Reading Comprehension Instruction for Students With LD

Background and Purpose

Research conducted in the 1980s and more recently has suggested that children with learning disabilities (LD) have difficulties with reading comprehension that are the result of broadly based language problems and not limited to simple difficulties with word recognition. Since reading comprehension is crucial to school success, it is essential to understand the difficulties children with LD face as they encounter new text and to identify instructional approaches that focus on learning and using the many skills that are needed for successful reading.

This research synthesis was conducted to critically review recent contributions to the body of research on reading comprehension in students with LD with the goal of enhancing current classroom practices and identifying avenues for future research. These points serve as background information for the following discussion:

• Successful reading comprehension is correlated with oral reading fluency and vocabulary knowledge. However, interventions that focus on improving fluency or vocabulary do not necessarily increase reading comprehension, especially of long passages.
• Students with LD often show signs of giving up too quickly when faced with a difficult passage. This so-called task persistence, a skill that must be acquired by all readers, is especially important for successful reading of expository text, such as history and science textbooks, newspapers, and voter pamphlets.
• Children with LD, who have a history of academic difficulties, have documented gaps in grade-appropriate knowledge of history, geography, and other subjects. These knowledge gaps interfere with their understanding of material they encounter in new texts and compound their reading comprehension problems.

Findings

An analysis of three recent research reviews brings the following issues and findings to the forefront of reading comprehension research.

What is the role of self-monitoring in reading comprehension?

So-called active readers learn to monitor how well they understand what they are reading, as they read. When reading difficult material, these students engage in beneficial self-monitoring strategies such as rereading portions of the text and trying to figure out the meaning of unfamiliar words central to understanding it. In contrast, students with LD often fail to realize that they must pay attention to how well they understand a text as they read so that they can go back and reread as necessary. Typically, students with LD must learn several self-monitoring techniques, such as asking themselves questions after reading a passage or summarizing in their own words the material they've read. While reading a story (a narrative text), they might try to predict what will happen next. Learning to make predictions helps reading comprehension.

The ability to reflect on how well a reading task is progressing is a critical component of reading comprehension. Students who are taught a number of strategies to use as they read, such as asking themselves questions as they read and summarizing what they read, generally experience more improvements in comprehension than students who are taught a single, specific comprehension skill. It is essential for students to learn "repair strategies" to use when they find themselves not understanding the text they are reading.
Repeated readings of a passage make it significantly easier for students to recall its important content. Repeated readings of the same passage is an easy strategy to implement in real classroom situations.

Although students with LD can be taught to use self-monitoring techniques, it is considerably more difficult for these students to generalize these skills, or apply them to other reading situations. Students frequently do not continue the comprehension strategies that they are taught after completion of the study unless they are asked to. It appears that intense, long-term interventions utilizing multiple self-monitoring interventions may be the most effective approach.

Students with LD process information inactively, and they have difficulty differentiating relevant and irrelevant associations. Possible solutions include techniques that force students to focus attention on the material being read and help them more readily identify the theme of a narrative.

What are the contributions of text structures to reading comprehension?

Skills in discerning and using text structures (the way reading material is organized) are important to understanding texts. Students with LD have trouble learning about the structures of stories. In addition, they typically recall less about stories they've read and cannot easily identify the important information in stories. The most useful text structure is referred to as story grammar, which is the way narrative texts are organized. That is, there are characters, a setting, problems, solutions to the problems, etc. Students with LD know less about narrative text structure than other students. This lack of knowledge interferes with comprehension. Fortunately, narrative text structure can be taught, and when it is, comprehension improves.

Expository writing, the kind of texts found in newspapers and history books, for example, presents LD students with even greater challenges. Expository writing typically contains a variety of organizational or text structures that are more difficult to identify. Thus, the tactics that may help when reading stories, such as identifying the main story elements and processing them, are often less effective with expository texts.

Peer-assisted learning strategies (PALS) improve comprehension and oral reading skills. In addition to having students reread text, PALS also has children work directly on comprehension by summarizing what they've read, identifying the most important information, and predicting what may happen next.

Although peer-assisted learning has shown strong benefits, additional research is necessary to determine whether peers have the skills to explain to another student how they handle the difficulties they encounter while reading. It's clear that students can help with practice and that practice is essential for internalizing strategies, but it's not clear to what extent proficient readers can actually teach less proficient readers.

Recommendations

Reading comprehension interventions are among the most effective interventions among children with LD.

