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LEARNING
DISABILITIES
01
Dr Masliza Yusoff
FMS KKB
30/6/2022
Learning disabilities
learning disabilities are due to genetic and/or neurological factors that alter the brain
functions to the point where it affects one or more cognitive processes related to learning.
Cognitive function –skill for brain on perception,attention, memory, learning,decision making
and language abilities
• Interference even when learning foundational skills such as reading, writing and/or math
at a younger age.
• In older children, they might also interfere with more advanced learning skills including
time planning, organizational skills, abstract reasoning, long or short term memory and
attention.
• The most common signs and symptoms of learning difficulties with reading and writing
are highly recognizable during a child's early schooling years.
• There are many children with learning disabilities in Malaysia that are not evaluated and
go through life with this challenge, even until they graduate to the workforce. 2
Risk factors
With family history of LD
Who live in poverty and understimulating environments
Who were born prematurely
With other developmental and mental health conditions, such
as attention deficit hyperactivity disorder, disruptive behavior
disorders, autism, anxiety disorders, and depression.
With neurologic conditions (eg, seizure disorders,neurofibromatosis,
tuberous sclerosis complex, Tourette
syndrome)
3
With chromosomal disorders (eg, fragile X
syndrome, Turner
syndrome, Klinefelter syndrome)
With certain chronic medical conditions (eg, type 1
diabetes
mellitus, HIV infection).
With a history of central nervous system infection
or
irradiation or traumatic brain injury.
Kurang upaya
pembelajaran
20/1/2021 Bengkel 'Training of Trainers" (TOT) Pengendalian Autism Spectrum Disorder(ASD)
Global Developmental delay (GDD) (< 5
years)
Intellectual Disability (ID) (>5 years)
Autism Spectrum Disorder(ASD)
Attention Deficit Hyperactive Disorder
(ADHD)
Specific Learning Disorder (SLD)- e.g
Dyslexia, Written Expression, Dyscalculia
Downs syndrome
neurodevelopmental
disorders)
a condition diagnosed before age 18 that includes below-average general
intellectual function, and a lack of the skills necessary for daily living.
this involves the person’s ability to learn, to think, to solve problems and to cope,
and have the skills needed to live independently
5
Intellectual Disability
Diagnostic criteria in DSM-5
1. Deficits in intellectual functioning
2. Deficits or impairments in adaptive functioning
3. These limitations occur during the developmental period.
1.Deficits in intellectual
functioning
This includes various mental abilities:
• Reasoning;
• Problem solving;
• Planning;
• Abstract thinking;
• Judgment;
• Academic learning (ability to learn in
school via traditional teaching
methods);
• Experiential learning (the ability to
learn through experience, trial and
error, and observation).
• Measured by IQ test
2.Deficits or impairments in
adaptive functioning
measured using standardized, culturally appropriate
tests.
Various skills are needed for daily living:
-Communication
-Social skills
-Personal independence at home or in community
settings
-School or work functioning
Tests available-Vineland
adaptive behaviour scales
Signs of ID
• sit up, crawl, or walk later than other children
• learn to talk later, or have trouble speaking,
• find it hard to remember things,
• not understand how to pay for things,
• have trouble understanding social rules, customs, and standards of public behavior.
• have trouble seeing the consequences of their actions
• have trouble solving problems, and/or have trouble thinking logically
• Communications involved impairment in receptive, expressive and pragmatic language functioning
• Personal independence at home or in community settings –affected ability of ADL(bathing, dressing),
basic and daily task(cooking, cleaning). Others like shopping, assessing public transportation
DIAGNOSIS :IQ AND ADAPTIVE FUNCTION
ASSESSMENT
Intelligent Quotient-test visual/perceptual reasoning,
Verbal comprehension
Mental age/ chronological age x 100
Normal range of IQ : 80 – 120
GHDAMT-assess more on child development,
reliable if child had mental disability
In DSM-5, intellectual disability is considered to be approximately two standard
deviations or more below the population, which equals an IQ score of about 70 or below
8
Severity of ID
9
Specific Learning disorders
10
COMMON TYPES OF LEARNING DISABILITIES IN CHILDREN
Dyslexia
Difficulty reading Problems reading, writing,
spelling, speaking
Dyscalculia
Difficulty with math Problems doing math
problems, grasping maths
concepts, understanding
time, using money
Dysgraphia Difficulty with writing Problems with handwriting,
spelling, organizing ideas
Dyspraxia (Sensory
Integration Disorder)
Difficulty with fine motor skills Problems with hand–eye
coordination, balance, manual
dexterity
Dysphasia/Aphasia Difficulty with language Problems understanding spoken
language, poor reading
comprehension
Auditory Processing
Disorder
Difficulty hearing differences
between sounds
Problems with reading,
comprehension, language
Visual Processing Disorder Difficulty interpreting visual
information
Problems with reading, math,
maps, charts, symbols, pictures
12
Elaborate on what you want to discuss.
