Learning Disabilities Flashcards
What are three subtypes of learning disabilities?
Reading (word recognition/dyslexia, reading fluency, comprehension)
Mathematics (computation, problem solving)
Written (handwriting, spelling, composition)
According to the DSM-5, what information is needed to diagnose LD?
Individual’s history, including development, medical, family, education, age of onset; psychoeducational reports of test scores and observations; and response to intervention (RTI)
According to the DSM-5, the affected skill(s) must meet what criteria?
The affected academic skills are substantially and quantifiably below those expected for the individual’s chronological age, AND cause significant interference with academic or occupational performance, or with activities of daily living, as confirmed by individually administered standardized achievement measures and comprehensive clinical assessment.
How long must symptoms persist to meet DSM-5 criteria for LD?
At least 6 months (despite the provision of interventions that target those difficulties)
By what age must symptoms begin?
Learning difficulties must begin during school-age years. However, diagnosis is not required by a specific age. For those 17 years and older, a documented history of impairing learning difficulties may be substituted for the standardized assessment.
What are important factors to consider when ruling out other causes of academic problems?
Intellectual disabilities, uncorrected visual or auditory acuity, mental or neurological disorders, psychosocial adversity, lack of proficiency in the language of academic instruction, inadequate educational instruction
Approximately what percentage of individuals have a LD in the US?
15-20%
What is the ratio of males to females affected by reading disability?
Males are 1.5 times as likely as females to have a reading disability
What is the heritability for reading disability?
0.3 to 0.9
What is the heritability for math disability?
0.5 to 0.8
Do difficulties associated with a learning disability improve throughout childhood?
No, disabilities typically persist over time, despite intervention efforts, and do not spontaneously remit with time or age. Many problems may not be fully manifested until later in childhood.
Exceptions include word-reading accuracy and/or mathematics calculation, which can improve if intervention is received by early elementary school
What are four models for diagnosing LD?
Aptitude-Achievement Discrepancy Model;
Low-Achievement Model;
Intraindividual Differences Model;
Response to Intervention (RTI) Model
Which of the proposed models has the most efficacy?
Low-achievement model - it has substantial validity, is frequently used in research and because children who perform below average on achievement tests can be differentiated on external variables
What is the incidence of reading disabilities, and what are three subtypes/specifiers of reading disabilities?
Reading disabilities occur in 10-15% of school-aged children and adolescents.
Word decoding, reading fluency, and reading comprehension
What is the most common form of reading disability and it’s characteristics?
Word decoding - ‘dyslexia’
Difficulties with accurate and/or fluent word recognition, poor spelling and decoding abilities, typically resulting from a deficit in the phonological component of language, that is often unexpected in relation to other cognition abilities and provision of effective classroom instruction
What is the neural signature of dyslexia?
Functional neuroimaging shows underactivation in Wenicke’s area, angular gyrus, and striate cortex, with concurrent overactivation in the inferior frontal gyrus, during tasks requiring phonological analysis.
Other findings: reduced activity in the left occipitotemporal junction (visual word form area) during word processing; less activation in left frontal regions in children with poor reading fluency
What structural abnormalities in the brain have been associated with dyslexia?
Postmortem studies found consistent symmetry of the planum temporale, as well as polymicrogryria of the left planum temporale and cortical dysplasias in the left hemisphere.
What skills are considered fundamental for acquisition of reading?
Phonological awareness
Decoding
Sight reading
Prediction
In reading acquisition, what is phonological awareness?
Phonological awareness - ability to understand that words are comprised of specific speech sounds (phonemes), to parse out the component sounds of words and to put them back together.
In reading acquisition, what is decoding?
Decoding - ability to convert letters into sounds and combine them to form a recognizable world; based on knowledge of the alphabet and phonological awareness.
In reading acquisition, what is sight reading?
Sight reading - retrieve or recognize words from sight that are already known; this becomes faster and more automatic as the skill develops and number of sight words grows.
In reading acquisition, what is prediction?
Prediction - applying context, linguistic and background knowledge, and memory to text to anticipate or guess the meaning of unknown words; type of top-down skills facilitated by knowledge of word-letter associations.
Independent of phonological awareness, what is strongly predictive of reading?
Rapid automatized naming (RAN) - automaticity of rapid naming and reading
What is the double-deficit model of reading disabilities?
Variables of reading acquisition (i.e., phoneme awareness, rapid naming) contribute to different aspects of reading. This model argues that having deficits in both areas, or a ‘double-deficit,’ leads to more pervasive and severe impairments, as opposed to having one or the other ‘single-deficit’
What skills are required in reading fluency?
phonological awareness, phonics, automaticity of sound-symbol relationship retrieval, decoding, recognition of sigh words, vocabulary, and processing speed
What skills are required in reading comprehension?
In addition to phonologic processing, reading comprehension requires orthographic (visual word form) and morphologic (word meaning) processing.
