EDUCATIONAL ISSUES.
GaDangme Journal of Education & Mental Health is of the view that formal education is the most effective vehicle for social change and social mobility in any given society. Nevertheless, we do not downplay the importance of informal education we receive from our parents, grandparents, aunts, uncles and from the general community.
In order for our children to do well or exceed in school in a level plainfield, we need to provide them with wholesome environment to grow physically, mentally and spiritually. We will focus our attention to learning in the school environment with references to Special Education, Behavior Analysis and Mental Health issues.
In the school systems in North America, Special Education programs are intended to assist students with significant academic difficulties due, perhaps, to low intellectual or cognitive functioning, severe receptive or expressive language delays, behavior problems, attention deficit-hyperactive disorder, learning disability, neurological/and or neuro-psychological impairment. Special Education programs are also aimed to helping intellectually superior students, who are not been actualized academically from the regular classroom programs. These intellectually superior students may channel their energies to anti-social behaviors, if they are ignored. Thus, individualized and much more challenging programs are designed to meet the needs of the intellectually superior students.
GaDangme Journal of Mental Health & Education will provide relevant information on the education to students and their parents to enable GaDangme parents and the wider public gain better understanding of their children's education.
Formal education in the schools is a complex process that draws on expertise from varieties disciplines,including teachers, school administrators, school counselors, clinical/ educational psychologist, the medical profession (audiologists, ophthalmologists, optometrists, physiotherapists, speech and language pathologists, Psychiatrists) and physical education teachers, etc.
School children may be referred by teachers, school administrators and/or parents to any or a number of the above-mentioned professionals for varieties of reasons, including but not limited to the following: learning problems, dysfunctional behaviors, attention deficit hyperactive disorder, severe language delays, visual and auditory problems, suspected neurological and neuro-psychological problems (following initial diagnosis by a duly qualified/certified psychologist). Please NOTE that referrals by educational personnel to other professionals for assessments may only be made with prior informed signed consent of the parents or guardian of the student. The term "informed" here means that the reasons for the the referral (s) must be thoroughly explained to the parent(s) and/or the guardian of the student. Parents/guardian of students should bear in mind that schools have no right to have their child/children evaluated by professionals without their prior informed written consent. Exceptions to this rule include teacher made tests and/or referrals to the Resource Room teacher for a quick diagnostic test, such as KeyMath test, to assess particular areas of the child's math difficulties and help the child. It is suggested that the assessment team should include the School Administrator, the Classroom teacher (s), the Resource Room teacher, the Guidance Counsellor, the parent(s) or Guardian of the student, the Student and the professional who will evaluate the student's difficulties, eg. the School Psychologist.
THE PSYCHO-EDUCATIONAL ASSESSMENT PROCESS
Let us examined what an Educational Psychologist does when a student say with academic problem is referred. After receiving the referral, it makes sense for the psychologist to consult with the student's teachers and parents/guardian to seek some background. He or she may examine the student's work and/or observe the student's interaction with his/her peers.
Prior to conducting the assessment of the student, the psychologist must formulate a tentative hypothesis regarding the referral question. In the case of poor academic performance, the psychologist may want to know, if the student has satisfactory intelligence to benefit from academic work. Using such instruments as the Wechsler scales, the Stanford Binet, etc., the psychologist may be able to assess the student's current intellectual functioning. He or she may be able to identify the strengths of the student, such as visual memory, long-term memory, auditory memory and short-term memory problems. On the other hand, the psychologist may identify that the child has good perceptual motor skills and that there are significance differences the student's Verbal IQ and Performance IQ in favor of the the Performance IQ. This indicates that the child's Perceptual motor skills appear to be better developed.
Significance of VIQ-PIQ differences. David Wechsler suggests that significant difference of 14 points or more between individual's Verbal IQ (VIQ) and the Performance IQ (PIQ) may suggest possible learning disabilities; neurological and/or neuro-psychological impairment; the student's cognitive preferences, implying one side
the student's brain is better developed than the other and hence the child prefers to use the side of the brain which is better developed. Thus, the student does very well using the side of his/her brain which is better developed. The intelligence tests tell the Psychologist more about the individual other than the Full Scale IQ alone.
Next the Psychologist may be interested in knowing the extent of the student's language development, since adequate language development plays a key role in academic success. The Psychologist may administer such instruments as the Peabody Picture Vocabulary Test the One-Word Expressive Vocabulary Test to the student to measure his/her receptive and expressive vocabulary development. Very poor performance by the student on these test may be indicative of receptive and/or expressive aphasia or both. The student can be helped by the Resource Room teacher, the regular Classroom teacher to improve his/her language difficulties.
The Clinician may also use an auditory discrimination tests, such as the Wepman Auditory Discrimination Test and the Goodman Friestoe Test of Auditory Discrimination to determine the student's auditory acuity. Poor performance on these tests may suggest auditory problems. With prior informed consent of the parent(s)/guardian of the student, the Psychologist may make refer to the Physician, or an Audiologist for further diagnosis and therapeutic intervention, if deemed necessary by the Physician or the Audiologist.
Furthermore, administration of such instruments as the Bender Visual-Motor Gestalt Test, the Benton, etc. may reveal possible visual-motor problems ,which may require further diagnosis by a Physician, an Ophthalmologist or Optometrist. The Bender Visual-Motor Gestalt Test is part of the Neuro-psychological Test Batteries. Quick Neurological Screening Test may provide valuable information, if the Clinician suspects neurological issues.
Next the Psychologist may consider to the student's performance in the three areas of school adjustment namely, Reading, Arithmetic and Spelling. The Wide Range Achievement Test, etc. may quickly be used. The Dyslexia Screening Test may be administered at the discretion of the Psychologist.
The student's academic problems may also be associated with behaviour disorders, attention deficit-hyperactive disorder or personality problems. There various standardized instruments to assess these problems, including Emotional and Behavior Problem Scale Personality Inventory for Children, Adolescent Psychopathology Scale, Million Adolescent Clinical Scale, Attention Deficit Disorder Evaluation Scales (Home and School Versions), Test of Variables of Attention (TOVA), Connors Continuous Performance Test and many more to numerous or discuss in details here.
Following the consultation with the parties involved or the Assessment Team, as case conference should be held to discuss the outcome of the test results and what decision should be taken, including school placement considerations as well as possible referral to other professional for further evaluation.
Simply put, the above-mention are generally what a Psychologist may do when a student with academic problem is referred to him/or her. The Psychologist may do more than what have briefly discussed to get to the roots of the student's problem and suggest appropriate remediation. Next we will be discussing what learning disabilities are, how the problem is diagnosed and what must be done following diagnosis.
LEARNING DISABILITY
The phrase "learning disability" is commonly used by educators and the wider public, generally in reference to reading difficulties that an individual faces. Let us now try to define the term. Learning disability is a classification including several areas of functioning in which a person has difficulty learning in a typical manner, usually caused by a unknown factor or factors. While learning disability and learning disorder are often used interchangeably, the two differ . Learning disability refers to significant learning problems in an academic area. These problems, however, are not sufficient to warrant official diagnosis. Learning disorder, on the other hand, is an official clinical diagnosis, whereby the individual meets certain criteria, as determined by a professional, such as a Psychologist, Pediatrician, etc.
The difference is in degree, frequency and intensity of reported symptoms and problems, and thus the two should not be confused. When the term "learning disabilities" is used, it describes a group of disorders characterized by inadequate development of specific academic, language and speech skills. Types of learning disabilities include reading disability (DYSLEXIA), mathematics inability (DYSCALCULIA), writing disability (DYSGRAPHIA), disturbance in language development, includes RECEPTIVE and EXPRESSIVE APHASIA), inability to draw or copy geometric figures (CONSTRUCTIVE APRAXIA). Students with learning disabilities also tend to have poor reasoning or listening skills.
It should be clearly noted that learning disability is not a problem with intelligence or motivation. Children with learning disabilities are NOT lazy or dumb. In fact, most of the children with learning disabilities have average, high or superior intellectual functioning than most people. Their brains are simply wired differently. This difference affects how they receive and process information. Simply put, children and adults with learning disabilities see, hear and understand things differently. This can lead to trouble learning new information and skills, and putting them to use.
CAN CHILDREN WITH LEARNING DISABILITIES LEARN AND SUCCEED?
