articles

Learning Disabilities

NATIONAL INSTITUTES OF HEALTH
National Institute of Mental Health
Decade of the Brain
NIH Publication No. 93-3611

cont.

• Sustaining Hope
  
  • Can learning disabilities be outgrown or cured?
  • What aid does the Government offer?
  • What hope does research offer?
  • What are sources of information and support?

Sustaining Hope

Susan

Susan is now in ninth grade and enjoys learning. She no longer believes she's retarded, and her use of words has improved. Susan has become a talented craftsperson and loves making clothes and furniture for her sister's dolls. Although she's still in a special education program, she is making slow but steady progress in reading and math.

Wallace

Over the years, Wallace found he liked tinkering with cars and singing in the church choir. At church, he met a woman who knew about learning disabilities. She told him he could get help through his county social services office. Since then, Wallace has been working with a speech therapist, learning to articulate and notice differences in speech sounds. When he complains that he's too old to learn, his therapist reminds him, "It's never too late to work your good brain!" His state vocational rehabilitation office recently referred him to a job-training program. Today, at age 46, Wallace is starting night school to become an auto mechanic. He likes it because it's a hands-on program where he can learn by doing.

Dennis

Dennis is now age 23. As he walks into the college job placement office, he smiles and shakes hands confidently. After shuffling through a messy stack of papers, he finally hands his counselor a neatly typed resume. Although Dennis jiggles his foot and interrupts occasionally, he's clearly enthusiastic. He explains that because tape-recorded books and lectures got him through college, he'd like to sell electronics. Dennis says he'll also be getting married next year. He and his fiancée are concerned that their children also will have LD. "But we'll just have to watch and get help early-a lot earlier than I did!"

Can learning disabilities be outgrown or cured?

Even though most people don't outgrow their brain dysfunction, people do learn to adapt and live fulfilling lives. Dennis, Susan, and Wallace made a life for themselves--not by being cured, but by developing their personal strengths. Like Dennis' tape-recorded books and lectures, or Wallace's hands-on auto mechanics class, they found alternative ways to learn. And like Susan's crafts or Wallace's singing, they found ways to enjoy their other talents.

Even though a learning disability doesn't disappear, given the right types of educational experiences, people have a remarkable ability to learn. The brain's flexibility to learn new skills is probably greatest in young children and may diminish somewhat after puberty. This is why early intervention is so important. Nevertheless, we retain the ability to learn throughout our lives.

In many cases, an adult with dyslexia can learn to read.

Even though learning disabilities can't be cured, there is still cause for hope. Because certain learning problems reflect delayed development, many children do eventually catch up. Of the speech and language disorders, children who have an articulation or an expressive language disorder are the least likely to have long-term problems. Despite initial delays, most children do learn to speak.

For people with dyslexia, the outlook is mixed. But an appropriate remedial reading program can help learners make great strides.

With age, and appropriate help from parents and clinicians, children with ADHD become better able to suppress their hyperactivity and to channel it into more socially acceptable behaviors. As with Dennis, the problem may take less disruptive forms, such as fidgeting.

Can an adult be helped? For example, can an adult with dyslexia still learn to read? In many cases, the answer is yes. It may not come as easily as for a child. It may take more time and more repetition, and it may even take more diverse teaching methods. But we know more about reading and about adult learning than ever before. We know that adults have a wealth of life experience to build on as they learn. And because adults choose to learn, they do so with a determination that most children don't have. A variety of literacy and adult education programs sponsored by libraries, public schools, and community colleges are available to help adults develop skills in reading, writing, and math. Some of these programs, as well as private and nonprofit tutoring and learning centers, provide appropriate programs for adults with LD.

What aid does the Government offer?

As of 1981, people with learning disabilities came under the protection of laws originally designed to protect the rights of people with mobility handicaps. More recent Federal laws specifically guarantee equal opportunity and raise the level of services to people with disabilities. Once a learning disability is identified, children are guaranteed a free public education specifically designed around their individual needs. Adolescents with disabilities can receive practical assistance and extra training to help make the transition to jobs and independent living. Adults have access to job training and technology that open new doors of opportunity.

Increased services, equal opportunity

The Individuals with Disabilities Education Act of 1990 assures a public education to school-aged children with diagnosed learning disabilities. Under this act, public schools are required to design and implement an Individualized Educational Program tailored to each child's specific needs. The 1991 Individuals with Disabilities Education Act extended services to developmentally delayed children down to age 5. This law makes it possible for young children to receive help even before they begin school.

