learningdisabilities-160223035008ll.pptx

learning disablities

1. Learning disorders Chandril Chandan Ghosh Rejin D Joel John Bichu Andrews Flobert Montero Bhagyanath Anmol Chawla Shravan Abraham

2. What we intend to cover: Introduction by Chandril Signs and symptoms by Bhagyanath Causes by Chandril Mechanism by Rejin Diagnosis by Shravan Prevention by Joel Management by Flobert Prognosis by Anmol Recent research by Bichu

3. INTRODUCTION

4. Why the need for discussing this? Up to one-third of parents of kids with learning disabilities (LD) don’t feel prepared to take on the challenge. The public is aware of LD but still has some incorrect ideas. Kids with LD have more trouble in school and out of school than other kids do.

5. SIGNS AND SYMPTOMS

6. Symptoms of Dyscalculia Difficulty when counting backwards. Poor sense of number and estimation. Has difficulty in understanding place value and the role of zero in the Arabic number system. Has no sense of whether any answers that are obtained are right or nearly right. Tends to be slower to perform calculations.

7. Symptoms of Dyscalculia Forgets mathematical procedures, especially as they become more complex, for example ‘long’ division. Addition is often the default operation. The other operations are usually very poorly executed (or avoided altogether). Avoids tasks that are perceived as difficult and likely to result in a wrong answer. Weak mental arithmetic skills. High levels of mathematics anxiety.

8. Symptoms of Dyslexia Speech problems, such as not being able to pronounce long words properly and "jumbling" up phrases Poorly organised written work that lacks expression Difficulty planning and writing essays, letters or reports Difficulties revising for examinations Trying to avoid reading and writing whenever possible Difficulty taking notes or copying Poor spelling Struggling to remember things such as a PIN or telephone number Struggling to meet deadlines

9. Symptoms of Dyslexia Problems learning the names and sounds of letters Inconsistent spelling Putting letters and figures the wrong way – such as writing "6" instead "9", or "b" instead of "d" Confusing the order of letters in words Reading slowly or making errors when reading aloud Visual disturbances when reading – may describe letters and words as seeming to move around or appear blurred Answering questions well orally, but having difficulty writing down the answer

10. Symptoms of Dysgraphia May have illegible printing and cursive writing (despite appropriate time and attention given the task) Shows inconsistencies: mixtures of print and cursive, upper and lower case, or irregular sizes, shapes or slant of letters Has unfinished words or letters, omitted words Inconsistent spacing between words and letters Exhibits strange wrist, body or paper position

11. Symptoms of Dysgraphia Has difficulty pre-visualizing letter formation Copying or writing is slow or laboured Shows poor spatial planning on paper Has cramped or unusual grip - may complain of sore hand Has great difficulty thinking and writing at the same time (taking notes, creative writing.)

12. Auditory P rocessing D isorder Easily distracted or unusually bothered by loud or sudden noises. N oisy environments upsets the individual. Behavior and performance improve in quieter settings. Difficulty following directions, whether simple or complicated. Have reading, spelling, writing, or other speech-language difficulties. Difficulty with verbal math problems. Disorganized and forgetful. Difficulty in following conversations.

13. CAUSES

14. Genes and heredity Studies found a child with dyscalculia often has a parent or sibling with similar math issues. If your child has dyslexia , there’s a chance you or another relative may have it too. Scientists located several genes associated with reading and language processing issues. There may also be a genetic link, with dysgraphia running in families. Auditory Processing Disorder (APD) is heavily influenced by our genes say researchers

15. Brain development D ifferences in the surface area, thickness and volume of parts of the brain, linked to learning and memory, setting up and monitoring tasks and remembering math facts in dyscalculia . MRI studies with dyslexia show different patterns of less electrical activation in parts of the left hemisphere of the brain involved with reading, such as the inferior frontal gyrus, inferior parietal lobule, and the middle and ventral temporal cortex. D ysgraphia (problems with handwriting) c an occur because the brain is starved of oxygen at birth or through near drowning, sustained high temperature, head injury or stroke. A working memory problem Auditory Processing Disorder can also cause due to premature birth or low birth weight.

16. Environment Dyscalculia has been linked to exposure to alcohol in the womb. Prematurity and low birth weight may also play a role in dyscalculia. People with dyslexia find it difficult to recognise the different sounds that make up words and relate these to letters.  Dysgraphia can result from intentionally poor penmanship, n o or inadequate instruction, and disorientation. A uditory processing disorder can be caused by chronic ear infections and lead poisoning.

17. Brain injury Studies show that injury to certain parts of the brain can result in what researchers call “ acquired dyscalculia .” Acquired dyslexia or alexia may be caused by brain damage due to stroke or atrophy. D ysgraphia can result from brain damage, either from an accident, a severe stroke, or the existence of Alzheimer’s disease. Auditory processing disorder can be caused by head trauma.

18. MECHANISMS of LD

19. Dyscalculia It was found that the right intraparietal sulcus in children with developmental dyscalculia was not modulated to the same extent in response to non-symbolic numerical processing as in typically developing child. Children with developmental dyscalculia have a weak magnitude representation in the parietal region . They might have a delayed development in their numerical magnitude representation.

