introduction to learning disability rehabilitation

Introduction to Learning Disorder Rehabilitation

Dr Hashem Farhangdoost

:ارائه شده در

کارگاه تخصصی توانبخشی شناختی

در اختالالت یادگیری96پاییز

Staff Development Resources

Who is a Student with a Learning Disability? 3

Causes of Learning DIFFICULTIES 4

Issues of Definition 6

Definition of Learning Disability 14

Indicators of Learning Disability 19

Identification and Testing 27

Assessment Report 30

Teaching Strategies 36

Course Assessment Accommodations 40

Learning Strategies 44

Support Services 50

Contents

Who is a Student with a Learning Disability?

A student with a Learning Disability is a student with

learning abilities who:

• falls within the range of intellectual ability from

average to superior intelligence;

• is able to learn (including tertiary level subjects);

• has disabilities in one or more of the academic skills

of reading, writing, spelling or mathematics; and

• is able to progress in their learning by navigating

around their learning difficulties.

Causes of Learning DIFFICULTIES

Learning difficulties may be the result of one or more

factors including:

• hearing impairment;

• vision impairment;

• muscular-skeletal impairment;

• brain injury;

• chronic illness (e.g. physical, psychiatric);

• the influence of legal and illegal drugs;

• trauma (physical or emotional);

Causes of Learning DIFFICULTIES cont.

• environmental factors e.g:

o malnutrition;

o poor educational instruction;

o deprivation;

o lack of resources;

o recent arrival in Australia - Non English speaking

background; or

• after excluding the above as cause, Learning

Disability.

Issues of Definition

There is no universally accepted definition of learning disability. In the United Kingdom for example, all learning disabilities are referred to as dyslexia, whereas learning disability is the term used for what we in Australia understand as intellectual or developmental disability.

Learning difficulties verses learning disability is a major issue that is currently being debated across Australian education sectors.

It is of paramount importance to fully comprehend the difference between the two if one is to understand and provide appropriate support

Learning Difficulties Verses Learning Disability

Learning difficulty framework

Learning difficulty is a non-categorical definition, including all those who have difficulties learning one or more of the basic academic skills. The Australian National Health & Medical Research Council estimates 10 -16% of population have learning difficulties.

Learning disability framework

Learning disability is a categorical definition based on diagnosis. The response to a 2002 national survey from 37 Australian universities identified that 12.5% of the student with disability population had disclosed as having a learning disability. University of Tasmania 2002

Learning Difficulties Verses Learning Disability cont.


Does not recognise the term 'learning disability' as

distinct from the term 'learning difficulty'.


Makes a distinction between 'learning difficulties' and

'learning disabilities'. Learning difficulties readily

respond to intensive educational intervention. Learning

disabilities are lifelong and pervasive, and do not

respond readily to intensive education intervention.



Does not focus on the primary cause of the learning difficulty. The focus is on the functional educational difficulties rather than on specific causes, except where the cause may influence the type of educational intervention applied.


Views learning disabilities as being of neurological origin. Views learning difficulties as resulting from specific causes, such as physical, educational, emotional, or environmental factors.



Learning difficulties are viewed as responsive to

intensive educational intervention.


Learning disabilities are viewed as lifelong conditions

which are highly resistant to educational interventions.

Even with intensive, proven educational interventions,

skills do not improve quickly or significantly.



Effective educational intervention will improve basic academic skills such as reading and writing, and will result in an improvement in the individual's academic achievement levels.


Intensive educational intervention alone will assist individuals with learning difficulties, but will provide minimal results for individuals with learning disabilities. Academic adjustments and accommodations, and individualised learning strategies are necessary to enable individuals with learning disabilities to achieve at their ability level.



The term 'learning difficulty' is used by some services,

support groups and peak bodies, as well as in most

areas of primary and secondary education.


The term 'learning disability' is used by universities,

TAFEs, most educational and clinical psychologists,

speech pathologists and in some areas of school

education.



