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LEARNING DISABILITY : A CASE STUDY

The present investigation was carried out on a girl name Harshita who has been identified with learning disability. She is presently studying at ‘Udaan’ a school for the special children in Shimla. The girl was brought to this special school from the normal school where she was studying earlier when the teachers and parents found it difficult to teach the child with other normal children. The learning disability the child faces is in executive functioning i.e. she forgets what she has memorized. When I met her I was taken away by her sweet and innocent ways. She is attentive and responsible but the only problem is that she forgets within minutes of having learnt something. Key words : learning disability, executive functioning, remedial teaching

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This article explains how learning disability affect on one's ability to know or use spoken affects on one's ability to know or use spoken or communication, do mathematical calculations, coordinate movements or direct attention learning disabilities are ignored, unnoticed and unanswered such children's needs are not met in regular classes. They needed special attention in classrooms. Learning disability is a big challenge for student in learning environment. The teacher's role is very important for identifying the learning disability. Some common causes and symptoms are there for children with learning disability. The classroom and teacher leads to main important role in identification and to overcome their disabilities.

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Case studies on disability and inclusion.

To document UNICEF’s work on disability and inclusion in Europe and Central Asia region, UNICEF Regional Office for Europe and Central Asia has developed a set of five case studies.

UNICEF takes a comprehensive approach to inclusion, working to ensure that all children have access to vital services and opportunities. When UNICEF speaks about “inclusion” this encompasses children with and without disabilities, marginalized and vulnerable children, and children from minority and hard-to-reach groups.

The case studies have a specific focus on children with disabilities and their families. However, many of the highlighted initiatives are designed for broad inclusion and benefit all children. In particular, this case study, covers such topics as: Inclusive Preschool, Assistive Technologies (AT), Early Childhood intervention (ECI), Deinstitutionalisation (DI).

Case studies

Case study 1: “Open source AAC in the ECA Region”

Files available for download (1).

Case study 2: “Inclusive Preschool in Bulgaria”

Case study 3: “Assistive technology in Armenia"

Case study 4: “Early childhood intervention in the ECA region”

Case study 5: “Deinstitutionalization in the ECA region”

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Home > Books > Learning Disabilities - Neurological Bases, Clinical Features and Strategies of Intervention

The Child with Learning Difficulties and His Writing: A Study of Case

Submitted: 30 May 2019 Reviewed: 16 August 2019 Published: 20 November 2019

DOI: 10.5772/intechopen.89194

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The purpose of this paper is to present one child with learning difficulties writing process in multigrade rural elementary school in México. It presents Alejandro’s case. This boy lives in a rural area. He shows special educational needs about learning. He never had specialized attention because he lives in a marginalized rural area. He was integrated into regular school, but he faced some learning difficulties. He was always considered as a student who did not learn. He has coursed 2 years of preschool and 1 year of elementary school. Therefore, this text describes how child writes a list of words with and without image as support. Analysis consists to identify the child’s conceptualizations about writing, his ways of approaching, and difficulties or mistakes he makes. The results show that Alejandro identifies letters and number by using pseudo-letters and conventional letter. These letters are in an unconventional position. There is no relationship grapheme and phoneme yet, and he uses different writing rules. We consider his mistakes as indicators of the learning process.

• writing difficulties
• learning difficulties
• writing learning
• writing process
• special education

Author Information

Edgardo domitilo gerardo morales *.

• Faculty of Philosophy and Letters, National Autonomous University of Mexico, México City, México

*Address all correspondence to: [email protected]

1. Introduction

One of the purposes of Mexican education system is that students acquire conventional writing during first grades in elementary school [ 1 ]. This purpose consists of students to understand the alphabetical code, its meaning, and functionality. In this way, they can integrate into a discursive community.

The elementary school teacher teaches a heterogeneous group of children [ 1 ,  2 ]. Some students show different acquisition levels of the writing. This is due to literacy environment that the family and society provide. Thus, some children have had great opportunities to interact with reading and writing practices than others. Therefore, some students do not learn the alphabetical principle of writing at the end of the scholar year. They show characteristics of initial or intermediate acquisition level of the writing. In this way, it is difficult for children to acquire writing at the same time, at the term indicated by educational system or teachers.

In addition, there may be children with learning difficulties in the classroom. Department of Special Education teaches some children. Students with special educational needs show more difficulties to learn than their classmates [ 3 ]. They require more resources to achieve the educational objectives. These authors point out that special educational needs are relative. These needs arise between students’ personal characteristics and their environment. Therefore, any child may have special educational needs, even if he/she does not have any physical disability. However, some students with learning difficulties do not have a complete assessment about their special educational needs. On the one hand, their school is far from urban areas; on the other hand, there are not enough teachers of special education for every school. In consequence, school teachers do not know their students’ educational needs and teach in the same way. Thereby, students with learning difficulties do not have the necessary support in the classroom.

Learning difficulties of writing may be identified easily. Children with special educational needs do not learn the alphabetical principle of writing easily; that is, they do not relate phoneme with grapheme. Therefore, children show their conceptualizations about writing in different ways. Sometimes, teachers censor their students’ written productions because they do not write in a conventional way. Children with special educational needs are stigmatized in the classroom. They are considered as less favored. At the end of the scholar year, children do not pass.

Therefore, the purpose of this paper is to present one child with special educational needs writing process in a Mexican multigrade rural school. This text describes how the child writes a list of words with and without image as support. Analysis consists to identify the child’s conceptualizations about writing [ 4 ], his ways of approaching, and difficulties or mistakes he makes. These mistakes are the indicators of learning process [ 5 ].

This paper presents Alejandro’s case. This boy lives in a rural area. He shows special educational needs about learning. He never had specialized attention because he lives in a marginalized rural area. He was integrated into regular school, but he faced some learning difficulties. He was always considered as a student who does not learn. Therefore, this text describes Alejandro’s writing, what he does after 2 years of preschool and 1 year of elementary school.

2. Children with learning difficulties and their diagnosis

According to the National Institute for the Evaluation of Education [ 6 ], Mexican education system provides basic education (preschool, elementary, and secondary school) for students with special educational needs. There are two types of special attention: Center of Multiple Attention (CAM, in Spanish) and Units of Service and Support to Regular Education (USAER, in Spanish). In the first one, children with special educational needs go to this Center. These children receive attention according to basic education and their educational needs. In the second, specialized teachers on special education go to school and provide support to students. These teachers provide information to school teachers too. In this way, there is educational equity and inclusion in Mexican school [ 7 ].

Physical appearance : Teacher describes the child’s physical characteristics. These features indicate the type of food the student eats, care his or her person, the parents’ attention, among other elements.

Behavior observed during the assessment : In this section, the teacher should record the conditions in which the assessment was carried out: child’s attitude, behavior, and interest.

Child’s development history : This section presents conditions in which pregnancy developed, physical development (ages in which child held his/her head, sat, crawled, walked, etc.), language development (verbal response to sounds and voices, age in which said his/her first words and phrases, etc.), family (characteristics of their family and social environment, frequent activities, etc.), hetero-family history (vision, hearing, etc.), medical history (health conditions, diseases, etc.), and scholar history (age at which he/she started school, type of school, difficulties, etc.).

Present condition : In this, there are four aspects:

It refers to student’s general aspects: intellectual area (information processing, attention, memory, understanding, etc.), motor development area (functional skills to move, take objects, position of his/her body, etc.), communicative-linguistic area (phonological, semantic, syntactic and pragmatic levels), adaptation and social interaction area (the child’s skills to initiate or maintain relationships with others), and emotional area (the way of perceiving the world and people). In each one, it mentions the instruments he suggests, although there is not enough information about them [ 3 ].

The second aspect is the curricular competence level. Teacher identifies what the student is capable of doing in relation to established purposes and contents by official curriculum.

The third aspect is about the learning style and motivation to learn. It presents physical-environmental conditions where the child works, their interests, level attention, strategies to solve a task, and the incentives he receives.

The fourth aspect is information about the student’s environment: factors of the school, family, and social context that influence the child’s learning.

Psycho-pedagogical assessment allows to identify children’s general educational needs. In this way, the school teacher could have information about the students’ difficulties. However, it is a general assessment. It contains several aspects and does not go deeper into one.

Therefore, this paper does not propose a new assessment. It consists of presenting one child’s writing difficulties, his ways of conceptualizing writing, and some mistakes he gets to make.

