Learning Objectives
By the end of this section, you will be able to:
- Define the various forms of specific learning disorders
- Outline approaches used to treat specific learning disorders
- Define and categorize motor disorders
Globally, learning disabilities occur in nearly 5 percent of all school-aged children. Learning disorders are caused by genetic and environmental factors (Dominguez & Carugno, 2023). Risk factors for developing learning disabilities include genetics, poverty, premature birth, alcohol exposure in utero, and traumatic brain injuries (Dominguez & Carugno, 2023). Typically, children will be evaluated for learning disorders after they begin experiencing difficulties in school. Children with learning disorders may feel frustrated when they cannot learn a topic or skill and may act out, act helpless, or withdraw. Learning disorders may also be present with other disorders, such as ADHD or anxiety, making it hard for a child to succeed in school. Children with learning disorders often require specialized instruction to meet their needs (CDC, 2021d). Moreover, motor disorders occur in two ways: increased movement and decreased movement. The most common motor disorder in children are tic disorders (Ueda & Black, 2021).
Defining Specific Learning Disorders
A learning disorder occurs when a person has a difficult time in an area of learning, but it is not related to motivation or IQ level, emotional problems, cultural differences, or level of disadvantage. There are four commonly recognized learning disorders: dyslexia, dyscalculia, dysgraphia, and nonverbal learning disability (Dominguez & Carugno, 2023).
Dyslexia
The most common learning difference is dyslexia, which affects a person’s ability to read because it causes problems with phonological processing (Dominguez & Carugno, 2023). Dyslexia occurs in 7 to 10 percent of the population (University of Michigan, 2023a) and is the result of brain differences in the regions that process language (Mayo Clinic, 2022). Symptoms are often missed until the child begins school and, at that time, the teacher may be the person to notice that the child is having a problem with word recognition. Some indications of dyslexia are being a late talker; reversing sounds in words; difficulty naming colors, letters, and numbers; difficulty spelling; taking a long time to complete reading and writing assignments; and avoiding reading. Early intervention is the best treatment. Nurses should encourage parents to talk to their child’s health-care provider if they notice their child is having difficulty with reading and comprehension.
Because dyslexia affects a person’s reading and comprehension, it is understandable that it would affect their academic performance. Every subject in school requires some type of reading or writing. Students with dyslexia might overcompensate by memorizing material and using their verbal processing skills (University of Michigan, 2023b). These students may be gifted in other learning areas, such as “thinking outside of the box, creativity, hands-on learning, and sports” (para. 3). Teachers can use a variety of approaches in the classroom that incorporate verbal, visual, and hands-on applications to address these students’ learning needs. Accommodations (such as having more time to take a test), an IEP (individualized education program), or a 504 (a less detailed plan often related to accommodations) are interventions that help to support the student who has dyslexia.
Dyscalculia
Difficulty with calculation and completion of arithmetic problems is called dyscalculia. In this disorder, the child may have difficulty completing math problems, learning basic math, using math symbols, and understanding the way numbers relate to one another (Mayo Clinic, 2023a). Early intervention can help the child better understand basic math by offering extra support to teach them ways to get their schoolwork completed. The child may also benefit from an individualized education program (IEP), which sets individual learning goals to meet the child’s needs.
Dysgraphia
Distorted writing, even with instruction and intact motor ability, is called dysgraphia. This disorder causes the child to have trouble remembering how to form letters, trouble with spelling, grammar, and punctuation, and difficulty putting thoughts into words (Mayo Clinic, 2023a). Tutoring, getting extra time to complete assignments, or occupational therapy may help the child have an easier time with the task of writing.
Nonverbal Learning Disability
Nonverbal learning disorders are often undiagnosed until the third grade when children begin to have difficulty with reading comprehension. This disability causes difficulty with “problem-solving, recognizing social cues and body language, and visual-spatial tasks” (Dominguez & Carugno, 2023, para. 9). Children with these disorders often have good language skills. They can also be good at memorizing words. Examples of symptoms seen in this disability are difficulty understanding abstract concepts, not being able to read other’s expressions, poor physical coordination, problems with fine motor skills, such as writing, and difficulty paying attention (Mayo Clinic, 2023a).
Approaches to Treating Specific Learning Disorders
Parents can ask the school to assess their child for learning disorders. A general physical exam may start the process to be sure that there are no problems with vision, hearing, or another medical condition that could be hindering learning. There may be a team of professionals to evaluate the child. This team can consist of a school psychologist, a special education teacher, an occupational therapist, a social worker or nurse, and a speech-language pathologist (Mayo Clinic, 2023a). The team gathers information through tests, feedback from teachers, feedback from parents, and a review of the child’s academic history. Based on all of this information, the team will determine whether the child has a learning disorder and plan for the best way to help that child reach age-appropriate learning goals.
The treatment plan is different for each child. It may include interventions, such as tutoring, an IEP, classroom accommodations, occupational or speech-language therapy, and possibly medication to address depression, anxiety, or behavioral issues (Mayo Clinic, 2023a).
Link to Learning
This video provides information on the skills and qualities of a learning disability nurse that can improve success with clients.
Criteria for Defining Motor Disorder
The Virginia Commission on Youth (2021) describes motor disorders as a group of disorders that begin in the developmental years and contribute to delays in children reaching motor milestones. Symptoms include difficulty climbing stairs and tying shoes, making repetitive movements, and possibly having physical or verbal tics.
The three most common categories of motor disorders are developmental coordination disorder, stereotypic movement disorder, and tic disorders (Virginia Commission on Youth, 2021). Developmental coordination disorder presents as a child not meeting motor milestones. Often, these discrepancies are not diagnosed until the child enters school. Stereotypic movement disorder presents early in childhood. In this disorder, individuals are unable to control repetitive movements other than by restricting themselves by wrapping their arms in their clothes or sitting on their hands. Tic disorders include vocal, motor, simple, and complex tics. The DSM-5 describes three primary tic disorders: Tourette disorder, persistent (chronic) motor or vocal tic disorder, and provisional tic disorder (CDC, 2023f). The nurse is a member of the treatment team and acts as an educator and support person. See 23.6 Tic Disorder and Tourette Syndrome for focused information on diagnosis, medical treatment, and nursing care.