20. DYSLEXIA Neural systems of reading in the brain’s left hemisphere. An anterior system in the region of the inferior frontal gyrus ( Broca’s area) is believed to serve articulation. A system in the parieto-temporal region is believed to serve word analysis, and a second in the occipito-temporal region (termed the word-form area) is believed to be responsible for the rapid, automatic, fluent identification of words.

21. Dysgraphia Writing represents a highly complex neurodevelopmental process which involves multiple brain mechanisms. It requires the simultaneous and sequential integration of attention, multiple information sources, memory, motor skill, language, and higher cognition, Gross and fine motor coordination, motor memory, and "kinetic melody " ( the automatic rhythm in the physical act of writing), require balancing, flexing, and contracting movements as well as simultaneously stimulating some muscle groups while inhibiting other muscle groups. 

22. Cont.. In order to self-monitor writing output: visual, proprio -kinesthetic, automatic motor memory and revisualization feedback mechanisms must be engaged.  Visual feedback mechanisms include eye-hand coordination and visual-fine motor integration .   Proprio -kinesthetic feedback mechanisms include awareness of the movement and location of the fingers in space, internal monitoring of rhythm and rate, and pencil grip.   . 

23. Cont.. Motor memory feedback mechanisms include motor plans or engrams, visual-fine motor coordination to produce symbols, sequentialization, speed, and accuracy.   Revisualization feedback mechanisms include visual memory for symbols, whole word memory, visual attention to detail and spelling.  All of these skills require developmental readiness and can be improved with practice

24. Auditory Processing D isorder APD results from impaired “bottom-up” sensory processing and abnormal neural representation of complex acoustic signals , e.g., speech. This may involve lesions in the central auditory nervous system or functional impairment of basic auditory processing ; the central auditory system begins in the cochlear nucleus of the medulla and ends with the auditory cortex.

25. Cont.. However, some researchers argue that the problem may be entirely cognitive, primarily affecting attention, memory or language processing, and exerting a non-specific effect on perception.

26. DIAGNOSIS

27. DSM IV-TR DIAGNOSTIC CRITERIA FOR READING DISORDER Reading achievement as measured by individually administered standardized tests of reading accuracy or comprehension, is substantially below that expected given the person’s chronological age, measured intelligence, and age-appropriate education The disturbance in criterion a significantly interferes with academic achievement or activities of daily living that require reading skills If a sensory deficit is present, the reading difficulties are in excess of those usually associated with it * If a general medical or neurological condition or sensory deficit is present, code the condition on axis iii

28. DSM IV-TR DIAGNOSTIC CRITERIA FOR MATHEMATICS DISORDER Mathematical ability as measured by individually administered standardized tests is substantially below that expected given the person's chronological age, measured intelligence, and age-appropriate education The disturbance in criterion a significantly interferes with academic achievement or activities of daily living that require mathematical ability If a sensory deficit is present, the reading difficulties in mathematical ability are in excess of those usual associated with it * If a general medical or neurological condition or sensory deficit is present, code the condition on axis iii

29. DSM IV-TR DIAGNOSTIC CRITERIA FOR DISORDER OFWRITTEN EXPRESSION Writing skills as measured by individually administered standardized tests or functional assessment of writing skills, are substantially below those expected given the person's chronological age, measured intelligence, and age-appropriate education The disturbance in criterion a significantly interferes with academic achievement or activities of daily living that require the composition of written texts e.g.. Writing grammatically correct sentences and organized paragraphs. If a sensory deficit is present, the reading difficulties in writing skills are in excess of those usually associated with it * If a general medical or neurological condition or sensory deficit is present, code the condition on axis iii

30. A standard battery of tests can include, but is not limited to, the following: Wechsler Intelligence Scale for Children-Third Edition (WISC-III) Kaufman Assessment Battery for Children (KABC) Stanford- Binet Intelligence Scale Woodcock-Johnson Psycho-Educational Battery Peabody Individual Achievement Tests-Revised (PIAT) Wechsler Individual Achievement Tests (WIAT ) Kaufman Tests of Educational Achievement (KTEA) Bender Gestalt Test of Visual Motor Perception

31. Beery Developmental Test of Visual-Motor Integration Motor-Free Visual Perception Test Visual Aural Digit Span Test (VADS) Test of Auditory Perception (TAPS) Test of Visual Perception (TVPS) Peabody Picture Vocabulary Test-Revised Expressive One-Word Picture Vocabulary Test Test for Auditory Comprehension of Language

32. PREVENTION OF LD

33. PRIMARY PREVENTION (keeping the disability from occurring in the first place) SECONDARY PREVENTION ( correcting the disability after it occurs, or at least keeping it from getting worse) TERTIARY PREVENTION (keeping the effects of the problem or disability from spreading to other areas of functioning)

34. PRIMARY PREVENTION Primary prevention in learning disabilities might involve reducing the chances of brain injury, improving teachers' skills in instruction and behavior management, or teaching parents child-rearing skills. For primary prevention to work, the strategy must be aimed at reducing or eliminating the cause(s) of learning disabilities or protecting against causal factors .

