Edited by-Tasnuva

Nusrat

SPECIFIC
LEARNING
DISABILITIES

1
SPEC
IFIC
LEAR
NING
DISA
BILIT
IES
First
Edition
Edited
by
Tasnuv
a
Nusrat 2

Bachel
 To,
Sifat Al Hsnat
Assistant Professor &Course
Facilitator
Proyash Institute of Special
Education and Research
(PISER, BUP)
[in appreciationof his kindness
to me]

3
Preface
With the constantly growing
volume of research in the area of
learning disabilities at all ages
during the life span, bringing this
text book up to date has become
increasingly difficult with each
revision since it first appeared in
1963. The major task has been to
selective to include pertinent new
materials, eliminate dated
materials, and to cut down on
content with which students have
become familiar in other courses.
To make this first revision a better
learning tool for students and a
better teaching tool for instructors
Lastly, writer will get her true
reward if the people, for whom the
book is written, are benefitted
through this book.
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Contents
1. Exceptional Children
1.1 Specific Learning Disability
2. Learning Disability
2.1 A Brief Historical Overview Of Learning
Disabilities
2.2 Defining Learning Disability
2.3 Common Characteristics Shown In
School
2.4 Causes Of Learning Disabilities
2.5 Types Of Learning Disabilities
3. Dyslexia
3.1 Signs And Symptoms
3.2 Other Issues That Can Co-Occur With
Dyslexia
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3.3 Causes Of Dyslexia
3.4 Assessment Of Dyslexia
3.5 Inclusive Education For Dyslexia
3.6 Individual Education Plan
3.7 Early Treatment
3.8 What Parents Can Do
4. Dyscalculia
4.1 Signs And Symptoms
4.2 Other Issues That Can Co-Occur With
Dyscalculia
4.3 Causes Of Dyscalculia
4.4 Assessment Of Dyscalculia
5. Dysgraphia
5.1. Signs And Symptoms
5.2 Other Issues That Can Co-Occur With
Dysgraphia
5.3 Causes Of Dysgraphia
5.4 Assessment Of Dysgraphia
5.5 Inclusive Education Of Dysgraphia
6. Auditory Processing Disorder
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6.1 Signs And Symptoms
6.2 Other Issues That Can Co-Occur With
Auditory Processing Disorder
6.3 Causes Of Auditory Processing Disorder
6.4 Assessment Of Auditory Processing
Disorder
6.5 Inclusive Education For Auditory
Processing Disorder
7. Dyspraxia
7.1 Signs And Symptoms
7.2 Other Issues That Can Co-Occur With
Dyspraxia
7.3 Causes Of Dyspraxia
7.4 Assessment Of Dyspraxia
7.5 Inclusive Education Of Dyspraxia
8. Visual Processing Disorder
8.1 Signs And Symptoms
8.2 Other Issues That Can Co-Occur With
Visual Processing Disorder

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8.3 Assessment Of Visual Processing
Disorder
8.4 Inclusive Education Of Visual Processing
Disorder
9. Non Verbal Learning Disorder
9.1 Signs And Symptoms
9.2 Other Issues That Can Co-Occur With
Non Verbal Learning Disorder
8.3 Assessment Of Non Verbal Learning
Disorder
8.4 Inclusive Education Of Non Verbal
Learning Disorder

8
Exceptional children

Its not easy being different. Of course, being different isn’t

always negative, its what makes us interesting people. But
it also forces us to adapt to meet social expectations that
are often designed for the person who is average. When
being different means that a child is not able to receive
information through the normal senses, is not able to
express himself or herself, or processes information too
slowly or too quickly, special adaptations in the education
program are necessary. A disability is any continuing
condition that restricts everyday activities.
The Disability Services Act (1993) defines 'disability' as
meaning a disability: which is attributable to an intellectual,
psychiatric, cognitive, neurological, sensory or physical
impairment or a combination of those impairments.

9
If we define a child with exceptionalities as one who differs
in some way from a group norm, then many children are
exceptional. A child with red hair is exceptional if all the
other children in the class have black or blonde hair. A child
who is a foot taller than his or her peers is exceptional. But
these differences, though interesting to geneticist, are if
little concern to the teacher. Educationally speaking, these
students are not considered exceptional because the
educational program does not have to be modified to serve
their needs. If their exceptionalities leave them unable to
read or to master learning in the traditional way, or place
them so far ahead that they are bored by what is being
10
taught or unable to socially fit into the classroom, then
special educational methods become necessary. The
standard groupings or categories of exceptional children
are:
Intellectual differences, including children who are
intellectually superior(gifted) and children who are
slow to learn (have intellectual and developmental
disabilities)
Communication differences, including children with
learning disabilities, speech and language disabilities,
or autism
Sensory differences, including children with auditory or
visual impairments
Behavioral differences, including children who are
emotionally disturbed or socially maladjusted
Multiple and severe handicapping conditions, including
children with combinations of impairments (such as
cerebral palsy and mental retardation, or deafness and
blindness)
Physical differences, including children with non-
sensory impairments that impede mobility and physical
vitality.

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Specific learning
disability
Disorder in one or more of the basic psychological
processes involved in understanding or in using
language, spoken or written, that may manifest itself in
an imperfect ability to listen, think, speak, read, write,
spell, or do mathematical calculations, including
conditions such as perceptual disabilities, brain injury,
minimal brain dysfunction, dyslexia, and
developmental aphasia (disorders not included:
Learning problems that are primarily the result of
visual, hearing, or motor disabilities, of mental
retardation, of emotional disturbance, or of
environmental, cultural, or economic disadvantage)

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 Learning Disability
Learning disabilities are neurologically-based processing
problems. These processing problems can interfere
with learning basic skills such as reading, writing and/or
math. They can also interfere with higher level skills such as
organization, time planning, abstract reasoning, long or
short term memory and attention.
Children with learning disabilities are both puzzling and
paradoxical. In spite of near- average or higher- than-
average intelligence, students with learning disabilities
often find school to be very difficult. Just as the term
learning disabilities implies, these children struggle to learn
and often need additional supports to help them succeed in
school.
The reasons that children with learning disabilities do not
do well in school have fascinated and baffled researches
and practitioners in the fields of reading, cognition, speech
and hearing, neurology, learning, vision, audition, and
education. Not all children with learning disabilities have
the same set of challenges. Most have difficulty learning to
read, spell, and write. Others have trouble with math or
with attending to information and tasks. Some have
difficulty with all academic areas.
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 A Brief Historical
Overview Of Learning
Disabilities
The phrase learning disability was coined in 1962 by Samuel
Kirk, the first author of this text. It came to life during
discussions at a 1963 conference with concerned parents
and professionals that focused on students who in spite of
average or above- average intelligence seemed to be
encountering substantial difficulties in school. Prior to
1962, these students had been labeled with terms such as
minimal brain dysfunction, Strauss syndrome, and brain
injured (Lerner, 2005, Swanson, Harris, and Graham, 2003).
From Kirk’s perspective, students with learning disabilities
were a heterogeneous group who shared one
commonality: all had a neurologically based problem that
affected learning in various ways (Hallahan and Mercer,
2002, Hallahan and Mock, 2003)
The assumption that a learning disability has a neurological
basis is sound, but it is hard for teachers to use
“neurological anomalies” as evidence when they are trying
to decide whether a student has learning disability. There
14
may come a time in the future when brain studies will be
part of the identification process, but currently we must
rely on a student’s behavior and performance to help us
determine the presence of a learning disability (Galaburda,
2005; Miller, Sanchez, and Hynd, 2003; Sternberg, 2008).
Because of this limitation, the students we currently
identify as having learning disabilities are a very diverse
group: They include those with assumed neurologically-
based learning problems (the group that Samuel Kirk was
focused on) and students who are performing well for
other reason(e.g., poor motivation, problems at home,
teacher-student personality conflicts, and so forth). This
situation has made the category of learning disabilities a
“catchall” for students who need additional support in
school. Many of these students do not have an underlying
neurological base for their difficulties. This group of
students has been identified as learning disabled because
of unexplained underachievement.
The Fourth Edition Text Revision of the Diagnostic and
Statistical Manual of Mental Disorders (DSM-IV-TR, a
handbook that mental health professionals use to diagnose
mental disorders) uses the term learning disorders,
formerly called academic skills disorders and defines this as
cognitive difficulties arising from brain dysfunction. The use
of the term learning disability is much more widely
recognized than the term learning disorder, perhaps
because learning disability terminology has been used more
15
often in clinical, research, educational and political circles
than has DSM terminology

16
 Defining Learning
Disability
More than forty- five years have passed since Samuel Kirk
used the term learning disabilities to describe children who,
despite average or above average intelligence, seemed to
be encountering problems with school (Coleman, Buysse,
and Neitzel, 2006). At that time Kirk believed that these
children would likely be a very small subset of children with
disabilities. Little did we know that children with learning
disabilities would become the largest group of students
served by our special education programs. Current
estimations indicate that 48 percent of the school-age
children who receive special education are categorized as
learning disabled (LD; U.S. Department of Education, 2005).
One possible explanation for the expansion is the way we
have defined learning disabilities. The U.S. Department of
Education (2004) gives us the following definition:
SEC. 602. DEFINITIONS
(29) SPECIFIC LEARNING DISABILITY
(A) IN GENERAL. The term “specific learning disability”
means a disorder in 1 or more of the basic psychological

