Specific Learning Disorder

A presentation by Samuel
Kimbowa
CAMHS training 3rd Module
Definition of SLD

 The term means a 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 to
do mathematical calculations, including conditions
such as perceptual disabilities, brain injury, minimal
brain dysfunction, dyslexia, and developmental
aphasia.
Specific Learning Disorder

• Disorders not included. The term does not include 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.

• Specific Learning disabilities can be characterized by a discrepancy

between a student’s ability and his or her achievement in areas such
as reading, writing, mathematics, or speaking. This option is up to the
individual school, or agency doing the assessment.
Diagnostic criteria

 Difficulties learning and using academic skills, as indicated by the

presence of at least one of the following symptoms that have
persisted for at least 6 months, despite the provision of interventions
that target those difficulties:
 1. Inaccurate or slow and effortful word reading (e.g., reads single
words aloud incor­rectly or slowly and hesitantly, frequently guesses
words, has difficulty sounding out words).

 2. Difficulty understanding the meaning of what is read (e.g., may

read text accurately but not understand the sequence, relationships,
inferences, or deeper meanings of what is read).

 3. Difficulties with spelling (e.g., may add, omit, or substitute vowels

or consonants).
Diagnostic criteria

 4. Difficulties with written expression (e.g., makes multiple

grammatical or punctua­tion errors within sentences; employs poor
paragraph organization; written expres­sion of ideas lacks clarity).

 5. Difficulties mastering number sense, number facts, or calculation

(e.g., has poor understanding of numbers, their magnitude, and
relationships; counts on fingers to add single-digit numbers instead
of recalling the math fact as peers do; gets lost in the midst of
arithmetic computation and may switch procedures).

 6. Difficulties with mathematical reasoning (e.g., has severe difficulty

applying math­ematical concepts, facts, or procedures to solve
quantitative problems).
Diagnostic criteria
 B. The affected academic skills are substantially and quantifiably
below those expected for the individual’s chronological age, and
interference with academic or occupational performance, or with
activities of daily living.
 C. The learning difficulties begin during school-age years but may not
become fully man­ifest until the demands for those affected academic
skills exceed the individual’s lim­ited capacities (e.g., as in timed tests
of reading or writing, tight deadline, excessively & heavy academic
loads).
 D. The learning difficulties are not better accounted for by
intellectual disabilities, uncor­rected visual or auditory acuity, other
mental or neurological disorders, psychosocial adversity, lack of
proficiency in the language of academic instruction, or inadequate
educational instruction.
Causes
 Learning disabilities. Learning disabilities are presumed to be
disorders of the central nervous system and a variety of factors may
contribute to their occurrence. Learning disabilities may be due to:

 Heredity. Learning disabilities tend to run in families. It is not unusual

to discover that people with learning disabilities come from families
in which other family members have reported similar difficulties.
 Problems during pregnancy and childbirth. Learning disabilities may
be caused by illness or injury during or before birth. Learning
disabilities may also be caused by the use of drugs and alcohol during
pregnancy, RH incompatibility with the mother (if untreated),
premature or prolonged labor or lack of oxygen or low weight at
birth.
 Incidents during/after birth. Head injuries, nutritional deprivation,
poisonous substances, (e.g., lead), and child abuse can contribute to
learning disabilities
Characteristics

Students who have learning disabilities may exhibit a wide

range of traits, including:
 problems with reading comprehension
 spoken language
 writing
 reasoning ability
 Hyperactivity
 Inattention
 perceptual coordination problems may also be associated
with learning disabilities.
Characteristics

 Other traits that may be present include a variety of symptoms, such

as:
 uneven and unpredictable test performance
 perceptual impairment
 motor disorders
 behaviors such as impulsiveness
 low tolerance for frustration
 problems in handling day-to-day social interactions and situations
 inconsistent school performance
Characteristics

• Difficulty remembering today what was learned yesterday,

but may know it tomorrow
• Short attention span (restless, easily distracted)
• Letter and number reversals (sees "b" for "d" or "p", "6" for
"9", "pots" for "stop" or "post")
• Poor reading (below age and grade level)
• Frequent confusion about directions and time (right-left, up-
down, yesterday-tomorrow)
Characteristics

 Personal disorganization (difficulty in following simple

directions/schedules; has trouble organizing, planning, and
making best use of time; frequent loss or misplacement of
homework, schoolbooks, or other items)
 Impulsive and/or inappropriate behavior (poor judgment in
social situations, talks and acts before thinking)
 Failure on written tests but high scores on oral exams (or
vice versa)
 speech problems (immature language development, trouble
expressing ideas, poor word recall)
Characteristics
 Difficulty understanding and following instructions unless
they are broken down to one or two tasks at a time
 Seems immature and has difficulty making friends
 Trouble remembering what someone just told him or her
 Poor coordination (in gross motor activities such as walking
or sports and/or in fine motor activities such as tying a
shoelace, holding a pencil, or handwriting - inconsistent,
slow, messy, or illegible)

