Learning Disabilities, Dyslexia, and Vision | From the American Academy of Pediatrics. Abstract. Learning disabilities constitute a diverse group of disorders in which children who generally possess at least average intelligence have problems processing information or generating output. Their etiologies are multifactorial and reflect genetic influences and dysfunction of brain systems.
Reading disability, or dyslexia, is the most common learning disability. It is a receptive language- based learning disability that is characterized by difficulties with decoding, fluent word recognition, rapid automatic naming, and/or reading- comprehension skills. These difficulties typically result from a deficit in the phonologic component of language that makes it difficult to use the alphabetic code to decode the written word. Early recognition and referral to qualified professionals for evidence- based evaluations and treatments are necessary to achieve the best possible outcome.
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Because dyslexia is a language- based disorder, treatment should be directed at this etiology. Remedial programs should include specific instruction in decoding, fluency training, vocabulary, and comprehension. Most programs include daily intensive individualized instruction that explicitly teaches phonemic awareness and the application of phonics. Vision problems can interfere with the process of reading, but children with dyslexia or related learning disabilities have the same visual function and ocular health as children without such conditions. Currently, there is inadequate scientific evidence to support the view that subtle eye or visual problems cause or increase the severity of learning disabilities.
From the age of approximately 6 months to 2 years, visual reinforcement audiometry is used to estimate auditory thresholds based on responses that have been shown to. INTRODUCTION. Reading is the complex process of extracting meaning from abstract written symbols. In modern societies, reading is the most important way to access.
Because they are difficult for the public to understand and for educators to treat, learning disabilities have spawned a wide variety of scientifically unsupported vision- based diagnostic and treatment procedures. Scientific evidence does not support the claims that visual training, muscle exercises, ocular pursuit- and- tracking exercises, behavioral/perceptual vision therapy, “training” glasses, prisms, and colored lenses and filters are effective direct or indirect treatments for learning disabilities. There is no valid evidence that children who participate in vision therapy are more responsive to educational instruction than children who do not participate. INTRODUCTIONReading is the complex process of extracting meaning from abstract written symbols. In modern societies, reading is the most important way to access information, and in today's Western society, literacy is a prerequisite for success. In elementary school, a large amount of time and effort is devoted to the complicated process of learning to read. Because of the difficulties encountered in teaching some children to read, Congress mandated that the Eunice Kennedy Shriver National Institute of Child Health and Human Development assemble a national panel of educators and scientists to research the optimal methods of teaching children to read.
The 2. 00. 0 report of the National Reading Panel, titled Teaching Children to Read: An Evidence- Based Assessment of the Scientific Research Literature on Reading and Its Implications for Reading Instruction,1 linked research findings with recommendations for specific approaches to teaching reading to all children. The panel concluded that existing evidence supported early explicit instruction in phonemic awareness, phonics- based reading programs, and guided oral reading to improve fluency. Learning disabilities may interfere with children reaching their full potential. The inability to read and comprehend is a major obstacle to learning that may have long- term educational, social, and economic implications. Teaching children with reading difficulties is a challenge for the student, parents, and educators. Therefore, the causes and treatment of reading disorders have been the subject of considerable thought and study. This report discusses how we learn to read, the phonologic model, the recognition and treatment of reading difficulties, visual function and reading, the magnocellular deficit theory, colored lenses and overlays, vision therapy, and the roles of the pediatrician and ophthalmologist.
BACKGROUNDHistory. In 1. 87. 7, Kussmal. Hinshelwood,2,4 an ophthalmologist from Scotland, studied and described an adult with word blindness in 1.
In 1. 90. 3, an autopsy of this patient revealed abnormalities in the left angular gyrus immediately posterior to Wernicke's area. Morgan,2,5 a general practitioner from England, published the first case of a child with congenital word blindness in 1. Subsequently, Hinshelwood turned his attention to both congenital and acquired word blindness.
