Learning Disability

Identifying learning disabilities early can pave the way for children to get the support they need to experience successful futures both in and out of school

Knowing the early warning signs that put young children at risk for Learning Disabilities and understanding normal developmental milestones helps with early diagnosis and intervention

If a child of birth to four years of age shows any developmental delays it gives a cause for concern

These delays include atypical patterns of development in cognition, communication, emergent literacy, motor and sensory abilities, and/or social-emotional adjustment that may adversely affect later educational performance

Development in each of these domains may be related to individual variations in rates and patterns of maturation, environmental factors such as language exposure, and quality of learning opportunities

It is recognized that adequate development across multiple domains is essential for subsequent
school success

MISIDENTIFIED

When children are exposed to high quality learning opportunities prior to kindergarten, they are less likely to experience school failure and be misidentified as having LD in the early grades

LD has been defined by the National Joint Committee on Learning Disabilities (NJCLD) as a heterogeneous group of disorders of presumed neurological origin manifested differently and to varying degrees during the life span of an individual

These disorders are developmental in nature, occur prior to kindergarten, and continue into adult life

Various manifestations of LD may be seen at different ages and as a result of varying learning demands

Early indicators that a child may have LD include delays in speech and language development, motor coordination, perception, reasoning and social interaction

These required for academic achievement and other areas relevant to meeting educational goals

These indicators may occur concomitantly with problems in self-regulation, attention, or social interaction

LD SPECIALIST

Then, in effective programs for infants, toddlers, and preschoolers you should...

(1)
Examine risk and protective factors,

(2)
Conduct systematic observations of individual children

(3)
Assess
developmental status

(4)
Create rich and varied learning opportunities,

(5)
Plan and deliver services and supports,

(6)
Provide intervention based on assessment data.

These programs are culturally and developmentally appropriate, linguistically sensitive, and based on scientific evidence

Let's Examine

How such programs can be established and implemented?

How the importance of family and caregiver involvement and responsibilities can be emphasised?

How issues in professional preparation and development
can be fixed?

What are the critical research needs how it can be addressed?

Pre-KG age, (0-4) is really important in all aspects of LD

This has been brought out by a revision and a paper “Learning Disabilities and the Preschool Child” in 1985 NJCLD (NJCLD, 1985/2001b)

There exists a strong link between spoken language development and Learning Disability

There has been an increasing emphasis in legislation, research, and practice on the provision of educational programs and services to the disabled

Evidence-based practices are grounded in valid and robust scientific research demonstrating that certain actions, under specific circumstances, are most likely to produce predictable and beneficial outcomes for children and families

Such practices are informed by an integration of theory, research, professional experience and judgment, and child/family values and preferences

The objective of all early identification efforts are to find out which children have developmental problems that may be obstacles to learning or that place children at risk

Development in infants, toddlers, and preschoolers is characterized by broad variability in rates and patterns of maturation

For other children, delays may persist in different domains of functioning, necessitating the child's referral for targeted screening and/or comprehensive evaluation

No clear distinction can be made in the early years between the children whose problems may persist from those who will make adequate progress with time

Therefore, young children who demonstrate difficulties in early development may or may not be at risk for LD

Nevertheless, screening, evaluation, enhanced learning opportunities, and possibly intervention services should be provided

It is not in the child's best interest to “wait and see” or hope that the child will “grow out of” his or her problems

It is important to guard against the premature identification of a disability, especially if high quality learning opportunities have not been provided

It is often during the early years that families and caregivers first suspect a problem and may share their concerns with qualified professionals

Some families initially may deny the existence of a problem because they are fearful of, or threatened by, its possibilities and consequences

Family Cooperation

Professionals must recognize and be sensitive to differences in family responses, including cultural differences in viewing and addressing a disability, and provide appropriate support

The Identification

(1)
Screening,

(2)
Examination for the presence of risk indicators and protective factors,

(3)
Systematic observations, and,
if indicated...,

(4)
A comprehensive evaluation.

An effective early identification program must take into account the numerous biological, environmental, and cultural factors that may influence the course of child's development

Information from the identification process is the basis for making decisions about the need for further services and supports

Screening
The purpose of screening is to determine if additional evaluation is required and in what developmental domains

Screening tools are not intended for diagnosis, placement, and educational planning

Careful consideration of reliability, validity, standardization, cultural and linguistic sensitivity, and relevance of screening instruments and procedures is to be ascertained

“All preschoolers should be screened to assess early language and reading skill development just as they are for vision and hearing”

Risk Indicators and Protective Factors:

A range of environmental, biological, genetic, and perinatal conditions may be associated with adverse developmental outcomes and may be risk indicators

Advances in medical technology have kept an increasing number of fragile children alive.
These children often are at risk for developmental and later educational problems

Such risk indicators, when several are present, warrant careful monitoring of a child's development. Ensure high quality learning opportunities for this population

Children who do not respond adequately to these opportunities may be at higher risk for LD

Young children with identified disabilities (e.g., cerebral palsy) also may be at risk for LD

Cerebral Palsy
A disorder usually caused by brain damage occurring at or before birth and marked by muscular impairment
Often accompanied by poor coordination, it sometimes involves speech and learning difficulties.

