Helping You Become All You are Capable of Becoming
Learning Disabilities and ADHD
6. Learning Disabilities and Attention Deficit Hyperactivity Disorder (ADHD) Tools for Getting Parents Involved in the Exceptional Education Process By James J. Messina, Ph.D. & Constance M. Messina, Ph.D.
Learning Disabilities The term "learning disabilities" describes a neurobiological disorder that affects people's ability to either interpret what they see and hear, or to link information from different parts of the brain.
These limitations can show up as specific difficulties with: * spoken language * written language * coordination * organization * socialization * self-control * attention.
Such difficulties extend to school work and can impede learning to read or write, or to do math.
A learning disability is a lifelong issue. With the right support and intervention, however, children with learning disabilities can succeed in school and go on to successful, distinguished careers later in life.
Parents can help children with learning disabilities achieve such success by: * encouraging their strengths * knowing their weaknesses * understanding the educational system * working with professionals and * learning about strategies for dealing with specific difficulties.
Facts About Learning Disabilities * Fifteen percent of the U.S. population, or one in seven Americans, has some type of learning disability, according to the National Institutes of Health. * Difficulty with basic reading and language skills are the most common learning disabilities. As many as 80 percent of students with learning disabilities have reading problems. * Learning disabilities often run in families. * Learning disabilities should not be confused with other disabilities such as mental retardation, deafness, blindness and behavioral disorders. None of these conditions are learning disabilities. In addition, they should not be confused with lack of educational opportunities like frequent changes of school or attendance problems. Also, children who are learning English as a second language do not necessarily have a learning disability. * Attention disorders, such as Attention Deficit/Hyperactivity Disorder (ADHD) and learning disabilities often occur together and display similar characteristics.
Common Learning Disabilities Dyslexia is a language-based disability in which a person has trouble understanding words, sentences or paragraphs. Dyscalcula is a mathematical disability in which a person has a difficult time solving arithmetic problems and grasping math concepts. Dysgraphia is a writing disability in which a person finds it hard to form letters or write within a defined space. Auditory and Visual Processing Disabilities are processing/sensory disabilities in which a person has difficulty understanding language despite normal hearing and vision. Common Signs of Learning Disabilities The good news about learning disabilities is that scientists are learning more every day, and their research provides hope and direction. If parents, teachers and other professionals discover a child's learning disability early and provide the right kind of help, it can give the child a chance to develop the skills needed to lead a successful and productive life. A recent National Institutes of Health study showed that 67 percent of young students who were at risk for reading difficulties became average or above average readers after receiving help in the early grades. Parents are most often the first to notice that "something doesn't seem right." If you are aware of the common signs of learning disabilities, you will be able to recognize potential problems early. The following checklist of characteristics may point to a learning disability. Most people will, from time to time, see one or more of these warning signs in their children. This is normal. If, however, you see several of these characteristics over a long period of time, consider the possibility of a learning disability.
Preschool Signs of a Learning Disability * Speaks later than most children * Experiences pronunciation problems * Has slow vocabulary growth, often unable to find the right word * Shows a lack of interest in story telling * Has difficulty rhyming words * Experiences trouble learning numbers, alphabet, days of the week, colors or shapes * Displays poor memory for routines * Is extremely restless and easily distracted * Has difficulty sitting still * Shows a lack of persistence at tasks * Has trouble interacting with peers * Struggles to follow directions or routines * Fine motor skills slow to develop * Has trouble learning self-help skills (tying shoelaces) * Clumsiness * Is reluctant to draw or trace * Has trouble learning left from right
Grades K to 4 signs of a Learning Disability * Is slow to learn the connection between letters and sounds * Confuses basic words (run, eat, want, was) * Makes consistent reading and spelling errors including letter reversals (b/d), inversions (m/w), transpositions (felt/left) and substitutions (house/home) * Transposes number sequences and confuses arithmetic signs * Has trouble following directions * Is slow to remember number facts * Has difficulty learning new skills, or relies heavily on memorization * Impulsive and has difficulty planning * Makes careless errors * Distractibility increases * Has organizational problems * Demonstrates unstable pencil grip * Struggles with letter formation * Has trouble learning about time and other math concepts * Demonstrates poor coordination, unaware of physical surroundings, prone to accidents
