case study specific learning disability

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LEARNING DISABILITY : A CASE STUDY

The present investigation was carried out on a girl name Harshita who has been identified with learning disability. She is presently studying at ‘Udaan’ a school for the special children in Shimla. The girl was brought to this special school from the normal school where she was studying earlier when the teachers and parents found it difficult to teach the child with other normal children. The learning disability the child faces is in executive functioning i.e. she forgets what she has memorized. When I met her I was taken away by her sweet and innocent ways. She is attentive and responsible but the only problem is that she forgets within minutes of having learnt something. Key words : learning disability, executive functioning, remedial teaching

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• Published: 31 December 2019

Students with specific learning disabilities experiences of pre-registration physiotherapy education: a qualitative study

• M. Norris   ORCID: orcid.org/0000-0001-7779-5612 1 ,
• J. Hammond 2 ,
• A. Williams 3 &
• S. Walker 2  

BMC Medical Education volume  20 , Article number:  2 ( 2020 ) Cite this article

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Attainment gaps for students with disabilities have been noted in pre-registration physiotherapy courses in the UK. Previous research suggests disclosure, lack of staff knowledge and poor communication between University and placement sites may be relevant, but these are limited to small case studies with students with visual or physical disabilities. The purpose of this study was to explore disabled physiotherapy students’ experiences of their education in order to elucidate factors that may influence success.

Qualitative study drawing on phenomenological traditions. Four focus groups including 15 students with disabilities were conducted. Transcripts were analysed thematically. Procedures for transparency and rigour such as member checking and peer debriefing were implemented.

Three major themes were derived from data. “It was quite a relief” explores the personal and social implications of diagnosis. “They’re not natural” focuses on academic assessment and the specifics of adjustments made and not made within that context. “My dyslexia doesn’t switch off” explores the inaccessibility of the learning environment and dissects the contrast between the 24-h nature of having a specific learning condition and the somewhat piecemeal nature of adjustments during their education.

Conclusions

This study indicates that having a specific learning disability or anxiety creates a number of hurdles to success in physiotherapy education. Most were within the University setting and were perceived to result from staff ignorance or piecemeal approaches to inclusion. A lack of consistency alongside facilitated dialogue and acknowledgement of enhancements results in frustration, ambiguity towards disclosure and reinforcement of a deficit model. Such an approach belies the intention of the profession and the NHS and does not maximise the potential of widening participation.

Peer Review reports

There has been a specific focus on widening participation to higher education in the United Kingdom (UK) and worldwide since the beginning of the twenty-first century. Initial focus in the UK was on improving access and increasing participation for all [ 1 , 2 ]. However, in the last decade evidence has emerged of attainment inequalities [ 3 ]. Hence attention has been drawn to not only making higher education accessible to all, but also ensuring that those who enter successfully complete their course of studies. This has been bolstered by the Equality Act published in 2010 [ 4 ], and specific action to monitor metrics of learning gain through the Teaching Excellence Framework [ 5 ], practices to enable equal access and appropriate support for all.

Disability is one area where attainment inequalities have been found within higher education. This is of specific relevance to physiotherapy, as 12% of pre-registration students across all UK Higher Education Institutions (HEIs) declared a disability in 2016–17 on entry to their course [ 6 ], with the majority reporting dyslexia or other specific learning disabilities. This is equivalent to national data for all courses in 2016–17 [ 7 ]. The physiotherapy profession has a long history of including people with disability within education and the workforce, in particular people with visual impairment [ 8 ]. This is supported by the National Health Service (NHS) which has stated the aim of employing people with disability [ 9 ]. However, a number of issues have been raised within the literature.

First is a recent study which demonstrates an attainment gap exists for pre-registration physiotherapy students with a disability, particularly those studying on pre-registration MSc courses [ 10 ]. While this study in physiotherapy mirrors a pattern in medicine, dentistry and higher education more generally [ 11 ], it did not explore potential reasons for attainment inequalities; other related literature in physiotherapy may give some indications. Reluctance to disclose disability before, during and after clinical training has been highlighted as an issue due to concerns with negative judgement and prejudice [ 8 , 12 , 13 ]. Likewise, poor levels of staff knowledge and familiarity with specific disabilities, has been linked with reduced acceptability and unsupportive behaviour [ 14 ]. This has specifically been related to placements where communication between sites (clinical and academic personnel) has not been optimised [ 12 ].

Research in higher education in other clinical professions is more prolific and highlights additional concerns such as the construction of disability within education generally and the consequential focus on ‘adjustments’ in a concessionary structure [ 15 ]. Stigma, marginalization and discrimination have been noted, both directly in universities and with clinical staff but also indirectly through the regulatory frameworks related to fitness to practice [ 16 , 17 , 18 , 19 ]. In contrast, studies also highlight agency of students with disabilities with potential enhancement as a consequence of living with a disability [ 15 , 20 ]. To date it is not explicitly known how these relate to the broad experience of physiotherapy education, or disabilities such as dyslexia. Likewise, while there are a number of recommendations for inclusive education [ 21 ], it is not clear how these are being implemented and perceived in physiotherapy.

To complicate things further, the term disability itself is debated. We have approached this research with an awareness of current debates, but without a specific lens, remaining open to the various narratives of the participants. Given the literature on stigma and discrimination [ 8 , 12 , 13 , 16 , 17 ], we are mindful of the social model, where focus is directed towards barriers created by society [ 22 ]. However, in-keeping with critiques of this model we acknowledge that a focus on society should not detract from a need to consider the individual and their specific situation which is strongly supported in the limited physiotherapy literature [ 8 , 23 ]. Furthermore, recognizing the narratives on agency and enhancements [ 15 , 20 ] draws attention to the affirmative model in which the celebration of positive social identity and ownership of impairment is highlighted [ 24 ]. In contrast, Campbell’s [ 25 ] call for a more radical refocusing of disability studies that critiques the processes and practices that support and perpetuate ableism as homonormativity within society, requires a consideration of how those processes and practices may play out in physiotherapy education. This is in part reflected by Bryne [ 26 ] who reminds us to remain vigilant to the dominant discourse of ability in which ‘support’ and ‘adjustment’ are considered both as unfluctuating and as a concession which have to be earned through assessment and evidence.

Within this context, the purpose of this study was to explore disabled physiotherapy students’ experiences of their education in order to elucidate what factors might be relevant in student success. Due to the dearth of literature in physiotherapy it was impossible to predict which factors (social/environmental/individual) are more prominent in the lived experiences of physiotherapy students. Therefore, the study purposefully focused on the broad educational experience of the participants so that any factors relevant to them could be raised.

This was a qualitative study informed by phenomenological traditions [ 27 ], in-keeping with the focus on the students’ experiences of life as a student physiotherapist with a disability.

For practical reasons two HEI’s in the South East of England were chosen to conduct the study. The total pool of students studying BSc and MSc pre-registration courses was approximately 500, therefore there were approximately 60 potential participants based on the 12% prevalence estimate of physiotherapy students with a disability previously indicated [ 6 ]. Students at the two HEI’s were invited to participate in the study via a cohort wide email. Inclusion criteria included current students, who had completed both academic modules and clinical placement and who had a confirmed disability (self-declared but also documented in University records). To maximize inclusion further sampling restrictions were not included. This can be considered a convenience sample [ 28 ] of those with the relevant experience to respond to the study aims.

Focus groups were selected given their ability to support collective responses and increased depth often prompted through interaction. A focus group at the penultimate (MSc yr 1 and BSc yr 2) and final (MSc yr 2 and BSc yr3) year level were conducted at each HEI to explore the shared phenomenon of physiotherapy education. They followed a topic guide developed in relation to previous literature and discussed and agreed by the research team (Additional file  1 ). It included opportunities for participants to discuss their identity, positive and more challenging experiences in university and placement, garner their thoughts on the previous study that showed an attainment gap [ 10 ] and opportunities for enhancement. Open questions were intentionally used in order to avoid leading participants in particular apriori directions.

All focus groups were facilitated by experienced qualitative researchers from outside the host institution, and therefore were previously unknown to the participants, who were also physiotherapy faculty members (MN with AW as co-facilitator, JH with SW as co-facilitator). One had a disability which was shared with the participants in order to enhance an atmosphere of openness. The focus groups were audio-recorded and key points were noted on flip charts during the focus groups to aid in collective member checking of the data. This was deemed particularly important as all researchers are academic faculty and these checks served to highlight potential presuppositions of priority areas.

Audio-recordings were transcribed verbatim and anonymised. They were analysed thematically by one lead researcher [ 29 ]. This followed a process of familiarisation through reading of the transcripts, detailed inductive line coding and iterative development of categories and super-ordinate themes. An example of a thematic tree is given in Fig.  1 . Negative case analysis was conducted to check thematic development. Three co-researcher’s read the transcripts closely and engaged in critical discussions with the lead researcher to enhance depth of analysis and transparency. One of these researchers has a specific learning disability which offered the opportunity to consider a perspective from inside the community and to challenge potential emergence of ableist discourse.

Example thematic tree

The sample included 15 students (11 F, 4 M, 12 BSc, 3 MSc) with a range of predominantly specific learning disabilities including dyslexia, anxiety, dyspraxia, Attention Deficit Disorder -ADD and Attention Deficit Hyperactivity Disorder - ADHD (Table  1 ). While one student with physical disability volunteered, they were unable to attend the focus group. The focus groups lasted on average 92 min (range 83–99).

Three major themes were derived from the focus group data. The first theme “it was quite a relief” explores the personal and social implications of diagnosis on a bedrock of previous hard work and social ignorance. “They’re not natural” focuses on academic assessment and the specifics of adjustments made and not made within that context. The final theme “My dyslexia doesn’t switch off” highlights aspects of education delivery which are not ideal to access learning. Students noted that while these issues would resonate with most students, they had particular significance for those with specific learning conditions. These illustrate the contrast between the 24-h nature of having a specific learning condition and the somewhat piecemeal nature of adjustments during their education. This theme ends with a clear call for institutional practices to support rather than hinder the self-management strategies that the students own. On the basis of the experiences discussed in the focus groups, students suggested specific recommendations to education and practice. These are presented in the discussion.

“It was quite a relief”: the personal and social implications of diagnosis

As a starting point the students shared their own personal histories of struggle. Most had completed the majority of their earlier education without any formal diagnosis and therefore described how they had often felt isolated and somewhat confused by the difficulties they faced as this female participant describes:

“I was diagnosed with dyslexia when I was 19. Beforehand I’d struggled all the way through…so I was just average but working extremely hard to be average…I think if you don’t know …then you feel like you’re struggling by yourself…no one understands” F3 FG2

One student related how this lack of understanding of herself and her condition impacted on her emotionally resulting in a diagnosis of anxiety at an earlier age. Yet these are students that had succeeded in their education despite this lack of knowledge and support and the sense they were working harder than their peers in order to achieve resonated through all focus groups.

While diagnosis came late for the majority and the categorisation as having a disability itself was not unproblematic, when it came it was met with a degree of relief:

“I quite like it [diagnosis]…it was quite a relief…it justifies things…I could identify an issue” They later continue, “it’s kind of something to make me aware, I’ve got an idea of how I think and I’ve got some ideas of where I should go with it” M1 FG1

Diagnosis was usually accompanied with detailed reporting of their own specific condition. As the participant above indicates this knowledge led to understanding and a re-framing of their previous struggles. Participants talked about a sense of empowerment, awareness and insight which ultimately led to clearer ideas of personal action and acceptance which this example shows:

“once I understood it, it kind of made me feel a lot better about myself and just umm, those negative emotions and feeling they kind of dissipated a lot over time, it’s cos I understood better myself.” M2 FG1

The positive benefits of detailed reporting were noted particularly when they were accompanied by a clear and relevant introduction to strategies and how they could be implemented in real life. For one student this came through work alongside an Occupational Therapist, while another noted the usefulness of a report which specifically focused on physiotherapy related skills.

This reframing of their past history led to an increase in confidence but also appreciation of the positive traits. The students discussed their increased capacity to problem solve, be creative with ideas, look outside the box and have empathy with people who struggle, all skills which they saw as relevant additions to their future careers as therapists. This personal understanding was not present for all, influenced by the timing of their diagnosis, or the recent onset of new challenges such as placement. For those most recently diagnosed (within the last 12 months), their strategies were still developing and the work of re-understanding and reframing was still in progress.

The majority of the participants were not diagnosed until University (current or previous degree), which raised the issue of identification processes. The driver to seek testing came from a number of sources: previous work colleagues, medical personnel, personal tutors, a generic talk at induction, advice from other students and placement educators. While all were grateful for the prompt, and the awareness of role models within the profession was noted particularly favourably, the haphazard way in which it occurred was the source of concern for the participants. Students strongly expressed the need for early identification to maximise their capacity on the course which they indicated required more robust and reliable processes of identification.

“I suppose one of the really key things is just getting diagnosed like early, so you can get support in place, I suppose that's quite a major part” F10 FG4

Early identification and diagnosis, for many, lay in better awareness of the conditions. The students discussed many misconceptions they held prior to their own diagnosis, relating conditions such as dyslexia with lower intelligence. But while their own understanding developed, there were significant concerns raised about others in society, including in the academic arena. Some students reported not declaring their disability on their application for fear of judgement as a ‘problem’. This also extended to disclosure on placement through concerns of being treated differently or being supervised by staff who are “not gonna know where to start with you” F2 FG1. Mostly though, the students described positive experiences on placement with staff who were well informed or indeed had specific learning difficulties themselves. The majority of the issues raised were within the Universities themselves and specifics of this will be discussed in the following themes.

Overall this theme illustrates the complex journey students with disability have in relation to diagnosis and subsequent understanding of self. They highlight the importance of early and consistent identification which requires better awareness of conditions and signposting.

“They’re not natural”: the false glare of assessment

This theme unpacks the assessment process and how students perceive their disability within that specific context. While the participants on the whole were appreciative of adjustments made to exams, their insights draw on potential misconceptions about their conditions resulting in apparently random decisions on adjustments to assessment.

Of particular concern were practical exams and participants consistently raised their frustration and confusion over the lack of adjustment to these assessments. A key feature of this was a lack of adjustment in time. While it was inconsistent, most described additional time for reading components of practical exams but nothing for the actual delivery of the practical skill and discussion. For them, this separation between reading and oral/aural/practical components made little sense when they had recognised problems with processing and organising information. For them this was often harder in aural/oral form then in written, which led to high levels of anxiety about the questioning processes in such exams as this example demonstrates:

“I find it hard when they ask you questions on the spot and you don’t have a couple of minutes to process it…I find if I take a couple of minutes I can produce quite an outstanding answer, but if you want answer like that, which in the exam conditions you just kind of go blurgh” F3 FG2

The anticipation of facing these exams without additional time created a vicious circle for these students. Knowledge of their own challenges with processing and delivery, led to fear of not completing the exams on time. This created anxiety and pressure to speed up, which resulted in more errors and heightened awareness of their difficulties.

A further challenge was distraction within their exam. For written assessments they were often in a room with few students or on their own. However, with practical exams they were with other students with several exams happening simultaneously. While they appreciated the complexity of organising such exams, this format resulted in a mix of distraction and pressure. The noise of others speaking and moving disturbed their focus, already a recognised challenge for many, and as a result they had to regather their thoughts, ask for questions to be repeated or misunderstood what was being asked of them. All were seen to contribute to additional stress, loss of time, but also the potential of responding to what they thought they had been asked rather than the actual question/task.

“I’ve had to ask a number of times for them to repeat the question to me because I’m fixing on something else, or like I hear a beep or something’s happening and they’ve asked me a question and cos you’re under pressure and time, I’ve suddenly forgotten, I wasn’t even listening to the question and that, I then need to ask, “Oh sorry, can you repeat that again?” F1 FG1

The participants in these focus groups frequently commented that the problems they faced were common to all students, but highlighted that they were exacerbated when you had a specific learning difficulty.

