Treatment of learning disorders

INTRODUCTION: The child neurologist, developmental pediatrician or child psychiatrist involved in the care of children with learning disabilities has a crucial role that extends beyond diagnosis. DEVELOPING: Despite the lack of sound scientific studies on treatment interventions for children with learning disabilities there are specific interventions that are helpful in the remediation of children with learning disabilities. CONCLUSIONS: The role of the health professional in the treatment of learning disabilities includes: 1. Making specific recommendations regarding early intervention strategies; 2. Putting into a neurological perspective the types of educational interventions that will maximize a child's potential; 3. Discussing the role of medications in the management of learning disorders, as well as using medications in appropriate situations, and 4. Coordinating the multimodal approach which is essential to the long term treatment of all children with learning disabilities.     

Factor analysis on the Sensory Profile from a national sample of children without disabilities

OBJECTIVE: The purpose of this study was to identify relationships in the 125 items of the revised Sensory Profile, a tool designed to assess children's responses to commonly occurring sensory events. METHOD: Parents of 1,115 children ages 3 to 10 years and without disabilities completed the Sensory Profile. The parents reported the percentage of time their children engaged in each of the 125 behaviors listed on the profile. RESULTS: Factor analysis revealed nine discreet factors that indicate sensory modulation and responsiveness: sensory seeking, emotionally reactive, low endurance/tone, oral sensory sensitivity, inattention/distractibility, poor registration, sensory sensitivity, sedentary, and fine motor/perceptual. CONCLUSIONS: In addition to the traditional method of organizing sensory history information by sensory system, we may need to consider a person's thresholds to sensory events as well as his or her responsiveness to sensation. Because the Sensory Profile factors in these children without disabilities are similar to patterns observed in children with various disabilities, it may be that some sensory processing problems are related to intensity or duration of behaviors as they begin to interfere with functional performance in daily life.     

Generalist Genes and Learning Disabilities.

The authors reviewed recent quantitative genetic research on learning disabilities that led to the conclusion that genetic diagnoses differ from traditional diagnoses in that the effects of relevant genes are largely general rather than specific. This research suggests that most genes associated with common learning disabilities--language impairment, reading disability, and mathematics disability--are generalists in 3 ways. First, genes that affect common learning disabilities are largely the same genes responsible for normal variation in learning abilities. Second, genes that affect any aspect of a learning disability affect other aspects of the disability. Third, genes that affect one learning disability are also likely to affect other learning disabilities. These quantitative genetic findings have far-reaching implications for molecular genetics and neuroscience as well as psychology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Vertical fixation disparity in learning disabled

In this correlation study of visual parameters as related to learning disabilities, we considered several deficits: uncorrected refractive error, accommodative infacility, inaccurate pursuits, and vertical fixation disparity. Because vision is the primary sensory input involved in reading, it is nothing new to find a correlation between visual deficits and learning problems; however, vertical fixation disparity, unique in its relation to other sensory systems, deserves a great deal of attention. The high incidence of vertical fixation disparity measured in 5th and 6th graders with learning disabilities suggests that there is a plausible causal relation. Vertical oculomotor imbalance, vestibular problems, and learning disability are discussed.     

The quality of friendships between children with and without learning problems

The nature and quality of preadolescent friendships between children with and without learning problems due to mental retardation or mild cognitive difficulties were investigated. Based on an assessment of the reciprocal relationship status of 373 children, including 54 with learning problems, 33 friend and 32 acquaintance dyads were identified. Of these dyads, half included a child with learning problems and half consisted of 2 children without learning problems. The dyads were observed performing a play task. Unlike friendships between children without disabilities, friendships between children with and without learning problems were marked by limited collaboration and shared decision-making, a low level of cooperative play and shared laughter, and an asymmetrical, hierarchical division of roles. The importance of advancing beyond the study of the social acceptance of children with learning problems to study the qualitative aspects of their friendships was discussed.     