Learning difficulties are not recognised as disabilities under the Disability Discrimination Act and under state disability legislation. Learning difficulties arising from physical, emotional or environmental causes are not covered by the legislation because they are not assumed to be underlying disorders or malfunctions (Puplick, 1995).


Learning disabilities are legally recognised as disabilities. The rights of individuals with learning disabilities are covered by the federal Disability Discrimination Act and by state disability legislation.


Definition of Learning Disability

LD Association of Ontario - Tertiary Level Definition

Learning disabilities refers to a variety of disorders that affect the acquisition, retention, understanding, organisation or use of verbal and/or non-verbal information.

These disorders result from impairments in one or more psychological processes related to learning, in combination with otherwise average abilities essential for thinking and reasoning.

Learning disabilities are specific not global impairmentsand as such are distinct from intellectual disabilities.


Definition of Learning Disability cont.

Learning disabilities range in severity and invariably interfere with the acquisition and use of one or more of the following important skills:

• oral language (listening, speaking and understanding)

• reading (decoding and comprehension)

• written language (spelling and written expression)

• mathematics (computation and problem solving)

Learning disabilities may also cause difficulties with organisational skills, social perception and social interaction.



The impairments are generally life-long. However, their effects may be expressed differently over time, depending on the match between the demands of the environment and the individual's characteristics.

Some impairments may be noted during the pre-school years, while others may not become evident until much later.

During the school years, learning disabilities are suggested by unexpectedly low academic achievement or achievement that is sustainable only by extremely high levels of effort and support.



Learning disabilities are due to genetic, other congenital and/or acquired neuro-biological factors. They are not caused by factors such as cultural or language differences, inadequate or inappropriate instruction, socio-economic status or lack of motivation, although any one of these and other factors may compound the impact of learning disabilities.

Frequently learning disabilities co-exist with other conditions, including attentional, behavioural and emotional disorders, sensory impairments or other medical conditions.



For success, persons with learning disabilities require

specialised interventions in home, school, community

and workplace settings, appropriate to their individual

strengths and needs, including:

• specific skill instruction;

• the development of compensatory strategies;

• the development of self-advocacy skills; and

• appropriate accommodations.


Indicators of Learning Disability

People with learning disabilities will exhibit problems in

SOME of the following areas related to learning:

• Language

• Visual/Spatial Perception

• Language, Memory and Attention - Combined

• Memory

• Attention

• Motor abilities - Gross & Fine

• Social/Emotional


Indicators of Learning Disability cont.

Language

• Spelling difficulties

• Longer to grasp concepts

• Difficulty finding words

• Difficulty with written expression

• Difficulties in analysis and synthesis

• Difficulties following complex instructions

• Abstract concepts may be difficult to grasp without

concrete examples

• Longer to process auditory information

• Word meaning and grammar errors



Visual/Spatial Perception

• Problematic mathematical skills in areas such as space,

direction, and calculation facts (e.g. +, ñ , x, ˜ ) due to

confusion with the mathematical signs

• Reversals or rotations of letters (e.g. ‘p’ & ‘q’, ‘b’ & ‘d’)

• Reversals or rotations of numbers (e.g. ‘5’ & ‘2’, ‘9’ & ‘6’)

• Reversals of words (some ‘mirror’ writing)

• Confusions with words e.g. when writing - using a word

that is similar in appearance to the required word

• Confusion with Left and Right (in space, direction or

position)



Memory

• Difficulty studying for exams

• Works more slowly

• Needs more time to comprehend material

• Slower reading rate

• Organisational problems

• Difficulty with mental problem-solving activities



Attention

• Mental fatigue

• Needs regular and more frequent breaks

• Inconsistency in output

• Organisational problems

• Difficulties focussing on only one line of thought



Language, Memory and Attention – Combined

• Spelling difficulties

• Slow acquisition of new skills

• Inconsistency in learning

• Poor or illegible handwriting

• Difficulty recalling mathematical concepts

• Difficulty sequencing ideas

• Problems in using grammar



Motor abilities - Gross & Fine

• Clumsy movements around the learning area

• Runs into objects and people

• Poor or illegible handwriting

• Slow at handwriting and keyboard writing

• Handles object or field equipment in a slow or clumsy manner



Social/Emotional

• Takes longer to respond and interpret social cues (facial expressions, body language, spoken instructions, peer interaction or interaction with mentors such as educators)

