When is it a learning disability?

Here's a rough guide to what constitutes an LD, and how to get kids the help they need

Whenever the teacher asked a question, Kyra Hope was always the first in her grade-one class to shoot her hand up with the right answer. But her reading was laboured and her writing virtually non-existent; she started falling behind. Her private school recommended a $2,500 assessment for learning disabilities (LDs). The psychologist’s verdict: Kyra was a bright, sociable and engaging child with no LDs. Yet Kyra continued to struggle. Her parents transferred her to a public school, but the problems persisted.

Kyra’s mother, Belinda, wasn’t willing to wait up to two years for a publicly funded assessment. She paid another $2,500 for a second assessment, by another private psychologist. This brought a radically different diagnosis: LDs severe enough to warrant special accommodation. Now in a tiny class of seven with two teachers (one with an LD herself) in a public school in Richmond Hill, Ont., eight-year-old Kyra is happier than she’s been in some time. The third-grader says proudly, “Today at school, I read a book and only made one mistake.” Her mom, meanwhile, is keeping her fingers crossed.

Learning disabilities affect how kids perceive, think, remember, understand or use verbal or non-verbal information. They are caused by genetic or neurobiological factors, including injury and exposure to toxic heavy metals, such as lead. (The Learning Disabilities Association of Canada, or LDAC, considers attention deficit hyperactivity disorder to be a distinct disorder and not an LD, although the two conditions can coexist: About one-third of kids with LDs also have ADHD.)
LDs are staggeringly common. It’s estimated that they affect one in 10 people, which means a typical classroom of 25 averages two or three kids with LDs. Kids with LDs have average to above-average IQs, explains Judy Kerr, executive director of LDAC, although they are often mistakenly assumed to be intellectually limited. In fact, while they have a range of abilities, they actually function at grade level intellectually. Some even exceed the scholastic expectations for their age group, which is very different from kids with developmental delays. With the right help, kids with LDs can not only learn, but accomplish great things, possibly because of their out-of-the-box thinking. Albert Einstein, Thomas Edison, Whoopi Goldberg, Leonardo da Vinci, Alexander Graham Bell and Tom Cruise all achieved remarkable success despite their LDs.

Trouble is a lot of kids don’t get the right help. The criteria for what constitutes an LD, and for the best ways to evaluate a child, vary widely across the country. “In every province, city, school board and school, there are radically different approaches and standards,” says David Philpott, an associate professor of education at Memorial University of Newfoundland in St. John’s. The result: a mishmash of services and a growing industry of expensive private special education, essentially creating a two-tier education system.

That often leaves parents in the position of having to do their own LD research. But data about LDs isn’t conclusive and studies are still ongoing, so it’s important not to be alarmist. “One sign by itself does not constitute a diagnosis,” says Elizabeth Walcot, a long-time LD researcher. “It’s the combination of a number of these signals that may denote a problem.” She adds that these indicators lie along a continuum: Everyone mixes up letters sometimes, but doing it excessively could indicate an LD.

While a professional assessment is necessary to determine whether and what kind of LD a child has, Kerr points out that “a lot of parents have already seen the clues at home and know there’s something hindering their child’s ability to learn.” Here are some guidelines for what to watch for as possible LD signs. Keep in mind, though, that there can be a great deal of crossover, and few children fall under a single category.

Auditory problems

Since kids start to talk before they start to read, the first LDs to appear are often auditory problems based on faulty perception of language (as opposed to physical hearing problems, which must be ruled out by your child’s physician). Kids with these problems tend to develop language late — after age two — and to mispronounce words. It’s normal for a two-year-old to say pasghetti instead of spaghetti, or hostipal instead of hospital; it may be a concern when a four- or five-year-old is still jumbling those letters.

These children have difficulty hearing the ending sounds of words, such as distinguishing between bag and bad, which makes them uninterested in rhyme. They can’t easily hear breaks between words in a phrase. They might hear bow and arrow as bone arrow. They have trouble following a fast-paced TV show or conversation.

They tend to have small vocabularies, limited to simple words. They might say, “I don’t want that thing for lunch.” When you say, “You mean a sandwich?” they’ll understand, but can’t come up with the word themselves.

If you speak quickly, they’ll miss some of what you say. If you give several orders, such as “Put your glass on the table, grab an apple and wait for me by the door,” they’ll forget one or two. You may find yourself saying, “I’ve asked you four times to get your shoes on!” while you look in frustration at your barefoot child.

As these kids try to read, they may have great difficulty sounding out letters and words. They may forget what sound t-h-i-s makes, even after encountering the word five times on the same page.

Visual-processing problems

As early as age two or three, kids with visual-processing problems may have difficulty with simple positional directions, such as up, down, over and under. They often reverse left and right, setting a table exactly backward to what you have requested.

Despite having vision problems ruled out by an eye doctor, these children may have difficulty seeing details in a picture or distinguishing foreground from background. If an activity sheet asks them to find the 10 rabbits hidden in the illustration, they may not find any.

Because they have trouble with left and right, they struggle to read print. They easily skip a line and lose their place. They may have a hard time with sequences, such as learning the alphabet or the days of the week. They often reverse letters and numbers when they read or write; for example, did may become bib.

