Learning Disorders and Academic Problems

A Brief Review

A clinical disorder: a _________of symptoms that significantly ________ an ________’s ability to ________, and is characterized by a particular ________ picture with a specifiable ______, _______, _______, _______, and response to _________, and associated _______, ________, and _______ correlates.

Intellectual Disability Brief Review

Prevalence Rate? _____

Three Primary Diagnostic Criteria for ID:

A.Deficits in _______ _______sB.Deficits in _______ _______sC.Onset of both types of deficits during the _______ period.D.4 Levels of specifiers: mild, ______, severe, & _______ based on adaptive functioning, not IQ.

Characteristics of Learning Disorders:

1. Children with LD have marked difficulty learning to read, write, or perform mathematics. These academic skill problems are believed to be due to dysfunction in underlying psychological processes.

2. Genetics often play a role in LD. Learning problems run in families and monozygotic twins usually show strong concordance for LD. Genes are believed to cause subtle abnormalities brain structure, functioning, perception, memory, and information processing which, in turn, interfere with learning.

3. Children with LD show marked deficits in academic achievement. If untreated, these deficits persist over time; they do not simply reflect delays in the acquisition of academic skills. Children with LD are not simply “slow learners” or academic “late bloomers.”

4. Although children’s intelligence and academic achievement are correlated, LDs are not caused by low intelligence or Mental Retardation.

5. LDs are not caused by emotional problems (e.g., test anxiety, depression), socioeconomic deprivation (e.g., malnutrition, poverty), or impoverished educational experiences (e.g., low quality schools). Although these factors can exacerbate children’s learning problems, they do not cause LD.

Learning Disorders (DSM-IV-TR)

• Reading Disorder

• Disorder of Written Expression

• Mathematics Disorder

Diagnosed when the person’s achievement in reading, mathematics, or written expression is “substantially below” the level of achievement expected based on her intelligence.

The individual’s learning problems must also interfere with her academic performance or her ability to perform tasks that require academic skills.

The person’s low academic performance cannot be attributed exclusively to Mental Retardation or pervasive developmental disorders, visual or hearing impairments, differences in language or cultural background, or impoverished educational experiences.

Learning Disability (PL 94-142; IDEA, 2004)

• Oral expression• Listening comprehension• Written expression• Basic reading skill• Reading fluency skills• Reading comprehension• Mathematics calculation• Mathematics problem solving

The term “specific learning disability” means a disorder in one or more of the psychological processes involved in understanding or in using language…which may manifest itself in an inability to listen, speak, read, write, spell, or do mathematical calculations. The term does not include children who have LD which are primarily the result of visual, hearing, or motor handicaps, or mental retardation, or emotional disturbance, or of environmental, cultural, or economic disadvantage (US Department of Education, 1977, p. 650863).

Methods to diagnose learning disabilities:

(1) IQ-Achievement discrepancy

Child shows a significant discrepancy between scores on an IQ test and at least one domain of a test of academic achievement; although this is

one of the most popular assessment methods it may lack empirical support as a means to identify learning problems in children

(2) Intra-Individual discrepancy

Child show a significant relative deficit in an area of cognitive functioning based on the results of an individually-administered, standardized test;

this significant relative deficit is associated with distress or impairment

(3) Responsiveness to Intervention

Child does not respond to “scientific, research-based” teaching methods; children who fail to show academic improvement relative to their peers,

despite progressively more in intensive tutoring, may be classified

Epidemiology

Overall prevalence: 4%-6% of school age children received special education services because of a learning disability

As many as 20% may have significant learning problems

Gender: In treatment, boys outnumber girls (1.6:1)

In the community, equally common in both genders

Ethnicity/SES: Ethnic minority youth and youth from low-SES families are two to three times more likely to be classified

Course: Learning problems often persist into adulthood if they are not targeted for treatment in early elementary school

Reading Disorder: Basic Reading Skills

Basic reading skills involve four processes; children with reading problems often show difficulty in each of these processes:

1. Letter recognition

2. Phoneme awareness

3. Basic phonics skills

4. Decoding unfamiliar words using phonemic mediation

Three brain regions are especially important:

• left occipital-temporal region (for processing “sight” words)

• left temporo-parietal region (Wenicke’s area; for phonological decoding)

• left inferior frontal region (Broca’s area; for processing word meaning)

Left occipito-temporal cortex – a small area (viz., the left fusiform gyrus) is critical to our ability to recognize ‘familiar’ words, and our ability to read quickly and rapidly.