• Has low self-esteem

• Displays frustration, anxiety & tension

• Fails to respond to requests


Identification and Testing

The information provided in the Identification and testing section of OAO II enables those involved in the referral, testing and reporting processes to ensure a consistent and quality approach is maintained within the higher education sector in the identification of learning disabilities within the student population.

www.utas.edu.au/options/identification.htm

There are Guidelines for the Assessment and Documentation of Learning Disability which provide a framework for standardised testing and reporting of learning disabilities to assist in determining study accommodations for students.

www.utas.edu.au/options/assessment_documentation.htm


Identification and Testing cont.

There are several models used by universities for the assessment of learning disabilities. These include internal and external service provision or a combination of both.www.utas.edu.au/options/models_of_assessment.htm

One model which is cost effective for all stakeholders the University Postgraduate Psychologist Assessment Program (UPPAP). www.utas.edu.au/options/uppap.htm

There are also some issues around who should pay for assessments and the age of documentation of learning disabilities. These are discussed in the documentation practices in higher education section.www.utas.edu.au/options/support_documentation.htm


Identification and Testing cont.

The Screening and Referral Tool Kit provides information on the identification of students' learning difficulties and the process for arranging referral for appropriate identification of a learning difficulty.

www.utas.edu.au/options/DLO_tool_kit.htm

The checklists and guidelines in the Kit assist University support staff to identify students' learning difficulties and arrange referrals to appropriate practitioners for accurate diagnosis of the cause/s of the difficulties. Forms are included for referring students for educational psychometric testing for the possible existence of learning disability.


Assessment Report

An Educational Psychometric Assessment Report should include:

• Reason for Referral

• Background Information

• Educational History

• Family and Medical History

• Presentation

• Tests Administered

• Test Results

• Summary and Recommendations


Assessment Report cont.

Summary & Recommendations – Example

The results of the current assessment indicate that Paul is significantly underachieving in basic spelling and reading tasks when compared with his above average cognitive potential. The assessment provides evidence for a learning disability based on the discrepancy between his overall cognitive ability, as assessed by the WAIS-III, and his overall reading and spelling abilities, as measured by the WRMT-R and the WRAT-R.

The difference between his cognitive ability and his reading ability would be expected in only approximately 7% of his same age peers.



It must also be noted that Paul’s processing speed, as

assessed by the WAIS-III, was below average. This

translates into a lack of fluency in copying information

and, when coupled with his slowness in reading printed

material, indicates that he would be experiencing

considerable difficulty. Well below average spelling ability

is also a considerable handicap for him.

Paul’s reading, spelling and processing speed problems

will have a substantial impact on his ability to maximise

his potential at university. Therefore a number of

accommodations are recommended to ensure that he

achieves at a level commensurate with his cognitive

ability.



1. Given the slowness of Paul’s ability to copy notes it would be helpful if he could gain access to material prior to the lecture so that he is able to focus on the lecture rather than on trying to copy notes from the board.

2. For formal assessment by examination Paul requires:

• An additional 15 minutes writing time per hour

• Consideration towards incorrect spelling and grammar

• A reader with an understanding of course terminology

• No more than one exam per day



3. Paul should undertake study skills sessions that cover aspects of basic writing structure, spelling, report writing and development of short-term memory skills from the Learning Skills Unit in order to develop these skills to the best of his ability.

4. Paul should use computer facilities (textHELP Read & Write software or spell check and grammar check as a minimum) for writing.

5. It is suggested that Paul make lists of words pertaining to his area of study as well as lists of commonly used words and regularly review and revise these words so that he can become more confident with his spelling and writing.



