Learning disabilities

LEARNING DISORDERS
• Chandril Chandan Ghosh
• Rejin D
• Joel John
• Bichu Andrews
• Flobert Montero
• Bhagyanath
• Anmol Chawla
• Shravan Abraham

WHAT WE INTEND TO COVER:
• Introduction by Chandril
• Signs and symptoms by Bhagyanath
• Causes by Chandril
• Mechanism by Rejin
• Diagnosis by Shravan
• Prevention by Joel
• Management by Flobert
• Prognosis by Anmol
• Recent research by Bichu

WHY THE NEED FOR DISCUSSING
THIS?
• Up to one-third of parents of kids with learning disabilities (LD) don’t feel prepared
to take on the challenge.
• The public is aware of LD but still has some incorrect ideas.
• Kids with LD have more trouble in school and out of school than other kids do.

SYMPTOMS OF DYSCALCULIA
• Difficulty when counting backwards.
• Poor sense of number and estimation.
• Has difficulty in understanding place value and the role of zero in the Arabic
number system.
• Has no sense of whether any answers that are obtained are right or nearly right.
• Tends to be slower to perform calculations.

SYMPTOMS OF DYSCALCULIA
• Forgets mathematical procedures, especially as they become more complex, for
example ‘long’ division.
• Addition is often the default operation. The other operations are usually very poorly
executed (or avoided altogether).
• Avoids tasks that are perceived as difficult and likely to result in a wrong answer.
• Weak mental arithmetic skills.
• High levels of mathematics anxiety.

SYMPTOMS OF DYSLEXIA
• Speech problems, such as not being able to pronounce long words properly and
"jumbling" up phrases
• Poorly organised written work that lacks expression
• Difficulty planning and writing essays, letters or reports
• Difficulties revising for examinations
• Trying to avoid reading and writing whenever possible
• Difficulty taking notes or copying
• Poor spelling
• Struggling to remember things such as a PIN or telephone number
• Struggling to meet deadlines

SYMPTOMS OF DYSLEXIA
• Problems learning the names and sounds of letters
• Inconsistent spelling
• Putting letters and figures the wrong way – such as writing "6" instead "9", or "b"
instead of "d"
• Confusing the order of letters in words
• Reading slowly or making errors when reading aloud
• Visual disturbances when reading – may describe letters and words as seeming to
move around or appear blurred
• Answering questions well orally, but having difficulty writing down the answer

SYMPTOMS OF DYSGRAPHIA
• May have illegible printing and cursive writing (despite appropriate time and
attention given the task)
• Shows inconsistencies: mixtures of print and cursive, upper and lower case, or
irregular sizes, shapes or slant of letters
• Has unfinished words or letters, omitted words
• Inconsistent spacing between words and letters
• Exhibits strange wrist, body or paper position

SYMPTOMS OF DYSGRAPHIA
• Has difficulty pre-visualizing letter formation
• Copying or writing is slow or laboured
• Shows poor spatial planning on paper
• Has cramped or unusual grip - may complain of sore hand
• Has great difficulty thinking and writing at the same time (taking notes, creative
writing.)

AUDITORY PROCESSING DISORDER
• Easily distracted or unusually bothered by loud or sudden noises.
• Noisy environments upsets the individual.
• Behavior and performance improve in quieter settings.
• Difficulty following directions, whether simple or complicated.
• Have reading, spelling, writing, or other speech-language difficulties.
• Difficulty with verbal math problems.
• Disorganized and forgetful.
• Difficulty in following conversations.

