The document discusses learning disabilities (LD), which are specific disorders affecting speech, language, perception, behavior, reading, writing, or arithmetic, leading to academic performance below age expectations. Types of LD include dyslexia, dysgraphia, dyscalculia, and dyspraxia, with factors contributing to their occurrence ranging from genetic predispositions to environmental influences. Management involves early detection, educational support, and nursing interventions to help affected children learn successfully and cope with their challenges.

1. Taare Zameen Par

3. By- Isha Thapa Magar
Nursing Instructor

4. Learning disability is a specific retardation
or disorder in one or more of the process of
speech, language, perception, behavior,
reading spelling, writing or arithmetic.
The child’s ability to achieve in the specific
academic is below what is expected for the
child age, education level & level of
intelligence.

5. .
Learning disability refers to a heterogeneous
group of disorders manifested by significant
difficulties in the acquisition and use of
listening, speaking, reading, writing, reasoning,
or mathematical abilities.
These disorders are intrinsic to the individual
and presumed to be due to central nervous
system dysfunction.
OR

6.  A learning disability is not a disease, so there
is no cure, but there are ways to overcome
challenges it poses through identification &
accommodation.
Among children with normal intelligence, as
many as 1 out of every 5 children have some
degree of LD.
LD is a chronic condition but with right help,
children with LD can & do learn successfully.

7. Children with LD get frustrated & intolerant when
they are not able to perform well in academics.
Parents and teachers often pressurize them & this
often has consequences
• fear and anxiety
• low self-esteem
• low confidence
• loss of interest
• emotional disturbances
• school phobia and school refusal.

8. TYPES:
1. Dyslexia
2. Dysgraphia
3. Dyscalcula
4. Dyspraxia

9. 1. Dyslexia ( Reading Disability)
• It is an impairment in brain’s ability to
translate written images received from the
eyes into meaningful language.

11. 2. Dysgraphia (Writing Disability)
• It is a learning disability resulting from the
difficulty in expressing thoughts in writing &
graphing.
• Impaired written language ability may include
- impairments in handwriting,
- spelling,
- organizations of ideas & composition.

12. Dysgraphia

13. 3. Dyscalculia (Math Disability)
• Impaired in math calculation ability cause
- difficulties in learning math concepts (such
as quantity, place value, & time),
- difficulty memorizing math facts,
- difficulty in recognizing mathematical signs,
- difficulty organizing numbers, &
- understanding how problems are organized
on page.

14. Dyscalculia

15. 4. Dyspraxia
• Also known as
- motor learning difficulties &
- developmental coordination disorder (DCD).
• It is a common disorder affecting fine and/or
gross motor coordination in children.

16. Dyspraxia

18. Heredity
LD occurs 2 to 3 times more often in males than in
females.
There is an increased risk of 4 to 8 times in first
degree relatives for reading deficits, and about 5 to
10 times for mathematical deficits – showing a strong
genetic tendency.

19. Factors before or during delivery
Chemical exposure such as pesticides, cigarette,
alcohol, lead etc during pregnancy.
Very low birth baby
Premature birth
Birth trauma or distress
The mother's poor nutrition

20. Factors in early childhood
Neonatal seizures
Developmental trauma (e.g. abuse, isolation or
neglect in infancy).
Chemotherapy treatment for cancer.
Infection (e.g. encephalitis, meningitis)
Poor nutrition

21. Educational factors
Inadequate, inappropriate teaching
 Unskilled or inefficiently trained teachers
 Too high or low teachers expectations towards
children
 Inappropriate materials and curriculum
 Poor learning environment due to a parent's own
learning disability, lack of school experience.

22. Environmental factors
Un-stimulating environment at home develops
language deprivation.
Language plays a crucial role in child's environment.

24. Average or above
average intelligence
Difficulty in
remembering
information and
instructions
Significant delay in
academic
achievement
Confusion of
similar words.
Problems
understanding
what is read.

