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Learning and Disabilities

Afr. Am. girl writing with teacher 
Children born prematurely are more at risk for having a learning disability (LD). Parents and other caregivers including paediatricians and other professions should keep an eye out for possible problems, especially in children who were born extremely premature, who are more at risk than children born mildly or moderately premature.

It should be remembered that a child’s corrected age, should always be taken into account early in life when assessing development, to differentiate between developmental lags due to maturation and true disabilities. Once your child has entered school, however, your child’s academic skills need to be judged by the standards expected for your child’s grade. If test results continue to be corrected for your child’s degree of prematurity, your child may appear to have skills that are age-appropriate, but these skills may not be adequately developed for the child’s grade. If you have your child assessed for a specific learning disability, make sure that the psychologist doing the assessment is knowledgeable about the issues facing children born prematurely.

The earlier that a child is evaluated, the sooner intervention can begin. Early intervention gives a child the best chance at minimizing the effect of a learning disability. Getting help early also means there is a smaller gap between a child and her peers, which makes it easier to catch up, and minimizes problems with self-esteem and anxiety over failure. Learning disabilities do not go away on their own. They can be treated, and leaving them untreated only exposes a child to failure and self-esteem problems.

An early diagnosis and intervention reduces the length of time that a child spends wondering why she is failing at something others do easily.

Common learning disabilities in children born prematurely

Although there are many different types of learning disabilities, children born prematurely seem to be susceptible to some more than others. Children born prematurely are often late to talk, and a significant number have trouble understanding what they hear. For some children, these language difficulties persist to school-age and affect their ability to learn to read, spell, and write stories. Many children born prematurely have problems with visual and motor processing, which hamper their ability to learn to print and write legibly and automatically. Children born prematurely also often have working memory and attention problems.   Difficulties in math are frequently observed by the middle elementary grades.  

Assessing development

Learning disabilities may not become apparent until the child begins school. Children who were born extremely premature, who were born very small, or those who suffered a brain injury following birth, are more at risk of developing a learning disability that those born only mildly premature.

Initially, it may be a parent that suspects that the child may have a learning disability. Parents should have their premature child followed up by a paediatrician or family doctor, or members of a follow-up clinic to look for signs of a learning disability. In addition to identifying possible problems, these professionals can help parents learn what the signs of a possible problem might look like. Although early signs may be picked up when the child is in preschool, the actual diagnosis of a specific learning disability cannot be made until there is evidence that the child is not learning academic material at the typical age and in the typical manner.

Following the initial indication of a possible problem, evaluations by specialists will need to be done to try to pinpoint where the problem might lie. It should be noted that these assessments are not always automatic: parents may have to insist that that an assessment take place.

There are several types of assessment that may take place. These may include a psychoeducational assessment, focusing on learning skills, interviews with the child, parents, and teachers as well as psychological tests and brain imaging. These results help guide interventions and provide a starting point for measuring progress.

Neurodevelopmental assessments measure the basic brain processes that affect learning: attention, learning and memory, language, visual and spatial processing, higher-order thinking, social thinking, and neuromotor skills as well as academic abilities. Using a range of brain imaging techniques or the results from previous brain imaging, these assessments attempt to identify underlying causes for a learning disability or predict the likelihood of a disability occurring. Because of the technology, these tests will be conducted at the hospital or at a clinic. Although this is a relatively new area of study, there is evidence that these assessments can be very accurate and can provide an earlier warning that there could be trouble ahead. Knowing that there is a specific problem is the first step towards some adjustment in teaching that can help the child work around the difficulty.

It should be noted that head ultrasound scans can only be carried out during a limited time frame: once the baby’s fontanelle has closed, head scans are no longer an assessment option.  

What happens after the assessment?

If the assessments have been done through a school, a plan will be made with parents, teachers, and school administrators to follow-up on the recommendations that have been made in the psychoeducational report.

If the assessments give a diagnosis and make recommendations for special education support, in many school boards, arrangements will be made by the school principal for the child’s case to be brought before a special committee who will decide if the child should be identified as having special needs and what special placement or services can be offered to the child. 

Depending upon the school board, this committee may be an in-school committee consisting of the principal, school psychology staff, special education teacher and classroom teacher. If a child is likely to require a special class placement, the committee may consists of, at minimum, a school board superintendent or senior administrator, the school principal or vice-principal, and a special education teacher or an administrator of special education services, as well as a school psychologist and other support personnel as necessary.   Parents are invited to attend these committee meetings for discussion of their child. Depending on the jurisdiction, the student herself may also be invited to attend if she is over 16 years of age.

The exact details of how this process occurs will vary from jurisdiction to jurisdiction.