Early Childhood Education
Learning Disabilities (LD)
Incidence and Characteristics of Learning Disabilities
Children with learning disabilities (LD) represent over half of those students in the United States identified for special education services during their elementary or secondary school years. International research shows this disability to be a cross-cultural phenomena, a universal problem found among individuals across all languages, nations, and cultures in the world (Lerner and Chen, 1992). Learning disabilities are evident among children learning an alphabet-based system of written language (e.g., English), as well as among children learning a logo-graphic or pictorial system of language as found in Chinese or Japanese (Tsuge, 2001). “Specific learning disabilities” are considered indicative of an underlying neurological disorder. This should not be confused with learning “differences” among children or simple learning “difficulties” which all children likely experience at one time or another.
Most children with learning disabilities are identified and officially diagnosed after they enter school and have received several years of academic instruction. Most students are identified between ages 9 and 14 according to data from the U.S. Department of Education. These disorders in learning become more obvious because of a student’s failure to acquire expected skills in reading, writing, spelling, arithmetic, and other subjects associated with the use or understanding of language/language symbols and their meaning. A cumulative history of failure (in one or two areas of academic achievement), along with a discrepancy in performance compared to a student’s overall ability, often serve as the catalyst leading to an evaluation and formal diagnosis of LD.
Boys are about four times more likely than girls to be diagnosed with LD. Research suggests, however, that incidence rates for males versus females do not differ significantly. Plausible explanations for this higher frequency of diagnosis among boys include: (a) cultural factors (i.e., males may be identified more frequently because they tend to be more aggressive and exhibit disruptive behaviors that adults consider more troublesome), (b) biological factors (i.e., males may be more genetically and biologically vulnerable to learning disabilities), and (c) academic expectations (i.e., expectations and pressures for school success may be greater for boys than girls, particularly during the higher grades when adolescent priorities may shift regarding academic achievement).
Characteristics or symptoms of learning disabilities (LD) vary from person to person. In fact, LD is a generic label representing a heterogeneous group of conditions that can range from mild to severe. Most individuals with this disability have average or near-average intelligence although LD can occur at all intelligence levels. Some children may even be intellectually gifted or talented in some specific area of achievement yet manifest a learning disability in another area.
Although work in the field of LD has focused primarily on elementary and middle school students, we know this disability can become evident at many stages of life. Manifestations of LD among children or adults at various ages can take a different form. For example, symptoms among school-age students are manifested most often through unexpectedly low levels of achievement in areas such as reading and associated skill areas (e.g., spelling and writing) and/or mathematics. Reading is the most common area of difficulty. Disabilities in math are second most common. In comparison, preschoolers or kindergarten-age youngsters may manifest emerging problems via developmental delays or irregular/abnormal behaviors that cause concern with parents or teachers. Characteristics often noted in young children before a diagnosis of LD is made include: slowness in acquiring age-appropriate speech/language skills, hyperactivity, attention and concentration deficits, poor coordination, poor fine/gross motor skills, difficulties in auditory or visual processing, poor perceptual-motor integration, and a lack of crucial pre-literacy skills. During late elementary and early-middle-school grades, learning difficulties in other academic areas may appear as the curriculum becomes more difficult (e.g., science, social studies, foreign languages). Frustration, anxiety, and tension may accelerate as these students experience repeated failure and become increasingly self-conscious of their learning difficulties compared to peers. This can lead to additional emotional/behavior problems as students attempt to cope with their inability to perform as expected. These secondary outcomes of LD can further complicate diagnosis as well as educational processes and become add-on impediments to successful learning.
Definition of Learning Disabilities
The most widely accepted definition of learning disabilities is contained in U.S. federal law, the Individuals with Disabilities Education Act and its regulations (IDEA). IDEA specifies that the term “specific learning disability” means the following:
a disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, which disorder may manifest itself in imperfect ability to listen, think, speak, read, write, spell or to do mathematical calculations. Such term includes conditions such as perceptual disabilities, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia. Such term does not include a learning problem that is primarily the result of visual, hearing, or motor disabilities; of mental retardation; of emotional disturbance; or of environmental, cultural, or economic disadvantage.
This definition of LD has been controversial. Modified definitions are offered by the National Joint Committee on Learning Disability (NJCLD—representatives from several professional organizations and disciplines involved with learning disabilities) and by the Interagency Committee on Learning Disabilities (ICLD-a committee commissioned by the U.S. Congress to develop a definition of learning disabilities). Although slight differences appear across these definitions, there is general agreement on the following five elements that define a learning disability:
1. A neurological disorder or central nervous system dysfunction.
2. A disorder in one or more of the basic psychological processes involved in using or understanding language (which includes perception or input of language and its meaning, the cognitive processing of language, and finally the expressive output or communication of thoughts/ideas in spoken or written language or other modes of communication).