3. Students with learning difficulties and their scholar integration

Since 1993, Mexican system education has tried to offer special education services to students with special educational needs in basic education [ 8 ]. The first step was to promote the integration of these children in regular education classrooms. However, only insertion of the student in the school was achieved. Therefore, the system of education searched for mechanisms to provide advice to teacher. In this way, student with learning difficulties can be attended at the same time in the classroom [ 8 ].

Educational integration has been directly associated with attention of students with learning difficulties, with or without physical disabilities [ 8 ]. However, this process implies a change in the school. For this, it is necessary to provide information and to create awareness to the educational community, permanent updating of teachers, joint work between teacher, family, and specialized teachers.

At present, Mexican education system looks at educational integration as process in which every student with learning difficulties is supported individually [ 9 ]. Adapting the curriculum to the child is the purpose of educational integration.

Curricular adequacy is one of the actions to support students with learning difficulties [ 10 , 11 ]. This is an individualized curriculum proposal. Its purpose is to attend the students’ special educational needs [ 3 ]. At present, Mexican education system indicates that there should be a curricular flexibility to promote learning processes. However, it is important to consider what the child knows about particular knowledge.

Regarding the subject of the acquisition of written language, it is necessary to know how the children build their knowledge about written. It is not possible to make a curricular adequacy if teachers do not have enough information about their students. However, children are considered as knowledge builders. Therefore, there are learning difficulties at the process.

4. Alejandro’s case

This section presents Alejandro’s personal information. We met him when we visited to his school for other research purposes. We focused on him because the boy was silent in class. He was always in a corner of the work table and did not do the activities. For this, we talked with his teacher and his mother to know more about him.

Alejandro is a student of an elementary multigrade rural school. He was 7 years old at the time of the study. He was in the second grade of the elementary school. His school is located in the region of the “Great Mountains” of the state of Veracruz, Mexico. It is a rural area, marginalized. To get to this town from the municipal head, it is necessary to take a rural taxi for half an hour. Then, you have to walk on a dirt road for approximately 50 min.

Alejandro’s family is integrated by six people. He is the third of the four sons. He lives with his parents. His house is made of wood. His father works in the field: farming of corn, beans, and raising of sheep. His mother is a housewife and also works in the field. They have a low economic income. Therefore, they receive a scholarship. One of his older brothers also showed learning difficulties at school. His mother says both children have a learning problem. But, they do not have any money for attending their sons’ learning difficulties. In addition, there are no special institutes near their house.

The boy has always shown learning difficulties. He went to preschool for 2 years. However, he did not develop the necessary skills at this level. At classes, this child was silent, without speaking. Preschool teachers believed that he was mute. Nevertheless, at scholar recess, he talked with his classmates. Alejandro was slow to communicate with words in the classroom.

When he started elementary school, Alejandro continued to show learning difficulties. At classes, he was silent too. He just watched what his classmates did. He did not do anything in the class. He took his notebook out of his backpack and just made some lines. Occasionally, he talked with his classmates. When the teacher asked him something, Alejandro did not answer. He looked down and did not answer. He just ducked his head and stayed for several minutes.

When Alejandro was in second grade, he did different activities than his classmates. His teacher drew some drawings for him and he painted these drawings. Other occasions, the teacher wrote some letters for him to paint. The child did every exercise during several hours. He did not finish his exercises quickly. Sometimes he painted some drawings during 2 h.

Although Alejandro requires specialized attention, he has not received it. He has not had a full psycho-pedagogical assessment at school by specialized teachers. His school does not have these teachers. Also, the child was not submitted to neurological structural examination or neurophysiological studies to exclude an organic origin of his learning difficulties. His parents do not have enough financial resources to do this type of study for him. In addition, one specialized institution that can do this type of study for free is in Mexico City. It is so far from child’s house. It would be expensive for the child’s parents. Therefore, he is only attended as a regular school student.

For this reason, this paper is interested in the boy’s writing process. This is because Alejandro coursed 2 years of preschool and 1 year of elementary school; however, he does not show a conventional writing yet. In this way, it is interesting to analyze his conceptualizations about writing and difficulties he experiences.

5. Methodology

The purpose of this paper is to know the child’s ways to approach writing spontaneously and his knowledge about the writing system. For this, the author used a clinical interview. He took into account the research interview guide “Analysis of Disturbances in the Learning Process of Reading and Writing” [ 12 ].

The clinical interview was conducted individually. We explored four points, but we only present two in this text: to write words and to write for image.

Interviewer took the child to the library room at school. There were no other students. First, the interviewer gave the child a sheet and asked to write his name. Alejandro wrote his name during long time. Interviewer only asked what it says there. He answered his name: “Alejandro.” Next, the interviewer asked the child to write some letters and numbers he knew. Alejandro wrote them. The interviewer asked about every letter and number. The child answered “letter” or “number,” and its name.

To write words : The interviewer asked the child to write a group of words from the same semantic field in Spanish (because Alejandro is from Mexico) and one sentence. Order of words was from highest to lowest number of syllables. In this case, interviewer used semantic field of animals. Therefore, he used following words: GATO (cat), MARIPOSA (butterfly), CABALLO (horse), PERRO (dog), and PEZ (fish). The sentence was: EL GATO BEBE LECHE (The cat drinks milk). The interviewer questioned every written word. He asked the child to show with his finger how he says in every written production.

To write for image : This task was divided into two parts. The first analyzed the size and second analyzed the number.

Interviewer used the following image cards: horse-bird and giraffe-worm ( Figure 1 ). Every pair of cards represents a large animal and a small animal.

Cards with large and small animals.

The purpose of this first task was to explore how the child writes when he looks at two images of animals with different size. The animal names have three syllables in Spanish: CA-BA-LLO (horse), PA-JA-RO (bird), etc. In this way, we can see how the child writes.

The interviewer used the following pair of cards for second task ( Figure 2 ).

Cards for singular and plural.

First card shows one animal (singular) and the second shows some animals (plural). In this way, we search to explore how the child produces his writings when he observes one or more objects, if there are similarities or differences to write.

The interviewer asked what was in every card. Next, he asked the child to write something. Alejandro wrote something in every picture. Afterward, the interviewer asked the child to read every word that he wrote. Child pointed with his finger what he wrote.

After, the interview was transcribed for analysis. We read the transcription. The author analyzed every written production. He identified the child’s conceptualizations about writing. He compared the written production and what the child said. In this way, the analysis did not only consist to identify the level of writing development. This text describes the child’s writing, the ways in which he conceptualizes the writing, the difficulties he experienced to write, and his interpretations about writing.

6. Alejandro’s writing

This section describes Alejandro’s writing process. As we already mentioned, Alejandro is 7 years old and he studies in the second grade of the elementary school. His teacher says the child should have a conventional writing, because he has already coursed 1 year of elementary school, but it is not like that. Most of his classmates write a conventional way, but he does not.

We organized this section in three parts. The first part presents how Alejandro wrote his name and how he identifies letters and numbers; the second part refers to the writing of words; and the third part is writing for picture.

6.1 Alejandro writes his name and some letters and numbers

The first part of the task consisted of Alejandro writing his name and some letters and numbers he knows. His name was requested for two reasons. The first reason is to identify the sheet, because the interviewer interviewed other children in the same school. Also, it was necessary to identify every written productions of the group of students. The second reason was to observe the way he wrote his name and how he identified letters and numbers.

The interviewer asked the child to write his name at the top of the sheet. When the interviewer said the instructions, Alejandro was thoughtful during a long time. He was not pressed or interrupted. He did not do anything for several seconds. The child looked at the sheet and looked at everywhere. After time, he took the pencil and wrote the following on the sheet ( Figure 3 ).

Alejandro’s name.

The interviewer looked at Alejandro’s writing. He asked if something was lacking. The interviewer was sure that Alejandro knew his name and his writing was not complete. However, Alejandro was thoughtful, and looked at the sheet for a long time. The interviewer asked if his name was already complete. The child answered “no.” The interviewer asked the child if he remembered his name. Alejandro denied with his head. So, they continued with another task.

Alejandro has built the notion of his name. We believe that he has had some opportunities to write his name. Perhaps, his teacher has asked him to write his name on his notebooks, as part of scholar work in the classroom. We observed that Alejandro used letters with conventional sound value. This is because he wrote three initial letters of his name: ALJ (Alejandro). The first two letters correspond to the beginning of his name. Then, he omits “E” (ALE-), and writes “J” (ALJ). However, Alejandro mentions that he does not remember the others. This may show that he has memorized his name, but at that moment he failed to remember the others, or, these letters are what he remembers.

