Children with a learning disability have difficulty in collecting, categorizing, and/or performing on verbal and nonverbal
information. Generally, children with learning disabilities have trouble understanding or using written or spoken language. The
difficulty is due to a neurological difference in brain structure or functioning. Learning disabilities are disorders that cause the
brain to process information in a way that obstructs learning. Most children with learning disabilities have average, nearly-
average, or above average intelligence. Untreated, learning disabilities can prevent a child from mastering the basics and
damage self-esteem and self confidence with lifelong effects.

School is often the setting where a child’s learning disability first becomes apparent. Areas of you may notice problems are
the following:

• language development and language skills (listening, speaking, reading, writing, and spelling)
• social studies
• mathematics
• social skills
• motor skills (fine motor skills, as well as coordination)
• cognitive development and memory
• attention and organization
• test-taking

However, their academic performance, as measured by standardized tests, is below what one would expect of someone of
their intelligence, age, and grade level. Therefore, a person with a learning disability may score poorly on tests, but the low
scores are due to a problem with learning, not to low intelligence.

Learning takes place in a series of interrelated steps. Information first has to be recorded in the brain (input). This information
then has to be organized and understood (integration). Next, the integrated knowledge has to be stored, later to be retrieved
(memory). Finally, one must be able to communicate information from the brain to people or to the environment (output).

Developmental Delay

Learning disabilities are developmental disabilities . Developmental delays can occur in all five areas of development or may
just happen in one or more of those areas. Additionally, growth in each area of development is related to growth in the other
areas. So if there is a difficulty in one area (e.g., speech and language), it is likely to influence development in other areas (e.
g., social and emotional).

Child development refers to the process in which children go through changes in skill development during predictable time
periods, called developmental milestones. A developmental delay occurs when a child does not reach these milestones by the
expected time period. For example, if the normal range for learning to walk is between 9 and 15 months, and a 20-month-old
child has still not begun walking, this would be considered a developmental delay.

Differences between a learning disability and a developmental delay

Ordinarily, an individual has a learning disability when there’s a considerable difference between intellectual ability and
achievement. The person with a learning disability may have low or high intelligence; the child simply learns below intellectual
capability because of a processing disorder.

A developmentally delayed child is one who is younger than five years old and who is behind schedule in attaining
developmental milestones, but usually reaches the milestone, eventually. The developmentally disabled child has severe and
long-lived physical or mental impairments that limit success in several major life areas, and this impairment begins in
childhood. Developmental disabilities include mental retardation, cerebral palsy, epilepsy, and autism. Low IQ is the largest
characteristic of someone with mental retardation.

Individuals with a learning disability generally have average or above average intelligence, yet they often do not achieve at the
same academic level as their peers. Weaker academic achievement, particularly in reading, written language, and math, is
perhaps the most basic characteristics of a learning disability. Significant deficits often correlate in memory, awareness and
understanding one's thinking and cognitive processes; and social skills as well. However they are not mentally handicapped;
but cannot grasp information, and they must compensate for this disability.

Areas of Learning Difficulties

Reading: Individuals with a learning disability have difficulties in reading, decoding or recognizing words (e.g., letter/sound
omissions, distinctions, substitutions, reversals) or comprehending them (e.g., recalling or knowing basic facts, main ideas,
sequences, or themes). They also may lose their places while reading or reading in an uneven pace.

Another term used for reading disabilities is dyslexia. Dyslexia is best understood as a type of reading disability. During early
childhood, children with dyslexia have difficulties learning spoken language. Later they have trouble decoding and spelling
words and, consequently, are likely to experience comprehension problems also. A reading disability affects every aspect of
an individual's life, from the early years of school when children learn to read, to later years when students are expected to
read in order to learn specific content, and into the community, home, and workplace where every person needs to acquire
and understand written information.

Written Language: Students with a learning disabilities exhibit problems in written language, handwriting, spelling, sentence
structure, vocabulary usage, volume of information produced, and organization of written ideas. Many students also present
difficulties in reading, writing, since both areas are language-based.

Math: Poor math achievement may appear in learning difficulties such as distinguishing numbers and copying shapes,
recalling math facts, writing numbers legibly, and relating math terms to meaning. Other weak areas may include complex
reasoning and awareness, including identifying, using, and lacks the knowledge of step-by-step problem-solving math

Memory: Some children with learning disabilities have defects in engaging memory. They have difficulty processing
information so that it can be stored in long-term memory. Difficulties in functioning memory can lead to difficulties in long-
term memory when a person needs to search for and retrieve knowledge.

Cognitive Process: Individuals with learning disabilities may have deficits with awareness of how one thinks and the
perceiving what people are thinking. Many children with learning disabilities do not know many effective cognitive strategies
for acquiring, processing, storing, demonstrating, and understanding of information.

