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Learning Disorders

By Stephen Brian Sulkes, MD, Golisano Children’s Hospital at Strong, University of Rochester School of Medicine and Dentistry

Learning disorders involve an inability to acquire, retain, or broadly use specific skills or information, resulting from deficiencies in attention, memory, or reasoning and affecting academic performance.

  • Affected children may be slow to learn names of colors or letters, to count, or to learn to read or write.

  • Children take a series of academic and intelligence tests given by learning specialists.

  • Treatment involves a learning plan tailored to the child’s skills.

Learning disorders are quite different from intellectual disability (previously called mental retardation) and occur in children with normal or even high intellectual function. Learning disorders affect only certain functions, whereas in children with intellectual disability, difficulties affect cognitive functions broadly.

Three common types of learning disorders are

  • Reading disorders

  • Disorders of written expression

  • Mathematics disorders

Thus, children with learning disorders may have significant difficulty understanding and learning math, but have no difficulty reading, writing, and doing well in other subjects. Dyslexia is the best known of the learning disorders. Learning disorders do not include learning problems that are due primarily to problems of vision, hearing, coordination, or emotional disturbance, although these problems can also occur in children with learning disorders.

Although the causes of learning disorders are not fully understood, they include abnormalities in the basic processes involved in understanding or in using spoken or written language or numerical and spatial reasoning.

Although the number of children with learning disorders is unknown, about 5% of the school-age population in the United States receives special educational services for learning disorders. Boys with learning disorders may outnumber girls five to one, although girls are often not recognized or diagnosed as having learning disorders.

Many children, particularly those with behavioral problems, do poorly in school and are tested by educational psychologists for learning disorders. However, some children with certain types of learning disorders hide their deficits well, avoiding diagnosis, and therefore treatment, for a long time.

Did You Know...

  • Learning disorders can occur in children with normal and high intellectual function.

Symptoms

Young children may be slow to learn the names of colors or letters, to assign words to familiar objects, to count, and to progress in other early learning skills. Learning to read and write may be delayed. Other symptoms may be a short attention span and distractibility (mimicking attention-deficit/hyperactivity disorder), speech/language problems, difficulty understanding spoken information, and a short memory span. Affected children may have difficulty with activities that require fine motor coordination, such as printing and copying.

Children with learning disorders may have difficulty communicating. Some children initially become frustrated and later develop behavioral problems, such as being easily distracted, hyperactive, withdrawn, shy, or aggressive.

Diagnosis

  • Educational, medical, and psychologic evaluations

Children who are not reading or learning at the grade level expected for their verbal or intellectual abilities should be evaluated. Testing of hearing and eyesight should be done, because problems with these senses can also interfere with reading and writing skills. Hearing and vision disorders should not be mistaken for a learning disorder.

Doctors examine children for any physical disorders. Children take a series of intelligence tests, both verbal and nonverbal, and academic tests of reading, writing, and arithmetic skills. Often these tests can be done by specialists at the child’s school, at the parents’ request. In the United States and other nations, schools are required by law to provide testing and appropriate accommodations.

Treatment

  • Educational management

The most useful treatment for a learning disorder is education that is carefully tailored to the individual child.

The federal Individuals with Disabilities Education Act (IDEA) requires public schools to provide free and appropriate education to children and adolescents with learning disorders. Education must be provided in the least restrictive, most inclusive setting possible—where the children have every opportunity to interact with nondisabled peers and have equal access to community resources.

Measures such as eliminating food additives, taking large doses of vitamins, and analyzing the child’s system for trace minerals are often tried but unproven. No drug treatment has much effect on academic achievement, intelligence, and general learning ability. Because some children with a learning disorder also have attention-deficit/hyperactivity disorder, certain drugs, such as methylphenidate, may improve attention and concentration, enhancing their ability to learn.

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* This is the Consumer Version. *