Many had raised their concerns about the lack of adjustments with academic tutors and had been told that exams were designed to mimic the clinical environment. However, this contrasted with experiences on placement where they described a greater willingness of colleagues to consider adjustments as demonstrated here:

F10: “I asked about that first year for my bad auditory memory for practical exams and they said to me, it’s not like the actual setting of being on placement…but I got extra time for my initial assessments [on placement]…When you’re here (university) they’re sort of well that’s not how it’s gonna be in real life”

F8: “but you’re learning, there’s a difference…we’re learning at uni so we should get extra time…which is why we get extra time on placement” FG4

They highlighted numerous cases where exam conditions created problems which were never replicated on placement. Time was one factor, as students described a number of placements which considered additional time to be a holistic requirement not just for writing notes. Similarly, instructions and feedback were adjusted to be given on paper rather than verbally to assist with processing and retention. Likewise, students were encouraged to create templates as memory assistance while on placement, whereas in exams they were entirely reliant on immediate recall. Mostly though it was the pressure of exams and the intense time limited focus on the student. This restriction was not perceived in clinical practice leading the participants to conclude that the assessment process placed a false glare on their abilities.

“Again it’s not natural, when you do it you’re in a placement on a ward, it’s so natural you just do it whereas in an exam in the OSCEs [Objective Structured Clinical Examination] you, as I said, it just doesn’t feel…“F3 FG2

This theme highlights a clear perceived discrepancy between how practical assessments operate within the university environment, which are not replicated within the clinical field. The complex processing and problem solving required within case based practical exams appeared not to be considered, coupled with limitations placed on strategies participants were encouraged to develop when working clinically.

“My dyslexia doesn’t switch off”: inaccessible learning environments and piecemeal approaches to disability support

In the previous theme, an acceptance that some experiences may parallel those of non-disabled students became apparent. This next theme dissects the minutiae of the learning experience, unpacking features that create general inaccessibility, but which further impact on students with specific learning difficulties. This highlights a perceived piecemeal approach to support which contrasts with the 24 h experience of living with a disability.

Students consistently flagged the lecture arena as a complex minefield to navigate. While they acknowledged their lecturers were generally knowledgeable and engaging, the forum of the lecture, it’s structure, pace and density of material, as well as length were seen as a significant obstacle to learning. Students referred to ‘zoning out’ or metaphorically ‘leaving the room’ while remaining in it as words washed over them. The result was frustration, not only in their lack of understanding but also the awareness that they had lost time which they would have to compensate for later.

“I leave a lecture and I can hear some people being like “oh that’s really interesting” and I’m like you heard that? When was that mentioned 'cos I’ve not picked that up?...because to me it’s like someone throwing stuff at me, but in no particular order for me to actually contemplate or even put down on paper what they’ve said…it’s a bit of a set back for me ‘cos I feel like now I’ve got to go and do double the work to try and actually understand what that hour lecture was actually about” F2 FG1

A specific challenge was the necessity to write notes while listening and trying to understand. This was deemed essential as the students perceived many lecturers left slides minimally populated. This was matched with a perceived delay in posting slides prior to lectures so participants had inadequate time to familiarise themselves with the material to ease the complexity of the lecture format. Of particular note here was the participants understanding that the decision to have minimalist slides and late posting was a positive decision by lecturers based in part on pedagogical principles. This frustrated the students at a number of levels. First was the sense that their learning styles may be different to standard research as this participant describes:

“it was kind of like that kind of paternalism of “this is how you should learn”, which I think they can be really frustrating because it’s not actually, it might be the best way to learn in terms of research or whatever but we learn differently” M1 FG1

But it was not just a potential mismatch between their learning style with research, but also on perceived intention. The students in this research interpreted the lack of detail and delay as obstruction by lecturers, reinforced by a lack of change following requests. The consequence was they perceived a lack of flexibility for them to use their own style and strategies to maximise their learning and indeed take ownership of their learning.

Timely posting of material generally was raised in relation to Virtual Learning Environments (VLE’s), the online portals where most learning resources are stored. The students suggested that a key strategy for most of them was to organise themselves early, so they knew what they needed to attend to well in advance. This was rendered impossible when materials were not posted in good time. But they also commented on their frustration when the location of materials changed, different modules posted things in different, seemingly random places or indeed the VLE itself changed.

Other areas participants highlighted included class numbers and room layout, all perceived to impact on their ability to engage. These students were aware that ‘putting things together’ is often an area that they have to work hard to achieve. Rather than facilitating that process, the academic practices created further obstacles which they were forced to navigate. As this participant suggests:

“So I think here they just limit it, you’ve got dyslexia, great, we’ll help you if you need to. Here’s extra time in exams, but that’s it. They (staff) don’t think about things like, so the presentations and what they look like and how visually it can affect. They don’t think about room sizes or, you know, one to one sessions or smaller group sessions and I think that is, is a big thing”. F3 FG2

Other points raised were the perception that timetables and group changes were haphazard which limited capacity to plan ahead or work with the people who understood their learning styles. The participants suggested that changes came with a lack of adequate explanation as to why they had occurred or an appreciation that such changes were disproportionately disruptive to some students with disabilities. For the participants in this study, this rather piecemeal approach to their disability was frustrating. They sensed that support was inconsistently applied which was in direct contrast to their 24-h experience of living with a disability.

For many this was a result of perceived staff ignorance of their diagnosis. While examples were given on placement, more often participants discussed clinical educators who themselves had specific learning difficulties. They were mostly seen as allies. Consequently, the call for more education was firmly directed towards University based staff.

“Personally in the physio department there’s not a big awareness of specific learning difficulties I don’t think…. My educator, I’d be on placement for two weeks, said I think you maybe should consider going and get tested, I’d been at university for two or three years now and I know, I get on with the lecturers and I give them pieces of work to have a look at, none of them advised that I get a test or anything like that “F6 FG3

This sense of staff ignorance was not universal, but like the adjustments was seen as piecemeal. It was chance if you had a tutor who recognised signs, made the effort to signpost appropriately, and who made suggestions on how placement could be approached. And chance was considered a problem.

Cumulatively, this lack of awareness, lack of consideration of the on-going challenges of studying with a disability and adjustments that were only periodically considered had one overriding impact on the participants; an impedance to them managing their own situation. This disempowerment lay at odds with a clear sentiment across the participants in this study, that they were aware of their own dis/abilities and they were very willing to take ownership of their personal situation.

The narratives from this group of students with disabilities highlight a number of aspects which they associate with potentially impeding their success.

Early identification and orientation to the physiotherapy context facilitated recognition, understanding and development of strategies in order for these students to succeed as the independent professionals they aspired to be. When successful, these processes had the potential to shift the participants’ identity resulting in confirmation of their skills and capabilities. Clouder et al. [ 15 ] note that students with a disability often have strong agency and a desire to engage. This was also evident in this study as the participants demonstrated how an understanding of self, resulted in a desire to reject the deficit view of their disability and affirm their positive skills and attributes, possibly reflecting an emerging affirmation model [ 24 ]. The findings suggest that the process of transformation and the students’ confidence in engagement was hampered as a consequence of inadequate and inconsistently applied systems and staff ignorance. Therefore informed, proactive, timely and responsive systems that are equitably delivered to maximise the students’ potential for self-discovery and development are important and may impact positively on their successful progression in the course.

The further findings from this study illustrate some of the challenges of the learning environment and practices for students. Interestingly, issues identified were most frequently situated within the university arena rather than the clinical environment which is surprising, given that previous literature in the field has largely focused on the practice environment [ 8 , 12 , 13 , 18 , 19 , 23 ].

One issue relevant to the clinical and university settings was ambiguity in disclosure. Disclosure of their disability was rarely discussed by the participants in relation to potential prejudice as described by other authors [ 8 , 30 , 31 , 32 , 33 , 34 , 35 ]. Rather, in-line with Opie and Taylor [ 13 ] concern was situated once more in ignorance. On one side the students were unclear how their disability may impact on placement and as a consequence questioned the need for disclosure. On the other, the students perceived their educators both at university and on placement to be ignorant of specific disabilities and therefore disclosure may not be met with a supportive response. This insight suggests that the ambiguity around disclosure requires more nuanced examination and perhaps further exploration of qualified staff awareness of disability (particularly specific learning disabilities) is needed.

In relation to the university environment, numerous examples were highlighted by the participants indicating how their engagement and assessment potential were hampered. These raise some significant questions about what might be done to make the education experience more inclusive and what adjustments might be considered reasonable alongside the expectations of professional behaviour and competence. Understanding these opportunities may assist in facilitating engagement and subsequent assessment success.

One example noted by the students was the inaccessibility of the learning environments, whether through lecture format and notes, class sizes and structure or the virtual learning sites. A number of possible contributing factors were implied for this apparent lack of consideration of the wider features of education delivery such as: i) lack of familiarity of staff with principles of inclusive education (as described by Hockings [ 21 ]), ii) a lack of willingness to deliver on it or alternatively iii) a mismatch between the students’ expectations of specific delivery methods (e.g. introductory lectures) and the pedagogical considerations by the faculty. What was explicit in this study is that standardised and inflexible teaching and learning practices actively impede the students’ engagement, autonomy and management of self, a view supported by related literature and linked to success [ 20 , 26 , 36 , 37 ]. Furthermore, there appeared to be little opportunity for effective dialogue with academic staff to redress this.

A potentially more complex example was that of a lack of consideration and flexibility in practical examinations. The ability of these assessments to reflect clinical reality was questioned by the students who found the clinical environment to be more accommodating of alternative ways of processing and delivering information. This contradiction in experience raises some key questions about the purpose and process of practical assessments.

While personal fitness to practice was not expressly raised in this study, the implied necessity of clinical competence suggests the concept of ensuring students are fit to practice may influence faculty staff decision making about flexibility within practical assessment. For instance, extra time adjustments may be given for reading preparation but not within situations that apparently replicate a clinical encounter, which is similar to guidance for medical education [ 38 ]. However, this neither considers the iterative real time clinical reasoning processes that occur during practical examinations that were often described by the participants in this study. Nor does it potentially reflect many therapeutic clinical encounters in which the assumption of immediate and time restricted response (for purposes of safety) are not necessarily required. Discrepancy is also noted in students’ descriptions of proactive use of templates to support their organisation and decision-making while on placement which are explicitly not permitted within university assessments. Interestingly, alternative formats for students to respond to clinical questions, such as use of paper and diagrams, is recommended by the General Medical Council [ 38 ].

As a consequence, the very purpose of reasonable adjustments is questioned and a dilemma of prioritising safety over effectiveness is created (also reported in nursing education [ 39 ]). A focus on examination competence that does not reflect clinical need and competence suggests an approach to university assessment based on homonormativity and ableist processes. This limits students’ potential and autonomy, decreases their capacity to explore and be appropriately assessed on strategies they could use in practice, but also inappropriately homogenises all clinical situations. Eaterbrook et al. [ 20 ] and Bulk et al. [ 36 ] note that there needs to be greater clarity on necessary competencies and appropriate inflexibility alongside acceptance of where approaches and structures can be changed. A more considered approach to practical based assessments which involves closer dialogue with both clinical partners and students would result in an improved capacity to align assessment with clinical reality and assist visibility of decision making. This is particularly required given that currently the students perceive that the support they receive on placement is more appropriate and flexible and utilises their enhanced skill set rather than remaining in a deficit model.

A key aspect of these findings is that understanding these students’ experiences and the implication of education has broad relevance. Their narratives are a challenge not only to how education providers engage with students with disabilities, but how they engage with educating all students. Shakespeare [ 40 ] calls for a deconstruction of an assumed normality and in highlighting discontinuities in their experience, which they note impacts on all students, the students in this study echo that call.

The overall sense of these data is that these students are caught within a focus and indeed the language of deficit by a system that they perceive prioritises normalisation, while they indicate a desire to explore, affirm and express their able diversity. Adjustments for them were not seen as a concession to normalise but an opportunity to learn and perform to the best of their ability and reflected their experience in the clinical environment. This lay in contrast to what they perceive as the fractured institutional processes which appeared to remain in concessionary structure, but specifically one that only pertained to particular tasks, reading and written assessments. As a consequence, the inclusivity of the curricula and its delivery may be questioned, and the opportunities to celebrate able diversity need to be reconsidered.

This study has number of strengths and limitations which are important to consider. The limited representation of different disabilities, specifically physical and visual is acknowledged. Likewise, the specific locality of the study and its focus on two institutions may limit that relevance of the findings to a wider audience, however readers are encouraged to consider similarities to their own context. To counter some of these limitations a researcher with a disability was included during all stages, care was taken to encourage open conversations within the focus groups and the rigour of the analysis and the member checking of initial summaries gives strength to the depth and direction of the analysis.

These focus groups with physiotherapy students with a range of different specific learning difficulties and other long term mental health disorders, has demonstrated that studying physiotherapy involves complex dynamics, which the students have to learn to navigate. The students navigate factors that include ignorance of their conditions within the profession and educational institutions which results in often haphazard routes to diagnosis, ambiguity with disclosure, and critically, both a lack of continuity in the institutions approach to support and inadequate consideration of the impact of the learning environment, assessment and resources. While the students accepted that these concerns often relate to all students, they felt that they disproportionately impacted on those with disabilities.

As a result, the students felt somewhat disempowered by structures and processes throughout their course. These hurdles also impede use of their self-management strategies that they have worked hard to develop and wish to implement.

This was a small study based in a particular region of the UK. However, given the dearth of research to date within physiotherapy, it is an important step forward. Specifically, this study extends the literature in this area by highlighting the issues experienced within the university setting which have been under-reported in physiotherapy. This particularly relates to the concepts of and limitations to reasonable adjustments. It further highlights the ambiguity of disclosure, indicating a need for further exploration.

There is a need for more studies looking at the experience and attainment of students with disabilities nationally, with a focus on the factors that impact on their learning experience and successful strategies to facilitate that process. Specific focus on the transition from University to clinical environments is also warranted.

Implications

Students have a wealth of knowledge based on their experiences of living with a disability while undertaking pre-registration physiotherapy studies. The insights they raise pose a number of challenges to education providers both in academic and clinical environments. While caution is appropriately raised in regard to generalisations for what is a very heterogeneous group, some general considerations can be raised from this study. These include; consistent and accessible signposting to facilitate early self-understanding and recognition of strategies and skills; increase staff awareness of individual experiences of disability and how this can impact on learning in different environments; critical examination of the justifications for what is considered ‘reasonable’ in terms of adjustments; improved interaction between clinical and university based education providers to share understanding and expectations in relation to adjustments and clinical competence; and a reconsideration of inclusive education that creates opportunity to allow and celebrate able diversity.

Availability of data and materials

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

Abbreviations

Attention deficit disorder

Attention deficit hyperactive disorder

Higher education institutions

National Health Service

Objective structured clinical examination

United Kingdom

Virtual learning environment

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Acknowledgements

Thanks to the students who volunteered to participate in this study and offered to share their experiences.

The study was funded by Health Education England North West London, but the design of the study, data collection, analysis, interpretation and writing was entirely the responsibility of the authors.

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MN, JH, AW, SW conducted the focus groups. MN analysed the data. JH, AW, SW all reviewed the data and analysis and participated in critical discussions. MN drafted the article. JH, AW and SW made significant contributions to the final draft, which all authors have approved.

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Norris, M., Hammond, J., Williams, A. et al. Students with specific learning disabilities experiences of pre-registration physiotherapy education: a qualitative study. BMC Med Educ 20 , 2 (2020). https://doi.org/10.1186/s12909-019-1913-3

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Learning Disabilities Research Studies: Findings from NICHD funded Projects

Brett miller.

