CESAR CHESTER O. RELLEVE, Ed D, RGC

The terms “specific learning disorder” (used by the medical community) and “specific learning disability” (used by the schools) refer to a neurodevelopmental problem in which a child of normal intellectual potential.

Diagnostic Criteria

A. Difficulties learning and using academic skills, as indicated by the presence of at least one of the following symptoms that have persisted for at least 6 months, despite the provision of interventions that target those difficulties:

1. Inaccurate or slow and effortful word reading

2. Difficulty understanding the meaning of what is read

3. Difficulties with spelling

4. Difficulties with written expression

5. Difficulties mastering number sense, number facts, or calculation

6. Difficulties with mathematical reasoning

B. The affected academic skills are substantially and quantifiably below those expected for the individual’s chronological age, and cause significant interference with academic or occupational performance, or with activities of daily living, as confirmed by individually administered standardized achievement measures and comprehensive clinical assessment.

C. The learning difficulties begin during school-age years but may not become fully manifest until the demands for those affected academic skills exceed the individual’s limited capacities.

D. The learning difficulties are not better accounted for by intellectual disabilities, uncorrected visual or auditory acuity, other mental or neurological disorders, psychosocial adversity, lack of proficiency in the language of academic instruction, or inadequate educational instruction.Note; The four diagnostic criteria are to be met based on a clinical synthesis of the individual’s history (developmental, medical, family, educational), school reports, and psychoeducational assessment.

is an innate neurobiological process and refers to the integration and interpretation of sensory stimulation from the environment by the brain.

In contrast, sensory integrative dysfunction is a disorder in which sensory input is not integrated or organized appropriately in the brain and may produce varying degrees of problems in development, information processing, and behavior.

A general theory of sensory integration and treatment has been developed by Dr. A. Jean Ayres from studies in the neurosciences and those pertaining to physical development and neuromuscular function.

The theory is used to explain the relationship between the brain and behavior and explains why individuals respond in a certain way to sensory input and how it affects behavior. The five main senses are:

Touch - tactile

Sound - auditory

Sight - visual

Taste - gustatory

Smell - olfactory

In addition, there are two other powerful senses:

a) vestibular

b) proprioception

Sensory integration focuses primarily on three basic senses--tactile, vestibular, and proprioceptive. Their interconnections start forming before birth and continue to develop as the person matures and interacts with his/her environment. The three senses are not only interconnected but are also connected with other systems in the brain.

1. Tactile System: includes nerves under the skin's surface that send information to the brain.

2. Vestibular System: refers to structures within the inner ear (the semi-circular canals) that detect movement and changes in the position of the head.

3. Proprioceptive System: refers to components of muscles, joints, and tendons that provide a person with a subconscious awareness of body position.

is based on the idea that some kids experience “sensory overload” and are oversensitive to certain types of stimulation, their brains have trouble processing or filtering many sensations at once.

Other kids are under sensitive to some kinds of stimulation, they don’t process sensory messages quickly or efficiently.

These children may seem disconnected from their environment. In either case, kids with sensory integration issues struggle to organize, understand and respond to the information they take in from their surroundings.

Sensory integration therapy exposes children to sensory stimulation in a structured, repetitive manner. The theory behind this treatment approach is that, over time, the brain will adapt and allow them to process and react to sensations more efficiently.

Sensory integration therapy can be fun for kids because it resembles playtime. It usually takes place in a specially designed setting where kids are encouraged to play with balls of different sizes, textures and weights. Therapy sessions often involve playing with clay and other materials. Children may also be asked to bounce, swing or spin on special equipment.

The therapist gradually makes these activities more challenging and complex. The idea is that through repetition, a child’s nervous system will respond in a more “organized” way to sensations and movement. Sometimes sensory integration therapy is paired with balance treatments or movement therapy. This type of therapy may involve going through an obstacle course, throwing a ball and standing on a balance board.