Subsequently, the interviewer asked Alejandro to write some letters and numbers he knew. The sequence was: a letter, a number, a letter, another letter, and number. In every Alejandro’ writing, the interviewer asked the child what he wrote. In this way, Alejandro wrote the following ( Figure 4 ).

Letters and numbers written by Alejandro.

For this task, Alejandro wrote for a long time. He did not hurry to write. He looked at sheet and wrote. The child looked at the interviewer, looked at the sheet again and after a few seconds he wrote. The interviewer asked about every letter or number.

We can observe that Alejandro differentiates between letter and number. He wrote correctly in every indication. That is, when the interviewer asked him to write a letter or number, he did so, respectively. In this way, Alejandro knows what he needs to write a word and what is not, what is for reading and what is not.

Also, we can observe that the child shows a limited repertoire of letters. He did not write consonants. He used only vowels: A (capital and lower) and E (lower). It shows us that he differentiates between capital and lower letter. Also, he identifies what vowels and letters are because the child answered which they were when the interviewer asked about them.

6.2 Writing words from the same semantic field

Asking the child to write words spontaneously is a way to know what he knows or has built about the writing system [ 12 ]. Although we know Alejandro presents learning difficulties and has not consolidated a conventional writing, it is necessary to ask him to write some words. This is for observing and analyzing what he is capable of writing, what knowledge he has built, as well as the difficulties he experiences.

The next picture presents what Alejandro wrote ( Figure 5 ). We wrote the conventional form in Spanish next to every word. We wrote these words in English in the parentheses too.

List of words written by Alejandro.

At the beginning of the interview, Alejandro did not want to do the task. He was silent for several seconds. He did not write anything. He looked at the sheet and the window. The interviewer insisted several times and suspended the recording to encourage the child to write. Alejandro mentioned he could not write, because he did not know the letters and so he would not do it. However, the interviewer insisted him. After several minutes, Alejandro took the pencil and started to write.

Alejandro wrote every word for 1 or 2 min. He required more seconds or minutes sometimes. He looked at the sheet and his around. He was in silence and looking at the sheet other times. We identified that he needs time to write. This shows that he feels insecure and does not know something for writing. He feels insecure because he was afraid of being wrong and that he was punished by the interviewer for it. It may be that in class he is penalized when he makes a mistake. There is ignorance because he does not know some letters, and he has a low repertoire of the writing system. Thus, Alejandro needs to think about writing and look for representing it. Therefore, this is why the child needs more time to write.

We identified that the child does not establish a phoneme-grapheme relationship. He only shows with his finger from left to right when he read every word. He does not establish a relationship with the letters he used. In each word, there is no correspondence with the number of letters. The child also does not establish a constant because there is variation in number and variety of letters sometimes.

Alejandro used letters unrelated to the conventional writing of the words. For example, when he wrote GATO (cat), Alejandro used the following letters: inpnAS. It is possible to identify that no letter corresponds to the word. Perhaps, Alejandro wrote those letters because they are recognized or remembered by him.

Alejandro shows a limited repertoire of conventional letters. This is observed when he uses four vowels: A, E, I, O. The child used these vowels less frequently. There is one vowel in every word at least. When Alejandro wrote PEZ (fish), he used two vowels. We observed that he writes these vowels at the beginning or end of the word. However, we do not know why he places them that way. Maybe this is a differentiating principle by him.

There is qualitative and quantitative differentiation in Alejandro’s writing. That is, he did not write any words in the same way. All the words written by him are different. Every word has different number and variety of letters. When two words contain the same number of letter, they contain different letters.

When Alejandro wrote MARIPOSA (butterfly), he used five letters. The number of letters is less than what he used for GATO (cat). Maybe he wrote that because the interviewer said “butterfly is a small animal.” This is because the cat is bigger than the butterfly. Therefore, it may be possible that he used lesser letters for butterfly.

In Spanish, PERRO (dog) contains five letters. Alejandro wrote five letters. In this case, Alejandro’s writing corresponds to the necessary number of letters. However, it seems that there is no writing rules for him. This is for two reasons: first, because there is no correspondence with the animal size. Horse is larger than dog and Alejandro required lesser letters for horse than for dog. Second, CABALLO (horse) is composed by three syllables and PERRO (dog) by two. Alejandro used more letters to represent two syllables. In addition, it is observed that there is a pseudo-letter. It looks like an inverted F, as well as D and B, horizontally.

When Alejandro wrote PEZ (fish), the interviewer first asked how many letters he needed to write that word. The child did not answer. Interviewer asked for this again and student said that he did not know. Then, interviewer said to write PEZ (fish). For several minutes, Alejandro just looked the sheet and did not say anything. The interviewer questioned several times, but he did not answer. After several minutes, Alejandro wrote: E. The interviewer asked the child if he has finished. He denied with his head. After 1 min, he started to write. We observed that his writing contains six letters. Capital letters are predominated.

Alejandro used inverted letters in three words. They may be considered as pseudo-letters. However, if we observe carefully they are similar to conventional letters. The child has written them in different positions: inverted.

May be there is a writing rule by Alejandro. His words have a minimum of four letters and a maximum of six letters. This rule has been established by him. There is no relation to the length of orality or the object it represents.

We can identify that Alejandro shows a primitive writing [ 4 ]. He is still in writing system learning process. The phoneticization process is not present yet. The child has not achieved this level yet. He only uses letters without a conventional sound value. There is no correspondence to phoneme-grapheme, and he uses pseudo-letters sometimes.

6.3 To write for image

Write for image allows us to know what happens when the child writes something in front of an image [ 12 ]. It is identified if there is the same rules used by the child, number of letters, or if there is any change when he writes a new word. It may happen that the length of the words is related to the size of the image or the number of objects presented. In this way, we can identify the child’s knowledge and difficulties when he writes some words.

6.3.1 The image size variable

The first task is about observing how the child writes when he is in front of two different sized images. That is, we want to identify if the image size influences on his writings. Therefore, two pairs of cards were presented to Alejandro. Every pair of cards contained two animals, one small and one large. The interviewer asked Alejandro to write the name on each one ( Figure 6 ).

Horse and bird writing.

Based on the writing produced by Alejandro, we mentioned the following:

Alejandro delimits his space to write. When he wrote for first pair of words, the child drew a wide rectangle and he made an oval and several squares for the second pair of words. The child wrote some letters to fill those drawn spaces. It seems that Alejandro’s rule is to fill the space and not only represent the word.

When Alejandro writes the words, we identified that he presents difficulty in the conventional directionality of writing. He wrote most of words from left to right (conventional directionality), but he wrote some words from right to left (no conventional). For example, the child started to write the second word on the left. He wrote seven letters. He looked at the sheet for some seconds. After, he continued to write other letters on the right. He wrote and completed the space he had left, from right to left.

Alejandro shows two ways to write: left–right (conventional) and right–left (no conventional). When he wrote the last word, the child wrote one letter under another. There was no limited space on the sheet. Alejandro wrote it there. The child has not learned the writing directionality.

When we compared Alejandro’s writings, we identified that the number of letters used by him does not correspond to the image size. Although the images were present and he looked them when he wrote, the child took into account other rules to write. The six names of animals had three syllables in Spanish and Alejandro used nine letters for CABALLO (horse) and eleven for PÁJARO (bird). The letters used by him are similar to the conventional ones. However, these are in different positions. There are no phonetic correspondences with the words. The child shows a primitive writing. Alejandro has not started the level of relation between phoneme and grapheme yet. We can believe that the boy wrote some letters to cover the space on the sheet. Alejandro takes into account the card size instead of the image size.

After writing a list of words, the interviewer asked Alejandro to read and point out every word he wrote. The purpose of this task is to observe how the child relates his writing to the sound length of the word. When Alejandro read CABALLO (horse), he pointed out as follows ( Figure 7 ).

Alejandro reads “caballo” (horse).

Alejandro reads every word and points out what he reads. In this way, he justifies what he has written. In the previous example, Alejandro reads the first syllable and points out the first letter, second syllable with the second letter. At this moment, he gets in conflict when he tries to read the third syllable. It would correspond to the third letter. However, “there are more letters than he needs.” When he reads the word, he shows the beginning of phoneticization: relation between one syllable with one letter. This is the syllabic writing principle [ 4 ]. Nevertheless, he has written more letters. Therefore, Alejandro says “o” in the other letters. In this way, we can point out that Alejandro justifies every letters and there is a correspondence between what he reads and what he writes.