GENES AND HEREDITY
• Studies found a child with dyscalculia often has a parent or sibling with similar math
issues.
• If your child has dyslexia, there’s a chance you or another relative may have it too.
Scientists located several genes associated with reading and language processing
issues.
• There may also be a genetic link, with dysgraphia running in families.
• Auditory Processing Disorder (APD) is heavily influenced by our genes say
researchers

BRAIN DEVELOPMENT
• Differences in the surface area, thickness and volume of parts of the brain, linked to
learning and memory, setting up and monitoring tasks and remembering math facts
in dyscalculia.
• MRI studies with dyslexia show different patterns of less electrical activation in parts
of the left hemisphere of the brain involved with reading, such as the inferior frontal
gyrus, inferior parietal lobule, and the middle and ventral temporal cortex.
• Dysgraphia (problems with handwriting) can occur because the brain is starved of
oxygen at birth or through near drowning, sustained high temperature, head injury
or stroke. A working memory problem
• Auditory Processing Disorder can also cause due to premature birth or low birth
weight.

ENVIRONMENT
• Dyscalculia has been linked to exposure to alcohol in the womb. Prematurity and
low birth weight may also play a role in dyscalculia.
• People with dyslexia find it difficult to recognise the different sounds that make up
words and relate these to letters.
• Dysgraphia can result from intentionally poor penmanship, no or inadequate
instruction, and disorientation.
• Auditory processing disorder can be caused by chronic ear infections and lead
poisoning.

BRAIN INJURY
• Studies show that injury to certain parts of the brain can result in what researchers
call “acquired dyscalculia.”
• Acquired dyslexia or alexia may be caused by brain damage due to stroke or
atrophy.
• Dysgraphia can result from brain damage, either from an accident, a severe stroke,
or the existence of Alzheimer’s disease.
• Auditory processing disorder can be caused by head trauma.

DYSCALCULIA
• It was found that the right intraparietal sulcus in children with
developmental dyscalculia was not modulated to the same extent in response
to non-symbolic numerical processing as in typically developing child.
• Children with developmental dyscalculia have a weak magnitude
representation in the parietal region.
• They might have a delayed development in their numerical magnitude
representation.

DYSLEXIA
• Neural systems of reading in the brain’s left hemisphere. An anterior system
in the region of the inferior frontal gyrus (Broca’s area) is believed to serve
articulation.
• A system in the parieto-temporal region is believed to serve word analysis,
and a second in the occipito-temporal region (termed the word-form area) is
believed to be responsible for the rapid, automatic, fluent identification of
words.

DYSGRAPHIA
• Writing represents a highly complex neurodevelopmental process which
involves multiple brain mechanisms.
• It requires the simultaneous and sequential integration of attention, multiple
information sources, memory, motor skill, language, and higher
cognition, Gross and fine motor coordination, motor memory, and
"kinetic melody" ( the automatic rhythm in the physical act of writing),
require balancing, flexing, and contracting movements as well as
simultaneously stimulating some muscle groups while inhibiting other muscle
groups.

CONT..
• In order to self-monitor writing output: visual, proprio-kinesthetic,
automatic motor memory and revisualization feedback mechanisms must
be engaged.
• Visual feedback mechanisms include eye-hand coordination and visual-fine
motor integration.
• Proprio-kinesthetic feedback mechanisms include awareness of the
movement and location of the fingers in space, internal monitoring of
rhythm and rate, and pencil grip.
• .

CONT..
• Motor memory feedback mechanisms include motor plans or engrams,
visual-fine motor coordination to produce symbols, sequentialization,
speed, and accuracy.
• Revisualization feedback mechanisms include visual memory for symbols,
whole word memory, visual attention to detail and spelling.
• All of these skills require developmental readiness and can be improved with
practice

AUDITORY PROCESSING DISORDER
• APD results from impaired “bottom-up” sensory processing and abnormal
neural representation of complex acoustic signals, e.g., speech.
• This may involve lesions in the central auditory nervous system or
functional impairment of basic auditory processing; the central auditory
system begins in the cochlear nucleus of the medulla and ends with the
auditory cortex.

CONT..
• However, some researchers argue that the problem may be entirely cognitive,
primarily affecting attention, memory or language processing, and exerting a
non-specific effect on perception.

