Reading and Learning Disabilities

Introduction

The National Dissemination Center for Children with Disabilities (NICHCY) is pleased to provide you with information about the problems many children, youth, and adults experience with learning in particular, with learning to read.

Having difficulty with reading is by no means unusual. Millions of people in the United States have trouble reading. Some may not be able to read at all, while others have basic reading skills but might be considered "slow readers." It is useful to know that problems with reading are often accompanied by problems with writing, listening, or speaking. Each person having trouble in any or all of these areas should know that help is available.

There are many reasons why a person might have difficulty in developing reading skills. One of the most common reasons is that the person has what is known as a learning disability. Dyslexia is one such learning disability. There are also many other types of learning disabilities that can cause problems with learning to read or learning in general. These are described later in this guide.

Not all troubles with reading are caused by learning disabilities. It is important to determine what is causing the problem. Some causes other than learning disabilities are poor vision or hearing, emotional disturbance, or mental retardation. A person having trouble with reading should talk with specialists in the reading field and receive a thorough assessment. Through tests and other evaluation techniques, the nature of the reading problem can be determined. Then action can be taken to help the person overcome or learn to compensate for his or her specific problem.

This publication has been developed with two major purposes in mind. These are:

• to describe some of the most common learning disabilities that can cause reading problems; and
• to put you in touch with organizations that can provide you with the help you need.

The rest of this publication is organized into as follows:

• a look at learning disabilities in children and youth;
• suggestions for parents in how to help their school-age children learn;
• considerations for adults with reading and learning problems, including steps that adults can take to find out if they do, indeed, have a learning disability; and
• book and organizational resources for: parents of school-age children with learning disabilities; adults with learning disabilities; and educators or other service providers who work with individuals with reading problems and/or learning disabilities.

We hope that you will take advantage of the expertise and assistance offered by the many excellent organizations we have listed throughout this document. If you find you have need of additional information or assistance, please feel free to contact NICHCY again.

A Look at Learning Disabilities in Children and Youth

by Larry B. Silver, M.D.
Reprinted with permission from the Learning Disability Association of Montgomery County, Inc., in Maryland

Children and adolescents perform poorly in school for various reasons. Some have emotional or family problems; for others, the source of trouble is the community, the school, or peers; and some are simply below average intellectually. But 10 to 20 percent have a neurologically-based disorder of the type called a learning disability. According to the definition used by the federal government, these children are of at least average intelligence (many are far above average), and their academic problems are not caused by an emotional disturbance, by social or cultural conditions, or by a primary visual, hearing, or motor disability. Instead, the reason for their learning problems seems to be that their brains are "wired" in a way slightly different from the average person's. About 20 percent of children with learning disabilities also have a related problem, attention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHD). Its symptoms include hyperactivity, distractibility, and impulsiveness. ADD or ADHD must be evaluated and treated separately from the learning disability.

Learning disabilities are lifelong conditions that may require special understanding and help throughout grade school, high school, and beyond. They are also life disabilities that have important effects outside of the classroom, interfering not only with academic work but also with children's games, daily activities, and even friendships. Therefore, help for these children means more than classroom special education.

Types of Learning Disabilities

By the late 1960s, the present model of learning disabilities was established. This model distinguishes four stages of information processing used in learning: input, integration, memory, and output.

Input is the process of recording in the brain information that comes from the senses.

Integration is the process of interpreting this information.

Memory is its storage for later retrieval.

Output of information is achieved through language or motor (muscular) activity. Learning disabilities can be classified by their effects at one or more of these stages. Each child has individual strengths and weaknesses at each stage.

Input
The first major type of problem at the input stage is a visual perception disability. Some students have difficulty in recognizing the position and shape of what they see. Letters may be reversed or rotated; for example, the letters d, b, p, q, and g might be confused. The child might also have difficulty distinguishing a significant form from its background. People with this disability often have reading problems. They may jump over words, read the same line twice, or skip lines. Other students have poor depth perception or poor distance judgement. They might bump into things, fall over chairs, or knock over drinks.

The other major input disability is in auditory perception. Students may have difficulty understanding because they do not distinguish subtle differences in sounds. They confuse words and phrases that sound alike, for example, "blue" with "blow" or "ball" with "bell." Some children find it hard to pick out an auditory figure from its background; they may not respond to the sound of a parent's or teacher's voice, and it may seem that they are not listening or paying attention. Others process sound slowly and therefore cannot keep up with the flow of conversation, inside or outside the classroom. Suppose a parent says, "It's getting late. Go upstairs, wash your face, and get into your pajamas. Then come back down for a snack." A child with this disability might hear only the first part and stay upstairs.