Child Development and Behavior Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, U.S. National Institutes of Health, U.S. Dept. of Health and Human Services, Bethesda, MD

Sharon Vaughn

Dept. of Special Education, College of Education, University of Texas at Austin

Lisa Freund

Advancements in prevention and treatment of learning disabilities hold the promise of improving the educational, health, social and civic lives of affected children, adolescents, adults, and their families. To meet this promise, a continued, concerted effort is needed to develop and refine intervention approaches targeting struggling or at-risk learners and those identified with a specific learning disability. These interventions will be delivered in diverse settings by practitioners representing a range of disciplines. We need intervention options that address the developmental range of learners from our youngest to older secondary learners and include a sufficient breadth of intervention approaches to be relevant along the prevention to remediation (e.g., general education classroom and special education services in schools) spectrum. This special issue aims to move us closer to that promise by focusing on projects designed to inform intervention development and test specific intervention models for young, struggling learners at risk for or identified with a reading disability.

Learning Disabilities Research Centers and Learning Disabilities Innovation Hubs Consortia

Since 1989, the Learning Disabilities Research Centers Consortia, established by the Eunice Kennedy Shriver National Institute of Child Health and Human Development 1 (NICHD), serve as NICHD's primary means for improving knowledge on the causes, origins, treatments, and developmental learning course of learning disabilities by supporting transdisciplinary research related to basic reading skills, reading fluency, reading comprehension, written comprehension, and response to intervention. Research studies funded through the LDRC consortia have influenced the field of reading and specific learning disabilities by contributing to: the understanding of phonemic awareness in reading, the importance of students needing explicit, high-quality instruction, the value of word reading approaches as well as fluency as contributors to reading comprehension, and the overall efficacy of response to intervention (RTI) approaches for identifying and treating individuals with learning disabilities. The contributions of research on reading disabilities through the LDRCs provide examples of how the depth of scientific knowledge accrues within a specific domain and then is meaningfully connected and integrated across disciplines to provide a more comprehensive explanation of a scientific finding – in this case knowledge about reading disabilities.

More recently, the NICHD enhanced its research investment in the area of learning disabilities by developing new Learning Disabilities Innovation Hubs (LD Hubs). The LD Hubs are intended to complement the LDRCs by focusing on understudied research topics in the area of learning disabilities (LDs) specific to reading, writing, or mathematics and include a focus on understudied populations at-risk for one or more LDs. This program intends to speed the cross-programmatic and transdisciplinary transitions underway in the learning disabilities research field to the benefit of all learners. To facilitate this transdisciplinary transition, both programs focus on mentoring of developing and early career investigators with a particular interest in increasing the representation of individuals from under-represented groups in science and hence, more broadly promoting diversity in the cadre of scientist conducting research. These projects provide mentored research opportunities to help ensure future researchers have the skills and experiences necessary to become integral parts of transdisciplinary teams.

Overview of Special Issue

In this special issue, investigators present research findings from three studies, funded wholly or in part through NICHD support of the LDRCs or LD Hub Consortia, related to high priority areas in the field of learning disabilities.

Accurate and appropriate early identification of students with learning disabilities has been an important, albeit somewhat contentious, issue for more than 50 years. Within the last ten years, multi-tiered systems of support or RTI frameworks have been implemented within states and schools across the country (for example, see www.intensiveintervention.org ). With recent flexibility permitted by the Individuals with Disabilities Education Act (IDEA; U.S. Department of Education, 2004 ), states may allow data from RTI practices to influence decisions regarding identification and treatment of individuals with significant learning difficulties most frequently applied to students with reading problems.

We have made great strides in early and accurate screening for reading difficulties leading to early interventions. These approaches to screening are particularly effective in identifying young children with reading difficulties (e.g., Jenkins, Hudson, & Johnson, 2007 ). Furthermore, we have experienced considerable success in developing and validating treatment protocols for young children (kindergarten through 2 nd grade) with reading problems (e.g., Wanzek & Vaughn, 2007 ). Despite these successes, there remain considerable gaps in our research knowledge that inhibit appropriate identification and treatment of individuals with learning disabilities.

One significant gap involves education supports for learners who are minimal responders to research-based standard protocols. As a field, we know considerably more about effective treatments for students who respond to research-based standard protocols than we know about students who are minimal responders to these treatments (e.g., Barth et al., 2008 ; Denton, et al., 2006 ; Denton, 2012 ; Toste et al., in press ; Vaughn et al., 2010 ; Vaughn & Fletcher, 2010 ;. When students are provided reading treatments typically associated with improved outcomes, and these students make minimal gains, the solutions for next steps are inadequately defined (e.g., Vaughn & Fletcher, 2012 ). One common next step when students do not respond adequately to secondary interventions (Tier 2) is to provide additional dosage of the same treatment or a similar treatment. This increased dosage may take the form of increasing the amount of time students are treated in each session, the overall length of the treatment, and/or reducing the group size; however, far less research exists to help inform practitioners' decisions about how and when to increase an intervention dosage (e.g., Al Otaiba, Schatschneider, & Silverman, 2005 ; Denton et al., 2011 ; Faggella-Luby, & Deshler, D., 2008 )

Additionally, we need to enhance considerably our understanding of the characteristics of learners who are minimally responsive to interventions that have demonstrated efficacy with the goal of informing prevention, early identification, and remediation strategies, not just for beginning readers, but data are needed across the developmental span. Understanding the relationship between the characteristics of learners who are minimal responders, their response to literacy interventions, and how their response may or may not be mediated by other attributes such as executive functioning skills is an imperative next step in LD research (see Bierman & Torres, in press ). Such research should provide the foundational understanding of who minimally responsive learners are such that we can strengthen their remediation efforts. Research studies also need to better define the mechanisms for designing treatments that are optimally aligned with these learners' characteristics. For example, if the majority of minimally responding students with a reading disability display attention problems, are there mechanisms for enhancing attention during reading treatments that can also enhance learning outcomes? Identifying specific learner characteristics that impact on or interact with interventions requires systematic research with an individual-differences approach. Furthermore, there are a myriad of developmental issues including: how treatments need to vary with students in older grades, the extent to which dispositional factors such as engagement, motivation, and affect influence outcomes and can be treated, the reciprocal role of writing and reading, and mechanisms for identifying and treating students in relation to various aspects of executive functioning.

Understanding the continuum of learners' responses to intervention necessitates an additional focus on underlying causes and hypothesized mechanism leading to adequate or minimal responses. These causes or mechanisms could be endogenous, exogenous or both. For example, there is robust evidence that reading disability and attention deficit-hyperactivity disorder (ADHD) have significant heritability (e.g., Bidwell, Willcutt, DeFries, & Pennington, 2007 ; Christopher et al., 2013 ; Christopher et al., 2012 ; Gayán & Olson, 2001 ; Olson et al. 2011 ; Petrill, Deater-Decker, Thompson, DeThorne, & Schatschneider, 2006 ; Willcutt, Pennington, & DeFries, 2000 ; Willcutt et al., 2010 ) and are associated with deficits in executive functioning. Although hereditability estimates of reading are often high, environmental characteristics can modulate these effects. This gene-environment relationship is a complex interplay that changes over time in terms of the estimated variance accounted for in the development of reading skills (e.g., Harlaar, Dale, & Plomin, 2007 ; Petrill et al., 2007 ). From an instructional perspective, critically, increasing evidence indicates that reading disabilities are malleable suggesting a need for, and potential benefit from, further refinement of our understanding of effective treatments (e.g., Keller & Just, 2009 ; Shaywitz et al., 2004 ; Simos et al., 2002 , 2006 )

Neuroimaging is also providing insights to both the nature of response and as a predictor of response. Brain imaging has been successfully utilized to show both structural and functional changes in response to successful behavioral intervention, i.e., reading intervention (e.g., Keller & Just, 2009 ; Krafnick, Flowers, Napoliello, & Eden, 2011 ; Shaywitz et al., 2004 ; Simos et al., 2002 , 2006). In the case of struggling and LD learners, these changes in response to intervention, appear to move brain systems closer to a normalized state consistent with more typically developing learners. Additionally, recent evidence suggests the potential power of imaging as predictive tool – to date in retrodictive studies, i.e., to ascertain who is likely to be responsive to a specific treatment (e.g., Hoeft et al. 2011 ). This is not to imply that we are advocating imaging learners to inform instruction, but rather these efforts help us understand the underlying mechanisms and causes of response (adequate or otherwise) in the hopes that this will help empower the next generation of interventions. A cogent understanding of risk could inform interventionists' efforts to focus resources on the most struggling learners and provide insights into the types of interventions that might be best applied to learners with historically less tractable learning disabilities. Studies addressing many of these topics are currently being investigated within the scope of work funded by the LDRCs, LD Hubs, and the broader NICHD investment in reading.

Contribution of Articles to this Special Issue

This special issue includes three research studies addressing issues related to reading difficulties in young students (1 st through 3 rd graders) and two commentaries. In the study reported by Miller and colleagues, teacher ratings of students' behavioral attention predicted at-risk 1 st grade students' responses to word reading instruction and then their later (3 rd grade) reading comprehension outcomes. This result emphasizes the importance of considering student's attention as it relates to reading outcomes. This finding is particularly notable given the expectation that in the one-on-one treatment intervention the children received, instructors would be more likely to minimize a student's attention related problems than in small or large group instruction. By the time students were in 3 rd grade, the relationship between attention and reading comprehension was mediated by word reading growth in 1 st grade and 3 rd grade word reading performance. This study provides evidence of potential value in assessing a learner characteristic, behavioral attention, as a means of interpreting at-risk students' responses to intervention.

The benefits of long-term research studies such as the one reported by Miller et al., are also evident in the study by Al Otaiba and colleagues. The Al Otaiba et al. study addresses the long-term effects of two, 1st grade models for implementing RTI on the reading outcomes of students in 2 nd and 3 rd grades. One of the approaches, referred to as Dynamic, was more responsive to students' individual reading profiles derived from the point of screening onward, whereas the second approach, referred to as Typical, corresponds to standard models of response to intervention. Students in the Dynamic condition demonstrated higher word reading scores at the end of 2 rd grade than students in the Typical RTI group. These initial findings may provide important guidance to educators. Students who received interventions that were matched to their individual needs yielded better overall outcomes than those in more traditional, static approaches to intervention. This suggests that moving students to more intensive interventions earlier rather than waiting for them to demonstrate low response to less intensive interventions may be beneficial.

The third study in this special issue is reported by Denton and colleagues and addresses two theoretically different approaches to providing interventions to 2 nd graders with significant reading difficulties. One approach is Guided Reading in which the emphasis is on text reading deemphasizing explicit instruction and reading skills. The second approach is described as explicit intervention and addresses more specific instruction in phonemic awareness, phonics, and word reading as well as text reading. Their findings suggest that more explicit instruction is likely to accelerate student progress in phonemic decoding, text reading fluency, and reading comprehension than guided reading. All students, regardless of condition, remained behind in word reading fluency at the end of the school year suggesting that these students require either a significantly more intensive intervention or interventions that are multi-year.

In the first commentary, Fletcher and Wagner (this issue) raise two key issues to inform one's determination of the impact of the studies in this issue and in the literature writ large: Specifically, are effects of intervention cumulative (if not, how do you make them cumulative?) and how does one know when to interpret smaller effect sizes as meaningful? In part through analogy, the authors highlight the potential of small effects being meaningful if they accumulate. Furthermore, they emphasize the import of examining outcomes in the context of findings from the field and general expectations for expected growth/gains for learners. Fletcher and Wagner also discuss conditions that are likely necessary to evaluate whether intervention effects are potentially cumulative (or could be). They emphasize the importance of rigorous designs that provide unbiased estimates of treatment effects, longitudinal designs for intervention to ascertain longer-term impact of intervention, and the inclusion of variables that align with the underlying causal model assumed by the intervention along with appropriate covariates in light of the intervention targets. This commentary further points out the value of context both in interpreting findings today as well as in considering the types of dosage and durations of intervention that may be necessary for struggling learners moving forward. Fletcher and Wagner's broader theme of the interpretation of smaller effect size and implications for intervention is also carried through in the second commentary.

In the second commentary, Snowling and Hulme (this issue) continue the theme of contextualizing why the field may be obtaining small or modest effect sizes and importantly provide suggestions for approaches to strengthen intervention frameworks to increase effect sizes and the benefit of learners. They point out that interventions may lack the intensity necessary for larger effects and also allude to potentially thinking of years of intervention, particularly for the most struggling learners, and that increasing the literacy experience outside of school (e.g. in the home) is likely needed to support this effort. Additionally, they encourage more attention to enhancing motivation and engagement in the reading process for learners and point out environmental and cultural factors that could inform underlying theory driving intervention development; models are often underspecified regarding these factors and other within-child factors (e.g., attention) that could impact literacy outcomes. Finally, they point out the significant need for more attention to the potential mismatch of language between child and instructor (e.g., differences in dialect) and highlight its potential role in literacy development, particularly for children from diverse backgrounds. Critically, they more broadly highlight need for the development of strong oral language skills to support literacy development. These commentaries, taken together, highlight the need to contextualize our effects in light of their potential cumulative impact as well as their expected impact and emphasize the need to redouble our efforts to strengthen our interventions through an enhanced focus on learner characteristics, environmental conditions, strengthening oral language, etc. These characteristics (and others) will need to be formally incorporating these into theoretical and conceptual accounts of reading development and be combined with extended dosage and duration to help drive improved outcomes from the next generation of interventions.

Implications

In closing, this special issue provides a small sample of the many essential learning disability questions being addressed through current LDRC and LD Hub funding. The articles in this special issue reflect the promise in the continuing efforts of a large cadre of dedicated researchers for not only identifying the mechanisms underlying learning differences, but finding the pathways to more individualized and effective interventions for the children struggling with learning disabilities.

1 The centers were established by the National Institute of Child Health and Human Development, which in 2008 was renamed the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

The opinions and assertions presented in this article are those of the authors and do not purport to represent those of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the U.S. National Institutes of Health, and the U.S. Department of Health and Human Services.

Contributor Information

Brett Miller, Child Development and Behavior Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, U.S. National Institutes of Health, U.S. Dept. of Health and Human Services, Bethesda, MD.

Sharon Vaughn, Dept. of Special Education, College of Education, University of Texas at Austin.

Lisa Freund, Child Development and Behavior Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, U.S. National Institutes of Health, U.S. Dept. of Health and Human Services, Bethesda, MD.

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Disability Inclusion and Inclusive Education pp 175–193 Cite as

Specific Learning Disability: A Hidden Disability

• Apoorva Panshikar 2  
• First Online: 23 February 2020

2435 Accesses

3 Citations

The chapter ‘Specific Learning Disability: A Hidden Disability’ purports to educate the reader about one of the high incidence disabilities, i.e. specific learning disability (SLD). In the chapter, attempts are made to bring about understanding of the concept of SLD, its characteristics and types. The causative factors are discussed not so much from a medical perspective as social perspective. Efforts are made to clarify the misconceptions surrounding the condition. The numerous ways to support a child with SLD in schools (to meet the academic and nonacademic needs) and in community are included. Discussions on the issues, challenges and future paths in the field of SLD attempt to give a near holistic understanding.

• Specific learning disability
• Disabilities
• Hidden disability
• Academic problems
• Strategy training

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In this chapter, we will attempt to comprehend the concept of specific learning disabilities, commonly represented as SLD, the context that guides the attachment of the label of SLD to an individual, the misconceptions around the condition, the academic and psychosocial needs of individuals with SLD and ways to help children with SLD in classrooms. The discussions cannot be complete without dwelling on the role of parents and important people in the child’s life in helping the child deal with SLD. There are challenges in any walk of life. This is true of the field of SLD as well. The future trends guide the way ahead for the field and individuals living with the condition.

Conceptual Foundations

In a mainstream or inclusive education classroom, the most commonly found disability is SLD. In India, various studies done have documented the prevalence of SLD between 3% and 14% of school-going population (Bandla et al. 2017 ; Padhy et al. 2016 ; Mogasale and Mogasale 2012 ). The term ‘learning disabilities’ was first coined in the year 1963 by Samuel Kirk, and even today it is a general term that is used to describe learning problems of a specific kind.