17
 processes involved in understanding or in using language,
spoken or written, which disorder may manifest itself in the
imperfect ability to listen, think, speak, write, spell, or do
mathematical calculations
(B) DISORDERS INCLUDE. Such term includes such
conditions as perceptual disabilities, brain injury, minimal
brain dysfunction, dyslexia, and developmental aphasia.
(C) DISORDERS NOT INCLUDED. Such term does not include
a learning problem that is primarily the result of visual,
hearing, or motor disabilities, of mental retardation, of
emotional disturbance, or of environmental, cultural, or
economic disadvantage.
This is a theoretical definition and must be operationalized
to help us actually identify students with learning
disabilities (Herr and Bateman, 2003). To operationalize this
definition, most states developed formulas that hinged on
the discrepancies between intellectual abilities(IQ) and
achievement and/or performance.
The U.S. National Joint Committee on Learning Disabilities
(NJCLD, 1988) defined learning disabilities as follows:
“Learning disabilities is a general term that refers to a
heterogeneous group of disorders manifested by significant
difficulties in the acquisition and use of listening, speaking,
reading, writing, reasoning, or mathematical abilities. These
disorders are intrinsic to the individual, presumed to be due
to central nervous system dysfunction and may occur
18
across the life span. Problems in self-regulatory behaviours,
social perception and social interaction may exist with
learning disabilities but do not, by themselves, constitute a
learning disability. Although learning disabilities may occur
concomitantly with other disabilities (e.g., sensory
impairment, mental retardation, serious emotional
disturbance), or with extrinsic influences (such as cultural
differences, insufficient or inappropriate instruction), they
are not the result of those conditions or influences” (NJCLD,
1988). The 1999 Federal Register that contains the
regulations for identifying and defining students with
specific learning disabilities under US legislation outlined
criteria that should be considered in identifying students
with this disorder. The disability must result from a deficit
in one or more basic learning behaviors such as memory,
reasoning, organization and perception; must manifest
itself in the form of one or more significant learning
difficulties in one or more of seven areas oral expression,
listening comprehension, written expression, basic reading
skills, reading comprehension, mathematics calculation and
mathematical reasoning-compared with other children of
the same age; must be evidenced by a severe discrepancy
between intellectual ability and academic achievement in
at least one of these seven areas; and must not be caused
by mental retardation, hearing or vision impairment, motor
impairment, emotional and behavioural disorder, or
environmental disadvantage (U.S. Department of
19
Education, 1999). 167 Another method of defining and
characterizing learning disabilities is through the DSM -IV
which outlines three major types of learning disorders:
reading disorder, mathematics disorder and disorders of
written expression, as opposed to offering one general
definition. However, the descriptions of these disorders in
the DSM-IV share one important similarity with that found
in the Federal Register. Both stipulate that there must be a
discrepancy between achievement in the area in question
and intelligence. Under U.S. federal law, public schools
consider a child to be learning disabled if his or her level of
academic achievement is two or more years below the
standard for age and IQ level. According to Bender (1995),
discrepancy criteria are used to indicate a substantial
difference between intelligence, as measured on
standardized IQ assessments and achievement in a number
of academic subject areas. Several researchers have
questioned the overall validity and usefulness of the ability
achievement discrepancy concept. On the basis of their
research, Stanovich and Siegel (1994), have concluded that
if there is a special group of children with reading
disabilities who are behaviourally, cognitively, genetically,
or neurologically different, it is becoming increasingly
unlikely that they can be easily identified by using IQ
discrepancy as a proxy for the genetic and neurological
differences themselves. Learning disabilities are intrinsic to
the individual and the basis of the disorders is presumed to
20
be due to central nervous system dysfunction. For the
individual with learning disabilities, evidence of central
nervous system dysfunction may or may not be elicited
during the course of a medical-neurological examination.
The critical elements in the diagnosis of learning disabilities
are elicited during psychological, educational and/or
language assessments. The failure to learn or to attain
curricular expectations may occur for diverse reasons.
Learning disabilities have their basis in inherently altered
processes of acquiring and Learning Disabilities: Nature,
Causes and Interventions 168 Counselling: Theory,
Research and Practice using information. It is essential to
understand this notion if one is to appreciate the resultant
interaction between the learner and the learning
environments. An understanding of this interaction
facilitates the development of effective service delivery
models and adaptive curriculum. This also leads to a clearer
understanding of the ways in which individuals with
learning disabilities may interact in a life-long social and
cultural milieu.

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 Common
characteristics shown in
the schools

Preschool
Speaks later than most children
Pronunciation problems
Slow vocabulary growth, often unable to find the right
word
Difficulty rhyming words
Trouble learning numbers, alphabet, days of the week,
colors, shapes
Extremely restless and easily distracted

Trouble interacting with peers

Difficulty following directions or routines
Fine motor skills slow to develop

Grades K-4
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 Slow to learn the connection between letters and
sounds
Confuses basic words (run, eat, want)
Makes consistent reading and spelling errors including
letter reversals (b/d), inversions
(m/w), transpositions (felt/left), and substitutions
(house/home)
Transposes number sequences and confuses arithmetic
signs (+, -, x, /, =)
Slow to remember facts
Slow to learn new skills, relies heavily on memorization
Impulsive, difficulty planning
Unstable pencil grip
Trouble learning about time
Poor coordination, unaware of physical surroundings,
prone to accidents

Grades 5-8
Reverses letter sequences (soiled/solid, left/felt)
Slow to learn prefixes, suffixes, root words, and other
spelling strategies
Avoids reading aloud
Trouble with word problems
Difficulty with handwriting
Awkward, fist-like, or tight pencil grip
Avoids writing assignments
Slow or poor recall of facts
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 Difficulty making friends
Trouble understanding body language and facial
expressions

High School Students and Adults

Continues to spell incorrectly, frequently spells the
same word differently in a single piece
of writing
Avoids reading and writing tasks
Trouble summarizing
Trouble with open-ended questions on tests

Weak memory skills

Difficulty adjusting to new settings
Works slowly
Poor grasp of abstract concepts
Either pays too little attention to details or focuses on
them too much
Misreads information

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 Causes of Learning
Disabilities
No one's exactly sure what causes learning disabilities. But
researchers do have some theories as
to why they develop, including:

Genetic influences. Experts have noticed that

learning disabilities tend to run in families and they think
that heredity could play a role. However, researchers are
still debating whether learning disabilities are, in fact,
genetic, or if they show up in families because kids learn
and model what their parents do.
Brain development. Some experts think that
learning disabilities can be traced to brain development,
both before and after birth. For this reason, problems
such as low birth weight, lack of oxygen, or premature
birth may have something to do with learning disabilities.
Young children who receive head injuries may also be at
risk of developing learning disabilities.
Environmental impacts. Infants and young kids
are susceptible to environmental toxins (poisons). For
example, you may have heard how lead (which can be
25
found in some old homes in the form of lead paint or
lead water pipes) is sometimes thought to contribute to
learning disabilities. Poor nutrition early in life also may
lead to learning disabilities later in life.
Heredity. Siblings and children of persons with reading
disabilities have a slightly greater than normal likelihood
of having reading problems. There is growing evidence
that genetics may account for at least some family links
with dyslexia (Pennington, 1995; Raskind, 2001).
Research has located possible chromosomal loci for the
genetic transmission of phonological deficits that may
predispose a child for reading problems later.

Biochemical Imbalance. It was once theorized

that biochemical disturbances within a child’s body
caused learning disabilities. For example, Feingold (1975,
1976) claimed that artificial colorings and flavorings in
many of the foods children eat can cause learning
disabilities and hyperactivity. He recommended a
treatment for learning disabilities that consisted of a diet
with no foods containing synthetic colors or flavors. In a
comprehensive review of research studies that tested the
special diet, spring and Sandoval (1976) concluded that
there was very little scientific evidence to support
Feingold’s theory.

26
 Types of learning
Disabilities
Dysgraphia.
Dyslexia.
Dyspraxia
Language Processing Disorder.
Non-Verbal Learning Disabilities.
Visual Processing Disorder.

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 Dyslexia
2.1 Overview
Dyslexia is a lifelong condition that makes it difficult for
people to read. It’s the most common learning issue,
although it’s not clear what percentage of kids have it.
Some experts believe the number is between 5 and 10
percent. Others say as many as 17 percent of people
show signs of reading issues. The reason for the wide
range is that experts may define dyslexia in different
ways.
Dyslexia is mainly a problem with reading accurately and
fluently. Kids with dyslexia may have
trouble answering questions about something they’ve
read. But when it’s read to them, they may
have no difficulty at all.
Dyslexia can create difficulty with other skills, however.
These include:
Reading comprehension
Spelling
Writing
Math
People sometimes believe dyslexia is a visual issue. They
think of it as kids reversing letters or writing backwards.
But dyslexia is not a problem with vision with seeing
letters in the wrong direction.
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It’s important to know that while dyslexia impacts
learning, it’s not a problem of intelligence. Kids with this
issue are just as smart as their peers. Many people have
struggled with dyslexia and gone on to have successful
careers. That includes a long list of actors, entrepreneurs
and elected officials.
If the child has dyslexia, she won’t outgrow it. But there
are supports, teaching approaches and
strategies to help her overcome her challenges.

29
 Signs and Symptoms
Signs of dyslexia can look different at different ages. Here
are some examples of signs of dyslexia:
Preschool
Has trouble recognizing whether two words rhyme
Struggles with taking away the beginning sound from a
word
Struggles with learning new words
Has trouble recognizing letters and matching them to
sounds
Grade School
Has trouble taking away the middle sound from a word
or blending several sounds to make a
word
Often can’t recognize common sight words
Quickly forgets how to spell many of the words she
studies
Gets tripped up by word problems in math

Middle School
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 Makes many spelling errors
Frequently has to re-read sentences and passages
Reads at a lower academic level than how she speaks
High School
Often skips over small words when reading aloud
Doesn’t read at the expected grade level
Strongly prefers multiple-choice questions over fill-in-
the-blank or short answer.
Dyslexia doesn’t just affect learning. It can impact everyday
skills and activities, as well. These include social interaction,
memory and dealing with stress.

31
 Other Issues That Can
Co-Occur With
Dyslexia
Many kids have more than one learning and attention issue.
There are a number of issues that often co-occur with
dyslexia. There are also issues that have symptoms that can
look like dyslexia symptoms. That’s why testing for dyslexia
should be part of a full evaluation that looks at all areas of
learning.
Here are some issues that often co-occur with or may be
mistaken for dyslexia:
ADHD can make it difficult to stay focused during
reading and other activities. Roughly 40 percent of
students with ADHD also have dyslexia. But kids with
dyslexia may fidget or act out in class because of
frustration over reading, not ADHD.
Executive functioning issues can affect different skills
and areas of learning. Executive functions include
organization, flexible thinking, and working memory.
Slow processing speed can impact reading, as well as
many other areas of learning. Kids who struggle with
32
processing speed are slower to take in, process and
respond to information. That can make it harder to
master basic reading skills and get the meaning of what
they’ve read.
Auditory processing disorder (APD) affects a child’s
ability to sort through the sounds she hears. This can
make reading difficult. Kids with APD often have
trouble recognizing the difference between letter
sounds and sounding out new words.

33
 Causes of Dyslexia

Researchers haven’t yet pinpointed exactly what causes

dyslexia. But they do know that genes and brain differences
play a role. Here are some of the possible causes of
dyslexia:
Genes and heredity: Dyslexia often runs in families.
About 40 percent of siblings of kids with dyslexia have
the same reading issues. As many as 49 percent of
parents of kids with dyslexia have it, too. Scientists
have also found a number of genes linked to issues
with reading and processing language.

