living that require mathematical ability.
      • D. If a sensory deficit is present, the difficulties in mathematical ability are in excess of those usually associated with it.
      • Coding Note: If a general medical (e.g., neurological) condition or sensory deficit is present, code the condition on Axis III.
    • Associated Features
      • The person's mathematical ability must be substantially below the levels of peers with symptoms usually occurring simultaneously. Early difficulties with arithmetic are very noticeable through low scores in math. There are four types of symptom categories that people with Mathematics Disorder can be observed having: 1.) Language Symptoms:misunderstanding of greater than or less than or misunderstanding of word problems 2.) Recognition or Perceptual Symptoms: difficulty reading numbers, difficulty understanding plus or minus signs, or properly aligning numbers to perform calculations 3). Mathematical Symptoms: difficiencies in the ability to count, memorize basic arithmetic data as multiplication tables, or follow sequential steps in problem solving 4.) Attention Symptoms: inability to copy numbers or ignoring operational signs
      • Other learning disabilities are common in comorbidity with mathematics disorders. Usually reading problems can be highly associated with mathematical disorders. For example, a child can experience difficulty when attempting to solve a math word problem if he/she cannot even understand the words he/she is reading
    • Child vs. Adult Presentation
      • This is primarily seen in children in elementary school more than in adults because of the amount of mathematical requirements that schools tend to impose on children to progress with their peers. It can also be seen in children as young as 6, but it is usually diagnosed when the child is 8 or in the third grade due to a foundation of basic math at that age. If proper diagnosis and treatment is not received early, studies show that there is higher risk of school drop out rates in children suffering from the disorder.
    • Gender and Cultural Differences in Presentation
      • Some studies have shown no significant gender difference, but it may occur with greater frequency in girls. Social constructs and state level administered tests tend to suggest that boys are better at math and girls are better at reading and writing. This way of thinking has been unconsciouly passed on to children and they test higher and perform academically superior in their gender specific areas. This has negatively impacted research as researchers must first eliminate that way of thinking before even beginning their research on gender differences in mathematics disorders. For the purpose of identifying cultural differences, a random sample of the population is tested, as well as the individualized testing that is performed to diagnose the disorder. Equally vital, is the inclusion of a similar socioeconomic and educational status for the participants that are being researched.
    • Epidemiology
      • According to the Diagnostic and Statistical Manual of Mental disorders, which is the basic manual consulted by mental health professional to asses the presence of mental disorders, approximately 1% of school age children have a mathematical disorder. It is difficult to determine the actual prevalence rate for mathematics disorders because so many studies focus on the prevalence of learning disabilites as a whole rather than separating into the specific reading, mathematic, or written expression disorders.
      • Mathematical disorders appear to be less prevalent than reading disorders. Approximately one in every five cases of learning disorders has a specific mathematics disorder.
      • This disorder appears to run in families, similar to other learning disabilities. This suggests that there is a genetic component to this disorder.
    • Etiology
        • The genetic components, which are thought to be a possible culprit for the disorder, are ones such as: Fragile X and Turner Syndrome. Fragile X is a genetic syndrome which results in a spectrum of characteristics: physical, intellectual retardation, emotional and behavioral features which range from severe to mild manifestation. It is the most common inherited cause of mental retardation and is associated with autism. It is a genetic disorder caused by a mutation of the FMR1 gene on the X chromosome. Mutation on that site is found in 1 out of every 4,000 males and in 1 out of every 6000 females. Turner Syndrome is a genetic disorder in which only an X chromosome is present, instead of an X and a Y chromosome. This disorder affects females and is associated with short stature, lack of sexual development, cardiac problems, kidney abnormalities, and possible mental retardation.
        • It is also more commonly seen in familial instances, in which one or more parents show more difficulty with mathematical subjects. Also, it is commonly thought to be multifactorial. Children seem to show signs of other learning disorders in reading and language skills, but can experience it independently if their reading and language skills are average or above average.
        • Injury to specific portions of the brain are also known to cause the inability to perform critical calculations thus leading to Mathematics disorder.
    • Twin Studies
        • Monozygotic twins have the same genotype, as opposed to dizygotic twins. In other words, monozygotic twins share the same environment and, therefore, share heritability. The results for a group of twins researched were shared genetic influences in mathematics disorders and language disorders.
    • Empirically Supported Treatments
      • Children diagnosed with this disorder are eligible for an individual education plan that focuses on giving them specific details that include learning accommodations for the child and a unique plan to treat their disorder. Studies show that those children need to be introduced to more problem-solving skills and tactics to eliminate distraction and add to their understanding.
      • Placement in special math classes with expert math teachers may be the most helpful to a child once he or she is diagnosed. Remedial education is shown to be effective for children because they need the specific help from teachers trained in learning disorders.
      • Tutoring can help when the child's learning disorder is diagnosed very early to help them develop more tactics to perform at the average level. Because of the wide variety of problems found under the diagnosis of mathematics disorder, plans vary considerably. Concrete, hands-on instruction is more successful than abstract or theoretical instruction.
      • Individualized Education Programs (IEPs) also address other language or reading disabilities that affect a child's ability to learn mathematics and assist children in overcoming them and coping with them.
      • Parents and teachers can look for the following signs to asses a potential mathematical disorder: problems counting, problems memorizing multiplication tables, inability to grasp the difference between addition and subtraction, poor computational skills, slowness in performing calculations, difficulty arranging numbers in order, inability to understand place values, difficulity understanding word problems, inability to understand mathmatical symbols, and inability to align two or three digit numbers to perform calculations. In most cases, the symptoms are present simultaneously with each other.