National Joint Committee on Learning Disabilities (NJCLD 2016 ), a coalition of parent and professional organizations in the USA, updated the following definition of learning disabilities in 2016 (which was adopted in 1990):

Learning disabilities is a general term that refers to a heterogeneous group of disorders manifested by significant difficulties in the acquisition and use of listening, speaking, reading, writing, reasoning, or mathematical abilities. These disorders are intrinsic to the individual, presumed to be due to central nervous system dysfunction, and may occur across the life span. Problems in self-regulatory behaviors, social perception, and social interaction may exist with learning disabilities but do not by themselves constitute a learning disability. Although learning disabilities may occur concomitantly with other disabilities (for example, sensory impairment, intellectual disabilities, emotional disturbance), or with extrinsic influences (such as cultural or linguistic differences, insufficient or inappropriate instruction), they are not the result of those conditions or influences.

An analysis of the definition of LD given by NJCLD indicates the following:

Specific learning disabilities (not learning disability) is a group of disorders. It is characterized by a group of difficulties (not just one problem) in a person that manifests differently in different individuals. To illustrate, a child may not show only reading problems; it may be accompanied by oral language issues and problems in doing math word problems as well.

There exist a wide range of problems in the skills that individuals acquire and use across their life span. These include listening, speaking, reading, writing, reasoning and mathematical abilities.

Different children with LD have different combinations of problems. The severity of the problems also differs. For example, one child with LD has problems in reading and maths, while another exhibits issue in reading and spelling, and a third child has difficulties in understanding and using oral language. Similarly, two children with reading difficulties manifest the problems differently. One student can read fluently but cannot understand what is read, while another child cannot read at all.

The above listed problems are not just difficulties but are ‘significant’ difficulties. This implies that when standardized tests (educational or tests of psychological processing) are administered to the person, she/he shows a lag of at least 1.5 to 2 years in academic achievement or cognitive processing on the tests.

LD is due to dysfunction in the central nervous system. There may be hereditary, genetic or even environmental factors responsible for causing the central nervous system dysfunction.

Along with the problems in reading, spelling, writing, mathematics, etc., the child may show problems in social skills and self-regulation. A child may thus have problems in making friends, difficulty understanding nuances of nonverbal behaviour, deficits in making decisions in social situations, etc.

A person with other disabilities as intellectual disability (formerly called mental retardation), visual impairment, hearing impairment and emotional disturbance may have an LD; however, intellectual disability (or any of the other disabling conditions) cannot lead to a LD. These conditions do not cause an LD; they can coexist.

LD exists irrespective of cultural background, social strata, economic strata, impoverished familial background, opportunities for educational access and school environment.

LD is neither a disability in the Western countries nor an English-language-based condition. It is therefore reassuring to review the definition of LD used in India and defined in the Rights of Persons with Disabilities Act (RPWD) of 2016 . It was only in the year 2016 that India acknowledged ‘specific learning disabilities’ as a disabling condition and defined ‘specific learning disabilities’ as:

a heterogeneous group of conditions wherein there is a deficit in processing language, spoken or written, that may manifest itself as a difficulty to comprehend, speak, read, write, spell, or to do mathematical calculations and includes such conditions as perceptual disabilities, dyslexia, dysgraphia, dyscalculia, dyspraxia, and developmental aphasia. (Rights of Persons with Disabilities Act 2016 )

The major difference that exists in the RPWD as compared to the NJCLD is that it does not refer to the aetiology of LD which is clearly listed in the NJCLD definition. Similarly, it does not mention the secondary manifestations of LD, the comorbid conditions or the deficits in acknowledging that problems in reasoning may be present.

Characteristics of Children with Specific Learning Disabilities

The case of a 12-year-old student may illustrate some of the classic problems experienced by a child with LD:

The class teacher of this grade 7 student had observed these behaviours: The student required constant reminders from the teachers to pay attention to any activity done in class – be it an academic activity or non-academic activities like art/craft. Incomplete notebooks, spelling errors, answers that made minimal sense characterised his written work. He read like a grade 3 student – slowly, with a lot of effort and he could barely retell what he read. He was a loner, his classmates found him stupid, and he was bullied by many in his class. He ‘seems lost’, his teacher would say.

Though the described case is a rather illustrative one, a single case description cannot highlight the wide spectrum of difficulties experienced by persons with SLD. Beyond doubt, the most common characteristics of SLD are difficulties in reading, writing and doing mathematical calculations. However, a person with SLD may not possess only just these characteristics. Janet Lerner ( 2000 ) has listed nine defining learning and behavioural characteristics of persons with SLD (some characteristics seen in the cases described above will be found here):

Attention related : Those students with attention disorders may not be able to focus their attention or sustain their attention to complete tasks. They are highly distractible. These children are the ones who may have attention deficit hyperactivity disorder along with SLD.

Poor motor abilities : Gross and fine motor movement problems may be exhibited by some students with SLD. Difficulties in coordination of motor skills may be observed as well.

Psychological processing and information processing problems : Issues in processing visual and auditory information to make sense of it may be present. Discriminating visual and auditory stimuli, blending sounds to make words, etc. is a difficulty faced.

Oral language difficulties : Several persons with SLD show problems in understanding oral language. Poor vocabulary, poor communication and listening and speaking skills are likely to be seen.

Reading difficulties : Problems in decoding words and reading sight words and problems in comprehending read information are seen in majority of students with SLD.

Written language difficulties : Many students may exhibit problems in writing. Communication of ideas through written mode is a concern, and it may be characterized by grammatical errors, poor ideas and vocabulary inappropriate for the level.

Mathematics difficulties : Understanding mathematical concepts, doing arithmetic computations, solving quantitative problems and understanding time and measurement seem to be problem areas for some students with SLD.

Social skills deficits : SLD for a few is manifested in learning to use appropriate social behaviours as well. Difficulty in learning how to act in social situations leads to poor social relationships and difficulty in making friends and maintaining friendships.

Executive functioning deficits : Some witness a major difficulty in regulating their thinking to organize information for effective use. Higher-order thinking, problem-solving and adaptability require use of executive functioning.

Prior to Lerner, Clements ( 1966 ) enumerated ten characteristics of SLD, viz. hyperactivity, impulsivity, perceptual-motor impairments, disorders of memory and thinking, emotional labiality, academic difficulties, coordination problems, language deficits, disorders of attention and equivocal neurological signs. In addition to the list of characteristics mentioned by Lerner, Clements mentions emotional labiality as an important characteristic. In many individuals with SLD, we observe sudden mood changes, a characteristic that increases the chances of poor social relations for them.

It may appear that the major concerns for a person with SLD are meeting the academic demands and fulfilling the expectations of structured and formal learning conditions. This primarily may be true; nonetheless it is seen that the experience of failure at academic tasks, inability to satisfy parental and teacher expectations, etc. lead to secondary problems. The emotional scars of repeated failure and the inability to achieve and develop a sense of competence and self-worth are often indelible. Consequently, students with SLD sometimes develop secondary emotional disturbances. About 30% of children with SLD have been found to show behavioural and emotional problems, viz. attention deficit hyperactivity disorder, depression, anxiety, suicidal ideation, substance abuse, etc. (Sahoo et al. 2015 ). The student whose failure to learn is accompanied by emotional problems may be the victim of a continuous cycle of failure to learn, and thus it can lead to adverse emotional responses – feelings of self-derision, poor ego perception and anxiety which augment the failure to learn syndrome. Low motivation, anxiety, poor self-esteem, behavioural concerns, psychosomatic effects and being self-critical and critical of others are some of the psychological effects of having SLD.

Types of Learning Disabilities

The fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) revised in 2013 lists specific learning disorder as a diagnostic condition and states that ‘it is a neuro-developmental disorder of biological origin manifested in learning difficulties and problems in acquiring academic skills markedly below age level and manifested in the early school years, lasting for at least 6 months; not attributed to intellectual disabilities, developmental disabilities, developmental disorders, or neurological or motor disorders’. The diagnosis requires the clinician to specify whether there is an impairment in reading, written expression or mathematics and specify the level of severity of the condition and requires that the diagnosis mention it.

Based on the identification criteria, at least three types of specific learning disabilities can be delineated: specific learning disability in reading, specific learning disability in writing and specific learning disability in mathematics:

SLD in reading includes possible deficits in word reading accuracy, reading rate or fluency and/or reading comprehension. This condition is also known as dyslexia. It is the most common type of SLD.

SLD in written expression includes possible deficits in spelling accuracy, grammar and punctuation accuracy and/or clarity or organization of written expression. Dysgraphia is another term used to communicate problems of this kind.

SLD in mathematics includes possible deficits in number sense, memorization of arithmetic facts, accurate or fluent calculation and/or accurate math reasoning. The given condition is called dyscalculia at times.

The RPWD Act ( 2016 ) mentions that conditions like dyslexia, dysgraphia, dyscalculia, perceptual disorders, developmental aphasia and dyspraxia are included in the term SLD. The terms dyslexia, dysgraphia and dyscalculia are synonymous with three SLDs – SLD in reading, SLD in written expression and SLD in mathematics, respectively. Developmental aphasia is an impairment of language, affecting the production or comprehension of speech and the ability to read or write (National Aphasia Association, n.d. ). Dyspraxia on the other hand as defined by Dyspraxia Foundation refers to a disability affecting fine and/or gross motor coordination in children and adults.

Sociological Perspective of SLD

That the cause of SLD is the dysfunction of the central nervous system is a known fact. The medical model of disability views disability as entrenched in the person (the brain, in case of SLD), and thus the locus of the problem is the person. The aetiology of SLD can be traced to heredity, genetic make-up, exposure to teratogenic influences in prenatal or postnatal developmental stages, trauma during birth or in the developmental period or metabolic conditions. It is a well-accepted fact that these conditions will cause SLD; yet, the severity of the manifestation of the condition is variant and dependent on many factors extant in the context the person lives in. Conceptually, the socio-environmental factors do not cause SLD. Nonetheless, the difficulties experienced by the person can be aggravated or abated due to conditions prevalent in the person’s social milieu.

The sociological aspects prompt not only the identification of the disabling condition but also the possibility and nature of service provision for a child with SLD. The identification of SLD appears to be guided by factors like exposure to educational opportunities, facilities for availing appropriate education, multilingualism (Ahmad 2015 ), multiculturalism, qualifications of school teachers, quality of teachers, stability of teachers in schools, impoverished family backgrounds, urban-rural differences, availability of cultural-fair assessment tools (Ahmad 2015 ), trained professionals to conduct assessments with expertise, media exposure to the disability, the government schemes and policies, teacher expectation of students learning vis-à-vis curricular demands, ability-based grouping of classes, social stigma/social acceptance (Ahmad 2015 ), etc. The situation in India is thus teeming with numerous instances affirming the same.

The case of Ajay, a 9-year-old studying in grade 4, may shed light on some socially driven factors that augment the likelihood of the identification of SLD and his not being able to get the services he needs. The child’s personal, medical and academic history as reported by his mother help understand it better (M. Raut, Personal Communication, September 11, 2017):

Ajay has a perinatal medical history of neonatal jaundice (that required hospitalization), and high fever accompanied by febrile convulsions at age of one and half year. Neonatal jaundice, high fever and febrile convulsions are documented causes of SLD. Hence, a neurobiological basis of SLD exists. Ajay’s parents are separated, and the mother is trying to make ends meet. She is unable to spend time with him. Ajay attends a government run vernacular school. The mother said that his teachers change very often and there is no consistency in the education the students receive. She feels that the problems started when Ajay was in grade 2 and his class did not have a teacher for 2-3 months. The school head is very particular about implementing government policies and so he refers underachieving students for SLD assessment. The school, however, has no special education teachers. When Ajay was referred for a clinical psycho-educational assessment, the professionals who were to assess him did not have standardized assessment tests in his language. He was assessed to have SLD using informal measures. Ajay’s mother has no cognizance of what the implications are of having SLD or what line of action is to be charted.

The case prompts us to dwell on the inherent sociological aspects that may be enumerated as the child’s family situation, the socio-economic stratum he belongs to, inconsistent teaching-learning opportunities, inconsistent quality of education, proactive school head, presence of mechanism to assess the student, nonavailability of appropriate assessment tools, absence of special educator in the school to provide remedial intervention, etc. Given this combination of factors, the child is bound to experience academic as well as psychosocial difficulties. Unlike in the case of Ajay, some children who have SLD may not be identified because the parents and the family fear social rejection and ridicule. Hence, they may deny the existence of the problem. In such a situation, the child will suffer academic failure and experience some psychosocial issues but may not get formal help.

Issues and Challenges

The field of SLD is rather fluid, and the discord far outweighs consensus. The NJCLD, (elaborate) in 1994 listed the following issues:

Lack of understanding, acceptance and willingness to accommodate normal variations in learning and behaviour

Lack of sufficient competent personnel and appropriate programmes to support the efforts of teachers to accommodate the needs of children who do not have learning disabilities but who require alternative instructional methods

Insufficient supply of competently prepared professionals to diagnose and manage exceptional individuals

The false belief that underachievement is synonymous with specific learning disability

Failure of multidisciplinary teams to consider and integrate findings related to the presenting problem(s)

General preference for the label ‘learning disability’ over ‘mental retardation’ or ‘emotional disturbance’, which leads to the misclassification of some individuals

Given the Indian scenario, there are plenty of issues that affect the well-being of persons with SLD, and many of them arise from the conceptual understanding of the disability to operationalizing the definition and to the nature and scope of research undertaken in the area. Lack of clear definition and understanding about SLD (Ahmad 2015 ), lack of awareness about SLD (Ahmad 2015 ; Karande 2008 ), nonavailability of standardized tests for the Indian population and in vernacular languages and high cost of remedial services (Karande 2008 ) are burning issues even today. Many a time, the fear of stigma and low awareness levels leads to poor referrals for assessment (Shah and Trivedi 2017 ).

The situation in our country is more than alarming because there is documentation of certification of SLD practices in just a handful of places, viz. Maharashtra, Karnataka, Kerala and Delhi (Sandhu 2015 ). In addition to this, lack of clarity about how to quantify SLD to meet the benchmark requirement of 40% disability as required by RPWD Act makes it difficult to diagnose an SLD (Sandhu 2015 ) that warrants legal provisions for educational supports.

It is observed that teachers are often unable to differentiate children with SLD from children who are underachieving for reasons other than the child’s distinctive characteristics. This leads to a skewed misrepresentation and teachers often resorting to grouping all underachieving children as ‘learning disabled’. In the USA in the late 1970s, the Response to Intervention (RTI) model was proposed. It aimed at systematically identifying children with LD than labelling them primarily based on ability-achievement discrepancy. The model is a three-tiered model, wherein at tier one all students receive systematic evidence-based teaching. Those who do not achieve set objectives are placed in small group instruction environment. Despite this if some student fails, then thorough assessment is conducted to ascertain the presence of a specific disability. This model is nearly non-existent in Indian schools (Venkatesan 2016 ), and therefore, any underachiever is referred for in-depth psycho-educational assessment. Though the RTI model is a widely employed model in the West, it is not without problems; for example, the underachievement criterion may exclude some high-ability students with LD as they often manage to achieve within the normal range and, therefore, are unlikely to receive the early individualized instruction that would enable them to make academic progress consistent with their abilities. Another situation may arise as well, for example, there are students who are underachievers and do not respond to intervention who may be inappropriately identified as having a learning disability. This includes environmentally disadvantaged, minority and English language learners who are overrepresented within the population of underachieving students and students who are at risk and in need of specialized supports and instruction for other reasons (e.g. lack of motivation, emotional stress).

The need of the hour is that schools employ universal screening policies to identify all those students who may exhibit learning problems. In-service training of mainstream classroom teachers will go long way in early identification and providing classroom-based supports for these students. Greater number of special education teachers certified by Rehabilitation Council of India is essential. The dearth of qualified personnel is a matter of concern as well (Karande 2008 ).