 Difficulty interpreting body language, facial expression, or

tone of voice.
 Difficulty with development of sound/symbol
correspondence
Affected areas
Learning disabilities may occur in the following academic areas:

 Spoken language: Delays, disorders, or discrepancies in listening and

speaking;
 Written language: Difficulties with reading, writing, and spelling;
 Arithmetic: Difficulty in performing arithmetic functions or in comprehending
basic concepts;

 Reasoning: Difficulty in organizing and integrating thoughts; and

 Organization skills: Difficulty in organizing all facets of learning.

 Some of these problems can be found in all children at certain stages of

development. When a child has a cluster of symptoms that do not disappear
as she/he gets older, you might suspect learning disabilities.
Common Types

I-Dyslexia - a language-based disability in which a person has trouble

understanding words, sentences, or paragraphs.

Approximately 85% of all individuals with learning disabilities have

difficulties in the area of reading.
Symptoms of Dyslexia

Symptoms in preschoolers
Some of the symptoms of dyslexia or SLD in a
preschooler could include:
 Delayed speech.
 Problems with pronunciation.
 Problems with rhyming words and learning rhymes.
 Difficulty with learning shapes, colors and how to
write their own name.
 Difficulty with retelling a story in the right order of
events.
Symptoms of Dyslexia

Symptoms in primary school children

Some of the symptoms in a primary school age child
could include:
 Problems with reading a single word.
 Regularly confuses certain letters when writing,
such as 'd' and 'b' or 'm' and 'w'.
 Regularly writes words backwards, such as writing
'pit' when the word 'tip' was intended.
Symptoms of Dyslexia

• Problems with grammar, such as learning prefixes

or suffixes.
• Tries to avoid reading aloud in class.
• Doesn't like reading books.
• Reads below their expected level.
Symptoms of Dyslexia

 Symptoms in high school children

Some of the symptoms in a high school student
could include:
 Poor reading.
 Bad spelling, including different misspellings of the
same word in one writing assignment.
 Difficulties with writing summaries.
 Problems with learning a foreign language.
Types

II-Dyscalculia - a mathematical disability in which a person has a

difficult time solving arithmetic problems and grasping math
concepts.

• DSM-5 defines dyscalculia as difficulties in the production or

comprehension of quantities, numerical symbols, or basic arithmetic
operations that are not consistent with the person's chronological
age, educational opportunities, or intellectual abilities.
Dyscalculia-Symptoms

 Normal or accelerated language acquisition: verbal, reading, writing.

Poetic ability. Good visual memory for the printed word. Good in the
areas of science (until a level requiring higher math skills is reached),
geometry (figures with logic not formulas), and creative arts.

 Difficulty with the abstract concepts of time and direction. Inability

to recall schedules, and sequences of past or future events. Unable
to keep track of time. May be chronically late.

 Mistaken recollection of names. Poor name/face retrieval. Substitute

names beginning with same letter.
Dyscalculia-Symptoms

 Inconsistent results in addition, subtraction, multiplication

and division. Poor mental math ability.
 When writing, reading and recalling numbers, these
common mistakes are made: number additions,
substitutions, transpositions, omissions, and reversals.
 Inability to grasp and remember math concepts, rules,
formulas, sequence (order of operations), and basic
addition, subtraction, multiplication and division facts. Poor
long term memory (retention & retrieval) of concept
mastery- may be able to perform math operations one day,
but draw a blank the next! May be able to do book work but
fails all tests and quizzes.
Dyscalculia-Symptoms

• May be unable to comprehend or "picture" mechanical

processes. Lack "big picture/ whole picture" thinking. Poor
ability to "visualize or picture" the location of the numbers
on the face of a clock, the geographical locations of states,
countries, oceans, streets, etc.

• Poor memory for the "layout" of things.  Gets lost or

disoriented easily. May have a poor sense of direction, loose
things often, and seem absent minded. (Remember the
absent minded professor?)
Dyscalculia-Symptoms
 May have difficulty grasping concepts of formal music education.
Difficulty sight-reading music, learning fingering to play an
instrument, etc.

 May have poor athletic coordination, difficulty keeping up with

rapidly changing physical directions like in aerobic, dance, and
exercise classes. Difficulty remembering dance step sequences, rules
for playing sports.