Instructions at the top of a worksheet (“Circle all the pictures of the foods you like to eat, and put an X over the foods you don’t like”) can sometimes be beyond them. As they get older, following a written recipe, such as on the back of a mac-and-cheese box, is impossible. They may struggle with maps.

Motor problems

Children with gross-motor problems appear clumsy. They’re awkward at throwing a ball or figuring out a climbing structure. As they get older, they struggle with sports or dance. “You only worry if this is compounded with other deficits,” says Walcot. “Kids with other kinds of LDs who are athletic are often admired and do well socially, but kids with LDs who also don’t do well athletically can have a tougher time.”

Kids with fine-motor problems tend to have poor hand-eye coordination. As toddlers, they can’t put a peg in a hole. In preschool, they can’t use scissors or get the paste on the paper. They don’t draw; they scribble. As they get older, they have difficulty copying letters, even their own name. They may be able to tell you how to spell cat, but struggle to form the letters on the page themselves.

Organizational problems

Kids with these kinds of LDs have trouble planning, monitoring and completing tasks. They can’t organize their time or their surroundings. Even by age six or seven, they don’t understand what “We’re leaving in five minutes” means. Their beds, rooms and desks may be unusually messy and they can’t find anything, but they don’t have the first clue how to tidy up. They may set out to build a Lego house, but they can’t plan how to do it.

In school, they can’t meet deadlines. On a test, they may use up the whole time to work on the first question. They have trouble understanding that to complete a project, they have to start early.

Conceptual problems

This category encompasses non-verbal learning disabilities (NLDs), which is a controversial area, with possible overlap into Asperger’s syndrome and mental health issues. But the LDAC considers an NLD to be a bona fide learning disability. A child with an NLD may have a great vocabulary, a good memory and an excellent grasp of detail, but miss the bigger picture. He may be a good reader, but a poor comprehender.

Kids with NLDs misread facial expressions and tones of voice. If you say, “Oh, great, I have to have a root canal!” they may take you literally and think you’re pleased. They don’t get most subtleties, sarcasm or jokes. They often don’t know how to make or keep friends, or engage in conversation. They’re impulsive and can monopolize a group. Socially awkward and uncomfortable, they tend to be loners with high levels of anxiety or depression.

Getting your child assessed

A good assessment should include a thorough history — compiled through interviews with the child, parents and teacher — that looks at social, emotional and behavioural indicators. It should use testing instruments that give in-depth measures of how a child processes information. These tools may include pictures, books, tapes and a current IQ test.

Before submitting your child to testing
• Find out who will be assessing your child. Ask about her training and experience.
• Trust your instincts — you know your child best. “I’ve assessed over a thousand kids and I’ve yet to shock a parent,” says Philpott.
• Ask for jargon to be explained in lay terms. A phrase like “figure-ground discrimination” is not helpful. Make sure everything makes sense to you.

Since research in this area supports the benefit of early intervention, look for ways to access as much help for your child as possible. “Many expenses are eligible for the federal government’s medical expense tax credit, which will give you a percentage back, based on income,” says Claudette Larocque, LDAC’s director of public policy and programs. These expenses include private assessment, tutoring, adaptive software, speech therapy and LD summer camps.
Philpott urges parents to work to change the system. “Parents are leading the way by continuing to rock the boat,” he says. And just as it’s crucial to keep advocating for your child, so is it important to teach him to advocate for himself. “You can’t take that responsibility away from the kid,” Walcot says. “Just teaching him when to say, ‘I need help’ is a good step forward.”

Report card

Canada misses the mark on learning disabilities
Between long wait times for publicly funded assessments and the lack of standardized diagnostic criteria, learning disabilities are often misunderstood and misdiagnosed. Adds David Philpott, an associate professor of education at Memorial University of Newfoundland in St. John’s: “There isn’t a province in the country that requires new teachers or new psychologists to have any specific training in learning disabilities.”

Assessing and accommodating kids with LDs is expensive, but the cost of not dealing with LD problems is even greater. Kids with LDs are twice as likely as the general population to drop out of high school, according to a groundbreaking study entitled Putting a Canadian Face on Learning Disabilities, published by the non-profit Learning Disabilities Association of Canada (LDAC) in 2007.

The study also found that when kids with LDs reach their 20s, they have much higher rates of depression, anxiety, suicidal thoughts, migraine and backache. “LD children are more highly stressed from younger ages, which may make them more vulnerable to other physical and mental health problems,” says co-principal investigator Lex Wilson, a professor of psychology and director of the Meighen Centre for Learning Assistance and Research at Mount Allison University in Sackville, NB.

Since LDs are lifelong, the losses can keep piling up: Between ages 30 and 44, almost half of adults with LDs are unemployed, compared to only 11 percent of the general population, the study reported. According to the LDAC, the cost of LDs to Canadian society, including social service programs, is $3 trillion.

For more information, contact: The Learning Disabilities Association of Canada, ldac-taac.ca; NLD Ontario, nldontario.org; or the US-based LD OnLine, ldonline.org.

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