One may ask if the GaDangme child or any other child regardless of ethnicity or race learn and succeed. My answer is definitely, "yes". It can be tough to face the possibility that your child your child has a leaning disability or learning disorder. No parents in his/her right mind want to see their child suffer. As indicated earlier most children with learning disabilities are just as bright or smart as everyone else. The child with learning disabilities needs to be taught in different ways that are tailored or geared to his/her unique learning styles. If GaDangme parents and guardians are able to learn more about learning disabilities and learning disorders in general, and the child's learning difficulties, in particular, the GaDangme parent along with the help from professionals, can help paved the for the success of the child at school and beyond. GaDangme Journal of Mental Health & Education will assist all GaDangme parents and guardians whose children are confronting learning and/or behavior difficulties at home or in school.
WHAT ARE THE SIGNS AND SYMPTOMS OF LEARNING DISABILITIES AND/OR DISORDERS?
Learning disabled children are different from one child to another. One learning disabled child may have reading and spelling problems, while another learning disabled child may books, reading and spelling, but has difficulty in understanding mathematical concepts. Also, another learning disable child may have difficulty understanding what others are saying or expressing his thoughts. The problems are fundamentally different, but they are all learning disorders.
However, it is not always easy to identify learning disabilities. In view of the wide variations of the disorder, there is no single symptom or profile that one can look to as an evidence of a problem. Yet, some warning signs are more common than others at different ages. If parents are aware of these signs, they are more likely to suspect a learning disorder early and take immediate steps to get help for the child.
Checklists:
The following checklists indicate some common red flags for learning disorders. Parents and guardians should note that children who do not have learning disabilities may still experience some of these difficulties are various times. The time for the parent to become concerned is when there is a consistent unevenness in one's child's ability to master certain skills or concepts.
Sign and Symptoms of Learning disabilities are pre-school age:
1. Problem pronouncing words
2. Trouble finding the right word.
3.Difficulty rhyming
4. Trouble learning the alphabet, numbers, colors, shapes, days of the week
5.Difficulty following directions or learning routines.
6.Difficulty controlling crayons, pencils, and scissors or coloring within the lines.
7.Trouble with bottoms, zippers, snaps, learning to tie shoes.
Signs and Symptoms of Learning Disabilities in Children Ages 5-9 years:
1. Trouble learning the connection between letters and sounds.
2. Unable to blend sounds to make words.
3. Confuses basic words when reading.
4. Consistently misspell words and make frequent reading errors.
5. Trouble learning basic math concepts.
6. Difficulty telling time and remembering sequences, eg. days of the week, events, etc.
7. Slow to learn new skills.
Signs and Symptoms of Learning Disabilities from ages 10-13 years of age:
1. Trouble with reading comprehension or math skills.
2.Trouble with open-ended test questions and word problems.
3.Dislikes reading and writing; avoids reading aloud.
4. Spells the same word differently in a single document.
5. Poor organization skills (bedroom, homework, desk is messy and disorganized.
6.Trouble following classroom discussions and expressing thoughts aloud.
7. Poor handwriting.
DIFFICULTIES WITH READING, SPELLING AND MATH
Learning disabled children have difficulties in the three basic areas of school adjustment, namely reading ,writing and math (arithmetic computation skills).
There are two types of learning disabilities in reading. Basic reading problems occur when the child has difficulty understanding the relationship between sounds, letters and words. Reading comprehension problems occur when the child has inability to grasp the meaning of words, phrases and paragraphs.
The following are signs of reading difficulties (dyslexia):
1. Letter and word recognition
2. Understanding words and ideas
3. Reading speed and fluency.
4. General vocabulary skills (receptive and expressive).
Learning Disabilities in math (Dyscalculia):
Learning disabilities in math vary considerably depending on the child's strengths and weakness (as may be indicated on intelligence text such as the Weschler scales or language test, etc). A child's ability to do math may be affected differently by a language learning disability, or a visual disorder or a difficulty with sequencing or organization. A child with math-based learning disorder is likely to struggle with memorization and organization of numbers, operation signs, and number "facts", such as 6+6+12 or 6x6=36. Children with math learning disorder may also have difficulties in counting principles (such as counting by 3's or counting by 5's). They may also problems telling time.
Children with writing disabilities (Dysgraphia).
Learning disabilities in writing may involve the physical act of writing or the mental activity of comprehending and synthesizing information. Basic writing disorder refer to the physical activity involve in words and letters. Expressive writing disability suggests a struggle to organize thoughts on paper. Symptoms of written language learning disability relates to the act of writing. They include problems with the following:
1. Neatness and consistency of writing.
2. Accurately copying letters and words.
3. Spelling consistency
4. Writing organization and coherence.
OTHER TYPES OF LEARNING DISORDERS OR DISABILITIES
It is important for us to bear in mind that reading, spelling, math, writing, language, etc. mentioned earlier are not the only types of learning disabilities. Other types of learning disabilities involve difficulties with motor skills (movement and co-ordination), understanding spoken language, distinguishing between sounds, and interpreting visual information. Let us examine some of these types of learning disabilities. They are as follows:
Learning Disabilities in Motor Skills (dyspraxia):
Motor difficulties refer to problems in movement and coordination whether is with fine motor skills (cutting, writing), or gross motor skills, such as jumping and running. A motor disability is sometimes referred to as an "output" activity meaning that it relates to the output of information from the brain in other to jump, run, write or cut something. The brain must be able to communicate with the necessary limbs to complete the action.
There are signs that may suggest that a child may have motor coordination disability. The child may have problem with physical abilities that require eye-hand coordination, eg, holding a pen or pencil or bottoming his/her shirt.
AUDITORY AND VISUAL PROCESSING PROBLEMS.
The importance of the ears and eyes cannot be overemphasized enough. The eyes and the ears are the primary means of delivering information to the brain, a process referred to as "input." In the event that the eyes and/or the ears are not functioning adequately, the individual is likely to suffer learning problems. For example, an inability to distinguish subtle differences in sound, or hearing sound at the wrong speed make it difficult to sound out words and understand the basic concepts of reading and writing.
Problems with visual perception, on the other hand, include missing subtle differences in shapes. reversing letters, or numbers, skipping words, skipping lines, misperceiving depth or distance, or having problems with eye-hand co-ordination. Psychologists and those in the medical professions may to the work of the eyes as "visual processing." Visual perception can affect gross and fine motor skills, such as reading, comprehension, and math.
OTHER DISORDERS THAT CONTRIBUTE TO LEARNING DIFFICULTIES
These include anxiety, depression, stressful events, emotional trauma, and other conditions that may affect concentration create learning problems. Besides, Attention Deficit Hyperactive Disorder (ADHD) and Autism sometimes co-occur or are confused learning disabilities.
Attention Deficit Hyperactive Disorder ADHD) is not considered as learning disability, but can certainly disrupt learning. Children with ADHD have difficulty in sitting still; they can't focus or follow instruction; they are disorganized and hardly complete their homework.
Autism: Autistic children tend to have difficulty mastering certain academic skills. This stems from pervasive developmental disorders including Asperger's Syndrome. Children with autism spectrum disorders may have communication problems, learning basic skills, making friends, reading body language, and making eye contact.
DIAGNOSIS AND TESTING FOR LEARNING DISORDER/DISABILITIES.
Earlier we have made made discussed the refer and testing procedures used by psychologist in evaluating learning disabilities and related learning disorders in the schools. Diagnosing learning disabilities is a process. It entails history taking, an observation by specialist. Types of specialist who can diagnose learning disabilities include: School Psychologists, Clinical Psychologists, Educational Psychologists, Child Psychologists, Developmental Psychologists, Neuro-psychologists, Psychometrics, Pediatricians, Speech and Language Pathologists, and Occupational Therapists. Occupational therapist tests for sensory disorders that can lead to learning difficulties.
WHAT CAUSES LEARNING DISABILITIES
Parents and teachers are always want to know the cause (s) of learning disabilities. In fact, the causes of learning disabilities are often not well understood. Sometimes there is no apparent cause for a learning disability. However, some causes of neurological impairments include:
1. Heredity - Learning disabilities often run in the family. Children with learning
disabilities are likely to have parents or relatives with similar disabilities.
2.Problems during pregnancy and child birth: Learning disabilities can result from
anomalies in the developing brain, illness or injury, fetal exposure to alcohol or drug,
low birth weight, oxygen deprivation, or premature or prolonged labor.
3. Accidents after birth: Learning disabilities can also be caused by head injuries, malnutrition, or by toxic exposure (such as pesticides, or heavy metals).
TREATMENT AND INTERVENTION
So we have discussed the nature, types, diagnosis of Learning Disabilities/Learning Disorders. Now, let us discuss intervention and treatment to help the learning disabled child. The following means of intervention may be considered.