When Alejandro reads the second word, the child pointed out as follows ( Figure 8 ).

Alejandro reads “pájaro” (bird).

Alejandro makes a different correspondence syllable-letter than the first word. Although his writing was in two ways, his reading is only one direction: from left to right. The first syllable is related to first three letters he wrote. The second syllable is related to the fourth letter. But, he faces the same problem as in the previous word: “there are many letters.” So he justifies the other letters as follows. He reads the third syllable in relation to the sixth and seventh letter. And, reads “o” for the other letters.

When interviewer showed the next pair of cards, Alejandro wrote as following ( Figure 9 ).

Giraffe and worm writing by Alejandro.

When the interviewer shows the pair of cards to Alejandro, the child said “It’s a zebra.” So, the interviewer said “It’s a giraffe and it’s a worm” and pointed out every card. The interviewer asked Alejandro to write the name of every animal. First, the child draws a rectangle across the width of the sheet. Next, he started to write on the left side inside the rectangle. He said the first syllable “JI” while writing the first letter. After, he said “ra,” he wrote a hyphen. Then, he said “e” and wrote another letter. At that moment, he looked at the sheet and filled the space he left with some letters ( Figure 10 ).

Giraffe writing.

Alejandro shows different rules of writing. These rules are not the same as previous. He delimited the space to write and filled the space with some letters. The child tries to relate the syllable with one letter, but he writes others. There is a limited repertoire of letters too. In this case, it seems that he used the same letters: C capital and lower letter, A capital and lower letter, and O. We believe that he uses hyphens to separate every letter. However, when he wrote the first hyphen, it reads the second syllable. We do not know why he reads there. Alejandro had tried to use conventional letters. He uses signs without sound value. In addition, there is no relation phoneme and grapheme.

When Alejandro wrote GUSANO (worm), he drew a rectangle and divided it into three small squares. Then, he drew other squares below the previous ones. After, he began to write some letters inside the squares, as seen in the following picture ( Figure 11 ).

Worm writing.

Alejandro used other rules to write. They are different than the previous. Alejandro has written one or two letters into every box. At the end, he writes some letters under the last box. There is no correspondence between what he reads and writes. There are also no fixed rules of writing for him. Rather, it is intuited that he draws the boxes to delimit his space to write.

6.3.2 Singular and plural writing

The next task consists to write singular and plural. For this, the interviewer showed Alejandro the following images ( Figure 12 ).

Cards with one cat and four cats.

Alejandro drew an oval for first card. This oval is on the left half of the sheet. He wrote the following ( Figure 13 ).

Alejandro writes GATO (cat).

Next, the interviewer asked Alejandro to write for the second card, in plural. For this, Alejandro draws another oval from the middle of the sheet, on the right side. The child did not do anything for 1 h 30 min. After this time, he wrote some different letters inside the oval ( Figure 14 ). He wrote from right to left (unconventional direction).

Alejandro writes GATOS (cats).

Alejandro wrote in the opposite conventional direction: from right to left. He tried to cover the delimited space by him. His letters are similar to the conventional ones. Also, there are differences between the first and the second word. He used lesser letters for first word than the second. That is, there are lesser letters for singular and more letters for plural. Perhaps, the child took into account the number of objects in the card.

The writing directionality may have been influenced by the image of the animals: cats look at the left side. Alejandro could have thought he was going to write from right to left, as well as images of the cards. Therefore, it is necessary to research how he writes when objects look at the right side. In this way, we can know if this influences the directionality of Alejandro’s writing.

With the next pair of images ( Figure 15 ), the interviewer asked Alejandro to write CONEJO (rabbit) and CONEJOS (rabbits).

Cards with one rabbit and three rabbits.

Alejandro draws a rectangle in the middle of the sheet for the first card (rabbit). He said “cone” (rab-) and wrote the first letter on the left of the sheet. Then, he said “jo” (bit) and wrote the second letter. He said “jo” again and wrote the third letter. He was thoughtful for some seconds. He started to write other letters. His writing is as follows ( Figure 16 ).

Alejandro writes CONEJO (rabbit).

At the beginning, Alejandro tries to relate the syllables of the word with first two letters. However, he justifies the other letters when he read the word. There is no exact correspondence between the syllable and the letter. As well as his writing is to fill the space he delimited.

Alejandro takes into account other rules for plural writing. He drew a rectangle across the width of the sheet. Starting on the left, he said “CO” and wrote one letter. Then, he said “NE” and drew a vertical line. After, he said “JO” and wrote other letters. His writing is as follows ( Figure 17 ).

Alejandro writes CONEJOS (rabbits).

Alejandro writes both words differently. He reads CONEJO (rabbit) for first word and CONEJOS (rabbits) for the second. Both words are different from each other. But, he wrote them with different rules. This is confusing for us because there are vertical lines between every two letters in the second word. We believe that the child tried to represent every object, although he did not explain it.

In summary, Alejandro shows different writings. He used pseudo-letters and conventional letter. These letters are in unconventional positions. There is no relationship between grapheme and phoneme yet; and, he uses different writing rules.

7. Conclusions

We described Alejandro’s writing process. According to this description, we can note the following:

Alejandro is a student of an elementary regular school. He presents learning difficulties. He could not write “correctly.” However, he did not have a full assessment by specialized teachers. His school is so far from urban areas and his parents could not take him to a special institution. Therefore, he has not received special support. Also, there is not a favorable literacy environment in his home. His teacher teaches him like his classmates. Usually, he has been marginalized and stigmatized because “he does not know or work in class.”

We focused on Alejandro because he was a child who was always distracted in class. We did not want to show his writing mistakes as negative aspects, but as part of his learning process. Errors are indicators of a process [ 5 ]. They inform the person’s skills. They allow to identify the knowledge that is being used [ 13 ]. In this way, errors can be considered as elements with a didactic value.

Alejandro showed some knowledge and also some difficulties to write. The child identifies and distinguishes letters and numbers. We do not know if he conceptualizes their use in every one. When he wrote, he shows his knowledge: letters are for reading, because he did not use any number in the words.

The writing directionality is a difficulty for Alejandro. He writes from left to right and also from right to left. We do not know why he did that. We did not research his reasons. But, it is important to know if there are any factors that influence the child to write like this.

The student does not establish a phoneme-grapheme relationship yet. He is still in an initial level to writing acquisition. He uses conventional letters and pseudo-letters to write. There are no fixed rules to write: number and variety of letters. However, we observed student’s thought about writing. He justifies his writings when he reads them and invents letters to represent some words.

There is still a limited repertoire of letters. He used a few letters of the alphabet. Therefore, Alejandro needs to interact with different texts, rather than teaching him letter by letter. Even if “he does not know those letters.” In this way, he is going to appropriate other elements and resources of the writing system.

Time he takes to write is an important element for us. He refused to write for several minutes at the beginning. After, he wrote during 1 or 2 min every word. As we mentioned previously, we believe that Alejandro did not feel sure to do the task. Perhaps, he thought that the interviewer is going to penalize for his writing “incorrectly.” He felt unable to write. Therefore, it is important that children’s mistakes are not censored in the classroom. Mistakes let us to know the child’s knowledge and their learning needs.

We considered that class work was not favorable for Alejandro. He painted letters, drawings, among others. These were to keep him busy. Therefore, it is important for the child to participate in reading and writing practices. In this way, he can be integrated into the scholar activities and is not segregated by his classmates.

About children with learning difficulties, it is important that these children write as they believe. Do not censor their writings. They are not considered as people incapable. It is necessary to consider that learning is a slow process. Those children will require more time than their classmates.

Special education plays an important role in Mexico. However, rather than attending to the student with learning difficulties in isolation, it is necessary that the teacher should be provided with information and the presence of specialized teachers in the classroom. In this way, the student with learning difficulties can be integrated into class, scholar activities, and reading and writing practices.

We presented Alejandro’s writing process in this paper. Although he was considered as a child with learning difficulties, we identified he shows some difficulties, but he knows some elements of the writing system too.

Acknowledgments

I thank Alejandro, his parents, and his teacher for the information they provided to me about him.

Conflict of interest

The authors declare no conflict of interest.