Paraumbilical vein in the cirrhotic patient: imaging with 3D CT angiography

This article provides a response to Stone's review and analysis of the scaffolding metaphor as it is applied to research applications for students with learning disabilities. We propose that, to advance the field of instructional research with students with learning disabilities, all available literature should be used when interpreting findings for instructional procedures for students with learning disabilities. Only when all of the intervention research literature in learning disabilities is examined can reliable conclusions be drawn regarding the efficacy of instructional procedures.     

Helping Chinese parents understand and support children with learning disabilities.

Despite common stereotypes of Chinese children as high academic achievers, school psychologists increasingly are coming across Chinese children with learning disabilities. In contrast to psychologists' attributions for children's learning problems, Chinese parents often attribute children's learning difficulties to a lack of self-discipline, an imbalance of yin and yang, or the influence of spirits. These beliefs affect parents' views of their children and their intervention preferences. The authors address the fundamental question: How do school psychologists mobilize Chinese parents to support their children in accessing and benefiting from school-based disability services? They provide guidance about building an alliance with Chinese parents, negotiating different explanatory models for children's learning problems, and reframing remediation efforts to make them consistent with Chinese parenting practices. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of "To Laugh: To Play: To Learn."

Reviews the film, To Laugh: To Play: To Learn produced by the Canadian Educational and Psychological Consultants Ltd. To Laugh: To Play: To Learn is a series of two 30 minute color films on the diagnosis and treatment of Learning Disabilities. The first film in the series, "An Introduction to Learning Disabilities" is well organized, interesting and has a certain charm. The film contains a substantial body of knowledge which could provide the basis for several hours of lecture or discussion. The film is a useful and charming approach to learning disabilities, but to gain the greatest value from it, the commentator should have some first-hand experience of clinical neuropsychology and learning disabled children. The second film in the series, "There is a Way," attempts to examine a number of common problems of children with learning disabilities. It begins with a demonstration of a learning machine for teaching arithmetic and moves on to perceptual discrimination, a demonstration of several remedial procedures, the use of medication for hyperactivity, the emotional and social development of the child, learning games, and interviews with two teenagers who had been successfully helped to circumvent or resolve their learning problems. While all of these topics are important, their discussion in a 30 minute film is necessarily brief and sometimes superficial. In spite of this, the film should be useful in presenting the ideas and problems for group or class discussion. Like the first film, it is given considerable diversity by a large number of short interviews and demonstrations with a variety of people and children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Short-term memory processes in children with reading and arithmetic learning disabilities.

Examined the role of phonemic coding in short-term memory in 45 children with a reading disability, 38 children with a specific arithmetic disability, and 89 normal children, as measured by the Wide Range Achievement Test. Ss, aged 7–13 yrs, were administered a series of tasks that involved the visual or auditory presentation of rhyming and nonrhyming letters and either an oral or a written response. Younger Ss (7–8 yrs) with a reading disability did not show any difference between the recall of nonrhyming and rhyming letters, whereas normal Ss of the same age did. Older reading-disabled Ss (aged 9–23 yrs), like their normal counterparts, had significantly poorer recall of rhyming as opposed to nonrhyming letters. However, their overall levels of performance were significantly lower than normals. The same pattern was found with Ss with arithmetic disabilities for the visual presentation of stimuli. For the auditory presentation of stimuli, the performance of Ss with arithmetic disabilities resembled that of normals, except at the youngest ages. Whereas a deficiency in phonological coding may characterize younger children with learning disabilities, older children with learning disabilities appear to use a phonemic code but have a more general deficit in short-term memory. (25 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychotherapeutic issues for the learning disabled adult.