1. Mastery Model: a) Learners work at their own level of mastery. b) Practice, c) Gain fundamental skills before moving onto the next level (Please, bear in mind that this approach is most likely to be used with adult learners or outside the mainstream school system.
2. Direct Instruction: a) Highly structured, intensive instruction, b) Emphasis carefully planned lessons for small learning increments. c) Scripted lesson plans. d) Rapid-paced interaction between the teachers and students. e) Correcting mistakes immediately. f) Achievement-based grouping. g) Frequent progress and assessments.
3. Classroom Adjustments: a) Special seating assignments. b) Alternative or modified assignments. d) Modified testing procedures. e) Quite environment.
Special Equipment:
4. Word processors with spell checkers and dictionaries. b) Text-to-speech and speech-t0-text programs. c) Talking calculators. d) Books on tape. f) Computer-based activities.
5. Classroom Assistants:
a) Note-takers. b) Readers. c) Proofreaders. d) Scribes.
6.Special Education:
a) Prescribed hours in a Resource Room. b) Placements in a Resource Room. c) Enrollment in a Special Education School for learning disabled students. d) Individual Education Plan (IEP). e) Educational therapy.
Note: Parents and guardians may note that early remediation/intervention can greatly reduce the number of children meeting diagnostic criteria for learning disabilities.
WhAT PARENTS/GUARDIANS CAN DO TO HELP THE LEARNING DISABLED CHILD. It is not always easy for parents of the learning disabled child to know what to do or where to find help. Turning to specialists who can pinpoint and diagnose the problem is, of course, important. It is equally important that parents and guardians with the school the child attends and received specialised professional and/or academic help. Since the parent/guardian knows the child than anyone else, he or she must take the lead in examining into options, learning about new treatments and services and overseeing the learning disabled child's education. In so doing, the parent/guardian may consider the followings:
1. Learn the specifics about your child's learning disabilities: Read and learn more about your child's type of learning disability. Find out from the professionals how the disability affects the learning process and what cognitive skills are involved. It is more easier for the parent to understand or evaluate learning techniques if he or she understand how the learning disability affects the child.
2. Research Treatments, Services, and new theories: Along with knowing about the type of learning disability your child has, educate yourself about more effective treatment options available. This can help the parent advocates for the child at school and pursue treatment at home.
3. Pursue treatment and services at home: Even if the school system does not have the resources to treat your child's learning disability optimally, you can pursue these options on your own at home, or with a tutor or therapist.
4. Nurture Your Child's Strengths: Children with learning disabilities may struggle in one area of learning and, yet may excel in other areas. Therefore, parents/guardians should pay particular attention to their child's interests and passions. Helping the child with learning disability develop his/her passion and strengths may help him or her with the areas of difficulty as well.
5. GaDangme parents may consider form advocacy groups, eg. GaDangme Association of Parents with Learning Disabilities/Disorders. Such a group or groups may acquaint themselves with information about Learning Disabilities and other Learning Disorders, such type, assessment, intervention. They may act advocates for Children with Learning Disabilities in Schools in their respective jurisdictions. They may call upon governments to provide more funding to schools, and resources to assist the learning disabled child.
GaDangme Journal of Mental Health & Education is very willing to lend support to GaDangme parents and community groups in this endeavor. GaDangme parents of children with learning disabilities may find the following links helpful.
1. The National Centre for Learning Disabilities. http//www.ncld.org.ld-basic/ld-explained/basic-facts/what-are-learning-disabilities/
2.www.dmoz.org/Health/Mental_Health/Disorders/Child_and_Adolescent/Learning_Disabilities//
3.htpp://www.brehm.org
ATTENTION DEFICIT HYPERACTIVE DISORDER (ADHD).
Attention Deficit Hyperactive Disorder, while not considered a learning disability, can certainly disrupt learning. Children with Attention Deficit Hyperactive Disorder have problems sitting still. staying focused, following instructions, staying organized and completing homework. What then is Attention Deficit Hyperactive Disorder?
Attention Deficit Hyperactive Disorder (ADHD) is a disorder characterized by inattentiveness, and hyperactivity resulting in significant impairment in functioning at home, school, or with peers. Various terms have been used in the past to describe the condition knwon as ADHD, including such terms as "minimal brain damage or dysfunction", "hyperkinenesia", hyperactivity" and "attention deficit disorder." It is suggested that between three to five (3-5) percent of school-age children have ADHD. ADHD is approximately six (6) times more frequent in boys than in girls. Symptoms persist into adulthood in forty to sixty (40-60) percent of individuals. The current and most widely used criteria for ADHD are defined by the American Psychiatric Association as stipulated in the Diagnostic and Statistical Manual for Mental Disorders (DSM IV).
DSM IV Criteria for Diagnosing Attention Deficit Hyperactive Disorder (ADHD).
Six or more of the following symptom of in attention have persisted for at least 6 months to a degree that is maladaptive and inconsistent with the developmental level:
Inattention:
1. The child fails to give close attention to details or make mistakes in schoolwork, or other activities.
2. He or she has difficulty sustaining attention in tasks or play activities.
3. Often does not seem to listen when spoken to directly.
4. He or she often does not follow through on instructions and fails to finish
schoolwork, chores or duties in the workplace (not due to oppositional behavior or
failure of comprehension).
5. He/she has difficulty organizing tasks and activities.
6. The individual often avoids, dislikes, or is reluctant to engage in tasks that require
sustained mental effort, such as schoolwork or homework.
7. He or she loses things necessary for tasks or activities at school or home, such as toys,
pencils, books, assignments.
8. The individual is often distracted by extraneous stimuli.
9. He/she is often forgetful in daily activities.
Hyperactivity-impulsivity
Six or more of the following symptoms of hyperactivity-impulsivity have persisted for at least six (6) months to a degree that is maladaptive and inconsistent with developmental level:
Hyperactivity:
1. The child often fidgets with hands or feet or squirms in seat.
2. He or she often leaves seat in classroom or in other situations in which remaining seated is
expected.
3. Often runs about or climbs excessively in situations in which it is inappropriate ( in adolescence
or adults, may be limited to subjective feeling of restlessness).
4.Has difficulty playing or engaging in leisure activities quietly.
5. Often talks excessively.
6. He or she is often on the go or often acts as if driven by motor.
Impulsivity:
1. The child often has difficulty awaiting turn in games or group situations.
2. He or she blurs out answers to questions before they have been completed.
3. He/she often intrudes on others, eg., butts into other children's games.
Onset before the age of 7. Some impairment from the symptoms is present in more than two or more settings ,eg., at school or work or at home. There must be clear evidence of significant impairment in social, academic, or occupational functioning.
NOTE that the symptoms of ADHD may vary considerably between home and school, in structure versus nonstructed settings, large versus small groups and situations having high versus low performance demands. There is now evidence to suggest that ADHD without hyperactivity, also known as Undifferentiated Attention Deficit Disorder (UADD) is a discrete entity. These children function with lower cognitive speed and appear more confused, apathetic, and lethargic and more likely to be depressed than are children who have ADHD with hyperactivity (ADHD+H). They also are identified later when they begin to fall behind academically in later primary grades. Children with ADHD+H are described as being more noisy ,disruptive, messy, irresponsible ,and immature and have more problems with peer relationships.
Coexisting Conditions:
About twenty five to thirty (25-30) percent of ADHD children have learning disability. Despite normal and even superior intelligence, the ADHD child is often a chronic underachiever. By adolescence up to one-third of ADHD children have failed at least one grade.
Speech and Language Disorders:
Many ADHD children have language disorders, mostly prominently found in expressive language. They may have limited vocabulary, word-finding difficulties and poor grammar. Some psychologist are of the opinion that language development is also linked to the development of self-control, as children use inner language to help them monitor behaviour.
Psychiatric Disorders:
It is estimated that fifty to sixty five (50-65) percent of ADHD children have at least one additional psychiatric disorder. Additional dignosis frequently include Oppositional Defiant Disorder and Conduct Disorder. The greatest risks for those who develop serious antisocial behaviour during adolescence are those who come from dysfunctional families involving alcoholism, drug abuse, and violence. Problem with poor self-estemm are common and 25-33 percent of ADHD children experience at least one episode of major depression during childhood years. Anxiety disorders resulting in fears and worries also occur in up to 25 percent of ADHD children.
What Are the Causes of Attention Deficit Hyperactive Disorder (ADHD)?
The cause of ADHD is unknown. However, there is evidence to suggest that the frontal lobes of the brain may have a role in ADHD. The frontal lobes lobes have long been known to play a critical role in regulation attention, activity, and emotional reactions.