Grades 5 to 8 signs of a Learning Disability * Reverses letter sequences (soiled/solid, left/felt) * Slow to learn prefixes, suffixes, root words and other spelling strategies * Avoids reading aloud * Has poor reading comprehension * Lacks verbal participation in class * Struggles with word problems * Has difficulty with handwriting * Demonstrates an awkward, fist-like or tight pencil grip * Avoids writing compositions * Slow or poor recall of number facts * Fails to demonstrate strong automatic memory * Inconsistent * Shows poor self-monitoring skills * Can't discern relevant detail * Demonstrates poor learning strategies * Disorganized in time or space * Experiences peer rejection * Has difficulty making and keeping friends * Struggles to understand body language and facial expressions
High School and Adulthood signs of a Learning Disability * Continues to spell incorrectly, frequently spells the same word differently in a single piece of writing * Avoids reading and writing tasks * Has trouble summarizing * Struggles with open-ended questions on tests * Demonstrates a weak grasp of information * Experiences foreign language problems * Has poor written expression * Mental fatigue * Weak memory skills * Has difficulty adjusting to new settings * Works slowly * Demonstrates a poor grasp of abstract concepts * Either pays too little attention to details or focuses on them too much * Misreads information
What to Do Next: 10 Steps Parents Can Take 1. Know your child's strengths. Children with learning disabilities are often highly intelligent, possess leadership skills or are superior in music, arts, sports or other creative areas. Rather than focusing solely on your child's deficiencies, emphasize and reward your child's strengths. Encourage your child in areas of interest outside the classroom.
2. Collect information about your child's performance. Meet with your child's teachers, tutors and school support personnel to understand performance levels and attitude toward school. Observe your child's ability to study, complete homework, and finish tasks that you assign at home.
3. Have your child evaluated. Ask school authorities to provide a comprehensive educational evaluation including assessment tests. Tests for learning disabilities are referred to as assessment tests because they evaluate and measure areas of strength and weakness. A comprehensive evaluation, however, includes a variety of procedures in addition to the assessment tests, such as interviews, direct observation, reviews of your child's educational and medical history and conferences with professionals who work with your child. Either you or the school can request this evaluation, but it is given only with your written permission. Since you are one of the best observers of your child's development, it is important that you be an active participant in the evaluation process. If you don't understand the test results, ask questions.
4. Work as a team to help your child. If the evaluation indicates a learning disability, your child is eligible for special education services. If eligible, you will work with a team of professionals, including your child's teacher, to develop an Individualized Education Program (IEP). The IEP is a written document summarizing your child's current educational performance; annual goals and short-term objectives; the nature and projected duration of your child's special services; and methods for evaluating progress. For students 14 years and older, an IEP must include a transition plan to move the student into the "real world."
5. Talk to your child about learning disabilities. Children with learning disabilities must be assured that they are not dumb or lazy. They are intelligent people who have trouble learning because their minds process words or information differently. It is important to be honest and optimistic--explain to your child that he struggles with learning, but that he can learn. Focus on your child's talents and strengths.
6. Ask for classroom accommodations. Teachers can change classroom routines to help children with learning disabilities. Meet with your child's teacher about these possibilities, including reading written information aloud, allowing extra time on tests, taping lessons and using technology.
7. Monitor your child's progress. Watch your child's progress to be sure that her needs are being met. Keep your child's education folder up to date, adding new samples of schoolwork and test results. If she is not making progress, discuss your observations with school personnel and work together to make changes.
8. Know your legal rights. Learn about your special education rights and responsibilities by requesting s summary of legal rights in your native language from your child's school. The Individuals with Disabilities Education Act (IDEA) ensures your child has the right to a "free and appropriate public education."
9. Organize information about your child. Start a folder of all letters and materials related to your child's education, and add copies of school files and names and dates of all tests and results, including medical exams and information from other professionals. Collect samples of schoolwork that demonstrate your child's difficulties as well as strengths. Keep a contact log of discussions with professionals, as well as a log of your own observations.