4. Disorder of Written Expression (315.2)

    • DSM-IV-TR criteria
      • A. Writing skills, as measured by individually administered standardized tests (or functional assessments of writing skills), are substantially below those expected given the person's chronological age, measured intelligence, and age-appropriate education.
      • B. The disturbance in Criterion A significantly interferes with academic achievement or activities of daily living that require the composition of written texts (e.g., writing grammatically correct sentences and organized paragraphs).
      • C. If a sensory deficit is present, the difficulties in writing skills are in excess of those usually associated with it.
      • Coding note: If a general medical (e.g., neurological) condition or sensory deficit is present, code the condition on Axis III.
    • Associated features
      • This disorder was previously called developmental expressive writing disorder. This disabilitiy affects both the physical reproduction of letters and the organization of thoughts and ideas in written compositions. Disorder of written expression is one of the more poorly understood learning disorders. Learning disabilities that only manifested themselves in written work were first described in the late 1960's. These early studies described three types of written disorders: 1.) Inability to form letters and numbers correctly, also called dysgraphia 2.) inability to form words spontaneously or form dictation 3.) inability to organize words into meaningful thoughts.
      • There are several in studying disorder of written expression and in implementing a remedial program. Disorder of written expression usually appears in conjunction with other reading and learning disorders, making it difficult to seperate manifestations of the disability related to only to written expression. Delays are noted in attention, visual-motor integration, visual processing, and expressive language.
      • Children with Disorder of Written Expression experience great difficulty with the use of their writing skills. The writing skills of these students are significantly lower than their peers according to a typical child’s age, acumen, and schooling. Writing complete sentences and forming adequate paragraphs are challenges for those with disorder of written expression. Also, the individuals with the disorder tend to make excessive errors and appear to have poor understanding in the areas of punctuation, grammar, and spelling. Some common symptoms of people with disorder of written expression include: poor or illegible handwriting, poorly formed letters or numbers, excessive spelling errors, excessive punctuation errors, excessive grammar errors, sentences that lack logical cohesion, paragraphs and stories that are missing elements and that do not make sense or lack logical conclusions, and dificient writing skills that significantly impact academic achievement or daily life.
      • Disorder of written expression is almost always associated with other learning disorders like a reading or mathematics disorder, and it is frequently accompanied by low self-esteem, social problems, increased rates of school dropout, conduct disorder, attention deficit disorder, and possibly depression. Often times, people assume because a person is diagnosed with a learning disability, such as disorder of written expression, the individual must also have lower intelligence. However, people diagnosed with disorder of written expression often have average or above average intelligence.
    • Child vs. adult presentation
      • Typically, an individual is diagnosed with disorder of written expression around the age of eight, which is usually around the time that children begin to read and write. Due to the fact that a child’s motor skills are still developing, the diagnosis is not usually made prior to age eight. Parents tend to recognize signs and symptoms of disorder of written expression in their children around grades four and five when writing skills become a big part in the classroom exercises. Ddsorder of written expression has no cure. Therefore, while the disorder is typically diagnosed in young children, it continues to be present throughout adulthood as well.
    • Gender and cultural differences in presentation
      • Most researchers say males are more commonly diagnosed with the disorder of written expression than females. In these cases, studies pertaining with learning disabilities, no significant gender difference has been found. On the other hand, general or special education teachers identify twice as many males than females. For the purpose of identifying cultural differences, a random sample of the population is tested, as well as the individualized testing that is performed to diagnose the disorder. Equally vital, is the inclusion of a similar socioeconomic and educational status for the participants that are being researched.
    • Epidemiology
      • Three to ten percent of school aged children in the United States are estimated to have disorder of written expression. Fifteen percent of the United States population are said to have a type of Learning Disability. When it is not comorbid with other learning disorders, a solitary experience with the disorder of written expression is extremely rare.
      • Deficits in written work may be attributed to a reading, language, or attention disorder, limited educational background, or lack of fluency in the language of the institution.
    • Etiology
      • The cause of disorder of written expression is unknown because of lack of research surrounding the disorder. Certain facts support the idea that biological and environmental factors can contribute to learning disorders. Research has shown that high levels of testosterone in the fetus may cause language delays. Which could contribute to the idea that disorder of written expression is more prevalent in boys. Also, the particular conditions to which the fetus is exposed to while in utero may be linked to learning disorders, but not just specifically disorder of written expression. Environmental factors can also cause learning disorders, however, there is no certain cause of disorder of written expression.
      • There are different factors that could contribute to written expression disorder. Some of these factors include: prenatal, environmental, and intrinsic factors. Prenatal factors refer to potential toxins, infections, and/or nutritional deficits to a fetus. Intrinsic factors refers to neurobiology, biochemical, genetic, and other medical conditions.
    • Empirically supported treatments
      • There are no standard tests specifically designed to evaluate disorder of written expression.
      • Some tests that might be helpful in diagnosing disorder of written expression include the Diagnostic Evaluation of Writing Skills (DEWS), the Test of Early Written Language (TEWL), and the Test of Adolescent Language (TAL).
      • Intense writing remediation may help, but no specific method or approach has proved particularly successful. The person being evaluated should also perform tasks such as writing from dictation or copying written material as part of diagnostic testing.
      • The most effective treatment approach for disorder of written expression is remedial education. Because little is known about disorder of written expression, treatment is often aimed toward learning disorders that are more common or familiar. Noticeable improvement is frequently seen after treatment, but the degree to which one recovers depends on the severity of the disorder.
      • A qualified evaluator should compare multiple samples of the student's written work with the written work normally expected from students of comparable backgrounds. The symptoms should be evaluated in light of a person's age, intelligence, educational experience, and culture or life experience. Written expression must be substantially below the samples of produced by other's of the same age, intelligence, and background.