Social and Behavioral Characteristics: Students with a learning disability may demonstrate social or behavioral challenges.
Some exhibit fewer socially acceptable behaviors than peers, are unable to predict consequences for behaviors, misinterpret
social cues, or are less likely to adapt their behavior to different social situations. Paired with academic shortcomings, this
experience can lead to lowered self-worth and a feeling of incompetence.

Forms of Learning Disabilities

Input Disabilities: (Collecting Information): Information enters the brain through all five senses. With learning, the most
important ones are visual and auditory. Input is a central process and does not refer to visual or knowledge; it refers to the
process of recording information in the brain. Since input refers to how one sees, hears, or perceives the world, the
description for this essential process is perception. Therefore, a child might have a visual perceptual or an auditory perceptual

Visual Perception Disability: Children might have difficulty with subtle differences in position or in relationships. A child might
reverse letters like “s” for “e” or “E” for “3” or reverse words like “saw” for “was.” He or she might confuse “d” and “b”
and “p’ and “q.” A “3” might be rotated to look like an “in.” This confusion with spatial positioning might show up in written
work, copying designs, or in doing tasks in which the eyes have to cue the hands as to what to do (i.e., visual motor tasks).

Types of visual perceptual problems are for example, when reading a page the child might skip words or jump lines. If a desk
or table is cluttered he or she might have difficulty focusing on the appropriate task. Some children have trouble with depth
perception and judging distances. The child might bump into things or fall off a chair. He or she might knock over a glass or
container because the distance is misjudged and the hand gets there too soon. A final form of visual perceptual disabilities
relates to doing tasks such as eye and hand coordination, like catching a ball, doing a puzzle, or using a hammer. The child
will have difficulty with catching, hitting, kicking a ball or jumping rope.

Auditory Perception Disabilities: Some children have difficulty distinguishing slight differences in sounds. The child might
appear to misunderstand what you are saying and, thus, respond incorrectly. Children might have difficulty with auditory
comprehension. If there is background noise the child may not listen when you are speaking. They may be distracted by the
background rather than listening to your words. It appears as if the child never pays attention. If you call his or her name first
and get eye contact the problem may improve. Some children cannot process sound inputs as fast as normal. They have an
auditory delay. If you speak at a normal pace they might miss part of what you are saying. You may find that you normally
speak slower with them.

Integration Disabilities (Sorting Information) : All of the information recorded in the brain has to be placed in sequence and
understood. The ADD child might have difficulty in either area. For some the problems are greater with auditory inputs, for
others visual inputs.

Sequencing Disabilities: The child has difficulty telling or writing a story; the sequence of thoughts or events is all mixed up;
he or she may go from the middle to the end then to the start. You might write a 32 on the board but the child copies it as 23.
Spelling errors may be noted; all of the letters are there, but in the wrong sequence.

Abstraction Disabilities: A child with this disability will have difficulty knowing meanings to words or phrases. The child
might have difficulty with the difference between the words, “the dog” and “your dog.” In a language exercise by reading a
story about a policeman a teacher will to discuss the policemen in the neighborhood. This child has difficulty going from the
specific policeman in the story to the concept of policemen in general.

Memory Disabilities (Storing Information) : Once information has been received and recorded in the brain and integrated, it
has to be stored so that it can be retrieved later. There are two forms of memory, short-term and long-term. Short-term
memory is that which you can hold onto as long as you are attending to it; (for example, getting a phone number from the
information operator and holding it in your head until you dial it) but which is lost when not attending to it (someone
interrupts you before you dial the number).

Long-term memory refers to information which has been repeated and stored so that it can be made available by just thinking
about it (for example, your home address). A child might have a short-term or a long-term memory disability. This disability
might be more for visual or for auditory information. For example, you might go over a spelling list or a math concept with a
child and he or she seems to know it (he’s attending to it); yet, later you find that the child has lost it.

In contrast, he or she might remember things done weeks or months ago in great detail. A child with a short-term memory
disability may have to go over something 10-15 times to learn it (make it long-term memory) whereas a child without this
problem might be able to learn it in 3-5 repetitions.

Output Disabilities (Expressing Information) : Information is communicated through words, language output or through
muscle activities (writing, drawing, gesturing, etc.) motor output. Children might have one or both of these output disabilities.

Language Disabilities: There are two types of oral language, spontaneous language (we initiate a conversation) and demand
language (someone asks a question). With spontaneous language one can organize thoughts and find the words before their
spoken; with demand language one does all this as one speaks. Some children have a demand language disability. What is
confusing is that when he or she speaks (spontaneous language) it sounds normal. When the same child is asked a question
then they may talk aimlessly or have trouble finding the right words. If you have a child in class who seems to speak up
when he or she wants to but refuses to answer any questions you ask, it is possible that he or she is not misbehaving but
might have a demand language disability.