Brain anatomy and activity: Brain imaging studies have

shown brain differences between people with and
without dyslexia. These differences occur in areas of
the brain involved with key reading skills. Those skills
are knowing how sounds are represented in words,
and recognizing what written words look like. The brain
can change, however. (This concept is known as
neuroplasticity.) Studies show brain activity in people
with dyslexia changes after they get proper tutoring.
And scientists are learning more all the time.
34
 Assessment of Dyslexia
There's no single test that can diagnose dyslexia. A number
of factors are considered, such as:
Child's development, educational issues and medical
history. The doctor will likely ask questions about these
areas and want to know about any conditions that run
in the family, including whether any family members
have a learning disability.
Home life. The doctor may ask for a description of
family and home life, including who lives at home and
whether there are any problems at home.
Questionnaires. The doctor may have child, family
members or teachers answer written questions. Child
may be asked to take tests to identify reading and
language abilities.
Vision, hearing and brain (neurological) tests. These
can help determine whether another disorder may be
causing or adding to child's poor reading ability.
Psychological testing. The doctor may ask parents and
child questions to better understand child's mental
health. This can help determine whether social
problems, anxiety or depression may be limiting child's
abilities.

35
Testing reading and other academic skills. Child may
take a set of educational tests and have the process
and quality of reading skills analyzed by a reading
expert.

36
 Inclusive Education for
Dyslexia
Dyslexia is treated using specific educational approaches
and techniques, and the sooner the intervention begins,
the better. Psychological testing will help your child’s
teachers develop a suitable teaching program.
Teachers may use techniques involving hearing, vision and
touch to improve reading skills. Helping a child use several
senses to learn — for example, listening to a taped lesson
and tracing with a finger the shape of the letters used and
the words spoken — can help in processing the
information.
Treatment focuses on helping the child:
Learning to recognize and use the smallest sounds that
make up words (phonemes)
Understanding that letters and strings of letters
represent these sounds and words (phonics)
Comprehending what he or she is reading
Reading aloud to build reading accuracy, speed and
expression (fluency)
Building a vocabulary of recognized and understood
words

37
If available, tutoring sessions with a reading specialist can
be helpful for many children with dyslexia. If your child has
a severe reading disability, tutoring may need to occur
more frequently, and progress may be slower.

38
 Individual education
plan
In the United States, schools have a legal obligation to take
steps to help children diagnosed with dyslexia with their
learning problems. Talking to child’s teacher about setting
up a meeting to create a structured, written plan that
outlines child’s needs and how the school will help him or
her succeed. This is called an Individualized Education
Plan (IEP).

Early treatment
Children with dyslexia who get extra help in kindergarten or
first grade often improve their reading skills enough to
succeed in grade school and high school.
Children who don’t get help until later grades may have
more difficulty learning the skills needed to read well.
They’re likely to lag behind academically and may never be
able to catch up. A child with severe dyslexia may never
have an easy time reading, but he or she can learn skills

39
that improve reading and develop strategies to improve
school performance and quality of life.

What parents can do

Addressing the problem early. If we suspect the child
has dyslexia, talking to child’s doctor. Early
intervention can improve success.
Reading aloud to the child. It’s best if you start when
your child is 6 months old or even younger. Trying and
listening to recorded books with child. When child is
old enough, reading the stories together after child
hears them.
Working with your child’s school. Talking to child’s
teacher about how the school will help him or her
succeed. Parents are child’s best advocate.
Encouraging reading time. To improve reading skills, a
child must practice reading.
Setting an example for reading. Designate a time each
day to read something of our own while child reads —
this sets an example and supports child. Showing the
child that reading can be enjoyable.

40
 Dyscalculia
Dyscalculia is a specific learning disability in math. Kids with
dyscalculia may have difficulty understanding number-
related concepts or using symbols or functions needed for
success in mathematics.
Dyscalculia is a lifelong condition that makes it hard for kids
to perform math-related tasks. It’s not as well known or
understood as dyslexia. But some experts believe it’s just as
common.
Experts don’t yet know for sure if dyscalculia is more
common in girls or in boys. But most agree it’s unlikely that
there’s any significant difference.
Kids with this learning issue have trouble with many
aspects of math. They often don’t understand quantities or
concepts like biggest vs. smallest. They may not understand
that the numeral 5 is the same as the word five. (These
skills are sometimes called number sense.)
Kids with dyscalculia also have trouble with the mechanics
of doing math, such as being able to recall math facts. They
may understand the logic behind math, but not how or
when to apply what they know to solve math problems.

41
They also often struggle with working memory. For
example, they may have a hard time holding numbers in
mind while doing math problems with multiple steps.
Dyscalculia goes by many names. Some schools refer to it
as a mathematics learning disability.
Doctors sometimes call it a mathematics disorder. You may
even hear kids and parents call it math dyslexia. (The term
math dyslexia can be misleading, though. Dyscalculia and
dyslexia are not the same thing.)

42
 Signs and Symptoms
Dyscalculia can cause different types of math difficulties. So
symptoms may vary from child to child. Observing your
child and taking notes to share with teachers and doctors is
a good way to find the best strategies and supports for your
child.
Dyscalculia often looks different at different ages. It tends
to become more apparent as kids get older. But symptoms
can appear as early as preschool. Here’s what to look for:
Preschool
Has trouble learning to count and skips over numbers
long after kids the same age can remember numbers in
the right order.
Struggles to recognize patterns, such as smallest to
largest or tallest to shortest.
Has trouble recognizing number symbols (knowing that
“7” means seven).
Doesn’t seem to understand the meaning of counting.
For example, when asked for five blocks, she just hands
you an armful, rather than counting them out.

Grade School
43
 Has difficulty learning and recalling basic math facts,
such as 2 + 4 = 6.
Struggles to identify +, ‒ and other signs, and to use
them correctly.
May still use fingers to count instead of using more
advanced strategies, like mental math.
Struggles to understand words related to math, such as
greater than and less than.
Has trouble with visual-spatial representations of
numbers, such as number lines.

Middle School
Has difficulty understanding place value.
Has trouble writing numerals clearly or putting them in
the correct column.
Has trouble with fractions and with measuring things,
like ingredients in a simple recipe.
Struggles to keep score in sports games.

High School
Struggles to apply math concepts to money, including
estimating the total cost, making exact change and
figuring out a tip.
Has a hard time grasping information shown on graphs
or charts?
44
 Has difficulty measuring things like ingredients in a
simple recipe or liquids in a bottle.
Has trouble finding different approaches to the same
math problem.

Other Issues That Can

Co-Occur With
Dyscalculia
Kids with learning and attention issues often have more
than one issue. There are a few issues that often co-occur
with dyscalculia. Also, symptoms of other issues can
sometimes look like dyscalculia symptoms.
Testing for dyscalculia should be done as part of a full
evaluation. That way, any other learning and attention
issues can be picked up at the same time.

45
Here are some issues that often appear along with
dyscalculia:
Dyslexia: Kids very often have both dyslexia and
dyscalculia. In fact, researchers have found that 43–65
percent of kids with math disabilities also have reading
disabilities.
ADHD: Dyscalculia and ADHD often occur at the same
time. Sometimes kids will make math errors because of
ADHD challenges. They might have trouble paying
attention to detail, for instance. So some experts
recommend re-evaluating math skills after getting
ADHD symptoms under control.
Executive functioning issues: Executive functions are
key skills that impact learning. They include working
memory, flexible thinking, and planning and organizing.
Weaknesses in these areas can make math difficult.
Math anxiety: Kids with math anxiety are so worried
about the prospect of doing math that their fear and
nervousness can lead to poor performance on math
tests. Some kids may have both math anxiety and
dyscalculia.

Dyscalculia is also associated with few genetic disorders.

These include fragile X syndrome, German’s syndrome and
Turner’s syndrome.

46
 Causes of Dyscalculia
Researchers don’t know exactly what causes dyscalculia.
But they’ve identified certain factors that indicate it’s
related to how the brain is structured and functions.
Here are some of the possible causes of dyscalculia:
Genes: Research shows that part of the difference in
kids’ math scores can be explained by genes. In other
words, differences in genetics may have an impact on
whether a child has dyscalculia. Dyscalculia tends to
run in families, which also suggests that genes play a
role.
Brain development: Brain-imaging studies have shown
some differences in brain function and structure in
people with dyscalculia. The differences are in the
surface area, thickness and volume of certain parts of
the brain. There are also differences in the activation of
areas of the brain associated with numerical and
mathematical processing. These areas are linked to key
learning skills, such as memory and planning.
Environment: Dyscalculia has been linked to fetal
alcohol syndrome. Prematurity and low birth weight
may also play a role in dyscalculia.

47
 Brain injury: Studies show that injury to certain parts of
the brain can result in what researchers call acquired
dyscalculia.

Assessment of
Dyscalculia
To find out if your child has dyscalculia, you’ll need to have
her evaluated. This can happen at school or privately.
There’s a set of tests just for dyscalculia. But they should be
given as part of a full evaluation that looks at other areas as
well. Certain learning and attention issues often co-occur
with dyscalculia.
So it’s important to have a complete picture of what’s going
on in order to make a proper diagnosis.

There are a number of professionals who do evaluations.

They include school psychologists, child psychologists and
pediatric neuropsychologists.
48
A psychologist may also look for other issues that might be
having an impact. These include ADHD and mental health
problems, such as anxiety and depression. (Kids with
learning issues are more likely to have these problems than
other kids.)
The evaluator might ask for a family history. And you might
be asked to fill out questionnaires about your child’s
strengths and weaknesses. Your child’s teacher may also be
asked about what he sees in the classroom.
A diagnosis (schools call it an identification) allows your
child to get supports and services at school. She might get
special instruction in math, for instance. She might also get
accommodations to make learning math easier. Learn
about the difference between a school identification and a
clinical diagnosis.
How Professionals Can Help With Dyscalculia
Different types of professionals can help kids with
dyscalculia in different ways. Some may work in a school
setting, while others work privately.
Here are some types of professionals who might help your
child:
Special education teachers
Math tutors or educational therapists
Child psychologists
Pediatric neuropsychologists
49
There are no medications for dyscalculia. And there aren’t
specialized teaching programs like there are for dyslexia.
But kids with dyscalculia may benefit from multisensory
instruction in math. This approach uses all of a child’s
senses to help her learn skills and understand concepts.
It also helps to teach math concepts systematically, where
one skill builds on the next. This can help kids with
dyscalculia make stronger connections to what they’re
learning.
If the child has an IEP or a 504 plan, she may get a variety of
supports at school. These might include assistive
technology or accommodations, such as extra time on tests
or being able to use a calculator. Or she may have fewer
problems to solve on her homework. These supports can
help “level the playing field” so your child is able to access
what she’s being taught.
The child can get support at school even if she doesn’t have
an IEP or a 504 plan. Her teacher might give informal
supports to help in class or with assignments and tests. The
child might also get instructional intervention through
response to intervention (RTI).