5. Learning Disorder Not Otherwise Specified (315.9)

  • DSM-IV-TR criteria
    • This category is for disorders in learning that do not meet the criteria for any specific learning disorder. This category might include problems in all three areas (reading, mathematics, or written expression) that alone or simultaneously significantly interfere with academic achievement even though intelligence levels on tests measuring each individual skill is not substantially below that expected given the person's chronological age, measured intelligence, and appropriate education.
  • Associated features
    • These features may include deficits in intelligence or genetic influences that make them the way they are. The referece to "reading, writing, and arithmetic" applies to the learning disorders. People are different and have different abilities when it comes to reading, writing, and arithmetic. Some present as having deficits in reading that may slow the pace of the reader and/or bad comprehensive abilities in which the individual may not or have difficulty actually understanding what is being read or being able to explain what one reads.
    • Writing is much easier to replicate and to teach such as movement of a writing utensil of just simply tracing over different words or symbols. There is an eraser on a pencil so if one messes up it is alright, as compared to speech where one might offend somebody.
    • Arithmetic is the most complicated to learn as it involves comprehension of equations, words and even more symbols. Comprehension and replication of how to work out problems is key to learning the processes of some of the operations such as the addition, subtraction, division, and multiplication signs. There is an order of operations in higher level math involving multiplication, division, addition, and subtraction. Arithmetic takes the most practice as compared to reading and writing, which are essential components to acquire the ability to effectively communicate in social environments. Repetition of these skills and processes is essential to an individual in this category in order to commit this knowledge to long-term memory.
  • Child vs. adult presentation
    • There seems to be about the same presentation in children versus adults in overall status. There are more children with these deficits in learning that affect their ability to function on a daily basis in school especially. These are the children that are put in these special classes that get help with their school work and are in a different environment than the majority of the school children. Bullying becomes a major problem when children with learning disabilities and typically learning children are placed in the same environments without supervision. The children just see these differences and are not fully mature enough to express empathy or view other perspectives.
    • Learning disorders usually begin during childhood in their school years, because that is when they are most noticeable. If the disorder is not treated or the child does not respond well to offered treatments, the disorder can be carried into adulthood and cause problems throughout their life.
  • Gender and cultural differences in presentation
    • There has been no significant studies that show gender preference for learning disabilities, however some research has shown that certain disorders, such as written expression, have higher rates when elevated levels of tetosterone are present in fetuses. Other disorders show a prevalence for males because of the difference in disruptive behavior between girls and boys. There has also been no significant studies that show that culture plays any role in weather or not an individual has a learning disability. However, minorities usually report a lower socioeconomic status, which could result in a higher prevalence of learning disabilities. There is no research regarding the specifics of learning disorder not otherwise specified. However, research for many learning disorders, specified or not specified, reveal correlations between low socioeconomic status and a increase in learning disabilities. This can be attributed to the lack of funding needed to provide better education, medical care (both physical and mental), poor nutritional states, and environmental factors such as location. For the purpose of identifying cultural and socioeconomic differences, a random sample of the population is tested, as well as the individualized testing that is performed to diagnose the disorder. Equally vital, is the inclusion of a similar socioeconomic and educational status for the participants that are being researched.
  • Epidemiology
    • Overall, anywhere from 2-10% of children have a learning disorder. However, there is a lack of research involving learning disorders not otherwise specified. There are no estimates on how many children have this disorder.
  • Etiology
    • Learning disorders must be differentiated from normal variations in achievement and distinguished from difficulties due to lack of opportunity, poor teaching, inadequate schooling, or psychosocial, cultural, or other factors. No one is certain of the causes of learning disorders, but they may be linked to genetic factors, environmental factors, or pregnancy complications.
  • Empirically supported treatments
    • The most common and helpful treatment for all learning disorders is an individualized special education plan. In other words, children are evaluated by a professional, a determination of a learning disorder is made, and a specific plan is constructed for their specific needs.
    • Learning disorders can now be diagnosed in the presence of a sensory deficit or general medical (e.g., neurological) condition as long as the learning deficit exceeds that associated with the other deficit or condition.

