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LEARNINGLEARNING
DISABILITYDISABILITYSneh RERCSneh RERC
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DEFINITIONDEFINITION
The term "learning disability" was apparently firstThe term "learning disability" was apparently first
used and defined by Dr. Samuel Kirk (1962,)used and defined by Dr. Samuel Kirk (1962,)
The term referred to a discrepancy between aThe term referred to a discrepancy between achilds apparent capacity to learn and his or herchilds apparent capacity to learn and his or herlevel of achievement.level of achievement.
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Learning disability is a generic term thatLearning disability is a generic term that
refers to a heterogeneous group ofrefers to a heterogeneous group ofdisorders manifested by significantdisorders manifested by significant
difficulties in the acquisition and use ofdifficulties in the acquisition and use of
listening, speaking, reading, writing,listening, speaking, reading, writing,
reasoning abilitiesreasoning abilities..
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What is a learning disability?What is a learning disability?
A person with a learning disability has difficultyA person with a learning disability has difficulty
in collecting, organizing, or acting on verbal andin collecting, organizing, or acting on verbal and
nonverbal information. Most commonly, thenonverbal information. Most commonly, theperson has trouble understanding or usingperson has trouble understanding or usingwritten or spoken languagewritten or spoken language
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People with learningPeople with learningdisabilities do not have lowdisabilities do not have low
intelligence; in fact, theyintelligence; in fact, theyhave average or abovehave average or above
average intelligenceaverage intelligence
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problems in one or more of theseproblems in one or more of these
areas:areas: language development and language skills (listening,language development and language skills (listening,speaking, reading, writing, and spelling)speaking, reading, writing, and spelling)
social studiessocial studies
mathematicsmathematics social skillssocial skills motor skills (fine motor skills, as well as coordination)motor skills (fine motor skills, as well as coordination) cognitive development and memorycognitive development and memory
attention and organizationattention and organization testtest--takingtaking
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CAUSES OF LDCAUSES OF LD
abnormal brain structure or functionabnormal brain structure or function
geneticsgenetics
factors before birth or during deliveryfactors before birth or during delivery
factors in early childhoodfactors in early childhood
brain trauma or tumorsbrain trauma or tumors
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Types of learning disabilityTypes of learning disability
Speech and language disorder.Speech and language disorder.
Academic skills disorder.Academic skills disorder.
Miscellaneous learning disability.Miscellaneous learning disability.
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Speech and language disordersSpeech and language disorders
the person is delayed by years in the development ofthe person is delayed by years in the development ofone of these skillsone of these skills
Difficulty producing speech sounds (developmental articulationdisorder).
Difficulty usingspoken language to communicate (developmental
Expressive languagedisorder).
Difficulty understanding what other people say(developmental receptive
languagedisorder)
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Academic skills disordersAcademic skills disorders
((the person is delayed by years in thethe person is delayed by years in the
development of one of these skillsdevelopment of one of these skills
ReadingReading problems (developmental reading disorder, orproblems (developmental reading disorder, ordyslexiadyslexia). The person cannot identify different word). The person cannot identify different wordsounds.sounds.
WritingWriting problems (developmental writing disorder, orproblems (developmental writing disorder, ordysgraphiadysgraphia). The person has problems with handwriting or). The person has problems with handwriting or
with creating sentences that make sense to others.with creating sentences that make sense to others.ArithmeticArithmetic skills problems (developmental arithmeticskills problems (developmental arithmeticdisorder, ordisorder, or dyscalculiadyscalculia). The person has problems with). The person has problems withcalculations or with abstract mathematical concepts.calculations or with abstract mathematical concepts.