There are a number of strategies teachers use to help kids

with dyscalculia. (You can try these at home, too). Here are
a few examples:

50
Using concrete examples that connect math to real life,
such as sorting buttons. This can help strengthen your
child’s number sense.
Using visual aids when solving problems. Your child
might draw pictures or move around objects, for
instance.
Using graph paper to help keep numbers lined up.
Using an extra piece of paper to cover up most of
what’s on a math sheet or test so your child can focus
on one problem at a time.

Dysgraphia
51
Dysgraphia is a Greek word. The base word graph refers
both to the hand’s function in writing and to the letters
formed by the hand. The prefix dyes indicates that there is
impairment. Graph refers to producing letter forms by
hand. The suffix is refers to having a condition. Thus,
dysgraphia is the condition of impaired letter writing by
hand, that is, disabled handwriting. Impaired handwriting
can interfere with learning to spell words in writing and
speed of writing text. Children with dysgraphia may have
only impaired handwriting, only impaired spelling (without
reading problems), or both impaired handwriting and
impaired spelling. Research to date has shown orthographic
coding in working memory is related to handwriting and is
often impaired in dysgraphia. Orthographic coding refers to
the ability to store written words in working memory while
the letters in the word are analyzed or the ability to create
permanent memory of written words linked to their
pronunciation and meaning. Children with dysgraphia do
not have primary developmental motor disorder, another
cause of poor handwriting, but may have difficulty planning
sequential finger movements such as the touching of the
thumb to successive fingers on the same hand without
visual feedback. Children with dysgraphia may have
difficulty with both orthographic coding and planning
sequential finger movements.

52
 Signs and Symptoms
The symptoms of dysgraphia fall into six categories: visual-
spatial, fine motor, language processing, spelling/handwriting,
grammar, and organization of language. A child may have
dysgraphia if his writing skills lag behind those of his peers and
he has at least some of these
symptoms:
Visual-Spatial Difficulties
Has trouble with shape-discrimination and letter
spacing
Has trouble organizing words on the page from left to
right
Writes letters that go in all directions, and letters and
words that run together on the page
Has a hard time writing on a line and inside margins
Has trouble reading maps, drawing or reproducing a
shape
Copies text slowly

Fine Motor Difficulties

53
 Has trouble holding a pencil correctly, tracing, cutting
food, tying shoes, doing puzzles, texting and
keyboarding
Is unable to use scissors well or to color inside the lines
Holds his wrist, arm, body or paper in an awkward
position when writing

Language Processing Issues

Has trouble getting ideas down on paper quickly
Has trouble understanding the rules of games
Has a hard time following directions
Loses his train of thought

Spelling Issues/Handwriting Issues

Has a hard time understanding spelling rules
Has trouble telling if a word is misspelled
Can spell correctly orally but makes spelling errors in
writing
Spells words incorrectly and in many different ways
Has trouble using spell-check—and when he does, he
doesn’t recognize the correct word
Mixes upper- and lowercase letters
Blends printing and cursive
Has trouble reading his own writing
Avoids writing
54
 Gets a tired or cramped handed when he writes
Erases a lot

Grammar and Usage Problems

Doesn’t know how to use punctuation
Overuses commas and mixes up verb tenses
Doesn’t start sentences with a capital letter
Doesn’t write in complete sentences but writes in a list
format
Writes sentences that “run on forever”

Organization of Written Language

Has trouble telling a story and may start in the middle
Leaves out important facts and details, or provides too
much information
Assumes others know what he’s talking about
Uses vague descriptions
Writes jumbled sentences
Never gets to the point, or makes the same point over
and over
Is better at conveying ideas when speaking

The symptoms of dysgraphia also vary depending on a

child’s age. Signs generally appear when children are first
learning to write.
55
Preschool children may be hesitant to write and draw
and say that they hate coloring.
School-age children may have illegible handwriting that
can be mix of cursive and print. They may have trouble
writing on a line and may print letters that are uneven
in size and height. Some children also may need to say
words out loud when writing or have trouble putting
their thoughts on paper.
Teenagers may write in simple sentences. Their writing
may have many more grammatical mistakes than the
writing of other kids their age.

Other issues that can

co-occur with
dysgraphia

56
Many children with dysgraphia have other learning issues.
These conditions, which can also affect written expression,
include:
Dyslexia: This learning issue makes it harder to read.
Dyslexia can also make writing and spelling a challenge.
Learn more about the difference between dysgraphia
and dyslexia.
Language disorders: Language disorders can cause a
variety of problems with written and spoken language.
Children may have trouble learning new words, using
correct grammar and putting their thoughts into
words.
Attention-deficit hyperactivity disorder (ADHD): ADHD
causes problems with attention, impulsivity and
hyperactivity.
Dyspraxia: Dyspraxia is a condition that causes poor
physical coordination and motor skills. It can cause
trouble with fine motor skills, which can affect physical
task of writing and printing.
The impact of dysgraphia on a child’s development
varies, depending on the symptoms and their severity.
Here are some common areas of struggle for kids with
dysgraphia:
Academic: Kids with dysgraphia can fall behind in
schoolwork because it takes them so much longer to

57
write. Taking notes is a challenge. They may get
discouraged and avoid writing assignments.
Basic life skills: Some children’s fine motor skills are
weak. They find it hard to do everyday tasks, such as
buttoning shirts and making a simple list.
Social-emotional: Children with dysgraphia may feel
frustrated or anxious about their academic and life
challenges. If they haven’t been identified, teachers
may criticize them for being “lazy” or “sloppy.” This
may add to their stress. Their low self-esteem,
frustration and communication problems can also
make it hard to socialize with other children. While
dysgraphia is a lifelong condition, there are many
proven strategies and tools that can help children with
dysgraphia improve their writing skills.

Causes of Dysgraphia
Brain damage: Can occur because the brain is starved
of oxygen at birth or through near drowning, sustained
58
high temperature, head injury or stroke. You would
know about it if this was the cause of poor
handwriting. The body is designed to heal itself, and
can do much given time. Development may be much
delayed but love, a stimulating but not overwhelming
atmosphere and faith in the child, or adult can
gradually achieve much. Handwriting would probably
be a long way to the end of any list of goals for such a
person.
Physical illness or deformity: could also be due to a
birth defect, an illness or an accident. If nerve damage
leads to paralysis the normal routes to handwriting will
not be open
Intentionally poor penmanship: This is not necessarily
related to dyslexia, but many, if not most, people who
do this are likely to be dyslexic. People with poor
spelling, punctuation or grammar may intentionally use
poor handwriting in an effort to hide these facts. Poor
spelling, punctuation and grammar can frequently be
side effects of dyslexia. Give the student the
opportunity to correct their dyslexia and they can
address these issues; in which case the need for poor
handwriting is gone. You may suspect that this is the
cause of poor handwriting if the quality of handwriting
varies, being good when words can be spelled easily
but poor when there are words consistently mis-
spelled. There may be cases, however, when such
59
symptoms are not intentional but are connected with
disorientation connected with confusion. This will be
considered in a minute.
No or inadequate instruction: If a student has never
been given any instruction in penmanship, this may
lead to dysgraphia. However, as a home educator I
know many children who have no problem teaching
themselves how to write once they are ready to do so.
This, though, may be at a later age than is required for
school. Inadequate instruction is frequently related to
dyslexia. The problem is not that they have not been in
a situation to receive instruction, simply that
disorientation has meant that they were unable to
engage with the instructions being given to the class
and take onboard the necessary information, thus their
instruction has been inadequate because the teacher
either did not recognize that the child was
disorientated, or did not understand the confusion
causing disorientation so could not help the child
resolve that confusion. Once the child is able to be in
an orientated state when writing, it is easy to show
how to hold the writing implement properly and draw
the letters correctly.

Disorientation: The ability to disorientate, or actively

alter focus, in order to include the imagination in the
60
thinking process is one of the advantages of the
thinking and learning style of the dyslexic individual.
However, it can create distortions of perception when
used with symbols, such as letters or words.
Disorientation as a cause of poor handwriting is linked
to dyslexia; it follows the same stimulus response
model as reading dyslexia. The individual in an
orientated state meets a stimulus that causes him to
disorientate, perhaps only for a split second, but this
causes the handwriting to go awry. The disorientation
can occur in response to a line or shape or to a
movement, but lines, shapes and movements on their
own do not cause disorientation. The thing that
triggers disorientation is an emotion. This emotion
could be confusion, as is the case with reading dyslexia.
Dyslexics find symbols confusing, hence they can
trigger into disorientation when they see letters. Most
find a way round this once the letters are part of a
word with a picture, such as cat, tree or table, but
words without a picture, such as and, but, the or of will
still cause confusion that triggers disorientation
because dyslexics think with the meaning, not the
sound, of words or groups of words. Confusion over
letters and words can trigger disorientation when
writing as well, leading to dysgraphia; because, when
disorientated, the individual will not perceive
accurately so will not see that the letters he is drawing
61
are malformed. This letter F, drawn large, clearly
reveals the glitch caused, in this case, by a line trigger.
This glitch is not caused by a disorientation due to
confusion but by an emotion from the student's past
life experience which is brought into the present when
the student meets the stimulus of this line. Somehow
an emotion from the past life experience of the
student has become subconsciously linked to a line
drawn in a particular direction or a certain shape or a
particular motion.

Multiple mental images: Some dyslexics have an

amazing ability to reproduce almost exactly what they
see. Even if they cannot actually achieve the perfection
they see in their mind's eye, they have an exact picture
that they are trying to copy. Problems arise if the
teacher helping the child learn to write does not
understand what can happen when a visual model is
given to a picture thinker. A reception class student
named John is learning to write his name. Here it is
-not quite perfect... The teacher draws the name, John,
next to the student's attempt, showing how the letters
should reach up to the correct lines. John tries again.
As you can see, it is still not perfect. The teacher draws
another example. This seems perfectly reasonable, but

62
if we look ... As we will see here, the teacher's 2
examples are not the same.
John is now trying to copy both examples at once. As
John is given more and more minutely different
pictures to copy. Ultimately John ends up with a
mental image that looks something like this. The more
instruction he receives, the harder it gets. He will grip
the pencil tighter, until his fingers are fatigued. And
press harder until the lead breaks or the paper tears.
His whole body will become tenser and he may come
to a point where he is no longer able to hold or use a
pen or pencil and the mere thought of writing may lead
to anxiety. Multiple mental images need to be
addressed by removing all pictures that a student may
have of how writing should look.

