HealthLeader

An Online Wellness Magazine produced by The University of Texas Health Science Center at Houston (UTHealth)

Learning Disabilities 101

Learning Disabilities 101

All children are different. 

As parents, we notice subtle differences early on in our children, and we automatically begin to compare them to others in their age group. We wonder whether they are hitting certain milestones at the right time, like rolling over, sitting up, walking or talking. We're so excited to hear their first words, but can quickly grow concerned when we hear the neighbor's child already speaking in complete sentences at the same age. 

The comparisons and concerns don't stop once our children reach school age, when the milestones relate to their abilities in the classroom. Our child seems to struggle with simple sentences while his classmates seem to breeze through. Is it our imagination or can’t he pay attention? At what point do we take action?

“Parents need to be concerned when children are not making adequate educational progress,” says Michael Assel, PhD, associate professor of pediatrics and a staff psychologist for the Children’s Learning Institute at The University of Texas Health Science Center at Houston (UTHealth). “Essentially, we are talking about a child who is struggling in a content area important for school, typically reading, math or written language.” 

Before jumping to conclusions, Assel cautions parents to consider an important issue when thinking about learning differences in their child. “One of the first things that must be considered is the educational environment,” he says. “We want to ensure that a child has had appropriate exposure to quality teaching. For example, it would be unfair to describe a child as having a disability in the area of reading unless that child has been provided with appropriate instruction in [that subject].” 

When parents become certain the educational environment is not the problem, then it's time to confront the possibility that their child might have a learning disability. 

What are learning disabilities?

Reading, writing and arithmetic aren't just the lyrics to an old song. They also are the top three learning disabilities diagnosed in children. Experts often use their technical names, including dyslexia (reading); dysgraphia (writing); and dyscalculia (arithmetic). Learning disabilities go by other names as well, Assel says, which is why we often hear them spoke of as “learning differences.” 

According to the Department of Education, it's estimated there are 2.4 million children with specific learning disabilities. “Children who struggle in the area of reading comprise the vast majority of students who have specific learning disabilities,” Assel says. “Research I have read estimates that approximately 80 percent of children enrolled in special education for a specific learning disability are qualified as having a disability in the area of reading, and most of these children have problems with word recognition skills.” 

The International Dyslexia Association (IDA) defines dyslexia as a specific learning disability characterized by difficulties with accurate and/or fluent word recognition and by poor spelling and decoding abilities. Secondary consequences may include problems in reading comprehension and reduced reading experience that can impede growth of vocabulary and background knowledge. 

This definition mentions nothing of seeing letters in reverse order or jumbled together on a page or even in a mirror image, which is how we usually think of dyslexia. 

“Dyslexia occurs primarily at the level of the single word and involves the ability to decode printed words,” Assel says. “This has been known for many years, but it has not been clear why.”

Assel says there is no simple answer for the cause of a learning disability, but adds that “we know there is a strong genetic heritability for learning disabilities.” 

In fact, a scientific article comparing the abilities and disabilities of identical and fraternal twins points to this correlation. In the article, the authors cite that “a review of twin studies of language disability reported the likelihood that one twin will be affected if the other twin is affected of 75 percent for identical twins and 43 percent for fraternal twins (Stromswold, 2001).” 

Furthermore, the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) states that learning disabilities seem to be related to “differences in brain structure” that are present from birth and often inherited. Alcohol or drug use and its effects on a developing baby also can lead to learning disabilities, as well as poor nutrition and exposure to toxins such as lead. 

Warning signs

To diagnose a child with a specific learning disability, it's important for parents, educators and experts to recognize the warning signs. The NICHD notes the following are common symptoms of learning disabilities in children:

  • Difficulty with reading and/or writing
  • Problems with math skills
  • Difficulty remembering
  • Problems paying attention
  • Trouble following directions
  • Poor coordination
  • Difficulty with concepts related to time
  • Problems staying organized 

These warning signs typically are present early on in a child's life, Assel says. “A child who struggles with reading in the second grade might have struggled playing with word sounds, such as rhyming games and blending words, when they were much younger,” he explains. “Children with math disability who hit the wall with long division and multiplication problems might have struggled as a much younger child with counting sets and determining which group of objects is larger or smaller.” 