Write Your
Topic or Idea
Dyslexia
difficulty in acquiring and processing language that is typically manifested by the lack or
proficiency in reading, spelling and writing.
difficulty connecting letters they see on a page with the sounds they make. As a result,
reading becomes slow and effortful and is not a fluent process for them.
• Problems in reading begin even before learning to read. For example, children may have
trouble breaking down spoken words into syllables and recognizing words that rhyme.
• Kindergarten-age children may not be able to recognize and write letters as well as their
peers.
• Difficulty with accuracy and spelling as well. It’s a common misconception that all
children with dyslexia write letters backwards or those who write letters backwards all
have dyslexia.
• often try to avoid activities involving reading when they can (reading for pleasure,
reading instructions). They often gravitate to other mediums such as pictures, video, or
audio.
13
Dyslexia
14
15
16
17
18
2
1
19
Ujian saringan bagi menentukan kebarangkalian murid
mengalami masalah pembelajaran spesifik disleksia
instrumen disediakan oleh Jabatan Pendidikan
Tahap penguasaan mengeja, membaca
dan menulis
: Kekuatan pada murid
Kelemahan yang ditunjukkan.
3
20
Diagnosis:
Clinical diagnosis using DSM 5 for ASD
A) Social Communication Interaction (SCI)
deficit
A①Lack of emotional/ social reciprocity
A②Marked impairment in non-verbal
communication
A③Severe problems in developing and
maintaining relationship at appropriate to
level
(Must fulfilled all 3,A1,A2,A3)
B) Restrictive Repetitive behaviour (RRB)
①Stereotyped and repetitive speech, motor
mannerisms or use of objects
②Inflexible adherence to non-functional routines,
ritualised verbal / non-verbal behaviour, or excessive
resistance to change
③Highly restricted patterns of interests, abnormal in
intensity or focus
④Unusual interest in sensory aspects of environment,
or hyper- / hypo-reactivity to sensory input
(Must fulfilled at least 2)
Signs and symptoms of possible autism in primary school
children (aged 5 – 11 years or equivalent mental age
22
24
Severity level Social communication Restricted, repetitive behaviours
Level 3
"Requiring very
substantial
support"
Severe deficits in social
communication skills, very limited
initiation of social interactions &
minimal response to social
overtures from others
Inflexibility of behaviour, extreme
difficulty coping with change, or
other restricted/repetitive behaviours
markedly interfere with functioning in
all spheres
Great distress/difficulty changing
focus or action
Level 2
"Requiring
substantial
support"
Marked deficits in social
communication skills, limited
initiation of social interactions &
reduced or abnormal responses
to social overtures from others
Obvious interference with
functioning in a variety of contexts
Distress &/or difficulty changing
focus or action
Level 1
"Requiring
support"
Without supports in place, deficits
in social communication cause
noticeable impairments
Difficulty initiating social
interactions & atypical responses
to social overtures of others
Inflexibility of behaviour causes
significant interference with
functioning in one or more contexts
Difficulty switching between
activities
Problems of organisation & planning
hamper independence
2. Attention deficit hyperactivity
disorder (ADHD)3
○ 53% children with ASD have ADHD
■ 22% - hyperactivity/impulsivity
■ 46% - inattentive
■ 32% - combined
○ Children with ASD who have ADHD
■ are usually younger
■ have a lower mean IQ
ASD & CO-MORBIDITY
25
ADHD
26
Introduction
• ADHD is a neuropsychiatric condition
• Characterized by 3 main core symptoms which are diminished sustained attention,
impulsivity or hyperactivity
• Biological basis of ADHD is due to ineffective neurotransmission at PFC involving DA and
NE
• ADHD affect up to 8% of school-aged children, and up to 60% of those diagnosed
continuing to be symptomatic until adulthood
• Children with ADHD often have significant impairment in academic function, social and
interpersonal situation
• ADHD frequently associated with comorbid disorders including learning disorders,
anxiety disorders, mood disorders and disruptive behavior disorders
Vanderbilt Assessment Scale
Dsm-5 diagnostic criteria for adhd
• A persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with
functioning or development
• Six or more symptoms
○ persisted for at least six months to a degree that is inconsistent with developmental
level and that negatively impacts directly on social and academic/occupational
activities.