Motor Disabilities: A child might have difficulty using large groups of muscles (gross motor disability). This child may be
clumsy, stumble, have trouble with walking, running, climbing, etc. Other children will have difficulty getting groups of
muscles to act as a team (fine motor disability). For example, to write, you have to get the information from your brain to the
many muscles of your dominant hand.
These muscles have to work in close coordination to produce written language. This child will have poor handwriting. The
child may have a thought but has trouble writing it down on paper at the same rate.

Causes of Learning Disabilities

Mental health professionals put emphasis on the fact that no one knows what causes learning disabilities; it doesn't help
parents to look backward to search for possible reasons. There are too many possibilities to pin down the cause of the
disability with certainty. It is far more important for the family to move forward in finding ways to get the right help.

Once, scientists thought that all learning disabilities were caused by a single neurological problem. But research has helped us
see that the causes are more diverse and complex. New evidence seems to show that most learning disabilities do not stem
from a single, specific area of the brain, but from difficulties in bringing together information from various brain regions.
Scientists, however, do need to study causes in an effort to identify ways to prevent learning disabilities.

Today, a leading theory is that learning disabilities originate from perplexing disturbances in brain structures and functions.
Some scientists believe that, in many cases, the disturbance begins before birth.

Risk factors for learning and developmental problems fall into two categories:

• Genetic
• Environmental

Genetic Factors

The fact that learning disabilities tend to run in families indicates that there may be a genetic link. For example, children who
lack some of the skills needed for reading, such as hearing the separate sounds of words, are likely to have a parent with a
related problem. However, a parent's learning disability may take a slightly different form in the child. A parent who has a
writing disorder may have a child with an expressive language disorder. For this reason, it seems unlikely that specific
learning disorders are inherited directly. Possibly, what is inherited is a complex brain dysfunction that can in turn lead to a
learning disability.

A person can inherit abnormal brain structure or function. Although a person may seem to have inherited a learning disability,
the environment can still make a difference. For instance, a child with a learning disability who is raised in a good learning
environment will have a better outcome than a child brought up in a poor learning environment.

There may be an alternative explanation for why learning disabilities might appear to run in families. Some learning difficulties
may actually originate from the family environment. For example, parents who have expressive language disorders might talk
less to their children or the language they use may be distorted. In such cases, the child lacks a good model for acquiring
language and therefore, may seem to be learning disabled.

Children are placed at genetic risk by being born with a genetic or chromosomal abnormality . A good example of a genetic
risk is Down syndrome, a disorder that causes developmental delay because of an abnormal chromosome.

Before birth or during delivery

The genetic relationship is very important for healthy brain development in the fetus. Negative influences on brain
development in the uterus and at birth are:

• the mother’s drug-use, alcohol-use, or smoking during pregnancy
• physical problems during pregnancy or delivery (e.g. Oxygen deprivation)
• very low birth weight
• premature birth
• birth trauma or distress
• the mother’s poor nutrition

During delivery, the umbilical cord may become twisted and temporarily cut off oxygen to the fetus. This, too, can impair
brain functions and lead to a learning disability

Toxins in the Child's Environment

Environmental risk results from exposure to harmful agents either before or after birth, and can include things like poor
maternal nutrition or exposure to toxins (e.g. Lead or drugs) or infections that are passed from a mother to her baby during
pregnancy (e.g., measles or HIV). Environmental risk also includes a child's life experiences. For example, children who are
born prematurely, face severe poverty, mother's depression, poor nutrition, or lack of care are at increased risk for
developmental delays.

New brain cells and the natural language process continue to be produced for a year or so after the child is born. These cells
are vulnerable to certain disruptions as well. Researchers are looking into environmental toxins that may lead to learning
disabilities, possibly by disrupting childhood brain development or brain processes.

Cadmium (a metallic element) and lead, both prevalent in the environment, are becoming a leading focus of neurological
research. Cadmium, used in making some steel products, can get into the soil, then into the foods we eat. Lead was once
common in paint and gasoline, and is still present in some water pipes. A study of animals sponsored by the National
Institutes of Health showed a connection between exposure to lead and learning difficulties. In the study, rats exposed to lead
experienced changes in their brainwaves, slowing their ability to learn. The learning problems lasted for weeks, long after the
rats were no longer exposed to lead.

In addition, there is growing evidence that learning problems may develop in children with cancer who had been treated with
chemotherapy or radiation at an early age.