Inadequate natural orientation otherwise known as

dyspraxia: This means that at some time very early in a
person's life, much earlier than might happen with
most dyslexics, they began to disorientate. This led to
the individual never being totally sure of where
physical reality is found. Their own natural orientation
will be in an unfavorable place. This person has poor
co-ordination, may have perceptual or speech
difficulties, will have difficulty telling left from right and
with crossing the midline of the body with hand or
63
foot. They will also be unable to scan across the
midline with their eyes. Not only is visual perception
affected, sound will also be affected. They may hear
sounds as garbled, too loud or soft or coming from the
wrong direction. If we look straight at a letter A we can
see the line of symmetry. A dyspraxic child cannot see
this. Because of his midline barrier, if he looked
straight at it he would only see half of it. To see the
whole letter he has to shift his point of focus in order
to see it on one side of the midline. In doing this he
loses the symmetry and the shape distorts. Straight
lines will become curvy, as in a distorting mirror at the
funfair. No matter how much instruction he gets he will
never see the letters accurately so his writing will
always be a problem. Identifying the problem is easy. If
the problem is dyspraxia the lines will not be straight
and there will be no symmetry in any of the letters.

Assessment of
Dysgraphia
64
The first step is for child's pediatrician to rule out any other
diseases or conditions that could cause writing difficulties.
A licensed psychologist trained in learning disorders can
diagnose dysgraphia. This could be child's school
psychologist. The specialist will give child academic and
writing tests that measure his ability to put thoughts into
words and his fine motor skills. For instance, he may be
asked to tap his fingers or turn his wrist a certain way.
The child also may be asked to write sentences or copy
words and letters. The specialist will look at his:
Finished work
Hand and body position
Pencil grip
Posture
Writing process

Inclusive Education of
Dysgraphia
65
 Having the child use wide-ruled paper, graph paper, or
paper with raised lines to help with letter and word
alignment.
Trying pencil grips or other writing aids for comfort.
Letting her use a computer to type instead of write,
and teach typing skills early.
Not criticizing sloppy work. Praise her hard work and
offer positive reinforcement.
Acknowledging the condition and talk to your child
about it.
Teaching her ways to relieve stress before writing. For
example, have her shake or rub her hands together
quickly.
Letting her squeeze a stress ball to improve hand-
muscle strength and coordination.
Talking to child's teacher about her condition and needs at
school. She may qualify for special
education services and an Individualized Education Program
(IEP) or other special assistance (such
as a 504 plan). These documents detail the child's needs
and give the school ways to help her.
Some things also might be asked for include:

66
 Shorter writing assignments or different questions
from her classmates
Use of a computer to type instead of write
Copies of the class notes to limit writing work
Use of a voice-to-dictation machine or another
electronic note taker
An option to record the teacher's lectures
Video or audio reports instead of written homework
assignments.
Oral instead of written exam.
Instructional activities improve the handwriting of
children with dysgraphia
Initially, children with impaired handwriting benefit from
activities that support learning to form letters:
playing with clay to strengthen hand muscles;
keeping lines within mazes to develop motor control;
connecting dots or dashes to create complete letter
forms;
tracing letters with index finger or eraser end of pencil;
imitating the teacher modeling sequential strokes in
letter formation; and
Copying letters from models.
Subsequently, once children learn to form legible letters,
they benefit from instruction that helps them develop
automatic letter writing, using the following steps to

67
practice each of the 26 letters of the alphabet in a different
order daily:
studying numbered arrow cues that provide a
consistent plan for letter formation
covering the letter with a 3 x 5 card and imaging the
letter in the mind’s eye
writing the letter from memory after interval that
increases in duration over the handwriting lessons
Writing letters from dictation (spoken name to letter
form).
In addition, to developing handwriting speed, they benefit
from writing letters during composing daily for 5 to 10
minutes on a teacher-provided topic.
Students benefit from explicit instruction in spelling
throughout K-12:
initially in high frequency Anglo-Saxon words
subsequently in coordinating the phonological,
orthographic, and morphological processes relevant for
the spelling of longer, more complex, less frequent
words
At all grade levels in the most common and important
words used for the different academic domains of the
curriculum.

68
 Auditory Processing
Disorder

Auditory processing disorder (also known as central

auditory processing disorder or CAPD) is a condition that
makes it hard for kids to recognize subtle differences
between sounds in words. It affects their ability to process
what other people are saying. Here are the signs of
auditory processing disorder (APD) and suggestions for how
we can help the child. Child passes a hearing test, but is
diagnosed with auditory processing disorder (APD).
Children with APD typically have normal hearing. But they
struggle to process and make meaning of sounds. This is
especially true when there are background noises.
Researchers don’t fully understand where things break
down between what the ear hears and what the brain
processes. But the result is clear: Kids with APD can have
trouble making sense of what other people say.
Typically the brain processes sounds seamlessly and almost
instantly. Most people can quickly interpret what they hear.
But with APD, some kind of glitch delays or “scrambles”
that process. To a child with APD,

69
“Tell me how the chair and the couch are alike” might
sound like “Tell me how a cow and hair are like.”
Many conditions, including ADHD and autism, can affect a
child’s ability to listen and understand what they hear.
What makes APD different is that the problem lies with
understanding the sounds of spoken language, not the
meaning of what’s being said. The number of children with
APD is estimated to be 2 to 7 percent. Some experts
estimate that boys are twice as likely as girls to have
auditory processing disorder, but there’s no solid research
to prove that.

Signs and Symptoms of

auditory processing
disorder
There are several kinds of auditory processing issues. The
symptoms can range from mild to severe. Children with

70
APD can have weaknesses in one, some or all of these
areas:
Auditory discrimination: The ability to notice, compare
and distinguish between distinct and separate sounds.
The words seventy and seventeen may sound alike, for
instance.
Auditory figure-ground discrimination: The ability to
focus on the important sounds in a noisy setting. It
would be like sitting at a party and not being able to
hear the person next to you because there’s so much
background chatter.
Auditory memory: The ability to recall what you’ve
heard, either immediately or when you need it later.
Auditory sequencing: The ability to understand and
recall the order of sounds and words. A child might say
or write “ephelant” instead of “elephant,” or hear the
number 357 but write 735.
Children with APD usually have at least some of the
following symptoms:
Find it hard to follow spoken directions, especially
multi-step instructions
Ask speakers to repeat what they’ve said, or saying,
“huh?” or “what?”
Be easily distracted, especially by background noise or
loud and sudden noises

71
 Have trouble with reading and spelling, which require
the ability to process and interpret sounds
Struggle with oral (word) math problems
Find it hard to follow conversations
Have poor musical ability
Find it hard to learn songs or nursery rhymes
Have trouble paying attention to and remembering
information presented orally
Have problems carrying out multistep directions
Have poor listening skills
Need more time to process information
Have low academic performance
Have behavior problems
Have language difficulty (e.g., they confuse syllable
sequences and have problems developing vocabulary
and understanding language)
Have difficulty
Have trouble remembering details of what was read or
heard
It’s difficult to diagnose children with APD before age 7 or
8. Some of these auditory skills don’t develop until then.
Getting a diagnosis requires finding a trained audiologist
who can run electrophysiological tests. These tests record
how the brain responds to sounds.

72
 Other issues that co
concur with auditory
processing disorder

Experts agree that children can learn to work around

challenges they face when dealing with APD. But APD can
present lifelong difficulties if it isn’t diagnosed and
managed. Here are some skills that are commonly affected:
Communication: Children with APD may not speak
clearly. They may drop the ends of words and syllables
73
 that aren’t emphasized. They might confuse similar
sounds (free instead of three) long after their peers
have learned to correct themselves.
Academics: Kids with APD often have trouble
developing reading, spelling and writing skills.
Learning vowels and developing phonemic awareness—the
building blocks for reading—can be especially difficult.
Understanding spoken instructions is challenging. Kids with
APD tend to perform better in classes that don’t rely heavily
on listening.
Social skills: Kids with APD have trouble telling stories
or jokes. They may avoid conversations with peers
because it’s hard for them to process what’s being said
and think of an appropriate response.
The first step is to have a pediatrician rule out other
possibilities such as hearing loss related to an ear infection.
A speech-language pathologist or school psychologist may
also give your child tests that measure receptive language
or listening comprehension skills as well as cognitive
abilities. But only a trained audiologist can conduct the
tests needed to make a diagnosis of
APD.

74
 Causes auditory
processing disorder

The exact causes of APD are still unknown. Research

suggests possible links to several factors.
These include
premature birth
Lead poisoning.
Low birth weight, head trauma & chronic ear
infections.

75
 Assessment auditory
processing disorder
There’s more than one method for helping kids with APD. If
your child has been diagnosed and is eligible for special
education services, the school will come up with a plan of
supports. These can include:
Accommodations (such as changes in timing,
formatting, setting or presentation of assignments)
Modifications (altering assignments to minimize the
area of weakness)
Remediation (training and therapy to build skills)
Among the therapies and treatments that may help:
Reading instruction: Your child could have one-on-one
or group instruction in reading skills, targeting any
areas of weakness.
Speech therapy: Speech therapists can provide
exercises and training to build kids’ ability to identify
sounds and develop conversational and listening skills.
Accommodations you and the school may want to consider
include:

76
 Preferential seating: Seating kids with APD in the front
of the room and away from distractions can help them
focus.
Improved acoustics: Closing doors and windows
minimizes outside noise.
Assistive technology: An amplification system, such as
a wireless FM system, reduces background noise and
poor acoustics. The child wears a headset and the
teacher wears a clip-on microphone.
Classroom visuals: The teacher uses images and
gestures to reinforce the child’s understanding and
memory.
Quiet rooms for taking tests.
Special instruction: Research funded by the NIDCD
found that some computer programs helped improve
children’s language-processing skills when the
programs were used intensively.
Note: Many of the services and accommodations listed
here require that the student have an Individualized
Education Program (IEP) or a 504 plan. But even without a
diagnosis, the school may be willing to offer informal
supports (such as providing copies of classroom notes) to
help the child succeed.