However, risk indicators do not always predict which children will have future learning problems

Risk indicators must be considered within the context of typical developmental expectations

An inability to follow one-step directions is not a risk indicator for a 6-month-old, but is for a 4-year-old, especially in combination with other risk indicators, such as poor fine motor coordination

Protective factors
that reduce risk and foster resilience can buffer children and families from circumstances that place them at risk

Risk indicators interact with protective factors in unique ways for each child

Some children with a history of birth complications may exhibit typical developmental patterns and require few if any special services,

Whereas other children without such histories may struggle to learn and may require formal assessment and intervention

Children who may have multiple risk indicators may not demonstrate learning problems if they receive strong culturally and developmentally appropriate early learning experiences

The two lists below, though not all-inclusive, identify possible risk indicators and protective factors for LD among infants, toddlers, and preschoolers:

Risk Indicators

Perinatal conditions
Low Apgar scores
Low birth weight and/or preterm birth
Hospitalization for longer than 24 hours in a neonatal intensive care unit

Difficulty with suckling, sucking, and swallowing

Chronic otitis media that may result in intermittent hearing loss

Genetic or environmental conditions:

Family history of LD
Adopted child status
Family history of spoken and/or written language problems
Exposure to environmental toxins or other harmful substances
Limited language exposure in home, childcare, and other settings
Poverty

Developmental milestones



Delay in cognitive skills

Not demonstrating object permanence

Limited understanding of means-ends relationships (e.g., using a stool to reach a cookie jar)

Lack of symbolic play behavior

Genetic or environmental conditions
Family history of LD
Adopted child status
Family history of spoken and/or written language problems
Exposure to environmental toxins or other harmful substances
Limited language exposure in home, childcare, and other settings
Poverty

Developmental milestones
Delay in cognitive skills
Not demonstrating object permanence
Limited understanding of means-ends relationships (e.g., using a stool to reach a cookie jar)
Lack of symbolic play behavior
Delay in comprehension and/or expression of spoken language
Limited receptive vocabulary
Reduced expressive vocabulary (“late talkers”)

Difficulty understanding simple (e.g., one-step) directions
Monotone or other unusual prosodic features of speech
Reduced intelligibility
Infrequent or inappropriate spontaneous communication (vocal, verbal, or nonverbal)
Immature syntax
Delay in emergent literacy skills

Difficulty understanding simple (e.g., one-step) directions
Monotone or other unusual prosodic features of speech
Reduced intelligibility
Infrequent or inappropriate spontaneous communication (vocal, verbal, or nonverbal)
Immature syntax

Delay in emergent literacy skills
Slow speed for naming objects and colours
Limited phonological awareness (e.g., rhyming, syllable blending)
Minimal interest in print
Limited print awareness (e.g., book handling, recognizing environmental print)

Delay in perceptual-motor skills

Problems in gross or fine motor coordination (e.g., hopping, dressing, cutting, stringing beads)


Difficulty coloring, copying, and drawing

Attention and behavior

Distracted Nature inattention
Impulsive Nature
Hyperactivity
Difficulty changing activities or handling disruptions to routines

Perseverance (i.e. ability to continue in a task till its consummation)

Protective Factors

Access to quality pre-, peri-, and postnatal care



Maternal education



High quality learning opportunities



Exposure to rich and varied vocabulary, syntax, and discourse patterns



Responsive learning environments sensitive to all cultural and linguistic backgrounds



Access to printed materials



Involvement in structured and unstructured individual/group play interactions and conversations



Engagement in gross and fine motor activities

Multiple supports

• Assistance adapted to the child's responsiveness to instruction or intervention
• Access to adaptive and assistive technology (AT) and services
• Transition planning between early intervention services (0 to 3 years) and preschool programs (3–5 years), and between pre and elementary school

In summary, risk indicators do not necessarily predict later learning problems or indicate the existence of a disability, particularly when only a single indicator is present

Similarly, protective factors do not rule out the presence of a disability

However, the presence of risk indicators warrants substantial and serious efforts to facilitate early learning success, because many children at risk respond positively to high quality instruction and support

