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Dr Anjana ThadhaniConsultant Developmental             Pediatrician
Specific Learning Disabilities Group of developmental disorders Significant unexpected, specific and persistent  difficu...
Salient FeaturesTypes: Dyslexia        Dysgraphia       DyscalculiaCreates a significant gap between the potential  and ac...
LEARNING             INPUT           PROCESSING            OUTPUT
INFORMATION PROCESSINGRECORDING INFORMATION (INPUT)    Perceptual   →Visual                  →AuditoryINTEGRATION    Seq...
READING Phonological awareness Letter-sound association Decoding & Blending Focus on printed words Control of eye mov...
CAUSES Neuro-developmental condition Multi-factorial Genetic predisposition ADHD - Strong association CO-MORBIDITY
GENETICS• In 1950, Hallgren, an autosomal dominant  disorder• Recent findings:  Dyslexia is a genetically heterogeneous a...
NEUROIMAGING Absence of usual asymmetry of planum  temporale (portion of temporal lobe lying  posterior to Heschl’s gyrus...
MANIFESTATIONS Varied spectrum presentation Mild to severe Academic Behavioral Co-morbidity Psychosocial
REFERRAL LETTER Repeated failures Does not write or read Spelling mistakes Oral work better than written work Problem...
EARLY POINTERS
Developmental delays Mild gross motor delays Fine motor problems Speech delay or difficulties Lack of dominant handedn...
AUDITORY PERCEPTION Auditory perception Auditory discrimination Auditory memory & sequencing Auditory filtering Audit...
VISUAL PERCEPTION Visual perception Visual discrimination Visual memory & sequencing Form constancy Visuomotor integr...
THE RED HOUSE
RED HOUSE & TREE
RED HOUSE, TREE & SUN
Learning Concerns Difficulty in pronouncing words. Poor phonological awareness Difficulty or slowness to add words. In...
 May have trouble learning the  alphabets, numbers, day of the  week, colors, shapes. May have difficulty telling or ret...
Behavioral concerns Hyperactivity Difficulty in following instructions Slow in ADLs Stubborness Temper tantrums
Dyslexia Avoids reading aloud Reads slowly Uses finger tracing Looses place or skips words Mispronounces or guesses w...
 Relies heavily on memorizing without  understanding. Poor comprehension Gives stress on wrong syllables Reads with su...
Dysgraphia Slow in writing or may avoid writing. Often uses an awkward pencil grip ( fist, thumb  hooked over finger, et...
 Spelling mistakes Bizarre spelling Spells the same word differently Punctuation & capitalization errors. Mixes upper...
Typical errors Letters reversals -d for b as in dog for bog. Word reversals – tip for pit. Inversions – m and w, u and ...
Spelling errors Amount – aomunt Awards – awords Consent – conset Recent – resent Domestic – domistic Brain – brian ...
Dyscalculia May transpose number sequences , 231 as 312 Confuse arithmetic signs. (+ - * / = ) Has trouble with word pr...
 Difficulty in carrying over or borrowing sums May count from left to right Poor in geometry Poor in algebra
Other concerns Appears very clumsy and untidy. Has difficulty making friends. May not understand body language and faci...
 Difficulty following step by step instructions Difficulty in telling time Difficulty in telling/ following directions...
Associated behavioral issues.. Hyperactivity Day dreaming Poor peer relations Aggressive behavior Poor participation
Pyschosocial concerns Poor self esteem Poor self confidence Poor interpersonal relations Emotional lability
Strengths Sensitive & compassionate Good at mechanical work Good at sports Usually good dancers Good at cooking & eat...
Key Messages Hidden Handicap Neurological Disorder Present since Birth Multi-factorial Essentially Normal child Aver...
To Summarize… “Every learning problem is not a Learning  Disability” With early intervention & provisions, they  can be ...
Specific Learning Disability
Specific Learning Disability
Specific Learning Disability
Specific Learning Disability
Specific Learning Disability
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Specific Learning Disability

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Dr. Anjana Thadhani's presentation at Tata Learning Disability Forum (TDLF), 2013.
The Forum for Learning Disabilities centred on the theme ‘Learning Disabilities – a more inclusive perspective’. The forum this year included in its purview three additional Learning Disabilities (LD), namely Specific Learning Disability (SpLD), Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD).

In line with the TATA Group’s corporate sustainability endeavors, TIS initiated the Tata Learning Disability Forum (TLDF) in 2006 to ensure that students with special education needs receive the required attention as well as to spread awareness about LD which had been receiving scant attention in India. Since then, via the TLDF platform, TIS has been successful in generating an increased level of awareness and enabling progress in remediation activities for students with LD.