Students with LD need to learn an array of strategies to enhance their understanding of the narrative and expository material they read.
With regard to expository text, more emphasis should be placed on a fluid approach to self-monitoring skills. Too few studies have looked at ways to improve comprehension of expository text. New areas of research are emphasizing that comprehension of expository text should focus on helping students use an array of strategies flexibly rather than having them adhere rigidly to text structure approach, as they might while reading a narrative text or story.

It appears that more successful interventions teach kids multiple strategies with the goal of having them internalize the strategies. Limited evidence suggests that internalization occurs with more intense interventions-usually longer and more frequent instructional times.

Socially mediated instruction, of which peer-assisted learning strategies (PALS) is one example, seems to hold considerable promise. In these situations, students learn to process verbally with a peer or group of peers what they've read verbally. After reading a passage, for example, students or a student and a teacher discuss the content of the passage, ask each other questions about it, and in narrative texts, predict what may happen next.

Frequent, ongoing discussions about the meaning of the text, in which the teacher models the array of strategies and tools that good readers use to make sense of text, is a promising approach to reading comprehension instruction.

Finding ways to help students generalize their newly acquired reading comprehension skills is essential. It's important to learn how these skills can be transferred to other academic areas and what needs to be done to make sure that students either continue using the specific strategies they've learned after the instructional intervention ends or internalize the essential parts of the strategy so that improvements in reading comprehension continue.

To date, student learning occurs on measures aligned to the focus of the intervention. So, if students learn to make predictions, for example, they tend to do quite well on tasks that ask them to make predictions. These types of closely aligned measures are called experimenter developed measures. When measures are not closely aligned to the specific focus of the intervention, as is typically the case with standardized measures, the learning outcomes are less impressive. One goal of reading comprehension research is to develop intervention approaches that have a larger impact on standardized measures, which suggest a more generalized or broad-based effect of the intervention.

---

This document was prepared for the Keys to Successful Learning Summit held in May 1999 in Washington, D.C. Keys to Successful Learning is an ongoing collaboration sponsored by the National Center for Learning Disabilities in partnership with the Office of Special Education Programs (US Department of Education) and the National Institute of Child Health & Human Development (National Institutes of Health).

The purpose of this initiative is to translate research and policy on learning disabilities into high standards for learning and achievement in the classroom, and to take action at the local, state and federal levels to ensure that all students, including those with learning disabilities, are afforded the highest quality education.

Keys to Successful Learning is supported by a coalition of national and regional funders as well as a broad range of participating education organizations.

What is Executive Function?

Executive function is a set of mental processes that helps connect past experience with present action. People use it to perform activities such as planning, organizing, strategizing, paying attention to and remembering details, and managing time and space.

 

If you have trouble with executive function, these things are more difficult to do. You may also show a weakness with working memory, which is like “seeing in your mind’s eye.” This is an important tool in guiding your actions.

As with other learning disabilities, problems with executive function can run in families. It can be seen at any age, but it tends to become more apparent as children move through the early elementary grades. This is when the demands of completing schoolwork independently can trigger signs of a problem with executive function.

The brain continues to mature and develop connections well into adulthood. A person’s executive function abilities are shaped by both physical changes in the brain and by life experiences, in the classroom and in the world at large. Early attention to developing efficient skills in this area can be very helpful. As a rule, it helps to give direct instruction, frequent reassurance and explicit feedback.

How Does Executive Function Affect Learning?

In school, at home or in the workplace, we’re called on all day, every day, to self-regulate behavior. Executive function allows us to:

• Make plans
• Keep track of time and finish work on time
• Keep track of more than one thing at once
• Meaningfully include past knowledge in discussions
• Evaluate ideas and reflect on our work
• Change our minds and make mid-course corrections while thinking, reading and writing
• Ask for help or seek more information when we need it
• Engage in group dynamics
• Wait to speak until we’re called on

What Are the Warning Signs of Executive Function Problems?

A student may have problems with executive function when he or she has trouble:

• Planning projects
• Comprehending how much time a project will take to complete
• Telling stories (verbally or in writing), struggling to communicate details in an organized, sequential manner
• Memorizing and retrieving information from memory
• Initiating activities or tasks, or generating ideas independently
• Retaining information while doing something with it, for example, remembering a phone number while dialing   

8 Activities to Help Young Children Develop Fine Motor Skills

Children who have issues with fine motor skills have a hard time developing strong muscles in their fingers, hands and wrists. Here are ideas for activities that can help them build the muscles needed for fine motor skills.

 

Stock up on play-dough. 