DSM IV-TR DIAGNOSTIC CRITERIA FOR
READING DISORDER
• Reading achievement as measured by individually administered standardized tests
of reading accuracy or comprehension, is substantially below that expected given
the person’s chronological age, measured intelligence, and age-appropriate
education
• The disturbance in criterion a significantly interferes with academic achievement or
activities of daily living that require reading skills
• If a sensory deficit is present, the reading difficulties are in excess of those usually
associated with it
• * If a general medical or neurological condition or sensory deficit is present, code
the condition on axis iii

MATHEMATICS DISORDER
• Mathematical ability as measured by individually administered standardized tests is
substantially below that expected given the person's chronological age, measured
intelligence, and age-appropriate education
activities of daily living that require mathematical ability
• If a sensory deficit is present, the reading difficulties in mathematical ability are in
excess of those usual associated with it

DISORDER OFWRITTEN EXPRESSION
• Writing skills as measured by individually administered standardized tests or
functional assessment of writing skills, are substantially below those expected given
the person's chronological age, measured intelligence, and age-appropriate
education
activities of daily living that require the composition of written texts e.g.. Writing
grammatically correct sentences and organized paragraphs.
• If a sensory deficit is present, the reading difficulties in writing skills are in excess of
those usually associated with it

A STANDARD BATTERY OF TESTS CAN
INCLUDE, BUT IS NOT LIMITED TO, THE
FOLLOWING:
• Wechsler Intelligence Scale for Children-Third Edition (WISC-III)
• Kaufman Assessment Battery for Children (KABC)
• Stanford-Binet Intelligence Scale
• Woodcock-Johnson Psycho-Educational Battery
• Peabody Individual Achievement Tests-Revised (PIAT)
• Wechsler Individual Achievement Tests (WIAT)
• Kaufman Tests of Educational Achievement (KTEA)
• Bender Gestalt Test of Visual Motor Perception

• Beery Developmental Test of Visual-Motor Integration
• Motor-Free Visual Perception Test
• Visual Aural Digit Span Test (VADS)
• Test of Auditory Perception (TAPS)
• Test of Visual Perception (TVPS)
• Peabody Picture Vocabulary Test-Revised
• Expressive One-Word Picture Vocabulary Test
• Test for Auditory Comprehension of Language

• PRIMARY PREVENTION
(keeping the disability from occurring in the first place)
• SECONDARY PREVENTION
( correcting the disability after it occurs, or at least keeping it
from getting worse)
• TERTIARY PREVENTION
(keeping the effects of the problem or disability from
spreading to other areas of functioning)

PRIMARY PREVENTION
• Primary prevention in learning disabilities might involve reducing
the chances of brain injury, improving teachers' skills in
instruction and behavior management, or teaching parents child-
rearing skills.
• For primary prevention to work, the strategy must be aimed at
reducing or eliminating the cause(s) of learning disabilities or
protecting against causal factors.

• Primary prevention may reduce the number of children who have
learning disabilities or lessen the severity of the disabilities, but it
will not eliminate learning disabilities.
• Thus, primary prevention is important in keeping the prevalence
of learning disabilities as low as possible. However, it is a
mistake to assume that it will reduce the prevalence to zero.

SECONDARY PREVENTION
• Most of the interventions for learning disabilities involve
secondary prevention, because the child's learning problems have
been noticed and the aim is to correct the problems or prevent
them from getting worse.
• If a special education teacher works not only with students already
identified as having learning disabilities but also with others who
are struggling academically but have not yet been identified, the
teacher may be practicing secondary prevention, both with
labeled students and those not labeled as having learning
disabilities.
• It is impossible to practice secondary prevention without a word
(label) designating the need for special attention or instruction

TERTIARY PREVENTION
• When remedial interventions are initiated long after a learning
disability has developed, the primary goal may be tertiary
prevention.
• For example, if a student has had learning disabilities in reading
that have existed since the early grades and these have not been
corrected, tertiary prevention at the high school level may involve
teaching the student skills that will prevent failure in finding and
holding a job.

• It is possible to practice secondary and tertiary prevention at the
same time and in essentially the same way.
• Secondary prevention addresses existing problems. Tertiary
prevention addresses complications or the development of
additional problems

Management of Dyslexia
Consists of using educational tools to enhance the ability to read.
Individualized Education Program (IEP)
Combination of educational methods
Teacher aide or tutor.