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Miscellaneous learning disabilitiesMiscellaneous learning disabilities
Fine motor skillsFine motor skills problems (problems (dyspraxiadyspraxia))
Nonverbal Learning DisorderNonverbal Learning Disorder
OthersOthers
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symptoms of a learning disabilitysymptoms of a learning disability
All of the following are necessary symptoms of an official learningAll of the following are necessary symptoms of an official learningdisability:disability:
average or above average intelligence (as measured by the IQaverage or above average intelligence (as measured by the IQscore)score)
significant delay in academic achievementsignificant delay in academic achievement
severe information processing deficitssevere information processing deficits
uneven pattern of cognitive development throughout lifeuneven pattern of cognitive development throughout life
a disparity between measured intellectual potential (IQ score)a disparity between measured intellectual potential (IQ score)
and actual academic achievementand actual academic achievement the learning disability persists despite instruction in standardthe learning disability persists despite instruction in standard
classroom situationsclassroom situations
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Types of learning styleTypes of learning style
anan auditoryauditory learnerlearner
kinesthetickinesthetic learnerlearner
aavisualvisual learnerlearner
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Diagnosis of LDDiagnosis of LD
clinical psychologistclinical psychologist
school psychologistschool psychologist
educational psychologisteducational psychologist
neuropsychologistneuropsychologist
psychometristpsychometrist
occupational therapist (tests sensory disorders that canoccupational therapist (tests sensory disorders that can
lead to learning problems)lead to learning problems) speech and language therapistspeech and language therapist
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What else can look like a learningWhat else can look like a learningdisability?disability?
ADHDADHD sensory integration dysfunction (DSI, or SI) (see below)sensory integration dysfunction (DSI, or SI) (see below) hearing deficitshearing deficits vision problemsvision problems
attachment disruptionattachment disruption emotional traumaemotional trauma anxietyanxiety depressiondepression
a home environment that is not conducive to learninga home environment that is not conducive to learning a mismatch between a childs personal learning style and thea mismatch between a childs personal learning style and the
expectations of the childs parents and/or teachersexpectations of the childs parents and/or teachers
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How is sensory integrationHow is sensory integration
dysfunction (DSI or SI)dysfunction (DSI or SI)
related to learningrelated to learningdisabilitiesdisabilities
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Sensory integration dysfunctionSensory integration dysfunction
DSI is a disorder in which brain is either not receiving,DSI is a disorder in which brain is either not receiving,processing and organizing the sensations properly.processing and organizing the sensations properly.
Causes of DSICauses of DSI
Brain damageBrain damage
Hereditary disposition.Hereditary disposition.
DSI may interfere directly with the learning process in theDSI may interfere directly with the learning process in the
brain to it causes poor behavior that interferes withbrain to it causes poor behavior that interferes withschool work, even though the child has a normalschool work, even though the child has a normalcapacity to learn.capacity to learn.
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Types of DSITypes of DSI
Disorder in posture and bilateral integration.Disorder in posture and bilateral integration.
Developmental apraxia.Developmental apraxia.
Form and space perception.Form and space perception.
Tactile defensiveness and related behavioral responses.Tactile defensiveness and related behavioral responses.
Unilateral disregard and function of the rigth cerebralUnilateral disregard and function of the rigth cerebralhemisphere.hemisphere.
Auditory language disorder.Auditory language disorder. Hand dominance and lateralization of cerebralHand dominance and lateralization of cerebral
functions.functions.
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Disorder in posture and bilateralDisorder in posture and bilateral
integrationintegration
Tendency of the child to use both hands for eachTendency of the child to use both hands for each
side of body, children tend not to cross theside of body, children tend not to cross themidline of the body with either of the hand.midline of the body with either of the hand.
Cause areCause are
Immature equilibrium reactions.Immature equilibrium reactions.
Poor ocular control.Poor ocular control. Inadequate integration of 2 sides of body.Inadequate integration of 2 sides of body.
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Neural connections change as aNeural connections change as a
consequence of experience.consequence of experience.
Therapy consist of experience specifically plannedTherapy consist of experience specifically plannedto control sensory input and elicit output thatto control sensory input and elicit output that
will bring about more normal function.will bring about more normal function.
Basic principleBasic principle
Recapitulation of the pertinent ontogenicRecapitulation of the pertinent ontogenicsequence.sequence.
Control of sensory input in a situationControl of sensory input in a situationconducive to its integration and adaptiveconducive to its integration and adaptiveresponse to it.response to it.
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DEVELOPMENTAL APRAXIADEVELOPMENTAL APRAXIA
It is a disorder in children because of DSI in whichIt is a disorder in children because of DSI in which
there is inability to plan and execute skilled orthere is inability to plan and execute skilled ornon habituated motor task.non habituated motor task.