He credited the term “dyslexia” to Berlin. In 1. 91. 7, he highlighted the potentially inherited aspect of reading disability. Hinshelwood estimated that 1 in 1. He strongly advocated intensive, individualized personal instruction. Beginning in the 1. Orton,2,7,8 a neuropsychiatrist, demonstrated a hereditary component for reading disabilities in children. His studies led to an expanded definition of reading disabilities that was much broader than Hinshelwood's and included a graded series of all degrees of severity of disability.
This more liberal definition increased the presumed prevalence to more than 1. IQ testing revealed that these children scored near or above average. In 1. 92. 5, Orton attributed dyslexia to a problem in the visual system, which suggests that an apparent dysfunction from “mixed cerebral dominance” caused problems in visual perception and visual memory, characterized by perception of letters and words in reverse. The theory that visual dysfunction caused dyslexia led to a proliferation of training programs developed for visual- perceptual and/or visual- motor disabilities.
In the 1. 96. 0s, those prominent in developing and promoting these programs included Kephart, Frostig, Getman, Barsch, Dorman, and Delacato. Research into the programs revealed that, although these programs were sometimes effective in improving perceptual and/or perceptual- motor development, they were ineffective in improving academic performance. Although the use of perceptual and perceptual- motor training by educators persisted for a time, by the mid- 1. Attempts at improved understanding of dyslexia led to the rejection of the visual theories.
This process began with a series of related studies that systematically evaluated traditional and widely accepted etiologic conceptualizations, such as Orton's optical reversibility theory,7 Hermann's spatial confusion theory,1. Although Orton attributed dyslexia to visual dysfunction, he was the first to advocate intensive phonics instruction, sound- blending, and multisensory training. Orton's work served as the stimulus for Gillingham and Stillman,1. Subsequently, the Orton- Gillingham phonics techniques have served as the basis for many remediation programs. The International Dyslexia Society, formerly the Orton Dyslexia Society, provides information and resources to professionals and parents regarding reading disabilities.
Learning Disabilities. Learning disabilities constitute a diverse group of disorders in which children who generally possess at least average intelligence have problems processing information or generating output. Learning disabilities can affect neurocognitive processes and may manifest as an imperfect ability to listen, speak, read, spell, write, reason, concentrate, solve mathematical problems, or organize information. Some children may have associated difficulties with motor coordination.
Learning difficulties can be associated with and complicated by attention- deficit/hyperactivity disorder (ADHD),1. Problems in self- regulatory behaviors, social perception, and social interaction may exist with learning disabilities but do not, by themselves, constitute a learning disability. Although learning disabilities may occur concomitantly with other disabilities (eg, sensory impairment, intellectual disability, serious emotional disturbance) or with extrinsic influences (eg, cultural differences, insufficient or inappropriate instruction), they are not the result of those conditions or influences.
Results of recent studies suggest that approximately 2. In 2. 00. 7, 2. 7 million public school students (5. Individuals With Disabilities Education Act (IDEA). Specific learning disabilities include dyslexia (reading disability), dysgraphia (writing disability), and dyscalculia (mathematics disability). Although not included in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Autism spectrum disorder, although not a specific learning disability, certainly affects learning, because people with autism have difficulties with verbal and nonverbal communication, social interactions, and motor function and may show inappropriate response to sensory information. Dyslexia. Difficulties in reading are found in a diverse group of conditions that include dyslexia and secondary forms of reading difficulties caused by visual or hearing disorders, intellectual disability, experiential and/or instructional deficits, and other problems.
Dyslexia is defined as a primary reading disorder that is separate from secondary forms. The terms “specific reading disability,” “reading disability,” “reading disorder,” and “dyslexia” are often used interchangeably in the literature. The term “dyslexia” is derived from Greek and means “difficulty with reading words.” Dyslexia is often unexpected in relation to the child's other cognitive abilities.
It is a receptive language- based learning disability that is characterized by difficulties with decoding, fluent word recognition, and/or reading- comprehension skills. These difficulties typically result from a deficit in the phonologic component of language that makes it difficult to use the alphabetic code to decode the written word.
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