3. A disorder manifested in an individual’s difficulties in academic and learning tasks (e.g., listening, thinking, speaking, reading, writing, spelling, or doing mathematical calculations).
4. A disorder manifested by a discrepancy between a student’s potential and his/her achievement in one or more of these areas (Note: Many professionals continue using this discrepancy concept. However, it is highly controversial including how “discrepancy” should be measured, what criteria apply, and whether this discrepancy model is valid.)
5. A disorder that is not the primary result of other disabilities (e.g., mental retardation, emotional disturbance, hearing or vision loss, motor disabilities, or cultural/environmental or economic disadvantage). It is suggested that LD may coexist or be manifested concurrently with other disabilities. However, it is often difficult to determine which condition is primary and which is secondary.
Identification of Learning Disabilities during the Early Childhood Years
The high incidence of LD among school-age students has brought greater urgency to early identification of young children who are at risk for this disability.
Obviously, earlier treatment might minimize the impact of LD upon a student’s academic achievement. This is a better strategy than attempting remediation after a student’s learning problems/failures have compounded and academic performance has fallen significantly below expected grade level. Formal diagnosis of LD in young children (i.e., birth to eight years), however, is somewhat complicated and presents issues frequently described in the professional literature.
Given the official definition of LD and underlying concepts about what constitutes a “specific learning disability,” formal diagnosis of this condition in young children is difficult for several reasons. First, the official definition of learning disabilities focuses upon deficiencies or irregularities in cognitive processes, thinking, and academic performance expected of older children. Young children are early in the process of acquiring these particular skills or cognitive functions. It is difficult to designate behavior as “deficient or indicative of cognitive disability” when a child has no exposure or only limited exposure to formal academic training. One can question whether it is possible to accurately determine the presence of a neurological, cognitive/language-based disability when a child is in the midst of acquiring the very behaviors by which we infer those cognitive processes are functioning normally or abnormally. Yet to identify LD in children during their preschool or early elementary years obviously requires a diagnosis based on behaviors/symptoms that come before cognitive/academic skills are learned and through which learning disabilities are manifested (e.g., reading, writing, spelling, math, etc.). The criteria for diagnosis implied in this accepted definition of LD simply do not apply to young children.
Second, young children develop and learn at different rates. Therefore, development considered “within the normal range” shows considerable variation from child to child. Children reflect this variation not only in their rate or speed of learning but in their level of mastery and quality of performance across the various developmental domains. Educators are well aware of these intra-individual differences (variation within a single child across developmental domains) as well as inter-individual differences (variation across youngsters of the same chronological age), which make each child unique and distinctive from his/her peers. The dilemma here is that some differences in children’s learning/developmental characteristics, which elicit concern about potential disabilities, may only reflect this normal developmental variation. They may not be actual symptoms or warning signs of learning disabilities that will persist. It is well understood that many environmental variables, as well as genetic/biological factors, contribute to these intra- and inter-individual differences among children. For example, some variation may result from differences in the early stimulation and learning opportunities children receive during their formative years. Quality of the home environment and parent-child interactions, differences in parenting skills and styles of childrearing, parent education and family resources all affect how children develop and learn. Educational opportunities available to young children at home and in their surrounding community environment (such as exposure to preschool education) also affect kindergarten readiness, preliteracy skills, and later academic achievement.
These individual differences among all children, added to the fact that students diagnosed with LD are an exceedingly diverse, heterogeneous population, further complicate the task of formal early diagnosis. No two students with LD are alike nor do they manifest exactly the same symptoms or performance profile. Educators and diagnosticians often find it difficult to separate what is merely normal developmental variation/individual differences in young children from deviations that signal a true neurologically based learning disability. It is also difficult to distinguish between young children with a “learning disability” from those who should simply be characterized as “slow-to-develop” or slow learners with generally low achievement.
A third factor complicating formal diagnosis of LD in young children is the fact that certain learning problems or developmental delays can be precursors of other cognitive, behavioral, sensory, or developmental disorders, not just a “learning disability.” Learning disabilities are not the only potential outcome of symptoms described here. To suggest that such deviations or limitations provide a basis for a conclusive, formal diagnosis of LD in a young child may be a presumptuous, premature conclusion. Educators are reluctant to apply the LD label to infants, toddlers, preschoolers, or even primary school-age students.