6. Common Types of Learning Disabilities

Acording to WETA's website, www.ldonline.org/, dyslexia, dyscalculia, dysgraphia, auditory and visual processing disorders, and non-verbal learning disabilites are a few common learning disabilities:
  • Dyslexia is a common type of reading disorder.
    • Current definition: neurobiological in origin and conceptualizing the reading disability as a specific type of disability rather than one of several general disabilities. Difficulties with accurate and fluent word recongition and by poor spelling and decoding abilities a result of phonological awareness deficit. Associated features include problems in reading comprehension and poor vocabulary development resulting in a lack of actual reading. In other words, people who exhibit dyslexia tend to spend more time working on the mechanincs of the letters and words than on the comprehension of the material.
    • Dyslexia is considered a learning diasbility because it can make learning extremely difficult for individuals who are diagnosed with it. The severity of the learning disability also has an effect on the individual. If it is severe enough, special education may be recommended for the individual (International Dyslexia Association, 2007).
    • Neurological basis of the disorder has been confirmed through functional magnetic resonance brain imaging (also known as fMRI) and magnetoencephalography. The images indicate that the left hemisphere posterior brain system does not respond properly to reading.
    • Many schools may use a model called the Response to Intervention (RTI) to identify children with learning disabilites. This model takes children who show a reading level below what they should be and given these children individual supplemental reading instruction. If the children's reading level does not improve as it should, a learning disability in reading may be identified as positive. Schools are encouraged to start screening the children as early as possible to catch any signs of a learning disability so the child can receive the help they need to continue on with their education (International Dyslexia Association, 2007).
    • If the individual does not go through the RTI evaluation, a formal evaluation is required. In a formal evaluation, assessments will be provided to the individual who is suspected of having the disability. If there is any indication that an individual has a learning disabilty, an individualized intervention plan would be put in place to accommodate the individual's unique learning needs. These assessments could be provided either in a school setting like the RTI or in a formal, professional setting with specialists on the matter.
    • When many people hear the term dyslexia, they think that means people with this disability 'read backwards.' This is not necessarily true. It is true that the letters may become jumbled to a dyslexic individual, because they may have difficulty remembering the sounds the letters make or forming memories of the words (International Dyslexia Association, 2007).
    • The following link from NPR's All Things Considered discusses the possibility of a genetic link for dyslexia.
    • It can be difficult to imagine what someone with dyslexia sees when they are trying to read, this video does a fairly good job demonstrating the symptoms.