Discusses previously held misconceptions about learning disabilities in childhood and their effects on subsequent adolescent and adult development. As a result of these misconceptions, learning disabled children were often told at the time of diagnosis that they were likely to spontaneously outgrow their affliction before reaching adulthood. Follow-up studies have shown this not to be true, and many adults are now presenting with a variety of emotional problems either directly or indirectly related to their learning disabilities. Obstacles to the development of normal interpersonal relationships at school and in the family are described. The effects of this impaired development on adult functioning and the types of problems that typically result are outlined. Modifications of traditional psychotherapy techniques that have helped to assure successful treatment of this type of patient and the case example of an 18-yr-old learning disabled male are presented. (14 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Socioemotional disturbances of learning disabled children.

A review of research on the relation between socioemotional functioning/disturbance and learning disabilities in children suggests that (a) although some learning disabled (LD) children suffer from socioemotional disturbance (SED), most do not; (b) there is no single, unitary pattern of emotional disturbance or social incompetence displayed by LD children; (c) the types of SED exhibited by LD children may be more frequent in such children than in their normally achieving age mates; (d) one pattern of central processing abilities and deficits appears to lead both to a particular configuration of academic achievement and to a particular form of SED, whereas other patterns do not; (e) psychopathology worsens in children with nonverbal learning disabilities; and (f) the methodologies and model developments designed to illuminate the relation between learning disabilities and SED must encompass the heterogeneity of the subtypal presentations evident in each. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Including the family perspective in sensory integration outcomes research

Occupational therapy, along with other health and rehabilitation professions, is experiencing an increased emphasis on measurement of intervention outcomes. The results of outcomes research are being used to develop practice guidelines, set standards for reimbursement, and justify health care policy. The outcome assessments used by therapists reflect our belief systems and the assumptions about behaviors we expect to influence. Using a sensory integration perspective to illustrate key points, we present a conceptual framework that is based on the disablement framework and Coster's occupational functioning for children model. We highlight the need to examine each of the multiple levels at which intervention may influence child and family function and the links among levels. Sensory integration theory and efficacy studies are reviewed to identify assumptions relative to how sensory integration affects the everyday occupations of children in the context of their families. Potential research methods and assessments are suggested to include the family perspective in outcome studies.     

Review of The science of learning disabilities.

Reviews the book, The science of learning disabilities, by K. A. Kavale and S. R. Forness (1985). Kavale and Forness assert that the field of learning disabilities has become a pseudoscience. They state that the purpose of their book is to demonstrate how the field of learning disabilities strayed from its scientific course and suggest how it can regain its scientific status. To accomplish their goals, the authors emphasize the importance of scientific inquiry, the history of the learning disabilities field, and possible solutions to the problems they depict as currently being characteristic of the field. The field of learning disabilities, they assert, strayed from the scientific method by emphasizing empirical associations per se without the proper formulation of theories regarding learning disabilities. The authors fulfill their stated goals of describing how many in the learning disabilities field drifted away from the scientific method and by outlining how the field can regain its scientific status. The review of the history of the learning disabilities field is comprehensive and informative. This book is written in a scholarly, unemotional style. Although its exploration of the scientific method, that forms the basis of the authors' arguments, is simple and consistent with that provided in most introductory texts in the sciences, the authors' discussions of research findings are, at times, complex. Readers who are not familiar with meta-analytical techniques are encouraged to obtain some familiarity with these before reading this book. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Disabilities of arithmetic and mathematical reasoning: perspectives from neurology and neuropsychology

Current research on brain-behavior relationships in disabilities of arithmetic and mathematical reasoning is reviewed from both a neurological and a neuropsychological perspective. Although no entirely satisfactory statement of the relationship between arithmetic skills and brain functions has yet emerged, investigators in this area have provided evidence regarding the involvement of some brain systems in processes of calculation. Also, the developmental importance of right- versus left-hemisphere integrity for the mediation of arithmetic learning and performance has been suggested. We propose that an account of brain-behavior relationships in children intended to explain and predict developmental disabilities of arithmetic learning needs to address several important content and processing distinctions in order to (a) encompass empirically derived subtypes of children with learning disabilities who exhibit difficulties with arithmetic and (b) provide adequate direction for future subtyping and intervention research.     

