PROACTIVE THERAPY INNOVATIONS
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To have a learning disability (LD) is to be “truly misunderstood”. This informational handout is, perhaps, the closest to my heart. I say this as an individual with a significant learning disability. As with all of our other informational handouts, this is not a complete dissertation on the subject. This is an informational paper designed for the average reader to give them a basic understanding of what it means to have a learning disability and the complex array of situations associated with having a learning disability.
In its simplest form, a learning disability is a minimal brain dysfunction. This means that there is some small part of the brain that either does not work or does not work as it is supposed to work. Some learning disabilities are made up of a number of little learning disabilities. The end result is that an individual with a learning disability does not learn like the average person. A critical factor must be stated right off: Having a learning disability in no way implies that the individual has less than average ability (intellectual potential). There are a great many individuals with learning disabilities that have an intellectual potential significantly above average.
Individuals with learning disabilities have a deficit (a gap, a weakness, etc) in some specific area or areas of their learning processes. When they try to learn something through the LD process, they do not experience positive gains at a level equal to the effort invested in the learning activity. What this means for me, with my LD in the area of visual processing of information, trying to learn something visually doesn’t work very well and tends to be quite frustrating. It is the frustration relative to the learning effort that many times offers the key to diagnosis and also serves as the critical element for missed diagnosis.
Misdiagnosis OF LD’S
An individual with an LD invests their self in trying to learn a task. All of their peers in the classroom, including their peers that are generally recognized to be “not quite as bright” have little difficulty in learning the task. The individual with the LD, no matter what they do and no matter how hard they try, just can’t quite seem to “get it”. Parents and teachers counsel them that if they would “just try harder” they could do it. And so they just try harder and they still don’t “get it”. The parents and teachers, not knowing what or why the situation is as it is, continue making demands and having expectations regarding performance in the classroom. The more effort the individual invests, the less reward they receive. They receive little or no reward from their attempts to learn and little or no recognition from the parents and teachers for their efforts. Everything is about mastering the task and it just is not happening. Now the individual experiences frustration. Frustration with the learning task and everyone involved. The individual experiences self-concept problems as a result of their inability to perform and comparisons with others. And so, very frequently they stop paying attention to the frustrating task and start paying attention to less frustrating tasks or situations. This begins the process of misdiagnosis. The individual learns how to get attention by not paying attention to frustrating situations. This situation is typical for children in elementary school. Their behavior is characterized by inappropriate attention-seeking behaviors (including method and amount), “off task” behaviors, disruption of the learning environment in their immediate area, and even disruption of the class. Professional assistance is sought to help with the problem, behavior is observed, diagnostic criteria are reviewed, and the child is, subsequently, diagnosed as Attention-Deficit Disorder (ADD) or Attention-Deficit Hyperactivity Disorder (ADHD). The treatment, of course, is some means of reducing “off task” behavior and disruption of the classroom. This usually involves some type of medical intervention involving a behavior suppressant medication such as Ritalin. At the risk of belaboring the obvious, none of these drugs are free, either financially or health-wise. I frequently see this situation with diagnosing professional never asking the magic question.
The diagnosing professional counts behaviors in terms of type and frequency and compares them with the diagnostic criteria that they so readily appear to be willing to choose. The reasons for their willingness to choose the ADD or ADHD diagnosis vary and may simply reflect a lack of education/experience. There are instances I know of where the diagnosing professional is encouraged/supported for this type of diagnosis as it puts the treatment back on the individual or their family. Misdiagnosis, of course, results in a failure to appropriately address the problem. All that would be necessary to address the diagnosis properly would be to ask the simple magic question: “Why are they not paying attention?”
Individuals with ADD or ADHD have a minimal brain dysfunction that interferes with their ability to pay attention. They always have trouble paying attention, not just in certain situations. There are some situations that make it much worse for individuals with ADD and ADHD, however, in general, these individuals have trouble paying attention. Individuals with an LD have the ability to pay attention. I’ve seen a number of children described as “hyper” that were able to sit for extended periods of time and remain focused on a specific task or situation. I see this as a clear indication for determining learning styles and checking to see if there is diagnostic information for a learning disability. It is important to remember that the reason many children do not pay attention is that they are not learning (“learning is intrinsically reinforcing”) and that to make them pay attention you have to help them learn.
Now that I have just spent a number of paragraphs on separating LD from ADD and ADHD, I must point out that it is possible to have an LD as well as ADD or ADHD. The more handicapping conditions that appear to be present, the more detailed the evaluation should be to determine the extent and degree of the handicapping conditions. This is supposed to be the job of the Pupil Appraisal Team in school settings. If you do not feel like your child has been adequately evaluated within the school system, by all means, get a second opinion. The earlier a condition or conditions that interfere with learning can be identified and a program of accommodations developed, the closer the individual can come to maximizing their individual potential. When an individual is thwarted from maximizing their individual potential, there are usually (continued)