○ symptoms are not solely a manifestation of oppositional behaviour, defiance,
hostility, or failure to understand tasks or instructions.
○ for older adolescents and adults (age 17 and older), five or more symptoms are
required
Dsm-5 diagnostic criteria for ADHD
• Several inattentive or hyperactive-impulsive symptoms were present prior to age 12 years
• Several inattentive or hyperactive-impulsive symptoms are present in two or more
settings (e.g. at home, school, or work; with friends or relatives; in other activities)
• There is clear evidence that the symptoms interfere with, or reduce the quality of, social,
academic or occupational functioning
• The symptoms do not occur exclusively during the course of schizophrenia or another
psychotic disorder and are not better explained by another mental disorder (e.g. mood
disorder, anxiety disorder, dissociative disorder, personality disorder, substance
intoxication or withdrawal)
Hyperactive-impulsive symptoms
1. often fidgets with or taps hands or squirms in seat
2. often leaves seat in situations when remaining seated is expected
3. often runs about or climbs in situations where it is inappropriate
4. often unable to play or engage in leisure activities quietly
5. is often "on the go" acting as if "driven by a motor"
6. often talks excessively
7. often blurts out answers before questions have been
8. often has difficulty awaiting turn
9. often interrupts or intrudes on others
Impulsivity – difficulty delaying action/response, need for
immediate gratification
Hyperactivity- excessive physical
activity, restlessness
Inattention symptoms
1. often fails to give close attention to details or makes careless mistakes in schoolwork,
work, or during other activities
2. often has difficulty sustaining attention in tasks or play activities
3. often does not seem to listen when spoken to directly
4. often does not follow through on instructions and fails to finish school work, chores, or
duties in the work place
5. often has difficulty organizing tasks and activities
6. often avoids or is reluctant to engage in tasks that require sustained mental effort
7. often loses things necessary for tasks or activities
8. is often easily distracted by extraneous stimuli
9. is often forgetful in daily activities
Inattention – a behavioural pattern in which the individual
has difficulty initiating, remaining engaged and completing
tasks
Includes distorted sense of time – underestimate time in
relation to tasks and tends to procrastinate
Treatment
Thank you!
Write a closing statement or call-to-action here.
37

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LD4- DR MAS.pptx

  • 2. Learning disabilities learning disabilities are due to genetic and/or neurological factors that alter the brain functions to the point where it affects one or more cognitive processes related to learning. Cognitive function –skill for brain on perception,attention, memory, learning,decision making and language abilities • Interference even when learning foundational skills such as reading, writing and/or math at a younger age. • In older children, they might also interfere with more advanced learning skills including time planning, organizational skills, abstract reasoning, long or short term memory and attention. • The most common signs and symptoms of learning difficulties with reading and writing are highly recognizable during a child's early schooling years. • There are many children with learning disabilities in Malaysia that are not evaluated and go through life with this challenge, even until they graduate to the workforce. 2
  • 3. Risk factors With family history of LD Who live in poverty and understimulating environments Who were born prematurely With other developmental and mental health conditions, such as attention deficit hyperactivity disorder, disruptive behavior disorders, autism, anxiety disorders, and depression. With neurologic conditions (eg, seizure disorders,neurofibromatosis, tuberous sclerosis complex, Tourette syndrome) 3 With chromosomal disorders (eg, fragile X syndrome, Turner syndrome, Klinefelter syndrome) With certain chronic medical conditions (eg, type 1 diabetes mellitus, HIV infection). With a history of central nervous system infection or irradiation or traumatic brain injury.
  • 4. Kurang upaya pembelajaran 20/1/2021 Bengkel 'Training of Trainers" (TOT) Pengendalian Autism Spectrum Disorder(ASD) Global Developmental delay (GDD) (< 5 years) Intellectual Disability (ID) (>5 years) Autism Spectrum Disorder(ASD) Attention Deficit Hyperactive Disorder (ADHD) Specific Learning Disorder (SLD)- e.g Dyslexia, Written Expression, Dyscalculia Downs syndrome neurodevelopmental disorders)
  • 5. a condition diagnosed before age 18 that includes below-average general intellectual function, and a lack of the skills necessary for daily living. this involves the person’s ability to learn, to think, to solve problems and to cope, and have the skills needed to live independently 5 Intellectual Disability Diagnostic criteria in DSM-5 1. Deficits in intellectual functioning 2. Deficits or impairments in adaptive functioning 3. These limitations occur during the developmental period.