Therefore, children at risk, who may or may not have LD, need to receive carefully planned and responsive services and supports to enhance their opportunities for learning

Systematic Observations

Systematic observation of a child's behavior and abilities continuously is an important addition to examining the presence of risk indicators and protective factors

Observations may be informal or may follow a standard observation protocol; in either case, they should be conducted multiple times and in varying contexts

An extended period of observation may be necessary for ensuring the validity of the hypothesis made from previous observsations

Observations should provide a description of the frequency, consistency, and severity of the behaviors causing concerns in relation to contextual demands

The child's family should be involved throughout the entire process. When professionals raise a question about the course of the child's development as a result of systematic observation, they should discuss the findings with the caregivers and family

When indicated, a referral should be made to appropriate professionals for further evaluation and, if warranted, provision of supports and services should be recommended

Comprehensive Evaluation

When a screening, a review of risk indicators and protective factors, and systematic observations suggest that a child is at risk for LD, professionals should conduct periodic evaluations to ascertain whether development follows expected patterns

The major goal of a comprehensive evaluation is to determine the individual child's specific pattern of abilities and needs and identify strategies and resources to address learning and behavioral problems

These evaluations should occur across different settings and should consider multiple perspectives offered by caregivers and professionals

An interdisciplinary approach is especially valuable in obtaining and interpreting evaluation of information derived from a variety of sources

Evaluations should focus on developmental norms across domains

Domains like cognition communication, emergent literacy, motor and sensory abilities, and/or social-emotional adjustment

However, it is important to recognize that there is a wide range of individual differences, both within and between children, some of which may fall within the “normal” range of expected behaviors

A comprehensive evaluation involves the use of multiple instruments and procedures, including norm- and criterion-referenced tests, teacher/parent rating scales, and developmental checklists

The use of a single instrument or procedure does not constitute a comprehensive evaluation

Practitioners should use culturally and linguistically sensitive instruments to ensure appropriate assessment of children with potential LD

Evaluation of the child's status and needs depends on an integrated assessment of the child's functioning in the following domains:

COGNITION, including perceptual organization, memory, concept formation, attention, and problem solving

Communication, including speech /
language form, content, and use for receptive and expressive purposes;

EMERGENT LITERACY, including phonological awareness, awareness of print; and numeracy, including number recognition, and number concepts;

MOTOR FUNCTION, including gross, fine, and oral motor abilities

SENSORY FUNCTIONS, including auditory, haptic, kinesthetic, and visual systems; and

SOCIAL-EMOTIONAL adjustment, including behavior, temperament, affect, self-regulation, play, and social interaction

Time-limited placement in a diagnostic preschool setting can be a useful part of the comprehensive evaluation for addressing diagnostic questions and determining the effectiveness of various evidence-based interventions for the child

Early Services and Supports

If a learning problem or delay in development has been suggested based on screening, review of risk indicators and protective factors

Systematic observation, if indicated, comprehensive evaluation, then the priority should be to ensure that services and supports based on individual needs and strengths are available

Such services and supports may include:

(a) providing special education interventions that meet the child's developmental, behavioral, and learning needs;

(b) offering strong preschool programs;

(c) enhancing the home language and literacy environment

Services and supports for young children should be evidence-based, developmentally appropriate, family-centered, and culturally and linguistically sensitive

Professionals must ensure that their findings and recommendations for services and supports are sensitive to all cultural and linguistic backgrounds

You must ensure that caregivers and family members have access to a range of supports such as the following:

Helping families and caregivers to recognize, understand, and accept the child's problems;

Selecting programmes that meet the child's individual needs

Locating parent support networks and programmes

Finding a service provider or agency whose treatment philosophy is congruent with the family's preferences

Identifying appropriate interventions and resources available within public or private preschool programs

Facilitating the child's development in the home and childcare environment

A variety of professionals, in collaboration with families and caregivers, is involved in the selection and delivery of services and supports

Collectively, the professionals should possess knowledge of typical and atypical patterns of development in the domains of cognition, communication, emergent literacy, pre-academic interventions, and motor, sensory, and social-emotional functioning, as well as the capacity to collaborate effectively

The following is a list of the roles of some of the professionals in addition to the child's pediatrician who typically are involved with infants, toddlers, and preschoolers

Audiologist—specialises in the non-medical management of hearing and related problems (e.g., balance)

Early childhood general and special education teachers—plan and provide educationally relevant interventions and other services

Occupational therapist-helps children improve their ability to perform fine motor skills and daily activities and to achieve independence

Physical therapist—helps children develop gross motor skills and coordination; they also provide services aimed at preventing or slowing the progression of conditions resulting from injury, disease, and other causes