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• 3. García-Cedillo E, Escalante I, Escandón M, Fernández L, Mustre A, Puga I. La Integración Educativa en el Aula Regular. Principios, Finalidades y Estrategias. México: Secretaría de Educación Pública; 2000. ISBN: 978-607-8279-18-0
• 4. Ferreiro E, Teberosky A. Los Sistemas de Escritura en el Desarrollo del Niño. México, D.F.: Editorial Siglo XXI; 1979. ISBN 968-23-1578-6
• 5. Dolz J, Gagnon R, Vuillet Y. Production écrite et Difficultés D’apprentisage. Genève: Carnets des Sciences de L’education. Université de Genéve; 2011. ISBN: 2-940195-44-7
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© 2019 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution 3.0 License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Case study: ‘He’s a 10-year-old child with disabilities . . . I can’t see how isolating helps’

Debbie kennedy says the regular use of seclusion has worsened her son’s behaviour.

Dylan Kennedy (10) with his mother Debbie Kennedy at home in Dublin. Photograph: The Irish Times

Debbie Kennedy accepts her 10-year-old son can be difficult to handle on occasion.

He’s autistic and has been diagnosed with attention deficit hyperactivity disorder.

There are times when he gets frustrated, angry and stressed. Equally, she says, he can be calmed down quickly with simple interventions.

“He’s very intelligent,” says Kennedy.”He could tell you anything about any car. He loves Top Gear . . . when he does act out, I can control him with one hand or distract him.”

But she says the past past two years have been marked by a sharp deterioration in his behaviour. She puts much of this down to what she says was the overuse of seclusion at school to control his behaviour.

In all, she estimates he was placed in a seclusion or “time-out” room on more than 30 occasions over a two-year period.

While in most cases she was told they were for short periods of time, she maintains that on a several occasions he was placed there for up to two hours at a time.

“In order to help a vulnerable child like Dylan manage his emotions and control his behaviour, he needs support, guidance and explanation,” she says.

“If he’s isolated from others, without guidance or support, I can’t see how that helps. In fact, it’s a more frightening experience – especially for a child with disabilities.”

Benincasa Special School in Blackrock, Co Dublin, said that while it was not in a position to comment on Dylan's individual case, the school had always acted "properly and in accordance with good practice at all times".

In line with its policies, seclusion was only ever used as a measure of last resort and where a child was disruptive to the point of posing an imminent danger to themselves or others.

Kennedy, however, feels the school was too quick to seclude her son and says he regularly came home in tears after being placed in the room, or isolated from the wider class.

“He would spend hours crying, saying how much he wanted to die and felt he wasn’t good enough.”

She also feels he was placed in the room on foot of relatively minor incidents, like throwing a pencil against a blackboard or refusing to do work.

School records, however, show there were occasions when he kicked or punched staff. On one occasion, he is said to have raised a chair in the air, before it was taken from him.

The seclusion room – based on photographs taken by Dylan’s mother – is a small bare room with no furniture.

There is a window with metal bars on the outside. The door has no handle on the inside and there is a peephole for staff.

The school said a staff member was present outside the seclusion room, monitoring the student, at all times.

“The seclusion room is designed with regards to the health and safety of the student in question. The room does not contain certain furniture as such items are often considered safety hazards to both the student or staff members,” it said.

Kennedy ended up withdrawing permission for her son to be placed in the room. Afterwards, she says she would receive phone calls from 9.10am onwards asking her to collect him.

He ended up being taught at home by his mother for long periods and resumed school on a limited basis.

She is careful to say Dylan enjoyed several successful years at his special school prior to this and many staff went out of their way to help and support him. “I couldn’t speak highly enough of them.”

But she feels the use of seclusion has left a damaging legacy which Dylan is still coming to terms with.

“He needs therapy after all that’s happened. We can be out having fun and he’ll mention what happened to him,” she says.

“He is the most caring and affectionate boy. He’s clever and funny and has a huge obsession with cars. I wouldn’t change him for anything.”

Carl O'Brien

Carl O'Brien is Education Editor of The Irish Times. He was previously chief reporter and social affairs correspondent

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Child disability case studies: an interprofessional learning opportunity for medical students and paediatric nursing students

Affiliation.

• 1 Centre for Child and Adolescent Health, University of Bristol, Bristol, UK. [email protected]
• PMID: 17661885
• DOI: 10.1111/j.1365-2923.2007.02800.x

Context: We describe an interprofessional learning (IPL) opportunity for pre-qualification medical and paediatric nursing students using community-based case studies of disabled children and their families.

Methods: A total of 160 students were randomly allocated into interprofessional and uniprofessional pairs. Each pair visited a disabled child at home and school and presented their experience to the rest of the group. Quantitative and qualitative evaluation methods were used to explore the learning experience. Data collection tools included a scale measuring attitudes towards IPL, which was completed by all students before and after their visits and focus groups.

Results: The value of the community setting and independent working of the case study was appreciated by the students. The intimacy involved in working in IP pairs demonstrated both positive and negative features. Nursing students showed more open and positive attitudes towards IPL than medical students. Nursing students in IP pairs appear to have benefited most from the exercise, notably in terms of confidence and self-esteem. Professional differences in communication skills and approach were identified as particular learning points for all students.

Conclusions: The added value of combining quantitative and qualitative research methods is well demonstrated by this study. Learning opportunities from the case study were greater as a result of working interprofessionally. Student attitudes towards IPL and professional stereotyping changed as a result of this IPL exercise. The importance of the social context of learning and the contact hypothesis are supported by our findings.

Publication types

• Randomized Controlled Trial
• Research Support, Non-U.S. Gov't
• Attitude of Health Personnel
• Disabled Children*
• Education, Medical, Undergraduate / methods*
• Education, Nursing / methods*
• Interprofessional Relations
• Pediatric Nursing / education*
• Students, Medical / psychology
• Students, Nursing / psychology
• Surveys and Questionnaires

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Learning Disabilities Research Studies: Findings from NICHD funded Projects

Brett miller.

Child Development and Behavior Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, U.S. National Institutes of Health, U.S. Dept. of Health and Human Services, Bethesda, MD

Sharon Vaughn

Dept. of Special Education, College of Education, University of Texas at Austin

Lisa Freund

Advancements in prevention and treatment of learning disabilities hold the promise of improving the educational, health, social and civic lives of affected children, adolescents, adults, and their families. To meet this promise, a continued, concerted effort is needed to develop and refine intervention approaches targeting struggling or at-risk learners and those identified with a specific learning disability. These interventions will be delivered in diverse settings by practitioners representing a range of disciplines. We need intervention options that address the developmental range of learners from our youngest to older secondary learners and include a sufficient breadth of intervention approaches to be relevant along the prevention to remediation (e.g., general education classroom and special education services in schools) spectrum. This special issue aims to move us closer to that promise by focusing on projects designed to inform intervention development and test specific intervention models for young, struggling learners at risk for or identified with a reading disability.

Learning Disabilities Research Centers and Learning Disabilities Innovation Hubs Consortia

Since 1989, the Learning Disabilities Research Centers Consortia, established by the Eunice Kennedy Shriver National Institute of Child Health and Human Development 1 (NICHD), serve as NICHD's primary means for improving knowledge on the causes, origins, treatments, and developmental learning course of learning disabilities by supporting transdisciplinary research related to basic reading skills, reading fluency, reading comprehension, written comprehension, and response to intervention. Research studies funded through the LDRC consortia have influenced the field of reading and specific learning disabilities by contributing to: the understanding of phonemic awareness in reading, the importance of students needing explicit, high-quality instruction, the value of word reading approaches as well as fluency as contributors to reading comprehension, and the overall efficacy of response to intervention (RTI) approaches for identifying and treating individuals with learning disabilities. The contributions of research on reading disabilities through the LDRCs provide examples of how the depth of scientific knowledge accrues within a specific domain and then is meaningfully connected and integrated across disciplines to provide a more comprehensive explanation of a scientific finding – in this case knowledge about reading disabilities.

More recently, the NICHD enhanced its research investment in the area of learning disabilities by developing new Learning Disabilities Innovation Hubs (LD Hubs). The LD Hubs are intended to complement the LDRCs by focusing on understudied research topics in the area of learning disabilities (LDs) specific to reading, writing, or mathematics and include a focus on understudied populations at-risk for one or more LDs. This program intends to speed the cross-programmatic and transdisciplinary transitions underway in the learning disabilities research field to the benefit of all learners. To facilitate this transdisciplinary transition, both programs focus on mentoring of developing and early career investigators with a particular interest in increasing the representation of individuals from under-represented groups in science and hence, more broadly promoting diversity in the cadre of scientist conducting research. These projects provide mentored research opportunities to help ensure future researchers have the skills and experiences necessary to become integral parts of transdisciplinary teams.