77
 Inclusive Education of
auditory processing
disorder
Even small steps can have a big impact on how the child
functions at home. Here are some suggestions we may try:
providing a quiet spot for studying, with background
noise kept to a minimum.
Having the child look at the speaker while speaking
Using simple, one-step directions.
Speaking at a slightly slower rate and at a slightly
higher volume.
Asking the child to repeat directions back. If he’ll need
to act on the directions later, asking him to write notes
to remind himself.

What can make the journey easier?

Whether the child has been diagnosed with APD or we
suspect he might have it, Understood can help us find
helpful tools, strategies and support.

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 Assistive technology can help kids with reading and
listening challenges.
Finder for ideas on apps for the child.
Connect with other parents. Other parents of kids with
APD may give us more information and strategies—as
well as the support we need to help the child. They
know what parents are going through and can share
tips to help propel you forward.
Get behavior advice from the experts. Parenting Coach
has strategies that can help with the social and
emotional issues that can come along with APD.

Dyspraxia

Dyspraxia and Developmental Coordination Disorder (DCD)

are neurological disorders impacting up to 10% of the
population. With DCD, dexterity and coordination (fine and
gross motor development) are impaired. With Dyspraxia
there may be additional concerns including problems with
eye movement (ocular motor), memory, judgment,
processing and function, sensory issues, and language
and/or speech.

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As of now, little is known about the underlying causes of
these conditions. What we do know is that in both DCD and
dyspraxia neural development is impaired, which results in
message errors between the brain and the body. What
causes the impairment has yet to be discovered.
(Apraxia, which shares many of the same symptoms, is
acquired through head injury, damage, lesion, or stroke.)

Signs and Symptoms

Exhibits poor balance; may appear clumsy; may
frequently stumble
Shows difficulty with motor planning
Demonstrates inability to coordinate both sides of the
body
Has poor hand-eye coordination
Exhibits weakness in the ability to organize self and
belongings
Shows possible sensitivity to touch
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 May be distressed by loud noises or constant noises
like the ticking of a clock or someone tapping a pencil
May break things or choose toys that do not require
skilled manipulation
Has difficulty with fine motor tasks such as coloring
between the lines, putting puzzles together; cutting
accurately or pasting neatly
Irritated by scratchy, rough, tight or heavy clothing
Feet swinging and tapping when seated
Hands clapping or twisting
Hands flapping when running or jumping
Unable to stay in one place longer than 5 minutes
Excitable
Loud and shrill voice
Easily distressed
Temper tantrums
Moves awkwardly
Constantly bumping into objects and falling
Difficulty pedaling tricycle
No sense of danger (jumps from inappropriate heights)
Messy eater; prefers to eat with hands
Spills liquid from drinking cup
Avoids construction toys (blocks, Legos, puzzles)

Fine Motor Skills

Awkward pencil grip
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 Immature writing
Poor scissors skills
Social Skills
Makes inappropriate choices
Struggles making friends
Problems with creative play
Prefers adult interaction

Causes of Dyspraxia
Very little is known about the cause of dyspraxia, also
known as developmental co-ordination disorder.
Performing smooth, planned movements involves a
number of different processes, including using our senses
to plan movements. All the information is then processed
by our central nervous system (brain, nerves and spinal
cord).
Dyspraxia is a disability that affects movement and co-
ordination. People with the condition have aproblem with
the processes in the brain that help co-ordinate movement.
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This means that they areunable to perform movements in a
smooth, coordinated way.
Developments in the brain
Dyspraxia may be caused by motor neurons in the brain not
developing properly. Motor neurons are specialized nerve
cells that pass signals from your brain to your muscles,
allowing you to move them.
It is thought that the motor neurons in people with
dyspraxia fail to form proper connections and are less
effective at transmitting electrical signals from the brain to
the muscles.
Sometimes, the electrical signal from the brain does not
reach the muscle at all and your muscles fail to respond to
requests from your brain to move.
Risk factors
Although it is not known what causes dyspraxia, there may
be a link between dyspraxia and:
being born prematurely (before week 37 of pregnancy)
being born with a low birth weight
having a family history of dyspraxia
the mother drinking alcohol, smoking or taking illegal
drugs while pregnant

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 Assessment of
Dyspraxia
We may notice that the child experiencing some of the
problems listed below, if so they are likely to need a
pediatric Occupational Therapy dyspraxia assessment.
Difficulties planning movements
Bumping into objects/people frequently
Clumsy
Uncoordinated
Unable to complete simple or complex movements
(skipping, hoping jumping, running)
Struggles to maintain balance

Fidgeting/ unable to stay still

Easily excited
Avoidance of construction based toys
Dominate hand not established
Struggles to understand verbal instruction
Concentration difficulties
Struggles to multitask
Struggles to remember more than a few pieces of
information
Poor handwriting
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 Slow at getting dressed

The Dyspraxia assessment will assess if the child has

Dyspraxia and to gain a better insight
Dyspraxia is affecting your child during day to day life, both
at school and at home. This would include a detailed
discussion and practical assessment of how the symptoms
of Dyspraxia are impacting on function, and provide
reasons why this could be.

Reasons why your child may need a dyspraxia assessment:

Impact on the school environment
Impact on the home
Impact of dyspraxia on function
Social or behavioral implications

Impact on the school environment

The Dyspraxia assessment also considers how the condition
is impacting upon the child within the school environment.
This could be the effect dyspraxia is having on movement in
Physical education lessons, or in joining in with other pupils
at playtime. Dyspraxia also has an effect on concentration
and working memory during class, this could possibly result
in the teacher having to repeat instructions directly to your
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child, or your child becoming lost and unsure on the task
when everyone else starts working.
Impact on the home
The Dyspraxia assessment will evaluate the effect the
condition is having on home life. This could include aspects
such as physical or behavioral impacts on the time taken to
complete activities. For example, playing outside with
siblings can be a challenge, often resulting in low
confidence in their own abilities ‘I can’t do it’ and a lack of
motivation to join in, possibly leading to isolation. The
occupational therapist would use the dyspraxia assessment
tool to assess how these problems are influencing the
dynamics and functional capabilities of the home.
Impact of Dyspraxia on function (Physical)
The Dyspraxia assessment would highlight the physical
implications on daily function. For example, children with
Dyspraxia have common difficulties in areas such as
coordination and planning. The Dyspraxia assessment
would be used to identify how these difficulties are
affecting your child’s ability to complete important
occupations (such as getting dressed and gross motor
skills).
Social/Behavioral implications
Not only does the Dyspraxia assessment consider the
implications of Dyspraxia on the home, school and its
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relation to physical function, it also considers how
Dyspraxia affects the child’s behavior.

Inclusive Education for

Dyspraxia
Pre-setting students for touch with verbal prompts,
“I’m going to touch your right hand.”
Avoiding touching from behind or getting too close and
make sure peers are aware of this
Providing a quiet place, without auditory or visual
distractions, for testing, silent reading or work that
requires great concentration
Warning the student when bells will ring or if a fire drill
is scheduled
Whispering when working one to one with the child
Allowing parents to provide earplugs or sterile waxes
for noisy events such as assemblies
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Making sure the parent knows about what is observed
about the student in the classroom
Referring student for occupational therapy or sensory
integration training
Being cognizant of light and light sources that may be
irritating to child
Task completion may be hampered by physical
difficulties and ability to confidently start a task or
determine completion.
Factor in opportunities for practice. Skills may need to
be broken down into smaller parts using a task
analysis. ‘Over-teaching’ may be necessary to ensure
that smaller components are achieved. Ensure that the
skills are developmentally appropriate.
Avoid time restrictions on the achievement of goals if
possible. Adhering to limits may not be physically
possible. Gradually build smaller components into
larger skills.
Ensure that goals are clear and achievable to
compensate for planning and organization problems.
Make directions clear, explicit and uncomplicated.
Have student repeat them to check for understanding.
Provide written and verbal direction in tandem where
possible.
Concentration difficulties may affect ability to listen
effectively. Consider topic lists or graphic organizers so
they can see ‘the whole picture’.
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 Verbal cues may help to re-focus or gain attention
when required to listen.
Assist student to identify steps to start and complete
tasks. Students should also be encouraged to verbalize
the steps they are undertaking through the process of
completing a task.
Students may be frustrated by not being understood.
Allow the student to have the option of not presenting
verbal information in front of peers if this causes
distress.
Non-verbal communication may be difficult to
interpret. Be explicit in use of language.
Working memory may be impaired. Verbally presented
information may not be effectively retained. Support
with easy-to-follow written notes.

Lesson Preparation & Materials

Provide graphic organizers for taking notes. Students
may be able to highlight text rather than write
summaries. Diagrams and larger print may be useful in
summaries.
Provide copies of notes or scaffolds which require
minimal completion. Students may have problems
remembering what to write down when reading from
the board.

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 A short checklist for the student to complete may
assist with motivation and focus.
Feedback & Assessment
Stress and anxiety are common problems. Learn to
recognize early signs of discomfort and seek the advice
of the student or parent in seeking solutions.
Provide frequent and positive feedback for effort.
Consider multiple choice, fewer questions and short
answers when planning written assessments.
Special provisions including rest breaks or writers may
be required.
Quality of work may be inconsistent from one day to
the next.
Work may appear hurried and disorganized.
Handwriting and planning will need support.
Always reassure students rather than criticize. Be
specific and descriptive with praise remembering to
praise effort rather than performance.
Classroom Management
A lack of coordination may make the student appear
clumsy or accident-prone. Staff must be aware of
potential difficulties in practical lessons or at recess
and lunch. Factor this into risk assessments and
classroom layout. Minimize visual distractions and
clutter.

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 Routines will be important as organization and task
completion will be a struggle. Aim for consistency ie.
Similar order or lesson activities and templates for
class work to reduce fear and anxiety of the unknown.
Inability to concentrate, difficulty complying with
requests involving fine motor or gross motor, peer
avoidance and lack of success may all contribute to
behavioral challenges. Awareness and effective
planning may explain and predict difficulties. Students
may imitate other students when performing tasks as
the coordination and organization to be successful may
be difficult to achieve.
Students may demonstrate avoidance behaviors due to
fear of failure. Support students during change of
activity or new tasks.
In some circumstances it helps to explain dyspraxia to
peers. Always seek approval from parents and
preferably collaborate with the parents and students
as to how information should be presented.
Students may avoid conversation with peers due to
language problems. Some social immaturity may be
present. The student may need the support of peer
buddies, and explicit social skills training to make
friendships. May have difficulty ‘reading’ non-verbal
gestures.
Peers & SLSOs

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 Practical Tasks may need peer or SLSO support due to
gross motor problems.
Students may prefer to work one-on-one to aid focus
due to possible reluctance to compete with peers.
SLSOs may be especially useful for ‘social engineering’,
note-taking and keeping student diaries up-to-date.

