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Learning Difficulties

Dyslexia

What is it?

The word dyslexia is derived from the Greek word, dys (meaning poor or inadequate) and the word lexis (meaning words or language). Dyslexic children seem to have trouble learning early reading skills, problems hearing individual sounds in words, analysing whole words in parts, and blending sounds into words. Letters such as “d” and “b” may be confused. Often a child with dyslexia has a problem translating language into thought (such as in listening or reading), or translating thought into language (such as in writing or speaking). Dyslexia is also referred to as developmental reading disorder (DRD).

Dyslexia is a problem involving higher (cortical) processing of symbols in the brain. Most children with dyslexia are of normal intelligence; many have above-average intelligence. However, when a child is dyslexic, there is often an unexpected difference between achievement and aptitude. Each child with dyslexia has different strengths and weaknesses, although many have unusual talents in art, athletics, architecture, graphics, drama, music, or engineering. These special talents are often in areas that require the ability to integrate sight, spatial skills, and coordination.

What causes Dyslexia?

The underlying cause of dyslexia is not known, although research suggests the condition is often inherited. In 1999, The Centre for Reading Research in Norway presented the first research to study the largest family with reading problems ever known. By studying the reading and writing abilities of close to 80 family members across four generations, the researchers reported, for the first time, that chromosome 2 can be involved in the inheritability of dyslexia. When a fault occurs on this gene, it leads to difficulties in processing written language. Previous studies have pointed out linkages of other potential dyslexia genes to chromosome 1, chromosome 15 (DYX1 gene), and to chromosome 6 (DYX2 gene). The researchers who pinpointed the localized gene on chromosome 2 (DYX3) hope that this finding will lead to earlier and more precise diagnoses of dyslexia.

Research suggests a possible link with a subtle visual problem that affects the speed with which affected people can read. Anatomical and brain imagery studies show differences in the way the brain of a dyslexic child develops and functions.

Indicators of dyslexia include:

  • Possible family history of learning disorders
  • Difficulty learning to recognize written words
  • Difficulty rhyming
  • Difficulty determining the meaning (idea content) of a single sentence
  • Writing or arithmetic learning problems
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How Dyslexia Affects Children?

Common characteristics of a child with dyslexia include problems with:

  • Identifying single words
  • Understanding sounds in words, sound order, or rhymes
  • Spelling
  • Transposing letters in words
  • Handwriting
  • Reading comprehension
  • The spoken language
  • Understanding directions
  • Understanding opposites, such as up/down or early/late

Social and emotional difficulties often accompany this disorder, as children are unable to meet expectations of parents and teachers and feel frustrated at their inability to achieve their goals. They may have a negative self-image and become angry, anxious, and depressed.

Demographics: about 15–20 percent of the population of the United States has a language-based learning disability. Of students with specific learning disabilities receiving special education services, 70–80 percent have deficits in reading. With such a high incidence, there is a question as to whether this is really a difference in learning style rather than a true “disability.” The condition affects males more than females, and appears in all ages, races, and income levels.

Prenatal screening and diagnosis?

Anyone who is suspected to have dyslexia should have a comprehensive evaluation, including medical, psychological, behavioural, hearing, vision, and intelligence testing. The test should include all areas of learning and learning processes, not only reading. Other causes of learning disabilities, such as attention deficit hyperactivity disorder (ADHD), affective disorders (e.g., depression or anxiety), central auditory processing dysfunction, pervasive developmental disorders, and physical or sensory impairments, must be ruled out before the diagnosis of dyslexia can be confirmed. A child of any age may be evaluated for dyslexia using an age-appropriate battery of tests.

Getting help?

Dyslexia is a life-long condition, but with proper intervention, a child can learn to read and/or write well. When a child is diagnosed with dyslexia, the parents should find out from the school or the diagnostician exactly what the problem is, what method of teaching is recommended, and why a particular method is suggested.

The primary focus of treatment is aimed at solving the specific learning problem of each affected child. Most often, this may include modifying teaching methods and the educational environment, since traditional educational methods will not always be effective with a dyslexic child. An Individual Education Plan (IEP) should be created for each child, reflecting his or her specific requirements. Special education services may include specialist help by an instructor specifically trained to teach dyslexic students through individualized tutoring or special day classes. It is important to teach these students using all the senses—hearing, touching, writing, and speaking—through a multi-sensory program.

People with dyslexia need a structured language program, with direct instruction in the letter-sound system. Teachers must provide the rules governing written language. Most experts agree that the teacher should emphasize the association between simple phonetic units with letters or letter groups, rather than an approach that stresses memorizing whole words.

To assist with associated social and emotional difficulties, teachers must use strategies that will help the child find success in academics and personal relationships. Such strategies include rewarding efforts and not just the results, helping the child set realistic goals, and encouraging the child to do volunteer work that requires empathy and a social conscience (for example, a child with dyslexia who does well in science or math could serve as a peer tutor in those subjects or could tutor a younger child with dyslexia). Psychological counselling may also be helpful.

Prognosis

There is a great deal of variation among different people with dyslexia, producing different symptoms and degrees of severity. The prognosis depends on the severity of the disability, but is usually good if the condition is diagnosed early, the intervention used is effective and appropriate for the specific child, and if the child has a strong self-image and supportive family, friends, and teachers. However, difficulties with reading may persist throughout adulthood, which may result in occupational problems in certain careers.

Prevention

Since learning disorders often run-in families, affected families should try to recognize learning disability problems early. For families without a previous history of learning disabilities, an intervention can begin as early as preschool or kindergarten if teachers detect early signs.