Overview of Special Issue

In this special issue, investigators present research findings from three studies, funded wholly or in part through NICHD support of the LDRCs or LD Hub Consortia, related to high priority areas in the field of learning disabilities.

Accurate and appropriate early identification of students with learning disabilities has been an important, albeit somewhat contentious, issue for more than 50 years. Within the last ten years, multi-tiered systems of support or RTI frameworks have been implemented within states and schools across the country (for example, see www.intensiveintervention.org ). With recent flexibility permitted by the Individuals with Disabilities Education Act (IDEA; U.S. Department of Education, 2004 ), states may allow data from RTI practices to influence decisions regarding identification and treatment of individuals with significant learning difficulties most frequently applied to students with reading problems.

We have made great strides in early and accurate screening for reading difficulties leading to early interventions. These approaches to screening are particularly effective in identifying young children with reading difficulties (e.g., Jenkins, Hudson, & Johnson, 2007 ). Furthermore, we have experienced considerable success in developing and validating treatment protocols for young children (kindergarten through 2 nd grade) with reading problems (e.g., Wanzek & Vaughn, 2007 ). Despite these successes, there remain considerable gaps in our research knowledge that inhibit appropriate identification and treatment of individuals with learning disabilities.

One significant gap involves education supports for learners who are minimal responders to research-based standard protocols. As a field, we know considerably more about effective treatments for students who respond to research-based standard protocols than we know about students who are minimal responders to these treatments (e.g., Barth et al., 2008 ; Denton, et al., 2006 ; Denton, 2012 ; Toste et al., in press ; Vaughn et al., 2010 ; Vaughn & Fletcher, 2010 ;. When students are provided reading treatments typically associated with improved outcomes, and these students make minimal gains, the solutions for next steps are inadequately defined (e.g., Vaughn & Fletcher, 2012 ). One common next step when students do not respond adequately to secondary interventions (Tier 2) is to provide additional dosage of the same treatment or a similar treatment. This increased dosage may take the form of increasing the amount of time students are treated in each session, the overall length of the treatment, and/or reducing the group size; however, far less research exists to help inform practitioners' decisions about how and when to increase an intervention dosage (e.g., Al Otaiba, Schatschneider, & Silverman, 2005 ; Denton et al., 2011 ; Faggella-Luby, & Deshler, D., 2008 )

Additionally, we need to enhance considerably our understanding of the characteristics of learners who are minimally responsive to interventions that have demonstrated efficacy with the goal of informing prevention, early identification, and remediation strategies, not just for beginning readers, but data are needed across the developmental span. Understanding the relationship between the characteristics of learners who are minimal responders, their response to literacy interventions, and how their response may or may not be mediated by other attributes such as executive functioning skills is an imperative next step in LD research (see Bierman & Torres, in press ). Such research should provide the foundational understanding of who minimally responsive learners are such that we can strengthen their remediation efforts. Research studies also need to better define the mechanisms for designing treatments that are optimally aligned with these learners' characteristics. For example, if the majority of minimally responding students with a reading disability display attention problems, are there mechanisms for enhancing attention during reading treatments that can also enhance learning outcomes? Identifying specific learner characteristics that impact on or interact with interventions requires systematic research with an individual-differences approach. Furthermore, there are a myriad of developmental issues including: how treatments need to vary with students in older grades, the extent to which dispositional factors such as engagement, motivation, and affect influence outcomes and can be treated, the reciprocal role of writing and reading, and mechanisms for identifying and treating students in relation to various aspects of executive functioning.

Understanding the continuum of learners' responses to intervention necessitates an additional focus on underlying causes and hypothesized mechanism leading to adequate or minimal responses. These causes or mechanisms could be endogenous, exogenous or both. For example, there is robust evidence that reading disability and attention deficit-hyperactivity disorder (ADHD) have significant heritability (e.g., Bidwell, Willcutt, DeFries, & Pennington, 2007 ; Christopher et al., 2013 ; Christopher et al., 2012 ; Gayán & Olson, 2001 ; Olson et al. 2011 ; Petrill, Deater-Decker, Thompson, DeThorne, & Schatschneider, 2006 ; Willcutt, Pennington, & DeFries, 2000 ; Willcutt et al., 2010 ) and are associated with deficits in executive functioning. Although hereditability estimates of reading are often high, environmental characteristics can modulate these effects. This gene-environment relationship is a complex interplay that changes over time in terms of the estimated variance accounted for in the development of reading skills (e.g., Harlaar, Dale, & Plomin, 2007 ; Petrill et al., 2007 ). From an instructional perspective, critically, increasing evidence indicates that reading disabilities are malleable suggesting a need for, and potential benefit from, further refinement of our understanding of effective treatments (e.g., Keller & Just, 2009 ; Shaywitz et al., 2004 ; Simos et al., 2002 , 2006 )

Neuroimaging is also providing insights to both the nature of response and as a predictor of response. Brain imaging has been successfully utilized to show both structural and functional changes in response to successful behavioral intervention, i.e., reading intervention (e.g., Keller & Just, 2009 ; Krafnick, Flowers, Napoliello, & Eden, 2011 ; Shaywitz et al., 2004 ; Simos et al., 2002 , 2006). In the case of struggling and LD learners, these changes in response to intervention, appear to move brain systems closer to a normalized state consistent with more typically developing learners. Additionally, recent evidence suggests the potential power of imaging as predictive tool – to date in retrodictive studies, i.e., to ascertain who is likely to be responsive to a specific treatment (e.g., Hoeft et al. 2011 ). This is not to imply that we are advocating imaging learners to inform instruction, but rather these efforts help us understand the underlying mechanisms and causes of response (adequate or otherwise) in the hopes that this will help empower the next generation of interventions. A cogent understanding of risk could inform interventionists' efforts to focus resources on the most struggling learners and provide insights into the types of interventions that might be best applied to learners with historically less tractable learning disabilities. Studies addressing many of these topics are currently being investigated within the scope of work funded by the LDRCs, LD Hubs, and the broader NICHD investment in reading.

Contribution of Articles to this Special Issue

This special issue includes three research studies addressing issues related to reading difficulties in young students (1 st through 3 rd graders) and two commentaries. In the study reported by Miller and colleagues, teacher ratings of students' behavioral attention predicted at-risk 1 st grade students' responses to word reading instruction and then their later (3 rd grade) reading comprehension outcomes. This result emphasizes the importance of considering student's attention as it relates to reading outcomes. This finding is particularly notable given the expectation that in the one-on-one treatment intervention the children received, instructors would be more likely to minimize a student's attention related problems than in small or large group instruction. By the time students were in 3 rd grade, the relationship between attention and reading comprehension was mediated by word reading growth in 1 st grade and 3 rd grade word reading performance. This study provides evidence of potential value in assessing a learner characteristic, behavioral attention, as a means of interpreting at-risk students' responses to intervention.

The benefits of long-term research studies such as the one reported by Miller et al., are also evident in the study by Al Otaiba and colleagues. The Al Otaiba et al. study addresses the long-term effects of two, 1st grade models for implementing RTI on the reading outcomes of students in 2 nd and 3 rd grades. One of the approaches, referred to as Dynamic, was more responsive to students' individual reading profiles derived from the point of screening onward, whereas the second approach, referred to as Typical, corresponds to standard models of response to intervention. Students in the Dynamic condition demonstrated higher word reading scores at the end of 2 rd grade than students in the Typical RTI group. These initial findings may provide important guidance to educators. Students who received interventions that were matched to their individual needs yielded better overall outcomes than those in more traditional, static approaches to intervention. This suggests that moving students to more intensive interventions earlier rather than waiting for them to demonstrate low response to less intensive interventions may be beneficial.

The third study in this special issue is reported by Denton and colleagues and addresses two theoretically different approaches to providing interventions to 2 nd graders with significant reading difficulties. One approach is Guided Reading in which the emphasis is on text reading deemphasizing explicit instruction and reading skills. The second approach is described as explicit intervention and addresses more specific instruction in phonemic awareness, phonics, and word reading as well as text reading. Their findings suggest that more explicit instruction is likely to accelerate student progress in phonemic decoding, text reading fluency, and reading comprehension than guided reading. All students, regardless of condition, remained behind in word reading fluency at the end of the school year suggesting that these students require either a significantly more intensive intervention or interventions that are multi-year.

