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Specific learning disorder

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NEURODEVELOPEMENTAL
DISORDERS
3rd Disorder
(Specific Learning Disorder)
By: Muhammad Musawar Ali
MPHIL, ICAP
Psychmmusawarali@gmail.com
1
When was the term learning disability first
used?
Kirk becomes the first to use the term “learning disability” at an education
conference in 1964 and association for Children with Learning Disabilities (ACLD) is
created.
2
Different learning disabilities
 Dyslexia.
 ADHD.
 Dyscalculia. ...
 Dysgraphia. ...
 Processing Deficits.
3
Dyslexia
 Dyslexia, also known as reading disorder, is characterized by
trouble with reading despite normal intelligence.
 Problems may include difficulties in spelling words, reading
quickly, writing words, "sounding out" words in the head,
pronouncing words when reading aloud and understanding
what one reads.
 Often these difficulties are first noticed at school.
 When someone who previously could read loses their ability,
it is known as alexia.
 Dyslexia is sometimes referred to as a Language-Based
Learning Disability.
4
Changes Made to SLD in DSM-5
 Two major changes
 Category of SLD with ‘specifiers’ to characterize the specific
manifestations of learning difficulties at the time of
assessment in three major academic domains, namely
reading, writing, mathematics (e.g., SLD With impairment in
reading).
 Elimination of the IQ-achievement discrepancy requirement
and its replacement with four criteria (A – D), all of which
must be met.
5
Diagnostic Criteria for Specific Learning
Disorder
 (A) Difficulties learning and using academic skills, as
indicated by the presence of at least one of the following
symptoms that have persisted for at least six months, despite
the provision of interventions that target those difficulties:
 (1) Inaccurate or slow and effortful word reading (e.g., reads
single words aloud incorrectly or slowly and hesitantly,
frequently guesses words, has difficulty sounding out words).
 (2) Difficulty understanding the meaning of what is read (e.g.,
may read text accurately but not understand sequence,
relationships, inferences, or deeper meanings of what is
read).
6
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Specific learning disorder

  • 1. NEURODEVELOPEMENTAL DISORDERS 3rd Disorder (Specific Learning Disorder) By: Muhammad Musawar Ali MPHIL, ICAP Psychmmusawarali@gmail.com 1
  • 2. When was the term learning disability first used? Kirk becomes the first to use the term “learning disability” at an education conference in 1964 and association for Children with Learning Disabilities (ACLD) is created. 2
  • 3. Different learning disabilities  Dyslexia.  ADHD.  Dyscalculia. ...  Dysgraphia. ...  Processing Deficits. 3
  • 4. Dyslexia  Dyslexia, also known as reading disorder, is characterized by trouble with reading despite normal intelligence.  Problems may include difficulties in spelling words, reading quickly, writing words, "sounding out" words in the head, pronouncing words when reading aloud and understanding what one reads.  Often these difficulties are first noticed at school.  When someone who previously could read loses their ability, it is known as alexia.  Dyslexia is sometimes referred to as a Language-Based Learning Disability. 4
  • 5. Changes Made to SLD in DSM-5  Two major changes  Category of SLD with ‘specifiers’ to characterize the specific manifestations of learning difficulties at the time of assessment in three major academic domains, namely reading, writing, mathematics (e.g., SLD With impairment in reading).  Elimination of the IQ-achievement discrepancy requirement and its replacement with four criteria (A – D), all of which must be met. 5
  • 6. Diagnostic Criteria for Specific Learning Disorder  (A) Difficulties learning and using academic skills, as indicated by the presence of at least one of the following symptoms that have persisted for at least six months, despite the provision of interventions that target those difficulties:  (1) Inaccurate or slow and effortful word reading (e.g., reads single words aloud incorrectly or slowly and hesitantly, frequently guesses words, has difficulty sounding out words).  (2) Difficulty understanding the meaning of what is read (e.g., may read text accurately but not understand sequence, relationships, inferences, or deeper meanings of what is read). 6
  • 7.  (3) Difficulties with spelling (e.g., may add, omit, or substitute vowels or consonants).  (4) Difficulties with written expression (e.g., makes multiple grammatical or punctuation errors within sentences; employs poor paragraph organization; written expression of ideas lacks clarity).  (5) Difficulties mastering number sense, number facts, or calculation (e.g., has poor understanding of numbers, their magnitude, and relationships; counts on fingers to add single- digit numbers instead of recalling the math fact as peers do; gets lost in the midst of arithmetic computation and may switch procedures). 7
  • 8.  (6) Difficulties with mathematical reasoning (e.g., has severe difficulty applying mathematical concepts, facts, or procedures to solve quantitative problems). 8