Play-dough has been a childhood favorite for decades. Not only is it downright fun, but handling play-dough also develops some important skills. Squeezing and stretching it helps strengthen finger muscles, and touching it is a valuable sensory experience.

Do some finger painting. 

Using finger paint can strengthen your child’s hand-eye coordination and manual dexterity. All you need is an easel or a thick piece of paper, some finger paints and a space—like the yard or garage—where your child can get messy.

Squeeze out a sponge. 

Set up two separate bowls, one filled with water and the other empty. Give your child a sponge and have her soak it in one bowl. Then have her squeeze the water out of the sponge into the other bowl. She can transfer water back and forth between bowls, too. This simple game can strengthen hands and forearms. It’s especially fun if you throw in some bubbles or some food dye.

Make bathroom murals. 

Show your child how to safely cut thin pieces of craft foam into whatever shapes she wants. Then she can use them to create murals during her bath. Simply wet them so they stick to the wall or to the side of the tub. It’s a fun way to improve cutting skills and manual dexterity.

Color with broken crayons. 
Difficulties with fine motor skills can make it tough to grip a pencil. Coloring with small, broken crayons encourages your child to hold the crayon correctly—between her thumb and forefinger. Pencils used on mini-golf courses and small pieces of chalk work well, too. No matter what you use, this activity a fun way to challenge your child.

Make paper dolls. 

Paper dolls have been around for generations, and kids still love them. By cutting and folding tabs, your child can strengthen important hand muscles. Start by cutting out larger dolls and outfits, and move to smaller pieces over time. Paper dolls can appeal to boys as well as girls—just look for characters that interest your child.

Play string games. 

Another low-tech activity that can provide hours of fun is string games, like Cat’s Cradle. String games help improve finger strength and hand-eye coordination. All you need is some yarn and a little time to teach your child.

Make macaroni necklaces. 

Stringing together necklaces is a great way for your child to be creative while working on her hand-eye coordination and developing her ability to manipulate objects. To start, give her thick string and big beads or large pieces of dry pasta. Over time, she can work on more complex designs using smaller pieces.

10 Helpful Dysgraphia Resources

Are you or your child struggling with dysgraphia, or difficulty writing? The following resources will help you learn more about dysgraphia and find help. You can always use NCLD’s Resource Locator to find programs in your local area.

1. Accommodations and Modifications for Students with Handwriting Problems and/or Dysgraphia: Visit this page by Susan Jones, MEd for ideas on classroom accommodations, modifications, and remediation for students with dysgraphia.
   
2. Assistive Technology for Writing: Assistive technology can be of great benefit for students with dysgraphia. Check out this page for a listing of some of the most popular keyboarding programs, portable keyboards, note-taking software, and speech-to-text dictation programs.
   
3. Eye to Eye: Eye to Eye is a “mentoring movement for different thinkers,” providing mentoring programs to students identified with learning disabilities such as dysgraphia and dyslexia. Visit their site to learn more about their program and find out how to get involved.
   
4. Family Center on Technology and Disability: Resource Reviews: There are many assistive technology tools to help people with dysgraphia and other learning disabilities. Research specific tools and find out what the experts think at this website.
   
5. The Importance of Teaching Handwriting: All children (especially those with dysgraphia) need explicit teaching of handwriting. Check out this article for information on why handwriting lessons are important and find out tips for teaching and assessing handwriting.
   
6. Parent Center Network - Parent Center Listing: If you are the parent of a K-12 student with dysgraphia, you’ll want to take a look at this site and find your nearest Parent Training and Information Center (PTI). PTIs are funded by the federal government and offer parents assistance in navigating special education and their child’s rights under the Individuals with Disabilities Education Act (IDEA).
   
7. Powerful Writing Strategies for All Students by Karen R. Harris, Steve Graham, Linda H. Mason, and Barbara Friedlander (Brookes Publishing, 2008): This handbook provides educators with practical, evidence-based lesson plans and support materials for teaching writing to students with and without dysgraphia and other learning disabilities.
   
8. Strategies for Dealing with Dysgraphia: This article from LD Online offers extensive tips on helping students with dysgraphia succeed in writing.
   
9. Strategies for the Reluctant Writer: Dysgraphia can make students reluctant to write. Read this article for ideas on building students’ motivation to write and supporting them throughout the writing process.
   
10. Understanding Dysgraphia: This factsheet from the International Dyslexia Association includes answers to frequently asked questions about dysgraphia and ideas for instructional activities to support students with dysgraphia.

