A Review of Learning Disorders and It’s Impact on Individuals and Others Staff Training Ken Kosko...

A Review of Learning Disorders and It’s Impact on Individuals and Others

Staff Training

Ken KoskoEducation Evaluation Center

The Teaching Research InstituteWestern Oregon University

SLDRehabilitation Services Administration (RSA)1985

Definition:A specific learning disability is a disorder in one or more of the central nervous system processes involved in perceiving, understanding, and/or using concepts through verbal (spoken or written) language or nonverbal means. This disorder manifests itself with a deficit in one or more of the following areas: attention, reasoning, processing, memory, communication, reading, writing, spelling, calculation, coordination, social competence, and emotional maturity. (Rehabilitation Services Administration. (1985, January 21). Program policy directive. Washington, DC: U.S. Office of Special Education and Rehabilitation Services.)

SLDDEFINITION-RSA

Spoken or Written Language

Central Nervous System Processes

1. Perceiving

2. Understanding

Manifestations:

Attention

Reasoning

Memory

Communicating

Academics (reading, writing, math)

Coordination

Social Competence

Emotional Maturity

Oregon Department of EducationOregon Administrative Rules 9/19/2007

Specific Learning Disabilities

(A) Basic Reading Skills

(B) Reading Fluency Skills

(C) Reading Comprehension

(D) Mathematics Calculation

(E) Mathematics Problems-solving

(F) Written Expression

(G) Oral Expression

(H) Listening Comprehension

A. Achievement Grades (1-12)

Oregon Department of EducationOregon Administrative Rules 9/19/2007

Specific Learning Disabilities

(1) Cognition

(2) Fine Motor

(3) Perceptual Motor

(4) Communication

(5) Social or Emotional

(6) Perception or Memory

B. Other: If needed

Major Components of a Learning Disabilities Definition

Learning Disabilities:

1. is a general term for a heterogeneous group of disorders

2. are manifested by significant difficulties in listening, speaking, reading, writing, or math;

3. are part of the person make-up (i.e., they will not go away);

4. are presumed to be a dysfunction of the central nervous system;

5. may be discovered across the life span;

6. may RESULT in problems with behavior, social perceptions, and social interactions (but these problems are NOT the disability);

7. are NOT the result of other disabilities such as lost of sight or hearing, lack of intelligence, or lack of schooling.

Common Challenges of Successful Adults with LD

Almost all experienced significant difficulty learning in school

Many never did learn to read, write, spell, or compute particularly well

Social skills were either a strength or an area of need

Dealing with LD is a daily task Felt vulnerable because of differences in learning Self-esteem tended to deteriorate when LD went

undiagnosed

(Gerber & Reiff, 1994)

Everyday Manifestations

Feeling constantly behind

Fear of filling out forms

Extreme stress or fear associated with any isolated measure of ability

Isolation resulting from fear of being misunderstood

Extreme stress over deadlines

Feeling inadequate because of difficulty doing tasks others find easy

Reading

Slow reader (estimated range up to four times as long to read a page as others)

Reading out of sequence (they went to see a movie=they to see a movie went)

Mistaking one word for another (for=from, to=of) Tracking difficulty: skipping over words or lines Difficulty reading multi-syllable words (aluminum) Difficulty with sound symbols relations Lack of vocabulary understanding & reading

comprehension

Spelling

Reversals common: d=b, friend=freind, (also number reversal: 0137=0317)

Frequently dropping, adding or reversing letters and word parts: know=now, bad dog=dab dog

Difficulty mixing up words that sound the same; there=their, through=threw, where=wear, well=will, write=right

Forgetting how to spell commonly used words

Writing

Excessive time required to organize papers and thoughts Difficulty conceptualizing a paper’s overall topic and

formulating a thesis on the paper as a whole Tendency to laboriously work out specific parts of the paper

instead of focusing on the paper as a whole Letters reversed Freezing up when trying to write Spelling errors Illegible handwriting; cursive script difficult Words and letters out of sequence in sentences Difficult taking notes in class Completely omitting words or phrases Writing things that make absolutely no coherent sense

Testing

Seldom able to complete exams in class or national exams

Difficulty with multiple choice questions; difficulty filling in the bubbles on forms

Misinterprets directions or questions on exams

Extreme test anxiety

Concentration

Focusing requires extraordinary effort

Easily distracted by noise and movement

Memory

Difficulty recalling familiar things like one’s phone number, address, names of friends