  • 9.  B) The affected academic skills are substantially and quantifiably below those expected for the individual’s chronological age, and cause significant interference with academic or occupational performance, or with activities of daily living, as confirmed by individually administered standardized achievement measures and comprehensive clinical assessment.  For individuals aged 17 years and older, a documented history of impairing learning difficulties may be substituted for the standardized assessment. 9
  • 10.  (C) The learning difficulties begin during school-age years but may not become fully manifest until the demands of those affected academic skills exceed the individuals limited capacities (e.g., as in timed tests, reading or writing lengthy complex reports for a tight deadline, excessively heavy academic loads). 10
  • 11. Specify if: With impairment in reading:  Word reading accuracy.  Reading rate or fluency.  Reading comprehension. 11
  • 12. With impairment in written expression:  Spelling accuracy.  Grammar and punctuation accuracy.  Clarity or organization of written expression. 12
  • 13. With impairment in mathematics:  Number sense.  Memorization of arithmetic facts.  Accurate or fluent calculation.  Accurate math reasoning. 13
  • 14. Specify current severity:  Mild: Some difficulties learning skills in one or two academic domains, but of mild enough severity that the individual may be able to compensate or function well when provided with appropriate accommodations or support services, especially during the school years. 14
  • 15.  Moderate: Marked difficulties learning skills in one or more academic domains, so that the individual is unlikely to become proficient without some intervals of intensive and specialized teaching during the school years. Some accommodations or supportive services at least part of the day at school, in the workplace, or at home may be needed to complete activities accurately and efficiently. 15
  • 16.  Severe: Severe difficulties learning skills, affecting several academic domains, so that the individual is unlikely to learn these skills without ongoing intensive individualized and specialized teaching for most of the school years. Even with an array of appropriate accommodations or services at home, at school, or in the workplace, the individual may not be able to complete all activities efficiently. 16
  • 17. Specific Learning Disorder By: Anum Hayyat Advance Diploma in clinical Psychology
  • 18. Specific Learning Disorder The term means a disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, that may manifest itself in an imperfect ability to listen, think, speak, read, write, spell, or to do mathematical calculations, including conditions such as perceptual disabilities, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia.
  • 19. Specific Learning Disorder Whether we are studying Roman history or calculus, applying ourselves to the task of learning requires exertion and concentration. Like physical activities, some learning activities are more difficult than others, especially for younger children who have not developed a foundation of good study habits and successful learning experiences. Parents and teachers may notice that a child is struggling unusually hard to master a particular skill, such as reading, and wonder why. The problem may be formally assessed by an IQ test and various standardized tests that assess abilities in specific academic areas.
  • 20.  When achievement in reading, math, or writing is well below average for the child’s age and intellectual ability, he or she may be diagnosed with a specific learning disorder (SLD). In other words, a child write a specific learning disorder is intellectually capable of learning key academic concepts of reading, writing, and math, but seems unable to do so. The phrase “unexpected academic underachievement” captures this notion that the child’s learning problems are indeed specific and not due to intellectual disability or global developmental delay.
  • 21.  James, at age 9, had problems primarily in reading and spelling. Contrast his reading difficulties with those of Tim, who struggles with spatial orientation and mathematical reasoning.  James’s pattern of strengths and weaknesses shows that although he has reading problems, other strengths compensate for this disability. He has strong talents for figuring out how things work and for drawing ideas on paper. Tim has several strengths, too, especially in linguistic skills such as word recognition, sentence structure, and reading. In contrast to James, Tim has problems primarily in the visual, spatial, and organizational spheres, which show up as difficulties with tactile (touch) perception, psychomotor activity (e.g., throwing and catching), and nonverbal problem solving (e.g., figuring out math problems and assembling things). Both boys fit the diagnostic criteria for SLD. Note how Tim’s academic problems, in particular, were almost masked by his frustration and low self-esteem.
