Specific learning disabilities

D.Y. Patil Education Society Deemed to be University
Dr Devavrat Harshe, M.D.
Assistant Professor, Department Of Psychiatry
DY Patil Medical College, Hospital & Research
Centre
1
Specific Learning
Disabilities
PSYCHIATRY
DEPARTMENT OF
DY Patil Medical College, Hospital & Research Centre
Kolhapur

2
LEARNING OBJECTIVES
DEPARTMENT OF PSYCHIATRY, D Y Patil Medical College, Hospital & Research Centre
D Y Patil Education Society, Deemed to be University. Kolhapur
 Know the distinction between intellectual disability (IQ
related problems) and specific learning disability.
 Understand the clinical features and presentation of
specific learning disability.
 Understand available therapeutic and remedial
alternatives for children with specific learning disability.
After going through this presentation, the reader shall

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INTRODUCTION TO SPECIFIC
LEARNING DISABILITIES (SpLD’s)
 Observed in 3 to 15% of all children
 It is a neurodevelopmental disability.
 Seen in children of all strata
 Religious
 Social
 Economical
 Ethnicity/race

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INTRODUCTION TO SPECIFIC
LEARNING DISABILITIES (SpLD’s)
 There is impairment in information processing
 Problems in
 Reading (dyslexia)
 Writing (dysgraphia)
 Arithmatic (dyscalculia)
Read
ComprehendUnderstand

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SPECIFIC LEARNING DISABILITIES (SpLD’s):
PROBLEM DOMAINS
DYSGRAPHIA
Problems in Writing
DYSLEXIA
Problems in
Reading
DYSCALCULIA
Problems in
Arithmatic
DYSMETRIA
Problems with distance, time and speed
DYSPRAXIA
Problems with fine motor
movements

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SPECIFIC LEARNING DISABILITIES
(SpLD’s): PROBLEM DOMAINS
DYSLEXIA
Problems in Reading Stuttering while reading.
 Inability to read the entire word at one go. Reads every individual
alphabet and try to form a word.
 Confuse between letters which are mirror images of each other, such as
भ/म, ज/च, b/d, a/g
 Adding or deleting letters/syllables while reading. For eg: schol (school),
hoome (home)
 Pronounciating as per the sound associated with each
alphabet/syllable, school चा उच्चार स्चूल असा करणे
 Ignoring punctuation. Robotic/machine like reading.

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DYSGRAPHIA
Problems in Writing Very slow writing speed. Can not complete the paper in time.
 Confuse between letters which are mirror images of each other, such as
भ/म, ज/च, b/d, a/g
 Adding or deleting letters/syllables while writing. For eg: schol (school),
hoome (home)
 Writing as per the sound associated with each alphabet/syllable, so
“school” is written as “skool”.
 Ignoring punctuation while writing. Cannot write in straight line or in the
space provided.
 Mistakes and confusion between capital and small letters.

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DYSCALCULIA
Problems in Arithmatic
 Unable to perform simple arithmetical operations.
 Mistakes in comprehension of simple formulae and symbols, such as
”+” and “=“, or between “+” and “X”
 Mistakes in understanding the concepts of carry-forward during
addition and subtraction.
 Mistakes and confusion between numbers that are mirror images of
each other, such as “6” and “9” or, “३” and ”६”
 Difficulty in mastering the abstract concepts, such as trigonometry,
calculus etc.
 Has problems converting a problem statement into a equation. Makes
mistakes while converting the sum into one effective equation.

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DYSPRAXIA
Problems in Fine Motor
Movements Problems with fine motor movements
 These movements are performed using the small muscles of hands and
fingers.
 Muscle power, tone and sensations are normal.
 Examples:
 Tying a shoelace
 Buttoning a shirt
 Combing hair
 Eating rice/chapati with hand.
 Finger painting.

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DYSMETRIA
Problems in Distance,
speed and time
 Problems with the concepts of time, speed and distance
 Confusion between right and left directions.
 Problems in driving, riding a bike.
 Frequent falls and stumbles.
 Problems in playing sports. Problems in catching the incoming ball.

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(SpLD’s): WHEN TO SUSPECT?
 When a child has normal intellect (normal understanding of the
subject), yet is lagging behind in academic performance.
 When a child performs well in practice/oral exams, but lags behind in
written forms.
 When a child shows significant problems in reading, writing, arithmetic
in one particular subject, despite doing well in other subjects.
 When a child has had normal milestones during development, but still
has problems in tying shoelaces, buttoning shirt or eating with hands at
the age of 7.

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(SpLD’s): HOW TO DIAGNOSE?
 Suspicion is the most important step in diagnoses.
 Conduct a thorough clinical examination.
 Get a thorough vision and hearing assessment done to rule out any
problems.
 Get a thorough assessment from a pediatrician/neurologist done.
 Get a psychiatric assessment done to rule out depression, intellectual
disability (low IQ) and ADHD.
 Refer the child for a thorough formal SpLD assessment if every
examination mentioned above turns out normal.

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(SpLD’s): LOOK ALSO FOR:
 Depression
 Poor self esteem:
 Often present due to significant academic decline and poor
acceptance from parents and teachers.
 Peer pressure and comparison with other children.
 ADHD
 Common comorbidity with SpLD.
 Often worsens the presentation and course of SpLD.
 Requires medical intervention.

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(SpLD’s): MANAGEMENT PRINCIPLES:
 Reassure parents and the child.
 Treat comorbid psychiatric diagnosis.
 Manage self esteem issues and school related problems.
 Start remedial education.
 Start behavior therapy for
 Promoting positive behavior
 Curtailing unwanted behavior.
 Involve school.
 Refer to regional Government Approved Certification Centre.

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(SpLD’s): GOVERNMENTAL SUPPORT
SCHEMES:
 SpLD’s are included in the Persons With Disabilities Act.
 Therefore, the government has granted certain provisions to integrate
those diagnosed with SpLD’s into the educational mainstream.
 Every state government has passed its own sanctions and provisions so
students can use them in their state SSC and HSC board.

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(SpLD’s): GOVERNMENTAL SUPPORT
SCHEMES:
 Providing an exam centre near to the candidate’s home, if he/she has
visual disabilities.
 25% more time to write the answers is provided.
 20 grace marks in all subjects, if the candidate fails a subject.
 If the candidate has problems in writing, he/she can appear for the
exam with a professional writer.
 Appearing with standard 7th mathematics or home science instead of
higher mathematics or science.
Some examples of Government Approved Sanctions

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(SpLD’s): NEED FOR INTERVENTION:
 Child keeps lagging behind despite normal intelligence.
 Loses self esteem and confidence due to academic problems, peer
pressure and frequent comparisons with other children.
 Has problems in higher education due to problems in basic concepts.
 Child starts losing interest in studies and school.
 Child is lablelld as “lazy”, “does not try”, “not interested” and ignored.

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(SpLD’s): REMEMBER:
 Children with SpLD’s can overcome their disabilities, with timely
diagnosis and management under trained and supervised
professionals.

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(SpLD’s): EFFECTIVENESS OF
INTERVENTIONS:
3
30
19
7
1
0
0
2
25
23
8
2
0 10 20 30 40
21-30
31-40
41-50
51-60
61-70
71-80
81-90
Before Diagnosis After Diagnosis
Percentage Of Students AndTheir Marks BeforeAnd After Diagnosis
And Management For SpLD’s
Kulkarni et al. Indian J Pediatr 2006;73(9):789-93.

D. Y. PATIL EDUCATION SOCIETY
DEEMED TO BE UNIVERSITY
KOLHAPUR
Department Of Psychaitry
Thank You
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