Not remembering what was said or what you were talking about

Not remembering what the teacher/instructor said and trying to take notes

Frequently misplacing, losing or forgetting things

Not remembering what you saw or read, (writing down information from the chalk board or overhead/power point)

Speech

Difficulty pronouncing multisyllabic or uncommon words

Difficulty reading aloud

Stuttering or hesitancy in speech

Difficulty communicating ideas clearly

Orientation

Difficulty in distinguishing left and right

Directions, map reading, and navigating difficulty

Feeling lost in a familiar setting; easily disoriented

Ranges of LDJournal of Learning Disabilities, 29, 17-30

MILD average to above average intelligence

adequate psychological adjustments and vocational/employability skills

high academic achievement

limited processing and language skills

Ranges of LD, cont.Journal of Learning Disabilities, 29, 17-30

MODERATE average to above average intelligence

some cognitive and language deficits

one or more academic disabilities

some psychological adjustment problems

difficulty with vocational/employment skills

Ranges of LD, cont.Journal of Learning Disabilities, 29, 17-30

SEVERE display below average intelligence

significant cognitive processing and language deficits

low academic achievement

lack of psychological adjustment

lack of vocational/employment skills

Types of Learning Disabilities

Auditory Perceptual Problems

Auditory Discrimination Problems

The difference between “th” and “f”, “m” and “n”

Auditory Figure-Ground Problems

Hearing over background noise

Auditory Sequencing Problems

Hearing 49 instead of 94 or “treats” instead of “street”

Types of Learning Diabilities

Visual Perceptual Problems Visual Discrimination Problems

Trouble seeing the difference between similar objects (V and U)

Visual Figure-Ground ProblemsTrouble seeing a specific image

Visual Sequencing ProblemsTrouble seeing things in order

Information Processing and Related Disabilities

Input Process Output

Auditory

Visual

Tactile

Olfactory

Gustatory

Thinking*Abstract *Concrete Memory*Auditory *Visual*Long Term*Short Term Sequencing Organization Attention

Talking

Reading

Writing

Motor

*Fine *Gross

Fluency/Speed

Accuracy

Findings of NIH Research in the Area of Learning Disabilities (1987-97)

Learning disabilities, as they are manifested in difficulties in school learning, are extremely deleterious to the development of children and have far ranging consequences that go well beyond school failure:

Poor peer relationships Poor self-efficacy (ability to produce effects or intended

results Poor post-school adjustments Juvenile delinquency Limited occupational status

(Lyon, 1991)

Continuum of Psychiatric Disorders Possible with Learning Disabilities – from Dr. Larry Silver

Internalized

Anxiety

Depression

Externalized

Oppositional defiant conduct disorder

Borderline personality disorder

Substance Abuse

Alcohol

Drugs

Able to cope and compensate for LD Determined to achieve Willing to work hard Found ways to learn that led to success Recognized and accepted LD – “goodness

of fit” in jobs/tasks assigned to them Used technology Recognized need for support and

found/had it

Common Strengths of Successful Adults with LD

ADD is most likely caused by a neurochemical imbalance or deficiency in the area of the brain responsible for attention and activity.

ADD is a neurobiological disability, frequently characterized by inappropriate degrees of: Inattention Impulsivity Hyperactivity

It is the neurotransmitters which enable the electrical impulse to be transmitted from one dendrite to another. Without these neurotransmitters, the relay of impulses in the brain would be impossible.

The power of determining one’s own behavior is not the power of one entity (the mind) over another (the body), but the influence the brain has on itself. In other words, we are our brain.

- Eric Hearth, Researcher

ADD affects 3-5% of the school-age population, which means approximately 2.5 to 3 million children in the United States.

Barkley’s Criteria

1. Physical restlessness2. Mental restlessness3. Easily distracted4. Impatient5. Hot or explosive temper6. Unpredictable behavior7. Difficulty completing tasks8. Shifting from one task to another9. Difficulty sustaining attention10. Impulsivity11. Talks too much12. Difficulty doing tasks alone13. Often interrupts others14. Doesn’t appear to listen to others15. Loses a lot of things16. Forgets to do things17. Engages in physically daring activities18. Always on the go, as if driven by a motor

Diagnostic Criteria for Attention-Deficit/Hyperactivity Disorder (DSM-IV)

A. Either (1) or (2): (1) Six (or more) of the following symptoms of

Inattention have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:

(a) Often fails to give close attention to details or make careless mistakes in schoolwork, work, or other activities;

(b) Often has difficulty sustaining attention in tasks or play activities;(c) Often does not seem to listen when spoke to directly;(d) Often does not follow through on instructions and fails to finish

schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions);

(e) Often has difficulty organizing tasks and activities;(f) Often avoids, dislikes, or is reluctant to engage in tasks that

require sustained mental effort (such as schoolwork or homework);

Diagnostic Criteria for Attention-Deficit/ Hyperactivity Disorder (DSM-IV), continued…

(2) Six (or more) of the following symptoms of Hyperactivity-Impulsivity have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:

(g) Often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools);

(h) Is often easily distracted by extraneous stimuli; and(i) Is often forgetful in daily activities.