Classroom Implications and Pedagogies for Children with SLD

Students with SLD require lot of support to manage not only their learning issues but also the psychosocial needs. Considering that most children with SLD attend inclusive schools, the supports that may be made available to them can be classified into two categories – academic supports and supports for socio-emotional needs or nonacademic supports:

Consider the case of two students in grade 8. Sahil who is assessed with SLD in Math/dyscalculia manifests major difficulties in reading the various mathematical signs and symbols. Difficulties in understanding the mathematical concepts and relationships are also observed. He now experiences anxiety whenever he is required to do Math. Solving equations in Chemistry is a huge stressor for him as well. Mala, his peer, has SLD in reading/dyslexia. She cannot comprehend what she reads unlike her peers. This also affects her Math performance. However, she has learnt to cope with her problems as she uses some strategy-based techniques to understand what she reads.

Both the above-mentioned students need different kinds of supports in the classroom. Sahil needs support to deal with his emotional concerns along with academic supports or dealing with math-related issues. Mala, on the other hand, requires academic support majorly.

Academic Support

Student with SLD will benefit immensely from certain changes in the classroom instructions and interactions. It is understood that the child will be expected to study the grade-level prescribed syllabus. For the child to truly access the prescribed curriculum at that grade level, it will be necessary to adapt the curriculum to meet the requirements of the child with SLD. Therefore, changes will have to be made in respect of what is taught (content), how it is taught (use of instructional methods) and how learning is demonstrated (methods of evidencing the learning so that it can be assessed) and when, where and with whom the teaching-learning happens (the teaching-learning environment). A few general guidelines may be specified for facilitating the teaching-learning process as well as student engagement in the class (Heward and Orlansky 1992 ):

Provide brief and simple instructions.

Be clear in giving instructions about homework, the dates of exams, etc.

Provide advance notice of any changes.

Provide handouts and visual aids, review sheets, study guides (where possible).

Use buddy system, peer tutoring in the classroom.

Use more than one way to demonstrate or explain information.

Break information into small steps when teaching many new ideas/tasks in one lesson.

Allow the student to use technological devices in the class, e.g. tape-recording lectures, spell-check, grammar-check, voice to text and text to voice readers, calculators, etc.

Provide alternative ways for the students to do tasks, such as dictations or oral presentations.

Reinforce, encourage and motivate the child.

When in doubt about how to assist the student, ask him or her.

Many a time this may not suffice, and the child may require individualized instruction (planned by developing an Individualised Education Programme/Plan, i.e. IEP). This helps to work on the key deficit areas that impede learning and develop the required skills in the student. When employing this ‘skill training approach’, the special educators/skill trainers:

Specifically identify the skills to be taught to the student.

Analyse the task into smaller tasks (or subskills) so that the student can master just one single skill at a time.

Use direct teaching methods that will help the student acquire and master the skill(s).

Monitor the student’s learning continuously so as to modify the instructional method, if the need be.

Evaluate the learning and instruction (Heward and Orlansky 1992 ).

Most often these skills may be reading skills, language skills, math skills or even executive functioning skills. Systematic, explicit and direct teaching is essential for the students to acquire and use these skills. Some of the major intervention areas for developing reading skills are vocabulary skills, phonemic awareness skills, phonic skills and reading comprehension skills. These four skills are extremely important to make the student a fluent reader who can then read and learn with minimal help. The Orton-Gillingham approach, Sounds in Symbols programme, Alpha to Omega programme, Slingerland method, Sonday system, Jolly Phonics, etc. are some of the well-known and widely used programmes to teach reading skills. In an attempt to use a combination of Multisensory Strategy Training based on Orton-Gillingham approach coupled with repeated reading, collaborative reading and multisensory reading, Thomas ( 2015 ) indicated that it produced better academic achievement in students with LD. Nag ( 2017 ) observed that in India most schools teaching akshara-based languages follow the synthetic phonics method. According to her following some simple guidelines will make reading acquisition of alpha-syllabaries more efficient:

In the beginning teach the high-frequency aksharas that will help read and spell early words.

Use explicit methods of teaching of phonemic markers to the students.

It is not essential to teach consonant blends at very early grades.

There is a need of a robust oral language programme to accompany the early reading programme.

Apart from use of synthetic phonics, use of phonologically based programmes along with non-phonologically based remedial intervention programmes (Sarkar 2012 ) improves reading. The use of neurolinguistic programming in the form of multisensory intervention shows improved phonemic awareness, phonological awareness, vocabulary, reading fluency and reading comprehension (Prabavathy 2014 ) in primary school children with dyslexia. It is not unheard of to use computer-assisted instruction (CAI) in process of remediation. The use of games and simulations modes in CAI help remediate deficits seen in children with LD (Kumar 2015 ). Similarly, attempts at using multimedia packages also benefit children with dysgraphia in primary schools (Anilakumari 2012 ).

At Samveda Research and Training Center, a Samveda Remedial Teaching – Math programme is run. After being exposed to this programme, students show gains in their math learning with respect to reduced errors in preoperational- and operational-level arithmetic (Karibasappa et al. 2008 ). In the programme, after doing an error analysis, the conceptual base is developed. This is followed by developing the language for math. The principle of mastery learning and use of instructional techniques helps in teaching fundamental arithmetic.

Explicit teaching of strategy takes precedence for children with SLD. Learning strategies instruction is vital for children with SLD as many may fail to use the acquired knowledge and skills in environments beyond the structured classroom or new situations. Learning strategies instruction entails teaching the students directly and explicitly the task-specific strategies that they master and then guide them to complete the tasks of similar nature. Many studies use cognitive behaviour intervention strategy approach to teach strategies for learning, and this can be done with the use of other methods like CAI (Jena 2013 ). Employing cognitive behaviour intervention involved a 6-step procedure (Jena 2013 ) reading errors reduced, word fluency increased and reaction time to task improved. The 6-step procedure involved the following:

Task description, i.e. knowing what to do

Formulation of strategy to solve the problem and plan the action to be taken

Modelling of the target skill by the teacher for the student

Guided practice to the student to complete the task

Verbalization by the student (overtly and covertly) to develop mediation behaviour

Self-monitoring and self-reinforcement of the behaviour and strategy by the student

There are numerous learning strategies which employ a similar training protocol, and over a period of time, the students internalize the well-structured strategies. Some such strategies are described here:

SQ3R – This is a learning strategy to develop comprehension skills. Herein the acronym is expanded as:

Survey the text.

Question yourself about each section of the text.

Read the whole text quickly.

Recite the question and identify the parts of the text that will help answer your questions.

Lastly, review the text slowly and find your answers.

COPS – COPS is a strategy that helps the students to become aware of and monitor their written composition skills. In this strategy COPS stands for:

Capitalization

Organization of ideas in the written composition

Punctuation

SQRQCR –Learning strategies are used in math learning too. SQRQCQ is a strategy to solve word problems:

Survey the word problem.

Question yourself what answer the problem wants you to get.

Read the problem to get information you need to solve the problem.

Question what operations are needed to solve the problem and in what order you should perform them.

Compute the answer.

Question yourself to whether the obtained answer is reasonable and correct.

Mehta ( 1994 ) developed and validated metacognitive strategies to develop reading comprehension skills, memory skills, concept development, reasoning skills and problem-solving skills. Some of these acronym-based learning strategies are described below. RUHAARS, a strategy for developing reading comprehension, stands for:

R – Read (to aid comprehension).

U – Understand.

H – Highlight what is to be understood.

A – Ask questions to self.

A – Answer them.

R – Recheck.

S – Seek help, if required.

UNIMOW is a strategy to develop memory skills. It is elaborated as:

U – Understand what is to be remembered.

N – Name the symbols.

I – Imagine the association.

M – Make words or sentences.

O – Overtly restate.

W – Write them own.

To develop reasoning skills, R-SERL strategy was developed. It stands for:

State what is asked.

Explore relationships.

Restate the relationship.

In your own words

Link it with what is asked.

Nonacademic Support

The support in the nonacademic areas would focus on reaching out to the students for their socio-emotional needs. Hence, a few guidelines mentioned below may help in the classroom:

Positive classroom environment – providing the student with a nonthreatening classroom environment that is open to individual differences and not averse to failures aids the student.

Acceptance of the child and his/her limitations – the acceptance of diversity in the class vis-à-vis the learning styles, learning rates and learning supports makes the classroom less threatening for the student.

Openness to child’s needs – this point also draws from acceptance of individual differences. Acknowledging that the student with LD has learning needs that cannot be met through regular classroom teaching and he/she will require specialized intervention and adaptations that will help the student develop interest in learning is essential.

Peer support – the use of peer and buddy support to encourage and motivate the student in completing and mastering different learning tasks can be used.

Counselling – many a time, despite making positive changes to the classroom, the student may need to unburden the pent-up emotions. Counselling from a teacher or professional counsellor will help the student articulate his/her concerns and gradually overcome emotional and social issues.

Probing questioning – students with SLD tend to take longer time to comprehend questions and process their thoughts to answer questions posed to them. Needless to say there may be exceptions. Therefore, it is imperative that the teachers have to be patient while posing questions to them to give them adequate time, also rephrase questions and use probing skills to help them answer.

As in cases of children with any type of disabilities, teachers have to assess the child with SLD holistically to identify the talents and other good qualities in them so as to provide opportunities to develop these dimensions of their personality and nurture reciprocity among peer group. This helps to develop a feeling of interdependence among peer group and boost the self-confidence and self-worth of children with SLD like any other child with any disability.

Supporting Children with SLD: Role of Various Stakeholders

Specific learning disabilities comprise much more than academic difficulties; there is a close relationship between a student’s academic learning and his/her socio-emotional domain. Thus, the manifestations of specific learning disabilities do not stop at academics, but extend themselves to encompass all the aspects of the person’s life, including social relationships, social involvement, life choices, etc. Hence, intervention for a person with SLD will never be restricted to an academic programme in the school. Any individual lesson plan made for the intervention for a student with SLD will have to involve a multidisciplinary aspect, thereby getting the family members, the immediate community as well as the professional support, all into the programme. Here, what will help the child are interventions which can enable the child to overcome his/her deficits in perception, motor skills and socio-emotional behaviour, thereby overcoming the impediments to his/her learning. It is thus important to examine the role of the key supports and support systems:

Raima is known to be a good dancer; what is also known is that she has Specific Learning Disability. When she was assessed to have SLD, she was depressed and felt very let down by God. She was angry and aloof, and refused to go to school. However, today she is a different person. A lot of credit goes to her family, teachers, school, and friends and peers for what she is today. Raima’s parents confided in the school authorities and the teachers and sought their cooperation in helping Raima deal with her issues. Her parents and teachers worked out an Individualised Education Plan so that Raima’s learning outcomes were specifically planned, monitored and evaluated. Since Raima was learning Kathak, her parents encouraged her to invest more time and effort in the same. With her teachers changing their teaching methods for Raima, her peers helping her in completing classwork and learn the taught content, Raima gained confidence. The school also encouraged Raima to participate in dance competitions. Her self-esteem was high as she saw that she was appreciated for her dancing skills. Raima, today is a happy person – thanks to the people around her. (J. Sengupta, Personal Communication, November 2016)

Role of Family Members

Remediation is a team effort where parents have to be active participants. The methods of engagement used by the educators in the school can be extended in smaller measures during home learning as well. Family members should act as facilitators of the child’s learning at home as this helps the child internalize the learning better. Parents should partner with the school and share relevant information about the child’s education and development. Parents should monitor the child’s progress and periodically ask for a report from the school, as well as provide their observations about how the programme is working (or not) for the child; this will help to modify the programme better.

Specialists like the occupational therapist, the speech therapist, the psychologist, etc. will include therapy activities in the IEP. These need to be followed up by activities in the daily life and play of the child. The parents play a role of facilitators of these activities in the home environment.

The most important thing needed for any child to blossom is acceptance. And acceptance by the immediate family, especially one’s siblings, cousins and extended family, goes a long way in helping the child fight all odds and reach his optimum potential. The child with SLD should be included in all family gatherings and festivities, as a neurotypical child would be. They sometimes have difficulties in self-regulation and may not understand social etiquette. However, regular exposure to these environments, with right encouragement and instruction, will gradually help the child to overcome these issues.

Role of Teachers

In terms of academic intervention, the greater onus lies on special educators. A special educator assesses the child’s strengths and weaknesses using various tools of assessment and collaborates with professionals from the multidisciplinary team as well. Following the data analysis, an IEP is drawn and implemented. As much as it is important to implement the IEP, it is crucial to follow the IEP and update and modify the IEP goals as per the changes seen in the child during the duration of the plan. Most students with SLD benefit greatly from experiential learning/learning by doing. The teachers may need to scaffold the learning process as well as provide different modes to express the learning and assess the child’s learning. The teachers employ a versatile approach towards the whole teaching-learning process.

Role of Peers

The peer group is particularly important for students with SLD as for any child. The involvement of the peers in the educational and social life of students with LD is seen to improve academic and cocurricular outcomes. Peer support or peer-mediated structures are strategies that involve placing students in pairs or in small groups to participate in learning activities that support academic instruction and social skills. The benefit of such placements is beneficial to students with and without disabilities alike. Using peer-mediated learning environments like peer tutoring, cooperative learning and buddy systems have proved to be particularly useful in teaching math skills (Calhoon and Fuchs 2003 ), world history (Mastropiere et al. 2003 ), vocabulary development (Hughes 2006 ) and improving prosocial behaviour and decreasing negative behaviours (Harris 2010 ).

Role of Community

A parent-community-school network can interlink resources from all three areas to create early literacy awareness, health care and mental health awareness and invite past students to participate in school programmes and partnerships with local businesses and indigenous organizations to provide work experience and structured work placements for students. At least some children with SLD may have skills like drawing, painting, athletics and sports. As a community, it is crucial we acknowledge that the child is good at a task that may not be conventionally considered valuable. Being forthright in supporting the children in the pursuit of their artistic abilities will make them happier individuals.

Role of Professional Support Team

An interdisciplinary team is most crucial for the benefit of the child. When an Individualised Education Plan (IEP) for a student with LD is designed in consultation with the different therapists (occupational therapist/physiotherapist/speech therapist), etc., along with the educators, the plan will incorporate all the disciplines.

Occupational therapists help children by working on the underlying motor problems, attention and self-regulation challenges or perceptual deficits that may be contributing to the academic difficulties of the child. This helps to provide any necessary accommodation and develop effective strategies to improve the child’s engagement in the classroom environment. When communication is clearly impaired due to language difficulties (receptive or expressive), speech and language therapy becomes a part of the remediation plan. Collaborative efforts not only save resources but also enable the child to achieve his/her best potential.

We can easily say that when schools, parents as well as communities appropriately and effectively attend to the intervention and remediation of students with learning disabilities, life outcomes for these students improve.

Misconceptions About Specific Learning Disabilities

It appears that though there is ample of literature available to increase awareness about SLD, the common man and some professionals as well have certain misconceptions about the condition. Many organizations in their literature on SLD and researchers (Dunne 2016 ; Sopczyk 2014 ) have tried to bust the myths and misconceptions about SLD. Below are some misconceptions and facts about SLD drawn from above literature.

Learning disabilities is such a high incidence condition that the discussions about SLD and the individuals with SLD are bound to continue. Even after 55 years of the term being coined, there are discussions about what conditions or what learning difficulties profiles can be included under the umbrella term of SLD – Dyslexia? Dyspraxia? Perceptual processing disorders? Nonverbal SLD? The issues about where should children with SLD be educated will continue to be of interest. Whether inclusive education, special education or resource room model of teaching is best will yet intrigue parents and professionals alike.

The field of SLD is also taking gradual strides for bettering the services provided to those with SLD. We can see an increase in the number of students with SLD not only enrolled in schools but also completing their school education satisfactorily. Many schools are becoming more and more inclusive by providing the students with an adapted curriculum – teaching as well as evaluation. The use of assistive technology is empowering the students by making the curriculum accessible. Preservice and in-service teacher training programmes are focusing on inclusive education pedagogies, and thus we will witness the use of Universal Designs for Learning employed widely. Differentiated instruction will focus on the needs of children with SLD giving them opportunities to benefit from educational experiences maximally. Individuals with SLD may prefer open learning and home-schooling for their education. Although SLD is a lifelong condition, the major thrust has been on school-going children. In the future, the life span coverage will start gaining prominence as services and provisions will be necessary for the children of today who will be the youth of tomorrow. We are already seeing this marginal shift as Government of India’s flagship programme Sarva Shiksha Abhiyan (for elementary school) has made way for Rashtriya Madhyamik Shiksha Abhiyan. Thus, we expect to find a substantial increase in the direct and indirect services for the adolescents and adults with SLD.