Integration
Integration disabilities take several forms, corresponding to the three stages of sequencing, abstraction, and organization.

A student with a sequencing disability might recount a story by starting in the middle, going to the beginning, and then proceeding to the end. The child might also reverse the order of letters in words, seeing "dog" and reading "god." Such children are often unable to use single units of a memorized sequence correctly. If asked what comes after Wednesday, they have to start counting from Sunday to get the answer. In using a dictionary, they must start with "A" each time.

The second type of integration disability involves abstraction. Students with this problem have difficulty in inferring meaning. They may read a story but not be able to generalize from it. They may confuse different meanings of the same word used in different ways. They find it difficult to understand jokes, puns, or idioms.

Once recorded, sequenced, and understood, information must be organized -- integrated into a constant flow and related to what has previously been learned. Students with an organization disability find it difficult to make bits of information cohere into concepts. They may learn a series of facts without being able to answer general questions that require the use of these facts. Their lives in and outside of the classroom reflect this disorganization.

Memory
Disabilities also develop at the third stage of information processing, memory. Short-term memory retains information briefly while we attend to it or concentrate upon it. For example, most of us can retain the 10 digits of a long distance telephone number long enough to dial, but we forget it if we are interrupted. When information is repeated often enough, it enters long-term memory, where it is stored and can be retrieved later. Most memory disabilities affect short-term memory only; students with these disabilities need many more repetitions than usual to retain information.

Output
At the fourth stage, output, there are both language and motor disabilities. Language disabilities almost always involve what is called "demand language" rather than spontaneous language. Spontaneous language occurs when we initiate speaking -- select the subject, organize our thoughts, and find the correct words before opening our mouths. Demand language occurs when someone else creates the circumstances in which communication is required. A question is asked, and we must simultaneously organize our thoughts, find the right words, and answer. A child with a language disability may speak normally when initiating conversation but respond hesitantly in demand situations - pause, ask for the question to be repeated, give a confused answer, or fail to find the right words.

Motor disabilities are of two types: poor coordination of large muscle groups, which is called gross motor disability; and poor coordination of small muscle groups, which is called fine motor disability. Gross motor disabilities make children clumsy. They stumble, fall, and bump into things; they may have difficulty in running, climbing, riding a bicycle, buttoning shirts, or tying shoelaces. The most common type of fine motor disability is difficulty in coordinating the muscles needed for writing. Children with this problem write slowly, and their handwriting is often unreadable. They may also make spelling, grammar, and punctuation errors.

Detecting Learning Disabilities in Children

There are several early clues to the presence of a learning disability. In preschool children we look for failure to use language in communication by age three, or inadequate motor skills (buttoning, tying, climbing) by age five. In school-age children, we observe whether they are learning the skills appropriate to their grade. Schools and families should always consider the possibility of a learning disability before assuming that a child who has been doing poorly in school is lazy or emotionally disturbed. The Individuals with Disabilities Education Act (IDEA), Public Law (P.L.) 105-17 - formerly known as the Education for All Handicapped Children Act (EHA), P.L. 94-142 - requires public school systems to evaluate children who are at risk for a learning disability. Evaluations can also be performed by professionals in private practice, beginning with family doctors. Attention deficit disorder (ADD), attention deficit hyperactivity disorder (ADHD), and other problems should always be considered as well and evaluated by qualified professionals with expertise with these conditions. It is important to distinguish between emotional, social, and family problems that are causes and those that are consequences of academic difficulties, because they require different treatments.

The psychological assessment may include a neuropsychological or a clinical psychological evaluation. The intelligence of the child should be determined to learn whether the child is performing below potential. Discrepancies in performance between different sections of the IQ (intelligence quotient) test will help to clarify learning strengths and weaknesses. Other tests may be used to assess perception, cognition, memory, and language abilities. Current academic skills are judged by achievement tests. Both IQ and achievement tests help to clarify discrepancies between potential and actual ability. There are also specific tests that help to uncover learning disabilities. A speech pathologist, occupational therapist, or other professional may contribute further information, as can parents.