What is a Learning Disability?

LDAC – Learning Disabilities Association of Canada – Official Definition of Learning Disabilities

Learning Disabilities refer to a number of disorders which may affect the acquisition, organization, retention, understanding or use of verbal or nonverbal information. This means an LD might affect how you learn, organize, remember or understand information.

These disorders affect learning in individuals who otherwise demonstrate at least average abilities essential for thinking and/or reasoning. As such, Learning Disabilities are distinct from global intellectual deficiency.

Learning Disabilities result from impairments in one or more processes related to perceiving, thinking, remembering or learning. These include, but are not limited to:

• Language Processing:
  Language Processing is the understanding and expression of oral and written language; includes vocabulary, word structure, sentence structure and meaning across sentences.
• Phonological Processing – is the ability to identify the different sounds that make words and to associate and manipulate these sounds within words we speak and write.
• Visual Processing – is the ability to make sense of information taken in through the eyes. Difficulties with visual processing affect how visual information is interpreted, or processed by the brain.
• Processing Speed – refers to the pace at which you are able to perceive information (visual or auditory), make sense of that information, and then respond.
• Memory & Attention: Short-term memory is the process by which you hold on to information as long as you are concentrating on it. Long-term memory refers to the process by which you store information that you have repeated often enough. Attention is the ability to sustain attention to a tasks.
• Executive Function: Executive Functioning is needed for planning, organization, strategizing, attention to details and managing time and space.

Features of Learning Disabilities:

Learning Disabilities range in severity and may interfere with the acquisition and use of one or more of the following:

• oral language (e.g. listening, speaking, understanding)
• reading (e.g. decoding, phonetic knowledge, word recognition, comprehension)
• written language (e.g. spelling and written expression)
• mathematics (e.g. computation, problem solving)

Learning Disabilities may also involve difficulties with:

• organizational skills
• social perception & interaction
• perspective taking

Learning Disabilities:

• are life long.
• change how they are expressed over an individual’s lifetime depending on the demands of the environment and the individual’s strengths and needs.
• often lead to unexpected academic under-achievement or achievement which is maintained only by unusually high levels of effort and support.
• are due to genetic and/or neurobiological factors or injury that alters brain functioning.
• can co-exist with other conditions as ADHD, behavioural or emotional disorders, sensory impairments or other medical conditions.

For success, individuals with Learning Disabilities require:

• early identification
• specialized assessments
• timely interventions and accommodations in the home, school, community and workplace

The interventions need to be appropriate for each individual’s learning disability and, at a minimum, include the provision of: specific skill instruction, accommodations, compensatory strategies, and self-advocacy skills.

The Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition (DSM-5)

The DSM-5 was developed by the American Psychiatric Association.DSM-5 uses the umbrella term, ‘Specific Learning Disorders (SLD)’ and then areas of impairment and specific difficulties:

SLD with impairment in Reading:

• Word reading accuracy
• Reading rate/fluency
• Reading comprehension
• Includes Dyslexia

SLD with Impairment in Writing:

• Spelling accuracy
• Grammar and punctuation accuracy
• Clarity or organization of written expression
• Includes Dysgraphia

SLD with Impairment in Math:

• Number sense
• Memorization of arithmetic facts
• Accurate or fluent calculation
• Accurate math reasoning
• Includes Dyscalculia

Symptoms:
According to DSM-5, the diagnosis of a Specific Learning Disorder (SLD) includes the following symptoms:

• Persistent difficulties in reading, writing, arithmetic, or mathematical reasoning skills during formal years of schooling.  Symptoms may include inaccurate or slow and effortful reading, poor written expression that lacks clarity, difficulties remembering number facts, or inaccurate mathematical reasoning.

• Current academic skills must be well below the average range of scores in culturally and linguistically appropriate tests of reading, writing, or mathematics. Accordingly, a person who is dyslexic must read with great effort and not in the same manner as those who are typical readers.

• Learning difficulties begin during the school-age years.

• The individual’s difficulties must not be better explained by developmental, neurological, sensory (vision or hearing), or motor disorders and must significantly interfere with academic achievement, occupational performance, or activities of daily living (APA, 2013).