    • Many people have been diagnosed with Dyslexia, including celebrities such as Orlando Bloom, Jay Leno, Kiera Knightley, Robin Williams, and Albert Einstein
    • Dyslexia is a life-long disorder. Treatment for individuals with dyslexia may help individuals learn to read and write as they normally should. It is important for teachers and tutors to introduce a multi-sensory learning method for individuals with dyslexia. It also helps if the student receives immediate feedback so they can develop word recognition skills. Individualized help for individuals with dyslexia is good because it allows the individual to continue the learning process at his or her own pace (International Dyslexia Association, 2007).
  • According to WETA (2010), Dyscalculia is a mathematics disorder.
    • Current definition: Dyscalculia is a broad term for severe difficulties in math. It includes all types of math problems ranging from the inability to understand the meaning of numbers to the inability to apply math principles to solve problems.
    • According to National Center for Learning Disabilities, this is a lifelong disorder as well. Since math disorders can be so different, the effects they have vary from individual to individual.. For example, an individual who presents difficulties in processing language will have different issues than a person who has difficulties in regards to spatial relationships (National Center for Learning Disabilities, [NCLD] 2006).
    • In early childhood, children with dyscalculia may show issues in regards to making sense of the numbers, sorting objects by their physical appearances such as size, shape and color, or recognizing patterns. These children may also show some difficulties in learning to count and matching numbers as well (National Center for Learning Disabilities [NCLD], 2006).
    • School-aged children with dyscalculia may show difficulties when trying to solve basic math problems involving simple addition and subtraction. It may also be difficult for these children to remember certain math facts and be able to apply them to solve a math problem. A weakness in the visual-spatial skills may also arise at this point. In this case, the child may know the math facts but experience difficulties in putting them down on paper and work them out (NCLD, 2006).
    • For adolescents and adults who have not mastered the basic math skills, moving on to more difficult math problems can prove to be difficult for them. Language processing disorders canmake learning math difficult as well because the individual may not understand the math vocabulary presented to them (NCLD, 2006).
    • Some sypmtoms of Dyscalculia may include but are not limited to:
      • Frequent difficulties with arithmetic, confusing the signs: +, −, ÷, x
      • Difficulty with everyday tasks like checking change and reading analog clocks
      • Often unable to grasp and remember mathematical concepts, rules, formulas, and sequences.
      • An inability to read a sequence of numbers, or transposing them when repeated, such as turning 56 into 65.
      • Difficulty keeping score during games

    • Acording to the National Center for Learning Disabilities, students who are evaluated for math disorders are usually interviewed about their range of math abilites. Tests may be given to the student to determine whether the students abilites are at the level in which they should be at while also noting specific strengths and weaknesses (2006).
    • Treating dyscalulia requires the student to fully understand their own strengths and weaknesses in regards to the math disorder. Parents and teachers can work together to form strategies to help the student improve their math skills. Tutors are usually a good way to help the student outside of the classroom. Repeated practice of straighforward ideas can make learning the math concepts easier for these children. Some other strategies include using graph paper so the individual can organize their thoughts better on the paper, finding different ways to approach math facts, starting with specific concrete examples before moving on to more abstract principles, and placing the child in a place with little distractions with all the materials needed for the study (NCLD, 2006).
  • According to WETA (2010), Dysgraphia is a writing disorder:
    • Dysgraphia can be defined as a deficiency in the ability to write, regardless of the ability to read, and is not due to intellectual impairment. Dyspgraphia is a neurological disorder and usually appears when a child first learns to write (Voice of America, 2008).
    • The cause of dysgraphia is unknown. Early recognition of dysgraphia can help the individual by having them perform special exercises when writing to increase muscle strength and memories of what it feels like to write certain letters (Voice of America, 2008)
    • Teachers can help children with dygraphia by allowing the student to take tests by recording their answers into a voice recorder or typing out their answers on a typewriter or computer instead of writing it down on a piece of paper (Voice of America, 2008).
    • According to Russell (2007), there are three subtypes of dysgraphia:
      • Dyslexic dysgraphia: when spontaneously written work is usually illegible while copied work is usually okay. Someone who presents dyslexic dysgraphia does not mean they also have dyslexia, although they are often found together.
      • Motor dysgraphia: usually linked to deficient fine motor skills. Most written work is usually illegible, even if it has been copied. Long periods of writing may be painful and the letters will get worse as the person continues to write. Spelling is not affected with motor dysgraphia.
      • Spatial dysgraphia: usually has idifficulties understanding the space available on the page. Again, written work, both spontaneous or copied is usually illegible.
    • According to Voice of America (2008), some sypmtoms of Dysgraphia include but are not limited to:
      • a mixture of upper and lower case letters in a written work
      • pain in the hand and arm as well as muscle spasms
