Learning disability

Learning disability is a relatively new term in India. Learning disability means a disorder in one or more of the basic psychological processes involved in understanding or in using a language, spoken or written, which may manifest in an imperfect ability to listen, think, read, write, spell or do mathematical calculations.

The term includes such conditions as perceptual handicaps, brain injury, minimal brain dysfunction, dyslexia & developmental aphasia.

The term does not include children who have learning problems, which are primarily the result of visual, hearing or motor handicaps or mental retardation, emotional disturbance or of environmental, cultural or economic disadvantages.


Learning disability


Identification of Children Having LD


Socialization
  • Difficulty in school learning : Usually the parents and the teachers are the first ones to spot something unusual about the child. He cannot cope up with the regular school work.
  • There is a vast difference between the child's oral performance and written work or gap between potential and achievement.
  • They are often clumsy. They have eye-hand coordination problems.
  • They are hyperactive (excessive motor activity), impulsive (choice of very first solution, be it correct or incorrect) and have short attention span.
  • Language problems, immature speech.
  • Cannot follow multiple directions.
  • Has difficulty telling time and telling right from left.
  • Writes poorly
  • Reverses letters or places them in incorrect sequences Example: 'd' for 'b' and 'saw' for 'was'.

Remember that these above symptoms can be found in all children at some time during their development, however a child with learning disability has a cluster of these symptoms which do not disappear with advancement of age and needs further examination. 

Causes

Learning disability is not a result of single causative factor. They are a combination of genetic, neurodevelopmental, environmental and constitutional factors. Various prenatal (before childbirth), perinatal (during childbirth) and postnatal (after childbirth) factors also contribute towards learning disabilities.


Types of Learning Disability

There are different kinds of learning disabilities.

  1. Dyslexia - Reading disorders.
  2. Dysgraphia - Disorders of written expression. Extremely poor handwriting or the inability to perform the motor movements required for handwriting.
  3. Dyscalculia - Mathematical disabilities.

A child with learning disability needs detailed assessment and remediation programme by a trained special educator. 

Remediation is the method of instruction to correct deficits in student's performance and ways to improve and enhance his learning.
These children have average or above average IQ and are in mainstream schools where they can learn with the help of remedial special educator/resource teacher.



Government Concessions

  • Students who fail can be given 20 grace marks in one or more subjects.
  • They need to study only two languages instead of three
  • If they make spelling errors or reverse numerals it should be overlooked during evaluation
  • Schools are supposed to maintain registers of children with learning disabilities and record their yearly progress made by these students.

Instructions for Learning Disability (LD) Certification

The following will help you to understand the procedure for obtaining LD Certification. Please read the instructions completely. At least one parent or, a guardian who knows the child well, should accompany the student.
1) How to get an appointment for a student's assessment in LD Clinic?

  • On Wednesday or Saturday, meet Dr. Sunil Karande, Professor of Pediatrics & In-Charge, Learning Disability Clinic, in the Pediatric Clinic No. 26, Room No 1, First Floor Multi-Storey (New) Building between 1:30 pm and 3:30 pm. If you enter the hospital through the main gate (no.2) ask for the " New Building " and you will be guided properly. While meeting Dr. Karande, you need to have the referral note from the school (see below); you need NOT make any "case paper/OPD paper" for the pediatric OPD. This will be issued to you during consultation with Dr. Karande.
  • The parent should have a referral letter (on school letter head) from the Principal of the school - describing the reasons for the referral. The letter should describe the academic difficulties observed in the child when he/she is reading and writing; his/her problems with spellings, performing mathematical calculations and the behavior of the child in the classroom (normal, hyperactive, inattentive, withdrawn). This information is very important and helpful in diagnosing the cause of the child's poor school performance.
  • The parent should bring along - notebooks of any one subject and also of mathematics . This is essential to see the child's handwriting and school work. Please also get along with you - photocopies of the last two report cards. This will help us get an idea of the child's scholastic performance.
  • After being assessed by Dr. Sunil Karande in the Pediatric Clinic the child will be given an appointment for assessment in the LD Clinic. The parent will be referred to the LD clinic for taking an appointment for child's assessment. Please do not seek appointment directly from the LD clinic without the student having been evaluated by Dr. Karande.

2) What are the assessments done in the LD clinic?
The child has to be brought at least three times to the LD Clinic for various assessments as per appointments given.These cannot be combined into a single session as this gets very taxing for the child. The dates of appointments for these testing are given by the Secretary in the LD Clinic and the entire procedure to be followed will be clearly explained by her to each parent.
  • The first appointment is given for child's detailed clinical and neurological examination. (which takes about 30 minutes to be completed).
  • The second appointment is for testing the child's intellectual capacity (IQ testing). (which takes about 60-90 minutes to be completed).
  • The third appointment is for the educational testing of the child. (which takes about 60-90 minutes to be completed).

In general the accompanying parent would have to take a half-day off from work / other family responsibilities for each of the three appointments. None of these examinations are painful or inconvenient to the child. The child need not be starving for any of these 'tests'.


3) What other tests are required to be done before certification?

  • Vision testing to be done by an Ophthalmologist (Eye Specialist)
  • Hearing testing (Audiometry) to be done from an ENT Specialist

These two tests can be done at KEM Hospital or at any public hospital near the child's residence. They can also be done from a private Ophthalmologist or ENT Specialist - if so desired by parent. Both the vision and hearing testing reports should be recent (done in the past 3 months) to be considered valid. Any questions you may have about these will be answered at the LD Clinic.

4) How long does it take for the entire assessment procedure to be completed?
Generally it takes about three weeks; beginning from the time of the first assessment done in the LD clinic (namely, the child's detailed clinical and neurological examination). The certificate will be issued to the parent(s) after a meeting with the Counselor in the LD Clinic who will explain the child's diagnosis and how to help the child achieve his/her maximum potential.

Contact Information
The Secretary can be contacted for any enquiry
from 10 am to 2 pm (Monday to Friday; excluding public holidays) at: telephone number 022-23027659
In case you wish to contact Dr Sunil Karande send an email to sunilkarande@kem.edu .
We especially welcome feedback on your experience at the LD clinic. This will help us make the clinic more student and parent friendly.

Learning Disability Clinic address:
Pediatric Research Laboratory ( PRL ),
2nd Floor, Above Ward 17/18,
(Near Ward 1, Department of Pediatrics, KEM Hospital Main building)

  • Remember that whatever secondary complementary therapies you may do to help your child, the structured learning environment will be the backbone of his improvement. Bear in mind that parents are first and the best teacher of the child.
  • Secondly, in children having learning disability, we do not see any apparent handicap as in spastic children. The brain structure is different, they function differently. These children have abilities that they express differently, which we have to accept, nourish and nurture.

Useful links


http://www.ldonline.com/
http://www.learningdisability.com/
http://www.dyslexia.com/
http://www.ncld.org/
http://www.kidshealth.org/
http://www.coping.org/
http://www.pacer.org/
http://www.learningdisabilitiesfacts.com/