Accurate Word Reading, also known as Word Recognition or Decoding. If you are weak in this area it means that you struggle to associate the letters (graphemes) within a word with their sounds (phonemes) and to blend those sounds together to pronouce and read the word accurately.

Fluency means you can read at a good pace and with expression. People who struggle with accurate word reading also have a hard time reading fluently, particularly if the material you are reading is quite hard for you to read accurately.
If you have to work hard to read the words accurately and at a steady pace, then that might distract you from being able to focus on comprehending (understanding) what you are reading. That is why assistive technology, like ‘text to speech’ is a really helpful tool for people who struggle with word reading (decoding).

Learning Disabilities Association of Canada (LDAC) may identify the above challenges as an impairment in phonological processing.

Phonological Processing is the ability to identify the different sounds that make words and to associate and manipulate these sounds within words we speak and write (sound blending, segmenting, playing with sounds, rhyming).

Phonemic Awareness Skills:
-blend the individual sounds into a word (reading/decoding)
-segment – break a word into syllables or individual sounds (spelling/encoding),
-manipulate or change the sounds within a word. Example: Change ‘cat’ to ‘sat’.

Phonological processing, including the more specific phonemic awareness skills, is a foundational skill needed for learning to read words accurately.

The DSM-5 Assessment tool describes this type of Learning Disability as: Specific Learning Disorder (SLD) in Reading; word reading accuracy, reading rate/fluency.

Dyslexia: Dyslexia is a well-known term used to describe a reading disorder characterized by deficits in accurate and fluent word recognition. Spelling accuracy is impaired as well. The term dyslexia is not commonly used by psychologists as an official diagnosis when assessing for an LD. However, dyslexia is a term widely known, particularly by organizations, educators, and parents (i.e.organizations like the International Dyslexia Association and Decoding Dyslexia Alberta).

If comprehending (understanding) what you read or hear is what you struggle with, it may be because you have weaker language processing skills.

Language Processing: LDAC defines Language Processing skills as the understanding and expression of oral and written language; includes vocabulary, word structure, sentence structure, and meaning across sentences.

Language Learning Disability: LDAC defines a language learning disability as a disorder that may affect the comprehension and use of spoken or written language as well as nonverbal language, such as eye contact and tone of  speech, in both adults and children.

Vocabulary can be described as oral vocabulary or reading vocabulary. Oral vocabulary refers to words that we use in speaking or recognize in listening. Vocabulary also is very important to reading comprehension. Readers cannot understand what they are reading without knowing what most of the words mean.

Specific Learning Disorder (SLD) in Reading – Comprehension (DSM-5). DSM-5 does not focus on the underlying processing skills that may be causing you problems, but instead the criteria is if you struggle academically with reading, in the area of Comprehension.

Spelling is also hard for someone who struggles with reading words accurately because you have to do the reverse process: 1) orally break the word into its individual sounds (segment), 2) identify and remember which letters represent those sounds, 3) and then say or write them down in correct order.

Dyslexia: People who are identified as being ‘dyslexic’ will struggle with spelling, along with accurate word reading and fluency.

LDAC definition: Processing impairments related to spelling and writing:

Spelling requires the ability to encode the sounds of a word into their appropriate print symbols. “When students are given strong spelling instruction focused on the orthography of English and learn to spell well, it positively impacts their ability to read (Ehri, 2000)

Orthographic Mapping is the encoding process in the brain that maps sounds to letters, turning unfamiliar printed words into instantly recognizable sight words.

Writing – Language Processing is the understanding and expression of oral and written language; includes vocabulary, word structure, sentence structure and meaning across sentences.

DSM-5 definition. SLD with impairment in writing (spelling, grammar, punctuation, clarity or organization of written expression)

DSM-5: Specific Learning Disorder (SLD) with impairment in Math:
-Number sense
-Memorization of arithmetic facts
-Accurate or fluent calculation
-Accurate math reasoning

Dyscalculia is a common term for a math disability characterized by poor number sense and arithmetic calculation.