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Panshikar, A. (2019). Specific Learning Disability: A Hidden Disability. In: Chennat, S. (eds) Disability Inclusion and Inclusive Education. Springer, Singapore. https://doi.org/10.1007/978-981-15-0524-9_9

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Specific Learning Disability

Our nation’s special education law, the Individuals with Disabilities Education Act (IDEA) defines specific learning disability as…

(10)   Specific learning disability  —(i)  General .   Specific learning disability  means a disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, that may manifest itself in the imperfect ability to listen, think, speak, read, write, spell, or to do mathematical calculations, including conditions such as perceptual disabilities, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia.

(ii)  Disorders not included.  Specific learning disability does not include learning problems that are primarily the result of visual, hearing, or motor disabilities, of intellectual disability, of emotional disturbance, or of environmental, cultural, or economic disadvantage.  [34 CFR §300.8(c)(10)]

From: Center for Parent Information and Resources, (2017), Categories of Disability Under IDEA. Newark, NJ, Author. Retrieved 3.28.19 from https://www.parentcenterhub.org/categories/  (public domain)

Table of Contents

• Go to Chapter on Dyslexia
• Go to Chapter on Dyscalculia
• Go to Chapter on Dysgraphia

DSM-5 Diagnostic Criteria

• General Overview of Specific Learning Disability/Case Study
• Evaluation Procedures for LD

Tips for Teachers

• Technology for Students with Learning Disabilities- Video

Dyslexia, sometimes called reading disorder , is the most common learning disability; of all students with specific learning disabilities, 70%–80% have deficits in reading. The term “developmental dyslexia” is often used as a catch-all term, but researchers assert that dyslexia is just one of several types of reading disabilities. A reading disability can affect any part of the reading process, including word recognition, word decoding, reading speed, prosody (oral reading with expression), and reading comprehension.

Dyscalculia

Dyscalculia is a form of math-related disability that involves difficulties with learning math-related concepts (such as quantity, place value, and time), memorizing math-related facts, organizing numbers, and understanding how problems are organized on the page. People with dyscalculia are often referred to as having poor “number sense.”

The term “dysgraphia” is often used as an overarching term for all disorders of written expression. Individuals with dysgraphia typically show multiple writing-related deficiencies, such as grammatical and punctuation errors within sentences, poor paragraph organization, multiple spelling errors, and excessively poor penmanship.

The following text is an adapted from: Boundless.com (n.d.) Textbooks/ Boundless Psychology/Neurodevelopmental Disorders/Specific Learning Disorder. CC-BY-SA 4.0

Specific learning disorder includes difficulties in general academic skills, specifically in the areas of reading, mathematics, or written expression.

Specific learning disorder is a classification of disorders in which a person has difficulty learning in a typical manner within one of several domains. Often referred to as learning disabilities, learning disorders are characterized by inadequate development of specific academic, language, and speech skills. Types of learning disorders include difficulties in reading (dyslexia), mathematics (dyscalculia), and writing (dysgraphia)

The diagnosis of  specific learning disorder  was added to the DSM-5 in 2013. The DSM does not require that a single domain of difficulty (such as reading, mathematics, or written expression) be identified—instead, it is a single diagnosis that describes a collection of potential difficulties with general academic skills, simply including detailed specifiers for the areas of reading, mathematics, and writing. Academic performance must be below average in at least one of these fields, and the symptoms may also interfere with daily life or work. In addition, the learning difficulties cannot be attributed to other sensory, motor, developmental, or neurological disorders.

The causes of learning disabilities are not well understood. However, some potential causes or contributing factors are:

• Heredity. Learning disabilities often run in the family—children with learning disabilities are likely to have parents or other relatives with similar difficulties.
• Problems during pregnancy and birth. Learning disabilities can result from anomalies in the developing brain, illness or injury, fetal exposure to alcohol or drugs, low birth weight, oxygen deprivation, or premature or prolonged labor.
• Accidents after birth. Learning disabilities can also be caused by head injuries, malnutrition, or toxic exposure (such as to heavy metals or pesticides).

(Boundless,n.d)

General Overview of SLD/ Case Study

The following text is an excerpt from: Educational Psychology. Chapter 5  Authored by : Kelvin Seifert and Rosemary Sutton. .  License :  CC BY: Attribution From  https://open.umn.edu/opentextbooks/textbooks/153 

LDs are by far the most common form of special educational need, accounting for half of all students with special needs in the United States and anywhere from 5 to 20 per cent of all students, depending on how the numbers are estimated (United States Department of Education, 2005; Ysseldyke & Bielinski, 2002). Students with LDs are so common, in fact, that most teachers regularly encounter at least one per class in any given school year, regardless of the grade level they teach.

Defining learning disabilities clearly

With so many students defined as having learning disabilities, it is not surprising that the term itself becomes ambiguous in the truest sense of “having many meanings”. Specific features of LDs vary considerably. Any of the following students, for example, qualify as having a learning disability, assuming that they have no other disease, condition, or circumstance to account for their behavior:

• Albert, an eighth-grader, has trouble solving word problems that he reads, but can solve them easily if he hears them orally.
• Bill, also in eighth grade, has the reverse problem: he can solve word problems only when he can read them, not when he hears them.
• Carole, a fifth-grader, constantly makes errors when she reads textual material aloud, either leaving out words, adding words, or substituting her own words for the printed text.
• Emily, in seventh grade, has terrible handwriting; her letters vary in size and wobble all over the page, much like a first- or second-grader.
• Denny reads very slowly, even though he is in fourth grade. His comprehension suffers as a result, because he sometimes forgets what he read at the beginning of a sentence by the time he reaches the end.
• Garnet’s spelling would have to be called “inventive”, even though he has practiced conventionally correct spelling more than other students. Garnet is in sixth grade.
• Harmin, a ninth-grader has particular trouble decoding individual words and letters if they are unfamiliar; he reads  conceal  as “concol” and  alternate  as “alfoonite”.
• Irma, a tenth-grader, adds multiple-digit numbers as if they were single-digit numbers stuck together:  42 + 59  equals  911  rather than  101,  though  23 + 54  correctly equals  77.

With so many expressions of LDs, it is not surprising that educators sometimes disagree about their nature and about the kind of help students need as a consequence. Such controversy may be inevitable because LDs by definition are learning problems with no obvious origin. There is good news, however, from this state of affairs, in that it opens the way to try a variety of solutions for helping students with learning disabilities.

Assisting students with learning disabilities

There are various ways to assist students with learning disabilities, depending not only on the nature of the disability, of course, but also on the concepts or theory of learning guiding you. Take Irma, the girl mentioned above who adds two-digit numbers as if they were one digit numbers. Stated more formally, Irma adds two-digit numbers without carrying digits forward from the ones column to the tens column, or from the tens to the hundreds column. Exhibit 4 shows the effect that her strategy has on one of her homework papers. What is going on here and how could a teacher help Irma?

Directions: Add the following numbers.

Three out of the six problems are done correctly, even though Irma seems to use an incorrect strategy systematically on all six problems.

Exhibit 4: Irma’s math homework about two-digit addition

Behaviorism: reinforcement for wrong strategies

One possible approach comes from the behaviorist theory. Irma may persist with the single-digit strategy because it has been reinforced a lot in the past. Maybe she was rewarded so much for adding single-digit numbers ( 3+5, 7+8  etc.) correctly that she generalized this skill to two-digit problems—in fact  over  generalized it. This explanation is plausible because she would still get many two-digit problems right, as you can confirm by looking at it. In behaviorist terms, her incorrect strategy would still be reinforced, but now only on a “partial schedule of reinforcement”.  Partial reinforcement schedules are especially slow to extinguish, so Irma persists seemingly indefinitely with treating two-digit problems as if they were single-digit problems.

From the point of view of behaviorism, changing Irma’s behavior is tricky since the desired behavior (borrowing correctly) rarely happens and therefore cannot be reinforced very often. It might therefore help for the teacher to reward behaviors that compete directly with Irma’s inappropriate strategy. The teacher might reduce credit for simply finding the correct answer, for example, and increase credit for a student showing her work—including the work of carrying digits forward correctly. Or the teacher might make a point of discussing Irma’s math work with Irma frequently, so as to create more occasions when she can praise Irma for working problems correctly.

Metacognition and responding reflectively

Part of Irma’s problem may be that she is thoughtless about doing her math: the minute she sees numbers on a worksheet, she stuffs them into the first arithmetic procedure that comes to mind. Her learning style, that is, seems too impulsive and not reflective enough. Her style also suggests a failure of metacognition , which is her self-monitoring of her own thinking and its effectiveness. As a solution, the teacher could encourage Irma to think out loud when she completes two-digit problems—literally get her to “talk her way through” each problem. If participating in these conversations was sometimes impractical, the teacher might also arrange for a skilled classmate to take her place some of the time. Cooperation between Irma and the classmate might help the classmate as well, or even improve overall social relationships in the classroom.

Constructivism, mentoring, and the zone of proximal development

Perhaps Irma has in fact learned how to carry digits forward, but not learned the procedure well enough to use it reliably on her own; so she constantly falls back on the earlier, better-learned strategy of single-digit addition. In that case her problem can be seen in the constructivist terms. In essence, Irma has lacked appropriate mentoring from someone more expert than herself, someone who can create a “ zone of proximal development” in which she can display and consolidate her skills more successfully. She still needs mentoring or “assisted coaching” more than independent practice. The teacher can arrange some of this in much the way she encourages to be more reflective, either by working with Irma herself or by arranging for a classmate or even a parent volunteer to do so. In this case, however, whoever serves as mentor should not only listen, but also actively offer Irma help. The help has to be just enough to insure that Irma completes two-digit problems correctly —neither more nor less. Too much help may prevent Irma from taking responsibility for learning the new strategy, but too little may cause her to take the responsibility prematurely.

(Seifert & Sutton, 2009)

The following section is an excerpt from:  Center for Parent Information and Resources, (2015), Learning Disabilities (LD). Newark, NJ, Author. Retrieved 3.28.19 from https://www.parentcenterhub.org/ld/  (public domain)

 Evaluation Procedures for LD

Now for the confusing part! The ways in which children are identified as having a learning disability have changed over the years. Until recently, the most common approach was to use a “severe discrepancy” formula. This referred to the gap, or discrepancy, between the child’s intelligence or aptitude and his or her actual performance. However, in the 2004 reauthorization of IDEA, how LD is determined has been expanded. IDEA now requires that states adopt criteria that:

• must not require the use of a severe discrepancy between intellectual ability and achievement in determining whether a child has a specific learning disability;
• must permit local educational agencies (LEAs) to use a process based on the child’s response to scientific, research-based intervention; and
• may permit the use of other alternative research-based procedures for determining whether a child has a specific learning disability.

Basically, what this means is that, instead of using a severe discrepancy approach to determining LD, school systems may provide the student with a research-based intervention and keep close track of the student’s performance. Analyzing the student’s response to that intervention (RTI) may then be considered by school districts in the process of identifying that a child has a learning disability.

There are also other aspects required when evaluating children for LD. These include observing the student in his or her learning environment (including the regular education setting) to document academic performance and behavior in the areas of difficulty.

This entire fact sheet could be devoted to what IDEA requires when children are evaluated for a learning disability. Instead, let us refer you to a training module on the subject. It’s quite detailed, but if you would like to know those details, read through Module 11 of the  Building the Legacy  curriculum on IDEA 2004.  Identification of Specific Learning Disabilities  is available online at the CPIR,

Learning disabilities (LD) vary from person to person.  One person with LD may not have the same kind of learning problems as another person with LD. Sara, in our example above, has trouble with reading and writing. Another person with LD may have problems with understanding math. Still another person may have trouble in both of these areas, as well as with understanding what people are saying.

Researchers think that learning disabilities are caused by differences in how a person’s brain works and how it processes information. Children with learning disabilities are not “dumb” or “lazy.” In fact, they usually have average or above average intelligence. Their brains just process information differently.

There is no “cure” for learning disabilities. They are lifelong. However, children with LD can be high achievers and can be taught ways to get around the learning disability. With the right help, children with LD can and do learn successfully.

Learn as much as you can about the different types of LD.  The resources and organizations listed below can help you identify specific techniques and strategies to support the student educationally.

Seize the opportunity to make an enormous difference in this student’s life!  Find out and emphasize what the student’s strengths and interests are. Give the student positive feedback and lots of opportunities for practice.

Provide instruction and accommodations to address the student’s special needs.  Examples:

• breaking tasks into smaller steps, and giving directions verbally and in writing;
• giving the student more time to finish schoolwork or take tests;
• letting the student with reading problems use instructional materials that are accessible to those with print disabilities;
• letting the student with listening difficulties borrow notes from a classmate or use a tape recorder; and
• letting the student with writing difficulties use a computer with specialized software that spell checks, grammar checks, or recognizes speech.

Learn about the different testing modifications  that can really help a student with LD show what he or she has learned.

Teach organizational skills, study skills, and learning strategies.  These help all students but are particularly helpful to those with LD.

Work with the student’s parents to create an IEP  tailored to meet the student’s needs.

Establish a positive working relationship with the student’s parents.  Through regular communication, exchange information about the student’s progress at school.

(CPIR, 2015, LD)

Technology for Students with Learning Disabilities

[TheDOITCenter], (2015, Aug. 20). Working Together: Computers and People with Learning Disabilities. [Video File]. Retrieved from https://youtu.be/-uaEdaD5wJE Creative Commons Attribution license (reuse allowed)    (11:24 minutes)

Photo Reference

Boy with notebook- Image by  paperelements  from  Pixabay

Center for Parent Information and Resources, (2015), Learning Disabilities (LD). Newark, NJ, Author. Retrieved 3.28.19 from https://www.parentcenterhub.org/ld/  (public domain)

Educational Psychology. Chapter 5  Authored by : Kelvin Seifert and Rosemary Sutton. .  License :  CC BY: Attribution From   https://open.umn.edu/opentextbooks/textbooks/153 

[TheDOITCenter], (2015, Aug. 20). Working Together: Computers and People with Learning Disabilities. [Video File]. Retrieved from https://youtu.be/-uaEdaD5wJE Creative Commons Attribution license (reuse allowed)

Wikipedia, (n.d.) Dyscalculia, From https://en.wikipedia.org/wiki/Dyscalculia#:~:text=on%20the%20topic.-,Etymology,calculation%22%20and%20%22calculus%22. 

updated 5.26.22

Understanding and Supporting Learners with Disabilities by Paula Lombardi is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License , except where otherwise noted.

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Case studies on disability and inclusion.

To document UNICEF’s work on disability and inclusion in Europe and Central Asia region, UNICEF Regional Office for Europe and Central Asia has developed a set of five case studies.

UNICEF takes a comprehensive approach to inclusion, working to ensure that all children have access to vital services and opportunities. When UNICEF speaks about “inclusion” this encompasses children with and without disabilities, marginalized and vulnerable children, and children from minority and hard-to-reach groups.

The case studies have a specific focus on children with disabilities and their families. However, many of the highlighted initiatives are designed for broad inclusion and benefit all children. In particular, this case study, covers such topics as: Inclusive Preschool, Assistive Technologies (AT), Early Childhood intervention (ECI), Deinstitutionalisation (DI).

Case studies

Case study 1: “Open source AAC in the ECA Region”

Files available for download (1).

Case study 2: “Inclusive Preschool in Bulgaria”

Case study 3: “Assistive technology in Armenia"

Case study 4: “Early childhood intervention in the ECA region”

Case study 5: “Deinstitutionalization in the ECA region”

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Learning Disabilities

Learning disabilities are differences in a person’s brain that can affect how well they read, write, speak, do math, and handle other similar tasks. Different groups may define “learning disability” differently, often depending on the focus of the organization.