  • 23.  Emotional problems are often seen in children who are bright enough to recognize that their performance is below that of others and are frustrated with their poor performance at school. The limitations of both James and Tim can affect every aspect of their formal education as well as their interpersonal abilities; therefore, these disorders require comprehensive and ongoing treatment plans.
  • 24.  The main diagnostic feature of SLD is that the child has difficulties learning keystone academic skills of reading, writing, spelling, or math.  These difficulties may appear in one or more of these skills, including inaccurate or slow reading, difficulty understanding the meaning of what is read, difficulties with spelling and/or written expression, or difficulties mastering num be sense, calculation, or mathematical reasoning.
  • 25. Causes Learning disabilities. Learning disabilities are presumed to be disorders of the central nervous system and a variety of factors may contribute to their occurrence. Learning disabilities may be due to
  • 26. Heredity: Learning disabilities tend to run in families. Problems during pregnancy and childbirth. Learning disabilities may be caused by illness or injury during or before birth. Learning disabilities may also be caused by the use of drugs and alcohol during pregnancy, RH incompatibility with the mother (if untreated), premature or prolonged labor or lack of oxygen or low weight at birth.
  • 27. Incidents after birth. Head injuries, nutritional deprivation, poisonous substances, (e.g., lead), and child abuse can contribute to learning disabilities
  • 28. Characteristics Students who have learning disabilities may exhibit a wide range of traits, including:  problems with reading comprehension  spoken language  writing  reasoning ability  Hyperactivity  Inattention  difficulty remembering today what was learned yesterday  short attention span (restless, easily distracted)
  • 29. Characteristics letter and number reversals (sees "b" for "d" or "p", "6" for "9", "pots" for "stop" or "post") poor reading (below age and grade level) frequent confusion about directions and time (right-left, up-down, yesterday-tomorrow)
  • 30. trouble remembering what someone just told him or her poor coordination (in gross motor activities such as walking or sports and/or in fine motor activities such as tying a shoelace, holding a pencil, or handwriting)
  • 31. Learning Disabilities Learning disabilities may occur in the following academic areas:  Spoken language: Delays, disorders, or discrepancies in listening and speaking.  Written language: Difficulties with reading, writing, and spelling.  Arithmetic: Difficulty in performing arithmetic functions or in comprehending basic concepts;  Reasoning: Difficulty in organizing and integrating thoughts.
  • 32. Types  I-Dyslexia - a language-based disability in which a person has trouble understanding words, sentences, or paragraphs.  II-Dyscalculia - a mathematical disability in which a person has a difficult time solving arithmetic problems and grasping math concepts.  III-Dysgraphia - a writing disability in which a person finds it hard to form letters or write within a defined space.
  • 33. Types  Auditory and Visual Processing Disabilities - sensory disabilities in which a person has difficulty understanding language despite normal hearing and vision.
  • 34.  When you consider everything involved in learning the basics of reading, such as associating shapes of letters (graphemes) with sounds (phonemes), it is not surprising that some children have difficulty and can quickly fall behind. Read the following sentence: “I believe that abnormal child psychology is one of the most fascinating and valuable courses I have taken.” As you read the sentence, did you notice that you had to simultaneously:  Focus attention on the printed marks and control your eye movements across the page?  Recognize the sounds associated with letters?  Understand words and grammar?  Build ideas and images?  Compare new ideas with what you already know?  Store ideas in memory?
  • 35.  Many clinical signs of reading disorders are first evident only to a trained eye. Some testing methods developed by teachers and school psychologists show how children with reading disorders function in the classroom. They often have trouble learning basic sight words, especially those that are phonetically irregular and must be memorized, such as the, who, what, where, was, laugh, said, and so forth. These children have developed their own unique and peculiar reading patterns, which signal the need for different teaching methods. Typical errors include reversals (b/d, p/q), transpositions (sequential errors such as was/ saw, scared/sacred), inversions (m/w, u/n), and omissions (reading place for palace or section for selection). However, these errors are common in many younger children who are just learning to read and write and do not necessarily imply a reading disorder.