      • irregular letter shapes and sizes within a written work
  • Auditory Processing Disorder (APD)
    • According to the National Institute on Deafness and Other Communication Disorders, auditory processing disorder interupts the way in which the brain recognizes and interprets sounds. Children with APD often do not recognize the subtle differences in sounds, even though they may be loud and clear to another individual. Loud environments may cause these issues to become even worse (2004).
    • The causes of APD are presently unknown. It may appear that a child with APD can hear normally, but they may have problems using the sounds they hear for speech and language. APD can be associated with conditions such as dyslexia, attention deficit disorder, autism, autism spectrum disorder, specific language impairment, pervasive developmental disorder, or developmental delay (National Institute on Deafness and Other Communication Disorders [NIDCD], 2004).
    • According to the NIDCD, Children with APD may have normal hearing and intelligence but can show any of the following symptoms (2004):
      • issues in regards to paying attention and remembering information that has been presented orally
      • issues in regards to carrying out multi-phase directions
      • appear to have poor listening skills
      • require more time to process information
      • academic performance may be lower than normal
      • some behavior problems may be present
      • language issues may also be present (the child may confuse certain syllables and have difficulties with learning vocabulary)
    • Professional observation is neccessary to determine whether a child has APD. An audiologic evaluation will be given to the child to determine the softest sounds the child is capable of hearing as well as other tests to show whether the child can recogize sounds and words in sentences (NIDCD, 2004).
    • Treatments are still being studied for child who have APD. The NIDCD lists the following as some available treatments for children with APD (2004):
      • Auditory trainers allow the child or adult to focus on the information being presented by taking out any of the background noise that would otherwise be a distracter to the individual. An example of this would be a chile wearing a special headset in the classroom and the teacher using a sort of microphone connected to the headset so the child will hear only what the teacher has to say.
      • Envionment modifications may also be suggested to aide those individuals with APD. Here, the acoustics in the room can be modified, or even something as simple and placing the individual in a different spot in the room.
      • Exercises in language building skills can be introduced to the child to help them improve their vocabulary.
      • Auditory memory enhancement helps the child to look at the basic information presented and to put the extra details aside.
  • Visual Processing Disorder
    • According to the National Center for Learning Disabilities (2003), the brain can process visual information in many different ways. There are several different categories in which an individual with this disorder may have difficulties in. The individual is also not limited to having difficulties in just one of these categories.
      • These categories include:
        • Visual discrimination is when the individual uses the sense of sight to notice and compare the features of different items to distinguish one item from another. An individual with difficultes in this category may have difficulties in regards to observing a difference between two similiar letters, objects or patterns (NCLD, 2003).
        • Visual figure-ground discrimination involves discriminating the difference between a figure and its background. An individual having difficulties in this category may have problems finding a certain piece of information on a page full of words or numbers. They may also have difficulties seeing an image if there is a competing background (NCLD, 2003).
        • Visual sequencing involves the ability to distinguish between symbols, words, and images. Individuals experiencing difficulites in this category may find themselves unable to stay in the correct spot while reading (skipping lines or re-reading the same line over and over again), have difficulties in regards to using a seperate answer sheet, reversing or misreading letters and words, and even understanding math equations (NCLD, 2003).
        • Visual motor processing involves using feedback from the eyes to coordinate movement of other body parts. Individuals may show difficultes in regards to staying between the lines while writing (or coloring), copying from a board onto a piece of paper, moving around without bumping into things, and have issues in regards to playing sports that require timed and precise movements in space (NCLD, 2003).
        • There are two types of visual memory in which individuals may have difficulties with. The first one has to do with the ability to recall something that was seen a long time ago. The second one has to do with the ability to recall something that was seen recently. An individual may show difficulties in regards to remembering how to spell familiar words, remember phone numbers, reading comprehension, as well as typing on a keyboard or pad (NCLD, 2003).
        • Visual closure is the ability to know what an object is when only certain parts of that object are visible. An individual might show difficultes recognizing an object in a picture that is not represented as its whole self (for example, showing a picture of a truck with no wheels), identifying a word with a letter missing, and recognizing a face when just one feature (such as the nose) is missing (NCLD, 2003).
        • Spatial relationships is the ability to identify an object in space and relate it to oneself. An understanding of space is required in this category. An individual who may show difficulties in regards to getting from one place to another, spacing of words and letters on a page, judging time, and reading maps National Center for Learning Disabilities, 2003).