Having a learning disability, or even several disabilities, isn’t related to intelligence. It just means that the person’s brain works differently from others. In many cases, there are interventions—treatments—that can help a person with learning disabilities read, write, speak, and calculate just as well or better than someone without these disabilities.

NICHD and other federal agencies are looking into what causes these disabilities, how to identify them, and ways to treat them. The institute also studies typical learning processes and the effectiveness of different treatments for learning disabilities.

About Learning Disabilities

Learning disabilities affect how a person learns to read, write, speak, and do math. They are caused by differences in the brain, most often in how it functions but also sometimes in its structure. These differences affect the way the brain processes information. 1

Learning disabilities are often discovered once a child is in school and has learning difficulties that do not improve over time. A person can have more than one learning disability. 2 Learning disabilities can last a person’s entire life, but he or she can still be successful with the right educational supports. 1

A learning disability is not an indication of a person’s intelligence. Learning disabilities are different from learning problems due to  intellectual and developmental disabilities , or emotional, vision, hearing, or motor skills problems. 1

Different groups may define “learning disability” differently, often depending on the focus of the organization. You can read more at the U.S. Department of Education , which provides statutes, regulations, and policies on the Individuals with Disabilities Education Act; the Learning Disabilities Association of America   ; and https://www.understood.org   , which is maintained by the National Center for Learning Disabilities.

Types of Learning Disabilities

Some of the most common learning disabilities are the following:

• Dyslexia.  People with dyslexia have problems with reading words accurately and with ease (sometimes called “fluency”) and may have a hard time spelling, understanding sentences, and recognizing words they already know. 3
• Dysgraphia.  People with dysgraphia have problems with their handwriting. They may have trouble forming letters, writing within a defined space, and writing down their thoughts. 4
• Dyscalculia.  People with this math learning disability may have difficulty understanding arithmetic concepts and doing addition, multiplication, and measuring. 5
• Apraxia of speech. This disorder involves problems with speaking. People with this disorder have trouble saying what they want to say. It is sometimes called verbal apraxia. 6
• Central auditory processing disorder.  People with this condition have trouble understanding and remembering language-related tasks. They have difficulty explaining things, understanding jokes, and following directions. They confuse words and are easily distracted. 7
• Nonverbal learning disorders.  People with these conditions have strong verbal skills but difficulty understanding facial expression and body language. They are clumsy and have trouble generalizing and following multistep directions. 8

Because there are many different types of learning disabilities, and some people may have more than one, it is hard to estimate how many people might have learning disabilities.

• LD Online. (n.d.).  What is a learning disability? Retrieved March 4, 2017, from  http://www.ldonline.org/ldbasics/whatisld   
• National Institute of Neurological Disorders and Stroke. (n.d.).  L earning disabilities information page . Retrieved March 6, 2017, from https://www.ninds.nih.gov/Disorders/All-Disorders/Learning-Disabilities-Information-Page
• International Dyslexia Association. (2008).  Dyslexia at a glance . Retrieved March 4, 2017, from  https://dyslexiaida.org/dyslexia-at-a-glance/  
• National Institute of Neurological Disorders and Stroke. (n.d.).  Dysgraphia information page. Retrieved March 4, 2017, from https://www.ninds.nih.gov/Disorders/All-Disorders/Dysgraphia-Information-Page
• Understood.org. (n.d.).  Understanding dyscalculia.  Retrieved August 24, 2018, from  https://www.understood.org/en/learning-attention-issues/child-learning-disabilities/dyscalculia/understanding-dyscalculia  
• National Institute on Deafness and Other Communication Disorders. (2010).  Apraxia of speech . Retrieved March 4, 2017, from http://www.nidcd.nih.gov/health/voice/pages/apraxia.aspx  
• American Speech-Language-Hearing Association. (n.d.) Auditory Processing Disorder in Children. Retrieved June 24, 2020, from   https://www.asha.org/public/hearing/Understanding-Auditory-Processing-Disorders-in-Children/  
• Learning Disabilities Association of America. (n.d.).  Non-verbal learning disorders . Retrieved March 4, 2017, from  https://ldaamerica.org/disabilities/non-verbal-learning-disabilities/  

Video Text Alternative: Manage Your Learning Disability Be Your Own Advocate

To view the original video, please go to http://www.nichd.nih.gov/health/topics/learning/conditioninfo/treatment/mld/Pages/default.aspx

Video Text Alternative: Manage Your Learning Disability Ensure Your Surroundings Facilitate Success

Video text alternative: manage your learning disability take advantage of assistive technology, what are some signs of learning disabilities.

Many children have trouble reading, writing, or performing other learning-related tasks at some point. This does not mean they have learning disabilities. A child with a learning disability often has several related signs, and they don’t go away or get better over time. The signs of learning disabilities vary from person to person.

Please note that the generally common signs included here are for informational purposes only; the information is not intended to screen for learning disabilities in general or for a specific type of learning disability.

Common signs that a person may have learning disabilities include the following:

• Problems reading and/or writing
• Problems with math
• Poor memory
• Problems paying attention
• Trouble following directions
• Trouble telling time
• Problems staying organized 1

A child with a learning disability also may have one or more of the following 1 :

• Acting without really thinking about possible outcomes (impulsiveness)
• “Acting out” in school or social situations
• Difficulty staying focused; being easily distracted
• Difficulty saying a word correctly out loud or expressing thoughts
• Problems with school performance from week to week or day to day
• Speaking like a younger child; using short, simple phrases; or leaving out words in sentences
• Having a hard time listening
• Problems dealing with changes in schedule or situations
• Problems understanding words or concepts

These signs alone are not enough to determine that a person has a learning disability. Only a professional can diagnose a learning disability .

Each learning disability has its own signs. A person with a particular disability may not have all of the signs of that disability.

Children being taught in a second language may show signs of learning problems or a learning disability. The learning disability assessment must take into account whether a student is bilingual or a second language learner. In addition, for English-speaking children, the assessment should be sensitive to differences that may be due to dialect, a form of a language that is specific to a region or group.

Below are some common learning disabilities and the signs associated with them:

People with dyslexia usually have trouble making the connection between letters and sounds and with spelling and recognizing words. 2

People with dyslexia often show other signs of the condition. These may include 3 , 4 :

• Having a hard time understanding what others are saying
• Difficulty organizing written and spoken language
• Delay in being able to speak
• Difficulty expressing thoughts or feelings
• Difficulty learning new words (vocabulary), either while reading or hearing
• Trouble learning foreign languages
• Difficulty learning songs and rhymes
• Slow rate of reading, both silently and out loud
• Giving up on longer reading tasks
• Difficulty understanding questions and following directions
• Poor spelling
• Problems remembering numbers in sequence (for example, telephone numbers and addresses)
• Trouble telling left from right

A child who has trouble writing or has very poor handwriting and does not outgrow it may have dysgraphia. This disorder may cause a child to be tense and twist awkwardly when holding a pen or pencil. 5

Other signs of this condition may include 5 :

• A strong dislike of writing and/or drawing
• Problems with grammar
• Trouble writing down ideas
• Losing energy or interest as soon as they start writing
• Trouble writing down thoughts in a logical sequence
• Saying words out loud while writing
• Leaving words unfinished or omitting them when writing sentences

Dyscalculia

Signs of this disability include problems understanding basic arithmetic concepts, such as fractions, number lines, and positive and negative numbers.

Other symptoms may include 6 :

• Difficulty with math-related word problems
• Trouble making change in cash transactions
• Messiness in putting math problems on paper
• Trouble with logical sequences (for example, steps in math problems)
• Trouble understanding the time sequence of events
• Trouble describing math processes
• Learning Disabilities Association of America. (n.d.).  Symptoms of learning disabilities . Retrieved June 15, 2012, from  https://ldaamerica.org/support/new-to-ld/  
• National Institute of Neurological Disorders and Stroke. (n.d.).  Dyslexia information page. Retrieved March 6, 2017, from https://www.ninds.nih.gov/Disorders/All-Disorders/Dyslexia-Information-Page#disorders-r1
• International Dyslexia Association. (n.d.).  Dyslexia at a glance . Retrieved March 6, 2017, from https://dyslexiaida.org/dyslexia-at-a-glance/  
• American Speech-Language-Hearing Association. (n.d.).  Learning disabilities . Retrieved August 24, 2018, from  http://www.asha.org/public/speech/disorders/LBLD.htm  
• Patino, E. (n.d.).  Understanding dysgraphia.  Retrieved March 6, 2017, from  https://www.understood.org/en/learning-thinking-differences/child-learning-disabilities/dysgraphia/understanding-dysgraphia  
• Learning Disabilities Association of America. (n.d.).  Dyscalculia . Retrieved March 6, 2017, from https://ldaamerica.org/disabilities/dyscalculia/  

What causes learning disabilities?

Researchers do not know all of the possible causes of learning disabilities, but they have found a range of risk factors during their work to find potential causes. Research shows that risk factors may be present from birth and tend to run in families. 1 In fact, children who have a parent with a learning disability are more likely to develop a learning disability themselves. 2 To better understand learning disabilities, researchers are studying how children’s brains learn to read, write, and develop math skills. Researchers are working on interventions to help address the needs of those who struggle with reading the most, including those with learning disabilities, to improve learning and overall health.

Factors that affect a fetus developing in the womb, such as alcohol or drug use, can put a child at higher risk for a learning problem or disability. Other factors in an infant’s environment may play a role, too. These can include poor nutrition or exposure to lead in water or in paint. Young children who do not receive the support they need for their intellectual development may show signs of learning disabilities once they start school. 3

Sometimes a person may develop a learning disability later in life due to injury. Possible causes in such a case include dementia or a  traumatic brain injury (TBI) . 4

• National Center for Learning Disabilities. (2017). Snapshot of learning and attention issues in the U.S. Retrieved August 7, 2018, from https://www.ncld.org/wp-content/uploads/2017/03/1-in-5-Snapshot.Fin_.03142017.pdf   (PDF 187 KB)
• Harstad, E. (n.d.). Are the learning issues in my family genetic? Retrieved August 7, 2018, from https://www.understood.org/en/family/siblings/multiple-children-learning-issues/are-the-learning-issues-in-my-family-genetic  
• National Center for Learning Disabilities. (2014).  The state of learning disabilities: Facts, trends and emerging issues (3rd ed.).New York: National Center for Learning Disabilities. Retrieved March 8, 2017, from http://www.ncld.org/wp-content/uploads/2014/11/2014-State-of-LD.pdf   (PDF 6.1 MB)
• National Institute of Neurological Disorders and Stroke. (n.d.).  Dyslexia information page. Retrieved March 8, 2017, from https://www.ninds.nih.gov/Disorders/All-Disorders/Dyslexia-Information-Page  

How are learning disabilities diagnosed?

Learning disabilities are often identified once a child is in school. The school may use a process called “response to intervention” to help identify children with learning disabilities. Special tests are required to make a diagnosis.

Response to Intervention

Response to intervention usually involves the following 1 :

• Monitoring all students’ progress closely to identify possible learning problems
• Providing children who are having problems with help on different levels, or tiers
• Moving children to tiers that provide increasing support if they do not show sufficient progress

Students who are struggling in school can also have individual evaluations. An evaluation can 2 :

• Identify whether a child has a learning disability
• Determine a child’s eligibility under federal law for special education services
• Help develop an individualized education plan (IEP) that outlines help for a child who qualifies for special education services
• Establish benchmarks to measure the child’s progress

A full evaluation for a learning disability includes the following 3 :

• A medical exam, including a neurological exam, to rule out other possible causes of the child’s difficulties. These might include emotional disorders, intellectual and developmental disabilities, and brain diseases.
• Reviewing the child’s developmental, social, and school performance
• A discussion of family history
• Academic and psychological testing

Usually, several specialists work as a team to do the evaluation. The team may include a psychologist, a special education expert, and a speech-language pathologist. Many schools also have reading specialists who can help diagnose a reading disability. 4

Role of School Psychologists

School psychologists are trained in both education and psychology. They can help diagnose students with learning disabilities and help the student and his or her parents and teachers come up with plans to improve learning. 5

Role of Speech-Language Pathologists

All speech-language pathologists are trained to diagnose and treat speech and language disorders. A speech-language pathologist can do a language evaluation and assess the child’s ability to organize his or her thoughts and possessions. The speech-language pathologist may evaluate the child’s learning skills, such as understanding directions, manipulating sounds, and reading and writing. 6

• National Center for Learning Disabilities. (n.d.).  What is RTI ? Retrieved March 8, 2017, from  http://www.rtinetwork.org/learn/what/whatisrti  
• Learning Disabilities Association of America. (2001).  Assessment & e valuation.  Retrieved March 8, 2017, from https://ldaamerica.org/category/assessment-evaluation/?audience=Parents  
• National Library of Medicine. (2015).  Developmental reading disorder . Retrieved March 8, 2017, from  http://www.nlm.nih.gov/medlineplus/ency/article/001406.htm
• Learning Disabilities Association of America. (n.d.).  Eligibility: Determining whether a child is eligible for special education services . Retrieved March 8, 2017, from  https://ldaamerica.org/info/eligibility-determining-whether-a-child-is-eligible-for-special-education-services/   (PDF 86 KB)
• National Association of School Psychologists. (n.d.).  Who are school psychologists? Retrieved March 8, 2017, from  http://www.nasponline.org/about-school-psychology/who-are-school-psychologists  
• American Speech-Language-Hearing Association. (n.d.).  Learning disabilities . Retrieved August 24, 2018, from http://www.asha.org/public/speech/disorders/LBLD.htm  

What are the treatments for learning disabilities?

Learning disabilities have no cure, but early intervention can lessen their effects. People with learning disabilities can develop ways to cope with their disabilities. Getting help earlier increases the chance of success in school and later in life. If learning disabilities remain untreated, a child may begin to feel frustrated, which can lead to low self-esteem and other problems. 1

Experts can help a child learn skills by building on the child’s strengths and finding ways to compensate for the child’s weaknesses. 2  Interventions vary depending on the nature and extent of the disability.

Learn tips for managing a learning disability in adulthood.

Special Education Services

Children diagnosed with learning disabilities can receive special education services. The  Individuals with Disabilities Education Act (IDEA) requires that public schools provide free special education supports to children with disabilities. 3

In most states, each child is entitled to these services beginning at age 3 years and extending through high school or until age 21, whichever comes first. The  rules of IDEA for each state   are available from the Early Childhood Technical Assistance Center.

IDEA requires that children be taught in the least restrictive environment appropriate for them. This means the teaching environment should meet a child’s needs and skills while minimizing restrictions to typical learning experiences.

Individualized Education Programs (IEPs)

Children who qualify for special education services will receive an Individualized Education Program, or IEP. This personalized and written education plan 4 :

• Lists goals for the child
• Specifies the services the child will receive
• Lists the specialists who will work with the child

Qualifying for Special Education

To qualify for special education services, a child must be evaluated by the school system and meet federal and state guidelines. Parents and caregivers can contact their school principal or special education coordinator to find out how to have their child evaluated. Parents can also review these resources:

• The Center for Parent Information and Resources   offers information about Parent Training and Information Centers and Community Parent Resource Centers   .
• IDEA Parent Guide  

Interventions for Specific Learning Disabilities

Below are just a few of the ways schools help children with specific learning disabilities.

• Intensive teaching techniques.  These can include specific, step-by-step, and very methodical approaches to teaching reading with the goal of improving both spoken language and written language skills. These techniques are generally more intensive in terms of how often they occur and how long they last and often involve small group or one-on-one instruction. 6
• Classroom modifications.  Teachers can give students with dyslexia extra time to finish tasks and provide taped tests that allow the child to hear the questions instead of reading them.
• Use of technology.  Children with dyslexia may benefit from listening to audio books or using word-processing programs.