What is Dysgraphia?

Dysgraphia is a learning disability that affects writing, which requires a complex set of motor and information processing skills. Dysgraphia makes the act of writing difficult. It can lead to problems with spelling, poor handwriting and putting thoughts on paper. People with dysgraphia can have trouble organizing letters, numbers and words on a line or page. This can result partly from:

• Visual-spatial difficulties: trouble processing what the eye sees
• Language processing difficulty: trouble processing and making sense of what the ear hears

As with all learning disabilities (LD), dysgraphia is a lifelong challenge, although how it manifests may change over time. A student with this disorder can benefit from specific accommodations in the learning environment. Extra practice learning the skills required to be an accomplished writer can also help.

What Are the Warning Signs of Dysgraphia?

Just having bad handwriting doesn’t mean a person has dysgraphia. Since dysgraphia is a processing disorder, difficulties can change throughout a lifetime. However since writing is a developmental process—children learn the motor skills needed to write, while learning the thinking skills needed to communicate on paper—difficulties can also overlap.

Dysgraphia: Warning Signs By Age

Young Children Trouble With: Tight, awkward pencil grip and body position Avoiding writing or drawing tasks Trouble forming letter shapes Inconsistent spacing between letters or words Poor understanding of uppercase and lowercase letters Inability to write or draw in a line or within margins Tiring quickly while writing

School-Age Children Trouble With: Illegible handwriting Mixture of cursive and print writing Saying words out loud while writing Concentrating so hard on writing that comprehension of what's written is missed Trouble thinking of words to write Omitting or not finishing words in sentences

Teenagers and Adults Trouble With: Trouble organizing thoughts on paper Trouble keeping track of thoughts already written down Difficulty with syntax structure and grammar Large gap between written ideas and understanding demonstrated through speech

What Strategies Can Help?

There are many ways to help a person with dysgraphia achieve success. Generally strategies fall into three main categories:

• Accommodations: providing alternatives to written expression
• Modifications: changing expectations or tasks to minimize or avoid the area of weakness
• Remediation: providing instruction for improving handwriting and writing skills

Each type of strategy should be considered when planning instruction and support. A person with dysgraphia will benefit from help from both specialists and those who are closest to the person. Finding the most beneficial type of support is a process of trying different ideas and openly exchanging thoughts on what works best.

Although teachers and employers are required by law to make “reasonable accommodations” for individuals with learning disabilities, they may not be aware of how to help. Speak to them about dysgraphia and explain the challenges faced as a result of this learning disability.

Here are examples of how to teach individuals with dysgraphia to overcome some of their difficulties with written expression.

Early Writers

Be patient and positive, encourage practice and praise effort. Becoming a good writer takes time and practice.

• Use paper with raised lines for a sensory guide to staying within the lines.
• Try different pens and pencils to find one that’s most comfortable.
• Practice writing letters and numbers in the air with big arm movements to improve motor memory of these important shapes. Also practice letters and numbers with smaller hand or finger motions.
• Encourage proper grip, posture and paper positioning for writing. It’s important to reinforce this early as it’s difficult for students to unlearn bad habits later on.
• Use multi-sensory techniques for learning letters, shapes and numbers. For example, speaking through motor sequences, such as “b” is “big stick down, circle away from my body.”
• Introduce a word processor on a computer early; however do not eliminate handwriting for the child. While typing can make it easier to write by alleviating the frustration of forming letters, handwriting is a vital part of a person's ability to function in the world.

Young Students

Encourage practice through low-stress opportunities for writing. This might include writing letters or in a diary, making household lists, or keeping track of sports teams.

• Allow use of print or cursive—whichever is more comfortable.
• Use large graph paper for math calculation to keep columns and rows organized.
• Allow extra time for writing assignments.
• Begin writing assignments creatively with drawing, or speaking ideas into a tape recorder.
• Alternate focus of writing assignments—put the emphasis on some for neatness and spelling, others for grammar or organization of ideas.
• Explicitly teach different types of writing—expository and personal essays, short stories, poems, etc.
• Do not judge timed assignments on neatness and spelling.
• Have students proofread work after a delay—it’s easier to see mistakes after a break.
• Help students create a checklist for editing work—spelling, neatness, grammar, syntax, clear progression of ideas, etc.
• Encourage use of a spell checker—speaking spell checkers are available for handwritten work.
• Reduce amount of copying; instead, focus on writing original answers and ideas.
• Have student complete tasks in small steps instead of all at once.
• Find alternative means of assessing knowledge, such as oral reports or visual projects.

