Learning DisabilityA way forward….

Learning Disability ClinicL.T.M.G.Hospital &

Tata Interactive SystemsMumbai

Specific Learning Disability

Generic term that refers to a heterogeneous group of disorders manifested by significant unexpected, specific and persistent difficulties in the acquisition and use of reading (dyslexia), writing (dysgraphia) or mathematical (dyscalculia) abilities despite conventional instruction, normal intelligence, proper motivation and adequate socio-cultural opportunity.

Learning Disability• Common neuro-developmental

disorder• Prevalence 5% to 15 %• Equal male : female

distribution • Most likely to be familial

Contd.....• Across all socio economic classes• May occur along with other

handicapping conditions.• Problems in learning to

read,write, spell or do mathematics.

• Presumed to be due to CNS Dysfunction.

What is not L.D.?• Mental Retardation• Borderline I.Q.• Sensory deficits: Vision,

Hearing• Emotional disturbances• Attention deficits• Late maturation

Why early diagnosis ?• Early acceptance• Early intervention• Reduction in emotional

problems• Effective main-streaming• Optimum development

Steps in AssessmentMulti-disciplinary Approach• Medical history and examination• School history• Vision and Hearing tests• Psychological assessment• Educational assessment• Review of school reports• Counselor’s evaluation• Psychiatry evaluation• Case conference

Management • Remedial Education• Counseling• Treatment of co-morbidities• School Responsibilities• Encouraging Talents• Facilities / Accommodation

Challenges• Early Detection• Standardized Tests in regional

languages• LD-friendly schools• Language barrier• Education Boards• Legal issues• Parents’ reactions

What can we do ?•Create Awareness•Organize Assessment•Guidance for management•Arrange Counseling•Support the family•Network

Awareness

Assessment

Whose?When?Where?Who?How?

Quantum• Population in general• Child population• School-going population• Children with suspected L.D.

Maharashtra Edu. boardSSC Exam. March 2007

No.Registere

d

No.Appeare

dPercent passed

Fresh 1326077 1315287 77.17

Repeater 335897 328599 44.24

Total 1661974 1643886 60.70

Region-wiseDivision No. Regi No.

Appear. Pass %Pune 200671 199365 80.63

Nagpur 169124 167220 59.19Aurangab

ad 139367 137933 80.53

Mumbai 249357 247857 84.57Kolhapur 166089 164613 78.66Amaravat

i 151167 149791 73.12

Nasik 156163 155382 77.17Latur 94139 93126 80.81

Repeaters

Division No. Regi No. Appear. Pass %

Pune 52538 50975 45.41Nagpur 60730 59934 37.26

Aurangabad 18055 17605 37.15

Mumbai 88627 86281 47.60Kolhapur 38295 37405 47.21

Amaravati 36905 36472 46.39Nasik 30450 29876 44.79Latur 10287 10051 42.89

When?• Referral Stage a) Pre-referral screening b) School committee review• Assessment Stage a) Multidisciplinary evaluation b) Case conference, team meeting c) Writing of IEP• Intervention Stage a) Implementation of IEP b) Monitoring student progress

By whom?Multi-disciplinary

Approach

Team

• School teacher• Pediatrician/Pediatric Neurologist• Clinical Psychologist• Special educator• Counselor• ENT, Ophthalmologist• Psychiatrist

Management Issues• Trained remedial teachers• Counselors• Support from Government

departments Curriculum for teachers’ training Courses for special educators/ counselors/ psychologists Curriculum for medical professionals

Key Messages

• L.D.commonly present as school problems

• Early detection :Early intervention • L.D. initiative in schools•Multi-disciplinary approach for

diagnosis•Remedial Education•Provisions•Parent Support

Acknowledgement• All Deans – L.T.M.G.Hospital • Dr. Karande, Dr. Thadhani, Dr. Naik• Ms. Sholapurwala, Ms. Chitre• Ms. Shiledar, Ms. Vinita, Ms. Pethe• Ms. Jaheeda, Ms. Rohini• Staff of Dept. of Pediatrics• All children and their Parent

Thank you !