Learning Difficulties

Learning difficulty specific impairment – written expression (formerly known as Dysgraphia – disorder of writing)

What is it?

Handwriting is one of the most complex skills that is learnt and taught. It requires motor, sensory, perceptual, praxis (motor planning) and cognitive functions and the integration of these functions (Chu, 1997). When the complexity of this skill is considered it is not surprising that many children experience difficulty in mastering this skill.

When handwriting difficulties affect a student’s academic performance, intervention is warranted, and a referral to an occupational therapist may be recommended. Occupational Therapists usually adopt a diagnostic approach to the assessment of handwriting difficulties and diagnosis of dysgraphia.

Evaluation of handwriting difficulties can include and may not be limited to:

Assessing Neuromuscular mechanisms – including postural control, upper limb stability and muscle tone.

Sensory integrative functioning – poor perception and discrimination of touch can influence pencil grip, visual perceptual deficits and poor motor planning skills can influence quality and speed of writing.

Motor control – poor fine motor control and dexterity. Lack of exposure and refinement of skills during preschool can exacerbate handwriting difficulties.

Cognitive and psychosocial behaviours – attention span, memory, behaviour, motivation and self-concept are all important factors incorporated in the evaluation of handwriting skills.

Following assessment of handwriting, it is important to establish what approach is most appropriate for the student. In some cases, remediation is not possible without significant effort and financial burden. In this current technologically advanced climate, alternative options provide a range of choices that can be both cost-effective and preferred by the student. In all cases, consultation and collaboration with parents and teachers are recommended.

Getting help?

Remedial approaches – aims to address underlying inefficiencies in sensory processing, motor coordination and perceptual skills that will result in improved handwriting performance. Therapy can be clinic based (sensory motor approaches) or school/home based.

Functional approaches – emphasises mastering the skills through practice and repetition. Like other acquisitional skills (learning to tie laces) handwriting may be improved through sequencing, tracing, templates, practice and modelling.

Compensatory approaches – pencil grips, slant boards, Dictaphones, use of word processors/ PC’s, a scribe, voice activated software. Due to technological advancement, these options are becoming more commonplace, appropriate and affordable.

From all perspectives, Handwriting is a complex “end product.” Identifying and seeking assistance at the earliest stages supports students achieving to their potential. For further advice and information contact an Occupational Therapist specialising in paediatrics.

Learning Difficulties

Dyscalculia

What is it?

Dyscalculia is a specific and persistent difficulty in understanding numbers which can lead to a diverse range of difficulties with mathematics. It will be unexpected in relation to age, level of education and experience and occurs across all ages and abilities.

Mathematics difficulties are best thought of as a continuum, not a distinct category, and they have many causal factors. Dyscalculia falls at one end of the spectrum and will be distinguishable from other maths issues due to the severity of difficulties with number sense, including subitising, symbolic and non-symbolic magnitude comparison, and ordering. It can occur singly but often co-occurs with other specific learning difficulties, mathematics anxiety and medical conditions.

What causes Dyscalculia?

Researchers don’t know exactly what causes dyscalculia. But they believe it’s at least partly due to differences in how the brain is structured and how it functions. They aren’t just looking into what causes dyscalculia. They’re also trying to learn if there are strategies that can help “rewire” the brain to make math easier.

There are two possible causes of dyscalculia:

  1. Genes and heredity: Dyscalculia tends to run in families. Research shows that genetics may also play a part in problems with math.
  2. Brain development: Brain imaging studies have shown some differences between people with and without dyscalculia. The differences have to do with how the brain is structured and how it functions in areas that are linked to learning skills.

How Dyscalculia affects children?

  • Difficulty counting backwards
  • Difficulty remembering ‘basic’ facts
  • Slow to perform calculations
  • Weak mental arithmetic skills
  • A poor sense of numbers & estimation
  • Difficulty in understanding place value
  • Addition is often the default operation
  • High levels of mathematics anxiety.
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    How Dyscalculia Affects Children?

    Common characteristics of a child with dyslexia include problems with:

    • Identifying single words
    • Understanding sounds in words, sound order, or rhymes
    • Spelling
    • Transposing letters in words
    • Handwriting
    • Reading comprehension
    • The spoken language
    • Understanding directions
    • Understanding opposites, such as up/down or early/late

    Social and emotional difficulties often accompany this disorder, as children are unable to meet expectations of parents and teachers and feel frustrated at their inability to achieve their goals. They may have a negative self-image and become angry, anxious, and depressed.

    Demographics: about 15–20 percent of the population of the United States has a language-based learning disability. Of students with specific learning disabilities receiving special education services, 70–80 percent have deficits in reading. With such a high incidence, there is a question as to whether this is really a difference in learning style rather than a true “disability.” The condition affects males more than females, and appears in all ages, races, and income levels.

    Prenatal Screening

    Most people diagnosed with the disorder have developmental dyscalculia, which means they were born with it. But, with what’s known as acquired dyscalculia, the disorder can also arise later in life, usually as the result of a stroke or injury.

    Getting help?

    There are no medications that treat dyscalculia, but there are lots of ways to help children with this math issue succeed in life and at school. Multisensory instruction can help children with dyscalculia understand math concepts. Using different manipulatives, and assistive technology can also help kids with dyscalculia.

    Children with dyscalculia can benefit from specialised instruction, especially in early years of school.

    There are no medications that treat dyscalculia, but medication could help children deal with co-occurring issues like ADHD or anxiety.

    There are no formal programs for teaching struggling math students like there are for struggling readers. But that doesn’t mean these children can’t benefit from specialised instruction, especially in early years of school.

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