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Specific Learning Disability

  1. 1. Dr Anjana ThadhaniConsultant Developmental Pediatrician
  2. 2. Specific Learning Disabilities Group of developmental disorders Significant unexpected, specific and persistent difficulties in the acquisition and use of reading (dyslexia), writing (dysgraphia) or mathematical (dyscalculia) abilities, despite conventional instruction, normal intelligence, proper motivation and adequate socio-cultural opportunity
  3. 3. Salient FeaturesTypes: Dyslexia Dysgraphia DyscalculiaCreates a significant gap between the potential and academic performancePrevalence - 10% of school going childrenDifficulty with information processing
  4. 4. LEARNING INPUT PROCESSING OUTPUT
  5. 5. INFORMATION PROCESSINGRECORDING INFORMATION (INPUT)  Perceptual →Visual →AuditoryINTEGRATION  Sequencing  Abstraction  OrganizationSTORAGE (MEMORY)  Short – term  Long – term
  6. 6. READING Phonological awareness Letter-sound association Decoding & Blending Focus on printed words Control of eye movements across the page Processing of images and ideas Comparisons and associations of ideas Storing of the information into memory
  7. 7. CAUSES Neuro-developmental condition Multi-factorial Genetic predisposition ADHD - Strong association CO-MORBIDITY
  8. 8. GENETICS• In 1950, Hallgren, an autosomal dominant disorder• Recent findings: Dyslexia is a genetically heterogeneous and complex trait that does not show classical mendelian inheritance Several chromosomal regions & genes affecting reading disability (chromosome 1, 2, 3, 6, 15, 18)
  9. 9. NEUROIMAGING Absence of usual asymmetry of planum temporale (portion of temporal lobe lying posterior to Heschl’s gyrus) Left is usually larger than right Neuronal ectopias in frontal and parietal regions
  10. 10. MANIFESTATIONS Varied spectrum presentation Mild to severe Academic Behavioral Co-morbidity Psychosocial
  11. 11. REFERRAL LETTER Repeated failures Does not write or read Spelling mistakes Oral work better than written work Problems in math
  12. 12. EARLY POINTERS
  13. 13. Developmental delays Mild gross motor delays Fine motor problems Speech delay or difficulties Lack of dominant handedness Perceptual problems
  14. 14. AUDITORY PERCEPTION Auditory perception Auditory discrimination Auditory memory & sequencing Auditory filtering Auditory processing
  15. 15. VISUAL PERCEPTION Visual perception Visual discrimination Visual memory & sequencing Form constancy Visuomotor integration Figure ground discrimination
  16. 16. THE RED HOUSE
  17. 17. RED HOUSE & TREE
  18. 18. RED HOUSE, TREE & SUN
  19. 19. Learning Concerns Difficulty in pronouncing words. Poor phonological awareness Difficulty or slowness to add words. Inability to rhyme by age 4 years. Confusion in directionality, words and space concepts, left versus right, over versus under, before versus after.
  20. 20.  May have trouble learning the alphabets, numbers, day of the week, colors, shapes. May have difficulty telling or retelling a story in the correct sequence. Abnormal grip or refusal to write.
  21. 21. Behavioral concerns Hyperactivity Difficulty in following instructions Slow in ADLs Stubborness Temper tantrums
  22. 22. Dyslexia Avoids reading aloud Reads slowly Uses finger tracing Looses place or skips words Mispronounces or guesses words Has difficulty decoding or blending single words
  23. 23.  Relies heavily on memorizing without understanding. Poor comprehension Gives stress on wrong syllables Reads with substitution While reading makes up his own stories Poor memory & recall
  24. 24. Dysgraphia Slow in writing or may avoid writing. Often uses an awkward pencil grip ( fist, thumb hooked over finger, etc.) Writes with illegible handwriting Poor letter formations Untidy written work Uses inappropriate pressure Uneven size of letters with poor spacing
  25. 25.  Spelling mistakes Bizarre spelling Spells the same word differently Punctuation & capitalization errors. Mixes upper & lowercase letters Problems with copy writing
  26. 26. Typical errors Letters reversals -d for b as in dog for bog. Word reversals – tip for pit. Inversions – m and w, u and n. Transpositions – felt and left. Substitutions – house and home. Omissions Additions.
  27. 27. Spelling errors Amount – aomunt Awards – awords Consent – conset Recent – resent Domestic – domistic Brain – brian Method - matheod
  28. 28. Dyscalculia May transpose number sequences , 231 as 312 Confuse arithmetic signs. (+ - * / = ) Has trouble with word problems Poor in mental maths Difficulty in learning tables Counting on fingers may be seen
  29. 29.  Difficulty in carrying over or borrowing sums May count from left to right Poor in geometry Poor in algebra
  30. 30. Other concerns Appears very clumsy and untidy. Has difficulty making friends. May not understand body language and facial expression of others. Has trouble with non-literal language (idioms, jokes, proverbs, slang)
  31. 31.  Difficulty following step by step instructions Difficulty in telling time Difficulty in telling/ following directions Slow in ADLs Poor understanding of abstract Disorganized behavior and thoughts
  32. 32. Associated behavioral issues.. Hyperactivity Day dreaming Poor peer relations Aggressive behavior Poor participation
  33. 33. Pyschosocial concerns Poor self esteem Poor self confidence Poor interpersonal relations Emotional lability
  34. 34. Strengths Sensitive & compassionate Good at mechanical work Good at sports Usually good dancers Good at cooking & eating too…
  35. 35. Key Messages Hidden Handicap Neurological Disorder Present since Birth Multi-factorial Essentially Normal child Average / above average Intelligence
  36. 36. To Summarize… “Every learning problem is not a Learning Disability” With early intervention & provisions, they can be mainstreamed Secondary behavioral problems need effective management.

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