Another law, the Americans with Disabilities Act of 1990, guarantees equal employment opportunity for people with learning disabilities and protects disabled workers against job discrimination. Employers may not consider the learning disability when selecting among job applicants. Employers must also make "reasonable accommodations" to help workers who have handicaps do their job. Such accommodations may include shifting job responsibilities, modifying equipment, or adjusting work schedules.

By law, publicly funded colleges and universities must also remove barriers that keep out disabled students. As a result, many colleges now recruit and work with students with learning disabilities to make it possible for them to attend. Depending on the student's areas of difficulty, this help may include providing recorded books and lectures, providing an isolated area to take tests, or allowing a student to tape record rather than write reports. Students with learning disabilities can arrange to take college entrance exams orally or in isolated rooms free from distraction. Many colleges are creating special programs to specifically accommodate theses students.

Programs like these made it possible for Dennis to attend and succeed in college. The HEATH Resource Center, sponsored by the American Council on Education, assists students with learning disabilities to identify appropriate colleges and universities. Information on the HEATH center and related organizations appears at the end of this brochure.

Public agency support

Effective service agencies are also in place to assist people of all ages. Each state department of education can help parents identify the requirements and the process for getting special education services for their child. Other agencies serve disabled infants and preschool children. Still others offer mental health and counseling services. The National Information Center for Children and Youth can provide referrals to appropriate local resources and state agencies.

Counselors at each state department of vocational rehabilitation serve the employment needs of adolescents and adults with learning disabilities. They can refer adults to free or subsidized health care, counseling, and high school equivalence (GED) programs. They can assist in arranging for job training that sidesteps the disability. For example, a vocational counselor helped Wallace identify his aptitude for car repair. To work around Wallace's language problems, the counselor helped locate a job-training program that teaches through demonstrations and active practice rather than lectures.

State departments of vocational rehabilitation can also assist in finding special equipment that can make it possible for disabled individuals to receive training, retain a job, or live on their own. For example, because Dennis couldn't read the electronics manuals in his new job, a vocational rehabilitation counselor helped him locate and purchase a special computer that reads books aloud.

Finally, state-run protection and advocacy agencies and client assistance programs serve to protect these fights. As experts on the laws, they offer legal assistance, as well as information about local health, housing, and social services.

What hope does research offer?

Sophisticated brain imaging technology is now making it possible to directly observe the brain at work and to detect subtle malfunctions that could never be seen before. Other techniques allow scientists to study the points of contact among brain cells and the ways signals are transmitted from cell to cell.

With this array of technology, NIMH is conducting research to identify which parts of the brain are used during certain activities, such as reading. For example, researchers are comparing the brain processes of people with and without dyslexia as they read. Research of this kind may eventually associate portions of the brain with different reading problems.

Clinical research also continues to amass data on the causes of learning disorders. NIMH grantees at Yale are examining the brain structures of children with different combinations of learning disabilities. Such research will help identify differences in the nervous system of children with these related disorders. Eventually, scientists will know, for example, whether children who have both dyslexia and an attention disorder will benefit from the same treatment as dyslexic children without an attention disorder.

Studies of identical and fraternal twins are also being conducted. Identical twins have the same genetic makeup, while fraternal twins do not. By studying if learning disabilities are more likely to be shared by identical twins than fraternal twins, researchers hope to determine whether these disorders are influenced more by genetic or by environmental factors. One such study is being conducted by scientists funded by the National Institute of Child Health and Human Development. So far, the research indicates that genes may, in fact, influence the ability to sound out words.

By studying if learning disabilities are more likely to be shared by identical twins than fraternal twins, researchers hope to determine whether these disorders are influenced more by genetic or by environmental factors.

Animal studies also are adding to our knowledge of learning disabilities in humans. Animal subjects make it possible to study some of the possible causes of LD in ways that can't be studied in humans. One NIMH grantee is researching the effects of barbiturates and other drugs that are sometimes prescribed during pregnancy. Another researcher discovered through animal studies that certain prenatal viruses can affect future learning. Research of this kind may someday pinpoint prenatal problems that can trigger specific disabilities and tell us how they can be prevented.

Animal research also allows the safety and effectiveness of experimental new drugs to be tested long before they can be tried on humans. One NIH-sponsored team is studying dogs to learn how new stimulant drugs that are similar to Ritalin act on the brain. Another is using mice to test a chemical that may counter memory loss.

