The basics of defining and evaluating Learning Disabilities.

By Amy Landsman

“Originally, we weren’t quite sure why he was having such difficulty,” recalls Charlotte Albro of Bel Air.
The trouble started in preschool. Albro’s son, Conor, wasn’t keeping up with the other children, and he couldn’t sit still. Plus, he got teased because he had difficulty interacting with the other kids.
Conor’s problems continued in kindergarten, so the Albros took him to a behavioral psychologist who diagnosed him with Attention Deficit Hyperactivity Disorder (ADHD).
Other concerns then surfaced.
“Developmentally, he was behind in his reading,” says Albro. “He couldn’t spell. He had difficulty writing. He was not at grade level, and we knew that was a problem.”
This led the Albros to take him to a neuropsychologist for additional testing. This time, Conor was diagnosed with having a learning disability (LD).

Defining LDs
According to the nonprofit National Center for Learning Disabilities, an LD is “a neurological disorder that affects the brain’s ability to receive, process, store, and respond to information. The term ‘learning disability’ is used to describe the seemingly unexplained difficulty a person of at least average intelligence has in acquiring basic skills.”
Kids with LDs can be very smart, but, because their brains are wired differently, it can be difficult for them to learn without extra support both at home and in school. Simply urging a child with an LD to buckle down and try harder won’t solve the problem.
Dyslexia is probably the best-known learning disability, but it isn’t the only one. There are LDs associated with math calculation and problem-solving as well as with skills involving handwriting, written expression, and reading comprehension. It is also not unusual for kids with a learning disability, such as Conor Albros, to have ADHD or some other co-existing condition.

Testing 1, 2, 3
If a child is having difficulty in school, there are warning flags indicating learning disabilities that families and teachers should be aware of. For instance, perhaps a preschooler has trouble forming letters, coloring, or using scissors. Maybe an elementary school student takes an hour to complete a 10-minute homework assignment.
A youngster with an LD might also have poor penmanship or struggle to learn math facts. And all of these hypothetical children probably lag behind their classmates academically.
The only way to confirm if a particular child has an LD is to have him or her take a battery of tests, generally referred to as a psycho-educational evaluation. The earlier the child is tested and his or her LD is identified, the better.

“Most of the time, you can see early signs emerging as young as kindergarten and first grade,” says Dr. Caitlin Joy, director of psychological testing services at Mt. Washington Pediatric Hospital in Baltimore. “But a lot of kids tend to be diagnosed closer to second or third grade because of the [expected] developmental variability in picking up some of those early skills. The earlier that we’re able to pick up on it, the earlier the child can get intervention and the better the outcome.”
A psychologist or neuropsychologist can administer a psycho-educational evaluation in private practice, but these tests can also be conducted in a hospital setting, such as at Mt. Washington Pediatric Hospital, or at the child’s public school.

Depending on the exact type of testing needed, private testing can cost anywhere from $1,200 to $3,000, with many insurance plans covering at least part of the cost. While public schools will assess students, including those attending private school, at no charge, the wait for such an evaluation can be longer than it is through a private practice or in a hospital setting. Typically, the testing takes a few hours, depending on the age of the child.
“Usually you start out with an IQ test, which is a measure of what we think the child’s capability is and how he or she will do in school,” says Dr. Kenneth Gelfand, director of Outpatient Psychology Services at Mt. Washington Pediatric Hospital.

Gelfand warns that parents should not focus on their child’s result on the IQ test alone, however. The psycho-educational evaluation, taken as a whole, is intended to provide a comprehensive picture of where the child stands in a variety of areas.
“IQ really isn’t a measure of how smart you are,” Gelfand explains. “It’s a predictor score.”
“We’re looking at, generally, an entire array of abilities, trying to get a sense of the child,” he continues. “IQ definitely does not correlate to how capable the child is in a number of areas. But it does measure a lot of skills that are very important for success in life. So, it’s important that parents understand the rationale for the evaluation rather than one specific score.”
Adds Joy: “We also give [children] academic tests to target specific areas, including reading, mathematics, written language—these types of things. We also test memory and attention and look at social, emotional, and behavioral functioning.”

Next Steps
In addition to conducting this sort of testing, the person administering the evaluation also often asks the child’s parents and teacher to fill out questionnaires about the child’s behavior and abilities. After the testing, the evaluator also typically reviews the scores with the family to explain the diagnosis and offer specific recommendations on the best strategies to help support the child. There is, in fact, a wide range of services available for kids with learning disabilities, everything from shortened assignments, to extended time for test-taking, to intensive special education services.
Many of these kids also participate in speech and language therapy to improve their processing and language-interpretation skills. Lesley Wofford, a speech pathologist at Mt. Washington Pediatric Hospital, explains why.
“For example,” she says, “somebody might hear the instructions at school, ‘Go get a book and sit at your desk to read.’ They’ve heard that, but they’ve only processed and interpreted ‘Sit at your desk.’ So, they’re missing a big chunk of the instructions.”

The Good News
But, in the end, while kids with learning disabilities may have to work harder to keep up with their peers, the good news is that, with support, they can shine just as brightly.
Take Conor Albro, for instance.
After a frustrating kindergarten year, his parents transferred him to The Highlands School in Bel Air, an independent, nonprofit, co-educational school serving kids in grades k-8 with language differences as well as ADHD. Currently 11 years old and in his fifth year at The Highlands School, Conor is doing very well, his mom reports.
“It’s amazing when you look at all the famous people who have dyslexia, ADHD, and learning differences,” she says, citing Bill Gates and Albert Einstein as two famous examples.
Then, very proudly, she adds, “We’ve seen huge growth in Conor.” BC

Amy Landsman is regular contributor to Baltimore’s Child and author of the monthly special needs column, Your Special Child.

For More Information
For more information about learning disabilities, visit the National Center for Learning Disabilities website, www.ncld.org.

© Baltimore’s Child Inc. October 2010

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