learning disability

When learning is a problem

http://www.telegraphindia.com/1150323/jsp/knowhow/story_10205.jsp

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Your Health - Dr. Gita Mathai

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In India, we place a premium on academic performance. A "good education", preferably in an English medium school, is a priority. Parents in many cities wait in serpentine queues for hours to get their tots admitted to the "best" nursery school.

In this scenario, when the child does not top the class, there is shame and consternation. The parents may adopt physical punishment, mega-vitamin therapy, a restricted diet, or alternative medicine (homeopathy, ayurveda) to treat their child.

Children find it difficult to perform academically if they have an IQ that is less than 70, or are vision or hearing impaired. Sometimes, they come from a background where academics is not stressed. The parents may be too busy or unable to guide or motivate the child. Comprehension may be a problem if the medium of education is different from the language spoken at home.

In 1.5-2 per cent of children, poor academic performance cannot be explained by any of these reasons. These children may have a normal IQ and no apparent physical defects and yet have learning disability. If this is not diagnosed and tackled, they grow up to have poor self esteem, may drop out of school, and, eventually, perform poorly in their careers.

Conventional education requires processing information gained by sight and hearing, integrating it in the brain with information already present, storing it away for future reference and using it again as and when required. A problem in any of these steps can cause difficulties with academic excellence.

Learning disability occurs when there is an impediment to the way the brain perceives and processes information. It covers a spectrum of disorders in reading (dyslexia), mathematics (dyscalculia) and writing (dysgraphia).

Sometimes, learning disability runs in families. An area of the brain responsible for any one of these acts may be defective and the problem may be inherited. The problem may occur due to a traumatic birth, with mild asphyxia, when the child did not cry immediately after birth. As the child grows, the problem may be due to poor nutrition (even in well-to-do families) or lead poisoning from the environment. Quite often, the reason for the disability cannot be ascertained.

The diagnosis is usually suspected when the child is in Class III. There is a disparity between the apparent intelligence of the child and performance in certain subjects. Simple tests like difficulty in identifying fingers, standing on one foot, right to left disorientation and difficulty in rapid alternating movements are markers for suspicion. The child then needs to be evaluated by a team with a paediatrician, a psychiatrist and neurologist.

Once the diagnosis has been made, arranging for a tutor to take over some of the workload helps. Parents may not have the time or the patience. It requires frequent and several repetitions. The study material often has to be broken into smaller components, which have to be repeated over and over.

Speech therapy may help with comprehension. Clumsiness can be tackled with occupational therapy.

Resources in India are limited. Specialised personnel are available only in a few cities. The schools too are rigid and have portions that have to be completed. They cannot cope with "slow learners". A differently-abled child may not be able to survive the stifling incomprehensible atmosphere.

If a child is unable to cope, open schooling is an option. Much of the studying can be done at home at the child's own pace. They need to attach themselves to schools accredited by the National Institute of Open Schooling (www.nios.org). Different subjects like painting or cooking can be taken in place of mathematics or geography.

Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her atyourh