2. Also heredity plays a role in ADHD since ADHD children are four times as likely to have close family members with the same problems. Moreover, identical twins are more likely to share ADHD than fraternal twins or other siblings.
3.Birth injuries associated with faetal distress and difficult labour play negligible role in ADHD. However, damage prior to birth, may play a role. Mothers who abuse alcohols ,drugs during pregnancy have children who suffer from ADHD and learning disabilities.
4. Environmental toxins, including lead, and artificial flavors, dyes, preservatives and other food additives have been claimed by some to be primary cause of ADHD.
Diagnosis of ADHD
There is no single diagnostic test that definitely make s the diagnosis of ADHD. Instead, the diagnosis involves the collection of information from variety of sources. The information gathered along with psycho-educational test battries as well as the TOVA, Conner's Continuous Performance Test, Attention Deficit Disorder Evaluation Scales (Home and School Version), Behavior Disorder Identification Scale (Home and School Versions), Emotional and Behavior Problem Scales (Home and School Versions) do provide useful diagnostic information about the ADHD child. These instruments along with diagnosis by a Psychiatrist have been know to lead to diagnosis of ADHD to some extent.
TREATMENT OF ATTENTION DEFICIT HYPERACTIVE DISORDER (ADHD).
Essentially, the goals of treatment of ADHD are to improve the child's functioning at home, in school and with peers through the modification of his/her inattention, impulsivity and hyperactivity. Also another goal of the therapy is to maximize cognitive functioning, social and behavior skills, self-esteem with minimal side effects. The long-term outcome of ADHD treatment has shown to be improved most when one uses a combination of education, medication. psychological treatments, and appropriate classroom intervention. Let us consider briefly some of these treatments.
Education:
Earlier we have suggested some ways by which a child with learning disabilities may be helped in the classroom. Similar techniques may be used to assist the child with Attention Deficit Hyperactive Disorder in the classroom.
Medications:
Medications in treating the child with ADHD may only be prescribed by a duly qualified/certified physician or a Psychiatrist. The medications used generally include: Stimulants such as Ritalin, Dexedrine and Pemoline. Others include Tricyclic Antidepressant and Clonidine. We strongly suggest the use of these medication with a qualified Psychiatrist of Physician.
Psychologican and Behavior Therapies:
A variety of psychological and behavior therapies ,alone and in combination, have been used in treating ADHD with varying degrees of success. The aim of the psychotherapeutic treatments is to modify the associated problems such as oppositional defiant behaviour and conduct problems.
Parent Training and Family Therapy:
This provides a variety of management strategies for the behavior problems seen in ADHD child. Family therapy in this case deals with variety of approaches to family skills training. This is problem solving, open and effective communication skills, anger management or conflict resolution.
LINK: http//www.utoronto.ca/kids/add.htm
EMOTIONAL AND BEHAVIOR DISORDERS IN SCHOOLS
Students with emotional and behavior disorders have serious and persistent difficulties that can be described by psychological and/or psychiatric diagnosis. When special educators identify a student as having an emotional or behavioral disorder, they are assisted by a psychologist or psychiatrist who conducts a thorough evaluation and makes a diagnosis of the disorder, using the categories listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM IV).
In discussing emotional and behavioral disorders, we may consider the term serious emotional disturbance and defines it as a condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects educational performance:
1. An inability to learn that cannot be explained by intellectual, sensory, or health factors.
2. An inability to build or maintain satisfactory interpersonal relationships with peers and teachers.
3. Inappropriate types of behavior or feelings under normal circumstances.
4. A general pervasive mood of unhappiness and depression; or
5. A tendency to develop physical symptoms or fears associated with personal or school problems.
As defined by the Individual with Disabilities Act (IDEA) in the United States, emotional and behavior disorders includes schizophrenia but does not apply to children who are socially "maladjusted." Behaviorally and emotionally students can exhibit widely varied types of behaviour, including both internalized behavior ,such as DEPRESSION or EATING DISORDER and externalized behavior such as verbal outbursts. Other common characteristics and behaviors include the following:
1. Hyperactivity characterized by short attention span, and impulsiveness.
2. Aggression or self-injurious behavior (acting out and fighting).
3. Withdrawals (failure or initiate interaction with others; retreat from exchanges of social interaction, excessive fear or anxiety).
4.Immaturity (inappropriate crying, temper trantrums, or poor coping skills).
5. Learning difficulties (academic performance below grade level).
Children with behavioral disorders do not necessarily have learning disabilities. Children with the most serious disorders exhibit the following: distorted thinking, excessive anxiety, bizarre motor acts, and abnormal mood swings. Psychoses can range in severity from temporary ad mild to recurring and severe as in schizophrenia.
TYPES OF EMOTIONAL AND BEHAVIOR DISORDERS
Defining and classifying emotional and behavior disorders can be a challenging task. DSM-IV contains eighteen (18) major classification areas, into which are grouped more than two hundred specific disorders. Here we will discuss the emotional and behavior diagnosis that parents and teachers are most likely to encounter.
1.Conduct Disorder:
The diagnosis of conduct disorder is based on antisocial behavior, and it says little about the child's inner life, motives, and disabilities. The disorder is classified by type: aggressive versus nonaggressive and overt (with violence or tantrums) versus overt (with lying, stealing, and/or drug use).
The distinction between "socialized" and "under-socialized" activity is common. For example, much serious adolescent misconduct takes place in street gangs, many of whom members are loyal to their friends and able to make serious social adjustments as adults. However, the situation is more serious when the misbehavior begins early and the child has no friends. Such children are more likely to develop "antisocial personality disorder" as adults, continuing a pattern of socially maladjusted behavior. Early symptoms include: a) Stealing, b) running away from home, c) habitual lying, d) cruelty to animals, e) and fire setting.
As the child grows older, the pattern may develop into: a) vandalism b) malicious mischief, c) truancy, d) drug and alcohol use, f) and various form of violence, from school bullying to robbery, assault, and rape. Children ,and especially, adolescents, with conduct disorders seem callous, hostile and manipulative.
EMOTIONAL DISTURBANCES
Emotional disturbances can include: a) eating disorders, b) depression, c) excessive stress reactions, and many others. Sometimes the disturbance is not readily visible. Emotional disturbances that manifest themselves in violence and similar extreme behavior occur less frequently than those with more complex subtle effect. And some disorders, such as eating disorders and substance abuse, are deliberately - often successfully - hidden by the child. Some children develop a negative or maladaptive pattern of behavior and interaction that become deeply entrenched and seems to be part of their personality.
PERSONALITY DIORDERS
The DSM IV defines personality disorder as "an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual culture, is pervasive and inflexible, has an onset in adolescence or early childhood, is stable over time, and lead to distress or impairment." The following are descriptions of few categories of personality disorder illustrate these maladaptive patterns:
Schizotypal Personality Disorder;
This is "a pattern of acute discomfort in close relationships, cognitive or perceptual distortions, and eccentricities of behavior."
Borderline Personality Disorder:
This may be described as "a pattern of instability in personal relationships, self-image, and affects, and marked impulsivity."
Dependent Personality Disorder:
This is "a pattern of submissive and clinging behavior related to an excessive need to be taken care of."
ANXIETY DISORDERS
Anxiety disorders are prevalent form of emotional difficulty, sharing with depression the dubious honor of most most pervasive emotional disorder. Children with anxiety disorder may be fearful, nervous, shy, and preoccupied, and they often strive to avoid the source of the anxiety, if there is a specific source.
Anxiety disorders include generalized anxiety disorder, phobia, panic disorder, obsessive-compulsive disorder, and post-traumatic stress disorder. Separation anxiety disorder specifically affects children and adolescence and can make separation from home and loved ones extremely distressing.
ADHD: This disorder has been discussed earlier
TREATMENT
In addition to medications as described earlier, treatment options include psychotherapy (particularly of the cognitive or behavior management type, and social skills training. Even if its is determined by experts that the child needs medication, behaviorally based treatment is often important as well.
EXTERNAL LINKS:
www.http://sped.wikidot.com/emotional-and-behavioral-disorders
http://en..wikipedia.org/w/index/phptitle+Oppositional_defiant_disorder&oldid=552243890
http://www.aacap.org/cs/ODD.Resource Center. American Academy of Child and Adolescent Psychiatry
http://www,mayoclinic.com/health/oppositional-defiant-disorder/DS00630
Dr. Joseph Nii Abekar Mensah, PhD,
Mental Health and Education Consultant.
