Children's Study Initiative

Devoted to Children with Learning Disabilities

Education is an important wealth which a person can have in this world. In the modern competitive world in which academic achievements are considered important, scholastic backwardness causes tremendous stress for the students. Academic stresss in children can present as physical, behavioural or emotional problems. Physical symptoms can be in the form of severe pain anywhere in the body (pain disorder). Pain disorder in children usually presents as severe head ache, abdominal pain, back ache, chest pain or pain in the limbs. All the investigations will be normal and the symptoms will be relieved with analgesics. This condition is called somatoform pain disorder and is usally managed with psychological therapies. Children can also have other types of somatoform disorders like somatoform autonomic disorder on facing stressful situations in which the child presents with symptoms related to the organs innervated by autonomic nervous system like cardivascular symptoms, gastrointestinal symptoms, respiratory or genitourinary symptoms. The anxiety related to the stress have to be managed through psychological therapies inorder get relief.

Stress related to exams can occur in chidren with scholastic backwardness as well as children with good academic performance if they become overanxious or overambitious. If the child is scholastically backward, he/she should get the help of professionals in child guidance to find out the underlying etiology. If there is learning disorder, remedial education should be started.

Self esteem of the children should be improved through counselling and they should be motivated to improve their academic performance. Parents should never compare the academic performance of their children with their classmates or peer group. They should support the child having academic stress and help the child to overcome the learning problem.

Learning problem is common among school children and it is a matter of concern not only for children, but also for parents and teachers. Learning disorders affect about 10% of school going children. Children with learning disorders have average or above average intelligence, but they have difficulty in reading, spelling, writing or mathematical skills. Another cause for scholastic backwardness is borderline intelligence (IQ between 70 – 85%). Mild mental retardation with IQ between 50 – 70% will also cause significant learning difficulty. Other causes presenting as learning problems in school going children include attention deficit hyperactivity disorder and other behaviour disorders like conduct disorder. Children with reduced motivation also have scholastic backwardness.

 If not identified and corrected at the earliest, children with scholastic backwardness and learning difficulty can have tremendous academic stress and it can lead to anxiety disorders and stress related disorders like somatoform disorders. Hence all children with difficulty in learning and children presenting with scholastic backwardness need detailed individualized evaluation and professional guidance by experts from child guidance / learning disability clinics.

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.