7. Other Helpful Information on Learning Disabilites

A really good website for parents who have a child with learning disabilites or who might be diagnosed with some sort of adult learning disability is WETA's website, http://www.ldonline.org/. This website lists many things that parents can do for their children if they are diagnosed with a learning disability and help them understand what a learning disability actually is.

Some facts the WETA gives on learning disabilites are as follows (2010):
- about 15% of the US population has been diagnosed with some type of learning disability
- the most common type of learning disability is a reading disorder
- a genetic link has been discovered in learning disabilites
- individuals who have been diagnosed with autism, mental retardation, deafness, blindness, or behavioral disorders do not neccessiarily have a learning disability
- individuals who have been diagnosed with ADHD do not always have a learning disability; however, they are often comorbid with one another

According to Horowitz, we know that there are some variations in brain development that are related to some reading disabilites. Using brain imaging tools, we can see that there are a number of regions and areas in the brain associated with certain skills that support the development of reading. Some learning disabilities can be traced back to prenatal dispositions such as fetal alcohol and cocaine exposure and possible maternal cigerette smoking. While Horowitz claims there is a strong genetic component in families, he also claims that learning disabilites can be influenced by environmental factors (2007).

Parents are usually the first to notice that their child may have some sort of learning disability. Parents should be aware of the following list that describes some common signs that a child may have a learning disability. Parents should remember that children may exhibit some symptoms of a learning deficiency occasionally, which is normal. Most children struggle with one concept or another at any given time, but a specific criteria must be met in order for the classification of a learning disability to be made. According to WETA (2010), a parent should seek assistance if their child exhibits several of these symptoms over a long period of time:
    • Preschool aged children
      • the child learns to speak later than normal.
      • the child's fine motor skills are be slow to develop
      • the child has difficulty in the pronunciation of words
      • the child has a slow vocabulary growth and often has a difficult time finding the right words
      • the child shows difficulty in learning numbers, patterns, days of the week, and the alphabet
      • the child is extremely restless
      • the child becomes easily distracted
      • the child shows difficulties when interacting with peers
      • the child has trouble following directions or even a routine that is set in place
    • School-aged children, grades Pre-K through 4
      • the child shows difficulty connecting letters to their sounds
      • the child shows confusion in basic words such as eat, want, play...
      • the child consistently makes reading and spelling errors, including letter reversals (b to d or vice versa), inverting letters (m/w), transpositions (left/felt) and substitutions (house/home). The child may also transpose number sequences as well as words.
      • the child is slow to recall facts
      • the child is slow to learn new skills and may depend greatly on memorization
      • the child is impulsive and have problems when it comes to planning
      • the child holds their writing utensil in an unstable way
      • the child shows problems when it comes to learn about time
      • the child shows poor coordination, often unaware of their surroundings, and may also come across as 'clumsy'
    • School-aged children, grades 5-8
      • the child reverses letter sequences, such as soiled/soild and left/felt
      • the child has difficultly learning the prefixes and suffixes of a word as well as the root word
      • the child avoids reading aloud when given the opportunity to choose
      • the child shows difficulty with word problems
      • the child's handwriting may be poor
      • the child exhibits an awkward way while holding a writing utensil
      • the child avoids writing assignments all together
      • the child is slow to recall facts
      • the child has some problems in regards to making friends
      • the child has difficulty understanding body language and facial expressions
    • High school students through adulthood
      • the individual continues to have issues in regards to spelling
      • the individual avoids reading and writing tasks all together
      • the individual shows some difficulties when summarizing
      • the individual has problems in regard to answering open-ending questions
      • the individual has weak memory recall
      • the individual works slowly
      • the individual shows difficulties adjusting to newer settings
      • the invididual has difficulty understanding abstract concepts
      • the individual has issues directing their attention correctly. For example, they may give too much attention to certain details or they might show too little attention to details
      • the individual misreads information

According to NCLD, building good self-esteem is a great way to improve job mastery skills and earn success in school. It is important to know that having a learning disability does not necessary decrease one's self-esteem, but rather the characteristics that some individuals with learning disabilies exhibit may affect their self-esteem. Some of these characteristics may include:
    • communication style and social awareness: the individual may not be able to understand clues as to when it is appropriate to participate or not, as well as not understanding how their own behavior can affect others
    • self knowledge: individuals may have issues understanding their own strengths and weaknesses as well as evaluating whether their behavior is appropriate in social situations.
    • language: individuals may have issues in regards to expressing their thoughts in a verbal manner
    • self-perceived social status: they have have issues in regards to understanding how they fit in in a group of people. This may cause the individual to become passive and withdraw from social situations, fearing that they will stick out in the crowd.
    • Self-perceived ability to affect change: the individual may believe that they have no control over their own successes and that luck or fate is responsible for the outcome of sitations rather than their own actions (2009).
The NCLD also gives a list of how parents can help children with learning disabilities who are showing some of the above characteristics by doing some of the following:
    • being empathetic to the child (seeing the world through their eyes)
    • communicate with respect--be sure not to interrupt them when they are talking and be sure to answer their questions
    • give undivided attention to the child
    • accept and love the child for who they are
    • give the child a chance to contribute--this lets the child know that you trust them and also give them a sense of responsibility
    • treat mistakes as learning experiences
    • emphasize their strengths and help give them a sense of accomplisment
    • allow the child to solve problems and make decisions
    • discipline to teach and do not try to intimidate the child (2009)