Teenagers and Adults

Many of these tips can be used by all age groups. It is never too early or too late to reinforce the skills needed to be a good writer.

• Provide tape recorders to supplement note taking and to prepare for writing assignments.
• Create a step-by-step plan that breaks writing assignments into small tasks (see below).
• When organizing writing projects, create a list of keywords that will be useful.
• Provide clear, constructive feedback on the quality of work, explaining both the strengths and weaknesses of the project, commenting on the structure as well as the information that is included.
• Use assistive technology such as voice-activated software if the mechanical aspects of writing remain a major hurdle.

What is Dyscalculia?

Dyscalculia refers to a wide range of lifelong learning disabilities involving math. There is no single type of math disability. Dyscalculia can vary from person to person. And, it can affect people differently at different stages of life.

Two major areas of weakness can contribute to math learning disabilities:

• Visual-spatial difficulties, which result in a person having trouble processing what the eye sees
• Language processing difficulties, which result in a person having trouble processing and making sense of what the ear hears

Using alternate learning methods, people with dyscalculia can achieve success.

What Are the Effects of Dyscalculia?

Disabilities involving math vary greatly. So, the effects they have on a person's development can vary just as much. For instance, a person who has trouble processing language will face different challenges in math than a person who has trouble with visual-spatial relationships. Another person may have trouble remembering facts and keeping a sequence of steps in order. This person will have yet a different set of math-related challenges to overcome.

For individuals with visual-spatial troubles, it may be hard to visualize patterns or different parts of a math problem. Language processing problems can make it hard for a person to get a grasp of the vocabulary of math. Without the proper vocabulary and a clear understanding of what the words represent, it is difficult to build on math knowledge.

When basic math facts are not mastered earlier, teens and adults with dyscalculia may have trouble moving on to more advanced math applications. These require that a person be able to follow multi-step procedures and be able to identify critical information needed to solve equations and more complex problems.

What Are the Warning Signs of Dyscalculia?

Having trouble learning math skills does not necessarily mean a person has a learning disability. All students learn at different paces. It can take young people time and practice for formal math procedures to make practical sense. So how can you tell if someone has dyscalculia? If a person continues to display trouble with the areas listed below, consider testing for dyscalculia. Extra help may be beneficial.

Dyscalculia: Warning Signs By Age

Young Children Trouble With: Difficulty learning to count Trouble recognizing printed numbers Difficulty tying together the idea of a number (4) and how it exists in the world (4 horses, 4 cars, 4 children) Poor memory for numbers Trouble organizing things in a logical way - putting round objects in one place and square ones in another

School-Aged Children Trouble With: Trouble learning math facts (addition, subtraction, multiplication, division) Difficulty developing math problem-solving skills Poor long term memory for math functions Not familiar with math vocabulary Difficulty measuring things Avoiding games that require strategy

Teenagers and Adults Trouble With: Difficulty estimating costs like groceries bills Difficulty learning math concepts beyond the basic math facts Poor ability to budget or balance a checkbook Trouble with concepts of time, such as sticking to a schedule or approximating time Trouble with mental math Difficulty finding different approaches to one problem

How Is Dyscalculia Identified?

When a teacher or trained professional evaluates a student for learning disabilities in math, the student is interviewed about a full range of math-related skills and behaviors. Pencil and paper math tests are often used, but an evaluation needs to accomplish more. It is meant to reveal how a person understands and uses numbers and math concepts to solve advanced-level, as well as everyday, problems. The evaluation compares a person's expected and actual levels of skill and understanding while noting the person's specific strengths and weaknesses. Below are some of the areas that may be addressed:

• Ability with basic math skills like counting, adding, subtracting, multiplying and dividing
• Ability to predict appropriate procedures based on understanding patterns—knowing when to add, subtract, multiply, divide or do more advanced computations
• Ability to organize objects in a logical way
• Ability to measure—telling time, using money
• Ability to estimate number quantities
• Ability to self-check work and find alternate ways to solve problems.

How Is Dyscalculia Treated?