  • 6. 1.Deficits in intellectual functioning This includes various mental abilities: • Reasoning; • Problem solving; • Planning; • Abstract thinking; • Judgment; • Academic learning (ability to learn in school via traditional teaching methods); • Experiential learning (the ability to learn through experience, trial and error, and observation). • Measured by IQ test 2.Deficits or impairments in adaptive functioning measured using standardized, culturally appropriate tests. Various skills are needed for daily living: -Communication -Social skills -Personal independence at home or in community settings -School or work functioning Tests available-Vineland adaptive behaviour scales
  • 7. Signs of ID • sit up, crawl, or walk later than other children • learn to talk later, or have trouble speaking, • find it hard to remember things, • not understand how to pay for things, • have trouble understanding social rules, customs, and standards of public behavior. • have trouble seeing the consequences of their actions • have trouble solving problems, and/or have trouble thinking logically • Communications involved impairment in receptive, expressive and pragmatic language functioning • Personal independence at home or in community settings –affected ability of ADL(bathing, dressing), basic and daily task(cooking, cleaning). Others like shopping, assessing public transportation
  • 8. DIAGNOSIS :IQ AND ADAPTIVE FUNCTION ASSESSMENT Intelligent Quotient-test visual/perceptual reasoning, Verbal comprehension Mental age/ chronological age x 100 Normal range of IQ : 80 – 120 GHDAMT-assess more on child development, reliable if child had mental disability In DSM-5, intellectual disability is considered to be approximately two standard deviations or more below the population, which equals an IQ score of about 70 or below 8
  • 11. COMMON TYPES OF LEARNING DISABILITIES IN CHILDREN Dyslexia Difficulty reading Problems reading, writing, spelling, speaking Dyscalculia Difficulty with math Problems doing math problems, grasping maths concepts, understanding time, using money Dysgraphia Difficulty with writing Problems with handwriting, spelling, organizing ideas Dyspraxia (Sensory Integration Disorder) Difficulty with fine motor skills Problems with hand–eye coordination, balance, manual dexterity Dysphasia/Aphasia Difficulty with language Problems understanding spoken language, poor reading comprehension Auditory Processing Disorder Difficulty hearing differences between sounds Problems with reading, comprehension, language Visual Processing Disorder Difficulty interpreting visual information Problems with reading, math, maps, charts, symbols, pictures
  • 12. 12 Elaborate on what you want to discuss. Write Your Topic or Idea
  • 13. Dyslexia difficulty in acquiring and processing language that is typically manifested by the lack or proficiency in reading, spelling and writing. difficulty connecting letters they see on a page with the sounds they make. As a result, reading becomes slow and effortful and is not a fluent process for them. • Problems in reading begin even before learning to read. For example, children may have trouble breaking down spoken words into syllables and recognizing words that rhyme. • Kindergarten-age children may not be able to recognize and write letters as well as their peers. • Difficulty with accuracy and spelling as well. It’s a common misconception that all children with dyslexia write letters backwards or those who write letters backwards all have dyslexia. • often try to avoid activities involving reading when they can (reading for pleasure, reading instructions). They often gravitate to other mediums such as pictures, video, or audio. 13
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  • 19. 2 1 19 Ujian saringan bagi menentukan kebarangkalian murid mengalami masalah pembelajaran spesifik disleksia instrumen disediakan oleh Jabatan Pendidikan Tahap penguasaan mengeja, membaca dan menulis : Kekuatan pada murid Kelemahan yang ditunjukkan. 3
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  • 21. Diagnosis: Clinical diagnosis using DSM 5 for ASD A) Social Communication Interaction (SCI) deficit A①Lack of emotional/ social reciprocity A②Marked impairment in non-verbal communication A③Severe problems in developing and maintaining relationship at appropriate to level (Must fulfilled all 3,A1,A2,A3) B) Restrictive Repetitive behaviour (RRB) ①Stereotyped and repetitive speech, motor mannerisms or use of objects ②Inflexible adherence to non-functional routines, ritualised verbal / non-verbal behaviour, or excessive resistance to change ③Highly restricted patterns of interests, abnormal in intensity or focus ④Unusual interest in sensory aspects of environment, or hyper- / hypo-reactivity to sensory input (Must fulfilled at least 2)
  • 22. Signs and symptoms of possible autism in primary school children (aged 5 – 11 years or equivalent mental age 22