Assel and his colleagues at the Dan L. Duncan Children’s Neurodevelopmental Clinic “rarely see cases of a learning disability popping up totally unexpected,” he says. “We are usually able to see subtle signs of a child who might have learning issues by examining the early developmental history and even the familial history.” 

While it's less common for a learning disability to just appear or develop in a child, sometimes earlier issues come up that make learning difficult for a child at school. “For example, a child who is treated for articulation difficulties early in life, at 2 to 3 years, might wind up struggling to learn to read due to difficulties mastering phonics in kindergarten or first grade,” Assel says. “In this case, it would seem that the difficulty with appropriate articulation early on was a warning sign.” 

If you think your child might have a learning disability, don't be afraid to do your own research. Assel says there is a lot of good information out there for parents about learning disabilities, including the National Center for Learning Disabilities, which has an online checklist that walks parents through the warning signs. 

Next steps for parents

When parents see a consistent pattern of actions or characteristics in their child that point to learning differences, the next steps are to speak with their child's teacher and to find out about testing options available at the school. 

“The first thing parents should do is have a conversation with their child’s classroom teacher to determine if the teacher has similar concerns and whether or not the teacher has any plans to increase the intensity of instruction, such as having the child participate in small group or one-on-one instruction in the classroom,” Assel says. 

Screening options and intervention services for children at risk for learning disabilities are more readily available today than in the past. “Over the last 10 to 15 years, there has been an explosion in Response-To-Intervention (RTI) approaches,” Assel says. “In the past, school officials seemed to adhere to a wait-to-fail model. In other words, teachers and administrators were often able to identify struggling readers but waited to have the child assessed, so that they could be sure that the child qualified for extra support.” 

Today, educators are more proactive in terms of their approach to learning disabilities. For instance, struggling readers are often placed into reading recovery or reading support programs. These types of interventions are known as Tier 2 approaches, which provide more intensive instruction to children who are struggling. 

“The beauty of the Tier 2 approaches is that children can be helped early,” Assel says. “In contrast, Tier 1 approaches seek to improve the general educational environment for all children. Tier 3, which include formally enrolling children into special education services, are provided when both Tier 1 and Tier 2 are not effective. 

The RTI approach typically has three tiers of interventions, or levels of instruction. If a child does not respond at the third level, he or she may be referred for a full evaluation under state and federal law. 

“Early intervention for children struggling academically is crucial to helping them keep pace with peers,” Assel says.  

Working together

Once a child's identified as having a learning disability, parents also need to develop a good working relationship with professionals at their child’s school, Assel says. 

“At a basic level, parents can be their child’s biggest advocate,” he says. “When talking to parents about developing a relationship with the professionals at their child’s school, I often use the old saying, ‘remember that the squeaky wheel gets the grease.’ I encourage parents to be the polite squeaky wheel.” 

Assel also encourages parents to ask school professionals to clarify technical terms about learning disabilities or to simply use words they can better understand. 

“In addition, parents should always inquire about the activities they can complete at home that further the goals of the professionals in the classroom,” he says. 

Assel says treatments for learning disabilities are varied but may include: 

  • enrollment in a reading enrichment/reading recovery program in school (i.e., Tier 2 intervention)
  • extra work at home with parents
  • participation in an organized instructional program to improve skills (e.g., a phonological-based reading intervention program)
  • commercial tutoring programs (e.g., Kumon or Sylvan Learning Centers)
  • speech therapy to address underlying phonological difficulties or comprehension
  • enrollment at a specialized school
  • participation in content mastery or resource classroom instruction within the public school setting. 

Learning disabilities do not disappear. But, if caught early enough and with the right tools, interventions and people in place to help, children can and do succeed in school and in their futures.