This accumulation of data sets the stage for applied research. In the coming years, NIMH-sponsored research will focus on identifying the conditions that are required for learning and the best combination of instructional approaches for each child.

Piece by piece, using a myriad of research techniques and technologies, scientists are beginning to solve the puzzle. As research deepens our understanding, we approach a future where we can prevent certain brain and mental disorders, make valid diagnoses, and treat each effectively. This is the hope, mission, and vision of the National Institute of Mental Health.

What are sources of information and support?

Several publications, organizations, and support groups exist to help individuals, teachers, and families to understand and cope with learning disabilities. The following resources provide a good starting point for gaining insight, practical solutions, and support. Further information can be found at libraries and book stores.

Publications

Books for children and teens with learning disabilities

Fisher, G., and Cummings, R., The Survival Guide for Kids with LD. Minneapolis: Free Spirit Publishing, 1990. (Also available on cassette)

Gehret, J. Learning Disabilities and the Don't-Give-Up-Kid. Fairport, NY: Verbal Images Press, 1990.

Janover, C. Josh: A Boy with Dyslexia. Burlington, VT: Waterfront Books, 1988.

Landau, E. Dyslexia. New York: Franklin Watts Publishing Co., 1991.

Marek, M. Different, Not Dumb. New York: Franklin Watts Publishing Co., 1985.

Levine, M. Keeping A Head in School: A Student's Book about Learning Abilities and Learning Disorders. Cambridge, MA: Educators Publishing Services, Inc., 1990.

Books for adults with learning disabilities

Adelman, P., and Wren, C. Learning Disabilities, Graduate School, and Careers: The Student's Perspective. Lake Forest, IL: Learning Opportunities Program, Barat College, 1990.

Cordoni, B. Living with a Learning Disability. Carbondale, IL: Southern Illinois University Press, 1987.

Kravets, M., and Wax, I. The K and W Guide: Colleges and the Learning Disabled Student. New York: Harper Collins Publishers, 1992.

Magnum, C., and Strichard, S., eds. Colleges with Programs for Students with Learning Disabilities. Princeton, NJ: Petersons Guides, 1992.

Books for parents

Greene, L. Learning Disabilities and Your Child: A Survival Handbook. New York: Fawcett Columbine, 1987.

Novick, B., and Arnold, M. Why Is My Child Having Trouble in School? New York: Villard Books, 1991.

Silver, L. The Misunderstood Child: A Guide for Parents of Children with Learning Disabilities: 2d ed. Blue Ridge Summit, PA: Tab Books, 1992.

Silver, L. Dr. Silver's Advice to Parents on Attention-Deficit Hyperactivity Disorder. Washington, DC: American Psychiatric Press, 1993.

Vail, P. Smart Kids with School Problems. New York: EP Dutton, 1987.

Weiss, E. Mothers Talk About Learning Disabilities. New York: Prentice Hall Press, 1989.

"The Scoutmaster's Guide to ADD" Positive People Press, 4741 Keet Seel Trail, Tucson, AZ. 85749 (520) 7549-5465

Books and pamphlets for teachers and specialists

Adelman, P., and Wren, C. Learning Disabilities, Graduate School, and Careers. Lake Forest, Learning Opportunities Program, Barat College, 1990.

Silver, L. ADHD: Attention Deficit-Hyperactivity Disorder, Booklet for Teachers. Summit, NJ: CIBA-GEIGY, 1989.

Smith, S. Success Against the Odds: Strategies and Insights from the Learning Disabled. Los Angeles: Jeremy Tarcher, Inc., 1991.

Wender, P. The Hyperactive Child, Adolescent, and Adult. Attention Disorder through the Lifespan. New York: Oxford University Press, 1987.

Related pamphlets available from NIH

Facts About Dyslexia National Institute of Child Health and Human Development Building 31, Room 2A32 9000 Rockville Pike Bethesda, MD 20892

(301) 496-5133

Developmental Speech and Language Disorders Hope through Research

National Institute on Deafness and Other Communicative Disorders
P.O. Box 37777
Washington, DC 20013
(800) 241-1044

Support Groups and Organizations

Listing of National and International Support and Self-Help Groups

ADDA
The National Attention Deficit Disorder Association
P.O. Box 972 Mentor, OH 44061.
Office Line: 216-350-9595
Tollfree Voice Mail:1-800-487-2282
To Fax to ADDA: 216-350-0223
Faxback number: 313-769-6729

American Speech-Language-Hearing Association
10801 Rockville Pike
Rockville, MD 20852
(800) 638-8255
Provides information on speech and language disorders, as well as referrals to certified speech-language therapists.