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  • 24. 24 Severity level Social communication Restricted, repetitive behaviours Level 3 "Requiring very substantial support" Severe deficits in social communication skills, very limited initiation of social interactions & minimal response to social overtures from others Inflexibility of behaviour, extreme difficulty coping with change, or other restricted/repetitive behaviours markedly interfere with functioning in all spheres Great distress/difficulty changing focus or action Level 2 "Requiring substantial support" Marked deficits in social communication skills, limited initiation of social interactions & reduced or abnormal responses to social overtures from others Obvious interference with functioning in a variety of contexts Distress &/or difficulty changing focus or action Level 1 "Requiring support" Without supports in place, deficits in social communication cause noticeable impairments Difficulty initiating social interactions & atypical responses to social overtures of others Inflexibility of behaviour causes significant interference with functioning in one or more contexts Difficulty switching between activities Problems of organisation & planning hamper independence
  • 25. 2. Attention deficit hyperactivity disorder (ADHD)3 ○ 53% children with ASD have ADHD ■ 22% - hyperactivity/impulsivity ■ 46% - inattentive ■ 32% - combined ○ Children with ASD who have ADHD ■ are usually younger ■ have a lower mean IQ ASD & CO-MORBIDITY 25
  • 27. Introduction • ADHD is a neuropsychiatric condition • Characterized by 3 main core symptoms which are diminished sustained attention, impulsivity or hyperactivity • Biological basis of ADHD is due to ineffective neurotransmission at PFC involving DA and NE • ADHD affect up to 8% of school-aged children, and up to 60% of those diagnosed continuing to be symptomatic until adulthood • Children with ADHD often have significant impairment in academic function, social and interpersonal situation • ADHD frequently associated with comorbid disorders including learning disorders, anxiety disorders, mood disorders and disruptive behavior disorders
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  • 32. Dsm-5 diagnostic criteria for adhd • A persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development • Six or more symptoms ○ persisted for at least six months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities. ○ symptoms are not solely a manifestation of oppositional behaviour, defiance, hostility, or failure to understand tasks or instructions. ○ for older adolescents and adults (age 17 and older), five or more symptoms are required
  • 33. Dsm-5 diagnostic criteria for ADHD • Several inattentive or hyperactive-impulsive symptoms were present prior to age 12 years • Several inattentive or hyperactive-impulsive symptoms are present in two or more settings (e.g. at home, school, or work; with friends or relatives; in other activities) • There is clear evidence that the symptoms interfere with, or reduce the quality of, social, academic or occupational functioning • The symptoms do not occur exclusively during the course of schizophrenia or another psychotic disorder and are not better explained by another mental disorder (e.g. mood disorder, anxiety disorder, dissociative disorder, personality disorder, substance intoxication or withdrawal)
  • 34. Hyperactive-impulsive symptoms 1. often fidgets with or taps hands or squirms in seat 2. often leaves seat in situations when remaining seated is expected 3. often runs about or climbs in situations where it is inappropriate 4. often unable to play or engage in leisure activities quietly 5. is often "on the go" acting as if "driven by a motor" 6. often talks excessively 7. often blurts out answers before questions have been 8. often has difficulty awaiting turn 9. often interrupts or intrudes on others Impulsivity – difficulty delaying action/response, need for immediate gratification Hyperactivity- excessive physical activity, restlessness
  • 35. Inattention symptoms 1. often fails to give close attention to details or makes careless mistakes in schoolwork, work, or during other activities 2. often has difficulty sustaining attention in tasks or play activities 3. often does not seem to listen when spoken to directly 4. often does not follow through on instructions and fails to finish school work, chores, or duties in the work place 5. often has difficulty organizing tasks and activities 6. often avoids or is reluctant to engage in tasks that require sustained mental effort 7. often loses things necessary for tasks or activities 8. is often easily distracted by extraneous stimuli 9. is often forgetful in daily activities Inattention – a behavioural pattern in which the individual has difficulty initiating, remaining engaged and completing tasks Includes distorted sense of time – underestimate time in relation to tasks and tends to procrastinate
  • 37. Thank you! Write a closing statement or call-to-action here. 37