6. Paul should use an electronic spellchecker/dictionary to check his spelling and develop competency to the best of his ability.

7. It would be beneficial for Paul to have access to a tutor or peer to proofread his written work for structural and spelling problems.

Although Paul will find the reading and writing aspects of his course more challenging than his peers, his higher than average cognitive abilities and motivation to succeed should mediate these effects.


Teaching Strategies

Most students with LD can perform successfully after minor adjustments or modifications to teaching and assessment methods. Accommodating students with LD must not entail reducing educational standards. Rather the aim is to:

• enhance students' learning through modified and/or different teaching methods and the use of assistive technology and educational materials;

• provide alternative assessment and examination procedures which accommodate students' disability related requirements; and

• allow students the opportunity to demonstrate their ability and knowledge in a fair and equitable way.


Teaching Strategies cont.

Before Semester - Course preparation and planningwww.utas.edu.au/options /course_planning.htm

1. Prepare course materials as early as possible.

• Endeavor to select required reading texts that are available in electronic format (e-text).

• If texts are not available in e-text, it may be necessary to have them audio-taped or transcribed to disk

2. Prepare comprehensive unit/subject outlines.

3. Prepare an environment and personal approach that encourages students with LD to identify themselves to you.

4. Prepare unit guides that help students with the practical tasks involved in learning in your subject area.



During Semester: Giving lectures, seminars and tutorialswww.utas.edu.au/options / lectures_seminars_tutorials.htm

1. Be sensitive about students with learning disabilities being self-conscious in lectures and tutorials - Don't put them on the spot. Give them extra time to think.

2. Encourage students with LD to sit close to the front of classes where visual and auditory cues are clearest.

3. Endeavor to post lecture notes, summaries or outlines of lecture content on the web (to be accessed by using assistive technology) or make hard copies and overheads available prior to lectures.

4. Use demonstrations and concrete examples where possible and relate new or abstract concepts to everyday life.



5. Use a variety of teaching styles and methods appealing to as many senses as possible when presenting material.

6. Encourage students with LD to sit close to the front of classes where visual and auditory cues are clearest.

7. Some disciplines are circumscribed by specialised terminology which cannot be reduced. In such cases, a lexicon of relevant and technical words would be very helpful.

8. If some aspects of subject content are particularly hard to grasp, consider holding additional tutorials that deal with these specific topics.

9. Encourage students who are experiencing difficulties resembling LD to consult the University's Disability, Counselling or Language and Learning support unit's.


Course Assessment Accommodations

Assessment Strategies

The assessment accommodations that are provided for students with LD must be based on knowledge of the individual's disability, the impact of the disability on performance and the effect that assistive aids have on assessment.

A student may have their study assessment requirements in their educational psychometric assessment report. Otherwise the University's Disability Liaison Officer should assist in interpreting the student's requirements.

Students with LD should receive appropriate accommodations and support, but it is not suggested that core elements or 'inherent' requirements of a course be diminished in any way.


Course Assessment Accommodations cont.

Assignments

1. Allow for alternative assignment formats, e.g. oral reports, demonstrations, on video or audio tape.

2. Where sequencing and structuring is problematic, permit students to submit assignments written in 'dot point' rather than essay format.

3. Permit time extensions for written assignments.

4. Allow students with LD to use a proofreader for assignments and/or give separate marks for content and structure.

5. Let students with LD know as early as possible if they are not reaching required standards and refer them to university support services.



Examinations

1. Provide practice exam questions that demonstrate exam format e.g. essay responses or short answer or multiple choice questions (MCQ).

2. Allow extra time. The amount of extra time students require will vary according to the severity of the LD, but an extra 15 to 30 minutes per hour of exam time is common.

3. Allow for alternative format presentation of exams:

• large print;

• electronic (on computer); and

• on coloured paper or with colour transparent overlays.

4. If a student has a working memory problem, change the exam paper from MCQ to essay question format.



5. If a student has a reading and/or processing disorder or a working memory problem, allow for the provision of a reader and scribe.