Dysgraphia 7

• Special tools.  Teachers can offer oral exams, provide a note-taker, or allow the child to videotape reports instead of writing them. Computer software can facilitate children being able to produce written text.
• Use of technology.  A child with dysgraphia can be taught to use word-processing programs, including those incorporating speech-to-text translation, or an audio recorder instead of writing by hand.
• Reducing the need for writing.  Teachers can provide notes, outlines, and preprinted study sheets.

Dyscalculia 7

• Visual techniques.  Teachers can draw pictures of word problems and show the student how to use colored pencils to differentiate parts of problems.
• Memory aids.  Rhymes and music can help a child remember math concepts.

Computers.  A child with dyscalculia can use a computer for drills and practice.

• Learning Disabilities Association of America. (2018).  New to LD. Retrieved August 24, 2018, from https://ldaamerica.org/support/new-to-ld/  
• National Institute of Neurological Disorders and Stroke. (n.d.).  Learning disabilities information page . Retrieved March 9, 2017, from https://www.ninds.nih.gov/Disorders/All-Disorders/Learning-Disabilities-Information-Page
• U.S. Department of Education. (2018). About IDEA . Retrieved August 24, 2018, from https://sites.ed.gov/idea/about-idea/  
• Center for Parent Information and Resources. (2017).  The short-and-sweet IEP overview. Retrieved August 24, 2018, from https://www.parentcenterhub.org/iep-overview/  
• International Dyslexia Association. (n.d.).  Dyslexia basics . Retrieved March 9, 2017, from  https://dyslexiaida.org/dyslexia-basics/  
• Understood.org. (n.d.). Treatment for kids with dyslexia. Retrieved August 7, 2018, from https://www.understood.org/en/learning-attention-issues/treatments-approaches/treatment-options/treatment-for-kids-with-dyslexia  
• Learning Disabilities Association of America. (n.d.).  Types of learning disabilities . Retrieved March 9, 2017, from  https://ldaamerica.org/types-of-learning-disabilities/  

What conditions are related to learning disabilities?

Children with learning disabilities may be at greater risk for certain conditions compared to other kids. Recognizing and treating these conditions can help a child be more successful.

Attention Deficit and Hyperactivity Disorder

Attention deficit and hyperactivity disorder (ADHD) occurs more frequently in children with learning disabilities compared to children without learning disabilities. A child with a learning disability who also has ADHD may be distracted easily and find it harder to concentrate.

An NICHD-supported study on reading disorders found that it is important to treat both the ADHD symptoms and reading problems. The findings show that although both disorders need separate treatments, these interventions can be done effectively at the same time.

Depression/Anxiety

A child with a learning disability may struggle with low self-esteem, frustration, worry, and other problems. Mental health professionals can help the child understand these feelings, learn ways to cope with them, and learn how to build healthy relationships.

3 Tips for Managing a Learning Disability in Adulthood

Support from schools can improve elementary and secondary students’ math, reading, and other language skills. But how can people with learning disabilities prepare for the demands of university or working life?

Dr. Brett Miller directs the Reading, Writing, and Related Learning Disabilities Program within NICHD’s  Child Development and Behavior Branch . In the video series below, he talks about tools, tips, and approaches that can help people manage their learning disabilities as adults.

Be Your Own Advocate

It's important to know and speak up for what you need. Understand your learning challenges, identify possible solutions, and ask for the resources that will allow you to reach your goals.

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Ensure That Your Surroundings Facilitate Success

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What Is a Learning Disability?

Sanjana is a health writer and editor. Her work spans various health-related topics, including mental health, fitness, nutrition, and wellness.

Daniel B. Block, MD, is an award-winning, board-certified psychiatrist who operates a private practice in Pennsylvania.

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Learning disabilities are a group of neurodevelopmental disorders that can significantly hamper a person’s ability to learn new things. As a result, the person may have trouble with tasks such as speaking, reading, writing, paying attention, understanding information, remembering things, performing mathematical calculations, or coordinating movements.

Learning disabilities typically develop at a young age and are often diagnosed during the person’s school years, since the primary focus at school is learning. It is estimated that 8% to 10% of children below the age of 18 in the United States have some type of learning disability.

However, some people are not diagnosed until they attend college or get a job, and others never receive an official diagnosis, so they go through life without knowing why they have so much trouble with academics, work, relationships, and basic day-to-day tasks.

It’s important to understand that people with learning disabilities generally have average to superior intelligence and are often gifted in fields such as science, math, fine arts, and other creative mediums. The person is often bright and intelligent, but there may be a gap between their potential and the skills expected from a person of their age .

Nevertheless, some of the most accomplished and influential people in history have had learning disabilities, including Albert Einstein, Leonardo da Vinci, Thomas Edison, and Winston Churchill.

This article explores the types, causes, symptoms, and treatment of learning disabilities.

Types of Learning Disabilities

“Learning disability” is an umbrella term that encompasses many types of specific learning disorders, including:

• Dyslexia: Dyslexia is the most common learning disability, accounting for 80% of all learning disability cases. It is a language processing disorder characterized by difficulty with speaking, reading, writing, or understanding words. This can cause the person's vocabulary to develop at a slower pace and lead to issues with grammar, reading comprehension, and other language skills.
• Dysgraphia: People with dysgraphia may have difficulty putting their thoughts into writing due to issues with vocabulary, spelling, grammar, memory, and critical thinking. This condition is characterized by poor handwriting, as the person may struggle with letter spacing, spatial awareness, and motor planning. Dysgraphia can make it hard for the person to think and write simultaneously.
• Dyscalculia: Sometimes known as “math dyslexia,” this condition includes learning disorders related to mathematics, such as difficulty with numbers, concepts, and reasoning. People with dyscalculia may struggle to count money, read clocks and tell time, perform mental math calculations, identify number patterns, and apply mathematical formulae.
• Auditory processing disorder (APD): People with APD may have difficulty processing sounds because their brain misinterprets auditory information received by the ear. As a result, they may confuse the order of sounds in certain words, or they may not be able to distinguish between sounds such as the teacher’s voice and the background noise in the classroom.
• Language processing disorder (LPD): This is a subset of APD, characterized by difficulties with processing spoken language . The person may have difficulty attaching meaning to sound groups representing words, sentences, and stories.
• Nonverbal learning disabilities (NVLD): NVLD is characterized by difficulty interpreting nonverbal cues such as facial expressions, body language, tone of voice, and other nonverbal signals.
• Visual perceptual/visual motor deficit: People with this condition may have difficulty with hand-eye coordination and motor activities. They may frequently lose their spot while reading, demonstrate unusual eye movements while reading or writing, confuse similar-looking letters, have difficulty navigating their environment, and struggle to manage items like pens, pencils, crayons, glue, and scissors.

Symptoms of Learning Disabilities

These are some of the symptoms of learning disabilities:

• Poor memory
• Difficulty focusing
• Short attention span
• Difficulty with reading or writing
• Inability to distinguish between sounds, letters, or numbers
• Difficulty sounding out words
• Tendency to put numbers or letters in the wrong sequence
• Difficulty telling time
• Confusion between right and left
• Tendency to reverse letters
• Difficulty grasping certain words and concepts
• Disconnect between words and meaning (i.e.. saying one thing but meaning another)
• Difficulty expressing thoughts and emotions
• Poor hand-eye coordination
• Delayed speech development 
• Disorganization
• Trouble with listening and following instructions
• Inappropriate responses
• Restlessness and impulsiveness
• Tendency to act out
• Difficulty with discipline
• Resistance to change 
• Inconsistent performance on a daily or weekly basis

While all children struggle with some of these things from time to time during their school years, people with learning disabilities tend to have a cluster of these symptoms that persist even as they get older.

According to the National Institute for Learning Development (NILD), frustration is a hallmark of this condition, since people with learning disabilities often excel at some things but do very poorly in other areas, and are often acutely aware of the gaps between what they can and cannot do.

The NILD notes that people with learning disabilities often find themselves failing in certain academic or professional areas due to reasons beyond their control, or having to put in tremendous amounts of effort in order to succeed. This experience can be difficult, confusing, and demotivating, often causing the person to feel sad and disappointed.

Causes of Learning Disabilities

Learning disabilities are caused by differences in the neurological functioning of the person’s brain. These differences can occur before the person is born, during their birth, or in early childhood, and may be caused by factors such as:

• Maternal illness during pregnancy
• Birth complications that block the flow of oxygen to the baby’s brain
• Certain genes that can make the person more genetically predisposed to developing a learning disability
• Injury or illness, such as meningitis, in early childhood 
• Health conditions such as cerebral palsy and Down’s syndrome often involve some extent of learning disability

However, it’s important to note that learning disabilities should not be mistaken for learning problems that arise due to other factors such as:

• Visual, hearing, verbal, or motor handicaps
• Intellectual disability
• Emotional disturbances
• Economic , cultural, or environmental disadvantages

Diagnosing Learning Disabilities

A healthcare professional can diagnose learning disabilities. The diagnostic process might involve:

• Academic testing: The healthcare provider may administer a standardized achievement test that checks the person’s reading, writing, and arithmetic skills, as well as an intelligence quotient (IQ) test . If the person performs well on the IQ test but has a lower score on the achievement test, it could indicate that they have a learning disability.
• Performance review: The healthcare provider may review and evaluate the person’s academic, professional, social, and developmental performance.
• Medical history: The healthcare provider will likely ask questions about the person’s personal and family medical history.
• Physical and neurological exam: The healthcare provider may conduct a physical and neurological exam to check for other health conditions such as brain diseases, mental health conditions, and developmental and intellectual disabilities .

Every learning disability has different symptoms and everyone’s experience of the condition is unique as they may experience differences in the frequency and intensity of their symptoms.

Some people may have a single, isolated learning difficulty that doesn’t have a severe impact on their day-to-day life; whereas others may have several learning disabilities that overlap with each other and make it difficult for them to function without support.

Treating Learning Disabilities

Learning disabilities are lifelong conditions that cannot be fixed or cured; however, with timely diagnosis, treatment, and support, people with learning disabilities can be successful at school, work, and among their community.

Treatment for learning disabilities may involve:

• Special education: Children with learning disabilities may benefit from education by specially trained teachers who perform a comprehensive evaluation of the child’s abilities and then help the child build on their strengths while compensating for their disabilities. 
• Medication: Some people may need to take medication to improve their ability to focus and concentrate.
• Therapy: Psychotherapy can help people with learning disabilities deal with emotional issues and develop coping skills.
• Other interventions: People with learning disabilities may also benefit from other interventions such as speech and language therapy.
• Support groups: People with learning disabilities as well as parents of children with learning disabilities may benefit from support group meetings that help them connect with others who have similar experiences. Learning difficulties can often lead to tension, misunderstandings, and conflicts among the family, particularly among families where the condition is hereditary.

A Word From Verywell

Every human being is equipped with a unique set of strengths and weaknesses. All of us are able to do some things effortlessly but struggle in other areas. 

It’s important to recognize that while people with learning disabilities have some challenges with learning, they are not in any way inferior to anyone else . Special education, treatment, support, kindness, and patience can help them achieve success.

Vidyadharan V, Tharayil HM. Learning disorder or learning disability: Time to rethink . Indian J Psychol Med . 2019;41(3):276-278. doi:10.4103/IJPSYM.IJPSYM_371_18

National Institute for Learning Development. What is a learning disability?

National Institute of Neurological Disorders and Stroke. Learning disabilities .

Learning Difficulties Association of America. Types of learning disabilities .

Walden University. 7 learning disabilities every psychology professional should study .

Kohli A, Sharma S, Padhy SK. Specific learning disabilities: Issues that remain unanswered . Indian J Psychol Med . 2018;40(5):399-405. doi:10.4103/IJPSYM.IJPSYM_86_18

Learning Difficulties Association of America. Symptoms of learning disabilities .

American Academy of Pediatricians. Diagnosing a learning disability .

National Health Service. Learning disabilities .

National Institute of Child Health and Human Development. How are learning disabilities diagnosed?

National Institute of Child Health and Human Development. What are some signs of learning disabilities?

By Sanjana Gupta Sanjana is a health writer and editor. Her work spans various health-related topics, including mental health, fitness, nutrition, and wellness.

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Students with disabilities face distinct challenges in social studies, including complex ideas, extensive vocabulary, and a need for broad background knowledge. Since 2006, Emerging America has guided social studies teachers with strategies and tools for inclusion, grounded in inquiry-based use of primary sources.

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Specific Learning Disability - Case Study

SPECIFIC LEARNING DISABILITY - CASE STUDY Specific Learning Disability - Case Study Specific Learning Disability - Case Study Introduction Specific Learning Disability (SLD) is a group of disorders significantly in the areas of reading, writing and mathematical abilities. The main cause of this disorder is not clear but it is related to nervous system or brain dysfunction. There are various types of SLDs and they may affect an individual all through his life or in some cases can be treated. Having SLD doesn't affect any physical features of an individual which can discriminate them from the others. Almost 80% of the SLD are in the reading area (Bradley, 2002). The children with Specific Learning Disabilities should be treated and taught with understanding and care. The children with SLD have average or even above average intelligence however they face difficulties in comprehending and understanding the knowledge. The severity of this disorder is different in each individual and can be from mild to severe. For students with SLDs, have difficulties in comprehending information as everything gets jumbled up in their brain. They can also have difficulties in organizing, attention, time management and task prioritizing (Berninger, 2001). The most common SLD is reading difficulties. Generally, the reading disabilities occur when the students face problems in comprehending the written text or are unable to understand the relation between the letters, words and sounds. The comprehension of reading occurs when students are not able to grasp the concept and meaning of the written sentences and phrases. The children facing learning activates can be identified at initial stages. They usually have trouble linking the sounds and letters patterns. Parents and teachers can easily spot such children due to their hesitancy in reading, frequent starts, stops and wrong pronunciation during reading (Berninger, 2001). Case Study of a Fictional SLD Student Adam, nine year old, is a grade 3 student who is facing reading disability. He is bright and intelligent student but he has difficulties in understanding the written words and lacks the ability to fluently read the text. He is usually hesitant in reading the words and often mispronounces the words. He frequently halts at most of the words and takes time in comprehending the text. Adam is a determined child and tries hard to read yet lately he seems to feel embarrassed in even trying due to the fact that his friends and classmates have moved on to more difficult words. He is shy in reading aloud and tries to hide away from the teacher during the reading lessons. He is an obedient child and is active in sports. He enthusiastically takes part in sports competitions and has even won in a race. Adam loves horses as well; he takes horse riding lessons after school. He is very happy and is often seen in high spirits during any outdoor activity. He is energetic and friendly most of the time. However, during the reading lessons he is often frustrated and confused. He usually disturbs the class and tries hard to skip his turn of ...

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ORIGINAL RESEARCH article

This article is part of the research topic.

Disciplinary Aesthetics: the Role of Taste and Affect for Teaching and Learning Specific School Subjects

Aesthetical Entanglements in Mathematics Learning

• 1 Manchester Metropolitan University, United Kingdom
• 2 The Open University (United Kingdom), United Kingdom

The final, formatted version of the article will be published soon.

In this paper we develop a perspective on the diverse aesthetics historically associated with mathematics, inspired by Rancière's approach to aesthetics and politics. We call 'Silencing Aesthetics' a dominant aesthetic that Rota has characterised as a "copout (...) intended to keep our formal description of mathematics as close as possible to the description of a mechanism." The challenge this paper attempts to explore is how to question silencing aesthetics to make space for inclusive ones. Our efforts have focused on setting up and studying inclusive and pluralist 'Studios', gathering craftworkers, anthropologists, mathematics educators and mathematics enthusiasts. We include here a case study based on a conversation among basket weavers, anthropologists, and mathematics educators, focused on the artisanal and mathematical nature of knots. We discuss the implications of aesthetical entanglements, such as those in our case study, for mathematics learning.

Keywords: aesthetics, Basketry, Knots, Mathematics, Materiality

Received: 31 Aug 2023; Accepted: 25 Oct 2023.

Copyright: © 2023 Nemirovsky, Kathotia and Megroureche. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Mx. Ricardo Nemirovsky, Manchester Metropolitan University, Manchester, United Kingdom

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