In the first commentary, Fletcher and Wagner (this issue) raise two key issues to inform one's determination of the impact of the studies in this issue and in the literature writ large: Specifically, are effects of intervention cumulative (if not, how do you make them cumulative?) and how does one know when to interpret smaller effect sizes as meaningful? In part through analogy, the authors highlight the potential of small effects being meaningful if they accumulate. Furthermore, they emphasize the import of examining outcomes in the context of findings from the field and general expectations for expected growth/gains for learners. Fletcher and Wagner also discuss conditions that are likely necessary to evaluate whether intervention effects are potentially cumulative (or could be). They emphasize the importance of rigorous designs that provide unbiased estimates of treatment effects, longitudinal designs for intervention to ascertain longer-term impact of intervention, and the inclusion of variables that align with the underlying causal model assumed by the intervention along with appropriate covariates in light of the intervention targets. This commentary further points out the value of context both in interpreting findings today as well as in considering the types of dosage and durations of intervention that may be necessary for struggling learners moving forward. Fletcher and Wagner's broader theme of the interpretation of smaller effect size and implications for intervention is also carried through in the second commentary.

In the second commentary, Snowling and Hulme (this issue) continue the theme of contextualizing why the field may be obtaining small or modest effect sizes and importantly provide suggestions for approaches to strengthen intervention frameworks to increase effect sizes and the benefit of learners. They point out that interventions may lack the intensity necessary for larger effects and also allude to potentially thinking of years of intervention, particularly for the most struggling learners, and that increasing the literacy experience outside of school (e.g. in the home) is likely needed to support this effort. Additionally, they encourage more attention to enhancing motivation and engagement in the reading process for learners and point out environmental and cultural factors that could inform underlying theory driving intervention development; models are often underspecified regarding these factors and other within-child factors (e.g., attention) that could impact literacy outcomes. Finally, they point out the significant need for more attention to the potential mismatch of language between child and instructor (e.g., differences in dialect) and highlight its potential role in literacy development, particularly for children from diverse backgrounds. Critically, they more broadly highlight need for the development of strong oral language skills to support literacy development. These commentaries, taken together, highlight the need to contextualize our effects in light of their potential cumulative impact as well as their expected impact and emphasize the need to redouble our efforts to strengthen our interventions through an enhanced focus on learner characteristics, environmental conditions, strengthening oral language, etc. These characteristics (and others) will need to be formally incorporating these into theoretical and conceptual accounts of reading development and be combined with extended dosage and duration to help drive improved outcomes from the next generation of interventions.

Implications

In closing, this special issue provides a small sample of the many essential learning disability questions being addressed through current LDRC and LD Hub funding. The articles in this special issue reflect the promise in the continuing efforts of a large cadre of dedicated researchers for not only identifying the mechanisms underlying learning differences, but finding the pathways to more individualized and effective interventions for the children struggling with learning disabilities.

1 The centers were established by the National Institute of Child Health and Human Development, which in 2008 was renamed the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

The opinions and assertions presented in this article are those of the authors and do not purport to represent those of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the U.S. National Institutes of Health, and the U.S. Department of Health and Human Services.

Contributor Information

Brett Miller, Child Development and Behavior Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, U.S. National Institutes of Health, U.S. Dept. of Health and Human Services, Bethesda, MD.

Sharon Vaughn, Dept. of Special Education, College of Education, University of Texas at Austin.

Lisa Freund, Child Development and Behavior Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, U.S. National Institutes of Health, U.S. Dept. of Health and Human Services, Bethesda, MD.