8. Learning Disabilities in Adults

  • S.H. Horowitz, discussed learning disabilites as they affect adults. He argued that although, learning disabilites are usually diagnosed during childhood, adults live and stuggle with learning disabilites as well since there is no cure for them. Therapy may be helpful in assisting individuals deal with the challenges that learning disabilites may cause (Horowitz, 2006).
  • Horowitz also refers to a paper written in 1985 called "Adults with Learning Disabilities: A Call to Action," which addresses facts about learning disabilities across the lifespan. While this paper was written about 25 years ago, Horowitz claims that the following facts from the paper are still true for adults with learning disabilities (Horowitz, 2006):
    1. Learning disabilities are both persistent and pervasive across the life span. Also, the manifestations of a learning disability may change across the individuals life span.
    2. There is a lack of research concerning learning disabilities with adults. As a result, there has been misuse and misinterpretation in regards to adult with learning disabilities because the assessments in which the adult goes through are usually meant for younger children.
    3. Older adolescents and adults do not have access or are denied proper education in both the academic settings and the work place to achieve development in certain adult abilities and skills .
    4. Professionals are not usually trained in helping adults with learning disabilites.
    5. Employers do not have the awareness, knowledge of, or sensitivity to address the needs of adults with learning disabilites.
    6. Adults with learning disabilities may experience personal, social, and emotional difficulties that may affect their adapation to certain life skills.
    7. There is little advocacy concerning adults with learning disabilites.
    8. Federal, state, and private funding agencies concerned with learning disabilities have not supported program development initiatives for adults with learning disabilities
  • According to Horowitz, students who graduate high school have an assortment of options available to them to include attending a 2-year community college, a 4-year university, a vocational training program, or an apprenticeship. Students with learning disabilities face challenges in regards to the realistic options that are available to them. About 39% of students with a learning disability drop out of school without receiving a high school diploma. Only 13%, compared to the 53% of students who do not have a learning disability, will attend some form of continued education after graduating high school. While these statistics are specifically concering students, it does reflect some of the challenges that young adults with learning disabilites are facing today (Horowitz, 2006).
  • If an adult suspects that they might have a learning disability but has never been diagnosed or tested for one, then that adult can find assistance by having some sort of assessment done by a qualified professional. The assessment procedure can vary depending on the setting in which it is given (such as a community college, vocational setting, or other basic adult education programs). There are usually three stages to the assessment: evaluation, diagnosis, and recommendations. The evaluation includes a screening and should obtain all relevant information about the individual in question. The diagnosis is a statement on the specific learning disability in which the indiviudal may have. The recommendations should be focused in regard to the individuals employment, education, and daily living (Learning Disabilities Association of America [LDA], 2010).
  • Adults should be assessed according to their age, experience, and career objectives; and regardless of their diagnosis, the adult should know more abou themselves, have a better idea of their strengths and weaknesses, and feel better about themselves (LDA, 2010).
  • According to the LDA (2010), adults who find themselves in need of an assessment or who feel they need to be assessed can look to the following for help:
    • Learning Disabilities Association of America, often listed with the name of the city or county first
    • adult education in the public school system
    • adult literacy programs or literacy councils
    • community mental health agencies
    • counseling or study skills center at a local college or university
    • educational therapists or learning specialists in private practice
    • guidance counselors in high schools
    • International Dyslexia Association
    • private schools or institutions specializing in learning disabilities
    • special education departments and/or disability support service offices in colleges or universities
    • state Vocational Rehabilitation Agency
    • University-affiliated hospitals

American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders. 4th ed. text revised. Washington DC: American Psychiatric Association, 2000.
Diagnostic and Stastistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC, American Psychiatric Association, 2000.

Horowitz, S. H. (2006). Learning disabilities in adulthood. LD Basics: LD Across the Lifespan. Retrieved from http://www.ncld.org/ld-basics/ld-explained/ld-across-the-lifespan/learning-disabilities-in-adulthood-the-struggle-continues

Horowitz, S. H. (2007). The neurobiology of learning disabilities. LD Basics: Basic Facts. Retrieved from http://www.ncld.org/ld-basics/ld-explained/basic-facts/the-neurobiology-of-learning-disabilities

International Dyslexia Association (2007). Dyslexia basics. Retrieved from http://www.ldonline.org/article/Dyslexia_Basics

Learning Disabilities Association of America (2010). For adults. Adults with Learning Disabilities: Assessing the Problem. Retrieved from http://www.ldanatl.org/aboutld/adults/assessment/assessing.asp
National Center for Learning Disabilities (2003). Visual processing disorders: In detail. Retrieved from http://www.ldonline.org/article/Visual_Processing_Disorders%3A_In_Detail

National Center for Learning Disabilities (2006). Dyscalculia. Retrieved from http://www.ldonline.org/article/Dyscalculia

National Institute on Deafness and Other Communication Disorders (2004). Auditory processing disorder in children. Retrieved from http://www.ldonline.org/article/Auditory_Processing_Disorder_in_Children

NCLD Editorial Staff (2009). Building self esteem. LD Basics: Social & Emotional Issues. Retrieved from http://www.ncld.org/ld-basics/ld-aamp-social-skills/self-esteem/building-self-esteem

Russell, M. (2007). Learning disabilites. Dysgraphia.Retrieved from http://ezinearticles.com/?Learning-Disability---Dysgraphia&id=417762

Voice of America (2008). Dysgraphia: More than just bad handwriting. Retrieved http://www.ldonline.org/article/Dysgraphia%3A_More_Than_Just_Bad_Handwriting

WETA (2010). LD basics. Retrieved from http://www.ldonline.org/ldbasics