CauseCause
Lack of integration between tactile, vestibular andLack of integration between tactile, vestibular and
proprioceptive system and show symptoms ofproprioceptive system and show symptoms of
postural and bilateral integration problem .postural and bilateral integration problem .
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Dyspraxic child can and does specific motorDyspraxic child can and does specific motor
skills through repeated attempts andskills through repeated attempts and
executionexecution
Body schema.Body schema.
Motor planning .Motor planning . Large number of repetitions.Large number of repetitions.
Activities should be self gratifying. And selfActivities should be self gratifying. And self
directed.directed.
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Form and space perceptionForm and space perception
Perception is the process by which we receive andPerception is the process by which we receive andinterpret information from the world around us.interpret information from the world around us.
80% of learning happens through vision.80% of learning happens through vision.
Some form of learning disability could be traced toSome form of learning disability could be traced toperceptual deficit.perceptual deficit.CauseCause
Disorder in form and space perception occurs inDisorder in form and space perception occurs inconjunction with postural, ocular and somatosensoryconjunction with postural, ocular and somatosensory
disabilities.disabilities. Some times it is associated with right cerebralSome times it is associated with right cerebral
hemisphere damage.hemisphere damage.
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InterventionIntervention
Intervention begins with generalized stimulationIntervention begins with generalized stimulationto tactile ,vestibular and proprioceptive system.to tactile ,vestibular and proprioceptive system.
Activities in quadruped position, which provideActivities in quadruped position, which provideequilibrium responses ,provide large quantity ofequilibrium responses ,provide large quantity ofthe proprioceptive stimuli and helps inthe proprioceptive stimuli and helps indevelopment of visual space perception.development of visual space perception.
Scooter board activities provide the movementScooter board activities provide the movementthrough space that especially requires the visualthrough space that especially requires the visualspace perception.space perception.
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Tactile defensiveness and relatedTactile defensiveness and related
behavioral problemsbehavioral problems
Tactile defensiveness is defined as an inability to interpretTactile defensiveness is defined as an inability to interpretapproximately the effective meaning of touchapproximately the effective meaning of touch,hypothesized to be the disorder of modulation or,hypothesized to be the disorder of modulation orregulation of tactile input.regulation of tactile input.
SignsSigns Child withdraws from touch.Child withdraws from touch. child avoids touch and interaction with certainchild avoids touch and interaction with certain
textures.textures.
Child hyperirritable with handling.Child hyperirritable with handling. child resist adl activities like teeth brushing, nailchild resist adl activities like teeth brushing, nail
cutting, hair cutting etc.cutting, hair cutting etc.
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InterventionIntervention
Sensory dietSensory diet
Frequent quick rapid tactileFrequent quick rapid tactile
stimulation,followed by deep pressure.stimulation,followed by deep pressure. Advanced tactile vestibular sensation.Advanced tactile vestibular sensation.
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Unilateral disregard and functions ofUnilateral disregard and functions of
right cerebral hemisphereright cerebral hemisphere
It is tendency to neglect or disregard or resistIt is tendency to neglect or disregard or resist
interaction with one side of the environmentalinteraction with one side of the environmentalschema.schema.
Tendency to avoid interaction with the one sideTendency to avoid interaction with the one sideof body space.of body space.
Child avoid moving to that side of neglect.Child avoid moving to that side of neglect.
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InterventionIntervention
The presence of this syndrome in children is notThe presence of this syndrome in children is notfrequently observed and the symptoms are so obscurefrequently observed and the symptoms are so obscurethat they are easily overlooked.that they are easily overlooked.
No well defined and tested treatment program forNo well defined and tested treatment program forunilateral disregard in LD children is offered. since thisunilateral disregard in LD children is offered. since thisproblem is recently recognized as a sensory integrativeproblem is recently recognized as a sensory integrativeproblem among this population.problem among this population.
But advanced somatosensory feed back, and vestibularBut advanced somatosensory feed back, and vestibularstimulation improves Childs performance.stimulation improves Childs performance.
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AuditoryAuditory language disorderlanguage disorder
This is most easily identified type of DSI.This is most easily identified type of DSI.