 Difficulty keeping score during games or difficulty remembering how

to keep score in games, like bowling, etc. Often looses track of whose
turn it is during games, like cards and board games. Limited strategic
planning ability for games, like chess.
Types

III-Dysgraphia - a writing disability in which a person finds it hard to

form letters or write within a defined space.
Dysgraphia-Symptoms

 Generally illegible writing (despite appropriate time and attention

given the task)
 Inconsistencies: mixtures of print and cursive, upper and lowercase,
or irregular sizes, shapes, or slant of letters
 Unfinished words or letters, omitted words
 Inconsistent position on page with respect to lines and margins.
 Inconsistent spaces between words and letters
 Cramped or unusual grip, especially:
Holding the writing instrument very close to the paper, or
Holding thumb over two fingers and writing from the wrist
Dysgraphia-Symptoms

• Strange wrist, body, or paper position

• Talking to self while writing, or carefully watching the hand that is
writing
• Slow or labored copying or writing - even if it is neat and legible
• Content which does not reflect the student's other language skills
Types

IV-Dysorthographia: Individuals with this disorder have difficulties

utilizing clues from several sources that aid in deciding on the correct
spelling of a word. It is a specific learning disability that involves an
inability or delay in learning to properly spell words from letters
Dysorthographia involves persistent problems with symbol recognition
and ordering that are essential for proper spelling
Dysorthographia-Symptoms

• People who are poor spellers typically have trouble analyzing the
sounds, syllables, and meaningful parts of words in both spoken
language and written language.
• In addition, they often have trouble learning other types of symbolic
codes such as math facts and math operation signs
Prevalence

 The prevalence of specific learning disorder across the academic

domains of reading, writ­ing, and mathematics is 5%-15% among
school-age children across different languages and cultures.
Prevalence in adults is unknown but appears to be approximately
4%.
 Approximately 85% of all individuals with learning disabilities have
difficulties in the area of reading.
 In fact, over half of all children who receive special education have a
learning disability
 Gender Differences: LD is twice as common in males as in females,
Males are significantly more likely than females to fall within each
major disability group
Development and Course

 Onset, recognition, and diagnosis of specific learning disorder usually

occurs during the elementary school years when children are
required to learn to read, spell, write, and learn mathematics.
 Precursors such as language delays or deficits, difficulties in rhyming
or counting, or difficulties with fine motor skills required for writing
commonly occur in early childhood before the start of formal
schooling. Manifestations may be be­havioral (e.g., a reluctance to
engage in learning; oppositional behavior).
 Examples of symptoms that may be observed among preschool-age
children include a lack of interest in playing games with language
sounds (e.g., repetition, rhyming), and they may have trouble
learning nursery rhymes.
Co-morbidity

 In 25% of the cases of specific Learning disabilities [ADHD], autistic

spectrum disorder, communication disorders, developmental coor­
dination disorder).
 Behavioural and emotional disorders: many children with SLD
experience anxiety in the classroom and for this reason may
contribute to a more general anxiety disorder. SDQ can be used to
assess behavioural and emotional difficulties in this case

 Specific Learning disabilities should not be confused with other

disabilities such as mental retardation, autism, deafness, blindness,
and behavioral disorders.
Assessment

 Clinical assessment can be done through taking child’s history

(developmental, medical, family, educational), school reports, and
psycho-educational assessment.
 Intelligence tests (WISC and BINET)
 Curriculum based assessment
 Kaufman Test of Educational Achievement (K-TEA)
 SDQ (Student and Teacher versions)
 Teacher observations (interaction with peers during play, during class
time)
Management
DYSLEXIA
Special teaching techniques. These can include helping a child learn
through multisensory experiences and by providing immediate
feedback to strengthen a child’s ability to recognize words.

Classroom modifications. For example, teachers can give students

with dyslexia extra time to finish tasks and provide taped tests that
allow the child to hear the questions instead of reading them.

Use of technology. Children with dyslexia may benefit from listening

to books on tape or using word-processing programs with spell-check
features
Management
DYSGRAPHIA
Special tools. Teachers can offer oral exams, provide a note-taker,
and/or allow the child to videotape reports instead of writing them.

Use of technology. A child with dysgraphia can be taught to use

word-processing programs or an audio recorder instead of writing by
hand.

Other ways of reducing the need for writing. Teachers can provide

notes, outlines, and preprinted study sheets.
DYSCALCULIA
Visual techniques. For example, teachers can draw pictures of word
problems and show the student how to use colored pencils to
differentiate parts of problems.
Use of memory aids. Rhymes and music are among the techniques
that can be used to help a child remember math concepts.
Use of computers. A child with dyscalculia can use a computer for
drills and practice.
Generally, a child with a learning disability may struggle with low self-
esteem, frustration, and other problems. Mental health professionals
can help the youngster understand these feelings, develop coping
tools, and build healthy relationships.
 QUESTIONS

•THANK YOU