Helping a student identify his/her strengths and weaknesses is the first step to getting help. Following identification, parents, teachers and other educators can work together to establish strategies that will help the student learn math more effectively. Help outside the classroom lets a student and tutor focus specifically on the difficulties that student is having, taking pressure off moving to new topics too quickly. Repeated reinforcement and specific practice of straightforward ideas can make understanding easier. Other strategies for inside and outside the classroom include:

• Use graph paper for students who have difficulty organizing ideas on paper.
• Work on finding different ways to approach math facts; i.e., instead of just memorizing the multiplication tables, explain that 8 x 2 = 16, so if 16 is doubled, 8 x 4 must = 32.
• Practice estimating as a way to begin solving math problems.
• Introduce new skills beginning with concrete examples and later moving to more abstract applications.
• For language difficulties, explain ideas and problems clearly and encourage students to ask questions as they work.
• Provide a place to work with few distractions and have pencils, erasers and other tools on hand as needed.

Help students become aware of their strengths and weaknesses. Understanding how a person learns best is a big step in achieving academic success and confidence.

What is ADHD?

What is Attention-Deficit/Hyperactivity Disorder (ADHD), and what does it have to do with learning disabilities (LD)? 

ADHD and LD are not the same thing, but ADHD certainly can interfere with learning and behavior. About one-third of people with LD have ADHD. Clear up your confusion about the two often co-occurring disorders by accessing the information below.

The Difference Between LD and ADHD

Although LD and ADHD are different, they do share some similarities. Both are neurological disorders that affect how the brain receives, processes and responds to information. But their origins are different and people receive different types of treatment for them.

Researchers are still studying the cause of ADHD. Evidence points to levels of brain chemicals (neurotransmitters such as dopamine and serotonin) being out of balance. This can lead to problems with organization, easy frustration and social interactions. In turn, this can affect schoolwork and learning.

With LD, the specific systems in the brain that are deficient are even less well understood. LD is a broad category that includes many different types of problems in areas such as listening, reading, writing, spelling and math. Processing information in each of these areas depends upon a brain that is wired for speed and efficiency. When the flow of information is misrouted or delayed, or when one area in the brain is not working at full capacity, the result is a breakdown in learning.

ADHD is often treated with medication and therapy, and LD with educational and behavioral approaches.

Causes and Symptoms of ADHD

ADHD is a common childhood brain disorder that may continue into adolescence and adulthood. ADHD often runs in families. Many studies suggest that genes do, in fact, play a big role in ADHD. Other potential contributors to ADHD include:

• Environmental factors such as early exposure to lead or to alcohol before birth
• Brain injury

Some people believe that refined sugar causes ADHD or makes it worse. However, the research does not support this theory. And more research is needed to confirm a possible link between ADHD and food additives such as artificial colors.¹ It’s also important to know that ADHD is not the result of poor parenting.

Symptoms of ADHD are often severe, frequent, and first occur early, between the ages of three and six. The main symptoms are related to:

• Staying focused and paying attention
• Delaying gratification or controlling impulses
• Being overly active or restless²
  

Types of ADHD

There are two main types of ADHD. A third type is a combination of the two main types.

Hyperactive-impulsive type of ADHD. Children with this type of ADHD usually receive a diagnosis at a younger age than those with other types. Children with this type of ADHD may:

• Move and fidget constantly (Teens and adults may have only a sense of internal restlessness.)
• Talk nonstop
• Have trouble with quiet activities
• Often act without thinking about the consequences of their actions
• Have trouble taking turns or often disrupt games and conversations
• Have trouble controlling temper outbursts

Inattentive type of ADHD. Children with this type of ADHD have trouble putting the needed attention and effort into their schoolwork. This type is more easily missed at an early age. As responsibility for schoolwork and life management increases, trouble staying organized becomes more apparent. Children with this type of ADHD may:

• Appear to not pay attention to details or to listen when spoken to
• Daydream a lot
• Be slow to process information
• Struggle to follow instructions
• Not sustain attention long enough to learn something new
• Have trouble completing homework
• Misplace things needed to complete tasks
• Become bored easily
• Be poorly organized

Treatment for ADHD

ADHD often occurs in combination with reading, spelling, writing, arithmetic and language problems, as well as social and emotional problems. And, ADHD can mimic other problems. That’s why it’s so important to get a careful and comprehensive medical and educational assessment by a qualified professional—someone who has the appropriate license or certification in the state in which they practice. This might be a:

• Physician
• Psychologist
• Social worker
• Professional counselor
• Psychiatric nurse³

It’s also important to make careful note of patterns of behavior over time.

Although treatment does not cure ADHD, it can greatly help with symptoms. Treatment is likely to include:

• Medication such as stimulants, which can restore a better balance of neurotransmitters and have a calming effect
• Different types of psychotherapy or behavior management
• Education and training¹

How You Can Help

Parents play a crucial role in helping children with ADHD. Here are some general guidelines. Many of these tips may be helpful not only for children, but also for teens and adults with ADHD.

