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Specific Learning Disability. Dr Anjana Thadhani Consultant Developmental Pediatrician. Specific Learning Disabilities. Group of developmental disorders

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specific learning disability

Specific Learning Disability

Dr AnjanaThadhani

Consultant Developmental Pediatrician

specific learning disabilities
Specific Learning Disabilities
  • Group of developmental disorders
  • Significant unexpected, specific and persistent difficulties in the acquisition and use of reading (dyslexia), writing (dysgraphia) or mathematical (dyscalculia) abilities,
  • despiteconventional instruction, normal intelligence, proper motivation and adequate socio-cultural opportunity
salient features
Salient Features

Types: Dyslexia

Dysgraphia

Dyscalculia

Creates a significant gap between the potential and academic performance

Prevalence - 10% of school going children

Difficulty with information processing

information processing
INFORMATION PROCESSING

RECORDING INFORMATION (INPUT)

  • Perceptual →Visual

→Auditory

INTEGRATION

  • Sequencing
  • Abstraction
  • Organization

STORAGE (MEMORY)

  • Short – term
  • Long – term
reading
READING
  • Phonological awareness
  • Letter-sound association
  • Decoding & Blending
  • Focus on printed words
  • Control of eye movements across the page
  • Processing of images and ideas
  • Comparisons and associations of ideas
  • Storing of the information into memory
causes
CAUSES
  • Neuro-developmental condition
  • Multi-factorial
  • Genetic predisposition
  • ADHD - Strong association
  • CO-MORBIDITY
genetics
GENETICS
  • In 1950, Hallgren, an autosomal dominant disorder
  • Recent findings:
    • Dyslexia is a genetically heterogeneous and complex trait that does not show classical mendelian inheritance
    • Several chromosomal regions & genes affecting reading disability (chromosome 1, 2, 3, 6, 15, 18)
neuroimaging
NEUROIMAGING
  • Absence of usual asymmetry of planumtemporale (portion of temporal lobe lying posterior to Heschl’sgyrus)
  • Left is usually larger than right
  • Neuronal ectopias in frontal and parietal regions
manifestations
MANIFESTATIONS
  • Varied spectrum presentation
  • Mild to severe
  • Academic
  • Behavioral
  • Co-morbidity
  • Psychosocial
referral letter
REFERRAL LETTER
  • Repeated failures
  • Does not write or read
  • Spelling mistakes
  • Oral work better than written work
  • Problems in math
pre school

PRE-SCHOOL

EARLY POINTERS

developmental delays
Developmental delays
  • Mild gross motor delays
  • Fine motor problems
  • Speech delay or difficulties
  • Lack of dominant handedness
  • Perceptual problems
auditory perception
AUDITORY PERCEPTION
  • Auditory perception
  • Auditory discrimination
  • Auditory memory & sequencing
  • Auditory filtering
  • Auditory processing
visual perception
VISUAL PERCEPTION
  • Visual perception
  • Visual discrimination
  • Visual memory & sequencing
  • Form constancy
  • Visuomotor integration
  • Figure ground discrimination
learning concerns
Learning Concerns
  • Difficulty in pronouncing words.
  • Poor phonological awareness
  • Difficulty or slowness to add words.
  • Inability to rhyme by age 4 years.
  • Confusion in directionality, words and space concepts, left versus right, over versus under, before versus after.
slide21

May have trouble learning the alphabets, numbers, day of the week, colors, shapes.

  • May have difficulty telling or retelling a story in the correct sequence.
  • Abnormal grip or refusal to write.
behavioral concerns
Behavioral concerns
  • Hyperactivity
  • Difficulty in following instructions
  • Slow in ADLs
  • Stubborness
  • Temper tantrums
dyslexia
Dyslexia
  • Avoids reading aloud
  • Reads slowly
  • Uses finger tracing
  • Looses place or skips words
  • Mispronounces or guesses words
  • Has difficulty decoding or blending single words
slide25

Relies heavily on memorizing without understanding.

  • Poor comprehension
  • Gives stress on wrong syllables
  • Reads with substitution
  • While reading makes up his own stories
  • Poor memory & recall
dysgraphia
Dysgraphia
  • Slow in writing or may avoid writing.
  • Often uses an awkward pencil grip ( fist, thumb hooked over finger, etc.)
  • Writes with illegible handwriting
  • Poor letter formations
  • Untidy written work
  • Uses inappropriate pressure
  • Uneven size of letters with poor spacing
slide27

Spelling mistakes

  • Bizarre spelling
  • Spells the same word differently
  • Punctuation & capitalization errors.
  • Mixes upper & lowercase letters
  • Problems with copy writing
typical errors
Typical errors
  • Letters reversals -d for b as in dog for bog.
  • Word reversals – tip for pit.
  • Inversions – m and w, u and n.
  • Transpositions – felt and left.
  • Substitutions – house and home.
  • Omissions
  • Additions.
spelling errors
Spelling errors
  • Amount – aomunt
  • Awards – awords
  • Consent – conset
  • Recent – resent
  • Domestic – domistic
  • Brain – brian
  • Method - matheod
dyscalculia
Dyscalculia
  • May transpose number sequences , 231 as 312
  • Confuse arithmetic signs. (+ - * / = )
  • Has trouble with word problems
  • Poor in mental maths
  • Difficulty in learning tables
  • Counting on fingers may be seen
slide33

Difficulty in carrying over or borrowing sums

  • May count from left to right
  • Poor in geometry
  • Poor in algebra
other concerns
Other concerns
  • Appears very clumsy and untidy.
  • Has difficulty making friends.
  • May not understand body language and facial expression of others.
  • Has trouble with non-literal language (idioms, jokes, proverbs, slang)
slide35

Difficulty following step by step instructions

  • Difficulty in telling time
  • Difficulty in telling/ following directions
  • Slow in ADLs
  • Poor understanding of abstract
  • Disorganized behavior and thoughts
associated behavioral issues
Associated behavioral issues..
  • Hyperactivity
  • Day dreaming
  • Poor peer relations
  • Aggressive behavior
  • Poor participation
pyschosocial concerns
Pyschosocial concerns
  • Poor self esteem
  • Poor self confidence
  • Poor interpersonal relations
  • Emotional lability
strengths
Strengths
  • Sensitive & compassionate
  • Good at mechanical work
  • Good at sports
  • Usually good dancers
  • Good at cooking & eating too…
key messages
Key Messages
  • Hidden Handicap
  • Neurological Disorder
  • Present since Birth
  • Multi-factorial
  • Essentially Normal child
  • Average / above average Intelligence
to summarize
To Summarize…
  • “Every learning problem is not a Learning Disability”
  • With early intervention & provisions, they can be mainstreamed
  • Secondary behavioral problems need effective management.