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by Dr. Calvin Wheeler, Pediatric
Neurologist
A learning disability (LD) exists when a child has overall normal intellect
but is deficient in acquiring the skills needed to perform a specific
cognitive task. Language delay is frequently the presenting complaint
in preschoolers. A child without meaningful words by age 18 months, without
meaningful phrases by age 24 months or speech that is unintelligible to
strangers by age 3 years should be evaluated. Hearing status should be
evaluated early on. The most common LD is dyslexia, a disorder manifested
by difficulty in learning to read.
In school-age children, learning disabilities usually
present as unexpected school failure in a child with a least average intelligence.
Standard intelligence and achievement tests should be administered to
verify normal intelligence and to verify failure to achieve the expected
level of school performance. There is frequently a family history of learning
problems. The routine neurologic exam in these children is usually normal:
however, so called "soft" signs may occur in about 50%. The
presence and importance of these neuromaturational signs are controversial.
Although dyslexia is the most commonly observed LD,
other learning disabilities may reflect arithmetic, handwriting, and spelling
disabilities. Symptoms of the attention-deficit hyperactivity disorder
(ADHD) are also common in these children. Both LD and ADHD are distinct
problems that frequently occur in the same child. They may very well be
genetically independent.
We at Kaiser believe that management of learning disabilities
require a complex balance of educational, cognitive-behavioral and, in
children suffering from ADHD, pharmacological interventions. Special class
placement and sometimes individualized interaction is often critical to
the child's success, Enlightened and encouraging parental and teacher
attitudes along with sheer determination of the child contribute to the
best possible outcome.
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