• Provide structure and a consistent schedule. Help your child learn routines around daily activities such as getting dressed and going to bed. Use a picture calendar/schedule for the younger child.
• Make sure that your child gets enough sleep.
• Work out “clean-up” routines and organize and label areas used for toy storage and clothing. Make picture labels for a young child and word labels for a child who can read.
• Provide consistent, low-key reminders, prompts, and cues when needed.
• Be consistent about rewards and consequences so that your child knows what to expect.
• Be generous with praise when your child performs well.
• Avoid being overly critical when things don't go well.
• Teach and monitor the use of organizational strategies. This might include color-coded folders for different subjects, checklists and to-do lists, goal setting, and breaking projects into small, manageable chunks.
• Supervise your school-age child daily in completion of homework assignments, organization of the backpack and filing of papers (but don't do it for him or her).

Also talk with your child’s teacher about ways to help your child. For example, teachers can help a lot by stressing organizational routines and staying in close communication with parents. Teachers can also allow hyperactive children to have movement breaks.

What are Learning Disabilities?

Learning disabilities (LDs) are real. They affect the brain's ability to receive, process, store, respond to and communicate information. LDs are actually a group of disorders, not a single disorder.

Learning disabilities are not the same as intellectual disabilities (formerly known as mental retardation), sensory impairments (vision or hearing) or autism spectrum disorders. People with LD are of average or above-average intelligence but still struggle to acquireskills that impact their performance in school, at home, in the community and in the workplace. Learning disabilities are lifelong, and the sooner they are recognized and identified, the sooner steps can be taken to circumvent or overcome the challenges they present.

How Can You Tell If Someone Has a Learning Disability?

The hallmark sign of a learning disability is a distinct and unexplained gap between a person's level of expected achievement and their performance. Learning disabilities affect every person differentlyand they present differently at various stages of development. 

LDs can range from mild to severe and it is not uncommon for people to have more than one learning disability. In addition, about one-third of individuals with LD also have Attention-Deficit/Hyperactivity Disorder (ADHD). While LD and ADHD can share common features, such as difficulties with concentration, memory, and organizational skills, they are not the same types of disorder. 

Unfortunately, LD is often confused with ADHD and is frequently mistaken as laziness or associated with disorders of emotion and behavior. A careful and thorough review of concerns, with input from multiple sources (including parents, educators, physicians, psychologists, speech-language providers and, of course, the person themselves) is the only way to rule in or rule out a learning disability.

Learning disabilities can affect a person’s ability in the areas of

• Listening
• Speaking
• Reading
• Writing
• Spelling
• Reasoning
• Mathematics

See the chart below for specific types of learning disabilities and related disorders.

LD Terminology
Disability	Area of difficulty	Symptoms include trouble with	Example
Dyslexia	Processing language	Reading Writing Spelling	Confusing letter names and sounds, difficulties blending sounds into words, slow rate of reading, trouble remembering after reading text
Dyscalculia	Math skills	Computation Remembering math facts Concepts of time and money	Difficulty learning to count by 2s, 3s, 4s, poor mental math skills, problems with spatial directions
Dysgraphia	Written expression	Handwriting Spelling Composition	Illegible handwriting, difficulty organizing ideas for writing
Dyspraxia	Fine motor skills	Coordination Manual dexterity	Trouble with scissors, buttons, drawing
Information Processing Disorders
Auditory Processing Disorder	Interpreting auditory information	Language development Reading	Difficulty anticipating how a speaker will end a sentence
Visual Processing Disorder	Interpreting visual information	Reading Writing Math	Difficulty distinguishing letters like “h” and “n”
Other Related Disorders
Attention-Deficit/ Hyperactivity Disorder (ADHD)	Concentration and focus	Over-activity Distractibility Impulsivity	Can't sit still, loses interest quickly, daydreams

What is Dyslexia?

 http://ncld.org/about-us/

 

As with other learning disabilities, dyslexia is a lifelong challenge. This language-based processing disorder can hinder reading, writing, spelling and sometimes even speaking. Dyslexia is not a sign of poor intelligence or laziness or the result of impaired hearing or vision. Children and adults with dyslexia have a neurological disorder that causes their brains to process and interpret information differently.

As with other learning disabilities, dyslexia is a lifelong challenge that people are born with. This language processing disorder can hinder reading, writing, spelling and sometimes even speaking. Dyslexia is not a sign of poor intelligence or laziness. It is also not the result of impaired vision. Children and adults with dyslexia simply have a neurological disorder that causes their brains to process and interpret information differently.