Dyscalculia is a specifier of a Specific Learning Disorder (SLD) in Math in the DSM-5 definition.

The Learning Disabilities Association of Canada (LDAC) has identified specific processing challenges:  Learning Disabilities result from impairments in one or more processes related to perceiving, thinking, remembering or learning.

These include, but are not limited to:

Language Processing​: is the understanding and expression of oral and written language; includes vocabulary, word structure, sentence structure, and meaning across sentences.

Phonological Processing: is the ability to identify the different sounds that make words and to associate and manipulate these sounds within words we speak and write.

Visual Processing: is the ability to make sense of information taken in through the eyes. Difficulties with visual processing affect how visual information is interpreted, or processed by the brain.

Processing Speed: refers to the pace at which you are able to perceive information (visual or auditory), make sense of that information, and then respond.

Memory and Attention: Short-term memory is the process by which you hold on to information as long as you are concentrating on it.
-Long-term memory refers to the process by which you store information that you have repeated often enough.
-Attention: is the ability to sustain attention to a task

Executive Function is needed for planning, organization, strategizing, attention to details and managing time and space.

Developmental Coordination Disorder (DCD) is a lifelong condition that makes it hard to learn motor skills and coordination. It’s not a learning disorder, but it can impact learning. Kids with DCD struggle with physical tasks and activities they need to do both in and out of school.

Dysgraphia is having difficulty with the physical act of writing.

More recently, DCD has become the more recognized term used to describe challenges with motor skills and coordination, such as difficulty with the physical act of writing. Occupational Therapists (OTs) may work with a person struggling with dysgraphia or DCD  to improve motor skills.

Nonverbal Learning Disability (NVLD) describes a well-defined profile that includes strengths in verbal abilities contrasted with deficits in visual-spatial abilities. Individuals with NVLD often have trouble with some of the following: organization, attention, executive functioning, nonverbal communication, and motor skills.

• Lifelong: Individuals do not grow out of Learning Disabilities, although the impact may change with changing life demands.
• Heterogeneous: Learning Disabilities are heterogeneous. There are many patterns of strengths and needs and levels of severity. Not all individuals with LD have the same strengths and difficulties. Different terms have been used to describe some of the different patterns of difficulties: dyslexia, dysgraphia, etc.
• Involve difficulties in processing information: Individuals with LD can learn, but they learn differently because they process information differently. Their brains deal with information in different ways. The differences may be in how they take in information through the senses, in how they make sense of the information and give it meaning and/or in how they express what they know through speaking, writing, demonstrating, etc.
  
• Result in academic under-achievement: For individuals with LD, the most obvious negative impact in their lives is on the development of academic skills, most often reading and writing.
  
• Neurologically (brain) based: Brain research has shown that LD results from a difference in the way an individual’s brain is “wired”. Structural brain differences have been found. Most importantly, brain imaging studies have demonstrated that during reading, the activation patterns of brains of individuals with LD differ from those of normal readers’ brain.
• Run in families: When the LD affects reading, between 25% and 50% of children with LD have a parent who has LD.
  
• Do not “walk alone”: Individuals with LD often have other difficulties. For example, 30% to 50% also have Attention Deficit/Hyperactivity Disorder (ADHD). Anxiety and depression are also common.
  

• An intellectual disability: Individuals with LD have at least average intelligence. They do many things well and have an uneven profile of abilities and difficulties. This is in contrast to an overall intellectual disability that affects all aspects of learning and development.
• A result of poor educational history: Individuals with LD have had opportunities to learn.
• A result of socio-economic factors: LD occur across all socio-economic levels, although access to opportunities and supports may vary across income levels.
• A result of cultural or linguistic differences: LD can occur in any cultural or economic group. Cross cultural research indicates that individuals exhibit characteristics associated with LD across the world.
• A result of emotional disorders: Many individuals with LD experience anxiety and depression as a result of their learning difficulties, but the learning difficulties are not the result of such emotional disorders.
• A result of vision or hearing problems: It is important to ensure that individuals do not have uncorrected hearing or vision problems.