Visual processing
disorder

When people think of eyesight, they usually think about

accuracy, as in 20/20 vision. But vision is much more than
that. The brain, not the eyes, processes the visual world,
including things like symbols, pictures and distances.
Weaknesses in these brain functions are called visual
processing disorder or visual processing issues.
While there are ways to help kids compensate for those
weaknesses, visual processing issues present lifelong
challenges. They are not considered a learning disability.
But they’re fairly common in kids who have learning issues.
Visual processing issues don’t just affect how a child learns.
They also impact his ability to do ordinary things like sorting
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socks or playing a simple game of kickball. Visual processing
issues can cause problems with socializing and self-esteem,
too. Some kids may become frustrated and withdrawn.

Visual processing issues are complex. That’s because there

are eight different types, and people can have more than
one. These issues often go undetected because they don’t
show up on vision tests. Here are the different types of
visual processing issues scientists have identified:
Visual discrimination issues: Kids with this type have
difficulty seeing the difference between two similar
letters, shapes or objects. So they may mix up letters,
confusing d and b, or p and q.
Visual figure-ground discrimination issues: Kids with
this type may not be able to pull out a shape or
character from its background. They may have trouble
finding a specific piece of information on a page.
Visual sequencing issues: Kids with these issues have
difficulty telling the order of symbols, words or images.
They may struggle to write answers on a separate
sheet or skip lines when reading. They also may
reverse or misread letters, numbers and words.
Visual-motor processing issues: Kids with these issues
have difficulty using feedback from the eyes to
coordinate the movement of other parts of the body.
Writing within the lines or margins can be tough. Kids
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also may bump into things and have trouble copying
from a book.
Long- or short-term visual memory issues: Kids with
either type have difficulty recalling what they’ve seen.
Because of that they may struggle with reading and
spelling. They may also have trouble remembering
what they’ve read and using a calculator or keyboard.
Visual-spatial issues: Kids with these issues have
difficulty telling where objects are in space. That
includes how far things are from them and from each
other. It also includes objects and characters described
on paper or in a spoken narrative. Kids may also have a
tough time reading maps and judging time.
Visual closure issues: Kids with these issues have
difficulty identifying an object when only parts are
visible. They may not recognize a truck if it’s missing
wheels. Or a person in a drawing that is missing a facial
feature. Kids may also have great difficulty with
spelling because they can’t recognize a word if a letter
is missing.
Letter and symbol reversal issues: Kids with these
issues switch letters or numbers when writing. Or make
letter substitutions when reading after age 7. They also
have trouble with letter formation that affects reading,
writing and math skills.

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 Signs and symptoms
It can be very hard to recognize the signs of visual
processing issues in the child. But once we do, we’ll be
better able to find the strategies and supports that will
help. Here are some of the most common symptoms of
visual processing issues:
Doesn’t pay attention to visual tasks
Is easily distracted by too much visual information
Is restless or inattentive during video or visual
presentations
Lacks interest in movies or television
Has difficulty with tasks that require copying (taking
notes from a board)
Reverses or misreads letters, numbers and words
Bumps into things
Has difficulty writing within lines or margins
Has trouble spelling familiar words with irregular
spelling patterns
Can’t remember phone numbers
Has poor reading comprehension when reading silently
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 Can’t remember even basic facts that were read
silently
Skips words or entire lines when reading, or reads the
same sentence over
Complains of eye strain or frequently rubs eyes
Has below-average reading comprehension and writing
skills, despite strong oral comprehension and verbal
skills
Has weak math skills; frequently ignores function signs,
omits steps, and confuses visually similar formulas
Routinely fails to observe or recognize changes in
bulletin board displays, signs or posted notices
What skills are affected by visual processing issues?
Kids may not show signs of visual processing issues until
they start school. But the longer they go without help, the
greater the impact may be on a wide range of skills. Here
are some of the areas visual processing issues can affect
most.
Academic: Kids can have great difficulty with reading,
writing and math. They may struggle to tell letters,
numbers and symbols apart. They may also have a hard
time remembering and recognizing what they read.
Emotional: As kids fall behind at school, their self-
confidence can take a big hit.

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 Life skills: Visual processing issues can make simple
tasks hard, from matching socks to learning phone
numbers.

Other issues that co-

occur with Visual
Processing Disorder
Visual processing issues aren’t a recognized learning
disability on their own. But the symptoms often appear in
kids with reading, writing and math issues. Some experts
believe visual processing issues are risk factors for learning
issues such as dyslexia. But a comprehensive report from
the American Academy of Pediatrics states that visual
processing issues are a result of that condition, not the
cause.

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 Assessment of visual
processing issues
diagnosed
When your child starts struggling in school and it seems like
it’s a vision problem, the first step is a trip to the
pediatrician. Before going it’s important to take notes on
what we’ve been seeing in the child. The doctor will most
likely give the child a vision test and look for any health
issues with his eyes. If everything checks out the doctor
may refer us to a specialist for further evaluation.
Pediatric ophthalmologist: Child’s doctor may refer us to a
pediatric ophthalmologist, a medical doctor who treats eye
and vision problems in children. This specialist will likely
perform a complete examination of child’s eyes and vision
to look for physical reasons for child’s issues. If there are
none there will be no further vision testing.
Pediatric optometrist: Instead of sending us to a pediatric
ophthalmologist child’s doctor may refer us to a pediatric
optometrist. This is a health-care professional who provides
primary eye care to children. In addition to prescribing

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glasses, optometrists can also evaluate patients for vision
or eye problems.
Neuropsychologist: If everything checks out with child’s
vision and eye health, the eye specialists or child’s doctor
may refer to a neuropsychologist. This is a psychologist who
is trained to diagnose learning issues and weakness. The
neuropsychologist may perform a series of tests to see how
child’s visual issues are affecting her development. The
tests are designed to measure intelligence, academic skills
(reading, writing, and math) language skills (vocabulary,
listening comprehension, and verbal expression), and
memory and attention abilities.
The specialist also may interview parents and child’s
teachers for more information. This is the specialist who
can tell if child has visual perception issues.
Behavioral optometrist: This is an optometrist who, after
ruling out physical issues, can provide something called
vision therapy. This approach involves a variety of exercises
using devices like prisms and lenses. There is no scientific
evidence that vision therapy helps, however.

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 Inclusive Education
Visual Processing
Disorder
There are no medications or recognized cures for visual
processing issues. Some pediatric optometrists may
recommend vision therapy for child. There’s no scientific
proof this approach works, however. It involves child doing
exercises using lenses, prisms and filters. The exercises are
done at home and in the office. The goal is to reduce the
signs and symptoms of visual processing issues.

Help at School
The professionals who may help the most are the ones
working with your child at school.
 If your child has been evaluated and qualifies for special
services, you and your school will come up with an
Individualized Educational Program (IEP). This written plan
guarantees school will provide specific supports for child.
Those supports can include things like tutoring in reading

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and writing skills. But even without an evaluation, child may
be able to get support.
 Response to intervention (RTI) is a program some schools
use to screen all students and find the ones who need extra
help. It starts out with small group instruction. Kids who still
don’t progress receive intensive one-on-one instruction.
 Teacher also can use informal supports. For example, she
might give child books with enlarged print or allow him to
write test answers on the same sheet of paper as the
questions.
 If child isn’t eligible for an IEP, the school may
recommend a 504 plan. A 504 plan lists the things child’s
school will do to meet child’s needs. That might include
things such as giving less homework or having tests read
aloud to your child.

What can be done at home for visual processing issues?

Raising a child with visual processing issues takes extra
patience and work. But there are many ways to help child
improve skills. Here are some strategies might be
considered:
 Learn as much as we can. The more we know, the more
we’ll be able to help the child.
 Observe and take notes. Observe the child closely and
take notes on problem areas. We’ll develop a better
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understanding of what he’s going through. Notes will also
be helpful while talking to family members, child’s doctor,
teachers and anyone else helping him.
 Write out schedules or instructions clearly. Break
instructions into concise steps, and number each step.
Write information in large, clear letters. Color coding can be
helpful too.
 Offer lots of practice. Help child on his visual processing
skills through fun activities. Try doing simple puzzles or
reading the Where’s Waldo? Books together. Play catch or
roll a ball back and forth together.
 Celebrate victories. If child has struggled with learning a
specific spelling rule, and aces the latest test, be generous
with praise. Our support and recognition for genuine
achievement may give child the boost he needs to keep
striving.

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 Non-verbal learning
disorder

Children with NLD have difficulties understanding

nonverbal information, which can result in academic, social,
and emotional challenges. Contrary to the name of this
disorder, these children often have excellent verbal skills
and do well in elementary school, delaying detection of
their learning disability. Nonverbal learning disabilities
(NLD) impact the ability to learn from and use nonverbal
information. Kids with NLD have trouble understanding the
“big picture.” They may also have problems with reading
comprehension, math, and implied meaning.
Because social interaction relies heavily on nonverbal cues
(facial expression, tone, body language), these children may
be socially awkward. They tend to be overly literal in their
interpretation of social cues, missing the nuances others
intuitively understand. They also tend to have difficulty
understanding cause-and-effect relationships and
anticipating the consequences of their actions.

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Despite the name of this disorder, those who have NLD are
far from nonverbal. In fact, verbal skills are their greatest
asset. But because they are adept with language, verbal
reasoning, and rote memory, their disabilities frequently
are not detected until middle or high school. As they move
up in school, comprehension often becomes challenging as
they have trouble inferring, interpreting, and reading
between the lines of complex assignments.