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Intellectual disability

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• 1. Menchie M. Garachico Freddie C. Santos Jr. INTELLECTUAL DISABILITY
• 2. *―An intellectual disability, formerly referred to as ―mental retardation‖ is characterized by a combination of deficits in both cognitive functioning and adaptive behavior. *The severity of the intellectual disability is determined by the discrepancy between the individual's capabilities in learning and in and the expectations of the social environment. (Project IDEAL, 2008) The Nature of Intellectual Disability
• 3. *―Mental retardation / intellectual disability is a term used when a person has certain limitations in mental functioning and skills such as communicating, taking care of himself/herself and social skills. *These limitations cause a child to learn and develop more slowly than a typical child. (J.F. Smith Library, 2005, as cited by Pierangelo & Giuliani, 2007) The Nature of Intellectual Disability
• 4. Mental Retardation/ Intellectual Disability in DSM – IV – TR is an Axis II Disorder criteria that includes: * Intelligence Test Scores * Adaptive Functioning * Age of Onset (DSM-IV-TR, 2000) The Nature of Intellectual Disability
• 5. “Significantly sub-average general intellectual functioning, existing concurrently with deficits in adaptive behavior and manifested during the developmental period, that adversely affects a child’s educational performance.‖ IDEA (Individuals with Disabilities Education Act) Definitions for Intellectual Disability
• 6. ―Characterized by significant limitations both in intellectual functioning and adaptive behavior, which covers many everyday social and practical skills. The disability originates before the age of 18.‖ AAIDD (American Association of Intellectual and Developmental Disabilities) Definitions for Intellectual Disability
• 7. *Conceptual skills—language and literacy; money, time, and number concepts; and self-direction. *Social skills—interpersonal skills, social responsibility, self-esteem, gullibility, naïveté (i.e., wariness), social problem solving, and the ability to follow rules/obey laws and to avoid being victimized. *Practical skills—activities of daily living (personal care), occupational skills, healthcare, travel/transportation, schedules/routines, safety, use of money, use of the telephone.
• 8. *Mild IQ = 55 – 69 *Moderate IQ = 40 – 54 *Severe IQ = 25 – 39 *Profound IQ = below 25 Severity of ID based on the levels of intellectual functioning
• 9. Intellectual disability is the most common developmental disability. Approximately 6.5 million people in the United States have an intellectual disability. (IDEA) In the Philippines, intellectual disability comprises 7.02% of the total population of persons with disabilities. (2000 National Statistics Office Census) Prevalence of Intellectual Disability
• 10. PRENATAL CAUSES PERINATAL CAUSES POSTNATAL CAUSES 1. Chromosomal Disorders 2. Inborn Errors of Metabolism 3. Developmental Disorders of Brain Formation 4. Environmental Influences 1. Anoxia (complete deprivation of oxygen) 2. Low birth weight (LBW) 3. Syphilis and herpes simplex 1. Biological 2. Psychosocial 3. Child Abuse and Neglect Etiology and Classifications of Intellectual Disability
• 11. PRENATAL CAUSES
• 12. *Congenital intellectual disability *Involves heart defects, hearing loss, and abnormalities of fingers and hands. *Manifest self-injurious behavior (Pierangelo & Giuliani,2007) PRENATAL CAUSES Cornelia de Lange Syndrome
• 13. *Difficulty swallowing and sucking *Low birth weight and poor growth *Unusual facial features *Hyperactive, aggressive, and repetitive movements (Pierangelo & Giuliani,2007) PRENATAL CAUSES Cri-du-Chat Syndrome
• 14. *Also referred to as trisomy 21 *Usually not an inherited condition *The most common type of chromosomal disorder *It involves the anomaly at the 21st set of chromosomes. *People with DS exhibits unusual facial features and with broad hands with short fingers (Hallahan & Kauffman,2003) PRENATAL CAUSES Down’s Syndrome
• 15. *Sterility in men *Decreased IQ *Poor coordination *Skeletal abnormalities *Poor coordination (Pierangelo & Giuliani, 2007) PRENATAL CAUSES Klinefelter’s Syndrome
• 16. *Inherited from father *Infants are lethargic and have difficulty eating but eventually becomes obsessed with food as they grow *The leading genetic cause of obesity. *People with Prader-Willi syndrome are at risk for a variety of other health problems such heart defects, kidney problems, scoliosis, etc. Prader-Willi Syndrome PRENATAL CAUSES (Hallahan & Kauffman,2003)
• 17. *Normally found in females *Persons with Turner’s syndrome has webbing of the neck, puffiness or swelling of the hands and feet *Associated with heart defects and kidney problems Turner’s Syndrome PRENATAL CAUSES (Pierangelo & Giuliani,2007)
• 18. *Caused by the absence of material on the seventh pair of chromosome. *People with William’s syndrome exhibit heart defects and “elfin” facial features. *Their unusual sensitivity to sound makes them competent in music and language despite of their low IQ level. William’s Syndrome PRENATAL CAUSES (Hallahan & Kauffman,2003) (Pierangelo & Giuliani, 2007)
• 19. *Most common known hereditary cause of intellectual disability *Associated with X chromosome in the 23rd pair of chromosomes *Occurs less often in females *Persons with Fragile X Syndrome have behavior and emotional problems and poor socialization skills *They become anxious when routines are change *They have unusual facial features Fragile X Syndrome PRENATAL CAUSES (Hallahan & Kauffman,2003) (Piearangelo & Giuliani, 2007)
• 20. PRENATAL CAUSES
• 21. *Galactosemia - inability of the body to use simple sugar galactose *Hunter Syndrome – defective breakdown of chemical mucopolysaccharide. *Phenylketonuria (PKU) – inability of the body to convert phenylalanine to tyrosine) *Tay-Sachs Disease – absence of Hex-A enzyme. PRENATAL CAUSES (Piearangelo & Giuliani, 2007) Can be prevented through an early detection (e.g. newborn screening) and can be treated by providing a special diet program.
• 22. PRENATAL CAUSES
• 23. *The intellectual disability usually ranges from severe to profound. *There is no specific treatment and life expectancy is low. Microcephalus PRENATAL CAUSES (Hallahan & Kauffman,2003)
• 24. *Results from an accumulation of cerebrospinal fluid inside or outside the brain. *The degree of intellectual disability depends on how early the condition is diagnosed and treated. Hydrocephalus PRENATAL CAUSES (Hallahan & Kauffman,2003)
• 25. PRENATAL CAUSES
• 26. *Maternal Malnutrition and Infection *Fetal Alcohol Syndrome (FAS) *Lead exposure *Illicit drug exposure *Exposure to Radiation *Rubella (German measles) PRENATAL CAUSES (Hallahan & Kauffman,2003) (Piearangelo & Giuliani, 2007)
• 27. PERINATAL CAUSES
• 28. *Anoxia (deprivation of oxygen) *Low birth weight (LBW) *Syphilis and herpes simplex PERINATAL CAUSES (Hallahan & Kauffman,2003)
• 29. POSTNATAL CAUSES Environmental and Psychosocial Problems
• 30. *Nutritional Problems *Adverse living conditions *Inadequate health care *Lack of early cognitive stimulation POSTNATAL CAUSES Environmental and Psychosocial Problems (Pierangelo & Giuliani,2007)
• 31. *Child abuse and neglect *Traumatic Brain Injury *Meningitis or Encephalitis *Lead Poisoning POSTNATAL CAUSES Environmental and Psychosocial Problems (Pierangelo & Giuliani,2007)
• 32. PLACEMENT PROGRAMS for Persons with Intellectual Disabilities
• 33. *For children with mild intellectual disability, readiness and functional academic skills are present and thus can be placed into Inclusion Programs. *Educational placement programs for children with moderate to severe intellectual disability can be more tedious. Curriculum and materials for these children should be age-appropriate, which should help develop independent behavior within the child. *Individualized Education Program (IEP) is designed to cater the special educational needs of special children. This is a useful and common vehicle to develop skills and educate children with intelletual disabilities who are in more severe cases. *Behavior Therapy Programs may also be employed, as they are very useful in altering behavior by lessening distruptive or inappropriate actions of a particular child. *Alternative Programs can also be incorporated in a child’s special education process. Such programs would include vocational training, physical education, theatre, music, etc.
• 34. *Unlike preschool programs for children at risk, in which the goal is to prevent intellectual disability from occurring, programs for infants and preschoolers who are already identified with intellectual disability are designed to help them achieve as high a cognitive level as possible (Hallahan & Kauffman, 2003). PLACEMENT PROGRAMS Early Childhood
• 35. *These programs gives more emphasis on conceptual and language development and usually involves speech and physical therapists most specially when children have multiple disabilities. PLACEMENT PROGRAMS Early Childhood
• 36. *Most authorities agree that although the degree of emphasis on transition programming should be greater for older than for younger students, such programming should begin in the elementary years (Hallahan & Kauffman, 2003). PLACEMENT PROGRAMS Transition to Adulthood
• 37. *Transition programming for individuals involves two related areas; first, community adjustment to acquire a number of self-help skills and second, employment to lead to a meaningful job. PLACEMENT PROGRAMS Transition to Adulthood
• 38. Current Researches about Intellectual Disability
• 41. Cerrero, M. E. (2009) Academic engagement of learners with moderate mental retardation through pictorial self-management and video self-modeling , Unpublished Master’s Thesis, University of the Philippines – Diliman Clark, L.L. and Griffiths, P. (2008) Learning Disability and other Intellectual Impairments, John Wiley & Sons, Ltd. Davidson, P.W., Janicki, M.P. and Prasher, V.P. (2003) Mental Health, Intellectual Disabilities and Aging Process, Blackwell Publishing Definition of Intellectual Disability, AAIDD (2006) retrieved from: http://www.aaidd.org/content_100.cfm Drew, C.J. and Hardman, M.L. (2007) Intellectual Disabilities Across the Life Span, 9th edition, Pearson Education, Inc. Friend, M. (2011) Special Education: Contemporary Perspectives for School Professionals, 3rd edition, Pearson Education, Inc. Hallahan, D.P. and Kauffman, J. M. (2003) Exceptional Learners: Introduction to Special Education, 9th edition, Pearson Education, Inc. REFERENCES
• 42. Heward, L.W. (2006) Exceptional Children: An Introduction to Special Education, 8th edition, Pearson Education, Inc. Intellectual Disability, Project IDEAL (2008) retrieved from: http://www.projectidealonline.org/intellectualDisabilities.php Koa, K.S. (2009) Young Adults with Mental Retardations:Their Response to Death, Grief and Bereavement, Unpublished Master’s Thesis, University of the Philippines – Diliman Oliver-Africano, P., Murphy, D., & Tyrer, P. (2009). Aggressive behaviour in adults with intellectual disability. CNS Drugs,23(11), 903-13. doi:http://dx.doi.org/10.2165/11310930-000000000-00000 Pierangelo, R. & Giuliani G. (2007) The Educator’s Diagnostic Manual of Disabilities and Disorders, John Wiley & Sons, Inc. Pownall, J. D., Jahoda, A., & Hastings, R. P. (2012). Sexuality and sex education of adolescents with intellectual disability: Mothers' attitudes, experiences, and support needs. Intellectual and Developmental Disabilities, 50(2), 140-54. Retrieved from: http://search.proquest.com/docview/1022483830?accountid=141440 Salvador-Curalla, L., & Bertelli, M. (2007). 'Mental retardation' or 'intellectual disability': Time for a conceptual change.Psychopathology, 41(1), 10-6. Retrieved from: http://search.proquest.com/docview/233349678?accountid=141440

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• A CASE STUDY ANALYSIS OF A CHILD WITH LEARNING...

A CASE STUDY ANALYSIS OF A CHILD WITH LEARNING DISABILITY/IES

The case study seeks to explore a child with a learning disorder that dropped out of his grade school, exploring the explicit factors that lead to that discussion and what he exactly went through. The case study will contain detailed information about the child starting from the point of birth, social, medical, and all other historical facts that are important in dissecting the learning disability in him. Historically, several children across the world struggle in school in certain circumstances of learning as monitored from time to time. Nevertheless, it has been noted that when a child struggles during learning in school with some skills for a period, it could be related to a learning disorder (O’Connell et al., 2019). The learning disorder has various definition depending on the prevailing parameters at that time. However, a learning disorder in a child can be defined as a scenario when a child exhibits some level of difficulty in one or more learning spheres.

Nastor, D. (2021). A CASE STUDY ANALYSIS OF A CHILD WITH LEARNING DISABILITY/IES. Afribary . Retrieved from https://afribary.com/works/a-case-study-analysis-of-a-child-with-learning-disability-ies

Nastor, Dan Paul "A CASE STUDY ANALYSIS OF A CHILD WITH LEARNING DISABILITY/IES" Afribary . Afribary, 05 Mar. 2021, https://afribary.com/works/a-case-study-analysis-of-a-child-with-learning-disability-ies. Accessed 26 Mar. 2024.

Nastor, Dan Paul . "A CASE STUDY ANALYSIS OF A CHILD WITH LEARNING DISABILITY/IES". Afribary , Afribary, 05 Mar. 2021. Web. 26 Mar. 2024. .

Nastor, Dan Paul . "A CASE STUDY ANALYSIS OF A CHILD WITH LEARNING DISABILITY/IES" Afribary (2021). Accessed March 26, 2024. https://afribary.com/works/a-case-study-analysis-of-a-child-with-learning-disability-ies

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