What are the specific categories of deficits in reading comprehension skills?
Basic word recognition skills;
Broad oral language skills;
Executive function, including working memory, planning, organized memory search, estimation
What is late-emerging reading disability?
Deficits in reading fluency and/or comprehension that are not evident until at least 3rd grade, often in the absence of basic word recognition/decoding problems; can be associated with the transition from ‘learning to read’ to ‘reading to learn’ or related to reduced vocabulary development in students of low SES backgrounds
According to the National Reading Panel, what domains are essential for instruction in normal reading development for all students?
Phonological awareness, phonics, sight word acquisition, vocabulary, and comprehension.
Moreover, oral reading enhances reading fluency; vocabulary should be taught directly, and augmented via computer; comprehension requires direct instructional methods to develop vocab, reading fluency, and strategy use
What treatments for reading disabilities are unproven and/or controversial?
Visual therapy and associated treatments (i.e., muscle exercises, ocular pursuit-and-tracking, prisms, colored lenses)
Fast ForWord
In Mathematics disabilities, what descriptive specifiers/subtypes are used?
Number sense;
Memorization of arithmetic facts;
Accurate or fluent calculations;
Accurate math reasoning
Other subtypes include: semantic memory subtype; procedural errors subtype; visuospatial subtype
In Mathematics disabilities, what does the semantic memory subtype entail?
deficient, inaccurate, or inconsistent arithmetic fact retrieval
In Mathematics disabilities, what does the procedural errors subtype entail?
Use of developmentally immature procedures or errors in the execution of procedures
In Mathematics disabilities, what does the visuospatial subtype entail?
Misalignment of numbers or place value errors in decimals; this subtype is unvalidated in studies with children and is largely based on adult lesion data
What is the incidence rate of mathematics disabilities?
Nearly as prevalent as reading disabilities; 18% and 27% of fourth and eighth-graders respectively performed below basic level in math achievement
What other LD frequently co-occurs with mathematics disabilities and what are their commonalities?
Reading disabilities
Skills in automaticity, processing speed, and working memory are needed to read single words and for automatizing math facts retrieval; some propose that phonological awareness is associated with mathematics computation in school-age kids
What genetic disorders are associated with mathematics disabilities?
Turner syndrome, Fragile X syndrome, Neurofibromatosis type I, spina bifida, 22q deletion syndromes, Williams syndrome
What congenital disorders and birth-related issues are associated with mathematics disabilities?
Congenital hydrocephalus, congenital hypothyroidism, preterm birth/very low birth weight
In terms of Written Expression disabilities, what specifiers are used in the DSM-5?
Spelling accuracy;
Grammar and punctuation accuracy;
Clarity or organization of written expression.
What is the incidence rate of written expression disabilities and gender ratio?
Varies from 7% to 15%, with boys being 2 to 3 times more likely to have it than girls
What percentage of those with written expression disabilities have dyslexia?
75%
What is dysgraphia?
Impairment in legible automatic letter writing, orthographic coding, and finger sequencing
What components of language are involved in translation of mental information into written format?
Transcription - subword level (handwriting) and word level (spelling) of written language
Syntax - level of language that provides structure for organizing words
What factors are associated with writing disabilities in adults?
Slow writing speed, poor handwriting, spelling errors, weak vocab, low verbosity
How is treatment of LD approached from preschool through adulthood?
In early years, it’s most important to focus on prevention and early identification of the learning disability.
Disabilities identified later require evidence-based interventions.
For adolescents and adults, accommodations become more important.
Regardless of age of dx, recommendations should always include intervention and not just accommodations so that students can improve their skills.
While not a recognized specific learning disability, what are though to be the hallmark signs of Nonverbal Learning Disability (NLD or NVLD)?
Deficits in visual-spatial processing, motor and tactile performance, and nonverbal problem solving in the presence of well-developed language skills.
Others consider deficits in spatial and temporal perception, handwriting, mathematics, and social perception as key symptoms
What hemisphere is associated with NVLD?
Right hemisphere, thought to be related to spatial and temporal perception
What score profile is commonly used to help identify NVLD samples?
VIQ > PIQ;
Poor academic performance in mathematics
What tests best characterize motor and visual deficits in NVLD?
Pegboard tasks have more consistent evidence than visual-perception measures, such as Rey-O
Are executive function deficits associated with NVLD?
Yes, particularly impairments in novel problem solving.
What helps distinguish NVLD from Asperger’s?
Stereotyped interests and transition rigidity are considered rare in NVLD.
What limitations hinder a consensus on diagnostic criteria for NVLD?
In research, inconsistent findings between studies, incompatible study designs, frequent design flaws.
Clinically, some characteristics of NVLD capture children with no functional impairments, while other samples include children who could be described as having symptoms of ADHD, Asperger’s, dyscalculia, dyspraxia, or some combination