Early Indicators of Risk for Learning Disabilities among Young Children
Current regulations under U.S. federal law (IDEA) allow the use of a noncategorical diagnosis of “developmental delay” for young children (from birth to nine years) to qualify them for special education services. This general diagnostic label offers greater flexibility and perhaps a more useful alternative for identifying many children needing early intervention, including those at risk for learning disabilities. Thus children can be evaluated for indicators of risk and delayed development that are correlated with the later diagnosis of LD. Educators can move ahead with timely treatment and intervention without getting caught up in cumbersome issues surrounding an early formal diagnosis of “learning disability.” The dangers of imposing a potentially inaccurate, premature diagnosis with potentially damaging labels can be avoided.
Precursors or indicators of risk that may be useful in identifying children needing early intervention include developmental delays and/or irregularities in areas described below.
Communication, speech and language skills. Difficulty acquiring speech and in using/understanding language or language symbols are among the most common precursors of LD. Some children may be slow in acquiring vocabulary. Word memory may seem poor. They may appear confused and slow to understand or to execute instructions from an adult. Oral speech may be delayed. When these children do talk, their communications may be unclear and fail to offer a coherent expression of what they are trying to say compared to other kids of the same chronological age. Word usage may be incorrect or seem strange. Children who should be talking in sentences may only be delivering disjointed words or short phrases. They may seem more immature compared to age-mates in initiating a conversation, engaging in interactive dialogue, explaining something, or using appropriate words to express a concept.
Fine/gross motor skills. Slowness in acquiring motor skills, poor coordination, and awkwardness in the performance of fine/gross motor skills also are common precursors of learning disabilities in some children. Parents of children diagnosed with LD often describe their child’s clumsiness in learning to walk, run, jump, skip, ride a tricycle, catch or throw a ball, and simply move around their environment without stumbling or bumping into things. Delayed fine motor control may be manifested as difficulty in learning to dress and undress, handle buttons or zippers, manipulate eating utensils, or handle a pencil or crayon. These problems become more evident in school-related activities as children have difficulty with working puzzles, building objects, or completing art projects that require cutting with scissors and coloring with crayons or paint brushes. It shows up as slowness in learning to print letters accurately. Handwriting may seem laborious, sloppy, and nearly illegible due to poorly formed alphabet letters and spacing between characters. However, it should be emphasized again that LD is only one of several possible diagnoses to consider when a child exhibits these problems.
Visual and auditory perception or processing. Students with learning disabilities often exhibit limitations in auditory and/or visual perception and processing skills. These modalities are important avenues for learning and academic success. These are not deficits in the ability to hear or in auditory acuity. Neither are these problems with eyesight and visual acuity. These students can see and hear, but the problem lies in the actual neurological processing of input from one or both sensory modalities.
Phonological awareness is a particularly crucial skill related to reading. This involves the ability to recognize that words are composed of individual sounds blended together. Some children with LD have great difficulty recognizing and isolating these separate distinctive sounds in a word. Other key auditory perception/processing subskills affecting reading ability include: (a) auditory discrimination (ability to hear differences in sounds), (b) auditory memory (ability to store and recall what one has heard), (c) auditory sequencing (ability to remember the order of items in a sequential list such as the alphabet, numbers, days of the week, etc.), and (d) auditory blending (combining single phonic elements or phonemes into a complete word). Children who show deficits in these auditory functions may be at risk for learning disabilities.
Visual perception involves the identification, organization, and interpretation of sensory input, which are important processes as children learn to read. Problems with visual perception processes may be another indicator of risk for a diagnosis of LD and/or difficulties in acquiring literacy skills. This includes: (a) visual discrimination of letters, words, and other visual images, (b) figure-ground discrimination (difficulty distinguishing an object from its surrounding background), (c) visual closure (ability to recognize or identify an object when the total stimulus is not presented), (d) letter or object recognition (ability to recognize or distinguish geometric shapes, alphabet letters or other entities such as a square versus triangle, letter c versus g, dog versus cat, or a particular face), and (e) visual memory (the ability to remember information that was received via the visual modality). Abilities of kindergarten-age children in these prerequisite skills are strong predictors of later reading achievement.
Attention and ability to concentrate. Some children diagnosed with LD also manifest behaviors related to attention deficit hyperactivity disorder. ADHD may be concurrent with LD, but it is not considered a problem directly caused by learning disabilities. While young children are expectedly very active and energetic, excessive activity and an inability to quiet down sufficiently for a story or focused activity may be warning signs. Such behaviors are especially disruptive to learning if they are continuous, extreme, and do not seem to lessen when the environment or activity changes. These are children whose parents complain that they don’t listen or pay attention. When parents or other caregivers find it difficult to get a child to settle down or sit quietly long enough to complete an age-appropriate task, there is cause for concern. This is especially true if the behaviors do not change over time, even accelerate in frequency and severity, and the child actually seems unable to focus upon a task or shift from an active to a quiet activity requiring more concentration.
