Genetic, developmental and environmental attributes may contribute to the deficits in learning ability. Recent studies have suggested that phonological awareness is linked to chromosome 6 and ability to identify single words has been linked to chromosome 15. Children with extremely low birth weight and prematurity are at higher risk for developing learning disorders. 35 – 45% of boys and 20% of girls with reading disability had a positive family history.
Children with learning disorders are at higher risk for social skills difficulties, expressive and receptive language disorders, attentional problems, anxiety, disruptive behaviour disorders and depressive disorders. Upto 25% of children with reading disorder are found to have attention deficit hyperactivity disorder. Academic stress can lead to poor self esteem and can cause adjustment disorders as well as somatoform disorders, particularly in older children.
As per the International Classification of Diseases (ICD 10) by the World Health Organization, learning disorders are termed as Specific Developmental Disorders of Scholastic Skills. Children with specific developmental disorders of scholastic skills have specific and significant impairment in learning of scholastic skills. These impairments are not the direct result of subnormal intelligence, visual or hearing defects, physical disorders, emotional disturbances or lack of adequate opportunities for learning these skills. Specific developmental disorders of scholastic skills are of 4 types: Specific reading disorder, specific spelling disorder, specific disorder of arithmetical skills and mixed disorder of scholastic skills.
Specific Reading Disorder
The main feature of this disorder is the specific and significant impairment in the development of reading skills. Reading performance should be significantly below the level expected on the basis of age, general intelligence and school placement. There may also be deficits in reading comprehension. Reading disorder is almost always the result of deficits in processing sound units and sound symbol relationships. Children with reading disorder have difficulty with phonologic processing.
Specific Spelling Disorder
There is a specific and significant impairment in the development of spelling skills. Ability to spell orally and to write out words correctly are both affected. It may be associated with grammatical errors, punctuation errors, poor paragraph organization and poor handwriting.
Specific Disorder of Arithmetical Skills
Child’s arithmetical performance should be significantly below what is expected on the basis of age, general intelligence and school placement. The arithmetical difficulties may include: failure to understand the basic concepts of arithmetical operations, lack of understanding of mathematical terms or signs, failure to recognize numerical symbols, poor spatial organization of arithmetical calculations, difficulty in properly aligning numbers and inability to learn mathematical tables satisfactorily.
Mixed Disorder of Scholastic Skills
The reading skills, spelling skills and arithmetical skills are significantly impaired in these children.
Introduction
Academic skills form the foundation upon which the scholastic performance of a child is determined. For some children, mastering the basic academic skills create significant difficulties. Children with learning disorders exhibit academic difficulties out of proportion to their intellectual capacities. In a society where personal worth and appreciation are gained by measures of academic achievement, learning disorders become a source of significant stress for children, leading to low self esteem, anxiety and behavioural problems. Hence early detection and management of learning disorders is of great importance and it merits the attention of all who are interested in child welfare
Prevalence
Learning disorders occur in approximately 10% of school going children in general. Prevalence as low as 3% to as high as 20% has been reported in several studies
Subtypes
1. Reading disorder
2. Disorder of written expression
3. Mathematics disorder
4. Mixed disorder of scholastic skills
Treatment
Intensive, individually determined one on one remedial training is the treatment of choice for learning disorders. Associated behavioural and emotional problems have to be managed adequately through behaviour therapy and appropriate psychotherapy. Parental guidance and counseling form an important part of the training program. Good therapist child relationship is essential for getting the best results.
