Learning Disorders

There are many reasons for school failure, but a common one is a specific learning disability. Children with learning disabilities may have normal intelligence, but the specific learning disability can make teachers and parents concerned about the general intelligence of the child. These children often try very hard to follow instructions, concentrate, and “be good” at home and in school.  Yet, despite this effort, he or she is not mastering school tasks and falls behind.  This can lead the child to perceive they are “dumb” and this negative self perception can begin to affect their self esteem.  Since learning disabilities affect at least 1 in 10 schoolchildren it is important that it be detected as soon as possible so that corrections can be made.

Learning Disorders occur when the child or adolescent’s reading, math, or writing skills are much below what is expected for his or her age, schooling, and level of intelligence. About 5% of students in public schools in the United States are identified as having a learning disorder. As previously mentioned, students with learning disorders can become so frustrated with their performance in school that by adolescence they may feel like failures and want to drop out of school.  They can even develop behavioral problems.  To make the diagnosis of a learning disorder and to develop appropriate remedial interventions special testing is always required. Learning disorders should be identified as early as possible during school years.

Learning disabilities are caused by a difficulty with the nervous system that affects the receiving, processing, or communication of information. They can also run in families. Some children with learning disabilities can also be hyperactive; unable to sit still, easily distracted, and have a short attention span.

Child and adolescent psychiatrists are keenly aware that some of the long-range consequence of learning disabilities can be decrease with early intervention.  However, if not detected and treated early, they can have a “snowballing” effect.  For instance, a child who does not learn addition in elementary school cannot understand algebra in high school.  Trying very hard to learn in the face of repeated failure, the child becomes more and more frustrated, and can develop emotional problems such as low self-esteem.  In fact, some learning disabled children misbehave in school because they would rather be seen as “the class clown” than “stupid.”

Frequent signals of learning disabilities that parents should watch for in their child include the following:

  • Difficulty understanding and following instructions.
  • Trouble remembering what someone just told him or her.
  • Fails to master reading, spelling, writing, and/or math skills.
  • Easily loses or misplaces homework, schoolbooks, or other items.
  • Lacks coordination in walking, sports, or small activities such as holding a pencil or tying a shoelace.
  • Difficulty understanding the concept of time; is confused by “yesterday, today, tomorrow.”
  • Difficulty distinguishing right from left; difficulty identifying words or a tendency to reverse letters, words, or numbers; (for example, confusing 25 with 52, “b” with “d,” or “on” with “no”).

An important first step is a comprehensive evaluation by an expert who can assess all of the different issues affecting the child.  This will allow a greater understanding of the child’s learning difficulties and consideration of how they will affect the child’s communication, self help skill, willingness to accept discipline, impact on play, and capacity for independence.

A child and adolescent psychiatrist can help coordinate the evaluation.  This will involve working with school professionals and others to have the evaluation and educational testing done and clarify if a learning disability exists. It will also include talking with the child and family, evaluating their situation, reviewing the educational testing, and consulting with the school. The child and adolescent psychiatrist can then make recommendations on appropriate school placement.  This may include the need for special help such as special educational services, speech-language therapy and helping parents assist their child in maximizing his or her learning potential.

Since parents need to be aware of the delicate balance between providing too much or too little assistance to their child, sometimes individual or family psychotherapy will be recommended. If other problems are present, medication may be prescribed, such as for hyperactivity or distractibility.  The final goal is to strengthen the child’s self-confidence and help parents and other family members better understand and cope with the realities of living with a child with learning disabilities.