Hyperactivity(a) Often fidgets with hands or feet or squirms in seat;(b) Often leaves seat in classroom or in other situations in which

remaining seated is expected.(c) Often runs or climbs excessively in situations which it is

inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness)

(d) Often has difficulty playing or engaging in leisure activities quietly;(e) Is often “on the go” or often acts as if “driven by a motor”;(f) Often talks excessively;

Diagnostic Criteria for Attention-Deficit/ Hyperactivity Disorder (DSM-IV), continued…

Impulsivity(g) Often blurts out answers before questions have been completed(h) Often has difficulty awaiting turn;(i) Often interrupts or intrudes on others (e.g., butts into conversations

or games)

B. Some hyperactive-impulsive or inattentive symptoms that caused impairment were present before age 7 years.

C. Some impairment from the symptoms is present in two or more settings (e.g., at school [or work] and at home).

D. There must be clear evidence of clinically significant impairment tin social, academic, or occupational functioning.

E. The symptoms do not occur exclusively during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder an are not better accounted for by another mental disorder (e.g., Mood Disorder, Anxiety Disorder, Dissociative Disorder, or Personality Disorder).

Characteristics of ADD Without Hyperactivity

Often daydreams of is “lost in a fog” Is frequently “spacey” or is internally

preoccupied Is often confused or lost in thought Often appears to be apathetic or

unmotivated Frequently is sluggish or slow moving Often stares

Conduct Problems:

Antisocial personality (35%+) Substance/alcohol addiction (25-35% at

adolescence; 10-15% in adulthood) More frequent moves (3X) More auto accidents (3X) More traffic citations (4X) Police involvement (50%); Court (20%) Physical Aggression (20% past 3 years)

Emotional Problems:

Greater suicide attempts (10) Sexual dysfunction (20%) Low self-esteem (65%) Often demoralized

Conditions Often Comorbid with ADHD

Psychiatric Disorders

Oppositional/Defiant Behavior (68%+)

Conduct Disorder (45%+)

Antisocial-Delinquent (25%+)

Anxiety Disorders (0-30%)

Major Depression (0-33%)

Somatization Disorder (24-35% of 12-16 year olds)

Sobering Statistics

50% retained in a grade at least once 35% never complete a high school

education (Weiss & Hechtman, 1986)

46% had been suspended, often more than once

11% had been expelled (Barkley et al., 1990)

If Unidentified and UntreatedIncreased Risk For:

Impaired educational performance Decreased self-esteem Social problems Family difficulties Potential long-term effects

Screening Clients for Learning Difficulties

Referring Clients for Testing

Education Evaluation CenterThe Teaching Research Institute

Western Oregon University

Section A

1. Did you have any problems learning in middle school or junior high school?... Yes No

2. Do any family members have learning problems?............................................ Yes No

3. Do you have difficulty working with numbers in columns?................................ Yes No

4. Do you have trouble judging distances?.......................................................... Yes No

5. Do you have problems working from a test booklet to an answer sheet?........ Yes No

Total “yes” answers: ___ x 1 = ___*

Section B

6. Did you have problems mixing arithmetic signs (such as + and x)?................ Yes No

7. Did you have any problems learning in elementary school?............................ Yes No

Total “yes” answers: ___ x 2 = ___*

Section C

8. Did you have difficulty remembering how to spell simple words you know?.... Yes No

9. Do you have difficulty filling out forms?............................................................ Yes No

10. Did you (do you) experience difficulty memorizing numbers?......................... Yes No

Total “yes” answers: ___ x 3 = ___*

Section D

11. Do you have trouble adding and subtracting small numbers in your head?.... Yes No

12. Do you have problems taking notes?................................................................ Yes No

13. Were you ever in a special program or given extra help in school? ................. Yes No

Total “yes” answers: ___ x 4 = ___*

A total score of 12 is seen as high enough

to merit a referral for a full educational assessment.

If the client wants to waive such an assessment,

Be sure they understand what they are waiving

and have them sign below.