School psychologist—collaborates with educators, parents, and other professionals to create safe, healthy, and supportive learning environments that strengthen connections between home and school

Speech-language pathologist—assesses, diagnoses, and provides intervention services and supports for individuals with speech, language, literacy, cognitive-communication, social communication, and swallowing problems

Other professionals may be involved, such as childcare providers, educational diagnosticians, educational therapists, reading specialists, social workers, English as a Second Language (ESL) teachers, child/developmental psychologists, pediatric neurologists, and child psychiatrists

The specific needs of the child should determine the mix of professionals who will assist the family and caregivers at home, in the preschool, and in the special education setting

The provision of services and supports may enhance the learning opportunities for young children who may be at risk for LD but who have not been identified with a specific disability

The services and supports required by children and their families and caregivers vary along a continuum of intensity and may be provided in different settings

Providing a continuum of services and supports is consistent with a response to intervention (RTI) model, which is a framework that may be used for identifying school-age students with LD

The application of RTI principles has been proposed for preschool-age children, with its characteristic use of different levels of instructional intensity, collaborative problem-solving, early response, and data to inform instruction and monitor progress

The initial level of early services and supports for young children at risk for LD would be less intensive and would revolve around daily experiences generally available in any strong preschool program

Such services and supports may involve assisting caregivers and families in increasing interactions with their children.

Experiences like shared book reading, conversations about current and past events, and family trips to the zoo, market, library, and playground provide opportunities for such interactions and also stimulate conceptual and linguistic development

It is important to provide activities that develop perceptual coordination, and fine and gross motor skills, such as use of scissors, crayons, finger paints, beads, balls, and puzzles

Emergent literacy can be encouraged by having books, magazines, and other literacy artifacts available at home, childcare, preschool, and other settings, and by engaging in activities such as word play, drawing, and storytelling

Literacy activities at home, in the preschool, and in other settings can develop print concepts, story sense, phonological awareness, and matching speech to print, and offer opportunities for practicing reading and writing skills

More intensive services and supports may add ongoing, regular consultation with one or more service providers and participation in
more structured programs

For preschool-age children, for example, such support might mean an increased emphasis on activities focusing on the acquisition of emergent literacy skills and enrollment in a high quality preschool program that includes more individualized activities

In fact, Head Start programs are now required to document children's progress in early development, particularly literacy

This has resulted from an increased recognition of the importance of early development to later school success and an increased awareness of the discrepancies in development for young children due to differences in socioeconomic, sociolinguistic, and sociocultural factors

If young children do not respond to the earlier levels, more specialized and individualized instruction and intervention strategies may be needed

Such services would be provided to children with identified disabilities who are eligible to receive special education

Some of these children with disabilities, such as those with developmental delay or speech and language impairment, may be identified later as having LD

Because no single instructional approach or intervention strategy can be expected to serve the different needs presented by children with disabilities, it is essential that selection of instructional strategies and programs be based on a clear understanding of a child's
specific strengths
and needs

The selection of the service delivery system, including the setting (e.g., inclusive or non-inclusive), models (e.g., pull-out, classroom-based, collaborative-consultation), and supports can then proceed

It's strongly recomended that young children with disabilities receive services in settings that best match their education needs

Instruction

An effective instructional program is based on a child's individual strengths and needs and includes well-defined goals, objectives, content, materials, and support (occupational and physical therapy)

Careful development of the individual instructional program is especially important due to the increased recognition that the pre-kindergarten years are a critical period during which intervention efforts are most effective

Decisions about instructional programming should be guided by five quality indicators of successful programs for young children:

1. Have a philosophy of individualized programming based on specific needs with a preference for inclusive practices

2. Rely on relevant research to design service delivery models that meet the individual, changing needs of a child over time and that provide opportunities for interactions in natural environments

3. Form collaborative partnerships that select and achieve goals for each child

4. Provide ongoing professional development

5. Conduct program evaluation and research

Decisions regarding which instructional approach or intervention strategy to use should be determined with interdisciplinary, family, and caregiver input on the basis of individual learner characteristics and needs and incorporated within the IFSP or IEP

The family and caregivers have an important responsibility for the application of learned skills in the home environment

Direct family and caregiver involvement is a major determinant of
intervention effectiveness

The interventions selected should be based on current research, principles of evidence-based practice (i.e., an integration of theory, research, professional judgment, and family preferences), and progress-monitoring data

In summary, appropriate evidence-based intervention practices should be a collaborative effort that
focuses on the child's needs while capitalizing on the child's existing strengths

LEARN YOUR CHILD
BEFORE YOU TRY TEACHING HIM