35. Primary prevention may reduce the number of children who have learning disabilities or lessen the severity of the disabilities, but it will not eliminate learning disabilities. Thus, primary prevention is important in keeping the prevalence of learning disabilities as low as possible . However, it is a mistake to assume that it will reduce the prevalence to zero.

36. SECONDARY PREVENTION M ost of the interventions for learning disabilities involve secondary prevention, because the child's learning problems have been noticed and the aim is to correct the problems or prevent them from getting worse . If a special education teacher works not only with students already identified as having learning disabilities but also with others who are struggling academically but have not yet been identified, the teacher may be practicing secondary prevention, both with labeled students and those not labeled as having learning disabilities . It is impossible to practice secondary prevention without a word (label) designating the need for special attention or instruction 

37. TERTIARY PREVENTION When remedial interventions are initiated long after a learning disability has developed, the primary goal may be tertiary prevention . For example, if a student has had learning disabilities in reading that have existed since the early grades and these have not been corrected, tertiary prevention at the high school level may involve teaching the student skills that will prevent failure in finding and holding a job .

38. It is possible to practice secondary and tertiary prevention at the same time and in essentially the same way. Secondary prevention addresses existing problems . Tertiary prevention addresses complications or the development of additional problems

39. management

40. Management of Dyslexia Consists of using educational tools to enhance the ability to read. Individualized Education Program (IEP) Combination of educational methods Teacher aide or tutor.

41. Management For Dyscalculia Dyscalculia cant be cured but there are therapies that could help your child. There are no medications that treat dyscalculia but medication could help kids deal with co- occuring issued like ADHD or anxiety. There are many non-medical ways to help kids with dyscalculia be successful. Educational therapy helps kids with different kinds of learning and attention issues develop strategies for working around their issues and dealing with frustration. An educational therapist may be able to help your child get better at working with numbers Speech therapy is also used Kids with dyscalculia may also have trouble with visual spatial skills.

42. Management for Dysgraphia There r several kinds of specialists who can help Occupational therapy can improve fine motor skills that control hand movement. Educational therapy can help kids develop strategies to approach writing assignments and reduce frustration. Classroom accomodation

43. Management for Dysgraphia

44. Management for Auditory Processing Disorder There aren't many scientifically based treatments for auditory processing disorder. Speech therapy could help with reading and language comprehension. There are many non-medical ways to help the child with auditory processing disorder. Sound discrimination is one of the main difficulties Speech therapy can help kids with auditory processing disorder make those sounds better and more clearly. Speech therapy help kids to Improve perception of individual sounds in words can help with reading skills. Develop active listening skills like asking a person a repeat directions Use language appropriately in social situations Educational therapy Auditory training therapy

45. PROGNOSIS

46. Dyslexia If diagnosed on time, management becomes easy. Problems may however persist. Mixed Remedial reading programs

47. Dysgraphia Prognosis is unpredictable. Some individuals improve abilties . Persist for most. Use of cursive writing.

48. Dyscalculia Cant be cured. Medications? Therapy?

49. Language Processing Disorder Better for children with less severe language impairments. (expressive-only language disorder) Severe LPD, poorer prognosis. Early identification, family support for better prognosis.

50. LD Lifelong condition. Several overlapping LD’s Isolated LD.

51. RECENT DEVELOPMENTS

52. Booth and Burman (2001) found that people with dyslexia have less gray matter in the left parieto temporal area than non dyslexic individuals. Having less gray matter in this region of the brain could lead to problems processing the sound structure of language (phonological awareness). People with dyslexia also have less white matter in this same area, which could lessen the ability or efficiency of the regions of the brain to communicate with one another. (Deutsch, Dougherty, Bammer, Siok, Gabrieli, & Wandell, 2005) Recent Studies -dyslexia

53. Shaywitz (2002) studied 144 right handed children with and without RD & found that the normal children had more activation in the areas for reading in the left hemisphere and less in the right hemisphere than the children with RD.  Children with RD, disruption in the rear reading systems in the left hemisphere that are critical for skilled, fluent reading leads the children to try and compensate by using other, less efficient systems in the right hemisphere. Children with dyslexia often show greater activation in the lower frontal areas of the brain. This leads to the conclusion that neural systems in frontal regions may compensate for the disruption in the posterior area (Shaywitz, 2003)

54. Kadosh(2007) discovered that a specific part of the brain was associated with automatic magnitude processing. Used fMRI in order to show that the intraparietal sulcus (IPS)had a role in the ability to recognize numbers. Children with developmental dyscalculia were found to have less gray matter in the left IPS. Dyscalculia

55. Viginia Berninger- normal children had more  white matter connections, which facilitate functional connections in gray matter for language processing and cognitive thinking. Bt children with dysgraphia showed less white matter connections and more functional connections to gray matter locations in other words, their brains had to work harder to accomplish the same tasks. People with dysgraphia face difficulties related to fine & gross motor movements, balancing & regulating movements, flexibility, understanding of time,money, info retrieval .etc(Sakineh,Razieh,Abolfazl,2014) Dysgraphia

56. Questions?

57. THANK YOU

58. Thank you