GaDangme Journal of Education & Mental Health is of the view that formal education is the most effective vehicle for social change and social mobility in any given society. Nevertheless, we do not downplay the importance of informal education we receive from our parents, grandparents, aunts, uncles and from the general community.
In order for our children to do well or exceed in school in a level plainfield, we need to provide them with wholesome environment to grow physically, mentally and spiritually. We will focus our attention to learning in the school environment with references to Special Education, Behavior Analysis and Mental Health issues.
In the school systems in North America, Special Education programs are intended to assist students with significant academic difficulties due, perhaps, to low intellectual or cognitive functioning, severe receptive or expressive language delays, behavior problems, attention deficit-hyperactive disorder, learning disability, neurological/and or neuro-psychological impairment. Special Education programs are also aimed to helping intellectually superior students, who are not been actualized academically from the regular classroom programs. These intellectually superior students may channel their energies to anti-social behaviors, if they are ignored. Thus, individualized and much more challenging programs are designed to meet the needs of the intellectually superior students.
GaDangme Journal of Mental Health & Education will provide relevant information on the education to students and their parents to enable GaDangme parents and the wider public gain better understanding of their children's education.
Formal education in the schools is a complex process that draws on expertise from varieties disciplines,including teachers, school administrators, school counselors, clinical/ educational psychologist, the medical profession (audiologists, ophthalmologists, optometrists, physiotherapists, speech and language pathologists, Psychiatrists) and physical education teachers, etc.
School children may be referred by teachers, school administrators and/or parents to any or a number of the above-mentioned professionals for varieties of reasons, including but not limited to the following: learning problems, dysfunctional behaviors, attention deficit hyperactive disorder, severe language delays, visual and auditory problems, suspected neurological and neuro-psychological problems (following initial diagnosis by a duly qualified/certified psychologist). Please NOTE that referrals by educational personnel to other professionals for assessments may only be made with prior informed signed consent of the parents or guardian of the student. The term "informed" here means that the reasons for the the referral (s) must be thoroughly explained to the parent(s) and/or the guardian of the student. Parents/guardian of students should bear in mind that schools have no right to have their child/children evaluated by professionals without their prior informed written consent. Exceptions to this rule include teacher made tests and/or referrals to the Resource Room teacher for a quick diagnostic test, such as KeyMath test, to assess particular areas of the child's math difficulties and help the child. It is suggested that the assessment team should include the School Administrator, the Classroom teacher (s), the Resource Room teacher, the Guidance Counsellor, the parent(s) or Guardian of the student, the Student and the professional who will evaluate the student's difficulties, eg. the School Psychologist.
THE PSYCHO-EDUCATIONAL ASSESSMENT PROCESS
Let us examined what an Educational Psychologist does when a student say with academic problem is referred. After receiving the referral, it makes sense for the psychologist to consult with the student's teachers and parents/guardian to seek some background. He or she may examine the student's work and/or observe the student's interaction with his/her peers.
Prior to conducting the assessment of the student, the psychologist must formulate a tentative hypothesis regarding the referral question. In the case of poor academic performance, the psychologist may want to know, if the student has satisfactory intelligence to benefit from academic work. Using such instruments as the Wechsler scales, the Stanford Binet, etc., the psychologist may be able to assess the student's current intellectual functioning. He or she may be able to identify the strengths of the student, such as visual memory, long-term memory, auditory memory and short-term memory problems. On the other hand, the psychologist may identify that the child has good perceptual motor skills and that there are significance differences the student's Verbal IQ and Performance IQ in favor of the the Performance IQ. This indicates that the child's Perceptual motor skills appear to be better developed.
Significance of VIQ-PIQ differences. David Wechsler suggests that significant difference of 14 points or more between individual's Verbal IQ (VIQ) and the Performance IQ (PIQ) may suggest possible learning disabilities; neurological and/or neuro-psychological impairment; the student's cognitive preferences, implying one side
the student's brain is better developed than the other and hence the child prefers to use the side of the brain which is better developed. Thus, the student does very well using the side of his/her brain which is better developed. The intelligence tests tell the Psychologist more about the individual other than the Full Scale IQ alone.
Next the Psychologist may be interested in knowing the extent of the student's language development, since adequate language development plays a key role in academic success. The Psychologist may administer such instruments as the Peabody Picture Vocabulary Test the One-Word Expressive Vocabulary Test to the student to measure his/her receptive and expressive vocabulary development. Very poor performance by the student on these test may be indicative of receptive and/or expressive aphasia or both. The student can be helped by the Resource Room teacher, the regular Classroom teacher to improve his/her language difficulties.
The Clinician may also use an auditory discrimination tests, such as the Wepman Auditory Discrimination Test and the Goodman Friestoe Test of Auditory Discrimination to determine the student's auditory acuity. Poor performance on these tests may suggest auditory problems. With prior informed consent of the parent(s)/guardian of the student, the Psychologist may make refer to the Physician, or an Audiologist for further diagnosis and therapeutic intervention, if deemed necessary by the Physician or the Audiologist.
Furthermore, administration of such instruments as the Bender Visual-Motor Gestalt Test, the Benton, etc. may reveal possible visual-motor problems ,which may require further diagnosis by a Physician, an Ophthalmologist or Optometrist. The Bender Visual-Motor Gestalt Test is part of the Neuro-psychological Test Batteries. Quick Neurological Screening Test may provide valuable information, if the Clinician suspects neurological issues.
Next the Psychologist may consider to the student's performance in the three areas of school adjustment namely, Reading, Arithmetic and Spelling. The Wide Range Achievement Test, etc. may quickly be used. The Dyslexia Screening Test may be administered at the discretion of the Psychologist.
The student's academic problems may also be associated with behaviour disorders, attention deficit-hyperactive disorder or personality problems. There various standardized instruments to assess these problems, including Emotional and Behavior Problem Scale Personality Inventory for Children, Adolescent Psychopathology Scale, Million Adolescent Clinical Scale, Attention Deficit Disorder Evaluation Scales (Home and School Versions), Test of Variables of Attention (TOVA), Connors Continuous Performance Test and many more to numerous or discuss in details here.
Following the consultation with the parties involved or the Assessment Team, as case conference should be held to discuss the outcome of the test results and what decision should be taken, including school placement considerations as well as possible referral to other professional for further evaluation.
Simply put, the above-mention are generally what a Psychologist may do when a student with academic problem is referred to him/or her. The Psychologist may do more than what have briefly discussed to get to the roots of the student's problem and suggest appropriate remediation. Next we will be discussing what learning disabilities are, how the problem is diagnosed and what must be done following diagnosis.
LEARNING DISABILITY
The phrase "learning disability" is commonly used by educators and the wider public, generally in reference to reading difficulties that an individual faces. Let us now try to define the term. Learning disability is a classification including several areas of functioning in which a person has difficulty learning in a typical manner, usually caused by a unknown factor or factors. While learning disability and learning disorder are often used interchangeably, the two differ . Learning disability refers to significant learning problems in an academic area. These problems, however, are not sufficient to warrant official diagnosis. Learning disorder, on the other hand, is an official clinical diagnosis, whereby the individual meets certain criteria, as determined by a professional, such as a Psychologist, Pediatrician, etc.
The difference is in degree, frequency and intensity of reported symptoms and problems, and thus the two should not be confused. When the term "learning disabilities" is used, it describes a group of disorders characterized by inadequate development of specific academic, language and speech skills. Types of learning disabilities include reading disability (DYSLEXIA), mathematics inability (DYSCALCULIA), writing disability (DYSGRAPHIA), disturbance in language development, includes RECEPTIVE and EXPRESSIVE APHASIA), inability to draw or copy geometric figures (CONSTRUCTIVE APRAXIA). Students with learning disabilities also tend to have poor reasoning or listening skills.
It should be clearly noted that learning disability is not a problem with intelligence or motivation. Children with learning disabilities are NOT lazy or dumb. In fact, most of the children with learning disabilities have average, high or superior intellectual functioning than most people. Their brains are simply wired differently. This difference affects how they receive and process information. Simply put, children and adults with learning disabilities see, hear and understand things differently. This can lead to trouble learning new information and skills, and putting them to use.
CAN CHILDREN WITH LEARNING DISABILITIES LEARN AND SUCCEED?