Common Types of Learning Disabilities

Dyslexia Difficulty reading Problems reading, writing, spelling, speaking

Dyscalculia Difficulty with math Problems doing math problems, understanding time, using money

Dysgraphia Difficulty with writing Problems with handwriting, spelling, organizing ideas

Dyspraxia Difficulty with 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

LEARNING DISABILITIES IN READING (DYSLEXIA)There are two types of learning disabilities in reading. Basic reading problems occur when there is difficulty understanding the relationship between sounds, letters and words. Reading comprehension problems occur when there is an inability to grasp the meaning of words, phrases, and paragraphs.

Signs of reading difficulty include problems with:

• letter and word recognition

• understanding words and ideas

• reading speed and fluency

• general vocabulary skills

A child with a math–based learning disorder may struggle with memorization and organization of numbers, operation signs, and number “facts” (like 5+5=10 or 5x5=25). Children with math learning disorders might also have trouble with counting principles (such as counting by 2s or counting by 5s) or have difficulty telling time.

Learning disabilities in writing can involve the physical act of writing or the mental activity of comprehending and synthesizing information. Basic writing disorder refers to physical difficulty forming words and letters. Expressive writing disability indicates a struggle to organize thoughts on paper.

Symptoms of a written language learning disability revolve around the act of writing. They include problems with:

neatness and consistency of writing

accurately copying letters and words

spelling consistency

writing organization and coherence

Reading, writing, and math aren’t the only skills impacted by learning disorders. Other types of learning disabilities involve difficulties with motor skills (movement and coordination), understanding spoken language, distinguishing between sounds, and interpreting visual information.

refers to problems with movement and coordination whether it is with fine motor skills (cutting, writing) or gross motor skills (running, jumping). A motor disability is sometimes referred to as an “output” activity meaning that it relates to the output of information from the brain.

Language and communication learning disabilities involve the ability to understand or produce spoken language.

Language is also considered an output activity because it requires organizing thoughts in the brain and calling upon the right words to verbally explain something or communicate with someone else.

The eyes and the ears are the primary means of delivering information to the brain, a process sometimes called “input.” If either the eyes or the ears aren’t working properly, learning can suffer.

Professionals may refer to the ability to hear well as “auditory processing skills” or “receptive language.” The ability to hear things correctly greatly impacts the ability to read, write and spell. An inability to distinguish subtle differences in sound, or hearing sounds at the wrong speed make it difficult to sound out words and understand the basic concepts of reading and writing.

– Problems in visual perception include missing subtle differences in shapes, reversing letters or numbers, skipping words, skipping lines, misperceiving depth or distance, or having problems with eye–hand coordination. Professionals may refer to the work of the eyes as “visual processing.” Visual perception can affect gross and fine motor skills, reading comprehension, and math.

1. Problematic pregnancies, occurring before, during, and after delivery causing injury whether minimal or severe to brain and brain dysfunction

2. Biochemical imbalance cause by intake of food with artificial food colorings and flavorings.

3. Environmental factors caused by emotional disturbance, poor quality of instruction and lack of motivation

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013.

Acero, Victorina D., et al. Child and Adolescent Development. Manila: Rex Bookstore, 2008

http://www.childrenshospital.org/conditions-and-treatments/conditions/learning-disorders-and-disabilities

http://www.autism.com/symptoms_sensory_overview

http://www.ldonline.org/article/5612/

http://www.helpguide.org/articles/learning-disabilities/learning-disabilities-and-disorders.htm

http://dyslexiahelp.umich.edu/professionals/students-strengths-and-interests/case-studies

http://bsrlm.org.uk/IPs/ip28-1/BSRLM-IP-28-1-04.pdf

http://files.eric.ed.gov/fulltext/EJ967123.pdf

http://dera.ioe.ac.uk/13779/1/task15.pdf

http://www.austincc.edu/apreview/PhysText/PNSafferentpt2.html

http://www.asha.org/public/speech/disorders/Aphasia/