Management For Dyscalculia
Dyscalculia cant be cured but there are therapies that could help your child.
There are no medications that treat dyscalculia but medication could help kids deal
with co-occuring issued like ADHD or anxiety.
There are many non-medical ways to help kids with dyscalculia be successful.
Educational therapy helps kids with different kinds of learning and attention issues
develop strategies for working around their issues and dealing with frustration. An
educational therapist may be able to help your child get better at working with numbers
Speech therapy is also used
Kids with dyscalculia may also have trouble with visual spatial skills.

Management for Dysgraphia
There r several kinds of specialists who can help
Occupational therapy can improve fine motor skills that control hand
movement.
Educational therapy can help kids develop strategies to approach
writing assignments and reduce frustration.
Classroom accomodation

Management for Auditory Processing Disorder
There aren't many scientifically based treatments for auditory processing disorder.
Speech therapy could help with reading and language comprehension.
There are many non-medical ways to help the child with auditory processing disorder.
Sound discrimination is one of the main difficulties
Speech therapy can help kids with auditory processing disorder make those sounds
better and more clearly.
Speech therapy help kids to
1. Improve perception of individual sounds in words can help with reading skills.
2. Develop active listening skills like asking a person a repeat directions
3. Use language appropriately in social situations
 Educational therapy
 Auditory training therapy

DYSLEXIA
• If diagnosed on time, management becomes easy.
• Problems may however persist.
• Mixed
• Remedial reading programs

DYSGRAPHIA
• Prognosis is unpredictable.
• Some individuals improve abilties.
• Persist for most.
• Use of cursive writing.

DYSCALCULIA
• Cant be cured.
• Medications?
• Therapy?

LANGUAGE PROCESSING DISORDER
• Better for children with less severe language impairments. (expressive-only
language disorder)
• Severe LPD, poorer prognosis.
• Early identification, family support for better prognosis.

LD
• Lifelong condition.
• Several overlapping LD’s
• Isolated LD.

• Booth and Burman (2001) found that people with
dyslexia have less gray matter in the left parieto
temporal area than non dyslexic individuals. Having
less gray matter in this region of the brain could lead
to problems processing the sound structure of
language (phonological awareness).
• People with dyslexia also have less white matter in
this same area, which could lessen the ability or
efficiency of the regions of the brain to communicate
with one another. (Deutsch, Dougherty, Bammer, Siok,
Gabrieli, & Wandell, 2005)
RECENT STUDIES -DYSLEXIA

• Shaywitz (2002) studied 144 right handed children with and
without RD & found that the normal children had more
activation in the areas for reading in the left hemisphere and
less in the right hemisphere than the children with RD.
• Children with RD, disruption in the rear reading systems in the
left hemisphere that are critical for skilled, fluent reading leads
the children to try and compensate by using other, less efficient
systems in the right hemisphere.
• Children with dyslexia often show greater activation in the
lower frontal areas of the brain. This leads to the conclusion
that neural systems in frontal regions may compensate for the
disruption in the posterior area (Shaywitz, 2003)

• Kadosh(2007) discovered that a specific part of the brain was
associated with automatic magnitude processing. Used fMRI in order
to show that the intraparietal sulcus (IPS)had a role in the ability to
recognize numbers.
• Children with developmental dyscalculia were found to have less
gray matter in the left IPS.
DYSCALCULIA

 Viginia Berninger- normal children had more white matter
connections, which facilitate functional connections in gray
matter for language processing and cognitive thinking.
 Bt children with dysgraphia showed less white matter connections
and more functional connections to gray matter locations in other
words, their brains had to work harder to accomplish the same tasks.
 People with dysgraphia face difficulties related to fine & gross
motor movements, balancing & regulating movements, flexibility,
understanding of time,money, info retrieval
.etc(Sakineh,Razieh,Abolfazl,2014)
DYSGRAPHIA

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