Tobacco, Alcohol, and Other Drug Use

Many drugs taken by the mother pass directly to the fetus. Research shows that a mother's use of cigarettes, alcohol, or
other drugs during pregnancy may have damaging effects on the unborn child. Therefore, to prevent potential harm to
developing babies, the U.S. Public Health Service supports efforts to make people aware of the possible dangers of smoking,
drinking, and using drugs.

Scientists have found that mothers who smoke during pregnancy may be more likely to bear smaller babies. This is a concern
because small newborns, usually those weighing less than 5 pounds, tend to be at risk for a variety of problems, including
learning disorders.

Alcohol also may be dangerous to the fetus' developing brain. It appears that alcohol may distort the developing neurons.
Heavy alcohol use during pregnancy has been linked to fetal alcohol syndrome, a condition that can lead to low birth weigh,
intellectual impairment, hyperactivity, and certain physical defects. Any alcohol use during pregnancy, however, may
influence the child's development and lead to problems with learning, attention, memory, or problem solving. Because
scientists have not yet identified "safe" levels, alcohol should be used cautiously by women who are pregnant or who may
soon become pregnant.

Drugs such as Cocaine

Cocaine especially the smokable form known as crack seem to affect the normal development of brain receptors. These brain
cell parts help to transmit incoming signals from our skin, eyes, and ears, and help regulate our physical response to the
environment. Because children with certain learning disabilities have difficulty understanding speech sounds or letters, some
researchers believe that learning disabilities, as well as ADHD, may be related to faulty receptors. Current research points to
drug abuse as a possible cause of receptor damage.

There are several general "warning signs" of possible delay. These include:

Behavioral Warning Signs

• Does not pay attention or stay focused on an activity for as long a time as other children of the same age
• Focuses on unusual objects for long periods of time; enjoys this more than interacting with others
• Avoids or rarely makes eye contact with others
• Gets unusually frustrated when trying to do simple tasks that most children of the same age can do
• Shows aggressive behaviors and acting out and appears to be very stubborn compared with other children
• Displays violent behaviors on a daily basis
• Stares into space, rocks body, or talks to self more often than other children of the same age
• Does not seek love and approval from a caregiver or parent

Vision Warning Signs

• Seems to have difficulty following objects or people with her eyes
• Rubs eyes frequently
• Turns, tilts or holds head in a strained or unusual position when trying to look at an object
• Seems to have difficulty finding or picking up small objects dropped on the floor (after the age of 12 months)
• Has difficulty focusing or making eye contact
• Closes one eye when trying to look at distant objects
• Eyes appear to be crossed or turned
• Brings objects too close to eyes to see
• One or both eyes appear abnormal in size or coloring

Hearing Warning Signs

• Talks in a very loud or very soft voice
• Seems to have difficulty responding when called from across the room, even when it is for something interesting
• Turns body so that the same ear is always turned toward sound
• Has difficulty understanding what has been said or following directions after 3 years of age
• Doesn't startle to loud noises
• Ears appear small or deformed
• Fails to develop sounds or words that would be appropriate at her age

In addition, because children usually acquire developmental milestones or skills during a specific time frame or "window", is
used to predict when most children will learn different skills. If a child is not learning a skill that other children the same age
are learning, that may be a "warning sign" that the child may be at risk for developmental delay.

If a child has not mastered skills during a specific time frame, it does not mean your child is delayed. It’s best that you let
your child's doctor know about your concerns and actively monitor your child’s progress. The child may also benefit from a
developmental screening or assessment.

How Developmental Delays are Identified

Developmental delay is identified through two types of play-based assessments:

• Developmental Screening
• Developmental Evaluation

A developmental screening test is a quick and general measurement of skills . Its purpose is to identify children who are in
need of further evaluation. A screening test can be in one of two formats, either a questionnaire that is handed to a parent or
childcare provider that asks about developmental milestones or a test that is given to your child by a health or educational

A screening test is only meant to identify children who might have a problem . The screening test may either over-identify or
under-identify children with delay. As a result, a diagnosis cannot be made simply by using a screening test. If the results of a
screening test suggest a child may have a developmental delay, the child should be referred for a developmental evaluation.

A developmental evaluation is a long, in-depth assessment of a child's skills and should be administered by a highly trained
professional, such as a Special Educator or Psychologist . Evaluation tests are used to create a profile of a child's strengths
and weaknesses in all developmental areas. The results of a developmental evaluation are used to determine if the child is in
need of early intervention services and/or an Individual Education Program Plan (IEP).

At times, when a child has a delay in one area (i.e. Speech), it can affect other developmental areas such as social or
emotional . Therefore, it is crucial that a child receive intervention as soon as possible.
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