Dyslexia occurs among people of all economic and ethnic backgrounds. Often more than one member of a family has dyslexia. According to the National Institute of Child and Human Development, as many as 15 percent of Americans have major troubles with reading.

Much of what happens in a classroom is based on reading and writing. So it's important to identify dyslexia as early as possible. Using alternate learning methods, people with dyslexia can achieve success.

What Are the Effects of Dyslexia?

Dyslexia can affect people differently. This depends, in part, upon the severity of the learning disability and the success of alternate learning methods. Some with dyslexia can have trouble with reading and spelling, while others struggle to write, or to tell left from right. Some children show few signs of difficulty with early reading and writing. But later on, they may have trouble with complex language skills, such as grammar, reading comprehension and more in-depth writing.

Dyslexia can also make it difficult for people to express themselves clearly. It can be hard for them to use vocabulary and to structure their thoughts during conversation. Others struggle to understand when people speak to them. This isn't due to hearing problems. Instead, it's from trouble processing verbal information. It becomes even harder with abstract thoughts and non-literal language, such as jokes and proverbs.

All of these effects can have a big impact on a person's self-image. Without help, children often get frustrated with learning. The stress of dealing with schoolwork often makes children with dyslexia lose the motivation to continue and overcome the hurdles they face.

Trained professionals can identify dyslexia using a formal evaluation. This looks at a person's ability to understand and use spoken and written language. It looks at areas of strength and weakness in the skills that are needed for reading. It also takes into account many other factors. These include family history, intellect, educational background, and social environment.

How Is Dyslexia Treated?

It helps to identify dyslexia as early in life as possible. Adults with unidentified dyslexia often work in jobs below their intellectual capacity. But with help from a tutor, teacher, or other trained professional, almost all people with dyslexia can become good readers and writers. Use the following strategies to help to make progress with dyslexia.

• Expose your child to early oral reading, writing, drawing, and practice to encourage development of print knowledge, basic letter formation, recognition skills and linguistic awareness (the relationship between sound and meaning).
• Have your child practice reading different kinds of texts. This includes books, magazines, ads and comics.
• Include multi-sensory, structured language instruction. Practice using sight, sound and touch when introducing new ideas.
• Seek modifications in the classroom. This might include extra time to complete assignments, help with note taking, oral testing and other means of assessment.
• Use books on tape and assistive technology. Examples are screen readers and voice recognition computer software.
• Get help with the emotional issues that arise from struggling to overcome academic difficulties.

Reading and writing are key skills for daily living. However, it is important to also emphasize other aspects of learning and expression. Like all people, those with dyslexia enjoy activities that tap into their strengths and interests. For example, people with dyslexia may be attracted to fields that do not emphasize language skills. Examples are design, art, architecture, engineering and surgery.

What Are the Warning Signs of Dyslexia?

The following are common signs of dyslexia in people of different ages. If you or someone you know displays these signs, it doesn't necessarily mean you have a learning disability. But if troubles continue over time, consider testing for dyslexia.

 Dyslexia: Warning Signs By Age

Young Children Trouble With: Recognizing letters, matching letters to sounds and blending sounds into speech Pronouncing words, for example saying “mawn lower” instead of “lawn mower” Learning and correctly using new vocabulary words Learning the alphabet, numbers, and days of the week or similar common word sequences Rhyming

School-Age Children Trouble With: Mastering the rules of spelling Remembering facts and numbers Handwriting or with gripping a pencil Learning and understanding new skills; instead, relying heavily on memorization Reading and spelling, such as reversing letters (d, b) or moving letters around (left, felt) Following a sequence of directions Trouble with word problems in math

Teenagers and Adults Trouble With: Reading at the expected level Understanding non-literal language, such as idioms, jokes, or proverbs Reading aloud Organizing and managing time Trouble summarizing a story Learning a foreign language Memorizing

 Dyslexia at a Glance

• Dyslexia is the name for specific learning disabilities in reading.
• Dyslexia is often characterized by difficulties with accurate word recognition, decoding and spelling.
• Dyslexia may cause problems with reading comprehension and slow down vocabulary growth.
• Dyslexia may result in poor reading fluency and reading out loud.
• Dyslexia is neurological and often genetic.
• Dyslexia is not the result of poor instruction.
• With the proper support, almost all people with dyslexia can become good readers and writers.