Most of the children suffering from LD have auditoryMost of the children suffering from LD have auditory--language disorder.language disorder.
Child will have problems in reading and understandingChild will have problems in reading and understandingspoken language.spoken language.
CauseCause
Inadequate interhemispherical communication.Inadequate interhemispherical communication.
Poor integration of sensory modalities,especially ofPoor integration of sensory modalities,especially ofauditory, vestibular, and somatosensory stimuli mayauditory, vestibular, and somatosensory stimuli mayeasily interfere with language development.easily interfere with language development.
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InterventionIntervention
Vestibular stimuli usually elicits vocalization.Vestibular stimuli usually elicits vocalization.
A more cognitive approach can follow afterA more cognitive approach can follow after
vocalization.vocalization. Intersensory integration helps in development ofIntersensory integration helps in development of
language.language.
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Hand dominance and lateralizationHand dominance and lateralization
of cerebral functionsof cerebral functions
.. The evolution process has moved towardsThe evolution process has moved towards
localization and specialization of cortical functions,localization and specialization of cortical functions,resulting in one hemisphere dominant for someresulting in one hemisphere dominant for somefunction and the other hemisphere for otherfunction and the other hemisphere for otherfunction.function.
Establishing one hand as dominant is an aspect ofEstablishing one hand as dominant is an aspect ofdevelopment that holds some significances for thedevelopment that holds some significances for the
total sensory integration process.total sensory integration process. Reading problems are repeatedly linked withReading problems are repeatedly linked withinadequate lateralization of cerebral functioninadequate lateralization of cerebral function
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Causes of failure to develop handCauses of failure to develop hand
dominancedominance Lateralized dysfunction i.e presence of more disorder on oneLateralized dysfunction i.e presence of more disorder on one
side than the other.side than the other.
Tendency towards unilateral disregard may interfere withTendency towards unilateral disregard may interfere withestablishment of hand dominance.establishment of hand dominance.
Differences in somatosensory perception of both upperDifferences in somatosensory perception of both upperextremity makes one hand less satisfactory or comfortable forextremity makes one hand less satisfactory or comfortable foruse, even though it is less skilled motorically resulting in conflictuse, even though it is less skilled motorically resulting in conflictover to use which hand for skilled work.over to use which hand for skilled work.
Syndrome affecting postural and bilateral integration can alsoSyndrome affecting postural and bilateral integration can alsolead to failure for hand dominance .when two sides of body failslead to failure for hand dominance .when two sides of body failsto integrate their function, there is tendency not to cross theto integrate their function, there is tendency not to cross themidline is seen.midline is seen.
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Considerations in selecting dominantConsiderations in selecting dominant
hand for a childhand for a child
The process of writing should be delegated to oneThe process of writing should be delegated to onehand only.hand only.
The decision should be taken based on a number ofThe decision should be taken based on a number of
datadata Determining handedness in family is important toDetermining handedness in family is important to
establish hereditory disposition.establish hereditory disposition.
The ease and naturalness with which a child uses hisThe ease and naturalness with which a child uses his
hand also reflects predisposition.hand also reflects predisposition. Both hands should be tested on motor accuracy testBoth hands should be tested on motor accuracy test
,data will tell which hand is more skilled.,data will tell which hand is more skilled.
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Considerations in selecting dominantConsiderations in selecting dominant
hand for a childhand for a child
Scores on kinesthesia, localization of tactileScores on kinesthesia, localization of tactile
stimuli, double tactile localization manual formstimuli, double tactile localization manual formperception,graphesthesia,crossing midline ofperception,graphesthesia,crossing midline of
body, all these will provide us with informationbody, all these will provide us with informationso as to which extremity is more skilled.so as to which extremity is more skilled.
Degree of hand preference the child has alreadyDegree of hand preference the child has already
established should also be considered.established should also be considered.
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Learning disabilities are a lifeLearning disabilities are a life--long condition, and are notlong condition, and are not"curable". Effective treatment involves multi"curable". Effective treatment involves multi--modal andmodal and
appropriately tailored teaching and compensatoryappropriately tailored teaching and compensatorystratigiesstratigies..