  • 36. A child with a SLD with impairment in reading lacks the critical language skills required for basic reading: word reading accuracy, reading comprehension, and reading rate or fluency. Dyslexia is an alternative term sometimes used to describe this pattern of reading difficulties. These core deficits stem from problems in decoding breaking a word into parts rapidly enough to read the whole word coupled with difficulty reading single small words (Elution et al., 2007). When a child cannot detect the phonological structure of language and automatically recognize simple words, reading development will very likely be impaired (Peterson & Pennington, 2010). The slow and labored decoding of single words requires substantial effort and detracts from the child’s ability to retain the meaning of a sentence, much less a paragraph or page.
  • 37. SLD with Impairment in Written Expression  SLD with impairment in written expression may manifest as problems in spelling accuracy, grammar and punctuation accuracy, and/or clarity or organization of written expression. This particular SLD is often found in combination with SLD in reading or mathematics, which also have underlying core deficits in language and neuropsychological development.
  • 38. Children with impairment in written expression often have problems with tasks that require eye– hand coordination, despite their normal gross motor development. Teachers notice that, as compared with children who have normal writing skills, children with impairments in writing produce shorter, less interesting, and poorly organized essays and are less likely to review spelling, punctuation, and grammar to increase clarity. However, spelling errors or poor handwriting that do not significantly interfere with daily activities or academic pursuits do not qualify a child for this diagnosis. In addition, problems in written expression signal the possibility of other learning problems
  • 39. SLD with Impairment in Mathematics  During their preschool years, children are not as naturally drawn to mathematical concepts as they are to reading. This changes rapidly as they discover that they need to count and add to know how much money it takes to buy something or how many days remain until vacation. As in reading, the need to know propels children to learn new and difficult concepts, and little by little their new skills help them understand the world better.
  • 40.  Children with an SLD with impairment in mathematics typically have core deficits in arithmetic calculation and/or mathematics reasoning abilities, which include naming amounts or numbers, enumerating, comparing, and manipulating objects, reading and writing mathematical symbols, understanding concepts and performing calculations mentally, and performing computational operations. These deficits imply that the neuropsychological processes underlying mathematical reasoning and calculation are underdeveloped or impaired
  • 41. Prevalence  As many as 1 out of every 5 people in the United States has a learning disability. Almost 3 million children (ages 6 through 21) have some form of a learning disability and receive special education in school.  In fact, over half of all children who receive special education have a learning disability.
  • 42. Gender Differences LD is twice as common in males as in females, Males are significantly more likely than females to fall within each major disability group.
  • 43. Co-morbidity  Co-morbidity means that certain diseases and disorders tend to occur together.  In 25% of the cases of Learning disabilities, a co-morbid condition is Attention Deficit/Hyperactive Disorder-AD/HD.
  • 44. Educational Implications  Supports or changes in the classroom (sometimes called accommodations) help most students with LD.
  • 45. Other Facts  Learning disabilities should not be confused with other disabilities such as mental retardation, autism, deafness, blindness, and behavioral disorders.  New statistics indicate that about 47.5% of the disability population are individuals with learning disabilities.  Approximately 85% of all individuals with learning disabilities have difficulties in the area of reading.
  • 46. 44% of parents who noticed their child exhibiting signs of problems with learning waited a year or more before acknowledging their child might have a serious problem. 35% of children with learning disabilities drop out of high school.
  • 47. Cultural, Class, and Gender Variations Social and cultural factors are less relevant to SLD than other types of cognitive and behavioral problems, in fact, the diagnostic criteria state that they cannot be attributed to these factors. Nevertheless, some cultural and ethnic factors may affect how children with SLD are identified and treated.
  • 48. Whereas attention to cultural and ethnic issues pertaining to SLD is a recent addition to research, sex differences have a long and contentious history. Boys are more often referred for learning difficulties than girls, perhaps because boys are more likely to show associated behavior problems such as aggression or inattention. Girls with learning problems often are quiet and withdrawn rather than loud and attention seeking, and they may be overlooked unless educators and parents are well informed. Nonetheless, when male–female ratios of SLD are derived from epidemiological estimates rather than from referrals, the ratio of boys to girls fall between 2:1 and 3:1.