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Fact Sheets

Learning Disabilities (LD) describe any condition affecting a person's ability to learn in the school environment to the level expected by their skills in other aspects of life. Persons with learning disabilities typically have intelligence in the ranges common to the general population, they are not "retarded" or "cognitively impaired". These people may have been premature, had some minor injury to their head, or may have no known problems. The limitation that leads to the condition called, learning disability involved difficulty or an inability to interpret visual and auditory stimuli and to integrate information processed by the brain. Difficulties may be isolated or encompass many aspects of learning including difficulties with written language, reading, calculating numbers, spelling, and communicating effectively.

Common symptoms/Course of the disease

• Disorders of Motor Function - This may range from clumsiness to poor performance in gross or fine motor performance, to deficits in equilibrium, motor planning, or sensorimotor problems.
• Educational Disorders - This can occur in a broad area of educational subjects. Skills that are often deficient are copying from one source to another (ex. Taking notes from a blackboard), writing (cursive and printing), organization, understanding directions (oral and written), the reversal of letters, cutting, coloring, drawing, and staying oriented to page while reading.
• Disorders of Attention and Concentration - This can include deficits ranging from short-attention span to perseveration (oral and verbal).
• Disorders of Thinking and Memory - This includes problems with general short and long-term memory, as well deficits in the ability for abstract reasoning.
• Problems with Speech and Communication - This may include physical problems such as slurring words or cognitive deficits in word sequencing or making "small talk".
• Auditory Difficulties - These problems are often not from hearing problems, but from auditory perceptual and memory problems.
• Sensory Integration and Perceptual Disorders - These children may have difficulty with tasks that require visual perceptual skills (ex. Laterality and directionality concepts)
• Psychosocial Problems - These children's social competencies may be delayed when compared to their chronological age, and they are also at a marked risk for low self-esteem. (Case-Smith, 2001)

Age of Onset: These disabilities are often not associated with a specific neurological insult, but likely present from birth. The parent or caregiver may not notice these deficits until school age when the child is along side children of a similar chronological age.

Sex Bias: LD's are more common in males than females. The ratio is 4:1. (Case-Smith, 2001)
Cultural Biases: LD's affect up to 10% of the population, and 5% of students in US public schools. These students also have a dropout rate 1.5x higher than the average. LD's are also found in 10%-20% of individuals diagnosed with Conduct Disorder, Oppositional Defiant Disorder, Attention-Deficit/Hyperactivity Disorder, Major Depressive Disorder, or Dysthymic Disorder. (Case-Smith, 2001; Rapoport & Ismond, 1996)

Current Medical Treatment: This is variable and dependent upon the specific deficits noted by the physician. Treatment could involve the following professionals: neuropsychologist, psychiatrist, certified reading specialist, occupational therapist, and/or educational consultant. A psychiatrist may recommend certain drugs in some instances, but treatments are usually focused on educational strategies.

Occupational Therapy Involvement

An occupational therapists involvement may change as the child develops. While the child is still young, sensory integration, play, socialization, and self-help skills may be addressed through early intervention and parent education. As the child enters schools, additional treatments such as social play, perceptual motor integration, and writing skills may be added as needed. As the child progresses into adolescence the goal of the occupational therapist shifts to ultimately enabling the client to live independently and be a contributing member of society. Treatments at this level may focus on developing independent living skills, vocational skills, or psychosocial skills. (Case-Smith, 2001)

Specific treatment strategies could include:

• Accommodations: Providing computer software with spell and grammar check, as well as giving more time to complete assignments.
• Relaxation therapy
• Stress management
• Behavioral rehearsal
• Assistive technology: Computers, and communication devices are examples of what could be recommended.
• Environmental adaptation: Decreasing or increasing the stimulation in the learning environment, changing the heights of tables, and exploring different types of seating are all options.
• Metacognitive teaching: The selection of the most effective way to learn, which may be through systematic practice or the use of a recording device.
• Multi-sensory teaching: Incorporates multiple sensory channels to enhance learning.
• Sensory integration therapy: This technique involves using controlled sensory stimulation during a self-directed activity.
  (Stein & Roose, 2000)

Referrences:

• Stein, F., Roose, B. (2000). Pocket guide to treatment in occupational therapy. San Diego, California: Singular Publishing Group.
• Rapoport, J. L., Ismond, D. R. (1996). DSM-IV training guide for diagnosis of childhood disorders. New York: Brunner/Mazel, Inc.
• Case-Smith, J. (2001). Occupational therapy for children. St. Louis, Missouri: Mosby, Inc.

How OT Makes a Difference: Evidence-Based Practice

Solan, Larson, Shelley-Tremblay, Ficarra, Silverman. (2001). Role of visual attention in cognitive control of oculomotor readiness in students with reading disabilities. Journal of Learning Disabilities, 34(2), 107-118.

This article studied children with reading disabilities in Grade 6. Both therapies, eye movement and comprehension, were found to be effective and suggest a cognitive link between visual attention, oculomotor readiness, and reading comprehension.

Anecdotal Reports

I conducted an interview with Mrs. K. Mrs. K’s child has been receiving occupational therapy intervention for approximately one month at the time of this interview. Her child, diagnosed with learning disability, visits the outpatient clinic twice a week and is treated by an OTR.

Mrs. K states that the OTR considered her and her child’s’ needs by involving them in the treatment and evaluation process. This was done by asking both her and her child what they each thought was important and what they wanted to choose as therapy goals. The types of activities that they worked on were copying letters and words from the board, and developing better coordination. Mrs. K also stated that the reasons for these treatments were explained to her, and this helped her get more involved in the sessions. The treatments were only started a month ago, but Mrs. K has noticed slight improvements in her child and a slight progression in the difficulty level of the therapy.

The major benefit of OT treatment for Mrs. K and her son is increased self-esteem, but they have also noticed improvements in his school performance. The treatments have also helped Mrs. K to learn different ways practice on the specific deficit areas of her child. When I asked Mrs. K if she had any recommendations to make, either positive or negative, she said, “It (OT treatment) is definitely worth it. Very helpful.”

Client Handout

• Learning Disabilities Handout (PDF File)

Web Links

Please note that the inclusion of these websites in no way endorses or recommends any of the products or information that may be offered, whether for sale or free.

• ABLEDATA
  http://www.abledata.com
  This website offers a wide list of Assistive Technology products, as well as a description of each. The National Institute on Disability and Rehabilitation Research, and U.S. Department of Education sponsors it. This site also lists prices and manufactures of the products listed, but one should consult with a qualified professional before making any decisions to purchase. It is also recommended that this site be used primarily to familiarize oneself with what is available in Assistive Technology.
• PBS/WBGH - Misunderstood Minds
  http://www.pbs.org/wgbh/misunderstoodminds/index.html
  This is a follow up to a PBS documentary “Misunderstood Minds”. It provides information about LD’s and lets the reader review the personal stories of children who are living with LD’s. This is a unique website in that it has programs designed to simulate learning disabilities for people who are otherwise “normal”.
• Learning Disabilities Association
  http://ldanatl.org/
  This is an organization that offers a support network for parents of children with learning disabilities, as well as provides information on advocacy.
• National Center for Learning Disabilities
  http://ncld.org/
  This is a great site that allows the reader keep current on relevant topics that involve learning disabilities.
• National Institute of Mental Health
  http://www.nimh.nih.gov/publicat/learndis.htm
  This a government sponsored website that is nearly all text, but very informative. It also recommends places to receive support, as well as recommending readings for specific populations.