Learning Disorders of Children and Adolescents

What are Learning Disorders?

Learning Disorders are diagnosed when a child's achievement on individualized, standardized tests in reading, mathematics, or written expression is substantially below that expected for their age, schooling, and level of intelligence.  These problems significantly interfere with academic achievement or activities of daily living that require reading, math, or writing skills.  These are a Reading Disorder, a Mathematics Disorder, and a Disorder of Written Expression.

A variety of statistical approaches can be used to establish that a discrepancy is significant.  Substantially below is usually defined as more that 2 standard deviations between achievement and IQ.  A smaller discrepancy between achievement and IQ is sometimes used, especially in cases where an individual's performance on an IQ test may have been compromised by an associated disorder in cognitive processing, a co-morbid mental disorder, a general medical condition, or the individual's ethnic or cultural background.  These factors can mean test scores deviate due to standardization issues of test development.  If a sensory deficit is present, the learning difficulties must be in excess of those usually associated with the deficit.  Learning Disorders may persist into adulthood.

These disorders should be differentiated from normal variations in academic progress.  They are not due to a lack of educational opportunity, or to poor teaching or cultural factors.  These disorders are not due to poor vision or hearing impairment.  For children with communication disorders, intellectual functioning may have to be assessed using standardized measures of nonverbal intellectual ability.

Psychological conditions are often associated with having one of these disorders.  Low self esteem, demoralization, and deficits in social skills may be present.  School drop out rates are reported to be as high as 40% for children and adolescents with these disorders (1.5 times greater than the average rate).  Many children with Conduct Disorder, Oppositional Defiant Disorder, Attention Deficit Hyperactivity Disorder, Major Depression, or Dysthymia also have a learning disability (10 to 25%).  Developmental delays in language may be associated.

Underlying abnormalities in cognitive processing may be present.  These can include deficits in visual processing, linguistic processes, attention, or memory, or a combination of these.  Standardized tests to measure these aspects are generally less reliable and valid than other psychoeducational tests.  Genetic predisposition, perinatal injury, and various neurological or medical conditions may be associated with Learning Disorders, but do not invariably predict that a disorder will develop.  Lead poisoning and fetal alcohol syndrome are often associated with this disorder.

What Can be Done About a Learning Disorder?

Assessment or testing procedures should be sensitive to an individual's ethnic or cultural background.  They should be administered by an examiner who is familiar with these issues.  Individualized testing is always required to make the diagnosis of a Learning Disorder.

Public schools are required to evaluate children who are not making satisfactory educational progress to determine whether they may have one of these disorders.  Parents can request such an evaluation, or the child may be referred for assessment by teachers or school staff (with the parents' permission).  Educational achievement testing and intellectual or cognitive testing are administered on an individual basis.  Parents may also request an independent evaluation, at the school's expense, usually after the school has completed their assessment.  This may be for a second opinion if the child is not found to have a disorder, or if they are not found to be eligible for services.  Educational consultants are available for independent evaluations.  Neuropsychological testing is often utililzed for a more thorough testing evaluation if questions remain after initial testing.

Children and adolescents with these disorders are able to benefit from two possible processes.  First, they may be able to request accommodations of their general educational curriculum (a 504 plan).  This is a written plan for special teaching, learning, production, evaluation, or homework methods, which are applied in normal classroom settings.  The second process is through Special Education resources.  These modifications of a child's educational planning may be offered in regular classrooms, in separate resource room classes, or in separate special schools.  These modifications can include special teachers, adaptive technology, and modifications of testing (including standardized tests).

Since many children with learning problems struggle with emotion, self esteem, behavior, social skills, or other psychological issues, counseling can be helpful in addition to accommodations or modifications made in their educational plan.  Some schools offer such counseling, but this is rare.  Guidance counselors spend their time with academic and career planning.  Adjustment counselors are available, but usually offer services for groups of students.  Individual and/or family counseling can be useful in helping children be successful educationally, personally, and socially.  Therapy can help kids and their parents/families to understand their learning problems, build self esteem, help teach and practice social skills, and focus on study and organization skill building.

If you live in southeast Massachusetts, in Plymouth county, Cranberry Counseling, P.C. in Marshfield would be more than happy to answer your questions and to make an appointment to help diagnose and start a treatment plan for your child or adolescent and your family.  See the Cranberry Counseling, P.C. page, or use the Contact Us form.  Psychotherapy can help to reduce problems related to these disorders.