One may ask if the GaDangme child or any other child regardless of ethnicity or race learn and succeed. My answer is definitely, "yes". It can be tough to face the possibility that your child your child has a leaning disability or learning disorder. No parents in his/her right mind want to see their child suffer. As indicated earlier most children with learning disabilities are just as bright or smart as everyone else. The child with learning disabilities needs to be taught in different ways that are tailored or geared to his/her unique learning styles. If GaDangme parents and guardians are able to learn more about learning disabilities and learning disorders in general, and the child's learning difficulties, in particular, the GaDangme parent along with the help from professionals, can help paved the for the success of the child at school and beyond. GaDangme Journal of Mental Health & Education will assist all GaDangme parents and guardians whose children are confronting learning and/or behavior difficulties at home or in school.
WHAT ARE THE SIGNS AND SYMPTOMS OF LEARNING DISABILITIES AND/OR DISORDERS?
Learning disabled children are different from one child to another. One learning disabled child may have reading and spelling problems, while another learning disabled child may books, reading and spelling, but has difficulty in understanding mathematical concepts. Also, another learning disable child may have difficulty understanding what others are saying or expressing his thoughts. The problems are fundamentally different, but they are all learning disorders.
However, it is not always easy to identify learning disabilities. In view of the wide variations of the disorder, there is no single symptom or profile that one can look to as an evidence of a problem. Yet, some warning signs are more common than others at different ages. If parents are aware of these signs, they are more likely to suspect a learning disorder early and take immediate steps to get help for the child.
Checklists:
The following checklists indicate some common red flags for learning disorders. Parents and guardians should note that children who do not have learning disabilities may still experience some of these difficulties are various times. The time for the parent to become concerned is when there is a consistent unevenness in one's child's ability to master certain skills or concepts.
Sign and Symptoms of Learning disabilities are pre-school age:
1. Problem pronouncing words
2. Trouble finding the right word.
3.Difficulty rhyming
4. Trouble learning the alphabet, numbers, colors, shapes, days of the week
5.Difficulty following directions or learning routines.
6.Difficulty controlling crayons, pencils, and scissors or coloring within the lines.
7.Trouble with bottoms, zippers, snaps, learning to tie shoes.
Signs and Symptoms of Learning Disabilities in Children Ages 5-9 years:
1. Trouble learning the connection between letters and sounds.
2. Unable to blend sounds to make words.
3. Confuses basic words when reading.
4. Consistently misspell words and make frequent reading errors.
5. Trouble learning basic math concepts.
6. Difficulty telling time and remembering sequences, eg. days of the week, events, etc.
7. Slow to learn new skills.
Signs and Symptoms of Learning Disabilities from ages 10-13 years of age:
1. Trouble with reading comprehension or math skills.
2.Trouble with open-ended test questions and word problems.
3.Dislikes reading and writing; avoids reading aloud.
4. Spells the same word differently in a single document.
5. Poor organization skills (bedroom, homework, desk is messy and disorganized.
6.Trouble following classroom discussions and expressing thoughts aloud.
7. Poor handwriting.
DIFFICULTIES WITH READING, SPELLING AND MATH
Learning disabled children have difficulties in the three basic areas of school adjustment, namely reading ,writing and math (arithmetic computation skills).
There are two types of learning disabilities in reading. Basic reading problems occur when the child has difficulty understanding the relationship between sounds, letters and words. Reading comprehension problems occur when the child has inability to grasp the meaning of words, phrases and paragraphs.
The following are signs of reading difficulties (dyslexia):
1. Letter and word recognition
2. Understanding words and ideas
3. Reading speed and fluency.
4. General vocabulary skills (receptive and expressive).
Learning Disabilities in math (Dyscalculia):
Learning disabilities in math vary considerably depending on the child's strengths and weakness (as may be indicated on intelligence text such as the Weschler scales or language test, etc). A child's ability to do math may be affected differently by a language learning disability, or a visual disorder or a difficulty with sequencing or organization. A child with math-based learning disorder is likely to struggle with memorization and organization of numbers, operation signs, and number "facts", such as 6+6+12 or 6x6=36. Children with math learning disorder may also have difficulties in counting principles (such as counting by 3's or counting by 5's). They may also problems telling time.
Children with writing disabilities (Dysgraphia).
Learning disabilities in writing may involve the physical act of writing or the mental activity of comprehending and synthesizing information. Basic writing disorder refer to the physical activity involve in words and letters. Expressive writing disability suggests a struggle to organize thoughts on paper. Symptoms of written language learning disability relates to the act of writing. They include problems with the following:
1. Neatness and consistency of writing.
2. Accurately copying letters and words.
3. Spelling consistency
4. Writing organization and coherence.
OTHER TYPES OF LEARNING DISORDERS OR DISABILITIES
It is important for us to bear in mind that reading, spelling, math, writing, language, etc. mentioned earlier are not the only types of learning disabilities. Other types of learning disabilities involve difficulties with motor skills (movement and co-ordination), understanding spoken language, distinguishing between sounds, and interpreting visual information. Let us examine some of these types of learning disabilities. They are as follows:
Learning Disabilities in Motor Skills (dyspraxia):
Motor difficulties refer to problems in movement and coordination whether is with fine motor skills (cutting, writing), or gross motor skills, such as jumping and running. A motor disability is sometimes referred to as an "output" activity meaning that it relates to the output of information from the brain in other to jump, run, write or cut something. The brain must be able to communicate with the necessary limbs to complete the action.
There are signs that may suggest that a child may have motor coordination disability. The child may have problem with physical abilities that require eye-hand coordination, eg, holding a pen or pencil or bottoming his/her shirt.
AUDITORY AND VISUAL PROCESSING PROBLEMS.
The importance of the ears and eyes cannot be overemphasized enough. The eyes and the ears are the primary means of delivering information to the brain, a process referred to as "input." In the event that the eyes and/or the ears are not functioning adequately, the individual is likely to suffer learning problems. For example, an inability to distinguish subtle differences in sound, or hearing sound at the wrong speed make it difficult to sound out words and understand the basic concepts of reading and writing.
Problems with visual perception, on the other hand, include missing subtle differences in shapes. reversing letters, or numbers, skipping words, skipping lines, misperceiving depth or distance, or having problems with eye-hand co-ordination. Psychologists and those in the medical professions may to the work of the eyes as "visual processing." Visual perception can affect gross and fine motor skills, such as reading, comprehension, and math.
OTHER DISORDERS THAT CONTRIBUTE TO LEARNING DIFFICULTIES
These include anxiety, depression, stressful events, emotional trauma, and other conditions that may affect concentration create learning problems. Besides, Attention Deficit Hyperactive Disorder (ADHD) and Autism sometimes co-occur or are confused learning disabilities.
Attention Deficit Hyperactive Disorder ADHD) is not considered as learning disability, but can certainly disrupt learning. Children with ADHD have difficulty in sitting still; they can't focus or follow instruction; they are disorganized and hardly complete their homework.
Autism: Autistic children tend to have difficulty mastering certain academic skills. This stems from pervasive developmental disorders including Asperger's Syndrome. Children with autism spectrum disorders may have communication problems, learning basic skills, making friends, reading body language, and making eye contact.
DIAGNOSIS AND TESTING FOR LEARNING DISORDER/DISABILITIES.
Earlier we have made made discussed the refer and testing procedures used by psychologist in evaluating learning disabilities and related learning disorders in the schools. Diagnosing learning disabilities is a process. It entails history taking, an observation by specialist. Types of specialist who can diagnose learning disabilities include: School Psychologists, Clinical Psychologists, Educational Psychologists, Child Psychologists, Developmental Psychologists, Neuro-psychologists, Psychometrics, Pediatricians, Speech and Language Pathologists, and Occupational Therapists. Occupational therapist tests for sensory disorders that can lead to learning difficulties.
WHAT CAUSES LEARNING DISABILITIES
Parents and teachers are always want to know the cause (s) of learning disabilities. In fact, the causes of learning disabilities are often not well understood. Sometimes there is no apparent cause for a learning disability. However, some causes of neurological impairments include:
1. Heredity - Learning disabilities often run in the family. Children with learning
disabilities are likely to have parents or relatives with similar disabilities.
2.Problems during pregnancy and child birth: Learning disabilities can result from
anomalies in the developing brain, illness or injury, fetal exposure to alcohol or drug,
low birth weight, oxygen deprivation, or premature or prolonged labor.
3. Accidents after birth: Learning disabilities can also be caused by head injuries, malnutrition, or by toxic exposure (such as pesticides, or heavy metals).
TREATMENT AND INTERVENTION
So we have discussed the nature, types, diagnosis of Learning Disabilities/Learning Disorders. Now, let us discuss intervention and treatment to help the learning disabled child. The following means of intervention may be considered.