Left inferior frontal cortex –a portion of Broca’s and Wernicke’s areas– is responsible for decoding unfamiliar words (converts graphemes into phonemes); also used to help us understand the meaning of words and its association with other words.

Methods to teach phoneme awareness

Phoneme isolation: Recognizing individual sounds in wordsTell me the first sound in paste. Answer: /p/

Phoneme identity: Recognizing common sounds in different wordsTell me the sound that is the same in bike, boy, and bell. Answer: /b/

Phoneme categorization: Recognizing the phoneme that does not belongWhich word does not belong: bus, bun, rug? Answer: rug

Phoneme blending: Listening to separately spoken phonemes and combining them to form a spoken word

What word is /s/ /k/ /u/ /l/? Answer: school

Phoneme segmentation: Breaking words into sounds by counting phonemesHow many sounds are in ship? Answer: three (/sh/ /i/ /p/)

Phoneme deletion: Recognizing the word that remains when a phoneme is deleted

What is smile without the /s/? Answer: mile

From National Reading Panel. (2000).

Direct Instruction

Step1: The teacher explicitly states the goals for the lesson. Today, we are going to learn how to read words that contain the letters “st” and make the sound /st/. By the end of the lesson, you will be able to read words that have /st/ in them.

Step2: The teacher breaks down material into small steps, giving students the chance to practice each step.Here are the letters “st.” What are the letters? (Child answers: “st.”)They make the /st/ sound. What sound do they make? (Child answers: /st/.)

Step3: Teacher provides clear and detailed instructions.Let’s practice some words that start with /st/. All of these words begin with the /st/ sound.

Ready? (Teacher gives examples.)

Step4: Teacher provides guidance during initial practice.Start with this word. (Teacher points to each part of the word as child reads it.)

Step5: Teacher provides systematic feedback and corrects child’s mistakes immediately.Now read this word. (Child correctly reads stop.)Good. Now this one. (Child incorrectly reads the word stem.)No. The word is ‘stem’. Read it again with me.

Step6: Teacher gives additional practice, either during seatwork, homework, or during the next lesson.During the last lesson, we learned about words that begin with /st/. Today, we’re going to

practice a few more /st/-words.

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Phonemic awareness Reading Ability Spelling

Outcome

Normal

At Risk

Disabled

Effects of phoneme awareness training. Children who receive systematic instruction in phoneme awareness showed greater gains in phoneme skills, reading, and spelling compared to children who do not receive training in phoneme awareness. Training can improve the phoneme and reading skills in normal children, at-risk children, and youth with reading disabilities. Based on National Reading Panel. (2000).

Effects of systematic phonics instruction on reading. Children who receive systematic phonics training, especially before 2nd grade, show improvements in basic reading, spelling, and reading comprehension compared to children who do not receive systematic phonics instruction. Based on National Reading Panel. (2000).

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Reading familiarwords

Reading novelwords

Spelling Comprehension

Outcome

Reading Disorder: Fluency and Comprehension Problems

Reading fluency

The ability to read rapidly, accurately, and with proper expression. Fluent readers recognize words quickly, attend to important words in sentences more than unimportant words, and emphasize certain words so that sentences make sense

Reading comprehension

The capacity to read text for meaning, to remember information from the text, and to use information to solve problems or share with others. Reading comprehension is an active process in which children construct meaning from what they read

Double-deficit model (Wolf & Bowers, 1999)

Explains the relationship between basic reading skills, reading fluency, and reading comprehension

1. Some children show problems with basic reading skills and reading comprehension

2. Some children show adequate basic reading skills but problems with reading fluency

3. A small group of children show both impairments in basic reading/comprehension skills and poor reading fluency. These children show the greatest level of reading problems overall

Few children show deficits only in comprehension; children who show only reading comprehension problems usually have deficits in the comprehension of spoken language too.