10. Work with your child at home. Parents are a child's first and best teachers. Show your child that reading can be fun: Read to your child every day, visit the library frequently, play word games, and point out words on billboards and traffic signs as you drive, on food labels at the grocery store, on packages, mail and letters. Set an example by giving your child a chance to see you reading and writing at home, and show an interest in your child's homework by inquiring about the subjects and the work to be done. Ask questions that require answers longer that one or two words. Help your child organize homework materials before beginning, and establish a regular time with your child to do homework. Find a specific place for your child to do homework that has plenty of light, quiet and work space. Encourage your child to ask questions and search for answers, and take the time to figure out correct answers. Make sure your child backs up answers with facts and evidence. Practice school-taught skills at home and relate homework to your child's everyday life. Praise your child for both the small steps and the big leaps in the right direction.
Parent Strategies for helping their children cope with learning disabilities
Attention The following activities may help easily distracted children learn to focus their attention:
1. Set a timer for 5 or 10 minutes and ask your child to "fasten his seat belt." Until the bell rings, he must sit and focus his attention on playing a game or reading a story. The time limit can be gradually increased as his attention span improves.
2. Play Concentration (a card game that relies on visual memory) or Simon (the electronic sound and lights game) to stretch visual attention.
3. To improve auditory memory, read your child a story and ask her to clap when she hears a certain word or the name of a given character.
4. When giving your child instructions, sit or stand nearby. Ask the teacher to seat your child up front so that he can see and hear what's going on more clearly.
Organization To reduce confusion and keep your child's day on something of a steady course, parents can do the following:
* Keep a special box for boots, gloves and school supplies near the front door. This will reduce off-to-school hassles and give the child a more orderly start to the day.
* If your child is constantly forgetting books, consider buying or borrowing extra copies of textbooks to keep at home.
* Post your child's appointments and long-term school assignments on a special bulletin board. For daily assignments, ask the teacher to write them herself in a notebook that you can check when your child gets home.
* Store your child's clothes, toys and other belongings on open shelves rather than in closets or cabinets. He'll make more of an effort to keep things in order if he can't close a door and forget the mess.
* Set a good example. Even if it is hard for you, make an effort to be on time, to keep a calendar, to maintain a shopping list and other regular schedules so your child can learn by imitation.
There are several kinds of memory deficits. The following activities may help with auditory and visual memory problems:
* The "trip" game is a means to enhance auditory memory. You start off by saying, "I'm going on a trip and I'm going to take..." Then you name an item that you would take. The child repeats your sentence, then adds another item. Keep taking turns until one of you loses track. Then start over.
* Ask your child to name as many colors (fruits, toys, car names, whatever) as she can in 30 seconds.
* If your child has good visual memory but poor retention of what you tell him, try to make concepts concrete. Assemble 25 pennies and place them beside a quarter.
* If memorizing facts is a problem, give your child extra drills. Mnemonic devices may help.
Handwriting There are several reasons for handwriting problems--poor eye-hand coordination, perceptual deficits, physical clumsiness or a combination of these difficulties. Whatever the source, bad handwriting can have a devastating effect on school performance. The following activities may help your child with handwriting difficulties:
* Give your child thick pencils and wide-ruled paper. These make the physical task of writing easier.
* Let your child practice anyway he finds enjoyable. Some children like to write with a stick in the dirt or write with a tool in shaving cream. Any kind of practice is good and should be encouraged.
* Once the teacher is aware of the problem, school assignments can be modified so the child isn't penalized for her writing difficulties.
* Teach your child to use a typewriter or a computer to complete written assignments.
* Ask for alternatives to assignments and tests. Some teachers are even willing to let kids take tests orally and dictate their assignments into a tape recorder.
Spelling The following procedures may help your child deal with the spelling problems:
* Typewriter and computer programs with built-in "spell checkers" are a help to children and adults with spelling problems.
* Spelling deficits shouldn't be permitted to damage your child's performance in other academic areas.
* Don't ask your child to look up words he can't spell. If he can't spell the word, he probably can't find it in the dictionary. It's better to tell him the correct spelling, or write it down and let him practice it.