Understanding child with learning disabilities

A knowledge of the characteristics of learning disabilities in children, the theories behind interventions, and the relevant research can guide child welfare practitioners in treatment.     

Neuropsychological testing: Relevance for assessing children's learning disabilities.

The traditional concept of learning disabilities makes two presumptions of direct relevance to neuropsychological assessment. The first is that deficits in psychological processes are responsible for learning problems in children who should otherwise be able to learn. The second is that these processing deficits are a reflection of biological-genetic factors. A review of the literature on neuropsychological test batteries suggests that both presumptions are credible. Although the neurological validity of these batteries is uncertain, there is at least indirect evidence for biological influences on performance. The psychological significance of test deficits has been more clearly established. Cognitive dimensions tapped by neuropsychological batteries discriminate disabled from nondisabled learners, appraise different sources of learning failure, help to identify the children most likely to develop these disabilities, and are useful in making treatment recommendations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Right hemisphere dysfunction in nonverbal learning disabilities: Social, academic, and adaptive functioning in adults and children.

Addresses recent research on social and nonverbal learning disabilities. Involvement of right hemispheric dysfunction in these disabilities has been hypothesized, as studies with adults have suggested that documented right hemisphere damage may lead to deficits in social skills, prosody, spatial orientation, problem solving, and recognition of nonverbal cues. Studies of children purported to evidence nonverbal learning disabilities are reviewed and compared with the results from studies of adults with right hemisphere damage. Specific subtypes of nonverbal learning disabilities are reviewed, including the nonverbal perceptual-organization-output subtype, Asperger's syndrome, Developmental Gerstmann syndrome, left hemisyndrome, right hemisphere syndrome, and right parietal lobe syndrome. Finally, implications and future research needs are addressed. The need for a diagnostic nosology and improved and validated intervention techniques is stressed as is early identification of these types of specific nonverbal learning disabilities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Environmental Toxicants and Developmental Disabilities: A Challenge for Psychologists.

Developmental, learning, and behavioral disabilities are a significant public health problem. Environmental chemicals can interfere with brain development during critical periods, thereby impacting sensory, motor, and cognitive function. Because regulation in the United States is based on limited testing protocols and essentially requires proof of harm rather than proof of lack of harm, some undefined fraction of these disabilities may reflect adverse impacts of this "vast toxicological experiment" (H. L. Needleman, as quoted in B. Weiss & P. J. Landrigan, 2000, p. 373). Yet the hazards of environmental pollutants are inherently preventable. Psychologists can help prevent developmental disabilities by mobilizing and affecting public policy, educating and informing consumers, contributing to interdisciplinary research efforts, and taking action within their own homes and communities to reduce the toxic threat to children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Instrument for locating students with suspected learning disabilities: a quantitative approach

The instrument to locate students with learning disabilities was developed to create equality and uniformity, so that such difficulties could be spotted independently of socialization factors, teachers and parents to whom the student had been exposed. The instrument was developed on the basis of research that defines the reading rate of students with reading disabilities in words per minute, the minimum number of errors for locating writing disabilities, and the number of answers and lines a student uses to reconstruct the content of a passage adapted to his or her age level. The research carried out in order to construct the instrument is the first to attempt to quantify disability, and on this basis to construct an instrument to locate students with disabilities in reading, writing and visual recall. The procedure can be carried out for a whole class in a single lesson period. One indirect conclusion from the research is that disability indicators remain with the learning disabled regardless of time since diagnosis or remedial help. Other implications related to combining the quantity component in diagnoses of degrees of difference in the disability identified, and in extra examination time for the learning disabled. The instrument should solve the problem of locating students with difficulty reading, writing or in visual recall, due to disability. Students thus identified will be directed to individual diagnosis to find out whether their difficulties are primary or secondary (e.g. a new immigrant who still has trouble with Hebrew). A personal corrective programme can then be constructed.