LEARNING DISABILITY (DYSLEXIA) IN CHILD

LEARNING DISABILITY (DYSLEXIA) IN CHILD

It is an imperfect ability to listen, speak, read, write, spell or to do mathematical calculations. It is a disorder that interferes with child’s ability to store, process or reproduce information. The disability may be mild enough to remain undetected throughout life.

Etiology

Genetic predisposition appears to play an important role. First degree relatives with learning disability, prenatal cigarette exposure, lead exposure and PEM are risk factors.

A large proportion of the children have had delayed speech and language development. There is no organic brain lesion in most of the cases. Likewise, socioeconomical, cultural, environmental and educational factors as also other disabilities are not the primary cause.

Classification

1. Global: All aspects of learning are affected because of low IQ
2. Specific

1. Reading disorder
2. Mathematical disorder
3. Disorder of written expression

Clinical Features

Child performance remain behind his actual potentials though his intelligence is by and large within normal limits. This results in poor scholistic achievements and even failures. Major manifestations are:

1. Difficulties in acquiring and using language:

a.       Reading and writing letters in the wrong order.

b.      There is directional confusion as well as confusion regarding capital and small letters.

2. Difficulties in learning to speak
3. Difficulties in learning letters and their sounds
4. Difficulties in memorizing number facts
5. Difficulties in learning foreign languages
6. Difficulties in correctly doing math operations.

Diagnosis

Discrepancy between potential (ability, IQ) and achievement, resulting in underachievement, especially in reading, is the most important clue. History it should enquire in to prenatal, prenatal or postnatal factors contributing to learning disability. Information with respect to marital disharmony, unrealistic expectation from the child, sibling rivalry, discrimination and emotional trauma should be sought.

Physical examination: It should exclude any neurological deficit, hearing and visual loss.

Investigations: These include screening for hearing, vision, speech and psycho-educational status.

Treatment:

A multidisciplinary approach, involving the class teacher, remedial teacher, parents, social worker, pediatrician, psychologist and, if warranted, even a psychiatrist, is important managing the learning disability. The teaching curriculum is adjusted and specific teaching materials employed to help the child explore his optimal learning potential. For reading disability, the child should be taught:

1.      To break the spoken words into smaller units of sound

2.      That letters on the page represent these sounds

3.      That written words have the same number and sequence of sounds as heard in spoken words

4.      Pheneme awareness

Additional helpful measures include:

1. Practice in reading stories is useful
2. Computer with spelling checker
3. Tape-recorders
4. Recorded books
5. Oral rather than written examinations
6. Drug therapy for comorbidity such as emotional problems, hyperactivity and enuresis.