* For many children, spelling problems are the result of handwriting difficulties. The physical act of writing is so demanding that many children forget to include letters, or they write them so badly, no one can read them. Let your child try spelling with magnetic letters or Scrabble tiles.
Mathematics For many children, math is simply a foreign language. They have no number sense or grasp of the abstract concepts. The following activities may help with these difficulties:
* Teach your child how to use a calculator. This will help her learn and keep her from being hindered by the disability.
* Give him practical experience with numbers. Focus on "survival" skills such as telling time and counting money. Play store or take him shopping and let him make purchases.
Socialization Social rejection is often a problem for learning disabled children. They often have trouble interpreting other people's body language and facial expressions, so they can't tell when their classmates are angry or kidding, playing or serious. As a result they often give inappropriate responses that irritate their peers.
* Encourage your child to spend time with peers in controlled situations such as scouting and camps that stress cooperation, not competition.
* Arrange social situations for your youngster. Observe your child with others. Later, use role-playing to teach your child correct behaviors.
Classroom Strategies For Improving Comprehension 1. Make sure that the student's vision has recently been checked.
2. Make certain the student is reading material on her level. If not, modify or adjust the reading material to the student's ability level.
3. Make sure the reader knows the purpose for the reading. If he is reading for enjoyment only, he will read differently than if he is being asked to look for specific information.
4. When the student has comprehension questions to answer, have her look over the questions before she begins to read so that she will be prepared when she comes to that information. Have her keep the questions and a pencil next to her as she reads so she can write down the answer or the page on which it can be found.
5. Teach the student to use context clues to identify the meaning of words and phrases not known.
6. Prerecord the student's reading material and have him listen to the recording while simultaneously reading the material.
7. Have the student read ahead on a subject to be discussed in class so that she is familiar with the new vocabulary and concepts that will be used during instructional time.
8. Outline reading material for the student using words and phrases on his reading level.
9. Arrange a peer who demonstrates good comprehension skills to read with the student and help her with the meanings of words not understood, comprehension strategies and ways to locate answers to comprehension questions.
10. Have the student take notes while reading in order to increase comprehension.
11. Teach the student to draw from personal learning experiences to enhance comprehension of reading material. Provide a variety of learning experiences at school in order to expand the student's background of knowledge.
12. Maintain mobility in the classroom in order to frequently be near the student to provide reading assistance.
13. Have the student verbally paraphrase material just read.
14. Teach the student to identify main points.
15. Underline or highlight important points before the student reads the material silently.
16. Have the student outline, underline or highlight important points in reading material.
17. Have the student read progressively longer segments of reading material in order to build comprehension skills.
18. Reduce the emphasis on competition. Competitive activities may make it difficult for the student to comprehend what he reads.
19. Use a sight vocabulary approach in order to teach the student key words and phrases when reading directions and instructions.
20. Have the student list new or difficult words in categories.
21. Have the student maintain a vocabulary notebook with definitions of words whose meaning are not known.
22. When the student encounters a new word or one whose meaning is not understood, have her practice making up sentences in which the word can be used in correct context.
23. Make certain the student learns dictionary skills in order to find the meanings of words independently.
24. Introduce new words and their meanings to the student before reading new material.
25. Make certain the student learns the meanings of all commonly used prefixes and suffixes.
26. Write notes and letters to the student to provide reading material that he will want to read for comprehension.
27. Give the student time to read a selection more than once, emphasizing accuracy over speed.
28. Determine whether or not the student can make inferences and predictions and determine cause-effect in everyday experiences. Teach these skills in contexts that are meaningful to the student in order to enhance the ability to employ these concepts when reading.
29. Have the student prepare "test" questions based on information that has been read in order to enhance the ability to focus on key elements of the reading material.
30. Include frequent written assignments on topics that are of interest to the student in order to reinforce the correlation between writing and reading ability.
31. Avoid subjecting the student to uncomfortable reading situations, such as reading aloud in a group or reading with time limits.
32. Stop the student at various points throughout a reading selection to check for comprehension.
33. Reduce the amount of information on a page if it is causing visual distractions for the student by including less print to read or fewer pictures.
