Children's Study Initiative

Devoted to Children with Learning Disabilities

We can be happy that there are over four billion literate persons in this world. But literacy for all is a target yet to be achieved. The United Nations General Assembly has declared the ten year period beginning from 1 January 2003 as the United Nations Literacy Decade. So the UN Literacy Decade will be 2003 -2012. It is estimated that 130 million young children not attending primary school in developing countries. Two thirds among these are girls. Hence total literacy remains a major global challenge. International Literacy Day programs are held under the auspices of the UNESCO and World Bank every year on 8th September. Various national and international organizations also participate in this effort. UNESCO awards Literacy prizes for the best projects every year.

Introduction

Schools play a crucial and formative role in the intellectual, cognitive, emotional, social and moral development of a child. Scholastic backwardness usually engender feelings of anxiety and inadequacy in children. This in turn can have negative impact on the emotional and social functioning of the child. Hence learning problem is an issue of concern not only for students, but also for parents and all the professionals involved in child welfare.

A child who fails in one or more subjects or in one or more classes and a child who is in the lowest 10th percentile in class is broadly categorized as being scholastically backward. Scholastic backwardness is one of the major complaints with which children are brought to the child guidance clinic. We should never brand such children as “lazy”. Poor scholastic performance is usually a reflection of a larger underlying problem in children. Hence scholastic backwardness should be analyzed scientifically. The underlying cause should be identified and the appropriate remedy given soon so that the academic performance of such children can be made better.

Aetiology

The reasons for scholastic backwardness can be broadly categorized into causes in the child, or in the environment or both.

1. Causes in the Child (Internal Factors)

a) Low intelligence – A Child with mild delay in milestones of development (either borderline intelligence – IQ: 70 – 85% or mild mental retardation – IQ: 50 -70%).

b) Learning Disability – About 10% of school going children have learning disorders. Their intelligence will be average or above average. They have problems only in reading, writing, spelling or arithmetic skills. Learning disorders are of four types – Reading disorder (Dyslexia), Disorder of written expression (Dysgraphia), Mathematics disorder (Dyscalculia) and Mixed disorder of scholastic skills.

c) Physical Problems – Chronic illnesses, problems in vision or hearing.

d) Attention Deficit Hyperactivity Disorder (ADHD) – Because of the inability to sustain attention, children with ADHD cannot concentrate in studies.

e) Emotional Problems – Anxiety or low mood due to any stress will lead to deterioration in academic performance.

f) Lack of Motivation and Inadequate Time Management

2. Causes in the Environment (External Factors)

a) Discordant environment at school (conflict with teachers or peer group).

b) Poor discipline at home (marital discord among parents, alcoholism / drug abuse in family members)

c) Sibling rivalry

d) Overambitious attitude of parents

Usual Presentations at Child Guidance Clinic

1. Failure in examinations

2. Not writing down notes in class

3. Forgetfulness

4. Not concentrating in studies / not interested in studies

5. Reluctance to go to school

6. Low self esteem and social isolation

7. Behavior problems

8. Anxiety and multiple physical symptoms (investigations being normal)

Evaluation of Scholastic Backwardness

1. Look for external factors

2. Rule out physical problem

3. Behavioral analysis

4. Assessment of intelligence

5. Assessment of scholastic skills

6. Psychological evaluation

Management

Common cause for scholastic backwardness in children is learning disability, which should be managed through intensive individualized one on one remedial training in a very supportive environment. Good therapist child relationship is essential. Behavioral and emotional problems should be managed through behavior therapy and psychotherapy. Motivational counseling and life skills training have an important role in improving the motivation and time management of children. Family counseling and parental guidance are also necessary.

Conclusion

Scholastic backwardness is seen in 20 -30% of school going children. If scholastic backwardness is not managed properly, it will cause significant academic stress in children leading on to somatoform disorders, anxiety disorders, depression and even deliberate self harm. Hence any child with difficulty in reading or arithmetic skills or deterioration in academic performance should be evaluated and managed scientifically at the earliest. Improvement in academic performance will help the child to excel in future life.

The prognosis depends on the severity of the disorder, the age at which remedial intervention is started and the presence or absence of associated problems. Any child with speech delay, expressive language disorder or scholastic backwardness should be evaluated at the earliest to exclude learning disorders. Intensive remedial training started at the onset of learning difficulty, gives good results.

At the outset we have to exclude the external factors which can negatively influence learning, like family and school related stressors. Evaluation of learning disorder requires individually administered tests of intellectual ability and scholastic skills. Diagnosis is based on the presence of a significant discrepancy between the scholastic skills and the intellectual capacity of the individual. The IQ should be above 70. Other factors in the child which can lead to scholastic backwardness like siginificant behavioral and emotional problems have to be excluded.