6. Where there is Dyslexia or other language deficits, allow the student to:

• take lists of commonly used words into the exam; and

• use a computer accessing Spell Check, Dictionary and Thesaurus.

7. Allow for deficiencies in handwriting, grammar and spelling where word processors aren’t used.

8. Consider alternative or supplementary assignment work such as taped interviews, slide presentations, photographic essays, handmade models or brief individual oral question and answer tests.


Learning Strategies

Students with LD can benefit by adopting and using learning strategies that relate to the areas of need as identified in their educational psychometric assessment report.

www.utas.edu.au/options/learning_strategies.htm

The Opening All Options II web resource provides a comprehensive range of learning strategies relating to:

• Memory

• Spelling

• Reading

• Mathematics

• Written Expression

• Lectures


Learning Strategies cont.

Before Starting University

Students can prepare for study by undertaking:

1. Reading and/or writing skills classes to to improve skills as much as is possible.

2. Skills training in time-management, note-taking, memorizing and examination preparation and techniques.

3. Technical skills training in the use of computers for word processing and to check spelling and grammar.

4. Training in the use of electronic pocket spellers or assistive equipment and software that assists with reading and writing.

5. A return to study course.



Before Semester

Students can prepare for start of semester by:

1. Undertaking university study preparation programs, where available.

2. Participating in information technology tutorials or workshops to use the university computer network for email and access to library databases.

3. Undertaking library tours or workshops to become familiar with library procedures, catalogues and databases.

4. Meeting with the Disability Liaison Officer to arrange the required services and study and assessment accommodations.



5. Talking to teaching staff about the implications of LD, course load, possible course adjustments and accommodations.

6. Obtaining unit/subject outlines early to assist with your planning.

7. Developing a wall planner:

• setting realistic study goals and priorities;

• working backwards from important deadlines; and

• planning study time and breaks on a daily basis as well as weekly and for the semester.



During Semester

Students can assist themselves during semester by:

1. Keeping only one diary or calendar for all appointments and dates of assignments and examinations.

2. Seeking assistance from support staff.

3. Joining or forming a co-operative learning groups.

4. Sitting at the front of classes where visual and auditory cues are clearer.

5. Ensuring a full understanding of all assessment requirements before starting work on assignments.

6. Asking someone to read over their written assignments.

7. Writing down questions for discussion later with the tutor or lecturer.



Before Examinations

Students can prepare for examinations by:

1. Ensuring that their exam accommodations are arranged with the Examinations Office several weeks prior to the exam period.

2. Seeking assistance from a counsellor, learning skills lecturer or mentor to develop strategies for studying effectively and stress management.

3. Obtaining copies of previous years' exam papers where available to practice exam technique.

4. Asking lecturers about the format that exams will be in, e.g. essay, short answer or multiple choice.


Support Services

Students with LD can also access assistance from University’s support service providers. Student Counsellors, Disability Liaison Officers and Learning Skills Lecturers provide services at universities that are useful to students with LD.

Counsellors can assist students to:

1. Come to terms with their disability where LD has been newly diagnosed.

2. Develop their organisational skills.

3. Manage stress associated with study.

4. Develop their interpersonal skills.

5. Understand their relationships with lecturers and other students.


Support Services cont.

Disability Liaison Officers can arrange the services, course accommodations and support that students require. This may include:

1. Providing access to a reader service or having essential texts transcribed into accessible format (electronic/disk, audio tape or large print).

2. Arranging access to lecture notes.

3. Discussing course workload and assist decision making about undertaking full time or part time study.

4. Negotiating course adjustments and accommodations with teaching staff.

5. Arranging course assessment accommodations with teaching staff and/or the Examination Office.


Support Services cont.

Learning Skills Lecturers can assist students to develop:

1. Strategies to reinforce their learning.

2. Organisational skills.

3. Essay writing skills.

4. Short-term memory skills.

5. Oral communication skills.

6. Strategies for academic reading and research.

7. Strategies for exam preparation and technique.

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introduction to learning disability rehabilitation

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