1. Mastery Model: a) Learners work at their own level of mastery. b) Practice, c) Gain fundamental skills before moving onto the next level (Please, bear in mind that this approach is most likely to be used with adult learners or outside the mainstream school system.
2. Direct Instruction: a) Highly structured, intensive instruction, b) Emphasis carefully planned lessons for small learning increments. c) Scripted lesson plans. d) Rapid-paced interaction between the teachers and students. e) Correcting mistakes immediately. f) Achievement-based grouping. g) Frequent progress and assessments.
3. Classroom Adjustments: a) Special seating assignments. b) Alternative or modified assignments. d) Modified testing procedures. e) Quite environment.
Special Equipment:
4. Word processors with spell checkers and dictionaries. b) Text-to-speech and speech-t0-text programs. c) Talking calculators. d) Books on tape. f) Computer-based activities.
5. Classroom Assistants:
a) Note-takers. b) Readers. c) Proofreaders. d) Scribes.
6.Special Education:
a) Prescribed hours in a Resource Room. b) Placements in a Resource Room. c) Enrollment in a Special Education School for learning disabled students. d) Individual Education Plan (IEP). e) Educational therapy.
Note: Parents and guardians may note that early remediation/intervention can greatly reduce the number of children meeting diagnostic criteria for learning disabilities.
WhAT PARENTS/GUARDIANS CAN DO TO HELP THE LEARNING DISABLED CHILD. It is not always easy for parents of the learning disabled child to know what to do or where to find help. Turning to specialists who can pinpoint and diagnose the problem is, of course, important. It is equally important that parents and guardians with the school the child attends and received specialised professional and/or academic help. Since the parent/guardian knows the child than anyone else, he or she must take the lead in examining into options, learning about new treatments and services and overseeing the learning disabled child's education. In so doing, the parent/guardian may consider the followings:
1. Learn the specifics about your child's learning disabilities: Read and learn more about your child's type of learning disability. Find out from the professionals how the disability affects the learning process and what cognitive skills are involved. It is more easier for the parent to understand or evaluate learning techniques if he or she understand how the learning disability affects the child.
2. Research Treatments, Services, and new theories: Along with knowing about the type of learning disability your child has, educate yourself about more effective treatment options available. This can help the parent advocates for the child at school and pursue treatment at home.
3. Pursue treatment and services at home: Even if the school system does not have the resources to treat your child's learning disability optimally, you can pursue these options on your own at home, or with a tutor or therapist.
4. Nurture Your Child's Strengths: Children with learning disabilities may struggle in one area of learning and, yet may excel in other areas. Therefore, parents/guardians should pay particular attention to their child's interests and passions. Helping the child with learning disability develop his/her passion and strengths may help him or her with the areas of difficulty as well.
5. GaDangme parents may consider form advocacy groups, eg. GaDangme Association of Parents with Learning Disabilities/Disorders. Such a group or groups may acquaint themselves with information about Learning Disabilities and other Learning Disorders, such type, assessment, intervention. They may act advocates for Children with Learning Disabilities in Schools in their respective jurisdictions. They may call upon governments to provide more funding to schools, and resources to assist the learning disabled child.
GaDangme Journal of Mental Health & Education is very willing to lend support to GaDangme parents and community groups in this endeavor. GaDangme parents of children with learning disabilities may find the following links helpful.
1. The National Centre for Learning Disabilities. http//www.ncld.org.ld-basic/ld-explained/basic-facts/what-are-learning-disabilities/
2.www.dmoz.org/Health/Mental_Health/Disorders/Child_and_Adolescent/Learning_Disabilities//
3.htpp://www.brehm.org
ATTENTION DEFICIT HYPERACTIVE DISORDER (ADHD).
Attention Deficit Hyperactive Disorder, while not considered a learning disability, can certainly disrupt learning. Children with Attention Deficit Hyperactive Disorder have problems sitting still. staying focused, following instructions, staying organized and completing homework. What then is Attention Deficit Hyperactive Disorder?
Attention Deficit Hyperactive Disorder (ADHD) is a disorder characterized by inattentiveness, and hyperactivity resulting in significant impairment in functioning at home, school, or with peers. Various terms have been used in the past to describe the condition knwon as ADHD, including such terms as "minimal brain damage or dysfunction", "hyperkinenesia", hyperactivity" and "attention deficit disorder." It is suggested that between three to five (3-5) percent of school-age children have ADHD. ADHD is approximately six (6) times more frequent in boys than in girls. Symptoms persist into adulthood in forty to sixty (40-60) percent of individuals. The current and most widely used criteria for ADHD are defined by the American Psychiatric Association as stipulated in the Diagnostic and Statistical Manual for Mental Disorders (DSM IV).
DSM IV Criteria for Diagnosing Attention Deficit Hyperactive Disorder (ADHD).
Six or more of the following symptom of in attention have persisted for at least 6 months to a degree that is maladaptive and inconsistent with the developmental level:
Inattention:
1. The child fails to give close attention to details or make mistakes in schoolwork, or other activities.
2. He or she has difficulty sustaining attention in tasks or play activities.
3. Often does not seem to listen when spoken to directly.
4. He or she often does not follow through on instructions and fails to finish
schoolwork, chores or duties in the workplace (not due to oppositional behavior or
failure of comprehension).
5. He/she has difficulty organizing tasks and activities.
6. The individual often avoids, dislikes, or is reluctant to engage in tasks that require
sustained mental effort, such as schoolwork or homework.
7. He or she loses things necessary for tasks or activities at school or home, such as toys,
pencils, books, assignments.
8. The individual is often distracted by extraneous stimuli.
9. He/she is often forgetful in daily activities.
Hyperactivity-impulsivity
Six or more of the following symptoms of hyperactivity-impulsivity have persisted for at least six (6) months to a degree that is maladaptive and inconsistent with developmental level:
Hyperactivity:
1. The child often fidgets with hands or feet or squirms in seat.
2. He or she often leaves seat in classroom or in other situations in which remaining seated is
expected.
3. Often runs about or climbs excessively in situations in which it is inappropriate ( in adolescence
or adults, may be limited to subjective feeling of restlessness).
4.Has difficulty playing or engaging in leisure activities quietly.
5. Often talks excessively.
6. He or she is often on the go or often acts as if driven by motor.
Impulsivity:
1. The child often has difficulty awaiting turn in games or group situations.
2. He or she blurs out answers to questions before they have been completed.
3. He/she often intrudes on others, eg., butts into other children's games.
Onset before the age of 7. Some impairment from the symptoms is present in more than two or more settings ,eg., at school or work or at home. There must be clear evidence of significant impairment in social, academic, or occupational functioning.
NOTE that the symptoms of ADHD may vary considerably between home and school, in structure versus nonstructed settings, large versus small groups and situations having high versus low performance demands. There is now evidence to suggest that ADHD without hyperactivity, also known as Undifferentiated Attention Deficit Disorder (UADD) is a discrete entity. These children function with lower cognitive speed and appear more confused, apathetic, and lethargic and more likely to be depressed than are children who have ADHD with hyperactivity (ADHD+H). They also are identified later when they begin to fall behind academically in later primary grades. Children with ADHD+H are described as being more noisy ,disruptive, messy, irresponsible ,and immature and have more problems with peer relationships.
Coexisting Conditions:
About twenty five to thirty (25-30) percent of ADHD children have learning disability. Despite normal and even superior intelligence, the ADHD child is often a chronic underachiever. By adolescence up to one-third of ADHD children have failed at least one grade.
Speech and Language Disorders:
Many ADHD children have language disorders, mostly prominently found in expressive language. They may have limited vocabulary, word-finding difficulties and poor grammar. Some psychologist are of the opinion that language development is also linked to the development of self-control, as children use inner language to help them monitor behaviour.
Psychiatric Disorders:
It is estimated that fifty to sixty five (50-65) percent of ADHD children have at least one additional psychiatric disorder. Additional dignosis frequently include Oppositional Defiant Disorder and Conduct Disorder. The greatest risks for those who develop serious antisocial behaviour during adolescence are those who come from dysfunctional families involving alcoholism, drug abuse, and violence. Problem with poor self-estemm are common and 25-33 percent of ADHD children experience at least one episode of major depression during childhood years. Anxiety disorders resulting in fears and worries also occur in up to 25 percent of ADHD children.
What Are the Causes of Attention Deficit Hyperactive Disorder (ADHD)?
The cause of ADHD is unknown. However, there is evidence to suggest that the frontal lobes of the brain may have a role in ADHD. The frontal lobes lobes have long been known to play a critical role in regulation attention, activity, and emotional reactions.
