Introduction:

A child with Learning Disability shows discrepancy between his ability and achievement or his potential and performance.

It is a generic term that refers to a heterogeneous group of disorders, manifested by significant difficulties in acquisition and use of listening, speaking, reading, writing, reasoning and mathematical abilities. These disorders are presumed to be due to some neurological dysfunction.

Problems with self-regulatory behaviors, social perception and social interaction may be present with a learning disability, but they themselves do not constitute a Learning Disability.

Learning Disability can occur concomitantly with other handicapping conditions or with external influences; however, they are not the result of such conditions.

Types :
There are three types of learning disabilities, which are commonly described. They are:


1) DYSLEXIA:
Language disorders affecting reading, spelling, speaking and listening.
The child presents with some of the following features:
Confusion of letters
For example: 'b' for'd' or 'bog' for 'dog'

Guessing the word from the first letter
For example: reads 'farm' for 'front'

Loosening place on a page when reading.

Reading word by word, very slowly, and laboriously and ignoring punctuation marks.

2) DYSGRAPHIA:
Disorder affecting writing.
The child presents with some of the following features:
Difficulty in putting thoughts into writing.
Jumbling of written sentences.
Difficulty in forming letters.
Poor muscle control.
Inappropriate size - writing may be very small or large and may be impossible to read.
Writes very hard, often digging holes in the paper.
Spelling problems. For example: Monkey as Munky, Bridge as Brig, Enough as Enuf.
Has trouble in writing blended sounds of double consonants. For example: GL in glass, BL in blast.

3) DYSCALCULIA:
Disorder affecting mathematical reasoning.

The child presents with some of the following features:
Counts numbers on finger.
Reads 13 for 31
Difficulty in learning tables or remembering Telephone numbers.
Difficulty in Abstract thinking (Mental Sums).
Counts from left to right.
Often mixes up the symbols '+', 'x', '_' and '='.
Difficulty in Arithmetic sums.
Difficulty in solving sums step wise.

Diagnosis:
If one suspects a learning problem in a child, one should approach one of the centres undertaking diagnosis of learning disabilities.
Identification of this disorder is a multidisciplinary approach involving a team of:

1) Pediatrician or Neurologist
2) Social worker, counselor
3) Clinical Psychologist
4) Educator
5) Psychiatrist
6) Occupational Therapist
7) Speech Therapist

Treatment:
There is no drug or medicine to cure this problem.
Remedial Education is the best treatment for the child to cope with his disability.
Remedial Education needs to go hand in hand with the school curriculum.
It should be started as early as possible and may be needed till middle/high school level.
A Remedial Teacher plans an individualized educational programme focusing on the child's strength's.

Educational Programme includes:
a) Spelling Problems
- Breaking words into smaller parts
- Pictorial representation
b) Reading Problems:
- Individual word reading
-Word combinations
- Pictorial representation
c) Story form or puzzles for study lessons.
d) Counseling of the child with focus on his strengths.
Parental Counseling.

No one knows for sure what causes most cases of cerebral palsy. For some babies, injuries to the brain during pregnancy or soon after birth may cause CP. Children most at risk of developing CP are small, premature babies (babies who are born many weeks before they were supposed to be born) and babies who need to be on a ventilator (a machine to help with breathing) for several weeks or longer. But for most children, the problem in the brain occurs before the baby is born, and doctors don't know why.

When trying to address specific behaviors, a good place to start is to take into consideration how these behaviors may be the result of the neurological impairments that are associated with autism. From this perspective, parents and teachers can then begin to examine their student's sensory environment for things that may be causing problematic behaviors.

Things such as fire alarms and school bells may be causing physical pain for someone with autism who has a high degree of sensitivity to high pitched sounds. Other possible causes of problematic behaviors could be uncomfortable or ill fitting clothes that a student may be asked to wear.

Types:
Spastic-Muscles are rigid, posture may be abnormal, and fine motor control is impaired
Athetoid-Marked by slow, writhing, involuntary movements
Hypotonic-Muscles are floppy, without tone
Ataxic-Balance and coordination are impaired
Dystonic-Mixed.


The location of the impairment usually falls into one of three broad categories:
Hemiplegia-One arm and one leg on the same side of the body involved
Diplegia-Both legs; arms may be partially involved
Quadriplegia-All four extremities involved

Diagnosis:
When an infant or child has brain damage, a variety of symptoms can lead doctors and parents to suspect that something is wrong. In the first few months of life, an infant with brain damage may demonstrate some or all of the following symptoms:

Lethargy, or lack of alertness
Irritability or fussiness
Abnormal, high-pitched cry
Trembling of the arms and legs
Poor feeding abilities secondary to problems sucking and swallowing
Low muscle tone
Abnormal posture, such as the child favoring one side of their body
Seizures, staring spells, eye fluttering, body twitching
Abnormal reflexes.

Many of the normal developmental milestones, such as reaching for toys (3-4 months), sitting (6-7 months), and walking (10-14 months), are based on motor function. A physician may suspect cerebral palsy in a child whose development of these skills is delayed. In making a diagnosis of cerebral palsy, the physician takes into account the delay in developmental milestones as well as physical findings that might include abnormal muscle tone, abnormal movements, abnormal reflexes and persistent infantile reflexes. Making a definite diagnosis of cerebral palsy is not always easy, especially before the child's first birthday.

In fact, diagnosing cerebral palsy usually involves a period of waiting for the definite and permanent appearance of specific motor problems. Most children with cerebral palsy can be diagnosed by the age of 18 months, but eighteen months is a long time for parents to wait for a diagnosis, and this is understandably a difficult period for them.

Making a diagnosis of cerebral palsy is also difficult when, for example, a two-year- old has suffered a head injury. The child may immediately appear to be severely injured, and three months after the injury he may have symptoms that are typical of a child with cerebral palsy. But one year after the injury such a child may be completely normal. This child does not have cerebral palsy. Although he has a scar on his brain, the scar is not permanently impairing his motor activities. After injury, waiting and observing are necessary before the diagnosis can be made.

Treatment:
For a kid with CP, the problem with the brain will not get any worse as the kid gets older. For example, a kid who has CP that affects only the legs will not develop CP in the arms or problems with speech later on. The effect of CP on the arms or legs can get worse, however, and some kids may develop dislocated hips (when the bones that meet at the hips move out of their normal position) or scoliosis (curvature of the spine).

That is why therapy is so important for a kid with CP. Kids with CP usually have physical, occupational, or speech therapy to help them develop skills like walking, sitting, swallowing, and using their hands. There are also medications to treat the seizures that some kids with CP have. Some medications can help relax the muscles in kids with spastic CP. And some kids with CP may have special surgeries to keep their arms or legs straighter and more flexible.

Therapy and Treatment
Physical Therapy
Occupational Therapy
Speech and Language Therapy
Medical Treatment: Surgery
Medical Treatment: Drug Therapy
Sensory Integration Therapy
Adaptive Equipment

Living With CP:
Cerebral palsy usually doesn't stop kids from going to school, making friends, or doing things they enjoy. But they may have to do these things a little differently or they may need some help. With computers to help them communicate and wheelchairs to help them get around, kids with CP often can do a lot of stuff that kids without CP can do.

Kids with cerebral palsy are just like other kids, but with some greater challenges that make it harder to do everyday things. More than anything else, they want to fit in and be liked. Be patient if you know someone or meet someone with CP. If you can't understand what a person with CP is saying or if it takes a person with CP longer to do things, give him or her extra time to speak or move. Being understanding is what being a good friend is all about, and a kid with CP will really appreciate it.