Attention Deficit Information Network
475 Hillside Avenue
Needham, MA 02194
(617) 455-9895
Provides up-to-date information on current research, regional meetings. Offers aid in finding solutions to practical problems faced by adults and children with an attention disorder.

Candlelighters Childhood Cancer Foundation
7910 Woodmont Avenue, Suite 460
Bethesda, MD 20814
(800) 366-2223
Provides information and support for children treated for cancer who later experience learning disabilities.

Center for Mental Health Services
Office of Consumer, Family, and Public Information
5600 Fishers Lane, Room 15-81
Rockville, MD 20857
(301) 443-2792
This new national center, a component of the U.S. Public Health Service, provides a range of information on mental health, treatment, and support services.

Children with Attention Deficit Disorders (CHADD)
499 NW 70th Avenue, Suite 308
Plantation, FL 33317
(305) 587-3700
Runs support groups and publishes two newsletters concerning attention disorders for parents and professionals.

Council for Exceptional Children
11920 Association Drive
Reston, VA 22091
(703) 620-3660
Provides publications for educators. Can also provide referral to ERIC Clearinghouse for Handicapped and Gifted Children.

Federation of Families for Children's Mental Health
1021 Prince Street
Alexandria, VA 22314
(703) 684-7710
Provides information, support, and referrals through federation chapters throughout the country. This national parent-run organization focuses on the needs of children with broad mental health problems.

HEATH Resource Center
American Council on Education
1 Dupont Circle, Suite 800
Washington, DC 20036
(800) 544-3284
A national clearinghouse on post-high school education for people with disabilities.

Learning Disabilities Association of America
4156 Library Road
Pittsburgh, PA 15234
(412) 341-8077
Provides information and referral to state chapters, parent resources, and local support groups. Publishes news briefs and a professional journal.

Library of Congress
National Library Service for the Blind
and Physically Handicapped
1291 Taylor Street, NW
Washington, DC 20542
(202) 707-5100
Publishes Talking Books and Reading Disabilities, a factsheet outlining eligibility requirements for borrowing talking books.

National Alliance for the Mentally Ill
Children and Adolescents Network (NAMICAN)
2101 Wilson Boulevard, Suite 302
Arlington, VA 22201
(800) 950-NAMI
Provides support to families through personal contact and support meetings. Provides education regarding coping strategies; reading material; and information about what works--and what doesn't.

National Association of Private Schools for
Exceptional Children
1522 K Street, NW
Suite 1032
Washington, DC 20005
(202) 408-3338
Provides referrals to private special education programs.

National Center for Learning Disabilities
381 Park Avenue South, Suite 1420
New York, NY 10016
(212) 687-7211
Provides referrals and resources. Publishes "Their World" magazine describing true stories on ways children and adults cope with LD.

National Information Center for Children and
Youth with Disabilities
P.O. Box 1492
Washington, DC 20013
(800) 999-5599
Publishes newsletter, arranges workshops. Advises parents on the laws entitling children with disabilities to special education and other services.

Orton Dyslexia Society
Chester Building, Suite 382
8600 LaSalle Road
Baltimore, MD 21286-2044
(410) 296-0232
Answers individual questions on reading disability. Provides information and referrals to local resources.

To arrange for special college entrance testing for LD adults, contact:

ACT Special Testing (319) 337-1332

SAT Scholastic Aptitude Test (609) 771-7137

GED (202) 939-9490

Credits

All material in this publication is free of copyright restrictions and may be copied, reproduced, or duplicated without permission from NIMH; citation of the source is appreciated.

This booklet was written by Sharyn Neuwirth, M.Ed., an education writer and instructional designer in Silver Spring, MD.

Scientific information and review was provided by NIMH staff members L. Eugene Arnold, M.D.; F. Xavier Castellanos, M.D.; and Judith Rumsey, Ph.D. Also providing review and assistance were Marcia Henry, Ph.D., Orton Dyslexia Society; Reid Lyon, Ph.D., National Institute of Child Health and Human Development; Jean Petersen, Learning Disabilities Association; and Larry B. Silver, M.D., Georgetown University. Editorial direction was provided by Lynn J. Cave, NIMH.

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