Acquisition of pre-literacy skills. A lack of appropriate kindergarten readiness skills and verbal language abilities when children enter school can be indicators of risk for disorders that affect academic progress and achievement including a learning disability. Limitations in the developmental areas previously described all affect literacy and contribute to learning problems that affect a child’s ability to read, write, spell, or do mathematical calculations. The relationship of language skills to reading achievement and reading disabilities is well established. Strong oral vocabulary skills (both expressive and receptive) are crucial skills for both reading and general academic success. Key readiness skills that reliably and robustly predict reading failure or success for most children include phonological awareness and manipulation skills (e.g., rhyming, blending, segmenting, letter knowledge, vocabulary, short-term memory for language, knowledge-related information, and rapid automatic naming). Other predictors of reading ability include letter knowledge and identification, word recognition, story recall, sentence imitation, and overall verbal ability. In fact, verbal abilities at ages 2-4 years have been well correlated, not only with eventual reading achievement itself, but also with the set of kindergarten skills shown to differentiate at risk from not-at-risk kindergarteners. Preschoolers with early language impairments are very likely to exhibit reading difficulties in their school years. Research also suggests that youngsters exhibiting delays or weaknesses in one or more of these skills described above at the end of the first grade are unlikely to become good readers. First grade reading ability has been shown to be a strong predictor of a variety of eleventh grade measures of reading ability even when measures of cognitive ability are all partialled out. Such children may be candidates for a later diagnosis of learning disability. Reading difficulties, of course, are the most frequent type of LD found in school-age students (Conference on Emergent and Early Literacy: Current Status and Research Directions, 2001; McCardle, Scarborough, and Catts, 2001).
In summary, research clearly shows the benefits of early identification and early intervention with young children who are at risk for disability, poor academic performance, and school failure. The challenge is identifying these children so interventions can be initiated to address their difficulties. Parents or other primary caregivers who spend significant time with these children also need support so they can facilitate their child’s learning and promote optimal development. Some argue against spending time pursuing an illusive and perhaps difficult formal diagnosis such as “learning disabilities” if this prevents timely interventions from occurring. Others caution against waiting until a formal and accurate diagnosis can be made, using the “wait and see approach” (sometimes called “wait and fail approach”), since withholding interventions until problems increase can compound into significant skill deficits. It is especially important to focus attention on the developmental delays and irregularities that are potential risk indicators known to be correlated with the disability or other learning problems. What children need during their early childhood years are early childhood professionals, including but not limited to those from the field of early childhood special education, who can work together with children’s families to identify environmental conditions and forms of instruction that are responsive to these specific problems. Young children identified with learning disabilities may need specific therapeutic interventions in their natural everyday routines couched in age-appropriate activities that help them progress developmentally and acquire essential skills for emerging literacy and academic success. See also Academics; Attention Deficit Dis- order/Attention Deficit Hyperactivity Disorder; Kindergarten; Parents and Parent Involvement.
Further Readings: Conference on Emergent and Early Literacy: Current Status and Research Direction (2001). Learning Disabilities Research and Practice (Special Issue) 16(4), 183-258; Committee on the Prevention of Reading Difficulties in Young Children (1998). Preventing reading difficulties in young children. Washington DC: National Academy Press; Lerner, J. W., and A. Chen (1992). The cross-cultural nature of learning disabilities: A profile in perseverance. Learning Disabilities Research and Practice 8, 147-149; Lerner, J. W. with F. Kline (2006). Learning disabilities and related disorders: Characteristics and teaching strategies. 10th ed. New York: Houghton Mifflin Company; McCardle, P., H. S. Scarborough, and H. W. Catts (2001). Predicting, explaining, and preventing children’s reading difficulties. Learning Disabilities Research and Practice 16(4), 230-239; Scruggs, T. E., and M. A. Mastropieri (2002). On babies and bathwater: Addressing the problems of identification of learning disabilities. Learning Disability Quarterly 25(3), 155-168; Swanson, H. L., K. R. Harris, and S. Graham, eds. (2003). Handbook of learning disabilities. New York: Guilford Press; Tsuge, M. (2001). Learning disabilities in Japan. In D. Hallahan and B. Keogh, eds., Research and global perspectives in learning disabilities: Essays in honor of William M. Cruickshank. Mahwah, NJ: Erlbaum, pp. 255-272.
Web Sites: Learning Disabilities (LD), http://www.ldonline.org; International Academy for Research on Learning Disabilities (IARLD), http://www.iarld.net. See IRLD journal Thalamus
Nancy L. Peterson