34. Highlight or underline important information the student should pay close attention to when reading.
35. Make it pleasant and positive for the student to ask questions about things not understood.
36. Have the student use a highlighter pen to highlight the facts requested by the teacher.
37. Have the student listen and take notes when concepts are being presented and identify the "What, How, Where, When and Why" in the text.
38. Have students map reading materials.
Classroom Strategies for Solving Math Problems 1. Make sure that the student's inability to read is not the cause of her difficulty in solving math word problems.
2. Have the student read the math word problem first silently, then aloud and identify the mathematical operation required.
3. Provide word problems that require a one-step process, making certain that the sentences are short and concise.
4. Teach the student to look for "clues" or "keywords" in word problems that indicate the mathematical operations.
5. Have the student orally analyze the steps required to solve word problems. Encourage questions such as "What is given?" "What is asked?" and "What operation is used?"
6. Represent the numerical amounts, in concrete forms.
7. Have the student write a number sentence after reading a math word problem.
8. Have the student create word problems for number sentences.
9. Have the student restate math word problems in his own words.
10. Ask the student to identify the primary question that must be answered to solve a given word problem. Continue this activity using more difficult word problems containing two or more questions. Make sure the student understands that questions are often implied rather than directly asked.
11. Have the student make up word problems. Other students in the classroom can then solve these problems.
12. Supplement textbook problems with teacher-made problems. These problems can deal with classroom experiences. Include students' names in the word problems to make them more realistic and meaningful to the student.
13. Use word problems that are of interest to the student and related to her experiences.
14. Make certain the student reads through the entire word problem before attempting to solve it.
15. Teach the student to break down each math word problem into specific steps.
16. Have the student solve math word problems by manipulating objects.
17. Help the student recognize common patterns in math word problems.
18. Discuss and provide the student with a list of words or phrases that usually indicate an addition operation, such as together, altogether, sum, in all, both, gained, received, total, won and saved.
19. Discuss words and phrases that usually indicate a subtraction operation, including difference, between, from, left, how many (more, less), how much (taller, farther, heavier), withdrawal, spend, lost, remain and more.
20. Discuss words and phrases which usually indicate a multiplication operation: area, each, times, product, triple and twice.
21. Discuss words and phrases that usually indicate a division operation, like into, share, each, average, monthly, daily, weekly, yearly, half as many, and quotient.
22. Teach the student to convert words into their numerical equivalents to solve word problems: 2 weeks = 14 days, 1 year = 12 months, one quarter = 25 pennies.
23. Teach the student relevant vocabulary often found in math word problems, including but not limited to dozen, amount, triple and twice.
24. Allow the student to use a calculator when solving problems.
25. Require the student to read math word problems at least twice before beginning to solve the problem.
26. Before introducing complete word problems, present the student with phrases to be translated into numbers: "6 less than 10 equals" is "10 - 6 =", for example.
27. Assign a peer to act as a model for the student and to demonstrate how to solve math word problems.
28. Reduce the number of problems assigned to the student at one time.
29. Demonstrate step-by-step how to solve math word problems by reading the problem and then solving the problem on paper while the student observes.
30. Correlate word problems with computation procedures just learned in the classroom.
31. Teach the student the meaning of mathematical terms including sum, dividend, quotient and product.
32. Highlight or underline key words in math problems.
33. Make sure the student has a number line on her desk to use as a reference.
34. Develop a math reference sheet for the student to keep at his desk outlining the steps used in various processes.
35. Recognize quality work, display it and congratulate the student for her accomplishments.
36. Have the student act as a peer tutor to teach a peer a math concept that the student has mastered. This can serve as reinforcement for the student.
37. Provide practice in solving math word problems by using a computer software program that gives the student immediate feedback.
38. Have the student manipulate objects--apples, oranges, toys, cars--as the teacher describes the operation.
39. When writing math problems, have the student use graph paper to keep the numbers lined up in straight columns so that one number is in one box.