2. Also heredity plays a role in ADHD since ADHD children are four times as likely to have close family members with the same problems. Moreover, identical twins are more likely to share ADHD than fraternal twins or other siblings.
3.Birth injuries associated with faetal distress and difficult labour play negligible role in ADHD. However, damage prior to birth, may play a role. Mothers who abuse alcohols ,drugs during pregnancy have children who suffer from ADHD and learning disabilities.
4. Environmental toxins, including lead, and artificial flavors, dyes, preservatives and other food additives have been claimed by some to be primary cause of ADHD.
Diagnosis of ADHD
There is no single diagnostic test that definitely make s the diagnosis of ADHD. Instead, the diagnosis involves the collection of information from variety of sources. The information gathered along with psycho-educational test battries as well as the TOVA, Conner's Continuous Performance Test, Attention Deficit Disorder Evaluation Scales (Home and School Version), Behavior Disorder Identification Scale (Home and School Versions), Emotional and Behavior Problem Scales (Home and School Versions) do provide useful diagnostic information about the ADHD child. These instruments along with diagnosis by a Psychiatrist have been know to lead to diagnosis of ADHD to some extent.
TREATMENT OF ATTENTION DEFICIT HYPERACTIVE DISORDER (ADHD).
Essentially, the goals of treatment of ADHD are to improve the child's functioning at home, in school and with peers through the modification of his/her inattention, impulsivity and hyperactivity. Also another goal of the therapy is to maximize cognitive functioning, social and behavior skills, self-esteem with minimal side effects. The long-term outcome of ADHD treatment has shown to be improved most when one uses a combination of education, medication. psychological treatments, and appropriate classroom intervention. Let us consider briefly some of these treatments.
Education:
Earlier we have suggested some ways by which a child with learning disabilities may be helped in the classroom. Similar techniques may be used to assist the child with Attention Deficit Hyperactive Disorder in the classroom.
Medications:
Medications in treating the child with ADHD may only be prescribed by a duly qualified/certified physician or a Psychiatrist. The medications used generally include: Stimulants such as Ritalin, Dexedrine and Pemoline. Others include Tricyclic Antidepressant and Clonidine. We strongly suggest the use of these medication with a qualified Psychiatrist of Physician.
Psychologican and Behavior Therapies:
A variety of psychological and behavior therapies ,alone and in combination, have been used in treating ADHD with varying degrees of success. The aim of the psychotherapeutic treatments is to modify the associated problems such as oppositional defiant behaviour and conduct problems.
Parent Training and Family Therapy:
This provides a variety of management strategies for the behavior problems seen in ADHD child. Family therapy in this case deals with variety of approaches to family skills training. This is problem solving, open and effective communication skills, anger management or conflict resolution.
LINK: http//www.utoronto.ca/kids/add.htm
EMOTIONAL AND BEHAVIOR DISORDERS IN SCHOOLS
Students with emotional and behavior disorders have serious and persistent difficulties that can be described by psychological and/or psychiatric diagnosis. When special educators identify a student as having an emotional or behavioral disorder, they are assisted by a psychologist or psychiatrist who conducts a thorough evaluation and makes a diagnosis of the disorder, using the categories listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM IV).
In discussing emotional and behavioral disorders, we may consider the term serious emotional disturbance and defines it as a condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects educational performance:
1. An inability to learn that cannot be explained by intellectual, sensory, or health factors.
2. An inability to build or maintain satisfactory interpersonal relationships with peers and teachers.
3. Inappropriate types of behavior or feelings under normal circumstances.
4. A general pervasive mood of unhappiness and depression; or
5. A tendency to develop physical symptoms or fears associated with personal or school problems.
As defined by the Individual with Disabilities Act (IDEA) in the United States, emotional and behavior disorders includes schizophrenia but does not apply to children who are socially "maladjusted." Behaviorally and emotionally students can exhibit widely varied types of behaviour, including both internalized behavior ,such as DEPRESSION or EATING DISORDER and externalized behavior such as verbal outbursts. Other common characteristics and behaviors include the following:
1. Hyperactivity characterized by short attention span, and impulsiveness.
2. Aggression or self-injurious behavior (acting out and fighting).
3. Withdrawals (failure or initiate interaction with others; retreat from exchanges of social interaction, excessive fear or anxiety).
4.Immaturity (inappropriate crying, temper trantrums, or poor coping skills).
5. Learning difficulties (academic performance below grade level).
Children with behavioral disorders do not necessarily have learning disabilities. Children with the most serious disorders exhibit the following: distorted thinking, excessive anxiety, bizarre motor acts, and abnormal mood swings. Psychoses can range in severity from temporary ad mild to recurring and severe as in schizophrenia.
TYPES OF EMOTIONAL AND BEHAVIOR DISORDERS
Defining and classifying emotional and behavior disorders can be a challenging task. DSM-IV contains eighteen (18) major classification areas, into which are grouped more than two hundred specific disorders. Here we will discuss the emotional and behavior diagnosis that parents and teachers are most likely to encounter.
1.Conduct Disorder:
The diagnosis of conduct disorder is based on antisocial behavior, and it says little about the child's inner life, motives, and disabilities. The disorder is classified by type: aggressive versus nonaggressive and overt (with violence or tantrums) versus overt (with lying, stealing, and/or drug use).
The distinction between "socialized" and "under-socialized" activity is common. For example, much serious adolescent misconduct takes place in street gangs, many of whom members are loyal to their friends and able to make serious social adjustments as adults. However, the situation is more serious when the misbehavior begins early and the child has no friends. Such children are more likely to develop "antisocial personality disorder" as adults, continuing a pattern of socially maladjusted behavior. Early symptoms include: a) Stealing, b) running away from home, c) habitual lying, d) cruelty to animals, e) and fire setting.
As the child grows older, the pattern may develop into: a) vandalism b) malicious mischief, c) truancy, d) drug and alcohol use, f) and various form of violence, from school bullying to robbery, assault, and rape. Children ,and especially, adolescents, with conduct disorders seem callous, hostile and manipulative.
EMOTIONAL DISTURBANCES
Emotional disturbances can include: a) eating disorders, b) depression, c) excessive stress reactions, and many others. Sometimes the disturbance is not readily visible. Emotional disturbances that manifest themselves in violence and similar extreme behavior occur less frequently than those with more complex subtle effect. And some disorders, such as eating disorders and substance abuse, are deliberately - often successfully - hidden by the child. Some children develop a negative or maladaptive pattern of behavior and interaction that become deeply entrenched and seems to be part of their personality.
PERSONALITY DIORDERS
The DSM IV defines personality disorder as "an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual culture, is pervasive and inflexible, has an onset in adolescence or early childhood, is stable over time, and lead to distress or impairment." The following are descriptions of few categories of personality disorder illustrate these maladaptive patterns:
Schizotypal Personality Disorder;
This is "a pattern of acute discomfort in close relationships, cognitive or perceptual distortions, and eccentricities of behavior."
Borderline Personality Disorder:
This may be described as "a pattern of instability in personal relationships, self-image, and affects, and marked impulsivity."
Dependent Personality Disorder:
This is "a pattern of submissive and clinging behavior related to an excessive need to be taken care of."
ANXIETY DISORDERS
Anxiety disorders are prevalent form of emotional difficulty, sharing with depression the dubious honor of most most pervasive emotional disorder. Children with anxiety disorder may be fearful, nervous, shy, and preoccupied, and they often strive to avoid the source of the anxiety, if there is a specific source.
Anxiety disorders include generalized anxiety disorder, phobia, panic disorder, obsessive-compulsive disorder, and post-traumatic stress disorder. Separation anxiety disorder specifically affects children and adolescence and can make separation from home and loved ones extremely distressing.
ADHD: This disorder has been discussed earlier
TREATMENT
In addition to medications as described earlier, treatment options include psychotherapy (particularly of the cognitive or behavior management type, and social skills training. Even if its is determined by experts that the child needs medication, behaviorally based treatment is often important as well.
EXTERNAL LINKS:
www.http://sped.wikidot.com/emotional-and-behavioral-disorders
http://en..wikipedia.org/w/index/phptitle+Oppositional_defiant_disorder&oldid=552243890
http://www.aacap.org/cs/ODD.Resource Center. American Academy of Child and Adolescent Psychiatry
http://www,mayoclinic.com/health/oppositional-defiant-disorder/DS00630
Dr. Joseph Nii Abekar Mensah, PhD,
Mental Health and Education Consultant.