25. Poor organization and
management of time
Confusion or reversal
of numbers or math
symbols.
Frequent spelling
errors
Letter reversals
Overly large
handwriting

26. Inability to
complete
assignments in
time allowed
Difficulty
discriminating size,
shape, color.
Difficulty with
sentence structure or
poor grammar
Poor memory of
recalling
materials

27. Poor peer relationships.
Difficulty making
decision.
Lag in development milestones
(e.g. motor, language)
Poor visual, motor
coordination

28. Diagnosis

29. Academic Performance
•Reading, spelling, writing or completing math
problem.
•Understanding or following directions
•Distinguishing right or left
•Reversing letters or numbers ( confusing "b" and
"d" or 12 and 21)

30. History of developmental and medical
Physical and neurological examination
IQ test
CT scan or MRI of brain

31. Management
Preventive Measure
Primary prevention
Secondary prevention
Tertiary prevention
Curative Measure
Nursing Management

32. Primary Preventive
Genetic Counseling at risk parents
Use universal iodination of salt to prevent iodine
deficiency disorder.
Rubella and tetanus immunization for women
before pregnancy
Adequate nutrition during pregnancy
Administration of folic acid tablets to reduce the
occurrence of neural tube defect.

33. Avoid pregnancy before 21 years of age and after
35 years.
Avoiding exposure of harmful chemical and
substances including alcohol nicotine and cocaine
during pregnancy.
Screening pregnant women in infections such as
syphilis and promptly treating it.
Detection and care of high risk pregnancy

34. Good obstetric care can reduce the incidence of
birth trauma such as avoid prolonged labor, proper
observation of mother during labor, provision for safe
delivery.
Prevent head injuries. step that can help prevent
head injuries include:
•Never shake an infant
•Protect children from falls, drown, burn etc.
Provide an enriching and stimulating environment
for children from infancy.

35. Universal immunization of children with BCG, Polio,
DPT and MMR to prevent may serious infection
having brain damage.
Proper nutrition throughout the development
period and particularly during the first 2 years after
birth.
Advice for hospital delivery.

36. Secondary Prevention
Early detection and treatment of preventable
disorder, infections, ADHA, learning disabilities.
Early detecting and intervention of 'at risk babies'.
Babies born prematurely or with a low birth weight
(less than 2 kg), who have suffer birth asphyxia etc.

37. Tertiary prevention
Behavior modification, using the principles of
positive and non punitive rewards.
Providing proper training in self helps skills which
include care of the personal hygiene, grooming, toilet
training, communication etc.
Speech therapy; systematic application of speech
therapy techniques will improve in promotion of
speech language and communication.

38. Curative measure
Early identification of the learning disabilities,
effective interventions.
Multidisciplinary approaches is necessary with
pediatrician, pediatric nurse, psychologist,
educational specialist, social worker, teacher and
when needed psychiatrics, psychiatrics nurse, parents
and teacher.
Drug may be useful to control hyperactivity,
enuresis and emotional difficulties.

39. Nursing
Management

40. •Take time to listen to your children as much as you
can.
•Love them by touching, hugging them, ticking
them, wrestling with them.
•Look for & encourage their strengths, interest &
abilities. Help them to use these as compensations
for any limitations or disabilities.
•Reward them with praise, good words, smiles and
pat on back as often as you can.

41. •Involve them in establishing rules & regulations,
schedules & family activities.
•Help them to correct their errors & mistake by
showing or demonstrating what they should do.
•Provide toys, games, motor activities &
opportunities that will stimulate them in their
development.

42. •Read enjoyable stories to them & with them.
Encourage them to ask questions, discuss stories, tell
story & to read stories.
•Don't get hung up on traditional school grades. It is
important that they progress at their own rates & be
rewarded for doing so.
•Take them to libraries & encourage them to select &
check out books of interest. Have them share their
books with you. Provide stimulating books & reading
material around the house.

43. •Serve as a model to them by reading & discussing
material of personal interest. Share with them some
of things you are reading & doing.
•Don't hesitate to consult with teachers or other
specialist whenever you feel it to be necessary in
order to better understand what might be done to
help you child you.