Effects of guided oral reading. Guided oral reading is associated with increases in children’s fluency and comprehension. Based on National Reading Panel. (2000).

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Reading Achievement

Accuracy

Speed

Comprehension

Techniques to improve reading comprehension:

Cooperative learning: Children read and discuss text with peers. Peers help each other understand material. This technique is associated with increased comprehension and more advanced strategies for analyzing text.

Graphic organizers: Children represent material from the text using charts, graphs, or pictures. Students might underline or highlight key terms or connect ideas with arrows. This strategy is often used in science and social studies classes. It is associated with improved memory for text.

Question answering: Children answer teachers’ questions about the text. This technique is effective in improving children’s recall of important ideas or themes.

Question generation: Children generate their own questions while reading. Readers might ask themselves who, what, when, where, and why. This method increases reading comprehension among youth in 1st through 12th grades.

Story structure: Children learn to identify elements of stories, such as the main characters, the plot, and the timeline of events. This technique is particularly effective with younger readers and readers who have marked deficits.

Summarization: Children identify the main idea of a passage and connect information in the text to the main idea. This technique is especially effective for older children.

Multiple strategy instruction: Teachers combine two or more of the above strategies in flexible ways. For example, a teacher might have students read a story, generate questions, summarize the main points, and draw a timeline of events. The use of multiple strategies is generally more effective than the use of single techniques.

Activating background knowledge: Teachers encourage students to recall information relevant to the passage before reading. For example, before reading a passage about Vikings, teachers might ask students to tell all that they know about Vikings.

Explicit teaching of vocabulary: Teachers provide students with systematic instruction on word meaning to make sure they understand individual words in the text.

Disorder of Written Expression:

Writing involves several important skills; children with writing problems often show deficits in one or more of these skills

1. Planning the writing task

2. Translation

3. Review

Effects of SRSD on writing. Children who participate in SRSD show improvements in four areas of writing compared to youth who receive traditional writing instruction. SRSD is associated with improvements in both average readers and children with learning disabilities. Based on Graham and Harris (2003).

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Quality Elements Grammar Length

Writing Outcomes

All students

Students with LD

Key Features of SRSDSuspend Judgment– Consider each side before taking a position. Brainstorm ideas for and against the topic.• Did I list ideas for each side? If not, do this now.• Can I think of anything else? Try to write more!• Another point I haven’t considered yet is...Take a Side– Read your ideas. Decide which side you believe in or which side can be used the make the strongest argument. Place a + on the side that shows your position.Organize Ideas– Choose ideas that are strong and decide how to organize them for writing.• Put a star next to the ideas you want to use. Choose at least ___.• Choose at least ___ arguments to refute.• Number your ideas in the order you will use them.Plan More as You Write– Continue to plan as you write. Use all four essay parts in DARE.• Develop your Topic Sentence• Add Supporting Ideas• Reject Arguments on the Other Side• End with a Conclusion

Mathematics Disorder:

Higher-order math skills are dependent on several foundational skills in computation, math reasoning, and verbal abilities; children who mathematics disorder often show problems in these foundational areas

1. Numerosity

2. Basic counting skills

3. Arithmetic computation and retrieval of math facts/procedures

4. Math reasoning and problem-solving

Butterworth (2005) proposed the defective number module hypothesis; he argues that neurological system that underlies the infant’s appreciation for numerosity and counting is defective and leads to other problems with math

Math Skills

Knowledge and Procedures

Executive Functioning

Attention to Important Information in Problem

Inhibition of Unimportant Information or Incorrect Procedures

Short-Term Memory

Language Abilities

Listening to oral problems

Reading story problems

Comprehending information

Visuospatial Abilities

Representing numbers on a “number line”

Lining up numbers for addition, subtraction, long division

Interpreting graphs, figures

A developmental model for Mathematics Disorder. According to Geary and Hoard (2005), problems in language, visuospatial abilities, and executive functioning underlie mathematics disabilities.

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Direct Instruction Self-Instruction Mediated/Assisted Instruction

Treatment Method

Effects of mathematics instruction. Youth who receive self-instruction show the greatest improvement in math skills. However, direct instruction was particularly effective in improving children’s computational skills. Based on Kroesbergen and van Luit (2003).