40. Have the student turn lined notebook paper to the side, so that he can line up his numbers in the proper columns.
Attention Deficit Hyperactivity Disorder (ADHD)
What ADHD Looks Like: Inattention/Distractibility: * doesn't seem to listen * fails to finish assigned tasks * often loses things * can't concentrate * easily distracted * daydreams * requires frequent redirection * can be very quiet in classroom and missed
Hyperactivity/Over-Arousal * restlessness * "can't sit still" * talks excessively * fidgeting * "always on the go" * easy arousal * unnecessary bodily movement
Different Names for ADHD Through the Years: * 1902 Defects in moral character * 1934 Organically driven * 1940 Minimal Brain Syndrome * 1957 Hyperkinetic Impulse Disorder * 1960 Minimal Brain Dysfunction (MBD) * 1968 Hyperkinetic Reaction of Childhood (DSM II) * 1980 Attention Deficit Disorder - ADD (DSM III) - with hyperactivity - without hyperactivity - residual type * 1987 Attention-deficit Hyperactivity Disorder (DSM III-R) - Undifferentiated Attention Deficit Disorder (DSM III-R) * 1994 Attention-Deficit/Hyperactivity Disorder (DSM IV) - 314.01: ADHD, Combined Type - 314.00: ADHD, Predominantly Inattentive type - 314.01: ADHD, Predominantly Hyperactive-Impulsive Type Diminished Proficiency in Four Executive Functions Due to ADHD 1. Prolongation: Holding and evaluating events in working memory 2. Separation and regulation of affect: Splitting facts from feelings 3. Internalization of language: Reflection, self-control, will power 4. Reconstitution: Break events into parts and reassemble into new ideas
Purposes of the four executive functions: * Self-regulation * Organization of behaviors across time * Directing behavior toward the future * Maximization of future consequences * Increased control over the environment * Conforming the environment to self
Consequences of diminished proficiency in executive functions: * Deficient self-regulation of behavior, mood, response * Impaired ability to organize/plan behavior over time * Inability to direct behavior toward the future * Diminished social effectiveness and adaptability How ADHD affects an Individual? Input : Output Visual : Cognition Auditory : Emotion Tactile : Behavior Rule-Outs for the Diagnosis of ADHD -rule out Gifted or Mentally Handicapped through an IQ Test -rule out Learning Disability by Academic-Perceptual Processing Tests -rule out Neurological Conditions (Seizures, Brain Lesion or Tourette's Syndrome) by Pediatric Neurologist through use of Neurological Evaluations through EEG, 24 hours EEG, MRI, CAT Scan -rule out Behavioral or Emotional Problems through a Psycho-Social History and Personality Testing How to Evaluate for ADHD after the Rule-Outs are Done: * Parent Interview * Parent and School Behavioral Ratings * Consistent History of ADHD like Behaviors * Classroom Observations * Behavioral Observations in Testing/Interviewing * Relevant History: - Family member(s) has ADHD-like problems - Pregnancy and birth history - Early infancy and developmental milestones - Previous school and at home history Causes and Contributing Factors of ADHD 1. Genetics--there is a strong hereditary link with ADHD-like symptoms 2. Fetal development: * Premature babies have higher risk of ADHD like symptoms * Trauma/infection/complications in during pregnancy can result in child being at risk for ADHD like symptoms 3. Fetal exposure to drugs and alcohol: many children who were exposed during pregnancy to drugs and/or alcohol have a greater risk for having ADHD like symptoms 4. Birth Factors which increase the risk of children having ADHD like symptoms are: * Prolonged or induced labor * Type of delivery can have impact if sudden, or extremely long and slow delivery * Weight at birth if below 5 lbs. a greater risk 5. Post-birth factors: * Cranial bleeding * Seizures * Concussion/coma 6. Abnormalities of brain structure * Frontal lobe involvement 7. Lead poisoning 8. Related medical conditions that look like ADHD * Hypothyroidism * Seizures * Mental retardation/autistic spectrum/Tourette's syndrome Effective Treatment Model of ADHD in a Child After a diagnosis has been made that a child has ADHD like symptoms then the behavioral team needs to insure that: Encourage the Parent to be a Consistent Pathfinder Parenting Team Home Modifications with logical and natural consequences Creation of strong Parent-Teacher Team with home and school strong communications 504 Plan with an Individual Education Plan for Classroom Modifications Consistency of Parent/Teacher Behavioral Team Unconditional Love from all Adults in Child's World Use of Medications as Last Resort