Sign and Symptoms of

Non-verbal Learning
Disorder
While symptoms of NVLD may include poor social skills,
NVLD may show up in other ways. For example, children
with NVLD may struggle with math, reading
comprehension, writing, and/or physical coordination. Here
are some of the symptoms:
Remembers information but doesn’t know why it’s
important
Shares information in socially inappropriate ways
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 Pays attention to details but misses the big picture
Struggles with reading comprehension
Struggles with math, especially word problems
Is physically awkward and uncoordinated
Has messy handwriting
Thinks in literal, concrete terms
Misses social cues such as verbal and/or nonverbal
expressions, which may make your child seem “off” to
others
Has poor social skills
Stands too close to people
Is oblivious to people’s reactions
Changes the subject abruptly in conversation
Is overly dependent on parents
Is fearful of new situations
Has trouble adjusting to changes

Kids with NVLD are often misunderstood because of these

behaviors. Peers and adults may see them as odd or
immature. Without knowing a child has NVLD, a teacher
may think he’s inattentive or defiant.
What skills are affected by nonverbal learning disabilities?
NVLD doesn’t affect all kids in the same way or to the same
degree. But for most, the condition will have some impact
on the following skills:

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Conceptual skills: Trouble grasping large concepts,
problem-solving and cause-and-effect relationships.
Motor skills: Problems with coordination and
movement. This includes gross motor skills (like
running and kicking), fine motor skills (like writing and
using scissors), and balance (such as riding a bike).
Visual-spatial skills: Has trouble with visual imagery,
visual processing, and spatial relations. Kids may
remember what they hear, but not what they see.
Social skills: Difficulty picking up on social cues and
sharing information in a socially appropriate way. They
may not understand sarcasm or teasing, and may
interrupt in the middle of conversation.
Abstract thinking: Trouble with reading
comprehension and understanding the “big picture.”
Kids may be good at memorizing details but not at
understanding the larger concepts behind them. They
may also have trouble organizing their thoughts.

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 Other issues that co-
occur with Non-verbal
Learning Disorder
NVLD is the condition most closely associated with social
skills issues. However, there are several other conditions
that make it hard for kids to connect. These conditions are
separate, but they can occur along with NVLD.
ADHD: Kids with NVLD may first be misdiagnosed with
ADHD. The two conditions have some similar
symptoms, such as excessive talking, poor coordination
and interrupting conversations. But ADHD isn’t a
learning disability. It’s a brain-based condition that can
make it difficult for kids to concentrate, consider
consequences and control their impulses.
Language disorders: These are problems with talking
(expressive language disorder) and understanding
(receptive language disorder) language. Kids with these
conditions may have trouble understanding and using
gestures, following directions and knowing how to
maintain a conversation. NVLD also may resemble
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 some symptoms of social (pragmatic) communication
disorder.
Asperger’s syndrome: This is a developmental disorder
that affects a child’s ability to socialize and
communicate clearly with others. It falls on the mild
end of the autism spectrum. There is a lot of overlap in
the symptoms of Asperger’s syndrome and NVLD, and
studies suggest that up to 80 percent of kids with
Asperger’s also have NVLD. But they are separate
conditions.
How can professionals help with nonverbal learning
disabilities?
There are a number of therapies and educational strategies
that can help your child manage and work around NVLD
symptoms. These include:
Social skills groups to teach kids how to handle social
situations such as greeting a friend, joining a
conversation, and recognizing and responding to
teasing.
Parent behavioral training, run by a psychologist, to
help parents learn how to collaborate with teachers. It
also can teach parents how to help kids with social
skills in playdates and extracurricular activities.
Occupational therapy to build tolerance for outside
experiences, improve coordination and enhance fine
motor skills.
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 Cognitive therapy to help deal with anxiety and other
mental health issues.
Child’s school to determine what services might be
available.

What can be done at home for nonverbal learning

disabilities?
Parenting a child with NVLD can be challenging, but there
are many things you can do at home to help your child
manage symptoms and learn social skills. Also some of the
strategies from behavior experts can be tried. These steps
can help to make positive changes in child’s life and in
family life.
Think about how you say things. Remember that kids
with NVLD have trouble sensing sarcasm and tone of
voice, and they’re likely to take instructions literally.
For example, if you say, “Don’t let me see you playing
with that toy,” he might continue playing with the toy
but turn his back so you can’t see him. Give clear
instructions such as, “Please put that toy down and
come over here.”
Help with transitions. Kids with NVLD tend to dislike
change because it’s hard for them to understand. They
may not have the abstract thinking skills needed to
envision what’s going to happen next. You can prepare

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your child for a change in routine by using logical
explanations.
Instead of saying, “We’re leaving soon to have dinner
with Grandma,” try “We’re going to eat dinner at
Grandma’s house tonight because it’s her birthday. We
need to leave in an hour.”
Keep an eye on your child. Kids with NVLD can become
overwhelmed by too much sensory input, such as
noise, smells, sounds and temperature. Try to avoid
situations that could trigger those reactions in your
child.
Encourage playdates. Help your child find kids who are
interested in the same things he enjoys, whether it’s
comic books or cooking. Set up one-on-one playdates
at your home, so your child can get social experience in
a familiar setting. Make sure to keep the playdate
structured, organizing activities to keep your child and
his friend busy. It’s also a good idea to plan playdates
for a time of day when your child tends to be on his
best behavior.

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 Assessment of Non-
verbal Learning
Disorder
Nonverbal learning disabilities aren’t included in the DSM,
the manual psychologists and other professionals use to
make a diagnosis. But you can still have your child
evaluated to find out if he has NVLD.
Since there is no single test for NVLD, getting a diagnosis
involves a number of steps, including:
Step 1: Get a medical exam. Child’s primary doctor
probably isn’t an expert in learning issues, but starting here
allows us to talk about our concerns and find out if a
medical condition could be causing child’s symptoms. The
doctor can rule out some conditions, but we may be
referred to a specialist such as a neurologist for further
evaluation.
Step 2: Get a referral to a mental health professional. After
ruling out medical causes, child’s doctor will likely refer to a
mental health professional such as a child
neuropsychologist. The specialist will talk to parents and
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the child about concerns. Then he’ll use a variety of tests to
evaluate your child’s abilities in these areas:
Speech and language: Speech development in younger
kids; and verbal skills, understanding of abstract ideas
and use of context in older kids
Visual-spatial organization: The ability to connect
visual information with abstract concepts, such as
telling time and reading a map
Motor skills: Fine motor skills like drawing and writing,
and gross motor skills like throwing and catching
objects. The specialist will look at how the child
performs these skills, and will ask about the symptoms
seen in your child.

Step 3: Put the pieces together. After gathering all the

information, the specialist will look for a pattern of
strengths and weaknesses that are common in kids with
NVLD. This will help determine if child has the condition.
Common Strengths
Average to above average intelligence
High verbal scores
Early language development
Strong ability to remember and repeat spoken
information
Learns better by hearing information than by seeing it

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Common Weaknesses
Social skills
Balance, coordination and handwriting
Understanding cause and effect
Visualizing information
Activity level (high when young; low when older)

Inclusive Education for

Nonverbal Learning
Disorder
Providing a "verbal-rope" to guide the student from
place to place;
Assigning a peer buddy who enjoys helping this child
and who is attentive to her needs;
Training this peer buddy to look out for her classmate
with NLD on the bus, during recess, at lunchtime,
during passing periods and so forth;
Eliminating any negative consequences for tardiness;

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Rehearsing getting from place to place, with significant
markers pointed out verbally
Providing a predictable and safe environment with a
consistent daily routine;
Minimizing transitions and giving several verbal cues to
the student before transitions;
Furnishing the child's parents with a schedule of
activities so they can "rehearse" (preview and prepare)
for the following day with their child and make sure he
has the necessary supplies required for the day's
activities;
Posting a simple written schedule on the blackboard at
the beginning of each day in primary grades;
Explaining the daily agenda to the older child so he can
begin to internalize the structure of his school day;
Writing out a high school student's daily schedule on a
card (with any changes in routine highlighted) that can
be carried from class to class, so it is always readily
available
Never expecting the student to automatically
generalize instructions or concepts;
Using language as the bridge to tie new situations to
old learning;
Reviewing past information before presenting new
concepts;
Verbally pointing out similarities, differences and
connections;
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Verbally indicating generalizations which can be drawn
in various situations;
Methodically discussing the cause-and-effect
relationships of events and situations with the student.
Writing out and/or tape recording multi-step
instructions;
Numbering and presenting instructions in the most
efficient sequence;
Breaking all tasks down into manageable segments and
presenting them a few at a time;
Making sure the student understands your
instructions- don't assume that repeating them back to
you means that he will remember and can follow
through;
Pairing the student with NLD with a nondisabled
"buddy" who can remind him of "the next step;"
Teaching the student mnemonic devices for short term
memory enhancement;
Checking with the student at frequent intervals to be
sure he is not "lost" or confused.
Explaining what you mean by the things you say which
may be misinterpreted;
Simplifying and breaking-down abstract concepts;
Starting with concrete concepts and images and slowly
moving to abstract concepts and images, at a pace set
by the student;

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Understanding that metaphors, emotional nuances,
multiple levels of meanings, and relationship issues as
presented in novels will not be understood unless
explained;
Teaching the student to say "I'm not sure what you
mean" or "That doesn't make sense to me" to give her
a specific vocabulary to help her decipher your intent.
Answering the student's questions whenever it is
possible and practical (other students in the class may
actually have the same questions, but be lacking in the
verbal abilities to ask them);
Starting the other students on the assignment and
then individually answering the rest of this student's
questions;
Designating a specific time during the day when you
can continue a discussion which needs to end at the
moment;
Telling the student you only have time to answer three
questions right now (a specific number is important - -
don't say "a few"), but that you will be glad to answer
three more of his questions during the recess break;
Specifically teaching the student when it is appropriate
to ask for help (i.e. if he will be unable to continue his
assignment unless something he doesn't understand is
explained to him) and the appropriate methods of
doing so;

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Explicitly teaching the rules of polite social conduct, so
that the child does not constantly interrupt class
activities with his questions.
Preparing the environment for the child (eliminating
known sensory stressors);
Reducing distractions and situations contributing to
sensory overload;
Focusing on one sensory modality at a time (avoiding
multi-sensory approaches to instruction);
Allowing modifications as needed to deal with
sensitivity issues (protecting the child from sounds that
hurt his ears or avoiding the use of fluorescent lights in
the classroom);
Talking in a low whisper to a child with extreme
auditory sensitivity;
Ensuring that this child is placed in a classroom location
with the least amount of distraction (usually up at the
front of the room, away from visual and auditory
sources of "clutter").
Providing a highly individualized educational program;
Applying age and grade-level expectations with
flexibility;
Emphasizing the strong academic skills and gifts of the
child with NLD by creating cooperative learning
situations in which his proficient verbal, reading, oral
spelling, vocabulary, and memory skills will be

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showcased to advantage (and his difficulties with
writing can be de-emphasized);
Never assuming this child understands something just
because he can parrot back what you have just said;
Never assuming this child understands what he has
read, just because he is a "proficient" reader (has
excellent word recognition);
Offering added verbal explanations when the child
seems "lost" or registers obvious confusion.

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References

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